| 1. |
- Olofsson, Peder S., et al.
(author)
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Blood pressure regulation by CD4+ lymphocytes expressing choline acetyltransferase
- 2016
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In: Nature Biotechnology. - : Nature Publishing Group. - 1087-0156 .- 1546-1696. ; 34:10, s. 1066-1071
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Journal article (peer-reviewed)abstract
- Blood pressure regulation is known to be maintained by a neuro-endocrine circuit, but whether immune cells contribute to blood pressure homeostasis has not been determined. We previously showed that CD4(+) T lymphocytes that express choline acetyltransferase (ChAT), which catalyzes the synthesis of the vasorelaxant acetylcholine, relay neural signals(1). Here we show that these CD4(+)CD44(hi)CD62L(Io) T helper cells by gene expression are a distinct T-cell population defined by ChAT (CD4 T-ChAT). Mice lacking ChAT expression in CD4(+) cells have elevated arterial blood pressure, compared to littermate controls. Jurkat T cells overexpressing ChAT (JT(ChAT)) decreased blood pressure when infused into mice. Co-incubation of JT(ChAT) and endothelial cells increased endothelial cell levels of phosphorylated endothelial nitric oxide synthase, and of nitrates and nitrites in conditioned media, indicating increased release of the potent vasorelaxant nitric oxide. The isolation and characterization of CD4 T-ChAT cells will enable analysis of the role of these cells in hypotension and hypertension, and may suggest novel therapeutic strategies by targeting cell-mediated vasorelaxation.
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| 2. |
- Holm, E., et al.
(author)
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Bleeding-related hospitalization in patients with von Willebrand disease and the impact of prophylaxis : Results from national registers in Sweden compared with normal controls and participants in the von Willebrand Disease Prophylaxis Network
- 2018
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In: Haemophilia. - : Wiley. - 1351-8216. ; 24:4, s. 628-633
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Journal article (peer-reviewed)abstract
- Introduction: Patients suffering from von Willebrand disease (VWD) have a variety of bleeding symptoms and require both outpatient care for treatment and, in more severe cases, hospitalization. Aim: To investigate the impact of having VWD on frequency of hospitalization compared to a control group and to evaluate whether regular replacement therapy (prophylaxis) is associated with reduction in the number of hospitalizations. Methods: Linkage of national population-based registries was used in the Congenital Bleeding Disorders study in Sweden (CBDS). Data were from the von Willebrand Disease Prophylaxis Network (VWD PN). Results: The national registries contained 2790 subjects with a diagnosis of VWD between 1987 and 2009. A total of 13 920 age- and gender-matched controls were identified. There were 2.0 times (range 1.5-2.5) as many inpatient hospitalizations among subjects with VWD compared to controls. The most common causes of hospitalization were gastrointestinal (GI) bleeding (n = 232 as primary diagnosis), menorrhagia (n = 198) and epistaxis (n = 192). Outpatient visits per year were also twice as common among those with VWD. From the VWD PN, 105 subjects were included (VWD type 3, 52.4%; type2A, 22.9%; type 1, 12.4% and other types, 3.9%). A total of 122 hospitalizations due to bleeding episodes, dominated by GI bleeds, were analysed. Significantly fewer hospitalizations occurred after initiation of prophylaxis (75 prior to and 45 after, P = .006). Conclusion: Our study indicates that subjects with VWD have a considerably higher consumption of healthcare resources compared to controls and that initiation of prophylaxis may reduce the number of hospitalizations due to bleeding.
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| 3. |
- Ljungkvist, M., et al.
(author)
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Low agreement between fresh and frozen-thawed platelet-rich plasma in the calibrated automated thrombogram assay
- 2017
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In: Haemophilia. - : Wiley. - 1351-8216. ; 23:3, s. 214-218
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Journal article (peer-reviewed)abstract
- Introduction: Thrombin generation tests (TGTs) are considered to give more detailed information of the overall coagulation capability of a patient than clotting-based routine assays. The TGT thrombin generation assay-calibrated automated thrombogram (TGA-CAT) uses both platelet-poor plasma (PPP) and platelet-rich plasma (PRP). Assessing PRP gives more physiological test conditions and is of great interest considering the important role platelets play in haemostasis. However, PRP needs to be assessed close after blood draw/preparation as freezing fragments the platelets. In several previous publications, the utility of frozen-thawed PRP (ft-PRP) has been promoted, and in one article, no significant difference between fresh PRP (f-PRP) and ft-PRP was reported. Aim: The aim of our study was to investigate the level of agreement between f-PRP and ft-PRP to further validate these results. Methods: Our test population contained 41 persons with haemophilia and 45 healthy subjects. We used the TGA-CAT method with a set-up according to the manufacturer of the method. Results: The measurements showed a poor level of agreement between f-PRP and ft-PRP and differences were not systematic. Conclusion: Fresh and ft-PRP cannot be assumed to show equal results in the TGA-CAT assay.
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| 4. |
- Lövdahl, Jenny, et al.
(author)
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Randomised clinical trial: individual versus group hypnotherapy for irritable bowel syndrome
- 2022
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In: Alimentary Pharmacology and Therapeutics. - : Wiley. - 0269-2813 .- 1365-2036. ; 55:12, s. 1501-1511
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Journal article (peer-reviewed)abstract
- Background: Gut-directed hypnotherapy improves symptoms for patients with irritable bowel syndrome (IBS). Group hypnotherapy, as well as hypnotherapy administered by nurses, can increase treatment availability, but there are few comparisons between individual and group-based hypnotherapy. Aim: We aimed to evaluate and compare the effectiveness of nurse-administered hypnotherapy for IBS delivered individually or in groups. Methods: IBS patients were randomised to individual or group hypnotherapy (8 sessions, 12 weeks). The primary endpoint was changes in severity of IBS symptoms. A responder was defined as reduction of IBS severity scoring system (IBS-SSS) ≥50 points at the end of treatment compared to baseline. The effects on extracolonic and psychological symptoms, and quality of life were also assessed. Symptoms were also followed up 6months after treatment start. Results: A total of 119 patients were randomised (61 individual, 58 group hypnotherapy). Patients reported improvements in IBS symptoms (IBS-SSS) (individual: 332 (273–401) (median, IQR), versus 216 (140–308), (p < 0.0001), group: 315 (239–382), versus 217 (149–314), (p < 0.0001)), with no differences between the groups (p=0.16). Extracolonic symptoms, psychological symptoms and quality of life also improved, without clear differences between the groups. Sixty-nine percent of the individual hypnotherapy patients were responders after treatment versus 57% of the group hypnotherapy patients (p=0.25). Symptom improvements were also seen at follow-up. Conclusions: Nurse-administered gut-directed hypnotherapy, delivered individually or in groups, relieves IBS symptoms, improves psychological symptoms and quality of life. Group hypnotherapy can be an efficacious alternative, enabling more patients to benefit from the treatment (ClinicalTrials.gov ID no of study: NCT03432078).
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| 5. |
- Osooli, M, et al.
(author)
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Comparative burden of arthropathy in mild haemophilia : a register-based study in Sweden
- 2017
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In: Haemophilia. - : Wiley. - 1351-8216. ; 23:2, s. E79-E86
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Mild haemophilia is a congenital bleeding disorder affecting males. The burden of arthropathy in mild haemophilia has not been comprehensively described.AIM: The aim of this study was to compare the incidence, age at diagnosis and surgery for arthropathy and related hospitalizations between people with mild haemophilia and the general population in Sweden.METHODS: This was a register-based cohort study. Eligible participants were those with mild haemophilia born between 1941 and 2008 and a randomly selected, birthdate and sex-matched comparison group from the general population. Follow-up was from birth (or earliest 1984) until death, emigration or end of the study in 2008. Data on arthropathy were obtained from a national patient register. Negative binomial and competing risk regression and Kaplan-Meier estimate curves were used in the analysis.RESULTS: Overall, 315 people with haemophilia and 1529 people in the comparison group were included. Participants with haemophilia born between 1984 and 2008 had a ninefold (95% CI: 3.3-27.2) and 16-fold (95% CI: 6.7-36.5) increased incidence of arthropathy-related hospital admission and arthropathy diagnosis respectively. None in this cohort underwent surgery. Among participants with haemophilia born prior to 1984, the rates of arthropathy diagnosis and surgery of the index joints (knee, elbow, ankle) were increased twofold (95% CI: 1.0-3.2) and fivefold (95% CI: 1.7-17.8) respectively.CONCLUSION: Our data suggested a higher burden of arthropathy among individuals with mild haemophilia compared to the general population. Further research should investigate the need for targeted joint screening programmes among individuals with mild haemophilia.
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