| 1. |
- Nowak, Jan Krzysztof, et al.
(författare)
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Age, Inflammation, and Disease Location Are Critical Determinants of Intestinal Expression of SARS-CoV-2 Receptor ACE2 and TMPRSS2 in Inflammatory Bowel Disease
- 2020
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Ingår i: Gastroenterology. - : American Gastroenterology Association Institute. - 0016-5085 .- 1528-0012. ; 159:3, s. 1151-1154
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Although the respiratory tract is implicated as the primary portal of entry of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), gastrointestinal involvement is well-reported, associated with nausea, vomiting, diarrhea, and highly persistent viral particle shedding in feces.(1,2)There is critical need to establish factors determining susceptibility to Coronavirus Disease 2019 (COVID-19) in patients with inflammatory bowel disease (IBD). Age, comorbidity, disease activity, and exposure to immunomodulatory and biological therapies provide the basis for new guidelines for risk stratification and shielding.(3)We hypothesize that expression levels of the SARS-CoV-2 spike protein receptor, angiotensin-converting enzyme 2 (ACE2),(4) may also determine susceptibility to SARS-CoV-2-inflicted damage. Transmembrane serine protease 2 (TMPRSS2) primes the viral spike protein,(5) allowing for the potent binding of ACE2. Both are known to be highly expressed in healthy ileal epithelium, with lower levels in epithelial cells in the colon. We report dysregulated mucosal ACE2 and TMPRSS2 expression in the colon and ileum in IBD, and identify the critical determinants of altered expression.
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| 2. |
- Vatn, Simen Svendsen, et al.
(författare)
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Mucosal Gene Transcript Signatures in Treatment Naïve Inflammatory Bowel Disease : A Comparative Analysis of Disease to Symptomatic and Healthy Controls in the European IBD-Character Cohort
- 2022
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Ingår i: Clinical and Experimental Gastroenterology. - : Dove Medical Press Ltd.. - 1178-7023. ; 15, s. 5-25
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies of the mucosal transcriptomic landscape have given new insight into the pathogenesis of inflammatory bowel disease (IBD). Recently, the predictive biomarker potential of gene expression signatures has been explored. To further investigate the mucosal gene expression in IBD, we recruited a cohort of treatment naïve patients and compared them to both symptomatic and healthy controls.Methods: Altogether, 323 subjects were included: Crohn's disease (N = 75), ulcerative colitis (N = 87) and IBD unclassified (N = 3). Additionally, there were two control groups: symptomatic controls (N = 131) and healthy controls (N = 27). Mucosal biopsies were collected during ileocolonoscopy and gene expression in inflamed and non-inflamed mucosa was explored. Gene expression profiling was performed using Agilent G3 Human Gene Expression 860K v3 One-Color microarray. We recorded information about treatment escalation to anti-TNF agents or surgery, and anti-TNF response, to explore predictive opportunities of the mucosal transcriptome.Results: Gene expression profiles in symptomatic controls in whom IBD had been excluded resembled that of IBD patients and diverged from that of healthy controls. In non-inflamed Crohn's disease and ulcerative colitis, gene set enrichment analysis revealed dysregulation of pathways involved in basic cellular biological processes. Mitochondria-associated pathways were dysregulated both in non-inflamed and inflamed Crohn's disease and ulcerative colitis (>2.6 normalized enrichment scores <-1.8). Gene expression signatures of Crohn's disease and ulcerative colitis did not predict time for treatment escalation (p = 0.175). No significant association was found between gene expression signatures and anti-TNF response.Conclusion: Non-inflamed samples are probably superior to inflamed samples when exploring gene expression signatures in IBD and might reveal underlying mechanisms central for disease initiation. The gene expression signatures of the control groups were related to if they were symptomatic or not, which may have important implications for future study designs.
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| 3. |
- Egeland, Karina Myhren, et al.
(författare)
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How to implement Illness Management and Recovery (IMR) in mental health service settings : evaluation of the implementation strategy
- 2017
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Ingår i: International Journal of Mental Health Systems. - : BIOMED CENTRAL LTD. - 1752-4458. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: The purpose of this study was to evaluate the implementation strategy used in the first-phase of implementation of the Illness Management and Recovery (IMR) programme, an intervention for adults with severe mental illnesses, in nine mental health service settings in Norway. Methods: A total of 9 clinical leaders, 31 clinicians, and 44 consumers at 9 service settings participated in the implementation of IMR. Implementation was conducted by an external team of researchers and an experienced trainer. Data were gathered on fidelity to the intervention and implementation strategy, feasibility, and consumer outcomes. Results: Although the majority of clinicians scored within the acceptable range of high intervention fidelity, their participation in the implementation strategy appeared to moderate anticipated future use of IMR. No service settings reached high intervention fidelity scores for organizational quality improvement after 12 months of implementation. IMR implementation seemed feasible, albeit with some challenges. Consumer outcomes indicated significant improvements in illness self-management, severity of problems, functioning, and hope. There were nonsignificant positive changes in symptoms and quality of life. Conclusions: The implementation strategy appeared adequate to build clinician competence over time, enabling clinicians to provide treatment that increased functioning and hope for consumers. Additional efficient strategies should be incorporated to facilitate organizational change and thus secure the sustainability of the implemented practice.
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| 4. |
- Holmøy, Trygve, et al.
(författare)
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Vitamin D supplementation and neurofilament light chain in multiple sclerosis.
- 2019
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 139:2, s. 172-176
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Tidskriftsartikel (refereegranskat)abstract
- The effect of vitamin D supplementation on the disease course of multiple sclerosis (MS) is not established. Neurofilament light chain (NFL) is a sensitive marker of axonal degeneration. The aim of this study was to establish whether high-dose vitamin D supplementation reduces serum levels of NFL.We have performed a 96weeks placebo-controlled randomized study of weekly supplementation with 20000IU vitamin D3 in 71 patients with relapsing remitting MS (RRMS). Serum levels of NFL were measured at baseline, week 48 and week 96 with a single molecule (Simoa) assay in 69 of these patients.Serum levels of 25-hydroxyvitamin D more than doubled in the vitamin D group. Compared to placebo, vitamin D supplementation had no overall effect on the change in serum levels of NFL from baseline (P=0.93 at week 48 and P=0.56 at week 96). In the subgroup of patients not receiving disease-modifying therapy, NFL decreased by 30.9% to week 48% and 32.6% to week 96 from baseline in the vitamin D group as compared to the placebo group (P=0.06 for both time points).With a possible exception for patients not treated with disease-modifying drugs, weekly supplementation with 20000IU vitamin D3 did not affect NFL levels in these RRMS patients.
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| 5. |
- Tveter Deilkas, Ellen, et al.
(författare)
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Exploring similarities and differences in hospital adverse event rates between Norway and Sweden using Global Trigger Tool
- 2017
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Ingår i: BMJ Open. - : BMJ PUBLISHING GROUP. - 2044-6055. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: In this paper, we explore similarities and differences in hospital adverse event (AE) rates between Norway and Sweden by reviewing medical records with the Global Trigger Tool (GTT). Design: All acute care hospitals in both countries performed medical record reviews, except one in Norway. Records were randomly selected from all eligible admissions in 2013. Eligible admissions were patients 18 years of age or older, undergoing care with an in-hospital stay of at least 24 hours, excluding psychiatric and care and rehabilitation. Reviews were done according to GTT methodology. Setting: Similar contexts for healthcare and similar socioeconomic and demographic characteristics have inspired the Nordic countries to exchange experiences from measuring and monitoring quality and patient safety in healthcare. The co-operation has promoted the use of GTT to monitor national and local rates of AEs in hospital care. Participants: 10 986 medical records were reviewed in Norway and 19 141 medical records in Sweden. Results: No significant difference between overall AE rates was found between the two countries. The rate was 13.0% (95% CI 11.7% to 14.3%) in Norway and 14.4% ( 95% CI 12.6% to 16.3%) in Sweden. There were significantly higher AE rates of surgical complications in Norwegian hospitals compared with Swedish hospitals. Swedish hospitals had significantly higher rates of pressure ulcers, falls and other AEs. Among more severe AEs, Norwegian hospitals had significantly higher rates of surgical complications than Swedish hospitals. Swedish hospitals had significantly higher rates of postpartum AEs. Conclusions: The level of patient safety in acute care hospitals, as assessed by GTT, was essentially the same in both countries. The differences between the countries in the rates of several types of AEs provide new incentives for Norwegian and Swedish governing bodies to address patient safety issues.
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