scholarly journals No Association between Prenatal Viral Infection and Depression in Later Life—A Long-Term Cohort Study of 6152 Subjects

2009 ◽  
Vol 54 (8) ◽  
pp. 565-570 ◽  
Author(s):  
Dong Pang ◽  
Saddaf Syed ◽  
Paul Fine ◽  
Peter B Jones
Keyword(s):  
Viral Infection ◽  
Primary Care Physicians ◽  
Viral Infections ◽  
Later Life ◽  
International Classification Of Diseases ◽  
In Utero ◽  
Matched Pair ◽  
Increased Risk ◽  
Uk National Health Service ◽  
The Uk

Objective: Previous studies have suggested a role for prenatal viral infections in the etiology of schizophrenia; however, little is known about depression. We examined whether in-utero viral infections result in increased risk of depression in later life. Method: We identified a cohort ( n = 3076) born between 1946 and 1980, whose mothers suffered known viral infections in pregnancy. Subjects were individually matched by birthdate, sex, and area of birth to another cohort ( n = 3076) from the UK National Health Service Central Register (NHSCR). These 2 cohorts, one exposed to viruses prenatally, the other not known to have been exposed, were then followed-up to June 1996 by sending a morbidity questionnaire to their primary care physicians. This included specific items on affective disorders, schizophrenia, mental handicap (mental retardation), epilepsy, as well as other central nervous system disorders and specified physical illness, all coded according to the International Classification of Diseases, Ninth Edition. Death certificates were supplied by the NHSCR. A method for matched-pair cohort data calculated the relative risk and 95% confidence intervals for depression in the exposed and unexposed cohorts by varying type of viral exposure. Results: The response to the questionnaire was high (85%). There was no overall increased risk for depression associated with viral exposure; a narrow confidence interval surrounded unity (RR = 1.0, 95% CI 0.8 to 1.2); effects for individual viral exposures were all scattered around unity. Conclusions: The results provide no support for the hypothesis that in-utero exposure to viral infection is associated with risk of subsequent nonpsychotic affective disorder. Further analyses on schizophrenia, bipolar disorder, and mental illness other than depression are required.

scholarly journals Pre-eclampsia and offspring cardiovascular health: mechanistic insights from experimental studies

2012 ◽  
Vol 123 (2) ◽  
pp. 53-72 ◽  
Author(s):  
Esther F. Davis ◽  
Laura Newton ◽  
Adam J. Lewandowski ◽  
Merzaka Lazdam ◽  
Brenda A. Kelly ◽  
...  
Keyword(s):  
Vascular Function ◽  
Cardiovascular Health ◽  
Experimental Studies ◽  
Later Life ◽  
In Utero ◽  
Experimental Models ◽  
In Utero Environment ◽  
Increased Risk ◽  
Environment Characteristic ◽  
Early Primary

Pre-eclampsia is increasingly recognized as more than an isolated disease of pregnancy. Women who have had a pregnancy complicated by pre-eclampsia have a 4-fold increased risk of later cardiovascular disease. Intriguingly, the offspring of affected pregnancies also have an increased risk of higher blood pressure and almost double the risk of stroke in later life. Experimental approaches to identify the key features of pre-eclampsia responsible for this programming of offspring cardiovascular health, or the key biological pathways modified in the offspring, have the potential to highlight novel targets for early primary prevention strategies. As pre-eclampsia occurs in 2–5% of all pregnancies, the findings are relevant to the current healthcare of up to 3 million people in the U.K. and 15 million people in the U.S.A. In the present paper, we review the current literature that concerns potential mechanisms for adverse cardiovascular programming in offspring exposed to pre-eclampsia, considering two major areas of investigation: first, experimental models that mimic features of the in utero environment characteristic of pre-eclampsia, and secondly, how, in humans, offspring cardiovascular phenotype is altered after exposure to pre-eclampsia. We compare and contrast the findings from these two bodies of work to develop insights into the likely key pathways of relevance. The present review and analysis highlights the pivotal role of long-term changes in vascular function and identifies areas of growing interest, specifically, response to hypoxia, immune modification, epigenetics and the anti-angiogenic in utero milieu.

scholarly journals SP-A and SP-D: Dual Functioning Immune Molecules With Antiviral and Immunomodulatory Properties

2021 ◽  
Vol 11 ◽  
Author(s):  
Alastair Watson ◽  
Jens Madsen ◽  
Howard William Clark
Keyword(s):  
Viral Infection ◽  
Influenza A ◽  
Viral Infections ◽  
Inflammatory Responses ◽  
Therapeutic Potential ◽  
Inflammatory Diseases ◽  
Chronic Obstructive ◽  
Cell Functions ◽  
Increased Risk ◽  
Syncytial Virus

Surfactant proteins A (SP-A) and D (SP-D) are soluble innate immune molecules which maintain lung homeostasis through their dual roles as anti-infectious and immunomodulatory agents. SP-A and SP-D bind numerous viruses including influenza A virus, respiratory syncytial virus (RSV) and human immunodeficiency virus (HIV), enhancing their clearance from mucosal points of entry and modulating the inflammatory response. They also have diverse roles in mediating innate and adaptive cell functions and in clearing apoptotic cells, allergens and other noxious particles. Here, we review how the properties of these first line defense molecules modulate inflammatory responses, as well as host-mediated immunopathology in response to viral infections. Since SP-A and SP-D are known to offer protection from viral and other infections, if their levels are decreased in some disease states as they are in severe asthma and chronic obstructive pulmonary disease (COPD), this may confer an increased risk of viral infection and exacerbations of disease. Recombinant molecules of SP-A and SP-D could be useful in both blocking respiratory viral infection while also modulating the immune system to prevent excessive inflammatory responses seen in, for example, RSV or coronavirus disease 2019 (COVID-19). Recombinant SP-A and SP-D could have therapeutic potential in neutralizing both current and future strains of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus as well as modulating the inflammation-mediated pathology associated with COVID-19. A recombinant fragment of human (rfh)SP-D has recently been shown to neutralize SARS-CoV-2. Further work investigating the potential therapeutic role of SP-A and SP-D in COVID-19 and other infectious and inflammatory diseases is indicated.

scholarly journals Building a Weight of Evidence to Prevent Cancer in Later Life

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 4s-4s
Author(s):  
G. Rosenberg ◽  
C. Thomas ◽  
L. Hooper ◽  
J. Vohra
Keyword(s):  
Cancer Research ◽  
Adult Population ◽  
Later Life ◽  
Food Marketing ◽  
Weight Of Evidence ◽  
Coalition Building ◽  
Junk Food ◽  
Preventable Risk Factor ◽  
Increased Risk ◽  
The Uk

Background: Obesity is the largest preventable risk factor for cancer in the UK after smoking. Being overweight as an adult is linked to 13 types of cancer, and overweight children are more likely to become overweight adults. Routine data shows that around one in three children leave primary school in the UK (aged 12) overweight or obese, with the children from the most deprived communities twice as likely to be so. Cancer Research UK is campaigning for restrictions on the marketing of foods high in salt sugar and fat (HFSS foods) to children as part of a comprehensive population level strategy to prevent obesity-related cancers in the future. Aim: To undertake a mixed methods program of research aimed at building a body of evidence to directly inform policy to address childhood obesity. Methods: Individual studies included: a national cross-sectional survey to investigate obesity and cancer awareness in the UK adult population; a modeling study to predict future obesity-related cancer cases; and qualitative and quantitative studies to explore obesity-linked behaviors and exposure to HFSS marketing in children. A narrative synthesis of results from individual studies was conducted to identify key themes and develop recommendations for policy. Results: Cancer was not at the forefront of people's minds when thinking about obesity, with only 26% of UK adults reporting (unprompted) awareness of the link. However, results from modeling identified that the projected impact of obesity on cancer is high: if current trends continue it will lead to a further 670,000 cases in the UK over the next 20 years. Qualitative research identified a high awareness of junk food marketing in children aged 8-19. This influenced their behavior using a variety of persuasive marketing techniques, including catchy slogans and jingles, celebrity endorsements or by referencing youth culture. Logistic regression modeling associated commercial TV screen time with an increased risk of high junk food consumption (OR 1.8, P = 0.002). Furthermore, recalling one extra broadcast advert predicted a significant increase in HFSS consumption, approximately 18,000 extra calories/person/year. Conclusion: These linked studies have informed Cancer Research UK's campaign on obesity, and results have been used to inform work with the media, coalition building and influencing. Findings that HFSS food marketing influenced children's consumption behaviors were published on the charity's lobbying day in parliament where the research was discussed with almost 170 members of parliament. To achieve further HFSS marketing restrictions, research evidence is essential to making the case for policy change and this approach from a large UK cancer charity could inform similar efforts in other countries.

Use of atomoxetine and suicidal ideation in children and adolescents: Results of an observational cohort study within general practice in England

2017 ◽  
Vol 39 ◽  
pp. 11-16 ◽  
Author(s):  
M. Davies ◽  
A. Coughtrie ◽  
D. Layton ◽  
S.A.S. Shakir
Keyword(s):  
Suicidal Ideation ◽  
Primary Care Physicians ◽  
Cohort Analysis ◽  
Case Series ◽  
Individual Case ◽  
Matched Pair ◽  
Old Patients ◽  
Increased Risk ◽  
Observational Cohort ◽  
Case Assessment

AbstractAimTo investigate the association between atomoxetine, a drug used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD), and suicidal ideation, within a cohort of 2–18-year-old patients in England.MethodsThe study was conducted using the observational cohort technique of Modified prescription event monitoring (M-PEM). Patients prescribed atomoxetine were identified from dispensed prescriptions issued by primary care physicians. A customised postal GP questionnaire was used to capture outcome data for suicidal ideation. A matched pair cohort analysis was performed within patients to compare the risk of suicidal ideation in the period after starting atomoxetine with the risk prior to starting atomoxetine; this was stratified by age and concomitant use of methylphenidate. Additional information on patient characteristics, and events of interest was also collected; individual cases of suicidal ideation were qualitatively assessed for drug relatedness.ResultsOf the final cohort (n = 4509); 85.5% male (n = 3857), median age 11 years (IQR: 9,14). Primary prescribing indication for atomoxetine was ADHD (n = 4261, 94.6%). Almost a quarter of the cohort had been co-prescribed methylphenidate. Results of the matched pair cohort analysis indicated that the period after starting atomoxetine was not associated with an increase in the incidence of suicidal ideation compared to the period prior to starting treatment (RR: 0.71; CI: 0.48–1.07; P-value: 0.104). Individual case assessment of suicidal ideation suggested a causal association within a number of cases.ConclusionsThis study found no evidence of an increased risk of suicidal ideation during treatment with atomoxetine, compared to the period prior to starting treatment. Amongst age specific subgroups, this risk may change. Nonetheless, individual case assessment suggested a causal relationship in some patients, hence physicians need to be aware of the possibility of developing this event, and furthermore consider how best to detect it in this paediatric population. This study demonstrates the importance of combining quantitative statistical analyses with a qualitative case series assessment.

Risk of dementia associated with psychotic disorders in later life: the health in men study (HIMS)

2018 ◽  
Vol 49 (2) ◽  
pp. 232-242 ◽  
Author(s):  
Osvaldo P. Almeida ◽  
Andrew H. Ford ◽  
Graeme J. Hankey ◽  
Bu B. Yeap ◽  
Jonathan Golledge ◽  
...  
Keyword(s):  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Age Of Onset ◽  
Bipolar Disorders ◽  
Later Life ◽  
International Classification Of Diseases ◽  
Renal Diseases ◽  
Increased Risk ◽  
Clinical Diagnoses ◽  
Classification Of Diseases

AbstractBackgroundRecent research has identified several potentially modifiable risk factors for dementia, including mental disorders. Psychotic disorders, such as schizophrenia and delusional disorder, have also been associated with increased risk of cognitive impairment and dementia, but currently available data difficult to generalise because of bias and confounding. We designed the present study to investigate if the presence of a psychotic disorder increased the risk of incident dementia in later life.MethodsProspective cohort study of a community-representative sample of 37 770 men aged 65–85 years who were free of dementia at study entry. They were followed for up to 17.7 years using electronic health records. Clinical diagnoses followed the International Classification of Diseases guidelines. As psychotic disorders increase mortality, we considered death a competing risk.ResultsA total of 8068 (21.4%) men developed dementia and 23 999 (63.5%) died during follow up. The sub-hazard ratio of dementia associated with a psychotic disorder was 2.67 (95% CI 2.30–3.09), after statistical adjustments for age and prevalent cardiovascular, respiratory, gastrointestinal and renal diseases, cancer, as well as hearing loss, depressive and bipolar disorders, and alcohol use disorder. The association between psychotic disorder and dementia risk varied slightly according to the duration of the psychotic disorder (highest for those with the shortest illness duration), but not the age of onset. No information about the use of antipsychotics was available.ConclusionOlder men with a psychotic disorder have nearly three times greater risk of developing dementia than those without psychosis. The pathways linking psychotic disorders to dementia remain unclear but may involve mechanisms other than those associated with Alzheimer's disease and other common dementia syndromes.

In utero exposure to virus infections and the risk of developing anorexia nervosa

2011 ◽  
Vol 41 (10) ◽  
pp. 2193-2199 ◽  
Author(s):  
A. Favaro ◽  
E. Tenconi ◽  
L. Ceschin ◽  
T. Zanetti ◽  
R. Bosello ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Hospital Admissions ◽  
Viral Infections ◽  
Economic Status ◽  
Public Mental Health ◽  
In Utero ◽  
Virus Infections ◽  
Increased Risk ◽  
Health Database ◽  
Female Subjects

BackgroundThe study aims to explore, using indirect ecological measures of exposure, the role of viral infections in the development of anorexia nervosa (AN).MethodThe cohort of participants consisted of all female subjects born in the Veneto region in the period between 1970 and 1984, and residing in the urban and suburban area of Padua (27 682 female subjects in an area of 424 km2). The main outcome measure was the diagnosis of AN resulting from the Public Mental Health Database, the Register of Hospital Admissions, and the Register of the Eating Disorders Unit (n=402, 1.4%). The number of cases of rubella, chickenpox, influenza and measles was ascertained for each month for the 15-year period.ResultsExposures during the sixth month of pregnancy to the peaks of chickenpox [odds ratio (OR) 1.6, 95% confidence interval (CI) 1.2–2.0] and rubella infections (OR 1.5, 95% CI 1.1–2.0) were significantly associated with an increased risk of developing AN, even after controlling for socio-economic status, urbanization and month of birth. We found weak evidence of a season-of-birth bias.ConclusionsIn utero exposure to viral infection could be a risk factor for developing AN. We need further epidemiological and serological studies to confirm this hypothesis.

scholarly journals Respiratory Viral Infections in Infants: Causes, Clinical Symptoms, Virology, and Immunology

2010 ◽  
Vol 23 (1) ◽  
pp. 74-98 ◽  
Author(s):  
John S. Tregoning ◽  
Jürgen Schwarze
Keyword(s):  
Immune Response ◽  
Immune System ◽  
Viral Infection ◽  
Viral Infections ◽  
Clinical Symptoms ◽  
Later Life ◽  
Treatment Needs ◽  
Syncytial Virus ◽  
Degree Of Similarity

SUMMARY In global terms, respiratory viral infection is a major cause of morbidity and mortality. Infancy, in particular, is a time of increased disease susceptibility and severity. Early-life viral infection causes acute illness and can be associated with the development of wheezing and asthma in later life. The most commonly detected viruses are respiratory syncytial virus (RSV), rhinovirus (RV), and influenza virus. In this review we explore the complete picture from epidemiology and virology to clinical impact and immunology. Three striking aspects emerge. The first is the degree of similarity: although the infecting viruses are all different, the clinical outcome, viral evasion strategies, immune response, and long-term sequelae share many common features. The second is the interplay between the infant immune system and viral infection: the immaturity of the infant immune system alters the outcome of viral infection, but at the same time, viral infection shapes the development of the infant immune system and its future responses. Finally, both the virus and the immune response contribute to damage to the lungs and subsequent disease, and therefore, any prevention or treatment needs to address both of these factors.

Mechanisms linking exposure to preeclampsia in utero and the risk for cardiovascular disease

2020 ◽  
Vol 11 (3) ◽  
pp. 235-242 ◽  
Author(s):  
Prabha H. Andraweera ◽  
Kathryn L. Gatford ◽  
Alison S. Care ◽  
Tina Bianco-Miotto ◽  
Zohra S. Lassi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Health ◽  
Strong Association ◽  
Later Life ◽  
In Utero ◽  
Cvd Risk ◽  
Multifactorial Diseases ◽  
Relative Contribution ◽  
Increased Risk ◽  
Shared Alleles

AbstractPreeclampsia (PE) is now recognised as a cardiovascular risk factor for women. Emerging evidence suggests that children exposed to PE in utero may also be at increased risk of cardiovascular disease (CVD) in later life. Individuals exposed to PE in utero have higher systolic and diastolic blood pressure and higher body mass index (BMI) compared to those not exposed to PE in utero. The aim of this review is to discuss the potential mechanisms driving the relationship between PE and offspring CVD. Exposure to an adverse intrauterine environment as a consequence of the pathophysiological changes that occur during a pregnancy complicated by PE is proposed as one mechanism that programs the fetus for future CVD risk. Consistent with this hypothesis, animal models of PE where progeny have been studied demonstrate causality for programming of offspring cardiovascular health by the preeclamptic environment. Shared alleles between mother and offspring, and shared lifestyle factors between mother and offspring provide alternate pathways explaining associations between PE and offspring CVD risk. In addition, adverse lifestyle habits can also act as second hits for those programmed for increased CVD risk. PE and CVD are both multifactorial diseases and, hence, identifying the relative contribution of PE to offspring risk for CVD is a very complex task. However, considering the emerging strong association between PE and CVD, those exposed to PE in utero may benefit from targeted primary CVD preventive strategies.

scholarly journals Contribution of viral infection to risk for cancer in systemic lupus erythematosus and multiple sclerosis

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0243150
Author(s):  
Deborah K. Johnson ◽  
Kaylia M. Reynolds ◽  
Brian D. Poole ◽  
Matthew D. Montierth ◽  
Vera M. Todd ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systemic Lupus Erythematosus ◽  
Autoimmune Disease ◽  
Viral Infection ◽  
Lupus Erythematosus ◽  
Viral Infections ◽  
Systemic Lupus ◽  
Increased Risk ◽  
Hematological Cancers ◽  
The Relationship

Patients with autoimmune disorders (AD) have altered cancer risks compared to the general population. Systemic lupus erythematosus and multiple sclerosis lead to a heightened risk for hematological malignancies and decreased risk for breast, ovarian, and prostate malignancies. Often patients with autoimmune disease have dysregulated antiviral immune responses, including against oncogenic viruses. To uncover the relationship between viral incidence and cancer risk in the context of autoimmune disease, we extracted electronic health records (EHR) from Vanderbilt University. ICD-9/10 codes and laboratory values were collected for hematological, lung, anal-vaginal, thyroid, hepatobiliary, bladder, prostate, and breast cancers; and viruses including Epstein Barr virus (EBV), Human papilloma virus (HPV), and Hepatitis A/B/C (Hep). Only viral infections that led to a physician visit or laboratory test were entered into the EMR; therefore, only clinically relevant cases were noted and considered positive in this study. The relationship between virus infection and cancer in an SLE cohort (SLE-cases n = 2,313, and SLE-controls n = 5,702) and an MS cohort (MS-case n = 7,277, MS-control n = 7,277) was examined by multilinear logistic regression. Viral infection was strongly associated with increased risk for cancer overall. SLE and MS patients were more susceptible to all viral infections. MS patients trended toward increased risk for cancers overall, while decreased risk for hormone-based cancers in SLE patients non-significantly reduced their risk for overall cancer. Both SLE and MS patients had increased clinically relevant EBV infection, which was associated with risk for hematological cancers. Preventing viral infections by vaccination may be especially helpful in controlling risk for cancer in SLE and MS patients.

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