- Browse by Subject
Browsing by Subject "Disease"
Now showing 1 - 10 of 13
Results Per Page
Sort Options
Item Association of Histologic Disease Activity With Progression of Nonalcoholic Fatty Liver Disease(JAMA Network, 2019-10-02) Kleiner, David E.; Brunt, Elizabeth M.; Wilson, Laura A.; Behling, Cynthia; Guy, Cynthia; Contos, Melissa; Cummings, Oscar; Yeh, Matthew; Gill, Ryan; Chalasani, Naga; Neuschwander-Tetri, Brent A.; Diehl, Anna Mae; Dasarathy, Srinivasan; Terrault, Norah; Kowdley, Kris; Loomba, Rohit; Belt, Patricia; Tonascia, James; Lavine, Joel E.; Sanyal, Arun J.; Nonalcoholic Steatohepatitis Clinical Research Network; Medicine, School of MedicineImportance: The histologic evolution of the full spectrum of nonalcoholic fatty liver disease (NAFLD) and factors associated with progression or regression remain to be definitively established. Objective: To evaluate the histologic evolution of NAFLD and the factors associated with changes in disease severity over time. Design, Setting, and Participants: A prospective cohort substudy from the Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) NAFLD Database study, a noninterventional registry, was performed at 8 university medical research centers. Masked assessment of liver histologic specimens was performed, using a prespecified protocol to score individual biopsies. Participants included 446 adults with NAFLD enrolled in the NASH CRN Database studies between October 27, 2004, and September 13, 2013, who underwent 2 liver biopsies 1 or more year apart. Data analysis was performed from October 2016 to October 2018. Main Outcomes and Measures: Progression and regression of fibrosis stage, using clinical, laboratory, and histologic findings, including the NAFLD activity score (NAS) (sum of scores for steatosis, lobular inflammation, and ballooning; range, 0-8, with 8 indicating more severe disease). Results: A total of 446 adults (mean [SD] age, 47 [11] years; 294 [65.9%] women) with NAFLD (NAFL, 86 [19.3%]), borderline NASH (84 [18.8%]), and definite NASH (276 [61.9%]) were studied. Over a mean (SD) interval of 4.9 (2.8) years between biopsies, NAFL resolved in 11 patients (12.8%) and progressed to steatohepatitis in 36 patients (41.9%). Steatohepatitis resolved in 24 (28.6%) of the patients with borderline NASH and 61 (22.1%) of those with definite NASH. Fibrosis progression or regression by at least 1 stage occurred in 132 (30%) and 151 [34%] participants, respectively. Metabolic syndrome (20 [95%] vs 108 [72%]; P = .03), baseline NAS (mean [SD], 5.0 [1.4] vs 4.3 [1.6]; P = .005), and smaller reduction in NAS (-0.2 [2] vs -0.9 [2]; P < .001) were associated with progression to advanced (stage 3-4) fibrosis vs those without progression to stage 3 to 4 fibrosis. Fibrosis regression was associated with lower baseline insulin level (20 vs 33 μU/mL; P = .02) and decrease in all NAS components (steatosis grade -0.8 [0.1] vs -0.3 [0.9]; P < .001; lobular inflammation -0.5 [0.8] vs -0.2 [0.9]; P < .001; ballooning -0.7 [1.1] vs -0.1 [0.9]; P < .001). Only baseline aspartate aminotransferase (AST) levels were associated with fibrosis regression vs no change and progression vs no change on multivariable regression: baseline AST (regression: conditional odds ratio [cOR], 0.6 per 10 U/L AST; 95% CI, 0.4-0.7; P < .001; progression: cOR, 1.3; 95% CI, 1.1-1.5; P = .002). Changes in the AST level, alanine aminotransferase (ALT) level, and NAS were also associated with fibrosis regression and progression (ΔAST level: regression, cOR, 0.9; 95% CI, 0.6-1.2; P = .47; progression, cOR, 1.3; 95% CI, 1.0-1.6; P = .02; ΔALT level: regression, cOR, 0.7 per 10 U/L AST; 95% CI, 0.5-0.9; P = .002; progression, cOR, 1.0 per 10 U/L AST; 95% CI, 0.9-1.2; P = .93; ΔNAS: regression, cOR, 0.7; 95% CI, 0.6-0.9; P = .001; progression, cOR, 1.3; 95% CI, 1.1-1.5; P = .01). Conclusions and Relevance: Improvement or worsening of disease activity may be associated with fibrosis regression or progression, respectively, in NAFLD.Item Cell-Cell Communication Breakdown and Endothelial Dysfunction(Elsevier, 2020-04) Lee, Daniel D.; Schwarz, Margaret A.; Medicine, School of MedicineGuided by organ-specific signals in both development and disease response, the heterogeneous endothelial cell population is a dynamic member of the vasculature. Functioning as the gatekeeper to fluid, inflammatory cells, oxygen, and nutrients, endothelial cell communication with its local environment is critical. Impairment of endothelial cell-cell communication not only disrupts this signaling process, but also contributes to pathologic disease progression. Expanding our understanding of those processes that mediate endothelial cell-cell communication is an important step in the approach to treatment of disease processes.Item Chitosan/interfering RNA nanoparticle mediated gene silencing in disease vector mosquito larvae(JOVE, 2015-03-25) Zhang, Xin; Mysore, Keshava; Flannery, Ellen; Michel, Kristin; Severson, David W.; Zhu, Kun Yan; Duman-Scheel, Molly; Department of Medical and Molecular Genetics, IU School of MedicineVector mosquitoes inflict more human suffering than any other organism-and kill more than one million people each year. The mosquito genome projects facilitated research in new facets of mosquito biology, including functional genetic studies in the primary African malaria vector Anopheles gambiae and the dengue and yellow fever vector Aedes aegypti. RNA interference- (RNAi-) mediated gene silencing has been used to target genes of interest in both of these disease vector mosquito species. Here, we describe a procedure for preparation of chitosan/interfering RNA nanoparticles that are combined with food and ingested by larvae. This technically straightforward, high-throughput, and relatively inexpensive methodology, which is compatible with long double stranded RNA (dsRNA) or small interfering RNA (siRNA) molecules, has been used for the successful knockdown of a number of different genes in A. gambiae and A. aegypti larvae. Following larval feedings, knockdown, which is verified through qRT-PCR or in situ hybridization, can persist at least through the late pupal stage. This methodology may be applicable to a wide variety of mosquito and other insect species, including agricultural pests, as well as other non-model organisms. In addition to its utility in the research laboratory, in the future, chitosan, an inexpensive, non-toxic and biodegradable polymer, could potentially be utilized in the field.Item Daily Situational Brief, February 4, 2015(MESH Coalition, 2/4/2015) MESH CoalitionItem Decision and discovery in defining 'disease'(Springer, 2007) Schwartz, Peter H.The debate over how to analyze the concept of disease has often centered on the question of whether to include a reference to values, in particular the ‘disvalue’of diseases, or whether to avoid such notions. ‘Normativists,’such as King ([1954], 1981) and Culver and Gert (1982) emphasize the undesirability of diseases, while ‘Naturalists,’ most prominently Christopher Boorse (1977, 1987, 1997), instead require just the presence of biological dysfunction. The debate between normativism and naturalism often deteriorates into stalemate, with each side able to point out significant problems with the other. It starts to look as if neither approach can work. In this paper, I argue that the standoff stems from deeply questionable assumptions that have been used to formulate the opposing positions and guide the debate. In the end, I propose an alternative set of guidelines that offer a more constructive way to devise and compare theories.Item ExonImpact: Prioritizing Pathogenic Alternative Splicing Events(Wiley, 2017-01) Li, Meng; Feng, Weixing; Zhang, Xinjun; Yang, Yuedong; Wang, Kejun; Mort, Matthew; Cooper, David N.; Wang, Yue; Zhou, Yaoqi; Liu, Yunlong; Medicine, School of MedicineAlternative splicing (AS) is a closely regulated process that allows a single gene to encode multiple protein isoforms, thereby contributing to the diversity of the proteome. Dysregulation of the splicing process has been found to be associated with many inherited diseases. However, in amongst the pathogenic AS events there are numerous “passenger” events whose inclusion or exclusion does not lead to significant changes with respect to protein function. In this study, we evaluate the secondary and tertiary structural features of proteins associated with disease-causing and neutral AS events, and show that several structural features are strongly associated with the pathological impact of exon inclusion. We further develop a machine learning-based computational model, ExonImpact, for prioritizing and evaluating the functional consequences of hitherto uncharacterized AS events. We evaluated our model using several strategies including cross-validation, and data from the Gene-Tissue Expression (GTEx) and ClinVar databases. ExonImpact is freely available at http://watson.compbio.iupui.edu/ExonImpactItem Health and Cognition among Adults with and without Traumatic Brain Injury: A Matched Case-Control Study(Taylor & Francis, 2022) Kumar, Raj G.; Ketchum, Jessica M.; Hammond, Flora M.; Novack, Thomas A.; O’Neil-Pirozzi, Therese M.; Silva, Marc A.; Dams-O’Connor, Kristen; Physical Medicine and Rehabilitation, School of MedicineObjectives: To evaluate associations between traumatic brain injury (TBI) and presence of health conditions, and to compare associations of health and cognition between TBI cases and controls. Methods: This matched case-control study used data from the TBI Model Systems National Database (TBI cases) and Midlife in the United States II and Refresher studies (controls). 248 TBI cases were age-, sex-, race-, and education-matched without replacement to three controls. Cases and controls were compared on prevalence of 18 self-reported conditions, self-rated health, composite scores from the Brief Test of Adult Cognition by Telephone. Results: The following conditions were significantly more prevalent among TBI cases versus controls: anxiety/depression (OR = 3.12, 95% CI: 2.20, 4.43, p < .001), chronic sleeping problems (OR = 2.76, 95% CI: 1.86, 4.10, p < .001), headache/migraine (OR = 2.61, 95% CI: 1.50, 4.54, p = .0007), and stroke (OR = 6.42, 95% CI: 2.93, 14.10, p < .001). The relationship between self-rated health and cognition significantly varied by TBI (pinteraction = 0.002). Conclusion: Individuals with TBI have greater odds of selected neurobehavioral conditions compared to their demographically similar uninjured peers. Among persons with TBI there was a stronger association between poorer self-rated health and cognition than controls. TBI is increasingly conceptualized as a chronic disease; current findings suggest post-TBI health management requires cognitive supports.Item Impact of and Correction for Outcome Misclassification in Cumulative Incidence Estimation(Public Library of Science, 2015) Bakoyannis, Giorgos; Yiannoutsos, Constantin T.; Department of Biostatistics, School of Public HealthCohort studies and clinical trials may involve multiple events. When occurrence of one of these events prevents the observance of another, the situation is called "competing risks". A useful measure in such studies is the cumulative incidence of an event, which is useful in evaluating interventions or assessing disease prognosis. When outcomes in such studies are subject to misclassification, the resulting cumulative incidence estimates may be biased. In this work, we study the mechanism of bias in cumulative incidence estimation due to outcome misclassification. We show that even moderate levels of misclassification can lead to seriously biased estimates in a frequently unpredictable manner. We propose an easy to use estimator for correcting this bias that is uniformly consistent. Extensive simulations suggest that this method leads to unbiased estimates in practical settings. The proposed method is useful, both in settings where misclassification probabilities are known by historical data or can be estimated by other means, and for performing sensitivity analyses when the misclassification probabilities are not precisely known.Item Impact of human pathogenic micro-insertions and micro-deletions on post-transcriptional regulation(Oxford University Press, 2014-06-01) Zhang, Xinjun; Lin, Hai; Zhao, Huiying; Hao, Yangyang; Mort, Matthew; Cooper, David N.; Zhou, Yaoqi; Liu, Yunlong; Department of Medical & Molecular Genetics, IU School of MedicineSmall insertions/deletions (INDELs) of ≤21 bp comprise 18% of all recorded mutations causing human inherited disease and are evident in 24% of documented Mendelian diseases. INDELs affect gene function in multiple ways: for example, by introducing premature stop codons that either lead to the production of truncated proteins or affect transcriptional efficiency. However, the means by which they impact post-transcriptional regulation, including alternative splicing, have not been fully evaluated. In this study, we collate disease-causing INDELs from the Human Gene Mutation Database (HGMD) and neutral INDELs from the 1000 Genomes Project. The potential of these two types of INDELs to affect binding-site affinity of RNA-binding proteins (RBPs) was then evaluated. We identified several sequence features that can distinguish disease-causing INDELs from neutral INDELs. Moreover, we built a machine-learning predictor called PinPor (predicting pathogenic small insertions and deletions affecting post-transcriptional regulation, http://watson.compbio.iupui.edu/pinpor/) to ascertain which newly observed INDELs are likely to be pathogenic. Our results show that disease-causing INDELs are more likely to ablate RBP-binding sites and tend to affect more RBP-binding sites than neutral INDELs. Additionally, disease-causing INDELs give rise to greater deviations in binding affinity than neutral INDELs. We also demonstrated that disease-causing INDELs may be distinguished from neutral INDELs by several sequence features, such as their proximity to splice sites and their potential effects on RNA secondary structure. This predictor showed satisfactory performance in identifying numerous pathogenic INDELs, with a Matthews correlation coefficient (MCC) value of 0.51 and an accuracy of 0.75.Item New-onset and relapsed liver diseases following COVID-19 vaccination: a systematic review(BMC, 2022-10-13) Alhumaid, Saad; Al Mutair, Abbas; Rabaan, Ali A.; ALShakhs, Fatemah M.; Choudhary, Om Prakash; Yong, Shin Jie; Nainu, Firzan; Khan, Amjad; Muhammad, Javed; Alhelal, Fadil; Al Khamees, Mohammed Hussain; Alsouaib, Hussain Ahmed; Al Majhad, Ahmed Salman; Al-Tarfi, Hassan Redha; ALyasin, Ali Hussain; Alatiyyah, Yaqoub Yousef; Alsultan, Ali Ahmed; Alessa, Mohammed Essa; Alessa, Mustafa Essa; Alissa, Mohammed Ahmed; Alsayegh, Emad Hassan; Alshakhs, Hassan N.; Al Samaeel, Haidar Abdullah; AlShayeb, Rugayah Ahmed; Alnami, Dalal Ahmed; Alhassan, Hussain Ali; Alabdullah, Abdulaziz Abdullah; Alhmed, Ayat Hussain; AlDera, Faisal Hussain; Hajissa, Khalid; Al-Tawfiq, Jaffar A.; Al-Omari, Awad; Medicine, School of MedicineBackground: Liver diseases post-COVID-19 vaccination is extremely rare but can occur. A growing body of evidence has indicated that portal vein thrombosis, autoimmune hepatitis, raised liver enzymes and liver injuries, etc., may be potential consequence of COVID-19 vaccines. Objectives: To describe the results of a systematic review for new-onset and relapsed liver disease following COVID-19 vaccination. Methods: For this systematic review, we searched Proquest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus and Nature through the Preferred Reporting Items for Systematic Reviews and Meta Analyses PRISMA guideline for studies on the incidence of new onset or relapsed liver diseases post-COVID-19 vaccination, published from December 1, 2020 to July 31, 2022, with English language restriction. Results: Two hundred seventy-five cases from one hundred and eighteen articles were included in the qualitative synthesis of this systematic review. Autoimmune hepatitis (138 cases) was the most frequent pathology observed post-COVID-19 vaccination, followed by portal vein thrombosis (52 cases), raised liver enzymes (26 cases) and liver injury (21 cases). Other cases include splanchnic vein thrombosis, acute cellular rejection of the liver, jaundice, hepatomegaly, acute hepatic failure and hepatic porphyria. Mortality was reported in any of the included cases for acute hepatic failure (n = 4, 50%), portal vein thrombosis (n = 25, 48.1%), splanchnic vein thrombosis (n = 6, 42.8%), jaundice (n = 1, 12.5%), raised liver enzymes (n = 2, 7.7%), and autoimmune hepatitis (n = 3, 2.2%). Most patients were easily treated without any serious complications, recovered and did not require long-term hepatic therapy. Conclusion: Reported evidence of liver diseases post-COIVD-19 vaccination should not discourage vaccination against this worldwide pandemic. The number of reported cases is relatively very small in relation to the hundreds of millions of vaccinations that have occurred and the protective benefits offered by COVID-19 vaccination far outweigh the risks.