A Polygenic Score for Type 2 Diabetes Improves Risk Stratification Beyond Current Clinical Screening Factors in an Ancestrally Diverse Sample.

A substantial proportion of the adult United States population with type 2 diabetes (T2D) are undiagnosed, calling into question the comprehensiveness of current screening practices, which primarily rely on age, family history, and body mass index (BMI). We hypothesized that a polygenic score (PGS) may serve as a complementary tool to identify high-risk individuals. The T2D polygenic score maintained predictive utility after adjusting for family history and combining genetics with family history led to even more improved disease risk prediction. We observed that the PGS was meaningfully related to age of onset with implications for screening practices: there was a linear and statistically significant relationship between the PGS and T2D onset (-1.3 years per standard deviation of the PGS). Evaluation of U.S. Preventive Task Force and a simplified version of American Diabetes Association screening guidelines showed that addition of a screening criterion for those above the 90th percentile of the PGS provided a small increase the sensitivity of the screening algorithm. Among T2D-negative individuals, the T2D PGS was associated with prediabetes, where each standard deviation increase of the PGS was associated with a 23% increase in the odds of prediabetes diagnosis. Additionally, each standard deviation increase in the PGS corresponded to a 43% increase in the odds of incident T2D at one-year follow-up. Using complications and forms of clinical intervention (i.e., lifestyle modification, metformin treatment, or insulin treatment) as proxies for advanced illness we also found statistically significant associations between the T2D PGS and insulin treatment and diabetic neuropathy. Importantly, we were able to replicate many findings in a Hispanic/Latino cohort from our database, highlighting the value of the T2D PGS as a clinical tool for individuals with ancestry other than European. In this group, the T2D PGS provided additional disease risk information beyond that offered by traditional screening methodologies. The T2D PGS also had predictive value for the age of onset and for prediabetes among T2D-negative Hispanic/Latino participants. These findings strengthen the notion that a T2D PGS could play a role in the clinical setting across multiple ancestries, potentially improving T2D screening practices, risk stratification, and disease management.

Growth and growth factor production by human nasal septal chondrocytes in serum-free media.

BACKGROUND: Tissue-engineered human cartilage offers vast possibilities as a source of graft implant material for reconstructive surgery. Serum-supplemented growth media is successful in supporting chondrocyte proliferation in vitro. Serum, however, contains exogenous growth factors that hamper the identification and quantification of growth factors autogenously produced by chondrocytes. We explore the possibility of using a commercially available serum-free medium UltraCULTURE as an alternative to modified Webber's medium (MWM), the standard media used in chondrocyte cell culture. METHODS: Human nasal septal chondrocytes were grown in UltraCULTURE containing various concentrations of basic fibroblast growth factor (bFGF; 0, 1, 10, and 100 ng/mL) with or without insulin-like growth factor and compared with chondrocytes grown in MWM. Growth curves and transforming growth factor (TGF) beta 1 production were analyzed. RESULTS: We found no differences in the ability to sustain cell viability in culture between the two base media types. We also found no statistically significant differences in TGF-beta 1 production by chondrocytes grown in either system. Finally, there were no statistically significant differences in chondrocyte proliferation between cultures supplemented with bFGF at 10 and 100 ng/mL. CONCLUSION: UltraCULTURE media is a cost-effective, serum-free alternative to standard media with compatible growth characteristics. It offers specific advantages over standard serum-containing media for the precise measurement of autogenous growth factor production by cultured chondrocytes. Furthermore, UltraCULTURE's serum-free environment would be ideal for safely producing tissue-engineered cartilage grafts.

Effects of copper tripeptide on the growth and expression of growth factors by normal and irradiated fibroblasts.

OBJECTIVE: To evaluate the effects of copper tripeptide (GHK-Cu) on the growth and autocrine production of basic fibroblast growth factor, transforming growth factor beta1, and vascular endothelial growth factor by normal and irradiated fibroblasts in a serum-free in vitro environment. METHODS: Primary human dermal fibroblast cell lines were established after explantation from intraoperative specimens obtained from patients who had undergone radiation therapy for head and neck cancer. Normal and irradiated fibroblasts were propagated in serum- and growth factor-free media. Treatment groups were exposed to GHK-Cu (1 x 10(-9) mol/L). We measured cell counts and production of basic fibroblast growth factor, transforming growth factor beta1, and vascular endothelial growth factor. RESULTS: Irradiated fibroblasts survived and replicated in serum-free media. The population-doubling times of normal and irradiated fibroblasts exposed to GHK-Cu were faster than those of nontreated controls. Irradiated fibroblasts treated with GHK-Cu doubled at a rate that approximated that of untreated controls, and produced significantly more basic fibroblast growth factor and vascular endothelial growth factor than untreated controls early after GHK-Cu exposure. CONCLUSIONS: Irradiated fibroblasts survive and replicate in serum-free media, establishing this model as ideal for evaluating growth factor production in vitro. Copper tripeptide accelerates the growth of normal and irradiated fibroblasts to the point where treated irradiated fibroblasts approximate the population-doubling time of normal controls. An early increase in basic fibroblast growth factor and vascular endothelial growth factor production by GHK-Cu-treated irradiated fibroblasts may improve wound healing.

Effect of blended CO2 and erbium:YAG laser irradiation on normal and keloid fibroblasts: a serum-free study.

OBJECTIVE: The purpose of this study was to determine the effect of combined CO2 and Er:YAG laser irradiation on normal (NF) and keloid (KF) facial dermal fibroblast production of TGF-beta1 and bFGF. BACKGROUND DATA: Keloids produce excess collagen. TGF-beta1 is integral to the growth and stimulation of fibroblasts and collagen; bFGF inhibits collagen synthesis. TGF-beta1 and bFGF production influence wound healing and may be manipulated by laser irradiation. MATERIALS AND METHODS: Human normal fibroblasts (NF) and keloid fibroblasts (KF) (2 x 10(4) cells/mL in serum-free media) were exposed to 1.7 J/pulse Er:YAG laser energy and CO2 delivered at either 3 or 5 W and at a duty cycle of 25%, 50%, or 100%. TGF-beta1 and bFGF were assayed using a quantitative ELISA. RESULTS: KF demonstrated a statistically significant mean population doubling time (PDT) when compared with NF (p=0.01). Irradiated KF and NF had longer PDTs than controls. All NF, excluding one irradiated group, and the three KF treated with 3 W secreted more bFGF than controls. Irradiated KF secreted less TGF-beta1 than controls. Significance was reached with the two groups exposed to 3 W at a duty cycle of 25% and 50% (p=0.04 and 0.05, respectively). All irradiated NF secreted less TGF-beta1 than controls. CONCLUSION: The combined CO2 and Er:YAG laser increased the release of bFGF, which has been shown to promote tightly organized collagen bundles, and decreased the concentration of TGF-beta1, which has also been shown to promote fibrosis formation. This laser may have a future role in keloid treatment, as well as normal facial scar prevention.