👤 Elizabeth B Claus

Cognitive impairment is common after transient ischemic attack (TIA) and stroke, but contemporary population-representative estimates of dementia risk after stroke are scarce, particularly in view of stroke severity and competing risk of mortality. We included individuals from the population-based Rotterdam Study with first-ever covert brain infarction (n=630), TIA (n=547), minor stroke (National Institutes of Health Stroke Scale score <4; n=392), or major stroke (National Institutes of Health Stroke Scale score ≥4; n=493) between 2002 and 2018, and matched those 1:3 to reference participants on age and sex. We determined 10-year dementia risks by event severity, comparing cause-specific and subdistribution hazards models to account for competing risk of death, and explored prognostic indicators of dementia after TIA and stroke. Of 1431 patients with first-ever TIA or stroke (mean age 75.2 years, 58.3% women), 161 had pre-event dementia and 205 developed dementia during a median follow-up of 6.1 years. After 10 years, 59.4% of patients had died, with highest risk in the first months after major stroke. Compared with reference participants, dementia risk was increased after minor (cause-specific hazard ratio [HR], 1.60 [95% CI, 1.21-2.12]) and major stroke (HR, 1.72 [95% CI, 1.29-2.30]), but not TIA (HR, 0.97 [95% CI, 0.76-1.23]). Among those with covert brain infarction, dementia risk was between that of TIA and minor stroke (HR, 1.34 [95% CI, 0.98-1.83]). Accounting for mortality, 10-year dementia risk ranged from 14% (95% CI, 12%-19%) after TIA to 21% (95% CI, 16%-25%) after minor stroke and 16% (95% CI, 12%-20%) after major stroke. These risks were substantially higher in the Kaplan-Meier-estimations for minor stroke (33%) and major stroke (40%). Prognostic indicators for dementia after TIA and stroke included higher age, less education, premorbid cognition, Dementia risk is elevated after stroke, and to a lesser extent covert brain infarction, but not after TIA. Excess risk extends to long-term follow-up for minor stroke, whereas competing risk of death attenuates risk after major stroke. Clinical and imaging indicators hold potential for personalized estimation of dementia risk. Show less

The Sprouty (SPRY) proteins are evolutionary conserved modulators of receptor tyrosine kinase (RTK) signaling. SPRY2 inhibits fibroblast growth factor (FGF) signaling, whereas it enhances epidermal growth factor (EGF) signaling through inhibition of EGF receptor (EGFR) endocytosis, ubiquitination, and degradation. In this study, we analyzed the effects of SPRY2 on endocytosis and degradation of FGF receptor 1 (FGFR1) using two human glioblastoma (GBM) cell lines with different endogenous SPRY2 levels. SPRY2 overexpression (SPRY2-OE) inhibited clathrin- and caveolae-mediated endocytosis of FGFR1, reduced the number of caveolin-1 vesicles and the uptake of transferrin. Furthermore, FGFR1 protein was decreased by SPRY2-OE, whereas EGFR protein was increased. SPRY2-OE enhanced FGFR1 degradation by increased c-casitas b-lineage lymphoma (c-CBL)-mediated ubiquitination, but it diminished binding of phospholipase Cγ1 (PLCγ1) to FGFR1. Consequently, SPRY2-OE inhibited FGF2-induced activation of PLCγ1, whereas it enhanced EGF-induced PLCγ1 activation. Despite the reduction of FGFR1 protein and the inhibition of FGF signaling, SPRY2-OE increased cell viability, and knockdown of SPRY2 enhanced the sensitivity to cisplatin. These results demonstrate that the inhibitory effect of SPRY2-OE on FGF signaling is at least in part due to the reduction in FGFR1 levels and the decreased binding of PLCγ1 to the receptor. Show less

Risk of tumors of the breast, ovary, and meninges has been associated with hormonal factors and with one another. Genome-wide association studies (GWAS) identified a meningioma risk locus on 10p12 near previous GWAS hits for breast and ovarian cancers, raising the possibility of genetic pleiotropy. We performed imputation-based fine-mapping in three case-control datasets of meningioma (927 cases, 790 controls), female breast cancer (28 108 cases, 22 209 controls), and ovarian cancer (25 509 cases, 40 941 controls). Analyses were stratified by sex (meningioma), estrogen receptor (ER) status (breast), and histotype (ovarian), then combined using subset-based meta-analysis in ASSET. Lead variants were assessed for association with additional traits in UK Biobank to identify potential effect-mediators. Two-sided subset-based meta-analysis identified rs7084454, an expression quantitative trait locus (eQTL) near the We identify a Show less

Genomic analyses of chronic lymphocytic leukemia (CLL) identified somatic mutations and associations of clonal diversity with adverse outcomes. Clonal evolution likely has therapeutic implications but its dynamic is less well studied. We studied clonal composition and prognostic value of seven recurrently mutated driver genes using targeted next-generation sequencing in 643 CLL patients and found higher frequencies of mutations in TP53 (35 vs. 12%, p < 0.001) and SF3B1 (20 vs. 11%, p < 0.05) and increased number of (sub)clonal (p < 0.0001) mutations in treated patients. We next performed an in-depth evaluation of clonal evolution on untreated CLL patients (50 "progressors" and 17 matched "non-progressors") using a 404 gene-sequencing panel and identified novel mutated genes such as AXIN1, SDHA, SUZ12, and FOXO3. Progressors carried more mutations at initial presentation (2.5 vs. 1, p < 0.0001). Mutations in specific genes were associated with increased (SF3B1, ATM, and FBXW7) or decreased progression risk (AXIN1 and MYD88). Mutations affecting specific signaling pathways, such as Notch and MAP kinase pathway were enriched in progressive relative to non-progressive patients. These data extend earlier findings that specific genomic alterations and diversity of subclones are associated with disease progression and persistence of disease in CLL and identify novel recurrently mutated genes and associated outcomes. Show less

The rapid expansion of Type 2 Diabetes (T2D), that currently affects 90% of people suffering from diabetes, urges us to develop a better understanding of the metabolic processes involved in the disease process in order to develop better therapies. The most commonly used model for T2D research is the db/db (BKS.Cg-Dock7 < m > +/+ Lepr < db >/J) mouse model. Yet, a systematic The aim of this study was to characterise the metabolic modulations associated with T2D in db/db mice in 18 relevant biological matrices. High-resolution 61 metabolites associated with T2D were identified. Kidney, spleen, eye and plasma were the biological matrices carrying the largest metabolomics modulations observed in established T2D, based on the total number of metabolites that showed a statistical difference between the diabetic and control group in each tissue (16 in each case) and the strength of the O-PLS DA model for each tissue. Glucose and glutamate were the most commonly associated metabolites found significantly increased in nine biological matrices. Investigated sections where no increase of glucose was associated with T2D include all intestinal segments (i.e. duodenum, jejunum, ileum and colon). Microbial co-metabolites such as acetate and butyrate, used as carbon sources by the host, were identified in excess in the colonic tissues of diabetic individuals. The metabolic biomarkers identified using Show less

Glioma is a rare, but highly fatal, cancer that accounts for the majority of malignant primary brain tumors. Inherited predisposition to glioma has been consistently observed within non-syndromic families. Our previous studies, which involved non-parametric and parametric linkage analyses, both yielded significant linkage peaks on chromosome 17q. Here, we use data from next generation and Sanger sequencing to identify familial glioma candidate genes and variants on chromosome 17q for further investigation. We applied a filtering schema to narrow the original list of 4830 annotated variants down to 21 very rare (<0.1% frequency), non-synonymous variants. Our findings implicate the MYO19 and KIF18B genes and rare variants in SPAG9 and RUNDC1 as candidates worthy of further investigation. Burden testing and functional studies are planned. Show less