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International Journal of Health Sciences 2021The basic objective of this systematic review was to identify potential biomarkers for chronic stress. (Review)
Review
OBJECTIVE
The basic objective of this systematic review was to identify potential biomarkers for chronic stress.
METHODS
A systematic review of studies linking biomarkers in people with chronic stress was conducted using PRISMA guidelines. The last 40 years' studies were included in the systematic review with no age restrictions; animal studies were excluded from the study. Electronic databases including PubMed, Embase, and Google Scholar were searched for the study purpose. The studies were searched using the combinations of search terms that comprised chronic stress together with the keywords hypothalamic-pituitary-adrenal axis (HPA axis), autonomic nervous system (ANS), immune system, metabolic biomarkers, cortisol, hair cortisol, salivary cortisol, urinary cortisol, epinephrine, norepinephrine, adrenocorticotropic hormone (ACTH), brain-derived neurotropic factor (BDNF), metabolic biomarkers, antioxidants, glucose, hemoglobin, C-reactive protein (CRP), cytokines, pro-inflammatory cytokines, anti-inflammatory cytokines, and tumor necrosis factor (TNF).
RESULTS
A total of 37 studies out of 671 studies met the eligibility criteria and were included in this review. Potential diagnostic biomarkers of chronic stress included cortisol, ACTH, BDNF, catecholamines, glucose, HbA1c, triglycerides, cholesterol, prolactin, oxytocin, dehydroepiandrosterone sulfate (DHEA-S), CRP, and interleukin - 6 and 8. While the others including antioxidants and natural killer (NK) cells require further validation. Taken together, addition, these stress biomarkers have critical prognostic capacities for stress-associated diseases and therapeutic guidance.
CONCLUSION
This systematic review provides an update to the literature by highlighting the role of physiological biomarkers in chronic stress and describing their prognostic and therapeutic values.
PubMed: 34548863
DOI: No ID Found -
Deutsches Arzteblatt International Aug 2011Hemoglobinopathies are among the most common inherited diseases around the world. They have become much more common recently in northern and central Europe, including...
BACKGROUND
Hemoglobinopathies are among the most common inherited diseases around the world. They have become much more common recently in northern and central Europe, including Germany, due to immigration.
METHOD
Selective review of the literature with consideration of national guidelines.
RESULTS
The hemoglobinopathies encompass all genetic diseases of hemoglobin. They fall into two main groups: thalassemia syndromes and structural hemoglobin variants (abnormal hemoglobins). α- and β-thalassemia are the main types of thalassemia; the main structural hemoglobin variants are HbS, HbE and HbC. There are many subtypes and combined types in each group. The highly variable clinical manifestations of the hemoglobinopathies range from mild hypochromic anemia to moderate hematological disease to severe, lifelong, transfusion-dependent anemia with multiorgan involvement. Stem-cell transplantation is the preferred treatment for the severe forms of thalassemia. Supportive, rather than curative, treatment consists of periodic blood transfusions for life, combined with iron chelation. Drugs to treat the symptoms of sickle-cell disease include analgesics, antibiotics, ACE inhibitors and hydroxyurea. Blood transfusions should be given only when strictly indicated. More than 90% of patients currently survive into adulthood. Optimally treated patients have a projected life span of 50 to 60 years.
CONCLUSION
Hemoglobinopathies are a public health issue in today's multiethnic German population. Adequate care of the affected patients requires a wide variety of diagnostic and therapeutic measures.
Topics: Blood Transfusion; Cross-Sectional Studies; Emigration and Immigration; Genetic Carrier Screening; Germany; Hemoglobin C; Hemoglobin E; Hemoglobin, Sickle; Hemoglobinopathies; Humans; Iron Chelating Agents; Palliative Care; Stem Cell Transplantation; alpha-Thalassemia; beta-Thalassemia
PubMed: 21886666
DOI: 10.3238/arztebl.2011.0532 -
The New England Journal of Medicine Jun 1994Information on life expectancy and risk factors for early death among patients with sickle cell disease (sickle cell anemia, sickle cell-hemoglobin C disease, and the...
BACKGROUND
Information on life expectancy and risk factors for early death among patients with sickle cell disease (sickle cell anemia, sickle cell-hemoglobin C disease, and the sickle cell-beta-thalassemias) is needed to counsel patients, target therapy, and design clinical trials.
METHODS
We followed 3764 patients who ranged from birth to 66 years of age at enrollment to determine the life expectancy and calculate the median age at death. In addition, we investigated the circumstances of death for all 209 adult patients who died during the study, and used proportional-hazards regression analysis to identify risk factors for early death among 964 adults with sickle cell anemia who were followed for at least two years.
RESULTS
Among children and adults with sickle cell anemia (homozygous for sickle hemoglobin), the median age at death was 42 years for males and 48 years for females. Among those with sickle cell-hemoglobin C disease, the median age at death was 60 years for males and 68 years for females. Among adults with sickle cell disease, 18 percent of the deaths occurred in patients with overt organ failure, predominantly renal. Thirty-three percent were clinically free of organ failure but died during an acute sickle crisis (78 percent had pain, the chest syndrome, or both; 22 percent had stroke). Modeling revealed that in patients with sickle cell anemia, the acute chest syndrome, renal failure, seizures, a base-line white-cell count above 15,000 cells per cubic millimeter, and a low level of fetal hemoglobin were associated with an increased risk of early death.
CONCLUSIONS
Fifty percent of patients with sickle cell anemia survived beyond the fifth decade. A large proportion of those who died had no overt chronic organ failure but died during an acute episode of pain, chest syndrome, or stroke. Early mortality was highest among patients whose disease was symptomatic. A high level of fetal hemoglobin predicted improved survival and is probably a reliable childhood forecaster of adult life expectancy.
Topics: Adult; Aged; Anemia, Sickle Cell; Cause of Death; Child; Female; Hemoglobin SC Disease; Humans; Life Expectancy; Male; Middle Aged; Probability; Regression Analysis; Risk Factors; Survival Analysis; beta-Thalassemia
PubMed: 7993409
DOI: 10.1056/NEJM199406093302303 -
The Lancet. Haematology Aug 2023Previous global analyses, with known underdiagnosis and single cause per death attribution systems, provide only a small insight into the suspected high population...
BACKGROUND
Previous global analyses, with known underdiagnosis and single cause per death attribution systems, provide only a small insight into the suspected high population health effect of sickle cell disease. Completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, this study delivers a comprehensive global assessment of prevalence of sickle cell disease and mortality burden by age and sex for 204 countries and territories from 2000 to 2021.
METHODS
We estimated cause-specific sickle cell disease mortality using standardised GBD approaches, in which each death is assigned to a single underlying cause, to estimate mortality rates from the International Classification of Diseases (ICD)-coded vital registration, surveillance, and verbal autopsy data. In parallel, our goal was to estimate a more accurate account of sickle cell disease health burden using four types of epidemiological data on sickle cell disease: birth incidence, age-specific prevalence, with-condition mortality (total deaths), and excess mortality (excess deaths). Systematic reviews, supplemented with ICD-coded hospital discharge and insurance claims data, informed this modelling approach. We employed DisMod-MR 2.1 to triangulate between these measures-borrowing strength from predictive covariates and across age, time, and geography-and generated internally consistent estimates of incidence, prevalence, and mortality for three distinct genotypes of sickle cell disease: homozygous sickle cell disease and severe sickle cell β-thalassaemia, sickle-haemoglobin C disease, and mild sickle cell β-thalassaemia. Summing the three models yielded final estimates of incidence at birth, prevalence by age and sex, and total sickle cell disease mortality, the latter of which was compared directly against cause-specific mortality estimates to evaluate differences in mortality burden assessment and implications for the Sustainable Development Goals (SDGs).
FINDINGS
Between 2000 and 2021, national incidence rates of sickle cell disease were relatively stable, but total births of babies with sickle cell disease increased globally by 13·7% (95% uncertainty interval 11·1-16·5), to 515 000 (425 000-614 000), primarily due to population growth in the Caribbean and western and central sub-Saharan Africa. The number of people living with sickle cell disease globally increased by 41·4% (38·3-44·9), from 5·46 million (4·62-6·45) in 2000 to 7·74 million (6·51-9·2) in 2021. We estimated 34 400 (25 000-45 200) cause-specific all-age deaths globally in 2021, but total sickle cell disease mortality burden was nearly 11-times higher at 376 000 (303 000-467 000). In children younger than 5 years, there were 81 100 (58 800-108 000) deaths, ranking total sickle cell disease mortality as 12th (compared to 40th for cause-specific sickle cell disease mortality) across all causes estimated by the GBD in 2021.
INTERPRETATION
Our findings show a strikingly high contribution of sickle cell disease to all-cause mortality that is not apparent when each death is assigned to only a single cause. Sickle cell disease mortality burden is highest in children, especially in countries with the greatest under-5 mortality rates. Without comprehensive strategies to address morbidity and mortality associated with sickle cell disease, attainment of SDG 3.1, 3.2, and 3.4 is uncertain. Widespread data gaps and correspondingly high uncertainty in the estimates highlight the urgent need for routine and sustained surveillance efforts, further research to assess the contribution of conditions associated with sickle cell disease, and widespread deployment of evidence-based prevention and treatment for those with sickle cell disease.
FUNDING
Bill & Melinda Gates Foundation.
Topics: Infant; Child; Infant, Newborn; Humans; Prevalence; Global Burden of Disease; beta-Thalassemia; Morbidity; Risk Factors; Anemia, Sickle Cell; Global Health
PubMed: 37331373
DOI: 10.1016/S2352-3026(23)00118-7 -
International Wound Journal Jun 2017Diabetes mellitus is a common metabolic disorder. Among various complications, diabetic neuropathy and peripheral vascular disorders are closely associated with diabetic... (Comparative Study)
Comparative Study
Diabetes mellitus is a common metabolic disorder. Among various complications, diabetic neuropathy and peripheral vascular disorders are closely associated with diabetic foot ulcers (DFUs). Lower extremity ulcers and amputations are ongoing problems among individuals with diabetes. There are several classification systems for DFUs; however, no prognostic system has to date been accepted as the gold standard or the optimum prediction tool for amputations. A retrospective study was designed. Demographic data and baseline laboratory data were gathered and scored or evaluated using five representative DFU classification systems. These included (i) the diabetic ulcer severity score (DUSS); (ii) University of Texas (UT) diabetic wound classification; (iii) Meggitt-Wagner classification; (iv) depth of the ulcer, extent of bacterial colonisation, phase of ulcer and association aetiology (DEPA) scoring system; and (v) site, ischaemia, neuropathy, bacterial infection and depth (SINBAD) score. Finally, a statistical analysis was performed. A total of 137 patients were included in this study. During the follow-up, DFU had healed in 51·1% of subjects and 48·9% of the individuals underwent lower extremity amputations (LEAs). In a univariable logistic regression analysis, history of previous DFU, hypertension, neuropathy, haemoglobin, C-reactive protein (CRP) and ankle-brachial index (ABI) showed a statistically significant difference between the healed group and the LEA group. Moreover, the stages, grades or overall prognostic ability of all five classifications were highly associated with the overall occurrence of LEA. On multivariable logistic regression analysis of the risk of LEA, all classifications showed a significant positive trend with an increased number of amputations. All the five classification systems exhibited high sensitivity, specificity, classification accuracy, positive predictive, negative predictive and area under the curve (AUC) values. They showed substantial accuracy and their main variables were associated with LEA occurrence. The Wagner and UT systems, although they are relatively simple to assess, were better predictors of LEA.
Topics: Adult; Aged; Aged, 80 and over; Amputation, Surgical; Diabetes Complications; Diabetes Mellitus, Type 2; Diabetic Foot; Female; Forecasting; Humans; Lower Extremity; Male; Middle Aged; Prognosis; Retrospective Studies; Risk Factors
PubMed: 27723246
DOI: 10.1111/iwj.12642 -
American Journal of Hematology Feb 2015
Topics: Cholecystectomy; Erythroblasts; Gallstones; Hemoglobin C; Hemoglobin C Disease; Humans; Male; Middle Aged
PubMed: 25488433
DOI: 10.1002/ajh.23915 -
Blood Nov 2013
Topics: Female; Hemoglobin C Disease; Homozygote; Humans
PubMed: 24263962
DOI: 10.1182/blood-2013-09-526764 -
Communications Biology 2019During intraerythrocytic development, the human malaria parasite alters the mechanical deformability of its host cell. The underpinning biological processes involve...
During intraerythrocytic development, the human malaria parasite alters the mechanical deformability of its host cell. The underpinning biological processes involve gain in parasite mass, changes in the membrane protein compositions, reorganization of the cytoskeletons and its coupling to the plasma membrane, and formation of membrane protrusions, termed knobs. The hemoglobinopathies S and C are known to partially protect carriers from severe malaria, possibly through additional changes in the erythrocyte biomechanics, but a detailed quantification of cell mechanics is still missing. Here, we combined flicker spectroscopy and a mathematical model and demonstrated that knob formation strongly suppresses membrane fluctuations by increasing membrane-cytoskeleton coupling. We found that the confinement increased with hemoglobin S but decreases with hemoglobin C in spite of comparable knob densities and diameters. We further found that the membrane bending modulus strongly depends on the hemoglobinopathetic variant, suggesting increased amounts of irreversibly oxidized hemichromes bound to membranes.
Topics: Biomechanical Phenomena; Computer Simulation; Erythrocyte Membrane; Hemoglobin C; Hemoglobin, Sickle; Humans; Mutation; Numerical Analysis, Computer-Assisted; Plasmodium falciparum
PubMed: 31428699
DOI: 10.1038/s42003-019-0556-6