30 results on '"Wedrén, Sara"'
Search Results
2. The National Prevalence of Clinically Diagnosed Psoriatic Arthritis in Sweden in 2017.
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Exarchou, Sofia, Wallman, Johan K., Giuseppe, Daniela Di, Klingberg, Eva, Sigurdardottir, Valgerdur, Wedrén, Sara, Lindström, Ulf, Turesson, Carl, Jacobsson, Lennart T. H., and Askling, Johan
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Objective. Psoriatic arthritis (PsA) prevalence estimates vary across studies; studies based on national data are few. We aimed to estimate the prevalence of clinically diagnosed PsA in Sweden in 2017, overall and stratified by sex, age, education, and geography, and to quantify disease-modifying antirheumatic drug (DMARD) use among those in contact with specialized rheumatology care between 2015 and 2017. Methods. Individuals who were 18 to 79 years of age, alive and residing in Sweden on December 31, 2017, and had a prior PsA diagnosis were identified from the National Patient Register (NPR) and/or the Swedish Rheumatology Quality Register (SRQ). PsA prevalence was estimated according to a base case (BC) definition (ie, ≥ 1 main PsA International Classification of Diseases code from rheumatology or internal medicine departments in the NPR or a PsA diagnosis in the SRQ), according to 4 sensitivity analysis definitions, and for those seen in specialized rheumatology care between 2015 and 2017. In the latter group, DMARD use during 2017 was also assessed. Data for stratifications were retrieved from national registers. Results. The crude national prevalence of PsA for adults, aged 18 to 79 years, was estimated at 0.39%, according to the BC definition; 0.34% after accounting for diagnostic misclassification; and 0.32% to 0.50% across all sensitivity analyses. The prevalence was lower in males and in those with a higher level of education. The prevalence for those seen in specialized rheumatology care between 2015 and 2017 was estimated at 0.24%. During 2017, 32% of patients in this population received biologic or targeted synthetic DMARDs, and 41% received conventional synthetic DMARDs only. Conclusion. The prevalence of clinically diagnosed PsA in adults, aged 18 to 79 years, in Sweden in 2017 was around 0.35%. Among PsA cases in recent contact with specialized rheumatology care, almost three-fourths received DMARD therapy in 2017. [ABSTRACT FROM AUTHOR]
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- 2023
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3. Remaining Pain in Early Rheumatoid Arthritis Patients Treated With Methotrexate.
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Altawil, Reem, Saevarsdottir, Saedis, Wedrén, Sara, Alfredsson, Lars, Klareskog, Lars, Lampa, Jon, and Wedrén, Sara
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METHOTREXATE ,ANTIRHEUMATIC agents ,PAIN ,QUESTIONNAIRES ,RHEUMATOID arthritis ,PAIN measurement ,TREATMENT effectiveness ,CASE-control method ,ODDS ratio ,DISEASE complications - Abstract
Objective: To investigate the frequency of remaining pain in early rheumatoid arthritis (RA) after 3 months of treatment with methotrexate as the only disease modifying antirheumatic drug, with a special focus on patients with a good clinical response.Methods: The study base was cases reported to a population-based early RA cohort who had followup data from the Swedish Rheumatology Quality Register (n = 1,241). The Disease Activity Score in 28 joints European League Against Rheumatism (EULAR) response criteria were used to evaluate clinical response to treatment as good, moderate, and no response. The primary end point was remaining pain at the 3-months followup visit, defined as pain >20 mm on a 100-mm visual analog scale (VAS).Results: Remaining pain in spite of a EULAR good response at followup was associated with higher baseline disability, using the Health Assessment Questionnaire (adjusted odds ratio [OR] 2.2 [95% confidence interval (95% CI) 1.4-3.4] per unit increase), and less baseline inflammation, using the erythrocyte sedimentation rate (adjusted OR 0.81 [95% CI 0.70-0.93] per 10-mm increase). Similar associations were detected for remaining pain at followup in spite of low inflammatory activity, defined as a C-reactive protein level <10. Increase in VAS pain during the treatment period was observed in 19% of the whole cohort, with frequencies in the EULAR response groups of 9% (good response), 15% (moderate response), and 45% (no response).Conclusion: These results are in line with the hypothesis that a subgroup of early RA patients exhibits pain that is not inflammatory mediated, where alternative treatment strategies to traditional antiinflammatory medications need to be considered. [ABSTRACT FROM AUTHOR]- Published
- 2016
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4. Impact of extra-articular spondyloarthritis manifestations and comorbidities on drug retention of a first TNF-inhibitor in ankylosing spondylitis: a population-based nationwide study.
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Lindström, Ulf, Olofsson, Tor, Wedrén, Sara, Qirjazo, Ilia, and Askling, Johan
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- 2018
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5. Pathogenenic Variant in the COL2A1 Gene is Associated with Spondyloepiphyseal Dysplasia Type Stanescu.
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Hammarsjö, Anna, Nordgren, Ann, Lagerstedt‐Robinson, Kristina, Malmgren, Helena, Nilsson, Daniel, Wedrén, Sara, Nordenskjöld, Magnus, Nishimura, Gen, and Grigelioniene, Giedre
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- 2016
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6. Preterm and postterm birth in immigrant- and Swedish-born parents: a population register-based study.
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Khanolkar, Amal, Wedrén, Sara, Essén, Birgitta, Sparén, Pär, and Koupil, Ilona
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PREMATURE infants ,IMMIGRANT families ,MINORITIES ,LOGISTIC regression analysis ,IMMIGRANTS ,MATERNAL health - Abstract
Ethnic minorities/immigrant groups tend to have increased risk for preterm birth. Less is known about this risk in diverse immigrant groups, couples of mixed ethnic-origin and in relation to duration of residence. Data from the Swedish Medical Birth Register on 1,028,303 mothers who gave birth to 1,766,026 singleton live born infants (1982-2002), was linked to the Education and Total Population Registers. Immigrant parents were identified by country of birth. Risk of early preterm, late preterm and postterm birth was analyzed using multinomial logistic regression. Polish, Yugoslavian, Iranian, South Asian, East Asian and Sub-Saharan African parents, Swedish mothers who had children with non-Swedish fathers, and parents from two different immigrant groups had higher risk of early preterm birth [adjusted relative risk (RR) (95 % CI) 1.76 (1.24-2.50), 1.57 (1.31-1.87), 1.67 (1.30-2.14), 1.52 (1.07-2.16), 1.51 (1.08-2.10), 2.03 (1.32-3.12), 1.56 (1.45-1.67), and 1.55 (1.35-1.77) respectively] compared to Swedish-born parents. South Asian, Sub-Saharan African, and East Asian immigrants had a higher risk of late preterm birth compared to Swedish-born parents. North African and Middle Eastern, Somali, and Ethiopian/Eritrean groups had increased risk of postterm birth [adjusted RR 1.31 (1.16-1.47), 2.57 (2.31-2.86), 1.85 (1.67-2.04) respectively]. Adjustment for covariates did not substantially change associations. Immigrant mothers resident <3 years had higher risk for early preterm and postterm birth compared to residents >10 years [adjusted RR 1.46 (1.24-1.71) and 1.16 (1.11-1.23) respectively]. In addition to higher risk of preterm birth in select immigrant groups, some immigrant groups are also at higher risk of postterm birth. Shorter duration of residence is associated with higher risk of non-term deliveries. [ABSTRACT FROM AUTHOR]
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- 2015
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7. Patients with regular physical activity before onset of rheumatoid arthritis present with milder disease.
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Sandberg, Maria E. C., Wedrén, Sara, Klareskog, Lars, Lundberg, Ingrid E., Opava, Christina H., Alfredsson, Lars, and Saevarsdottir, Saedis
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Objectives Physical activity has been shown to decrease inflammatory markers; here we investigate the effect on the clinical presentation of rheumatoid arthritis (RA). Methods We used the cases from the populationbased EIRA study (N=617), followed in the Swedish Rheumatology Quality Register, calculating the odds of having above median level of 28-joint disease activity score (DAS28), physician assessment, pain (visualanalogue scale (VAS), VAS-pain) and activity limitation (health assessment questionnaire (HAQ)) at diagnosis, as an effect of physical activity 5 years before diagnosis, investigated both in categories and dichotomised. Results Dose--response relationships were seen for all measures; the higher the level of physical activity, the lower the likelihood of having outcome measure above median. Further, regular physical activity associated with 42% reduced odds of having DAS28 above median (OR=0.58 (95% CI 0.42 to 0.81)). Effects were similar for VAS-pain (OR=0.62 (95%CI 0.45 to 0.86)) and physician assessment (OR=0.67 (95%CI 0.47 to 0.95)) but not for HAQ. Statistically significant effects were also found both for the combined objective components and the combined subjective components of DAS28. Conclusions Physically active individuals seem to present with milder RA, which adds to the evidence of beneficial effects of physical activity on inflammatory diseases. The observation should be important for both health professionals and individuals seeking to reduce their risk. [ABSTRACT FROM AUTHOR]
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- 2014
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8. Association Between Life Events and Rheumatoid Arthritis: Results From a Population-Based Case-Control Study.
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Wesley, Annmarie, Bengtsson, Camilla, Skillgate, Eva, Saevarsdottir, Saedis, Theorell, Töres, Holmqvist, Marie, Klareskog, Lars, Alfredsson, Lars, and Wedrén, Sara
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- 2014
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9. Parity and the risk of developing rheumatoid arthritis: results from the Swedish Epidemiological Investigation of Rheumatoid Arthritis study.
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Orellana, Cecilia, Wedrén, Sara, Källberg, Henrik, Holmqvist, Marie, Karlson, Elizabeth W., Alfredsson, Lars, and Bengtsson, Camilla
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Objective To study the impact of parity history on the risk of antibodies to citrullinated peptide antigens (ACPA) positive and ACPA-negative rheumatoid arthritis (RA), in different age-groups. Method Data from a population-based case-control study of female incident RA cases were analysed (2035 cases and 2911 controls, aged 18-70 years ). Parity history was assessed through a questionnaire. Parous women were compared with nulliparous, by calculating odds ratios (ORs) with 95% confidence interval (CI). Results Parity was associated with an increased risk of ACPA-negative RA in women aged 18-44 years (OR=2.1, 95% CI 1.4 to 3.2), but not in those aged 45-70 years (OR=0.9, 95% CI 0.7 to 1.3). Among young women, an increased risk of ACPA-negative RA was found in those who gave birth during the year of symptom onset (OR=2.6, 95% CI 1.4 to 4.8) and who were at a young age at first birth (<23) (OR=2.5, 95% CI 1.5 to 4.1). Parity and the postpartum period were not associated with ACPA-positive RA, but older age at first birth was weakly associated with a decreased risk. Conclusions The increased risk of ACPA-negative RA in parous women of reproductive age seemed to be associated with an increased postpartum risk and with young age at first birth. Further research is needed to explore the biological mechanisms behind our findings. [ABSTRACT FROM AUTHOR]
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- 2014
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10. Genome-Wide Association Study and Gene Expression Analysis Identifies CD84 as a Predictor of Response to Etanercept Therapy in Rheumatoid Arthritis.
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Jing Cui, Stahl, Eli A., Saevarsdottir, Saedis, Miceli, Corinne, Diogo, Dorothee, Trynka, Gosia, Raj, Towfique, Umiċeviċ Mirkov, Maša, Canhao, Helena, Katsunori Ikari, Chikashi Terao, Yukinori Okada, Wedrén, Sara, Askling, Johan, Hisashi Yamanaka, Shigeki Momohara, Atsuo Taniguchi, Koichiro Ohmura, Fumihiko Matsuda, and Tsuneyo Mimori
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Anti-tumor necrosis factor alpha (anti-TNF) biologic therapy is a widely used treatment for rheumatoid arthritis (RA). It is unknown why some RA patients fail to respond adequately to anti-TNF therapy, which limits the development of clinical biomarkers to predict response or new drugs to target refractory cases. To understand the biological basis of response to anti-TNF therapy, we conducted a genome-wide association study (GWAS) meta-analysis of more than 2 million common variants in 2,706 RA patients from 13 different collections. Patients were treated with one of three anti-TNF medications: etanercept (n = 733), infliximab (n = 894), or adalimumab (n = 1,071). We identified a SNP (rs6427528) at the 1q23 locus that was associated with change in disease activity score (ΔDAS) in the etanercept subset of patients (P = 8×10
−8 ), but not in the infliximab or adalimumab subsets (P>0.05). The SNP is predicted to disrupt transcription factor binding site motifs in the 3′ UTR of an immune-related gene, CD84, and the allele associated with better response to etanercept was associated with higher CD84 gene expression in peripheral blood mononuclear cells (P = 1×10−11 in 228 non-RA patients and P = 0.004 in 132 RA patients). Consistent with the genetic findings, higher CD84 gene expression correlated with lower cross-sectional DAS (P = 0.02, n = 210) and showed a non-significant trend for better ΔDAS in a subset of RA patients with gene expression data (n = 31, etanercept-treated). A small, multi-ethnic replication showed a non-significant trend towards an association among etanercept-treated RA patients of Portuguese ancestry (n = 139, P = 0.4), but no association among patients of Japanese ancestry (n = 151, P = 0.8). Our study demonstrates that an allele associated with response to etanercept therapy is also associated with CD84 gene expression, and further that CD84 expression correlates with disease activity. These findings support a model in which CD84 genotypes and/or expression may serve as a useful biomarker for response to etanercept treatment in RA patients of European ancestry. [ABSTRACT FROM AUTHOR]- Published
- 2013
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11. Association between body mass index and anti-citrullinated protein antibody-positive and anti-citrullinated protein antibody-negative rheumatoid arthritis: Results from a population-based case-control study.
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Wesley, Annmarie, Bengtsson, Camilla, Elkan, Ann-Charlotte, Klareskog, Lars, Alfredsson, Lars, and Wedrén, Sara
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Objective Being overweight or obese is associated with many chronic diseases, but previous studies of the association with rheumatoid arthritis (RA) have shown inconsistent results. The aim of this study was to investigate the association between body mass index (BMI) and the risk of developing the 2 main subtypes of RA. Methods At inclusion, cases and controls answered questions about their weight and height and donated blood samples. The presence of antibodies to citrullinated protein antigens (ACPAs) was analyzed among 2,748 cases and 3,444 controls (28% men). Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using conditional logistic regression. Results Compared to those with normal weight (BMI <25 kg/m
2 ), the adjusted overall OR for developing ACPA-negative RA was 1.1 (95% CI 0.9-1.3) for overweight individuals (BMI ≥25 to <30 kg/m2 ) and 1.4 (95% CI 1.1-1.9) for obese individuals (BMI ≥30 kg/m2 ). When stratified by sex, the OR for ACPA-negative RA for obese women was 1.6 (95% CI 1.2-2.2), and there was no association between obesity and ACPA-negative RA in men (OR 1.1, 95% CI 0.6-1.8). In obese men compared to men with normal weight, the OR for ACPA-positive RA was 0.6 (95% CI 0.3-0.9), while there was no association between BMI and ACPA-positive RA among women (OR 1.0, 95% CI 0.8-1.2). Conclusion Our findings show that obesity is associated with developing ACPA-negative RA in women, and indicate an inverse association between BMI and ACPA-positive RA in men. [ABSTRACT FROM AUTHOR]- Published
- 2013
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12. Genetic variation in the androgen estrogen conversion pathway in relation to breast cancer prognosticators.
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Darabi, Hatef, Czene, Kamila, Wedrén, Sara, Li, Yuqing, Liu, Jianjun, Hall, Per, and Humphreys, Keith
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Genetic variation in the androgen-to-estrogen conversion pathway has been shown to be associated with risk of breast cancer and, in particular, with estrogen receptor (ER) positive tumours. We aimed at studying how the genetic alterations, which have been identified for risk, are associated with breast cancer prognosticators, with a prior hypothesis that, in general, hormone-related breast cancers have a better prognosis than non-hormone-related breast cancers. Association between tagging SNPs in genes involved in estrogen metabolism and patient's lymph node status, tumour size and histological grade were estimated in a sample of 1569 Swedish breast cancer patients. Polymorphisms in CYP19A1, which have previously been linked to breast cancer risk, are shown to be associated with breast cancer prognosticators. The strongest association was observed for rs4646, with histological grade. The common allele of rs4646, which has been associated with increased breast cancer risk, was associated with low-histological grade and small tumour size ( P = 0.001 and 0.015; 1-sided, respectively). We also found evidence that SNP rs7167936 is associated with histological grade and tumour size ( P = 0.010 and 0.005; 1-sided, respectively). We show that rs4646 and rs7167936 are associated with histological grade even amongst only ER-positive tumours ( P = 0.008 and 0.011; 1-sided, respectively). Our results provide new evidence that CYP19A1 is involved in both breast cancer risk and prognosis. [ABSTRACT FROM AUTHOR]
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- 2011
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13. Genetic variation of ESR1 and its co-activator PPARGC1B is synergistic in augmenting the risk of estrogen receptor-positive breast cancer.
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Yuqing Li, Yi Li, Wedrén, Sara, Guoliang Li, Charn, Tze Howe, Vasant Desai, Kartiki, Bonnard, Carine, Czene, Kamila, Humphreys, Keith, Darabi, Hatef, Einarsdóttir, Kristjana, Heikkinen, Tuomas, Aittomäki, Kristiina, Blomqvist, Carl, Kee Seng Chia, Nevanlinna, Heli, Hall, Per, Liu, Edison T., and Liu, Jianjun
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BREAST cancer ,ESTROGEN ,HUMAN genetic variation ,STEROID hormones - Abstract
Introduction: Given the role of estrogen in breast carcinogenesis and the modification of estrogen receptor (ER) activity by its biochemical cofactors, we hypothesize that genetic variation within ER cofactor genes alters cellular response to estrogen exposure and consequently modifies the risk for ER-positive breast cancer. Methods: We genotyped 790 tagging SNPs within 60 ER cofactor genes in 1,257 cases and 1,464 controls from Sweden and in 2,215 cases and 1,265 controls from Finland, and tested their associations with either ER-positive or ER-negative breast cancer. Results: Seven SNPs showed consistent association with ER-positive breast cancer in the two independent samples, and six of them were located within PPARGC1B, encoding an ER co-activator, with the strongest association at rs741581 (odds ratio = 1.41, P = 4.84 × 10-5) that survived Bonferroni correction for multiple testing in the combined ER-positive breast cancer sample (Pcorrected = 0.03). Moreover, we also observed significant synergistic interaction (Pinteraction = 0.008) between the genetic polymorphisms within PPARGC1B and ESR1 in ERpositive breast cancer. By contrast, no consistent association was observed in ER-negative breast cancer. Furthermore, we found that administration of estrogen in the MCF-7 cell line induced PPARGC1B expression and enhanced occupancies of ER and RNA polymerase II within the region of SNP association, suggesting the upregulation of PPARGC1B expression by ESR1 activation. Conclusions: Our study revealed that DNA polymorphisms of PPARGC1B, coding a bona fide ER co-activator, are associated with ER-positive breast cancer risk. The feed-forward transcriptional regulatory loop between PPARGC1B and ESR1 further augments their protein interaction, which provides a plausible mechanistic explanation for the synergistic genetic interaction between PPARGC1B and ESR1 in ER-positive breast cancer. Our study also highlights that biochemically and genomically informed candidate gene studies can enhance the discovery of interactive disease susceptibility genes. [ABSTRACT FROM AUTHOR]
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- 2011
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14. Patients with early rheumatoid arthritis who smoke are less likely to respond to treatment with methotrexate and tumor necrosis factor inhibitors: Observations from the Epidemiological Investigation of Rheumatoid Arthritis and the Swedish Rheumatology Register cohorts
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Saevarsdottir, Saedis, Wedrén, Sara, Seddighzadeh, Maria, Bengtsson, Camilla, Wesley, Annmarie, Lindblad, Staffan, Askling, Johan, Alfredsson, Lars, and Klareskog, Lars
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ANALYSIS of variance ,CONFIDENCE intervals ,DRUG resistance ,EPIDEMIOLOGY ,METHOTREXATE ,RESEARCH funding ,RHEUMATOID arthritis ,SMOKING ,TUMOR necrosis factors ,DATA analysis ,CHEMICAL inhibitors ,PHARMACODYNAMICS - Abstract
Objective [ABSTRACT FROM AUTHOR]
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- 2011
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15. Migration and child health inequities in Nigeria: a multilevel analysis of contextual- and individual-level factors D. Antai et al.
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Antai, Diddy, Wedrén, Sara, Bellocco, Rino, and Moradi, Tahereh
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EMIGRATION & immigration ,CHILDREN'S health ,REGRESSION analysis ,CHILD death ,SOCIOECONOMIC factors ,SOCIAL conditions of women - Abstract
Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2010
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16. Rheumatoid arthritis risk allele PTPRC is also associated with response to anti-tumor necrosis factor alpha therapy.
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Cui, Jing, Saevarsdottir, Saedis, Thomson, Brian, Padyukov, Leonid, van der Helm-van Mil, Annette H M, Nititham, Joanne, Hughes, Laura B, de Vries, Niek, Raychaudhuri, Soumya, Alfredsson, Lars, Askling, Johan, Wedrén, Sara, Ding, Bo, Guiducci, Candace, Wolbink, Gert Jan, Crusius, J Bart A, van der Horst-Bruinsma, Irene E, Herenius, Marieke, Weinblatt, Michael E, and Shadick, Nancy A
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OBJECTIVE: Anti-tumor necrosis factor alpha (anti-TNF) therapy is a mainstay of treatment in rheumatoid arthritis (RA). The aim of the present study was to test established RA genetic risk factors to determine whether the same alleles also influence the response to anti-TNF therapy. METHODS: A total of 1,283 RA patients receiving etanercept, infliximab, or adalimumab therapy were studied from among an international collaborative consortium of 9 different RA cohorts. The primary end point compared RA patients with a good treatment response according to the European League Against Rheumatism (EULAR) response criteria (n = 505) with RA patients considered to be nonresponders (n = 316). The secondary end point was the change from baseline in the level of disease activity according to the Disease Activity Score in 28 joints (triangle upDAS28). Clinical factors such as age, sex, and concomitant medications were tested as possible correlates of treatment response. Thirty-one single-nucleotide polymorphisms (SNPs) associated with the risk of RA were genotyped and tested for any association with treatment response, using univariate and multivariate logistic regression models. RESULTS: Of the 31 RA-associated risk alleles, a SNP at the PTPRC (also known as CD45) gene locus (rs10919563) was associated with the primary end point, a EULAR good response versus no response (odds ratio [OR] 0.55, P = 0.0001 in the multivariate model). Similar results were obtained using the secondary end point, the triangle upDAS28 (P = 0.0002). There was suggestive evidence of a stronger association in autoantibody-positive patients with RA (OR 0.55, 95% confidence interval [95% CI] 0.39-0.76) as compared with autoantibody-negative patients (OR 0.90, 95% CI 0.41-1.99). CONCLUSION: Statistically significant associations were observed between the response to anti-TNF therapy and an RA risk allele at the PTPRC gene locus. Additional studies will be required to replicate this finding in additional patient collections. [ABSTRACT FROM AUTHOR]
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- 2010
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17. Rheumatoid Arthritis Risk Allele PTPRC Is Also Associated With Response to Anti-Tumor Necrosis Factor α Therapy.
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Jing Cui, Saevarsdottir, Saedis, Thomson, Brian, Padyukov, Leonid, van der Helm-van Mil, Annette H. M., Nititham, Joanne, Hughes, Laura B., de Vries, Niek, Raychaudhuri, Soumya, Alfredsson, Lars, Askling, Johan, Wedrén, Sara, Bo Ding, Guiducci, Candace, Wolbink, Gert Jan, Crusius, J. Bart A., van der Horst-Bruinsma, Irene E., Herenius, Marieke, Weinblatt, Michael E., and Shadick, Nancy A.
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GENES ,RHEUMATOID arthritis ,TUMOR necrosis factors ,GENETIC polymorphisms ,RHEUMATOID factor ,AUTOANTIBODIES ,AGE ,HUMAN sexuality ,THERAPEUTICS - Abstract
The article presents a study which examined the response of rheumatoid arthritis risk allele PTPRC to anti-tumor necrosis factor (TNF) alpha therapy. According to the authors, there was strong statistical evidence favoring the association of PTPRC single-nucleotide polymorphism with response to anti-TNF-alpha therapy in patients who were seropositive for either rheumatoid factor and anti-citrullinated protein autoantibodies. They explain that age, sex and drugs were analyzed as correlates of treatment response.
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- 2010
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18. Multi-Variant Pathway Association Analysis Reveals the Importance of Genetic Determinants of Estrogen Metabolism in Breast and Endometrial Cancer Susceptibility.
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Yen Ling Low, Yuqing Li, Humphreys, Keith, Thalamuthu, Anbupalam, Yi Li, Darabi, Hatef, Wedrén, Sara, Bonnard, Carine, Czene, Kamila, Iles, Mark M., Heikkinen, Tuomas, Aittomäki, Kristiina, Blomqvist, Carl, Nevanlinna, Heli, Hall, Per, Liu, Edison T., and Jianjun Liu
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ESTROGEN ,BREAST cancer ,GENETIC polymorphisms ,ANDROGENS ,TUMORS - Abstract
Despite the central role of estrogen exposure in breast and endometrial cancer development and numerous studies of genes in the estrogen metabolic pathway, polymorphisms within the pathway have not been consistently associated with these cancers. We posit that this is due to the complexity of multiple weak genetic effects within the metabolic pathway that can only be effectively detected through multi-variant analysis. We conducted a comprehensive association analysis of the estrogen metabolic pathway by interrogating 239 tagSNPs within 35 genes of the pathway in three tumor samples. The discovery sample consisted of 1,596 breast cancer cases, 719 endometrial cancer cases, and 1,730 controls from Sweden; and the validation sample included 2,245 breast cancer cases and 1,287 controls from Finland. We performed admixture maximum likelihood (AML)-based global tests to evaluate the cumulative effect from multiple SNPs within the whole metabolic pathway and three sub-pathways for androgen synthesis, androgen-to-estrogen conversion, and estrogen removal. In the discovery sample, although no single polymorphism was significant after correction for multiple testing, the pathway-based AML global test suggested association with both breast (p
global = 0.034) and endometrial (pglobal = 0.052) cancers. Further testing revealed the association to be focused on polymorphisms within the androgen-to-estrogen conversion sub-pathway, for both breast (pglobal = 0.008) and endometrial cancer (pglobal = 0.014). The sub-pathway association was validated in the Finnish sample of breast cancer (pglobal = 0.015). Further tumor subtype analysis demonstrated that the association of the androgen-to-estrogen conversion sub-pathway was confined to postmenopausal women with sporadic estrogen receptor positive tumors (pglobal = 0.0003). Gene-based AML analysis suggested CYP19A1 and UGT2B4 to be the major players within the sub-pathway. Our study indicates that the composite genetic determinants related to the androgen-estrogen conversion are important for the induction of two hormone-associated cancers, particularly for the hormone-driven breast tumour subtypes. [ABSTRACT FROM AUTHOR]- Published
- 2010
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19. Ethnic disparities in child health in Nigeria: a multilevel analysis of individual and contextual factors.
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Antai, Diddy, Wedrén, Sara, Bellocco, Rino, and Moradi, Tahereh
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CHILDREN'S health ,ETHNIC groups ,CHILD health services ,DEMOGRAPHIC surveys ,HEALTH surveys ,HEALTH - Abstract
Each ethnic group has its own peculiar cultural practices that may widen inequalities in child health and survival among ethnic groups. This study estimated ethnic disparities in mortality of under-five-year-olds, controlling for individual and community level characteristics. Using multilevel multivariable regression analysis on a nationally representative sample drawn from 7,864 households in the 2003 Nigeria Demographic and Health Survey, we estimated the risks of deaths under-five-year-olds for 6,029 children nested within 2,735 mothers aged 15-49 years old, who were in turn nested within 365 communities. Results were expressed as odds ratios with 95% confidence intervals. The observed risk of under-five death was highest among children of Hausa/Fulani/Kanuri mothers and lowest among children of Yoruba mothers. The mother's affiliation to the Yoruba ethnic group, compared to Hausa/Fulani/Kanuri, was still significantly associated with decreased under-five mortality (OR = 0.66, 95% CI = 0.45 - 0.96) after adjustment for individual and community level factors. Under-five mortality was significantly related to socio-economic and demographic factors (birth order/birth interval, mother's age, and mother's education), which explained much but not all of the ethnic disparities. Findings underscore the need for measures aimed at improving female education and the socio-economic standard of women, changing short birth spacing norms and reducing inequitable distribution of maternal and child health services. [ABSTRACT FROM AUTHOR]
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- 2009
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20. No Increased Occurrence of Ischemic Heart Disease Prior to the Onset of Rheumatoid Arthritis.
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Holmqvist, Marie E., Wedrén, Sara, Jacobsson, Lennart T. H., Klareskog, Lars, Nyberg, Fredrik, Rantapaã-Dahlqvist, Solbritt, Alfredsson, Lars, and Askling, Johan
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ETIOLOGY of diseases ,RHEUMATOID arthritis ,CORONARY heart disease risk factors ,DISEASE prevalence ,MYOCARDIAL infarction ,ANGINA pectoris - Abstract
The article presents a study which examines the relative significance of shared etiologies for rheumatoid arthritis (RA) and ischemic heart disease (IHD) in terms of the well known increased risk of IHD in patients with RA. Prevalence of IHD, myocardial infarction (MI), and angina pectoris prior to the onset of RA among Swedish population was assessed. Results reveal that IHD, MI, and angina pectoris occurrence was not observed before onset of RA.
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- 2009
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21. Inequities in Under-Five Mortality in Nigeria: Differentials by Religious Affiliation of the Mother.
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Antai, Diddy, Ghilagaber, Gebrenegus, Wedrén, Sara, Macassa, Gloria, and Moradi, Tahereh
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POLIOMYELITIS vaccines ,CHILD mortality ,CHILDREN'S health ,EQUALITY ,PRENATAL care - Abstract
Observations in Nigeria have indicated polio vaccination refusal related to religion that ultimately affected child morbidity and mortality. This study assessed the role of religion in under-five (0–59 months) mortality using a cross-sectional, nationally representative sample of 7,620 women aged 15–49 years from the 2003 Nigeria Demographic and Health Survey and included 6,029 children. Results show that mother’s affiliation to Traditional indigenous religion is significantly associated with increased under-five mortality. Multivariable modelling demonstrated that this association is explained by differential use of maternal and child health services, specifically attendance to prenatal care. To reduce child health inequity, these results need to be incorporated in the formulation of child health policies geared towards achieving a high degree of attendance to prenatal care, irrespective of religious affiliation. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
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22. On the origins of complex immune-mediated disease: the example of rheumatoid arthritis.
- Author
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Klareskog, Lars, Wedrén, Sara, and Alfredsson, Lars
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ESSAYS ,RHEUMATOID arthritis ,MOLECULAR models ,MOLECULAR immunology ,GENETIC epidemiology - Abstract
This essay discusses strategies for understanding the origins and outcomes of complex chronic inflammatory diseases using genetic and environmental determinants as tools for new definitions of disease subsets. Rheumatoid arthritis has been chosen as the prototype to illustrate these general concepts. Through recent data on two different disease subsets, it has been possible to devise a new molecular model for disease development by incorporating multiple genes and environmental agents which generate immune reactions that may eventually cause disease. These kinds of studies, aiming to integrate genetic epidemiology and molecular immunology, require close proximity between institutions for molecular medicine, clinical departments able to provide follow-up, careful surveillance of large patient groups and collaboration with experts in epidemiology and biostatistics. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
- View/download PDF
23. Effect of ATM, CHEK2 and ERBB2 TAGSNPs and haplotypes on endometrial cancer risk.
- Author
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Einarsdóttir, Kristjana, Humphreys, Keith, Bonnard, Carine, Li, Yuqing, Li, Yi, Chia, Kee Seng, Liu, Edison T., Hall, Per, Liu, Jianjun, and Wedrén, Sara
- Published
- 2007
24. Hormone-replacement therapy influences gene expression profiles and is associated with breast-cancer prognosis: a cohort study.
- Author
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Hall, Per, Ploner, Alexander, Bjöhle, Judith, Fei Huang, Chin-Yo Lin, Liu, Edison T, Miller, Lance D, Nordgren, Hans, Pawitan, Yudi, Shaw, Peter, Skoog, Lambert, Smeds, Johanna, Wedrén, Sara, OÖd, John, and Bergh, Jonas
- Subjects
HORMONE therapy for menopause ,BREAST cancer ,GENE expression ,GENOMES ,PROGNOSIS - Abstract
Background: Postmenopausal hormone-replacement therapy (HRT) increases breast-cancer risk. The influence of HRT on the biology of the primary tumor, however, is not well understood. Methods: We obtained breast-cancer gene expression profiles using Affymetrix human genome U133A arrays. We examined the relationship between HRT-regulated gene profiles, tumor characteristics, and recurrence-free survival in 72 postmenopausal women. Results: HRT use in patients with estrogen receptor (ER) protein positive tumors (n = 72) was associated with an altered regulation of 276 genes. Expression profiles based on these genes clustered ER-positive tumors into two molecular subclasses, one of which was associated with HRT use and had significantly better recurrence free survival despite lower ER levels. A comparison with external data suggested that gene regulation in tumors associated with HRT was negatively correlated with gene regulation induced by short-term estrogen exposure, but positively correlated with the effect of tamoxifen. Conclusion: Our findings suggest that post-menopausal HRT use is associated with a distinct gene expression profile related to better recurrence-free survival and lower ER protein levels. Tentatively, HRT-associated gene expression in tumors resembles the effect of tamoxifen exposure on MCF-7 cells. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
25. Physical activity and risk for breast cancer a prospective cohort study among Swedish twins.
- Author
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Moradi, Tahereh, Adami, Hans-Olov, Ekbom, Anders, Wedrén, Sara, Terry, Paul, Floderus, Birgitta, and Lichtenstein, Paul
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- 2002
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26. Estrogen receptor α gene polymorphisms and endometrial cancer risk.
- Author
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Weiderpass, Elisabete, Persson, Ingemar, Melhus, Håkan, Wedrén, Sara, Kindmark, Andreas, and Baron, John A.
- Abstract
Since the estrogen receptor α (ER) is an important mediator of hormonal responses such as proliferation in estrogen-sensitive tissues, we hypothesized that polymorphisms in the ER gene could be functional and associated with endometrial cancer risk. We performed a population-based case–control study in Sweden, focusing on restriction fragment length polymorphisms for XbaI and PvuII and an upstream TA repeat polymorphism. In the main analysis, 154 cases and 205 controls who never used hormone replacement therapy took part and we calculated age-adjusted and multivariate odds ratios (OR) and 95% confidence intervals (CI) using unconditional logistic regression. The XbaI X allele appeared to confer a reduced risk for endometrial cancer. The multivariate OR for the XX genotype was 0.52 (95% CI 0.21–1.29) compared to the xx genotype and there were suggestions of decreasing risk with increasing number of X alleles (P for trend = 0.07). The PvuII PP genotype was also associated with a non-significantly decreased risk for endometrial cancer (multivariate OR 0.70, 95% CI 0.34–1.44) compared with the pp genotype (P for trend = 0.43). The multivariate OR for two short TA (<19 repeats) alleles versus two long alleles was 1.54 (95% CI 0.73–3.27) and there were suggestions of increasing risk with increasing number of short alleles (P for trend = 0.26). We observed the same pattern of results in an expanded group of subjects, which included women who had used hormone replacement (in total 288 cases and 392 controls). Our data suggest that variants of the ER gene may be associated with an altered risk of endometrial cancer. [ABSTRACT FROM PUBLISHER]
- Published
- 2000
- Full Text
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27. Incidence of ovarian cancer among alcoholic women: A cohort study in Sweden.
- Author
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Lagiou, Pagona, Ye, Weimin, Wedrén, Sara, Ekbom, Anders, Nyrén, Olof, Trichopoulos, Dimitrios, and Adami, Hans-Olov
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- 2001
- Full Text
- View/download PDF
28. Biological treatment of ankylosing spondylitis: a nationwide study of treatment trajectories on a patient level in clinical practice.
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Lindström, Ulf, Olofsson, Tor, Wedrén, Sara, Qirjazo, Ilia, and Askling, Johan
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- 2019
- Full Text
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29. Linkage disequilibrium mapping of CHEK2: common variation and breast cancer risk.
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Einarsdóttir, Kristjana, Humphreys, Keith, Bonnard, Carine, Palmgren, Juni, Iles, Mark M., Sjölander, Arvid, Yuqing Li, Kee Seng Chia, Liu, Edison T., Hall, Per, Jianjun Liu, Wedrén, Sara, Einarsdóttir, Kristjana, Sjölander, Arvid, Li, Yuqing, Chia, Kee Seng, Liu, Jianjun, and Wedrén, Sara
- Subjects
BREAST cancer ,CELL cycle ,DNA repair ,GENETIC polymorphisms ,CANCER research ,PROTEIN kinases ,RESEARCH ,GENETICS ,RESEARCH methodology ,ACQUISITION of data ,MEDICAL cooperation ,EVALUATION research ,COMPARATIVE studies ,TRANSFERASES ,DISEASE susceptibility ,POSTMENOPAUSE ,LOGISTIC regression analysis ,BREAST tumors - Abstract
Background: Checkpoint kinase 2 (CHEK2) averts cancer development by promoting cell cycle arrest and activating DNA repair in genetically damaged cells. Previous investigation has established a role for the CHEK2 gene in breast cancer aetiology, but studies have largely been limited to the rare 1100delC mutation. Whether common polymorphisms in this gene influence breast cancer risk remains unknown. In this study, we aimed to assess the importance of common CHEK2 variants on population risk for breast cancer by capturing the majority of diversity in the gene using haplotype tagging single nucleotide polymorphisms (tagSNPs).Methods and Findings: We analyzed 14 common SNPs spanning 52 kilobases (kb) of the CHEK2 gene in 92 Swedish women. Coverage evaluation indicated that these typed SNPs would efficiently convey association signal also from untyped SNPs in the same region. Six of the 14 SNPs predicted well both the haplotypic and single SNP variations within CHEK2. We genotyped these six tagSNPs in 1,577 postmenopausal breast cancer cases and 1,513 population controls, but found no convincing association between any common CHEK2 haplotype and breast cancer risk. The 1100delC mutation was rare in our Swedish population--0.7% in cases and 0.4% in controls--with a corresponding odds ratio for carriers versus noncarriers of 2.26 (95% confidence interval, 0.99-5.15). Estimates of the population frequency and the odds ratio of 1100delC indicate that our sample is representative of a Northern European population.Conclusions: Notwithstanding the involvement of the CHEK2 gene in breast cancer aetiology, we show that common polymorphisms do not influence postmenopausal breast cancer risk. [ABSTRACT FROM AUTHOR]- Published
- 2006
- Full Text
- View/download PDF
30. Estrogen receptor alpha gene polymorphism and endometrial cancer risk--a case-control study.
- Author
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Wedrén S, Lovmar L, Humphreys K, Magnusson C, Melhus H, Syvänen AC, Kindmark A, Landegren U, Fermér ML, Stiger F, Persson I, Baron JA, Weiderpass E, Wedrén, Sara, Lovmar, Lovisa, Humphreys, Keith, Magnusson, Cecilia, Melhus, Håkan, Syvänen, Ann-Christine, and Kindmark, Andreas
- Abstract
Background: Estrogen is an established endometrial carcinogen. One of the most important mediators of estrogenic action is the estrogen receptor alpha. We have investigated whether polymorphic variation in the estrogen receptor alpha gene (ESR1) is associated with endometrial cancer risk.Methods: In 702 cases with invasive endometrial cancer and 1563 controls, we genotyped five markers in ESR1 and used logistic regression models to estimate odds ratios (OR) and 95 percent confidence intervals (CI).Results: We found an association between rs2234670, rs2234693, as well as rs9340799, markers in strong linkage disequilibrium (LD), and endometrial cancer risk. The association with rs9340799 was the strongest, OR 0.75 (CI 0.60-0.93) for heterozygous and OR 0.53 (CI 0.37-0.77) for homozygous rare compared to those homozygous for the most common allele. Haplotype models did not fit better to the data than single marker models.Conclusion: We found that intronic variation in ESR1 was associated with endometrial cancer risk. [ABSTRACT FROM AUTHOR]- Published
- 2008
- Full Text
- View/download PDF
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