Study reverses thinking on genetic links to stress, depression

For years, scientists have been trying to determine what effect a gene linked to the brain chemical serotonin may have on depression in people exposed to stress. But now, analysing information from more than 40,000 people who have been studied over more than a decade, researchers led by a team at Washington University School of Medicine in St. Louis have found no evidence that the gene alters the impact stress has on depression.
New research findings often garner great attention. But when other scientists follow up and fail to replicate the findings? Not so much.
In fact, a recent study published in PLOS One indicates that only about half of scientific discoveries will be replicated and stand the test of time. So perhaps it shouldn’t come as a surprise that new research led by Washington University School of Medicine in St. Louis shows that an influential 2003 study about the interaction of genes, environment and depression may have missed the mark.
Since its publication in Science, that original paper has been cited by other researchers more than 4,000 times, and some 100 other studies have been published about links between a serotonin-related gene, stressful life events and depression risk. It indicated that people with a particular variant of the serotonin transporter gene were not as well-equipped to deal with stressful life events and, when encountering significant stress, were more likely to develop depression.
Such conclusions were widely accepted, mainly because antidepressant drugs called selective serotonin reuptake inhibitors (SSRIs) help relieve depression for a significant percentage of clinically depressed individuals, so many researchers thought it logical that differences in a gene affecting serotonin might be linked to depression risk.
But in this new study, the Washington University researchers looked again at data from the many studies that delved into the issue since the original publication in 2003, analysing information from more than 40,000 people, and found that the previously reported connection between the serotonin gene, depression and stress wasn’t evident.
“Our goal was to get everyone who had gathered data about this relationship to come together and take another look, with each research team using the same tools to analyze data the same way,” said the study’s first author, Robert C. Culverhouse, PhD, an assistant professor of medicine and of biostatistics. “We all ran exactly the same statistical analyses, and after combining all the results, we found no evidence that this gene alters the impact stress has on depression.”
Over the years, dozens of research groups had studied DNA and life experiences involving stress and depression in the more than 40,000 people revisited in this study. Some previous research indicated that those with the gene variant were more likely to develop depression when stressed, while others didn’t see a connection. So for almost two decades, scientists have debated the issue, and thousands of hours of research have been conducted. By getting all these groups to work together to reanalyze the data, this study should put the questions to rest, according to the researchers.
“The idea that differences in the serotonin gene could make people more prone to depression when stressed was a very reasonable hypothesis,” said senior investigator Laura Jean Bierut, MD, the Alumni Endowed Professor of Psychiatry at Washington University. “But when all of the groups came together and looked at the data the same way, we came to a consensus. We still know that stress is related to depression, and we know that genetics is related to depression, but we now know that this particular gene is not.”
Culverhouse noted that finally, when it comes to this gene and its connection to stress and depression, the scientific method has done its job.

Washington University School of Medicine
medicine.wustl.edu/news/study-reverses-thinking-genetic-links-stress-depression/

Vitamin D deficiency may indicate cardiovascular disease in overweight and obese children

In overweight and obese children and adolescents, vitamin D deficiency is associated with early markers of cardiovascular disease, a new study reports.
"Paediatric obesity affects 17 percent of infants, children, and adolescents ages 2 to 19 in the United States, and obesity is a risk factor for vitamin D deficiency. These findings suggest that vitamin D deficiency may have negative effects on specific lipid markers with an increase in cardiovascular risk among children and adolescents," said lead author Marisa Censani, M.D., pediatric endocrinologist and director of the Pediatric Obesity Program in the Division of Pediatric Endocrinology at New York Presbyterian Hospital/Weill Cornell Medicine in New York, N.Y.
"This research is newsworthy because this is one of the first studies to assess the relationship of vitamin D deficiency to both lipoprotein ratios and non-high density lipoprotein (non-HDL) cholesterol, specific lipid markers impacting cardiovascular risk during childhood, in children and adolescents with obesity/overweight," Censani noted.
Censani and her colleagues reviewed the medical records, including vitamin D levels, of children and adolescents between 6 and 17 years of age who were evaluated at the paediatric endocrinology outpatient clinics at Weill Cornell Medicine over a two-year period.
Overall, 178 of 332 patients met criteria for overweight and obesity: Body Mass Index (BMI) above the 85th percentile; and 60 patients with BMI above the 85th percentile had fasting lipid test results available.
Total cholesterol, triglycerides, HDL, low-density lipoprotein (LDL), and non-HDL cholesterol were collected; and total cholesterol/HDL and triglyceride/HDL ratios were calculated. Vitamin D deficiency was considered to be 25 hydroxyvitamin D (25OHD) below 20 ng/ml.
Vitamin D deficiency was found to be significantly associated with an increase in atherogenic lipids and markers of early cardiovascular disease. Total cholesterol, triglycerides, LDL, non-HDL cholesterol, as well as total cholesterol/HDL and triglyceride/HDL ratios, were all higher in vitamin D-deficient patients compared to patients without vitamin D deficiency.
"These results support screening children and adolescents with overweight and obesity for vitamin D deficiency and the potential benefits of improving vitamin D status to reduce cardiometabolic risk," Censani said.

The Endocrine Society
www.endocrine.org/news-room/current-press-releases/vitamin-d-deficiency-may-indicate-cardiovascular-disease-in-overweight-and-obese-children

Scientists discover biological evidence of “atypical” Chronic Fatigue Syndrome

Scientists at the Center for Infection and Immunity (CII) at Columbia University’s Mailman School of Public Health are the first to report immune signatures differentiating two subgroups of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): “classical” and “atypical.” This complex, debilitating disease is characterized by symptoms ranging from extreme fatigue after exertion to difficulty concentrating, headaches, and muscle pain.
Typically, symptoms of ME/CFS begin suddenly following a flu-like infection, but a subset of cases classified by the investigators as “atypical” follows a different disease course, either from triggers preceding symptoms by months or years, or accompanied by the later development of additional serious illnesses.
To uncover evidence of these disease types, first author Mady Hornig, MD, director of translational research at CII and associate professor of Epidemiology at Mailman, and colleagues used immunoassays to measure levels of 51 immune biomarkers in cerebrospinal fluid samples taken from 32 cases of classical and 27 cases of atypical ME/CFS. All study participants were diagnosed using the same standard criteria, but atypical cases either had prior histories of viral encephalitis, illness after foreign travel or blood transfusion, or later developed a concurrent malady—seizure disorders, multiple sclerosis-like demyelinating disorders, Gulf War Illness, or a range of cancers—at rates much higher than seen in the general population.
Their analysis revealed lower levels of immune molecules in individuals with atypical ME/CFS than those with a classical presentation and course of illness, including dramatically lower levels of interleukin 7 (IL7), a protein linked to viral infections, and interleukin 17A (IL 17A) and chemokine (C-X-C motif) ligand 9 (CXCL9), inflammatory molecules implicated in a variety of neurological disorders.
“We now have biological evidence that the triggers for ME/CFS may involve distinct pathways to disease, or, in some cases, predispose individuals to the later development of serious comorbidities,” says Hornig. “Importantly, our results suggest that these early biomarker profiles may be detectable soon after diagnosis of ME/CFS, laying a foundation for better understanding of and treatments for this complex and poorly understood illness.”
“Early identification of patients who meet the usual clinical criteria when first diagnosed but then go on to develop atypical features would help clinicians like myself identify and treat these complex cases and even prevent fatal outcomes,” says co-author Daniel L. Peterson, MD, principal clinician at Sierra Internal Medicine in Incline Village, NV.
The new study builds on earlier research by Hornig and collaborators that found robust evidence of distinct stages in ME/CFS. A pair of 2015 publications based on analyses of blood and cerebrospinal fluid showed differences in the immune signatures of ME/CFS patients who had the disease for three years or less as compared with those who had been ill for more than three years. The researchers reported that patients were flush with cytokines and chemokines until around the three-year mark—suggesting an over-activated immune response in that phase of the illness; thereafter the immune system showed evidence of “exhaustion,” and levels of immune molecules dropped.
In the new study, both subsets of ME/CFS patients showed signs of an unbalanced or dysregulated immune system within the central nervous system, with immune markers different than those seen in healthy individuals. However, the dampened immune profiles previously observed after the three-year mark were only observed in individuals with the classical form of the disease, not in those with atypical ME/CFS. Among subjects in the atypical group, levels of cytokines and chemokines were more likely to remain steady or increase.
According to Hornig, instead of the immune exhaustion seen in later phases of classical ME/CFS, atypical patients may be experiencing a “smouldering inflammatory process” in which the immune system is still working to recover, although she acknowledges that much work remains to be done to confirm this hypothesis. Alternatively, these findings could suggest a pathway to disease in atypical individuals that involves biomarkers not captured in the 51-molecule assay, potentially even involving non-immune-related processes. Atypical individuals may also have genetic susceptibilities that lead their immune systems to respond differently than in classical cases.

Columbia University Mailman School of Public Health]
www.mailman.columbia.edu/public-health-now/news/scientists-discover-biological-evidence-atypical-chronic-fatigue-syndrome

New technique tests therapies for breast cancer metastasis

A new laboratory technique developed by researchers at Baylor College of Medicine and other institutions can rapidly test the effectiveness of treatments for life-threatening breast cancer metastases in bone.
“For a number of breast cancer patients, the problem is metastasis – the dissemination of breast tumour cells to other organs – after the primary tumour has been eliminated,” said corresponding author Dr. Xiang Zhang, associate professor of molecular and cellular biology and the Lester and Sue Smith Breast Center at Baylor. “Metastases, however, tend to respond differently than the primary tumour to the treatment in part due to residing in a different organ with a different microenvironment.”
Until now, there has not been an effective experimental platform to study metastatic tumours in their new microenvironment.
“We have created an experimental system in which we can mimic the interactions between cancer cells and bone cells, as bone is the place where breast cancer, and many other cancers too, disseminates most frequently,” said Zhang, who also is a McNair Scholar at Baylor. “We have developed a system that allows us to test many different drug responses simultaneously to discover the therapy that can selectively act on metastatic cancer cells and minimize the effect on the bone.”
To mimic the interactions between metastatic breast cancer cells and bone cells in a living system in the lab, Zhang and his colleagues developed a bone metastasis model, called bone-in culture array, by fragmenting mouse bones that already contain breast cancer cells.
The scientists determined that the bone-in culture maintains the micro-environmental characteristics of bone metastasis in living animal models, and the cancer cells maintain the gene expression profile, the growth pattern and their response to therapies.
Using the bone-in model, the researchers determined that the drug danusertib preferentially inhibits bone metastasis. They also found that other drugs stimulate the growth of slow-growing cancer cells in the bone.
In addition to determining the effect of drugs in the growth of metastasis in bone, the bone-in culture can be used to investigate mechanisms involved in bone colonization by cancer cells.
 
Implications for cancer treatment
“We think that this new system has the potential to be applied not only to breast cancer but to other cancers that also metastasize to the bone,” Zhang said. “This technique can be scaled up to larger sample sizes, which would help accelerate the process of discovering metastatic cancer treatments. We have already found a few interesting drugs. We will keep looking for more and focus on those that are most promising.”


Baylor College
www.bcm.edu/news/cancer-breast/new-breast-cancer-metastasis-technique

Scientists name ‘Connshing syndrome’ as a new cause of high blood pressure

Research led by scientists at the University of Birmingham has revealed a new cause of high blood pressure which could lead to major changes in managing the disease.
High blood pressure, also known as hypertension, often goes unnoticed but if left untreated can increase the risk of heart attack and stroke.
Studies estimate that one in four adults suffer from hypertension, but most patients have no identifiable cause for the condition.
However, it is known that in up to 10 per cent of hypertensive patients the overproduction of the adrenal hormone aldosterone – a condition known as primary aldosteronism or Conn syndrome – is the cause of disease.
Now the University of Birmingham-led study has, for the first time, made the important discovery that a large number of patients with Conn syndrome do not only overproduce aldosterone but also the stress hormone cortisol.
Professor Wiebke Arlt, Director of the Institute of Metabolism and Systems Research (IMSR) at the University of Birmingham, said: “Our findings show that the adrenal glands of many patients with Conn syndrome also produce too much cortisol, which finally explains puzzling results of previous studies in Conn patients.
“These previous studies had found increased rates of type 2 diabetes, osteoporosis and depression in Conn patients – problems typically caused by overproduction of cortisol, also termed Cushing syndrome, and not by too much aldosterone.”
The authors of the University of Birmingham-led study, conducted in collaboration with a group of scientists from Germany, decided to name this new cause of hypertension – the combined overproduction of aldosterone and cortisol – as Connshing syndrome.
At present, many Conn syndrome patients are treated with drugs that are directed against the adverse effects of aldosterone. However, this leaves the cortisol excess untreated.
Second author of the study, published in JCI Insight, Dr Katharina Lang – an academic clinical lecturer at IMSR – said: “These findings are very likely to change clinical practice.
“Patients will now need to undergo more detailed assessment to clarify whether they suffer from Conn or Connshing syndrome.


University of Birmingham
www.birmingham.ac.uk/news/latest/2017/04/connshing-syndrome.aspx

20 Times Faster Biosensor

DGIST research team led by Professor CheolGi Kim has developed a biosensor platform which has 20 times faster detection capability than the existing biosensors using magnetic patterns resembling a spider web.
The sensing capability of a biosensor is determined by the resolution of the sensor and the movement and reaction rate of molecules. Many research groups in Korea and other countries have been improving the resolution through the development of nanomaterials but there has been a limitation to improve the sensors’ sensitivity due to the low diffusion transport of biomolecules toward the sensing region.                                
Professor Kim and his research team used a magnetic field in order to overcome the drawback that the movement of biomolecules such as proteins and DNA is slow when the transport only depends on diffusion. The biomolecules labelled with superparamagnetic particles and the use of an external magnetic field enabled the movement of the biomolecules to be easily controlled and detected with an ultra-sensitive magnetic sensor.
The research team developed a new biosensor platform using a spider web-shaped micro-magnetic pattern. It improved the sensing ability of the biosensor as it increased the ability to collect low-density biomolecules by attracting biomolecules labelled with the superparamagnetic particles to the sensing area.
The first author Byeonghwa Lim at DGIST’s Ph.D program of Emerging Materials Science elaborated on the biosensor platform, "We placed a spider web-shaped micro-magnetic pattern which was designed to move the superparamagnetic particles toward the center of the biosensor and a high sensitivity biosensor on the platform. When a rotating magnetic field is applied to a spider web-shaped magnetic pattern, it can attract biomolecules labelled with superparamagnetic particles faster to the sensor. The speed of the movement is very fast and it can detect the subject 20 times faster than the diffusion method."
The research team also succeeded in monitoring the biomolecules conjugated to the superparamagnetic particles at a distance from the sensing area by utilizing the biosensor platform. In addition, the team has identified that the superparamagnetic particles not only play the role of biomolecular cargo for transportation, but also act as labels for the sensor to indicate the location of biomolecules.
Professor Kim stated "The existing biosensors require long time to detect low density biomolecules and result in poor sensing efficiency as they only depend on diffusion. The magnetic field based biosensor platform improves the collection capability of biomolecules and increases the speed and sensitivity of the biomolecules movement. Therefore, we are planning to use this platform for early diagnosis as well as recurrence diagnosis of diseases such as cancer. "

DGIST
en.dgist.ac.kr/site/dgist_eng/menu/508.do?siteId=dgist_eng&snapshotId=3&pageId=429&cmd=read&contentNo=34358

RNA sequencing applied as a tool to solve patients’ diagnostic mysteries

Recent advances in large-scale clinical DNA sequencing have led to genetic diagnoses for many rare disease patients, but the diagnosis rate based on these approaches is still far from perfect. On average, clinicians are unable to provide a genetic diagnosis for over half of patients in the clinic. The lack of a clear genetic diagnosis can lead to profound uncertainty about patients’ long-term prognoses, treatment options, and family planning decisions.
In a new Science Translational Medicine study, a team led by researchers from the Broad Institute of MIT and Harvard and the National Institute of Neurological Disorders and Stroke adds RNA sequencing to the diagnostic toolkit to identify disease-causing mutations buried inside the genome.
The researchers sequenced the RNA from muscle samples of 50 patients with undiagnosed genetic muscle disorders — who had undergone extensive genetic testing — and, in conjunction with DNA sequence information and a reference database, successfully located pathogenic mutations that had previously gone undetected in one-third of the patients. The study firmly positions RNA sequencing as a tool that adds additional power to the existing set of technologies deployed to solve genetic disease mysteries.
“For some patients, we know that there is variation in the human genome, with an effect on the transcript, that we just haven’t been capturing with our traditional genetic sequencing methods,” says senior author Daniel MacArthur, co-director of the Medical and Population Genetics Program at the Broad Institute and group leader at Massachusetts General Hospital. “With RNA sequencing, we were able to take a set of patients who had gone through diagnostic odysseys — often lasting many years, where many methods had been used to try to detect the cause of their disease without success — and find the biological answers that previous technologies had missed.”
Having a molecular diagnosis in-hand is a medical milestone for some patients and their families, and opens the door to potential therapies while offering some peace of mind. “For example, one patient’s family had opted to delay having other children until they knew the genetic basis of her condition,” MacArthur adds. “Our clinical collaborators were able to report that they had found the genetic cause, and now the parents have the option of prenatal testing for that mutation.”
The study demonstrates that RNA sequencing, or RNA-seq, applied to relevant tissue samples and coupled with genetic analysis, can detect pathogenic mutations hidden in the noncoding sections of a gene, highlight relevant mutations missed in the noise of whole-genome analysis, and rule out other genetic variants suspected to cause disease. Previously, the technology was rarely applied in a clinical setting, and then only for single patients when specific mutations were already suspected — but the research team saw the potential for RNA-seq to augment other clinical tools earlier in diagnostics.

Broad Institute of MIT and Harvard
www.broadinstitute.org/news/rna-sequencing-applied-tool-solve-patients%E2%80%99-diagnostic-mysteries

Cause of fatal childhood disorder revealed in gene study

A gene involved in brain development that can lead to severe disability and infant death has been identified by scientists.
Mutations in the gene cause profound developmental problems and seizures in young children, researchers have found.
Scientists and doctors worked with children with a range of severe problems, including seizures and abnormal brain scans, and discovered that the infants all had mutations in a gene known as PLAA. The researchers have named the condition PLAA-associated neurodevelopment disorder, or PLAAND.
By making a mouse with the same mutation as found in patients, the team – led by the University of Edinburgh – showed how this gene had to function properly for the healthy brain to develop.
PLAA is essential for signalling cells to clear build-up of damaged proteins, which is crucial for brain cell function, the researchers say.
Cells in children with PLAAND have lost this ability and damaged proteins build up, causing severe problems in brain development and at synapses – parts of brain cells that communicate with other cells.
Insights learned from the study may enable scientists to uncover new drugs to treat this rare disease. They could also shed light on conditions such as Alzheimer’s disease, in which there is also an issue with damaged protein build up.
Pinpointing mutations in this gene that lead to such severe outcomes in the affected children is an important advance.
Children affected with PLAAND die before the age of six and most heart-breaking for their families is that they fail to meet any developmental milestones. There is no treatment currently available. In identifying this gene and the processes it controls, we have made significant steps in understanding its role in healthy brain development, which will help us target drug studies in future.

University of Edinburgh
www.ed.ac.uk/news/2017/fatal-childhood-disorder-gene

Find out how Randox are shaping the future of clinical diagnostics at Euromedlab

Randox is a global leader in healthcare diagnostics, with more than 370 million people across 145 countries receiving a medical diagnosis from one of our products each day. For more than 30 years Randox has been shaping the future of clinical diagnostics with our pioneering high quality, cost effective laboratory solutions. Join us at stand #13 on Monday 12th June, 11 am, for an exclusive brunch, where we will be launching 6 exciting new products into the European market.

In addition to this launch, we will be hosting LIVE demonstrations of these products, featuring; Acusera 24.7 the most powerful QC data management software, the RX altona semi-automated & Modena fully automated clinical chemistry analysers and our Evidence Evolution & Evidence MultiSTAT. There will also be talks on our new HDL3-C Reagent and its use in more extensive lipid profiling.

These will take place Monday to Wednesday at the following times:
11:00-11:20        12:20-12:40        12:45-13:05        13:10-13:30        15:10-15:30
Don’t miss your opportunity to find out more about these laboratory innovations for yourself.
Education
Randox will also be hosting two ISWs at the Euromedlab conference. These are being held on Tuesday 13th and Wednesday 14th June. The details for these educational events are;
EduW16 – Meeting ISO 15189 requirements for Uncertainty of Measurement

·         When: Tuesday 13th June 2017

·         Time: 15:45-16:45

·         Where: Trianti Hall

·         Speaker: Margaret Fick

·         Chair: Prof. MM. Corsi Romanelli MD PHD

Book your place now – https://measurement-uncertainty-eduw-16.eventbrite.co.uk

EduW31 – A rapid multi-analyte biochip array for early stroke diagnosis

·         When: Wednesday 14th June 2017

·         Time: 14:30-15:30

·         Where: Hall A

·         Speakers: Jim Curry and Dr. Konstantinos Makris

·         Chair: Prof. MM. Corsi Romanelli MD PHD

Book your place now – https://www.eventbrite.co.uk/e/eduw-31-a-rapid-multi-analyte-biochip-array-for-early-stroke-diagnosis-tickets-33215586714

Study on the Analytical Performance of the DxN VERIS System HCV Assay

This article presents data from a multicenter evaluation of the VERIS HCV assay that runs on the DxN VERIS Molecular Diagnostics System.* The study by Braun et al. was published online at the Journal of Clinical Microbiology in February 2017, and is to be published in print in the journal’s April issue. Data includes an assessment of system performance related to precision, analytical sensitivity, analytical measurement range and clinical specificity. The study featured a large number of tests performed by ten (10) participating evaluation sites based in the United Kingdom, Germany, Italy, Spain and France.

Study results demonstrated overall precision with a standard deviation (SD) of 0.22 log IU/mL or lower for each level tested. This was despite the challenges involved with the evaluation of a high number of sites. The analytical sensitivity observed among the sites was between 6.2 and 9.0 IU/mL. A broad linear range and detection of all HCV genotypes were also demonstrated.

The data is robust owing to the large numbers of tests performed. The analytical results demonstrate that the VERIS HCV assay meets the recommendations of current clinical guidelines for patient management in terms of performance and precision. The consistency of the VERIS HCV assay’s analytical performance is, in part, ascribed to the fully automated capabilities of the DxN VERIS System.

To review the full abstract please visit http://jcm.asm.org/content/early/2017/01/27/JCM.02163-16.abstract.