Why “Winter” Vomiting Disease? Seasonality, Hydrology, and Norovirus Epidemiology in Toronto, Canada

Norovirus is a common cause of gastroenteritis, and is thought to be the causative agent in 68–90% of all gastroenteritis outbreaks. The seasonality of disease occurrence is sufficiently stereotyped to result in this disease being dubbed “winter vomiting disease.” The genesis of this seasonality has been obscure. We sought to identify environmental factors associated with Norovirus outbreaks in Toronto, Canada. We evaluated 253 outbreaks of gastroenteritis linked to Norovirus between November 2005 and March 2008. Poisson regression models were constructed to evaluate associations between average environmental exposures and case counts. A case-crossover approach was used to evaluate associations between acute changes in environment and outbreak risk. Case-crossover analysis indicated an association between low Lake Ontario temperature (≤4°C) (hazard ratio [HR], 5.61 [95% CI, 2.81–11.12]) and high flow (>2.5 m³/s) in the Don River (HR, 3.17 [95% CI, 2.30–4.36]), 1–7 days prior to case occurrence. For both exposure variables, the highest hazard ratios were found 24–48 h prior to case onset. Regression models provided further support for these patterns. The association between local watershed conditions and Norovirus outbreak risk suggest a source-water reservoir for this pathogen. We hypothesize that the reservoir may be maintained through the discharge of wastewater containing virus particles; wintertime seasonality may be explained by enhanced viral persistence at low temperatures.     

Going with the Flow: Legionellosis Risk in Toronto,Canada Is Strongly Associated with Local Watershed Hydrology

Legionella species are increasingly recognized as a cause of both healthcare- and community-acquired pneumonia (so-called “Legionnaire’s disease”). These pathogens are ubiquitous in the environment, but environmental factors in the occurrence of sporadic legionellosis remain poorly understood. We analyzed all legionellosis cases identified in the Greater Toronto Area of Ontario from 1978 to 2006, and evaluated seasonal and environmental patterns in legionellosis case occurrence by using both negative binomial models and case-crossover analysis. A total of 837 cases were reported during the study period. After adjusting for seasonal effects, changes in the local watershed, rather than weather, were the strongest contributors to legionellosis risk. A 3.6-fold increase (95% confidence interval (CI), 2.4–5.3) in odds of disease was identified with decreasing watershed levels approximately 4 weeks before case-occurrence. We also found a 33% increase (95% CI, 8–64%) in odds of disease with decreasing lake temperature during the same period and a 34% increase (95% CI, 14–57%) with increasing humidity 5 weeks before case-occurrence. We conclude that local watershed ecology influences the risk of legionellosis, notwithstanding the availability of advanced water treatment capacity in Toronto. Enhancement of risk might occur through direct contamination of water sources or via introduction of micronutrients or commensal organisms into residential and hospital water supplies. These observations suggest testable hypotheses for future empiric studies.     

Weather Variability, Sunspots, and the Blooms of Cyanobacteria

The roles of weather variability and sunspots in the occurrence of cyanobacteria blooms, were investigated using cyanobacteria cell data collected from the Fred Haigh Dam, Queensland, Australia. Time series generalized linear model and classification and regression tree (CART) model were used in the analysis. Data on notified cell numbers of cyanobacteria and weather variables over the periods 2001 and 2005 were provided by the Australian Department of Natural Resources and Water, and Australian Bureau of Meteorology, respectively. The results indicate that monthly minimum temperature (relative risk [RR]: 1.13, 95% confidence interval [CI]: 1.02–1.25) and rainfall (RR: 1.11; 95% CI: 1.03–1.20) had a positive association, but relative humidity (RR: 0.94; 95% CI: 0.91–0.98) and wind speed (RR: 0.90; 95% CI: 0.82–0.98) were negatively associated with the cyanobacterial numbers, after adjustment for seasonality and auto-correlation. The CART model showed that the cyanobacteria numbers were best described by an interaction between minimum temperature, relative humidity, and sunspot numbers. When minimum temperature exceeded 18°C and relative humidity was under 66%, the number of cyanobacterial cells rose by 2.15-fold. We conclude that weather variability and sunspot activity may affect cyanobacteria blooms in dams.     

The reported incidence of campylobacteriosis modelled as a function of earlier temperatures and numbers of cases,Montreal, Canada, 1990–2006

Previous studies have detected an effect of earlier temperatures on the incidence of campylobacteriosis in humans, but without adjustment for earlier numbers of cases of the disease. We estimated the effect of temperature on the number of cases notified by week in Montreal, Canada, from 1 January 1990 to 26 March 2006, simultaneously with the effect of the numbers of cases notified in the preceding weeks. The current campylobacteriosis count (week 0) was modelled by negative binomial regression, with earlier weekly average temperatures and earlier counts as predictors. Secular trends were accounted for by cubic spline functions and seasonal variations by sine-cosine functions. Indicator variables identified weeks with fewer than 5 working days. In the final statistical model, a 1°C increase in temperature above 10°C during any of weeks −1 to −6 was associated with a 0.8% (95% CI: 0.3% to 1.3%) increase in the current count. For each additional notified case during any of weeks −1 to −5 or −9 to −12, the increase in the current count was approximately 0.5% (95% CI: 0.2% to 1.0%). Thus, earlier temperatures and earlier counts have independent effects, that of temperatures being the larger one. The temperature effect is too small to require short term public health planning. However, in Montreal, an increase in average temperature of the order of 4.5°C, forecast by some for 2055, could produce a 23% increase in incidence, resulting in about 4,000 excess cases per year.     

The <Emphasis Type="Italic">MSX1</Emphasis> allele 4 homozygous child exposed to smoking at periconception is most sensitive in developing nonsyndromic orofacial clefts

Nonsyndromic orofacial clefts (OFC) are common birth defects caused by certain genes interacting with environmental factors. Mutations and association studies indicate that the homeobox gene MSX1 plays a role in human clefting. In a Dutch case-control triad study (mother, father, and child), we investigated interactions between MSX1 and the parents’ periconceptional lifestyle in relation to the risk of OFC in their offspring. We studied 181 case- and 132 control mothers, 155 case- and 121 control fathers, and 176 case- and 146 control children, in which there were 107 case triads and 66 control triads. Univariable and multivariable logistic regression analyses were applied, and odds ratios (OR), 95% confidence intervals (CI) were calculated. Allele 4 of the CA marker in the MSX1 gene, consisting of nine CA repeats, was the most common allele found in both the case and control triads. Significant interactions were observed between allele 4 homozygosity of the child with maternal smoking (OR 2.7, 95% CI 1.1–6.6) and with smoking by both parents (OR 4.9, 95% CI 1.4–18.0). Allele 4 homozygosity in the mother and smoking showed a risk estimate of OR 3.2 (95% CI 1.1–9.0). If allele 4 homozygous mothers did not take daily folic acid supplements in the recommended periconceptional period, this also increased the risk of OFC for their offspring (OR 2.8, 95% CI 1.1–6.7). Our findings show that, in the Dutch population, periconceptional smoking by both parents interacts with a specific allelic variant of MSX1 to significantly increase OFC risk for their offspring. Possible underlying mechanisms are discussed. D. de Costa and I. P. C. Krapels have equally contributed to this work.     

Association of the −33C/G <Emphasis Type="Italic">OSF</Emphasis>-<Emphasis Type="Italic">2</Emphasis> and the 140A/G <Emphasis Type="Italic">LF</Emphasis> gene polymorphisms with the risk of chronic rhinosinusitis with nasal polyps in a Polish population

Nasal polyps are strongly associated with a risk of chronic rhinosinusitis development as well as other obstruction including asthma and allergy. The following study tested the association of the 140A/G polymorphism of lactoferine (LF) encoding gene and the −33C/G polymorphism of osteoblast-specific factor-2 (OSF-2) encoding gene with a risk of chronic rhinosinusitis with nasal polyps in a Polish population. One hundred ninety five patients of chronic rhinosinusitis with nasal polyps as well as 200 sex, age and ethnicity matched control subjects without chronic sinusitis and nasal polyps were enrolled in this study. Among the group of patients 63 subjects were diagnosed with allergy and 65 subjects with asthma, respectively. DNA was isolated from peripheral blood lymphocytes of patients as well as controls and gene polymorphisms were analyzed by restriction fragments length polymorphism polymerase chain reaction (RFLP-PCR). We reported that the 140A/G LF (OR 4.78; 95% CI 3.07–7.24), the −33C/G OSF-2 OR 3.48; 95% CI 2.19–5.52) and the −33G/G OSF-2 (OR 16.45; 95% CI 6.71–40.30) genotypes were associated with an increased risk of chronic rhinosinusitis with nasal polyps among analyzed group of patients. Moreover, the group of patients without allergy or asthma indicated the association of the −33C/G (OR 3.72; 95% CI 2.24–6.19 and OR 15.11; 95% CI 5.91–38.6) and −33G/G (OR 3.73; 95% CI 2.24–6.19 and OR 14.07; 95% CI 5.47–36.16) genotypes of the OSF-2 as wells as 140A/G (OR 3.89; 95% CI 2.40–6.31 and OR 3.62; 95% CI 2.45–5.34) genotype of OSF-2 with an increased risk of chronic rhinosinusitis with nasal polyps. Finally, it was also found that the selected group of patients with allergy or asthma indicated a very strong association of the −33C/G (OR 2.40; 95% CI 1.23–4.69 and OR 2.40; 95% CI 1.23–4.69, respectively) and −33G/G (OR 16.01; 95% CI 5.77–44.41 and OR 17.90; 95% CI 6.53–49.05, respectively) genotypes of the OSF-2 as wells as 140A/G (OR 3.22; 95% CI 1.74–6.11 and OR 3.25; 95% CI 1.75–6.04, respectively) genotypes with an increased risk of chronic rhinosinusitis with nasal polyps. Thus, our results suggest that LF and OSF-2 gene polymorphisms may have deep impact on the risk of rhinosinusitis nasal polyps’ formation which may also depend on asthma or allergy. Our results showed that the 140A/G polymorphism of LF gene and the −33C/G polymorphism of the OSF-2 gene may be associated with the risk of chronic rhinosinusitis with nasal polyps in a Polish population.     

Spatial-temporal mapping and risk factors for hand foot and mouth disease in northwestern inland China

BackgroundHand foot and mouth disease (HFMD) is becoming one of the common human infectious diseases in China. Previous studies have described HFMD in tropical or coastal areas of Asia-Pacific countries. However, limited studies have thoroughly studied the epidemiology and potential risk factors for HFMD in inland areas with complex environmental conditions.Methodology/Principal findingsUsing the data from 2009 to 2018 on reported cases of Xinjiang Uighur Autonomous Region, we characterized the epidemic features of HFMD. Panel negative binomial model was used to identify climate, geographical and demographic determinants for HFMD incidence. A total of 70856 HFMD cases (average annual incidence: 305 per million persons) were reported in Xinjiang during the 10-year study period, of which 10393 (14.7%) were laboratory-confirmed and 98 (0.1%) were severe. HFMD peaked in summer every year during the study period, and incidence in 2012, 2015, 2016 and 2018 had minor peaks in autumn. After adjusting the school or holiday month, multiple factors were found to affect HFMD epidemiology: urban area being major land cover type (incidence risk ratio, IRR 2.08; 95% CI 1.50, 2.89), higher gross domestic product per capita (IRR 1.14; 95% CI 1.11, 1.16), rise in monthly average temperature (IRR 1.65; 95% CI 1.61, 1.69) and monthly accumulative precipitation (IRR 1.20; 95% CI 1.16, 1.24) predicted increase in the incidence of HFMD; farmland being major land cover type (IRR 0.72; 95% CI 0.64, 0.81), an increase of percentage of the minority (IRR 0.91; 95% CI 0.89, 0.93) and population density (IRR 0.98; 95% CI 0.98, 0.99) were related to a decrease in the incidence of HFMD.Conclusions/SignificanceIn conclusion, the epidemic status of HFMD in Xinjiang is characterized by low morbidity and fatality. Multiple factors have significant influences on the occurrence and transmission of HFMD in Xinjiang.     

Germination responses to temperature responsible for the seedling emergence seasonality ofPrimula sieboldii E. Morren in its natural habitat

Temperature requirements for the breaking of seed dormancy and germination inPrimula sieboldii E. Morren and the annual surface-soil temperature regime in one of its natural habitats were investigated in order to clarify the germination responses determining the seedling emergence seasonality of the species. In a grassland nature reserve in an abandoned flood plain of the Arakawa River, natural seedling emergence of the species was shown to be restricted to mid- to late-spring before the closure of seasonal vegetational gaps, when the daily mean soil surface temperature reached about 15°C, accompanied by large daily fluctuations of about 10°C. Mature seeds collected in late June were never able to germinate at any constant temperature in the range of 8–40°C unless they had been previously subjected to moist-chilling treatment. The proportion of seeds which were released from dormancy increased with increasing duration of the moist-chilling treatment at 2°C, 70–85% of seeds becoming germinable at 16–28°C after 12 weeks of pretreatment at 2°C. The thermal time required for the germination of the thus-pretreated seed population was 905–1690 Kh with a base temperature of around 5°C. Fluctuating temperatures between 24°C and 16 or 12°C had a remarkable dormancy-breaking effect, inducing considerably quick germination in most of the seeds previously subjected to 2°C moist-chilling for 8 weeks.     

Association of GSTM1T1 genes with COPD and prostate cancer in north Indian population

The glutathione S-transferase (GST) family of enzymes is known to play a pivotal role in phase II of biotransformation of xenobiotics, environmental carcinogens and pharmacological drugs. The objective of the present study was to investigate the role of GSTM1 and GSTT1 null genotypes as risk factors for chronic obstructive pulmonary disease (COPD) and prostate cancer. The subjects appraised were 200 COPD cases, 150 prostate cancer cases, 150 benign prostatic hyperplasia (BPH) cases, 200 age matched controls for COPD and 172 age matched controls for prostate cancer. GSTM1 and GSTT1 null genotype was found to confer 2.5 (OR 2.45; 95% CI 1.56–3.82; P value = 0.00008) and 2.4-fold (OR 2.39; 95% CI 1.36–4.20; P value = 0.002) significant higher risk for prostate cancer. Smoking imparted a 2.2-fold significant risk of prostate cancer cases (OR 2.23; 95% CI 1.36–3.65 P value = 0.001) and twofold risk in BPH (OR 2.09; 95% CI 1.26–3.46; P value = 0.005). In case of COPD only null genotype of GSTT1 has shown 2.1-fold (OR 2.11; 95% CI 1.22–3.62; P value = 0.007) significant increased risk.     

Effect of LEPR Gln223Arg polymorphism on breast cancer risk in different ethnic populations: a meta-analysis

Leptin and leptin receptor have been implicated in processes leading to breast cancer initiation and progression. An A to G transition mutation in codon 223, in exon 6 of the leptin receptor gene (LEPR) can result in glutamine to arginine substitution (Gln223Arg). A variety of case–control studies have been published evaluating the association between LEPR Gln223Arg polymorphism and breast cancer. However, published studies have yielded contradictory conclusions. This meta-analysis enrolled eight studies to estimate the overall risk of LEPR Gln223Arg polymorphism associated with breast cancer. The pooled ORs were performed for codominant model (Arg/Arg versus Gln/Gln; Arg/Gln versus Gln/Gln), dominant model (Arg/Arg + Arg/Gln versus Gln/Gln), recessive model (Arg/Arg versus Arg/Gln + Gln/Gln). Overall significantly elevated breast cancer risk was found for recessive model (OR 1.32, 95% CI 1.03–1.69) and for genotype Arg/Gln versus Gln/Gln (OR 1.16, 95% CI 1.01–1.34). In the stratified analysis by ethnicity, significantly increased risks were also found among Africans for genotype Arg/Arg versus Gln/Gln: OR 1.86, 95% CI 1.28–2.71, Arg/Gln versus Gln/Gln: OR 1.48, 95% CI 1.10–1.99, dominant model: OR 1.60, 95% CI 1.21–2.11 and recessive model: OR 1.48, 95% CI 1.07–2.05; for Asians, Arg/Arg versus Gln/Gln: OR 6.79, 95% CI 3.42–13.47 and dominant model: OR 2.03, 95% CI 1.42–2.90. However, no significantly increased risk was found among Europeans for all genetic models. In conclusion, the LEPR 223Arg is a low-penetrant risk for developing breast cancer, especially for black African women.     

What determines global positioning system fix success when monitoring free-ranging mouflon?

We have assessed behavioural and environmental factors influencing the success of global positioning system (GPS) fixes recorded from 15 collared free-ranging female Mediterranean mouflon (Ovis gmelini musimon x Ovis sp.). We have demonstrated that fix success was 8% lower in resting animals (0.81, 95% CI = 0.79–0.84) than in active animals (0.89, 95% CI = 0.86–0.91) at an average temperature (13.8°C), but was similar and relatively constant at lower temperatures. When temperatures increased above the average temperature, fix success strongly decreased in resting animals (0.44, 95% CI = 0.36–0.52 at 30°C) as compared to active animals (0.76, 95% CI = 0.65–0.85). These results probably involved behavioural changes in habitat use of mouflon, as temperature and activity strongly influence the use of cover in ungulates. We also found that the success of GPS fixes was influenced by habitat types, increasing from 0.76 to 0.93 (under average sky openness of 33%) along a continuum going from forested to open areas. After controlling for differences in vegetation, sky openness had a positive effect on fix success (from 0.76 to 0.97 in evergreen oak forest). Our approach based on free-ranging animals and using a robust interpolation procedure should provide biologists with a more reliable method to account for bias in GPS studies.     

The importance of climatic factors and outliers in predicting regional monthly campylobacteriosis risk in Georgia,USA

Incidence of Campylobacter infection exhibits a strong seasonal component and regional variations in temperate climate zones. Forecasting the risk of infection regionally may provide clues to identify sources of transmission affected by temperature and precipitation. The objectives of this study were to (1) assess temporal patterns and differences in campylobacteriosis risk among nine climatic divisions of Georgia, USA, (2) compare univariate forecasting models that analyze campylobacteriosis risk over time with those that incorporate temperature and/or precipitation, and (3) investigate alternatives to supposedly random walk series and non-random occurrences that could be outliers. Temporal patterns of campylobacteriosis risk in Georgia were visually and statistically assessed. Univariate and multivariable forecasting models were used to predict the risk of campylobacteriosis and the coefficient of determination (R ²) was used for evaluating training (1999–2007) and holdout (2008) samples. Statistical control charting and rolling holdout periods were investigated to better understand the effect of outliers and improve forecasts. State and division level campylobacteriosis risk exhibited seasonal patterns with peaks occurring between June and August, and there were significant associations between campylobacteriosis risk, precipitation, and temperature. State and combined division forecasts were better than divisions alone, and models that included climate variables were comparable to univariate models. While rolling holdout techniques did not improve predictive ability, control charting identified high-risk time periods that require further investigation. These findings are important in (1) determining how climatic factors affect environmental sources and reservoirs of Campylobacter spp. and (2) identifying regional spikes in the risk of human Campylobacter infection and their underlying causes.     

Effects of extreme changes of sea water temperature and salinity on the development of the sand dollar <Emphasis Type="Italic">Scaphechinus mirabilis</Emphasis>

The combined effects of temperatures of 14, 17, 20, 22, and 25°C and salinities of 36–12‰ on embryos and larvae of the sand dollar Scaphechinus mirabilis was studied. Embryonic development is the most sensitive stage in the early ontogenesis of S. mirabilis. It is completed at a temperature of 14–20°C in a salinity range of 36–24‰ and at temperature of 22°C to 26‰. The fertilization proceeds in wider ranges of temperature and salinity. Among the swimming larvae, blastulae showed the greatest resistance to variations of these environmental factors. All the larvae survived at a temperature of 14–22°C and a salinity of 36–20‰, and more than 70% of them at 18‰. The pluteus I is the most vulnerable stage; probably this is related to the formation of the larval skeleton and transition to phytoplankton feeding. The survival of larvae at the age of 20 days was 100% at 14–22° C and a salinity of 36–24‰, most of them survived at 14–20°C and a salinity 18‰. The temperature 25 ° C is the most damaging for early development of S. mirabilis. The duration of development of that species lasts 28.5–29 days at 20°C and a salinity of 32.2–32.6‰. At 20 and 22°C, the larvae settled and completed metamorphosis more quickly if sand from the parental habitat was present. The larvae did not settle during the experiment (14 days) at 14 ° C and in the absence of sand.     

Campylobacteriosis in Urban versus Rural Areas: A Case-Case Study Integrated with Molecular Typing to Validate Risk Factors and to Attribute Sources of Infection

Campylobacter infection is a leading cause of bacterial gastroenteritis worldwide, and most clinical cases appear as isolated, sporadic infections for which the source is rarely apparent. From July 2005 to December 2007 we conducted a prospective case-case study of sporadic, domestically-acquired Campylobacter enteritis in rural versus urban areas and a prevalence study of Campylobacter in animal and environmental sources in the Eastern Townships, Quebec. Isolates were typed using Multilocus Sequence Typing (MLST) to reinforce the case-case findings and to assign a source probability estimate for each human isolate. The risk of human campylobacteriosis was 1.89-fold higher in rural than urban areas. Unconditional multivariate logistic regression analysis identified two independent risk factors associated with human Campylobacter infections acquired in rural area: occupational exposure to animals (OR = 10.6, 95% CI: 1.2–91, p = 0.032), and household water coming from a private well (OR = 8.3, 95% CI: 3.4–20.4, p<0.0001). A total of 851 C. jejuni isolates (178 human, 257 chicken, 87 bovine, 266 water, 63 wild bird) were typed using MLST. Among human isolates, the incidence rates of clonal complexes (CC) CC-21, CC-45, and CC-61 were higher in rural than urban areas. MLST-based source attribution analysis indicated that 64.5% of human C. jejuni isolates were attributable to chicken, followed by cattle (25.8%), water (7.4%), and wild birds (2.3%). Chicken was the attributable source for the majority of cases, independent of residential area, sex and age. The increased incidence in rural compared to urban areas was associated with occupational exposure to animals, particularly cattle among those aged 15–34 years, and with consumption of private well water. Both bovine and water exposure appeared to contribute to the seasonal variation in campylobacteriosis. These results provide a basis for developing public education and preventive programs targeting the risk factors identified.     

Excess deaths during the 2004 heatwave in Brisbane, Australia

The paper examines whether there was an excess of deaths and the relative role of temperature and ozone in a heatwave during 7–26 February 2004 in Brisbane, Australia, a subtropical city accustomed to warm weather. The data on daily counts of deaths from cardiovascular disease and non-external causes, meteorological conditions, and air pollution in Brisbane from 1 January 2001 to 31 October 2004 were supplied by the Australian Bureau of Statistics, Australian Bureau of Meteorology, and Queensland Environmental Protection Agency, respectively. The relationship between temperature and mortality was analysed using a Poisson time series regression model with smoothing splines to control for nonlinear effects of confounding factors. The highest temperature recorded in the 2004 heatwave was 42°C compared with the highest recorded temperature of 34°C during the same periods of 2001–2003. There was a significant relationship between exposure to heat and excess deaths in the 2004 heatwave [estimated increase in non-external deaths: 75 ([95% confidence interval, CI: 11–138; cardiovascular deaths: 41 (95% CI: −2 to 84)]. There was no apparent evidence of substantial short-term mortality displacement. The excess deaths were mainly attributed to temperature but exposure to ozone also contributed to these deaths.     

CDH1 promoter polymorphism and stomach cancer susceptibility

The relationship of stomach cancer susceptibility and the presence of E-cadherin (CDH1) promoter −160 C/A polymorphism had been reported with conflicting results. To further explore the association of this polymorphism with stomach cancer susceptibility, we performed an extensive search of relevant studies and carried out a meta-analysis to obtain a more precise estimate. A total of 16 studies including 2,611 cases and 3,788 controls were involved in this meta-analysis. When all studies involved, the meta-analysis results suggest no statistically significant association between CDH1 −160 C/A polymorphism and stomach cancer risk (CA vs. CC: OR = 1.01, 95% CI: 0.85–1.19; AA vs. CC: OR = 1.05, 95% CI: 0.75–1.46; dominant model: OR = 1.02, 95% CI: 0.86–1.20; recessive model: OR = 1.04, 95% CI: 0.76–1.41). When subgroup analyses were performed by ethnicity, the A-allele carriers conferred a decreased stomach cancer risk in Asians (AA vs. CC: OR = 0.67, 95% CI: 0.47–0.96; dominant model: OR = 0.85, 95% CI: 0.72–0.99), but no statistically significant association was found in Caucasians. In conclusion, this meta-analysis suggests that CDH1 −160 A-allele may play a protective role of stomach cancer development in Asians but not in Caucasians.     

CYP46 T/C Polymorphism is not Associated with Alzheimer’s Dementia in a Population from Hungary

Multiple genetic and environmental factors regulate the susceptibility to Alzheimer’s disease (AD). Recently, several independent studies have reported that a locus on chromosome 14q32.1, where a gene encoding a cholesterol degrading enzyme of the brain, called 24-hydroxylase (CYP46A1) is located, has been linked with AD. The single nucleotide polymorphism (T/C) in intron 2 of CYP46 gene has been found to confer the risk for AD. The water soluble 24(S)-hydroxysterol is the product of the CYP46A1, and elevated plasma and cerebrospinal fluid hydroxysterol concentrations have been found in AD, reflecting increased brain cholesterol turnover or cellular degradation, due to the neurodegenerative process. A case–control study was performed on 125 AD and 102 age- and gender-matched control subjects (CNT) from Hungary, to test the association of CYP46 T/C and apolipoprotein E (ApoE) gene polymorphisms in AD. The frequency of the CYP46 C allele was similar (χ²=0.647, df=1, P=0.421, exact P=0.466, OR=0.845; 95% CI: 0.561–1.274) in both groups (CNT: 27%; 95% CI: 21.3–33.4; AD 30%; 95% CI: 25.0–36.3). The ApoE ɛ4 allele was significantly over-represented (χ²=11.029, df=2, P=0.004) in the AD population (23.2%; 95% CI: 18.2–29.0) when compared with the CNT (11.3%; 95% CI: 7.4–16.6). The presence or absence of one or two CYP46C alleles together with the ApoE ɛ4 allele did not increase the risk of AD (OR=3.492; 95% CI: 1.401–8.707; P<0.007 and OR=3.714; 95% CI: 1.549–8.908; P<0.003, respectively). Our results indicate that the intron 2 T/C polymorphism of CYP46 gene (neither alone, nor together with the ɛ4 allele) does not increase the susceptibility to late-onset sporadic AD in the Hungarian population.     

A risk-associated single nucleotide polymorphism of <Emphasis Type="Italic">SMAD7</Emphasis> is common to colorectal,gastric, and lung cancers in a Han Chinese population

SMAD7 has been demonstrated to antagonize TGF-β-mediated fibrosis, carcinogenesis, and inflammation. Two previous genome-wide association studies identified three single nucleotide polymorphisms (SNPs) (rs4939827, rs12953717 and rs4464148) in SMAD7 to be associated with colorectal cancer in a Western population. We conducted the first case–control study in a Han Chinese population to explore the associations between these three SNPs and colorectal, gastric, and lung cancers. Of the three SNPs, only rs12953717 was strongly associated with the three types of cancer, fitting the overdominant model. Compared with the CC/TT (CC combined with TT) genotype, the adjusted odds ratios for the CT genotype were 2.002 (95% CI, 1.250–3.207, P = 0.004), 1.678 (95% CI, 1.048–2.689, P = 0.031), 3.825 (95% CI, 2.310–6.335, P < 1 × 10⁻⁴), and 2.294 (95% CI, 1.537–3.343, P < 1 × 10⁻⁴), respectively, for colorectal, gastric, lung, and combined cancers. These outcomes suggest that rs12953717 is a common risk marker of these three types of cancer in the Han Chinese.     

Varied association of prothrombin G20210A polymorphism with coronary artery disease susceptibility in different ethnic groups: evidence from 15,041 cases and 21,507 controls

Published data on the association between prothrombin G20210A polymorphism and coronary artery disease (CAD) risk are inconclusive. To derive a more precise estimation of the relationship, a meta-analysis was performed. A total of 42 case–control studies including 15,041 cases and 21,507 controls were included in this meta-analysis. Overall, significantly elevated CAD risk was associated with prothrombin G20210A polymorphism (OR, 1.22; 95% CI 1.07–1.40; P = 0.003) when 39 eligible studies were pooled into the meta-analysis. In the subgroup analysis, borderline statistically increased risk was found for myocardial infarction in 22 case–control studies (OR, 1.27; 95% CI 1.00–1.61; P = 0.05). When stratified by ethnicity, significantly elevated risk was found in Europeans (OR, 1.19; 95% CI, 1.02–1.38; P = 0.02). However, no statistical differences were found among Americans and Asians. In summary, this meta-analysis indicated that prothrombin G20210A allele is a low-penetrant risk factor for developing CAD in Europeans.     

Lack of association between <Emphasis Type="Italic">MDR1</Emphasis> C3435T polymorphism and chemotherapy response in advanced breast cancer patients: evidence from current studies

The transmembrane transport of anticancer drugs is mainly regulated by P-glycoprotein encoded by the human multidrug resistance gene 1 gene (MDR1). Since there were controversies regarding the association between MDR1 C3435T polymorphism and response to chemotherapy among patients with advanced breast cancer, a meta-analysis of the link was conducted. A total of 7 studies consist of 464 advanced breast cancer patients relating MDR1 C3435T polymorphism to the response of chemotherapy were included in this meta-analysis. The main analysis revealed a lack of association between the MDR1 C3435T and response to chemotherapy, with odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) of 1.37 (95% CI: 0.78–2.40), 1.17 (95% CI: 0.69–2.01), 1.18 (95% CI: 0.76–1.84) and 1.61 (95% CI: 0.70–3.68) for homozygous comparison, heterozygous comparison, dominant model and recessive model, respectively. The subgroup analysis by ethnicity did not change the pattern of results, with ORs of 0.99 (95% CI: 0.11–9.07), 0.68 (95% CI: 0.29–1.60), 0.81 (95% CI: 0.36–1.85) and 1.51 (95% CI: 0.77–2.96), in homozygous comparison, heterozygous comparison, dominant model and recessive model, respectively in Caucasian, and 1.50 (95% CI: 0.75–3.03), 1.72 (95% CI: 0.85–3.47), 1.59 (95% CI: 0.90–2.80) and 2.29 (95% CI: 0.51–10.35), respectively in Asian. The available evidence indicates that MDR1 C3435T polymorphism cannot be considered as a reliable predictor of response to chemotherapy in patients with advanced breast cancer.