Searched for: school:SOM
Department/Unit:Cell Biology
Lysosomal NEU1 deficiency affects amyloid precursor protein levels and amyloid-beta secretion via deregulated lysosomal exocytosis
Annunziata, Ida; Patterson, Annette; Helton, Danielle; Hu, Huimin; Moshiach, Simon; Gomero, Elida; Nixon, Ralph; d'Azzo, Alessandra
Alzheimer's disease (AD) belongs to a category of adult neurodegenerative conditions, which are associated with intracellular and extracellular accumulation of neurotoxic protein aggregates. Understanding how these aggregates are formed, secreted and propagated by neurons has been the subject of intensive research, but so far no preventive or curative therapy for AD is available, and clinical trials have been largely unsuccessful. Here we show that deficiency of the lysosomal sialidase NEU1 leads to the spontaneous occurrence of an AD-like amyloidogenic process in mice. This involves two consecutive events linked to NEU1 loss-of-function--accumulation and amyloidogenic processing of an oversialylated amyloid precursor protein in lysosomes, and extracellular release of Abeta peptides by excessive lysosomal exocytosis. Furthermore, cerebral injection of NEU1 in an established AD mouse model substantially reduces beta-amyloid plaques. Our findings identify an additional pathway for the secretion of Abeta and define NEU1 as a potential therapeutic molecule for AD.
PMCID:4015463
PMID: 24225533
ISSN: 2041-1723
CID: 1085972
Insulin-Stimulated Degradation of Apolipoprotein B100: Roles of Class II Phosphatidylinositol-3-Kinase and Autophagy
Andreo, Ursula; Guo, Liang; Chirieac, Doru V; Tuyama, Ana C; Montenont, Emilie; Brodsky, Jeffrey L; Fisher, Edward A
Both in humans and animal models, an acute increase in plasma insulin levels, typically following meals, leads to transient depression of hepatic secretion of very low density lipoproteins (VLDL). One contributing mechanism for the decrease in VLDL secretion is enhanced degradation of apolipoprotein B100 (apoB100), which is required for VLDL formation. Unlike the degradation of nascent apoB100, which occurs in the endoplasmic reticulum (ER), insulin-stimulated apoB100 degradation occurs post-ER and is inhibited by pan-phosphatidylinositol (PI)3-kinase inhibitors. It is unclear, however, which of the three classes of PI3-kinases is required for insulin-stimulated apoB100 degradation, as well as the proteolytic machinery underlying this response. Class III PI3-kinase is not activated by insulin, but the other two classes are. By using a class I-specific inhibitor and siRNA to the major class II isoform in liver, we now show that it is class II PI3-kinase that is required for insulin-stimulated apoB100 degradation in primary mouse hepatocytes. Because the insulin-stimulated process resembles other examples of apoB100 post-ER proteolysis mediated by autophagy, we hypothesized that the effects of insulin in autophagy-deficient mouse primary hepatocytes would be attenuated. Indeed, apoB100 degradation in response to insulin was significantly impaired in two types of autophagy-deficient hepatocytes. Together, our data demonstrate that insulin-stimulated apoB100 degradation in the liver requires both class II PI3-kinase activity and autophagy.
PMCID:3596368
PMID: 23516411
ISSN: 1932-6203
CID: 248342
A real time chemotaxis assay unveils unique migratory profiles amongst different primary murine macrophages
Iqbal, Asif J; Regan-Komito, Daniel; Christou, Ivy; White, Gemma E; McNeill, Eileen; Kenyon, Amy; Taylor, Lewis; Kapellos, Theodore S; Fisher, Edward A; Channon, Keith M; Greaves, David R
Chemotaxis assays are an invaluable tool for studying the biological activity of inflammatory mediators such as CC chemokines, which have been implicated in a wide range of chronic inflammatory diseases. Conventional chemotaxis systems such as the modified Boyden chamber are limited in terms of the data captured given that the assays are analysed at a single time-point. We report the optimisation and validation of a label-free, real-time cell migration assay based on electrical cell impedance to measure chemotaxis of different primary murine macrophage populations in response to a range of CC chemokines and other chemoattractant signalling molecules. We clearly demonstrate key differences in the migratory behavior of different murine macrophage populations and show that this dynamic system measures true macrophage chemotaxis rather than chemokinesis or fugetaxis. We highlight an absolute requirement for Galphai signaling and actin cytoskeletal rearrangement as demonstrated by Pertussis toxin and cytochalasin D inhibition. We also studied the chemotaxis of CD14(+) human monocytes and demonstrate distinct chemotactic profiles amongst different monocyte donors to CCL2. This real-time chemotaxis assay will allow a detailed analysis of factors that regulate macrophage responses to chemoattractant cytokines and inflammatory mediators.
PMCID:3597586
PMID: 23516549
ISSN: 1932-6203
CID: 350012
Laser capture microdissection for analysis of macrophage gene expression from atherosclerotic lesions
Feig, Jonathan E; Fisher, Edward A
Coronary artery disease, resulting from atherosclerosis, is the leading cause of death in the Western world. Most previous studies have subjected atherosclerotic arteries, a tissue of mixed cellular composition, to homogenization in order to identify the factors in plaque development, thereby obscuring information relevant to specific cell types. Because macrophage foam cells are critical mediators in atherosclerotic plaque advancement, we reasoned that performing gene analysis on those cells would provide specific insight in novel regulatory factors and potential therapeutic targets. We demonstrated for the first time in vascular biology that foam cell-specific RNA can be isolated by laser capture microdissection (LCM) of plaques. As expected, compared to whole tissue, a significant enrichment in foam cell-specific RNA transcripts was observed. Furthermore, because regression of atherosclerosis is a tantalizing clinical goal, we developed and reported a transplantation-based mouse model. This involved allowing plaques to form in apoE-/- mice and then changing the plaque's plasma environment from hyperlipidemia to normolipidemia. Under those conditions, rapid regression ensued in a process involving emigration of plaque foam cells to regional and systemic lymph nodes. Using LCM, we were able to show that under regression conditions, there was decreased expression in foam cells of inflammatory genes, but an up-regulation of cholesterol efflux genes. Interestingly, we also found that increased expression of chemokine receptor CCR7, a known factor in dendritic cell migration, was required for regression. In conclusion, the LCM methods described in this chapter, which have already lead to a number of striking findings, will likely further facilitate the study of cell type-specific gene expression in animal and human plaques during various stages of atherosclerosis, and after genetic, pharmacologic, and environmental perturbations.
PMCID:4278963
PMID: 23912984
ISSN: 1064-3745
CID: 484152
HDL Induces the Expression of the M2 Macrophage Markers Arginase 1 and Fizz-1 in a STAT6-Dependent Process
Sanson, Marie; Distel, Emilie; Fisher, Edward A
Our lab has previously shown in a mouse model that normalization of a low HDL level achieves atherosclerotic plaque regression. This included the shift from a pro ("M1") to an anti-inflammatory ("M2") phenotypic state of plaque macrophages. Whether HDL can directly cause this phenotypic change and, if so, what the signaling mechanism is, were explored in the present studies. Murine primary macrophages treated with HDL showed increased gene expression for the M2 markers Arginase-1 (Arg-1) and Fizz-1, which are classically induced by IL-4. HDL was able to potentiate the IL-4-induced changes in Arg-1, and tended to do the same for Fizz-1, while suppressing the expression of inflammatory genes in response to IFNgamma. The effects of either IL-4 or HDL were suppressed when macrophages were from STAT6(-/-) mice, but inhibitor studies suggested differential utilization of JAK isoforms by IL-4 and HDL to activate STAT6 by phosphorylation. Overall, our results describe a new function of HDL, namely its ability to directly enrich macrophages in markers of the M2, anti-inflammatory, state in a process requiring STAT6.
PMCID:3749183
PMID: 23991225
ISSN: 1932-6203
CID: 519522
Uncoupling proteostasis and development in vitro with a small molecule inhibitor of the pancreatic endoplasmic reticulum kinase, PERK
Harding, Heather P; Zyryanova, Alisa F; Ron, David
Loss-of-function mutations in EIF2AK3, encoding the pancreatic endoplasmic reticulum (ER) kinase, PERK, are associated with dysfunction of the endocrine pancreas and diabetes. However, to date it has not been possible to uncouple the long term developmental effects of PERK deficiency from sensitization to physiological levels of ER unfolded protein stress upon interruption of PERK modulation of protein synthesis rates. Here, we report that a selective PERK inhibitor acutely deregulates protein synthesis in freshly isolated islets of Langerhans, across a range of glucose concentrations. Acute loss of the PERK-mediated strand of the unfolded protein response leads to rapid accumulation of misfolded pro-insulin in cultured beta cells and is associated with a kinetic defect in pro-insulin processing. These in vitro observations uncouple the latent role of PERK in beta cell development from the regulation of unfolded protein flux through the ER and attest to the importance of the latter in beta cell proteostasis.
PMCID:3531748
PMID: 23148209
ISSN: 0021-9258
CID: 919142
A molecular roadmap of reprogramming somatic cells into iPS cells
Polo, Jose M; Anderssen, Endre; Walsh, Ryan M; Schwarz, Benjamin A; Nefzger, Christian M; Lim, Sue Mei; Borkent, Marti; Apostolou, Effie; Alaei, Sara; Cloutier, Jennifer; Bar-Nur, Ori; Cheloufi, Sihem; Stadtfeld, Matthias; Figueroa, Maria Eugenia; Robinton, Daisy; Natesan, Sridaran; Melnick, Ari; Zhu, Jinfang; Ramaswamy, Sridhar; Hochedlinger, Konrad
Factor-induced reprogramming of somatic cells into induced pluripotent stem cells (iPSCs) is inefficient, complicating mechanistic studies. Here, we examined defined intermediate cell populations poised to becoming iPSCs by genome-wide analyses. We show that induced pluripotency elicits two transcriptional waves, which are driven by c-Myc/Klf4 (first wave) and Oct4/Sox2/Klf4 (second wave). Cells that become refractory to reprogramming activate the first but fail to initiate the second transcriptional wave and can be rescued by elevated expression of all four factors. The establishment of bivalent domains occurs gradually after the first wave, whereas changes in DNA methylation take place after the second wave when cells acquire stable pluripotency. This integrative analysis allowed us to identify genes that act as roadblocks during reprogramming and surface markers that further enrich for cells prone to forming iPSCs. Collectively, our data offer new mechanistic insights into the nature and sequence of molecular events inherent to cellular reprogramming.
PMCID:3608203
PMID: 23260147
ISSN: 0092-8674
CID: 215822
Mechanism of polarized lysosome exocytosis in epithelial cells
Xu, Jin; Toops, Kimberly A; Diaz, Fernando; Carvajal-Gonzalez, Jose Maria; Gravotta, Diego; Mazzoni, Francesca; Schreiner, Ryan; Rodriguez-Boulan, Enrique; Lakkaraju, Aparna
Fusion of lysosomes with the plasma membrane is a calcium-dependent process that is crucial for membrane repair, limiting pathogen entry and clearing cellular debris. In non-polarized cells, lysosome exocytosis facilitates rapid resealing of torn membranes. Here, we investigate the mechanism of lysosome exocytosis in polarized epithelia, the main barrier between the organism and the external environment and the first line of defense against pathogens. We find that in polarized Madin-Darby canine kidney (MDCK) cells, calcium ionophores or pore-forming toxins cause lysosomes to fuse predominantly with the basolateral membrane. This polarized exocytosis is regulated by the actin cytoskeleton, membrane cholesterol and the clathrin adaptor AP-1. Depolymerization of actin, but not microtubules, causes apical lysosome fusion, supporting the hypothesis that cortical actin is a barrier to exocytosis. Overloading lysosomes with cholesterol inhibits exocytosis, suggesting that excess cholesterol paralyzes lysosomal traffic. The clathrin adaptor AP-1 is responsible for accurately targeting syntaxin 4 to the basolateral domain. In cells lacking either the ubiquitous AP-1A or the epithelial-specific AP-1B, syntaxin 4 is non-polar. This causes lysosomes to fuse with both the apical and basolateral membranes. Consistent with these findings, RNAi-mediated depletion of syntaxin 4 inhibits basolateral exocytosis in wild-type MDCK, and both apical and basolateral exocytosis in cells lacking AP-1A or AP-1B. Our results provide fundamental insight into the molecular machinery involved in membrane repair in polarized epithelia and suggest that AP-1 is a crucial regulator of this process.
PMCID:3585513
PMID: 23038769
ISSN: 0021-9533
CID: 375082
A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010
Lim, Stephen S; Vos, Theo; Flaxman, Abraham D; Danaei, Goodarz; Shibuya, Kenji; Adair-Rohani, Heather; Amann, Markus; Anderson, H Ross; Andrews, Kathryn G; Aryee, Martin; Atkinson, Charles; Bacchus, Loraine J; Bahalim, Adil N; Balakrishnan, Kalpana; Balmes, John; Barker-Collo, Suzanne; Baxter, Amanda; Bell, Michelle L; Blore, Jed D; Blyth, Fiona; Bonner, Carissa; Borges, Guilherme; Bourne, Rupert; Boussinesq, Michel; Brauer, Michael; Brooks, Peter; Bruce, Nigel G; Brunekreef, Bert; Bryan-Hancock, Claire; Bucello, Chiara; Buchbinder, Rachelle; Bull, Fiona; Burnett, Richard T; Byers, Tim E; Calabria, Bianca; Carapetis, Jonathan; Carnahan, Emily; Chafe, Zoe; Charlson, Fiona; Chen, Honglei; Chen, Jian Shen; Cheng, Andrew Tai-Ann; Child, Jennifer Christine; Cohen, Aaron; Colson, K Ellicott; Cowie, Benjamin C; Darby, Sarah; Darling, Susan; Davis, Adrian; Degenhardt, Louisa; Dentener, Frank; Des Jarlais, Don C; Devries, Karen; Dherani, Mukesh; Ding, Eric L; Dorsey, E Ray; Driscoll, Tim; Edmond, Karen; Ali, Suad Eltahir; Engell, Rebecca E; Erwin, Patricia J; Fahimi, Saman; Falder, Gail; Farzadfar, Farshad; Ferrari, Alize; Finucane, Mariel M; Flaxman, Seth; Fowkes, Francis Gerry R; Freedman, Greg; Freeman, Michael K; Gakidou, Emmanuela; Ghosh, Santu; Giovannucci, Edward; Gmel, Gerhard; Graham, Kathryn; Grainger, Rebecca; Grant, Bridget; Gunnell, David; Gutierrez, Hialy R; Hall, Wayne; Hoek, Hans W; Hogan, Anthony; Hosgood, H Dean 3rd; Hoy, Damian; Hu, Howard; Hubbell, Bryan J; Hutchings, Sally J; Ibeanusi, Sydney E; Jacklyn, Gemma L; Jasrasaria, Rashmi; Jonas, Jost B; Kan, Haidong; Kanis, John A; Kassebaum, Nicholas; Kawakami, Norito; Khang, Young-Ho; Khatibzadeh, Shahab; Khoo, Jon-Paul; Kok, Cindy; Laden, Francine; Lalloo, Ratilal; Lan, Qing; Lathlean, Tim; Leasher, Janet L; Leigh, James; Li, Yang; Lin, John Kent; Lipshultz, Steven E; London, Stephanie; Lozano, Rafael; Lu, Yuan; Mak, Joelle; Malekzadeh, Reza; Mallinger, Leslie; Marcenes, Wagner; March, Lyn; Marks, Robin; Martin, Randall; McGale, Paul; McGrath, John; Mehta, Sumi; Mensah, George A; Merriman, Tony R; Micha, Renata; Michaud, Catherine; Mishra, Vinod; Hanafiah, Khayriyyah Mohd; Mokdad, Ali A; Morawska, Lidia; Mozaffarian, Dariush; Murphy, Tasha; Naghavi, Mohsen; Neal, Bruce; Nelson, Paul K; Nolla, Joan Miquel; Norman, Rosana; Olives, Casey; Omer, Saad B; Orchard, Jessica; Osborne, Richard; Ostro, Bart; Page, Andrew; Pandey, Kiran D; Parry, Charles D H; Passmore, Erin; Patra, Jayadeep; Pearce, Neil; Pelizzari, Pamela M; Petzold, Max; Phillips, Michael R; Pope, Dan; Pope, C Arden 3rd; Powles, John; Rao, Mayuree; Razavi, Homie; Rehfuess, Eva A; Rehm, Jurgen T; Ritz, Beate; Rivara, Frederick P; Roberts, Thomas; Robinson, Carolyn; Rodriguez-Portales, Jose A; Romieu, Isabelle; Room, Robin; Rosenfeld, Lisa C; Roy, Ananya; Rushton, Lesley; Salomon, Joshua A; Sampson, Uchechukwu; Sanchez-Riera, Lidia; Sanman, Ella; Sapkota, Amir; Seedat, Soraya; Shi, Peilin; Shield, Kevin; Shivakoti, Rupak; Singh, Gitanjali M; Sleet, David A; Smith, Emma; Smith, Kirk R; Stapelberg, Nicolas J C; Steenland, Kyle; Stockl, Heidi; Stovner, Lars Jacob; Straif, Kurt; Straney, Lahn; Thurston, George D; Tran, Jimmy H; Van Dingenen, Rita; van Donkelaar, Aaron; Veerman, J Lennert; Vijayakumar, Lakshmi; Weintraub, Robert; Weissman, Myrna M; White, Richard A; Whiteford, Harvey; Wiersma, Steven T; Wilkinson, James D; Williams, Hywel C; Williams, Warwick; Wilson, Nicholas; Woolf, Anthony D; Yip, Paul; Zielinski, Jan M; Lopez, Alan D; Murray, Christopher J L; Ezzati, Majid
BACKGROUND: Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. METHODS: We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. FINDINGS: In 2010, the three leading risk factors for global disease burden were high blood pressure (7.0% [95% uncertainty interval 6.2-7.7] of global DALYs), tobacco smoking including second-hand smoke (6.3% [5.5-7.0]), and alcohol use (5.5% [5.0-5.9]). In 1990, the leading risks were childhood underweight (7.9% [6.8-9.4]), household air pollution from solid fuels (HAP; 7.0% [5.6-8.3]), and tobacco smoking including second-hand smoke (6.1% [5.4-6.8]). Dietary risk factors and physical inactivity collectively accounted for 10.0% (95% UI 9.2-10.8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved water and sanitation and childhood micronutrient deficiencies, fell in rank between 1990 and 2010, with unimproved water and sanitation accounting for 0.9% (0.4-1.6) of global DALYs in 2010. However, in most of sub-Saharan Africa childhood underweight, HAP, and non-exclusive and discontinued breastfeeding were the leading risks in 2010, while HAP was the leading risk in south Asia. The leading risk factor in Eastern Europe, most of Latin America, and southern sub-Saharan Africa in 2010 was alcohol use; in most of Asia, North Africa and Middle East, and central Europe it was high blood pressure. Despite declines, tobacco smoking including second-hand smoke remained the leading risk in high-income north America and western Europe. High body-mass index has increased globally and it is the leading risk in Australasia and southern Latin America, and also ranks high in other high-income regions, North Africa and Middle East, and Oceania. INTERPRETATION: Worldwide, the contribution of different risk factors to disease burden has changed substantially, with a shift away from risks for communicable diseases in children towards those for non-communicable diseases in adults. These changes are related to the ageing population, decreased mortality among children younger than 5 years, changes in cause-of-death composition, and changes in risk factor exposures. New evidence has led to changes in the magnitude of key risks including unimproved water and sanitation, vitamin A and zinc deficiencies, and ambient particulate matter pollution. The extent to which the epidemiological shift has occurred and what the leading risks currently are varies greatly across regions. In much of sub-Saharan Africa, the leading risks are still those associated with poverty and those that affect children. FUNDING: Bill & Melinda Gates Foundation.
PMCID:4156511
PMID: 23245609
ISSN: 0140-6736
CID: 209482
Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010
Vos, Theo; Flaxman, Abraham D; Naghavi, Mohsen; Lozano, Rafael; Michaud, Catherine; Ezzati, Majid; Shibuya, Kenji; Salomon, Joshua A; Abdalla, Safa; Aboyans, Victor; Abraham, Jerry; Ackerman, Ilana; Aggarwal, Rakesh; Ahn, Stephanie Y; Ali, Mohammed K; Alvarado, Miriam; Anderson, H Ross; Anderson, Laurie M; Andrews, Kathryn G; Atkinson, Charles; Baddour, Larry M; Bahalim, Adil N; Barker-Collo, Suzanne; Barrero, Lope H; Bartels, David H; Basanez, Maria-Gloria; Baxter, Amanda; Bell, Michelle L; Benjamin, Emelia J; Bennett, Derrick; Bernabe, Eduardo; Bhalla, Kavi; Bhandari, Bishal; Bikbov, Boris; Bin Abdulhak, Aref; Birbeck, Gretchen; Black, James A; Blencowe, Hannah; Blore, Jed D; Blyth, Fiona; Bolliger, Ian; Bonaventure, Audrey; Boufous, Soufiane; Bourne, Rupert; Boussinesq, Michel; Braithwaite, Tasanee; Brayne, Carol; Bridgett, Lisa; Brooker, Simon; Brooks, Peter; Brugha, Traolach S; Bryan-Hancock, Claire; Bucello, Chiara; Buchbinder, Rachelle; Buckle, Geoffrey; Budke, Christine M; Burch, Michael; Burney, Peter; Burstein, Roy; Calabria, Bianca; Campbell, Benjamin; Canter, Charles E; Carabin, Helene; Carapetis, Jonathan; Carmona, Loreto; Cella, Claudia; Charlson, Fiona; Chen, Honglei; Cheng, Andrew Tai-Ann; Chou, David; Chugh, Sumeet S; Coffeng, Luc E; Colan, Steven D; Colquhoun, Samantha; Colson, K Ellicott; Condon, John; Connor, Myles D; Cooper, Leslie T; Corriere, Matthew; Cortinovis, Monica; de Vaccaro, Karen Courville; Couser, William; Cowie, Benjamin C; Criqui, Michael H; Cross, Marita; Dabhadkar, Kaustubh C; Dahiya, Manu; Dahodwala, Nabila; Damsere-Derry, James; Danaei, Goodarz; Davis, Adrian; De Leo, Diego; Degenhardt, Louisa; Dellavalle, Robert; Delossantos, Allyne; Denenberg, Julie; Derrett, Sarah; Des Jarlais, Don C; Dharmaratne, Samath D; Dherani, Mukesh; Diaz-Torne, Cesar; Dolk, Helen; Dorsey, E Ray; Driscoll, Tim; Duber, Herbert; Ebel, Beth; Edmond, Karen; Elbaz, Alexis; Ali, Suad Eltahir; Erskine, Holly; Erwin, Patricia J; Espindola, Patricia; Ewoigbokhan, Stalin E; Farzadfar, Farshad; Feigin, Valery; Felson, David T; Ferrari, Alize; Ferri, Cleusa P; Fevre, Eric M; Finucane, Mariel M; Flaxman, Seth; Flood, Louise; Foreman, Kyle; Forouzanfar, Mohammad H; Fowkes, Francis Gerry R; Franklin, Richard; Fransen, Marlene; Freeman, Michael K; Gabbe, Belinda J; Gabriel, Sherine E; Gakidou, Emmanuela; Ganatra, Hammad A; Garcia, Bianca; Gaspari, Flavio; Gillum, Richard F; Gmel, Gerhard; Gosselin, Richard; Grainger, Rebecca; Groeger, Justina; Guillemin, Francis; Gunnell, David; Gupta, Ramyani; Haagsma, Juanita; Hagan, Holly; Halasa, Yara A; Hall, Wayne; Haring, Diana; Haro, Josep Maria; Harrison, James E; Havmoeller, Rasmus; Hay, Roderick J; Higashi, Hideki; Hill, Catherine; Hoen, Bruno; Hoffman, Howard; Hotez, Peter J; Hoy, Damian; Huang, John J; Ibeanusi, Sydney E; Jacobsen, Kathryn H; James, Spencer L; Jarvis, Deborah; Jasrasaria, Rashmi; Jayaraman, Sudha; Johns, Nicole; Jonas, Jost B; Karthikeyan, Ganesan; Kassebaum, Nicholas; Kawakami, Norito; Keren, Andre; Khoo, Jon-Paul; King, Charles H; Knowlton, Lisa Marie; Kobusingye, Olive; Koranteng, Adofo; Krishnamurthi, Rita; Lalloo, Ratilal; Laslett, Laura L; Lathlean, Tim; Leasher, Janet L; Lee, Yong Yi; Leigh, James; Lim, Stephen S; Limb, Elizabeth; Lin, John Kent; Lipnick, Michael; Lipshultz, Steven E; Liu, Wei; Loane, Maria; Ohno, Summer Lockett; Lyons, Ronan; Ma, Jixiang; Mabweijano, Jacqueline; MacIntyre, Michael F; Malekzadeh, Reza; Mallinger, Leslie; Manivannan, Sivabalan; Marcenes, Wagner; March, Lyn; Margolis, David J; Marks, Guy B; Marks, Robin; Matsumori, Akira; Matzopoulos, Richard; Mayosi, Bongani M; McAnulty, John H; McDermott, Mary M; McGill, Neil; McGrath, John; Medina-Mora, Maria Elena; Meltzer, Michele; Mensah, George A; Merriman, Tony R; Meyer, Ana-Claire; Miglioli, Valeria; Miller, Matthew; Miller, Ted R; Mitchell, Philip B; Mocumbi, Ana Olga; Moffitt, Terrie E; Mokdad, Ali A; Monasta, Lorenzo; Montico, Marcella; Moradi-Lakeh, Maziar; Moran, Andrew; Morawska, Lidia; Mori, Rintaro; Murdoch, Michele E; Mwaniki, Michael K; Naidoo, Kovin; Nair, M Nathan; Naldi, Luigi; Narayan, K M Venkat; Nelson, Paul K; Nelson, Robert G; Nevitt, Michael C; Newton, Charles R; Nolte, Sandra; Norman, Paul; Norman, Rosana; O'Donnell, Martin; O'Hanlon, Simon; Olives, Casey; Omer, Saad B; Ortblad, Katrina; Osborne, Richard; Ozgediz, Doruk; Page, Andrew; Pahari, Bishnu; Pandian, Jeyaraj Durai; Rivero, Andrea Panozo; Patten, Scott B; Pearce, Neil; Padilla, Rogelio Perez; Perez-Ruiz, Fernando; Perico, Norberto; Pesudovs, Konrad; Phillips, David; Phillips, Michael R; Pierce, Kelsey; Pion, Sebastien; Polanczyk, Guilherme V; Polinder, Suzanne; Pope, C Arden 3rd; Popova, Svetlana; Porrini, Esteban; Pourmalek, Farshad; Prince, Martin; Pullan, Rachel L; Ramaiah, Kapa D; Ranganathan, Dharani; Razavi, Homie; Regan, Mathilda; Rehm, Jurgen T; Rein, David B; Remuzzi, Guiseppe; Richardson, Kathryn; Rivara, Frederick P; Roberts, Thomas; Robinson, Carolyn; De Leon, Felipe Rodriguez; Ronfani, Luca; Room, Robin; Rosenfeld, Lisa C; Rushton, Lesley; Sacco, Ralph L; Saha, Sukanta; Sampson, Uchechukwu; Sanchez-Riera, Lidia; Sanman, Ella; Schwebel, David C; Scott, James Graham; Segui-Gomez, Maria; Shahraz, Saeid; Shepard, Donald S; Shin, Hwashin; Shivakoti, Rupak; Singh, David; Singh, Gitanjali M; Singh, Jasvinder A; Singleton, Jessica; Sleet, David A; Sliwa, Karen; Smith, Emma; Smith, Jennifer L; Stapelberg, Nicolas J C; Steer, Andrew; Steiner, Timothy; Stolk, Wilma A; Stovner, Lars Jacob; Sudfeld, Christopher; Syed, Sana; Tamburlini, Giorgio; Tavakkoli, Mohammad; Taylor, Hugh R; Taylor, Jennifer A; Taylor, William J; Thomas, Bernadette; Thomson, W Murray; Thurston, George D; Tleyjeh, Imad M; Tonelli, Marcello; Towbin, Jeffrey A; Truelsen, Thomas; Tsilimbaris, Miltiadis K; Ubeda, Clotilde; Undurraga, Eduardo A; van der Werf, Marieke J; van Os, Jim; Vavilala, Monica S; Venketasubramanian, N; Wang, Mengru; Wang, Wenzhi; Watt, Kerrianne; Weatherall, David J; Weinstock, Martin A; Weintraub, Robert; Weisskopf, Marc G; Weissman, Myrna M; White, Richard A; Whiteford, Harvey; Wiersma, Steven T; Wilkinson, James D; Williams, Hywel C; Williams, Sean R M; Witt, Emma; Wolfe, Frederick; Woolf, Anthony D; Wulf, Sarah; Yeh, Pon-Hsiu; Zaidi, Anita K M; Zheng, Zhi-Jie; Zonies, David; Lopez, Alan D; Murray, Christopher J L
BACKGROUND: Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither effort quantified uncertainty in prevalence or years lived with disability (YLDs). METHODS: Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, and large methodological variation between data sources. For some disorders, we used natural history models, geospatial models, back-calculation models (models calculating incidence from population mortality rates and case fatality), or registration completeness models (models adjusting for incomplete registration with health-system access and other covariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs by cause at age, sex, country, and year levels were adjusted for comorbidity with simulation methods. We included uncertainty estimates at all stages of the analysis. FINDINGS: Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per 1 million people to 350,000 cases per 1 million people. Prevalence and severity of health loss were weakly correlated (correlation coefficient -0.37). In 2010, there were 777 million YLDs from all causes, up from 583 million in 1990. The main contributors to global YLDs were mental and behavioural disorders, musculoskeletal disorders, and diabetes or endocrine diseases. The leading specific causes of YLDs were much the same in 2010 as they were in 1990: low back pain, major depressive disorder, iron-deficiency anaemia, neck pain, chronic obstructive pulmonary disease, anxiety disorders, migraine, diabetes, and falls. Age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010. Regional patterns of the leading causes of YLDs were more similar compared with years of life lost due to premature mortality. Neglected tropical diseases, HIV/AIDS, tuberculosis, malaria, and anaemia were important causes of YLDs in sub-Saharan Africa. INTERPRETATION: Rates of YLDs per 100,000 people have remained largely constant over time but rise steadily with age. Population growth and ageing have increased YLD numbers and crude rates over the past two decades. Prevalences of the most common causes of YLDs, such as mental and behavioural disorders and musculoskeletal disorders, have not decreased. Health systems will need to address the needs of the rising numbers of individuals with a range of disorders that largely cause disability but not mortality. Quantification of the burden of non-fatal health outcomes will be crucial to understand how well health systems are responding to these challenges. Effective and affordable strategies to deal with this rising burden are an urgent priority for health systems in most parts of the world. FUNDING: Bill & Melinda Gates Foundation.
PMID: 23245607
ISSN: 0140-6736
CID: 209492