Researchers funded by the National Institutes of Health Genotype-Tissue Expression (GTEx) project, including scientists from the Broad Institute of MIT and Harvard, have created a new and much-anticipated data resource to help establish how differences in an individual’s genomic make-up can affect gene activity and contribute to disease. The new resource will enable scientists to examine the underlying genomics of many different human tissues and cells at the same time, and promises to open new avenues to the study and understanding of human biology.
GTEx investigators reported initial findings from a two-year pilot study in several papers. These efforts provide new insights into how genomic variants – inherited spelling differences in the DNA code – control how, when, and how much genes are turned on and off in different tissues, and can predispose people to diseases such as cancer, heart disease, and diabetes.
“GTEx was designed to sample as many tissues as possible from a large number of individuals in order to understand the causal effects of genes and variants, and which tissues contribute to predisposition to disease,” said Emmanouil Dermitzakis, Ph.D., professor of genetics at the University of Geneva Faculty of Medicine, Switzerland, and a corresponding author. “The number of tissues examined in GTEx provides an unprecedented depth of genomic variation. It gives us unique insights into how people differ in gene expression in tissues and organs.”
NIH launched the GTEx Project in 2010 to create a data resource and tissue bank for scientists to study how genomic variants may affect gene activity and disease susceptibility. Investigators are collecting more than 30 tissue types from autopsy and organ donations in addition to tissue transplant programs. The DNA and RNA from those samples are then analysed using cutting-edge genomic methods. The project will eventually include tissue samples from about 900 deceased donors.
“GTEx will be a great resource for understanding human biological function, and will have many practical applications in areas such as drug development,” said NHGRI Program Director Simona Volpi, Pharm.D., Ph.D. “Scientists studying asthma or kidney cancer, for example, will be interested in understanding how specific variants influence the biological function of the lung, kidney, and other organs.”
Broad Institute
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In a recent study, Virginia Commonwealth University School of Medicine researchers predicted which cirrhosis patients would suffer inflammations and require hospitalization by analysing their saliva, revealing a new target for research into a disease that accounts for more than 30,000 deaths in the United States each year.
The findings could trigger a change in the way researchers study chronic liver disease and associated microbiota, the network of tiny organisms in the human body such as bacteria and fungi that can either bolster an immune system or weaken it.
The breakdown of defences in the mucosa of the gut has long been a signal of inflammation in those with cirrhosis, which sees healthy liver tissue replaced by scar tissue.
The recent findings suggest that another part of the body also can produce warning signs.
“It has been believed that most of the pathogenesis of cirrhosis starts in the gut, which is what makes this discovery so fascinating,” said Jasmohan S. Bajaj, M.D., associate professor of hepatology in the VCU School of Medicine and Hunter Holmes McGuire Veterans Affairs Medical Center.“The fact that saliva, along with fluid in the gut, can be an indicator of inflammation tells us that we need to further explore the oral cavity and its connections to liver disease.”
The paper describes a study of more than 100 cirrhosis patients from VCU and VA Medical Center, 38 of which had to be hospitalized within 90 days because of flare-ups. Researchers found that the ratio of good-to-bad microbes was similar in the saliva as in the stool of these patients who required hospitalization.
Another part of the same study looked at an additional group of more than 80 people with and without cirrhosis. Those with cirrhosis had impaired salivary defenses, mirroring the immune deficiencies that take place in the gut.
“The data suggest that there may be a change in the overall mucosal-immune interface in cirrhosis patients, allowing a more toxic microbiota to emerge in both the gut and oral cavity,” said Phillip B. Hylemon, Ph.D., professor of microbiology and immunology in the VCU School of Medicine and co-author of the paper.
In addition to using oral microbiota to predict the disease status of cirrhosis patients, Hylemon said the new evidence could provide a useful tool for testing treatment protocols for patients with cirrhosis or other diseases driven by inflammation.
Virginia Commonwealth University Scool of Medicine
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Sleep seems simple enough, a state of rest and restoration that almost every vertebrate creature must enter regularly in order to survive. But the brain responds differently to stimuli when asleep than when awake, and it is not clear what brain changes happen during sleep. “It is the same brain, same neurons and similar requirements for oxygen and so on, so what is the difference between these two states?” asks Rodolfo Llinás, a professor of Neuroscience at New York University School of Medicine and a Whitman Center Investigator at the Marine Biological Laboratory (MBL) in Woods Hole. In a recent paper, Choi, Yu, Lee, and Llinás announced that a specific calcium channel plays a crucial role in healthy sleep, a key step toward understanding both normal and abnormal waking brain functions.
To tackle the broad question of sleep, Llinás and his colleagues focused on one crucial part of the puzzle in mice. Calcium channels, selective gates in neuron walls, are integral in neuron firing, ensuring that all parts of the brain keep talking to one other. But during sleep, calcium channel activity is increased, keeping a slow rhythm that is different from patterns found during wakefulness. Based on this clue, the scientists removed one type of calcium channel, Cav3.1, and looked at how the absence of that channel’s activity affected mouse brain function.
This calcium channel turns out to be a key player in normal sleep. The mice without working Cav3.1 calcium channels took longer to fall asleep than normal mice, and stayed asleep for much shorter periods. “They basically took cat naps,” says Llinás. Their brain activity was also abnormal, more like normal wakefulness than sleep. Most importantly, these mice never reached deep, slow-wave sleep. “This means that we have discovered that Cav3.1 is the channel that ultimately supports deep sleep,” Llinás says.
Because these mice completely lack the ability to sleep deeply, they eventually express a syndrome similar to psychiatric disorders in humans. Llinás believes that studying how the brain functions during unconsciousness is key to understanding normal consciousness, as well as abnormal brain activity. This paper begins to uncover one of the key mechanisms of normal sleep, as well as the role for one important calcium channel in overall brain function.
The Marine Biological Laboratory
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The gene and hormone soup that enables women to breastfeed their newborns also can be a recipe for breast cancer, particularly when the first pregnancy is after age 30.
Researchers have now found that the gene DNMT1 is essential to maintaining breast, or mammary, stem cells, that enable normal rapid growth of the breasts during pregnancy, as well as the cancer stem cells that may enable breast cancer. They’ve learned that the DNMT1 gene also is highly expressed in the most common types of breast cancer.
Conversely, ISL1 gene, a tumour suppressor and natural control mechanism for stem cells, is nearly silent in the breasts during pregnancy as well as cancer, said Dr. Muthusamy Thangaraju, biochemist at the Medical College of Georgia at Georgia Regents University.
“DNMT1 directly regulates ISL1,” Thangaraju said. “If the DNMT1 expression is high, this ISL1 gene is low.” They first made the connection when they knocked out DNMT1 in a mouse and noted the increase in ISL1. Then they got busy looking at what happened in human breast cancer cells.
They found ISL1 is silent in most human breast cancers and that restoring higher levels to the human breast cancer cells dramatically reduces the stem cell populations and the resulting cell growth and spread that are hallmarks of cancer.
When they eliminated the DNMT1 gene in a breast-cancer mouse model, “The breast won’t develop as well,” Thangaraju said, but neither would about 80 percent of breast tumours. The deletion even impacted super-aggressive, triple-negative breast cancer.
The findings point toward new therapeutic targets for breast cancer and potentially using blood levels of ISL1 as a way to diagnose early breast cancer, the researchers report. In fact, they’ve found that the anti-seizure medication valproic acid, already used in combination with chemotherapy to treat breast cancer, appears to increase ISL1 expression, which may help explain why the drug works for these patients, he said. The scientists are screening other small molecules that might work as well or better.
Georgia Regents University and Health System
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A blood test undertaken between 10 to 14 weeks of pregnancy may be more effective in diagnosing Down syndrome and two other less common chromosomal abnormalities than standard non-invasive screening techniques, according to a multicentre study led by a UC San Francisco researcher.
In the study, which followed pregnancy outcomes in close to 16,000 women, the cell-free DNA blood test resulted in correctly identifying all 38 foetuses with Down syndrome, a condition associated with cognitive impairments and an increased risk of several medical disorders. The diagnosis was confirmed by newborn exam, prenatal or postnatal genetic analysis.
The test focuses on the small percentage of foetal DNA found floating in a pregnant woman’s blood. DNA is amplified by PCR, and sequenced so that comparisons can be made between relative amounts of each chromosome’s DNA. A greater quantity of DNA is indicative of some chromosomal conditions, including Down syndrome, which is characterized by an extra copy of chromosome 21, one of the 23 pairs of chromosomes.
When the same women underwent standard screening, 30 of the 38 foetuses with Down syndrome were flagged, according to the study published on April 1, 2015, in the New England Journal of Medicine. The screening comprises a blood draw in which hormones and proteins associated with chromosomal defects are identified, together with an ultrasound of the nuchal fold fluid in the back of the neck, an excess of which is suggestive of Down syndrome.
The average age of the pregnant women was 30 and approximately one-quarter were over 35 – the age at which women have traditionally been considered high risk and offered prenatal invasive testing with procedures like amniocentesis.
A second compelling advantage of cell-free DNA analysis, reported by the researchers who were led by first author Mary Norton, MD, professor of clinical obstetrics and gynaecology at UCSF, was the relatively low incidence of Down syndrome misdiagnoses. While standard testing is acknowledged to result in a large number of false positives, these were significantly less likely with the cell-free DNA tool. There were nine false positives resulting from this method, vs. 854 with standard screening.
University of Central Florida
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New research from the University of Alberta shows that body fluids such as saliva may hold the keys to understanding a person’s likelihood of developing Alzheimer’s, even among those who don’t yet have memory and thinking problems associated with the disease.
Knowing that Alzheimer’s typically coexists with certain metabolic disorders, Shraddha Sapkota, a neuroscience PhD student at the U of A, along with psychology professor Roger Dixon and chemistry professor Liang Li, as well as colleagues from the Faculty of Medicine & Dentistry, reported success in identifying substances in saliva that could differentiate people with Alzheimer’s from those who were aging normally.
“Saliva is easily obtained, safe and affordable, and has promising potential for predicting and tracking cognitive decline, but we’re in the very early stages of this work and much more research is needed,” says Sapkota.
Early detection of Alzheimer’s symptoms is critically important for people with the disease and for clinical studies seeking to slow or stop its progression. However, many diagnosis techniques can be costly or invasive. Saliva is simple to obtain and easy to transport, and has been successfully used to help identify a variety of diseases and conditions. And because multiple samples can be readily obtained, saliva testing is particularly useful for performing repeated assessments that span days, weeks, months or longer.
“There is now consensus that Alzheimer’s disease begins with changes in the brain that are happening while people are still cognitively normal, decades before memory and thinking problems begin, which then accelerate as the disease progresses,” says Maria Carrillo, chief science officer of the Alzheimer’s Association. “Still, diagnosis of Alzheimer’s usually happens fairly late in the progression of the disease, typically not until symptoms are severe enough to prompt a visit to the doctor.”
The researchers conducted their study using saliva samples, clinical diagnoses and cognitive data from the Victoria Longitudinal Study, a long-term, large-scale investigation of human aging. Liquid chromatography-mass spectrometry was used to analyse the saliva samples and identify which substances were predominant in the saliva of three types of individuals: people with normal aging (NA), those with an earlier phase of dementia known as mild cognitive impairment (MCI), and those with Alzheimer’s disease (AD).
Linking that data back to each participant’s clinical diagnosis, researchers reported strong associations between certain substances and a person’s cognitive abilities. For example, higher levels of one substance in the MCI group and another in the Alzheimer’s group were observed. When these were examined in NA, higher levels of both predicted worse episodic memory performance. Another substance with higher levels in the Alzheimer’s group predicted slower speed in processing information.
“Equally important is the possibility of using saliva to find targets for treatment to address the metabolic component of Alzheimer’s, which is still not well understood,’ Sapkota notes. ‘This study brings us closer to solving that mystery.”
University of Alberta
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What began as a chat between husband and wife has evolved into an intriguing scientific discovery. The results show a ‘highly significant’ correlation between periodic solar storms and incidences of rheumatoid arthritis (RA) and giant cell arteritis (GCA), two potentially debilitating autoimmune diseases. The findings by a rare collaboration of physicists and medical researchers suggest a relationship between the solar outbursts and the incidence of these diseases that could lead to preventive measures if a causal link can be established.
RA and GCA are autoimmune conditions in which the body mistakenly attacks its own organs and tissues. RA inflames and swells joints and can cause crippling damage if left untreated. In GCA, the autoimmune disease results in inflammation of the wall of arteries, leading to headaches, jaw pain, vision problems and even blindness in severe cases.
Inspiring this study were conversations between Simon Wing, a Johns Hopkins University physicist and first author of the paper, and his wife, Lisa Rider, deputy unit chief of the Environmental Autoimmunity Group at the National Institute of Environmental Health Sciences in the National Institutes of Health, and a coauthor. Rider spotted data from the Mayo Clinic in Rochester, Minnesota, showing that cases of RA and GCA followed close to 10-year cycles. ‘That got me curious,’ Wing recalled. ‘Only a few things in nature have a periodicity of about 10-11 years and the solar cycle is one of them.’
Wing teamed with physicist Jay Johnson of the U.S. Department of Energy’s Princeton Plasma Physics Laboratory, a long-time collaborator, to investigate further. When the physicists tracked the incidence of RA and GCA cases compiled by Mayo Clinic researchers, the results suggested ‘more than a coincidental connection,’ said Eric Matteson, chair of the division of rheumatology at the Mayo Clinic, and a coauthor. This work drew upon previous space physics research supported by the DOE Office of Science.
The findings found increased incidents of RA and GCA to be in periodic concert with the cycle of magnetic activity of the sun. During the solar cycle, dramatic changes that can affect space weather near Earth take place in the sun. At the solar maximum, for example, an increased number of outbursts called coronal mass ejections hurl millions of tons of magnetic and electrically charged plasma gas against the Earth’s magnetosphere, the magnetic field that surrounds the planet. This contact whips up geomagnetic disturbances that can disrupt cell phone service, damage satellites and knock out power grids. More importantly, during the declining phase of the solar maximum high-speed streams develop in the solar wind that is made up of plasma that flows from the sun. These streams continuously buffet Earth’s magnetosphere, producing enhanced geomagnetic activity at high Earth latitudes.
The research, which tracked correlations of the diseases with both geomagnetic activity and extreme ultraviolet (EUV) solar radiation, focused on cases recorded in Olmsted County, Minnesota, the home of the Mayo Clinic, over more than five decades. The physicists compared the data with indices of EUV radiation for the years 1950 through 2007 and indices of geomagnetic activity from 1966 through 2007. Included were all 207 cases of GCA and all 1,179 cases of RA occurring in Olmsted County during the periods and collected in a long-term study led by Sherine Gabriel, then of the Mayo Clinic and now dean of the Rutgers Robert Wood Johnson Medical School.
Correlations proved to be strongest between the diseases and geomagnetic activity. GCA incidence — defined as the number of new cases per capita per year in the county — regularly peaked within one year of the most intense geomagnetic activity, while RA incidence fell to a minimum within one year of the least intense activity. Correlations with the EUV indices were seen to be less robust and showed a significantly longer response time.
The findings were consistent with previous studies of the geographic distribution of RA cases in the United States. Such research found a greater incidence of the disease in sections of the country that are more likely to be affected by geomagnetic activity. For example, the heaviest incidence lay along geographic latitudes on the East Coast that were below those on the West Coast. This asymmetry may reflect the fact that high geomagnetic latitudes — areas most subject to geomagnetic activity — swing lower on the East Coast than on the opposite side of the country. While Washington, D.C., lies just 1 degree farther north than San Francisco geographically, for example, the U.S. capital is 7 degrees farther north in terms of geomagnetic latitude.
Although the authors make no claim to a causal explanation for their findings, they identify five characteristics of the disease occurrence that are not obviously explained by any of the currently leading hypotheses. These include the east-west asymmetries of the RA and GCA outbreaks and the periodicities of the incidences in concert with the solar cycle. Among the possible causal pathways the authors consider are reduced production of the hormone melatonin, an anti-inflammatory mediator with immune-enhancing effects, and increased formation of free radicals in susceptible individuals. A study of 142 electrical power workers found that excretion of melatonin — a proxy used to estimate production of the hormone — was reduced by 21 percent on days with increased geomagnetic activity.
Confirming a causal link between outbreaks of RA and GCA and geomagnetic activity would be an important step towards developing strategies for mitigating the impact of the activity on susceptible individuals. These strategies could include relocating to lower latitudes and developing methods to counteract direct causal agents that may be controlled by geomagnetic activity. For now, say the authors, their findings warrant further investigations covering longer time periods, additional locations and other autoimmune diseases.
Princeton Plasma Physics Laboratory
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A distinct pattern in the changing length of blood telomeres, the protective end caps on our DNA strands, can predict cancer many years before actual diagnosis, according to a new study from Northwestern Medicine in collaboration with Harvard University.
The pattern – a rapid shortening followed by a stabilization three or four years before cancer is diagnosed – could ultimately yield a new biomarker to predict cancer development with a blood test. This is the first reported trajectory of telomere changes over the years in people developing cancer.
Scientists have been trying to understand how blood cell telomeres, considered a marker of biological age, are affected in people who are developing cancer. But the results have been inconsistent: some studies find they are shorter, some longer and some show no correlation at all.
The Northwestern and Harvard study shows why previous results were confusing.
In the new study, scientists took multiple measurements of telomeres over a 13-year period in 792 persons, 135 of whom were eventually diagnosed with different types of cancer, including prostate, skin, lung, leukaemia and others.
Initially, scientists discovered telomeres aged much faster (indicated by a more rapid loss of length) in individuals who were developing but not yet diagnosed with cancer. Telomeres in persons developing cancer looked as much as 15 years chronologically older than those of people who were not developing the disease.
But then scientists found the accelerated aging process stopped three to four years before the cancer diagnosis.
“Understanding this pattern of telomere growth may mean it can be a predictive biomarker for cancer,” said Lifang Hou, MD, PhD, the lead study author and associate professor in Preventive Medicine-Cancer Epidemiology and Prevention. “Because we saw a strong relationship in the pattern across a wide variety of cancers, with the right testing these procedures could be used to eventually diagnose a wide variety of cancers.” Hou also is a member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.
The Northwestern and Harvard study is believed to be the first to look at telomere length at more than one time point before diagnosis. That’s significant because cancer treatment can shorten telomeres. Post treatment, it’s uncertain whether their length has been affected by the cancer or the treatment.
“This likely explains why the previous studies have been so inconsistent,” Dr. Hou said. “We saw the inflection point at which rapid telomere shortening stabilizes. We found cancer has hijacked the telomere shortening in order to flourish in the body.”
Telomeres shorten every time a cell divides. The older you are, the more times each cell in your body has divided and the shorter your telomeres. Because cancer cells divide and grow rapidly, scientists would expect the cell would get so short it would self-destruct. But that’s not what happens, scientists discovered. Somehow, cancer finds a way to halt that process.
Feinberg School of Medicine
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Despite modern chemoradiation therapy it is still very difficult to give reliable prognoses for malignant gliomas. Surgical removal of the glioma is still the preferred method of treatment. Doctors at Universitätsklinikum Erlangen’s Department of Neurosurgery have now developed a new procedure for analysing radiological imaging scans which makes it possible to predict the course of a disease relatively precisely.
The Friedlein Grading A/B (FGA/B) classification system – named after the physician Katharina Friedlein – is a quick and precise way of determining whether surgical removal is the best possible treatment method for a given tumour. Essentially, the Erlangen-based doctors classify tumours according to their position in the brain in the context of a routine magnetic resonance imaging (MRI) scan. Tumours that are not located in functional brain regions or that are located at a certain distance from such regions are classified as FGA, while tumours that are close to or inside a functional brain region are classified as FGB.
With the FGA/B method it possible to plan the consequences of tumour surgery, which is crucial for the success of the treatment, in a precise, low-risk and quantitative manner. This makes the Friedlein Grading system the first classification system which can be easily applied in clinical practice. ‘There have already been several attempts in medicine to develop such a classification system. However, most approaches were too complicated and were based on academic values only, which made it difficult to use them in clinical practice,’ says PD Dr. Nicolai Savaskan from FAU’s Chair of Neurosurgery. ‘The FGA/B method can be applied on the basis of a standard MRI scan which glioma patients have to undergo anyway and is highly reliable despite being so simple. We hope that our colleagues in neurosurgery departments in smaller hospitals will also be able to use it successfully in everyday clinical practice.’
Universitätsklinikum Erlangen
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Researchers conducting a comprehensive proteomics analysis of human aqueous humour samples identified 763 proteins – including 386 proteins detected for the first time – in this clear fluid that helps maintain pressure in the eye and nourishes the cornea and the lens. These proteins could have a role in disease processes affecting the eye and serve as valuable biomarkers for the development of diagnostics and drug candidates to improve visual health.
A team of researchers from the United States and India, led by Akhilesh Pandey, MD, PhD, Johns Hopkins University School of Medicine (Baltimore, MD) and Krishna Murthy, DO, MRCOphth (Lon) Institute of Bioinformatics (Bangalore, India), used high-resolution mass spectrometry to analyse and identify the proteins isolated from aqueous humour samples collected from 250 individuals. More than a third of the proteins were located outside of cells, in the extracellular matrix, and are involved in cell communication and signal transduction. Others have roles in cell growth, differentiation, and proliferation.
Among the proteins unique to this study are growth factors, immunomodulators, and proteins that regulate blood vessel formation. Other enzymes have a role in metabolism and the energy needs of ocular components such as the lens and cornea. For example, sorbitol dehydrogenase, one of the 386 novel proteins identified in the aqueous humour, plays an important role in the metabolism of glucose in the lens.
EurekAlert
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