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1.
N Engl J Med ; 372(26): 2481-98, 2015 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-26061751

RESUMO

BACKGROUND: Diffuse low-grade and intermediate-grade gliomas (which together make up the lower-grade gliomas, World Health Organization grades II and III) have highly variable clinical behavior that is not adequately predicted on the basis of histologic class. Some are indolent; others quickly progress to glioblastoma. The uncertainty is compounded by interobserver variability in histologic diagnosis. Mutations in IDH, TP53, and ATRX and codeletion of chromosome arms 1p and 19q (1p/19q codeletion) have been implicated as clinically relevant markers of lower-grade gliomas. METHODS: We performed genomewide analyses of 293 lower-grade gliomas from adults, incorporating exome sequence, DNA copy number, DNA methylation, messenger RNA expression, microRNA expression, and targeted protein expression. These data were integrated and tested for correlation with clinical outcomes. RESULTS: Unsupervised clustering of mutations and data from RNA, DNA-copy-number, and DNA-methylation platforms uncovered concordant classification of three robust, nonoverlapping, prognostically significant subtypes of lower-grade glioma that were captured more accurately by IDH, 1p/19q, and TP53 status than by histologic class. Patients who had lower-grade gliomas with an IDH mutation and 1p/19q codeletion had the most favorable clinical outcomes. Their gliomas harbored mutations in CIC, FUBP1, NOTCH1, and the TERT promoter. Nearly all lower-grade gliomas with IDH mutations and no 1p/19q codeletion had mutations in TP53 (94%) and ATRX inactivation (86%). The large majority of lower-grade gliomas without an IDH mutation had genomic aberrations and clinical behavior strikingly similar to those found in primary glioblastoma. CONCLUSIONS: The integration of genomewide data from multiple platforms delineated three molecular classes of lower-grade gliomas that were more concordant with IDH, 1p/19q, and TP53 status than with histologic class. Lower-grade gliomas with an IDH mutation either had 1p/19q codeletion or carried a TP53 mutation. Most lower-grade gliomas without an IDH mutation were molecularly and clinically similar to glioblastoma. (Funded by the National Institutes of Health.).


Assuntos
DNA de Neoplasias/análise , Genes p53 , Glioma/genética , Mutação , Adolescente , Adulto , Idoso , Cromossomos Humanos Par 1 , Cromossomos Humanos Par 19 , Análise por Conglomerados , Feminino , Glioblastoma/genética , Glioma/metabolismo , Glioma/mortalidade , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Modelos de Riscos Proporcionais , Análise de Sequência de DNA , Transdução de Sinais
2.
Am J Med Genet B Neuropsychiatr Genet ; 162B(3): 283-292, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23505265

RESUMO

A non-synonymous, single nucleotide polymorphism (SNP) in the gene coding for steroid 5-α-reductase type 2 (SRD5A2) is associated with reduced conversion of testosterone to dihydrotestosterone (DHT). Because SRD5A2 participates in the regulation of testosterone and cortisol metabolism, hormones shown to be dysregulated in patients with PTSD, we examined whether the V89L variant (rs523349) influences risk for post-traumatic stress disorder (PTSD). Study participants (N = 1,443) were traumatized African-American patients of low socioeconomic status with high rates of lifetime trauma exposure recruited from the primary care clinics of a large, urban hospital. PTSD symptoms were measured with the post-traumatic stress symptom scale (PSS). Subjects were genotyped for the V89L variant (rs523349) of SRD5A2. We initially found a significant sex-dependent effect of genotype in male but not female subjects on symptoms. Associations with PTSD symptoms were confirmed using a separate internal replication sample with identical methods of data analysis, followed by pooled analysis of the combined samples (N = 1,443, sex × genotype interaction P < 0.002; males: n = 536, P < 0.001). These data support the hypothesis that functional variation within SRD5A2 influences, in a sex-specific way, the severity of post-traumatic stress symptoms and risk for diagnosis of PTSD.


Assuntos
3-Oxo-5-alfa-Esteroide 4-Desidrogenase/genética , 3-Oxo-5-alfa-Esteroide 4-Desidrogenase/fisiologia , Polimorfismo Genético , Transtornos de Estresse Pós-Traumáticos/genética , Adulto , Negro ou Afro-Americano , Depressão/diagnóstico , Depressão/genética , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Hidrocortisona/metabolismo , Masculino , Fenótipo , Fatores Sexuais , Transtornos de Estresse Pós-Traumáticos/etnologia , Inquéritos e Questionários , Testosterona/metabolismo , Ferimentos e Lesões
3.
Depress Anxiety ; 28(12): 1058-66, 2011 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-21898707

RESUMO

BACKGROUND: Posttraumatic stress disorder (PTSD) patients show heightened fear responses to trauma reminders and an inability to inhibit fear in the presence of safety reminders. Brain imaging studies suggest that this is in part due to amygdala over-reactivity as well as deficient top-down cortical inhibition of the amygdala. Consistent with these findings, previous studies, using fear-potentiated startle (FPS), have shown exaggerated startle and deficits in fear inhibition in PTSD participants. However, many PTSD studies using the skin conductance response (SCR) report no group differences in fear acquisition. METHOD: The study included 41 participants with PTSD and 70 without PTSD. The fear conditioning session included a reinforced conditioned stimulus (CS+, danger cue) paired with an aversive airblast, and a nonreinforced conditioned stimulus (CS-, safety cue). Acoustic startle responses and SCR were acquired during the presentation of each CS. RESULTS: The results showed that fear conditioned responses were captured in both the FPS and SCR measures. Furthermore, PTSD participants had higher FPS to the danger cue and safety cue compared to trauma controls. However, SCR did not differ between groups. Finally, we found that FPS to the danger cue predicted re-experiencing symptoms, whereas FPS to the safety cue predicted hyper-arousal symptoms. However, SCR did not contribute to PTSD symptom variance. CONCLUSIONS: Replicating earlier studies, we showed increased FPS in PTSD participants. However, although SCR was a good measure of differential conditioning, it did not differentiate between PTSD groups. These data suggest that FPS may be a useful tool for translational research.


Assuntos
Condicionamento Clássico/fisiologia , Medo/fisiologia , Resposta Galvânica da Pele/fisiologia , Reflexo de Sobressalto/fisiologia , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Adulto , Negro ou Afro-Americano , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Neurociências/métodos , Índice de Gravidade de Doença , Pesquisa Translacional Biomédica/métodos
4.
Dev Psychopathol ; 23(2): 439-52, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-23786688

RESUMO

The ability to effectively regulate emotions and a secure attachment style are critical for maintaining mental health across the life span. The experience of childhood maltreatment interferes with normal development of emotional regulation and dramatically increases risk for a wide range of psychiatric disorders in adulthood. The central nervous system oxytocin systems are critically involved in mediating social attachment and buffering psychophysiological responses to stress. We therefore investigated the impact of childhood maltreatment and an oxytocin receptor (OXTR) single nucleotide polymorphism (rs53576) and their interaction on emotional dysregulation and attachment style in adulthood in a sample of low-income, African American men and women recruited from primary care clinics of an urban, public hospital. Consistent with prior research, we found that the severity of childhood maltreatment was associated with increased levels of emotional dysregulation in adulthood. Childhood maltreatment was also positively associated with ratings of disorganized/unresolved adult attachment style and negatively associated with ratings of secure adult attachment style. There was no direct association between rs53576 and emotional dysregulation or ratings of adult attachment style. However, there were significant interactions between rs53576 and childhood maltreatment in predicting level of adult emotional dysregulation and attachment style. Specifically, G/G genotype carriers were at risk for increased emotional dysregulation when exposed to three or more categories of childhood abuse. In addition, G/G genotype carriers exhibited enhanced disorganized adult attachment style when exposed to severe childhood abuse compared to A/A and A/G carriers. Our findings suggest that A allele carriers of OXTR rs53576 are resilient against the effects of severe childhood adversity, by protection against emotional dysregulation and disorganized attachment.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Negro ou Afro-Americano/psicologia , Emoções , Pobreza/psicologia , Receptores de Ocitocina/genética , População Urbana , Adolescente , Adulto , Negro ou Afro-Americano/genética , Idoso , Idoso de 80 Anos ou mais , Criança , Maus-Tratos Infantis/psicologia , Feminino , Humanos , Acontecimentos que Mudam a Vida , Masculino , Saúde Mental , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Estresse Psicológico/genética , Estresse Psicológico/psicologia , Inquéritos e Questionários
5.
ACS Appl Mater Interfaces ; 5(6): 2075-84, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23432452

RESUMO

Nonvolatile and nonflammable ionic liquids (ILs) have distinct thermal advantages over the traditional organic solvent electrolytes of lithium ion batteries. However, this beneficial feature of ILs is often counterbalanced by their high viscosity (a limiting factor for ionic conductivity) and, sometimes, by their unsuitable electrochemistry for generating protective layers on electrode surfaces. In an effort to alleviate these limiting aspects of ILs, we have synthesized a PEGylated imidazolium bis(trifluoromethylsulfonyl)amide (bistriflamide) IL that exhibited better thermal and electrochemical stability than a conventional electrolyte based on a blend of ethylene carbonate and diethyl carbonate. The electrochemical performance of this IL has been demonstrated using a cathode consisting of ball-milled LiMn2O4 particles. A direct comparison of the ionic liquid electrolyte with the nonionic low-viscosity conventional solvent blend is presented.


Assuntos
Fontes de Energia Elétrica , Eletroquímica/métodos , Eletrólitos/química , Líquidos Iônicos/química , Lítio/química , Manganês/química , Óxidos/química , Eletrodos
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