| 1. |
- Amare, Azmeraw, et al.
(författare)
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Association of Polygenic Score and the involvement of Cholinergic and Glutamatergic Pathways with Lithium Treatment Response in Patients with Bipolar Disorder.
- 2023
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Ingår i: Research square. - : Research Square Platform LLC.
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Tidskriftsartikel (refereegranskat)abstract
- Lithium is regarded as the first-line treatment for bipolar disorder (BD), a severe and disabling mental disorder that affects about 1% of the population worldwide. Nevertheless, lithium is not consistently effective, with only 30% of patients showing a favorable response to treatment. To provide personalized treatment options for bipolar patients, it is essential to identify prediction biomarkers such as polygenic scores. In this study, we developed a polygenic score for lithium treatment response (Li+PGS) in patients with BD. To gain further insights into lithium's possible molecular mechanism of action, we performed a genome-wide gene-based analysis. Using polygenic score modeling, via methods incorporating Bayesian regression and continuous shrinkage priors, Li+PGS was developed in the International Consortium of Lithium Genetics cohort (ConLi+Gen: N=2,367) and replicated in the combined PsyCourse (N=89) and BipoLife (N=102) studies. The associations of Li+PGS and lithium treatment response - defined in a continuous ALDA scale and a categorical outcome (good response vs. poor response) were tested using regression models, each adjusted for the covariates: age, sex, and the first four genetic principal components. Statistical significance was determined at P<����������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������.
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| 2. |
- Amare, Azmeraw T, et al.
(författare)
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Association of polygenic score and the involvement of cholinergic and glutamatergic pathways with lithium treatment response in patients with bipolar disorder.
- 2023
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Ingår i: Molecular psychiatry. - 1476-5578. ; 28, s. 5251-5261
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Tidskriftsartikel (refereegranskat)abstract
- Lithium is regarded as the first-line treatment for bipolar disorder (BD), a severe and disabling mental healthdisorder that affects about 1% of the population worldwide. Nevertheless, lithium is not consistently effective, with only 30% of patients showing a favorable response to treatment. To provide personalized treatment options for bipolar patients, it is essential to identify prediction biomarkers such as polygenic scores. In this study, we developed a polygenic score for lithium treatment response (Li+PGS) in patients with BD. To gain further insights into lithium's possible molecular mechanism of action, we performed a genome-wide gene-based analysis. Using polygenic score modeling, via methods incorporating Bayesian regression and continuous shrinkage priors, Li+PGS was developed in the International Consortium of Lithium Genetics cohort (ConLi+Gen: N=2367) and replicated in the combined PsyCourse (N=89) and BipoLife (N=102) studies. The associations of Li+PGS and lithium treatment response - defined in a continuous ALDA scale and a categorical outcome (good response vs. poor response) were tested using regression models, each adjusted for the covariates: age, sex, and the first four genetic principal components. Statistical significance was determined at P<0.05. Li+PGS was positively associated with lithium treatment response in the ConLi+Gen cohort, in both the categorical (P=9.8×10-12, R2=1.9%) and continuous (P=6.4×10-9, R2=2.6%) outcomes. Compared to bipolar patients in the 1st decile of the risk distribution, individuals in the 10th decile had 3.47-fold (95%CI: 2.22-5.47) higher odds of responding favorably to lithium. The results were replicated in the independent cohorts for the categorical treatment outcome (P=3.9×10-4, R2=0.9%), but not for the continuous outcome (P=0.13). Gene-based analyses revealed 36 candidate genes that are enriched in biological pathways controlled by glutamate and acetylcholine. Li+PGS may be useful in the development of pharmacogenomic testing strategies by enabling a classification of bipolar patients according to their response to treatment.
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| 3. |
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| 4. |
- Coombes, Brandon J, et al.
(författare)
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Association of Attention-Deficit/Hyperactivity Disorder and Depression Polygenic Scores with Lithium Response: A Consortium for Lithium Genetics Study.
- 2021
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Ingår i: Complex psychiatry. - : S. Karger AG. - 2673-3005 .- 2673-298X. ; 7:3-4, s. 80-89
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Tidskriftsartikel (refereegranskat)abstract
- Response to lithium varies widely between individuals with bipolar disorder (BD). Polygenic risk scores (PRSs) can uncover pharmacogenomics effects and may help predict drug response. Patients (N = 2,510) with BD were assessed for long-term lithium response in the Consortium on Lithium Genetics using the Retrospective Criteria of Long-Term Treatment Response in Research Subjects with Bipolar Disorder score. PRSs for attention-deficit/hyperactivity disorder (ADHD), major depressive disorder (MDD), and schizophrenia (SCZ) were computed using lassosum and in a model including all three PRSs and other covariates, and the PRS of ADHD (β = -0.14; 95% confidence interval [CI]: -0.24 to -0.03; p value = 0.010) and MDD (β = -0.16; 95% CI: -0.27 to -0.04; p value = 0.005) predicted worse quantitative lithium response. A higher SCZ PRS was associated with higher rates of medication nonadherence (OR = 1.61; 95% CI: 1.34-1.93; p value = 2e-7). This study indicates that genetic risk for ADHD and depression may influence lithium treatment response. Interestingly, a higher SCZ PRS was associated with poor adherence, which can negatively impact treatment response. Incorporating genetic risk of ADHD, depression, and SCZ in combination with clinical risk may lead to better clinical care for patients with BD.
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| 5. |
- Herrera-Rivero, Marisol, et al.
(författare)
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Exploring the genetics of lithium response in bipolar disorders.
- 2023
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Ingår i: Research square.
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Lithium (Li) remains the treatment of choice for bipolar disorders (BP). Its mood-stabilizing effects help reduce the long-term burden of mania, depression and suicide risk in patients with BP. It also has been shown to have beneficial effects on disease-associated conditions, including sleep and cardiovascular disorders. However, the individual responses to Li treatment vary within and between diagnostic subtypes of BP (e.g. BP-I and BP-II) according to the clinical presentation. Moreover, long-term Li treatment has been linked to adverse side-effects that are a cause of concern and non-adherence, including the risk of developing chronic medical conditions such as thyroid and renal disease. In recent years, studies by the Consortium on Lithium Genetics (ConLiGen) have uncovered a number of genetic factors that contribute to the variability in Li treatment response in patients with BP. Here, we leveraged the ConLiGen cohort (N=2,064) to investigate the genetic basis of Li effects in BP. For this, we studied how Li response and linked genes associate with the psychiatric symptoms and polygenic load for medical comorbidities, placing particular emphasis on identifying differences between BP-I and BP-II.We found that clinical response to Li treatment, measured with the Alda scale, was associated with a diminished burden of mania, depression, substance and alcohol abuse, psychosis and suicidal ideation in patients with BP-I and, in patients with BP-II, of depression only. Our genetic analyses showed that a stronger clinical response to Li was modestly related to lower polygenic load for diabetes and hypertension in BP-I but not BP-II. Moreover, our results suggested that a number of genes that have been previously linked to Li response variability in BP differentially relate to the psychiatric symptomatology, particularly to the numbers of manic and depressive episodes, and to the polygenic load for comorbid conditions, including diabetes, hypertension and hypothyroidism.Taken together, our findings suggest that the effects of Li on symptomatology and comorbidity in BP are partially modulated by common genetic factors, with differential effects between BP-I and BP-II.
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| 6. |
- Herrera-Rivero, Marisol, et al.
(författare)
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Immunogenetics of lithium response and psychiatric phenotypes in patients with bipolar disorder.
- 2023
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Ingår i: Research square.
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The link between bipolar disorder (BP) and immune dysfunction remains controversial. While epidemiological studies have long suggested an association, recent research has found only limited evidence of such a relationship. To clarify this, we investigated the contributions of immune-relevant genetic factors to the response to lithium (Li) treatment and the clinical presentation of BP. First, we assessed the association of a large collection of immune-related genes (4,925) with Li response, defined by the Retrospective Assessment of the Lithium Response Phenotype Scale (Alda scale), and clinical characteristics in patients with BP from the International Consortium on Lithium Genetics (ConLi+Gen, N = 2,374). Second, we calculated here previously published polygenic scores (PGSs) for immune-related traits and evaluated their associations with Li response and clinical features. We found several genes associated with Li response at p < 1×10- 4 values, including HAS3, CNTNAP5 and NFIB. Network and functional enrichment analyses uncovered an overrepresentation of pathways involved in cell adhesion and intercellular communication, which appear to converge on the well-known Li-induced inhibition of GSK-3β. We also found various genes associated with BP's age-at-onset, number of mood episodes, and presence of psychosis, substance abuse and/or suicidal ideation at the exploratory threshold. These included RTN4, XKR4, NRXN1, NRG1/3 and GRK5. Additionally, PGS analyses suggested serum FAS, ECP, TRANCE and cytokine ligands, amongst others, might represent potential circulating biomarkers of Li response and clinical presentation. Taken together, our results support the notion of a relatively weak association between immunity and clinically relevant features of BP at the genetic level.
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| 7. |
- Holmberg, Anna, et al.
(författare)
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General somatic health and lifestyle habits in individuals with obsessive- compulsive disorder : an international survey
- 2024
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Ingår i: BMC Psychiatry. - 1471-244X. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Obsessive-compulsive disorder (OCD) has been associated with a broad range of health-related issues. Unhealthy lifestyle habits such as physical inactivity, an unhealthy diet, smoking, and alcohol consumption are hypothesized to contribute to this association. However, the lifestyle habits of individuals with OCD have been scarcely investigated. In this international survey, we explored the physical health and lifestyle habits of adults with a self-reported diagnosis of OCD. Methods: An online global survey available in seven languages was disseminated through interest organizations and social media between July 2021 and March 2022. The survey included questions relating to socio-demographic variables and clinical characteristics (including OCD symptom severity – as measured with the 12-item self-report scale Obsessive-Compulsive Inventory [OCI-12] – and psychotropic medication), physical health, and lifestyle habits. Frequencies and percentages, or means and standard deviations, as appropriate, were calculated. Subgroup analyses by OCD symptom severity, gender, and age group were performed. Results: A total of 496 individuals with OCD completed the survey and were included in the analyses (mean age = 36.0 years, SD = 12.5, range 18–79; 78.8% women). Most participants were from Europe (n = 245, 49.4%) and North America (n = 187, 37.7%). OCD symptom severity scores were on the moderate range (OCI-12 mean score = 21.2, SD = 9.1). A majority (n = 354, 71.4%) reported having comorbid somatic health issues, mainly allergies, gastrointestinal conditions, and cardiometabolic conditions. Nearly half of the sample (n = 236, 47.6%) reported a body mass index ≥ 25, corresponding to at least overweight. A significant proportion of the participants reported low physical activity (n = 271, 55.0%), unhealthy dietary habits (n = 182, 36.7%), risk consumption of alcohol (n = 111, 22.3%), and non-restorative sleep (n = 268, 54.0%). Subgroup analyses showed overall similar results across groups, with some exceptions. Conclusions: In this sample, individuals with OCD self-reported a range of health-related issues and a number of unhealthy lifestyle behaviors, most prominently a lack of physical activity. Interventions aimed at modifying unhealthy lifestyles to prevent or improve health conditions beyond the psychiatric symptoms should be considered.
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| 8. |
- Hällström, Lina P.B., et al.
(författare)
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The geochemical behaviour of Be and F in historical mine tailings of Yxsjöberg, Sweden
- 2020
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Ingår i: Journal of Geochemical Exploration. - : Elsevier. - 0375-6742 .- 1879-1689. ; 218
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Tidskriftsartikel (refereegranskat)abstract
- The speciation, mobility, transport, and fate of beryllium (Be) in the terrestrial environment is poorly studied even though it is considered to be one of the most hazardous elements in the periodic table. Historical tailings containing the unusual mineral danalite [Be3(Fe4.4Mn0.95Zn0.4)(SiO4)3.2S1.4] together with Fe-sulfides and fluorite has been stored open to the atmosphere for more than 50y. Environmental mineralogy, which combines geochemical and mineralogical techniques, was used to elucidate the weathering of danalite and fluorite. Danalite is unstable in oxic conditions due to the occurrence of Fe(II) and S-(II) in the crystal lattice and has oxidized at the same pace as pyrrhotite in the tailings. The acidic conditions generated from sulfide oxidation and the release of F from fluorite weathering have most likely enhanced Be mobility in the tailings. Secondary gypsum, hydrous ferric oxides and Al-oxyhydroxides are hypothesized to have played an important role regarding the mobility of Be in the tailings. The results indicate that Be released from danalite was first scavenged by these secondary minerals through co-precipitation. However, the dissolution of secondary gypsum due to changing geochemical conditions has also released Be to the groundwater. The groundwater at the shore of the tailings revealed the highest Be concentrations measured anywhere in the world (average: 4.5 mg/L) even though the water has a circumneutral pH. This extraordinary finding can be explained by high concentrations of F (73 mg/L), as F and Be have been shown to form strong complexes. The weathering of danalite and fluorite will continue for hundreds of years if remediation measures are not taken. Re-mining the tailings could be an appropriate remediation method.
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| 9. |
- Hällström, Lina, et al.
(författare)
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Scheelite weathering and tungsten (W) mobility in historical oxidic-sulfidic skarn tailings at Yxsjöberg, Sweden
- 2020
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Ingår i: Environmental Science and Pollution Research. - : Springer. - 0944-1344 .- 1614-7499. ; 27:6, s. 6180-6192
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Tidskriftsartikel (refereegranskat)abstract
- More knowledge of the geochemical behavior of tungsten (W) and associated contamination risks is needed. Therefore, weathering of scheelite (CaWO4) and secondary sequestration and transport of W to groundwater in historical skarn tailings and surface water downstream of the tailings were studied. The tailings contained 920 mg/kg W, primarily in scheelite. Mineralogical and geochemical analyses were combined to elucidate the geochemical behavior of W in the tailings, and water samples were taken monthly during 2018 to monitor its mobility. In the tailings, a large peak of W was found at 1.5 m depth. There, 30 wt%. of W was present in easily reducible phases, indicating former scheelite weathering. Currently, W is being released from scheelite to water-soluble phases at 2.5 m depth. The release of WO42− is hypothetically attributed to anion exchange with CO32− released from calcite neutralizing acid produced from pyrrhotite oxidation in the upper tailings and transported downwards to pH conditions > 7. Higher concentrations of dissolved W were found in the groundwater and particulate W in downstream surface water than in reference water, but they were lower than current contamination thresholds. Tungsten showed correlations with hydrous ferric oxides (HFO) in both the tailings and surface water.
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| 10. |
- Hällström, Lina
(författare)
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Source, mobility and fate of critical Be, Bi, F and W from historical sulfidic-oxidic skarn tailings : Re-mining as remediation method?
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is a potential risk that geochemical cycles of several critical metals will be affected in the pristine environment, when mining of these metals increases to meet the demand in green technology. The identification of critical metals is based on the economic importance and vulnerability to supply restrictions. In the past, naturally low concentrations in the environment, and instrumental analysis with higher detection limits, has limited research regarding several of these critical metals. However, to understand their geochemical behavior and potential environmental impact are of high importance to ensure a responsible development of mine waste- and water management. Skarn ores can contain high amounts of Fe-sulfides, carbonates and fluorite, together with enriched concentrations of critical metals such as Be, Bi and W. Nevertheless, little attention has been paid to mine drainage from skarn tailings and their environmental impact, compared to tailings from sulfidic deposits. At Yxsjö mine site, Sweden, skarn tailings enriched in the major elements C, F, S (1.0, 1.9 and 1.2 wt.%.) and Be, Bi, and W (average 280, 500 and 960 ppm, respectively) were deposited in Smaltjärnen repository (1918-1963). The tailings were stored in ambient conditions until 1993 when the tailings were covered by sewage sludge. In-between 1969-1989, tailings were discharged into Morkulltjärnen repository, which was covered with sewage sludge and partly water saturated directly after closure. This thesis focuses on the Smaltjärnen tailings. The element distribution in the tailings were identified by combining 1) total concentrations of nine targeted minerals from rock drilled cores, 2) total concentrations of 99 samples from four intact tailings cores, and 3) environmental mineralogy (EM) conducted on one of the cores. The environmental mineralogy included paste-pH, sequential extractions, optical microscopy, scanning electron microscopy (SEM) with energy dispersive X-ray spectroscopy (EDS), Raman vibrational spectroscopy and X-ray diffraction (XRD). Environmental mineralogy was also used to reveal geochemical processes affecting the mobility of elements in the tailings. Monthly water samples (May-October, 2018) were taken in three groundwater wells in the tailings, and at five surface water locations downstream the tailings. At three surface water locations, the diatom taxonomy response to the water quality was used to evaluate the impact on ecosystems. The quality of the mine drainage was compared to surface water downstream Morkulltjärnens repository and to a reference point. The overall results were used to evaluate the need for remediation, and particularly, the possibility to use re-mining as remediation method. The Smaltjärnen tailings contained 88 wt.%. of Ca-rich silicates accompanied by minerals such as calcite [CaCO3], fluorite [CaF2], monoclinic and hexagonal pyrrhotite [Fe1-xS)], danalite [Be3(Fe4.4Mn0.95Zn0.4)(SiO4)3.2S1.4], scheelite [CaWO4] and bismuthinite [Bi3S2] (average 5.7, 3.6, 2.4, 0.3, 0.1 wt.%. and 0.1 wt.%., respectively). Both pyrrhotite and danalite had oxidized in the upper parts of the tailings down to 2.5m depth, and calcite had partly neutralized the acid produced resulting in a pH decrease from 8 to 4 in the upper parts of the tailings. Weathering of danalite was intensified by the more acidic conditions (pH<6), in which Be hydrolyzes. The lowered pH enabled dissolution of fluorite, resulting in severely high concentrations of F in the groundwater (average 73 mg/L) and surface water (average 1.6 mg/L). In the uppermost tailings, secondary gypsum [CaSO4], Al-complexes and hydrous ferric oxides (HFO) had formed. The geochemical behavior of Be was complex in the tailings and in surface water downstream the tailings. According to the sequential extraction, Be released from danalite in the upper most tailings were present in water soluble phases, as exchangeable phases and had co-precipitated with Al- and Fe-oxyhydroxides. A strong correlation between Be, Ca and S in water soluble phases and in the surface water downstream the tailings indicated that Be partly substituted for Ca in secondary gypsum. In two groundwater wells, secondary precipitates of a white sludge containing Be, Al, F and Zn were found, indicating that Be was partly removed from the groundwater by Al-complexes. In the third groundwater well, the globally highest dissolved concentrations of Be were measured (average 4.5 mg/L), and in the surface water the concentrations (average 41 µg/L) were well above thresholds values for aquatic organisms (1 µg/L). In these pH-conditions (average 5.7-6.5) and oxygenated waters, Be is expected to precipitate as Be(OH)2 if complexing ligands are absent. A strong correlation between dissolved Be and F was found in the surface water, indicating that Be-fluorocomplexes had formed. Bismuth and W have previously been considered as relatively immobile elements. However, the results showed that both Bi and W had partly been mobilized from their primary minerals (bismuthinite and scheelite) in the tailings. Weathered bismuthinite and scheelite grains with rims of goethite and water soluble phases of Bi and W were found in the deeper tailings with pH>7. The release of WO42- was hypothetically attributed to anion exchange with CO32- on surfaces of scheelite. Because, at the same depth where W was mobilized, solid C was accumulated and secondary orthogonal calcite was frequently detected with Raman spectroscopy. Bismuth was scavenged in the tailings by exchangeable phases and co-precipitation with HFO in the upper-most tailings. In the groundwater, Bi was just above the detection limit in all groundwater wells, while W was found in elevated concentrations. In the surface water, Bi and W were transported in the particulate phase together with Fe, and settled in the sediments a few 100 meters from the tailings outlet. Surface water downstream Morkulltjärnen had a near-neutral pH (average 6.6) and of all elements analyzed, only dissolved W (average 1.1 µg/L) were high compared to threshold values (0.8 µg/L) and the reference sample. Dissolved Be, Ca, F and S from Smaltjärnen, and dissolved W from Morkulltjärnen were found in elevated concentrations more than 2 km from the mine site. Along this distance, metal tolerant diatom species (Achnanthidium minutissimum group II and Brachysira neoexilis, respectively) were dominant (>50%), indicating a negative impact on ecosystems. The mine drainage from Smaltjärnen had a larger negative impact on the diatom taxonomy with higher abundance of metal tolerant species, lower richness and evenness, more than 1% of deformed valves and the taxonomy was affected by the lower pH, compared to diatoms downstream Morkulltjärnen repository. In conclusion, pyrrhotite oxidation was the direct or indirect cause of Be, Bi, F and W mobilization in the Smaltjärnen tailings, resulting in low quality mine drainage. The oxidation rate decrease with time, but weathering of the Smaltjärnen tailings is expected to be ongoing for hundreds of years since only a small part had weathered during the 50-100 years of storage. The low water quality and negative impact on diatoms, stress the need for remediation. Low concentrations of Be, Bi, Ca, F, Fe and S, accompanied by a near-neutral pH (average pH 6.6) downstream Morkulltjärnen, suggested that cover and water saturation could inhibit sulfide and danalite oxidation, and indirectly prevent fluorite weathering. However, high concentrations of dissolved W downstream Morkulltjärnen displayed that cover and water saturation can increase the mobility of W in the Smaltjärnen tailings, which needs to be taken into consideration. This thesis shows the importance of understanding the complex mineral and element matrix in skarn tailings before choosing remediation technique. Re-mining could be a beneficial remediation method since most W were found in intact scheelite grains. However, more research regarding the mineral processing and metallurgy is needed to ensure a sustainable extraction technique that separates sulfides, carbonates, danalite and fluorite, and deposits them in a proper way.
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