While Sjögren's syndrome (SS) is more common than related autoimmune disorders, such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), scientific and medical research in SS has lagged behind significantly. This is especially true in the field of SS genetics, where efforts to date have relied heavily on candidate gene approaches. Within the last decade, the advent of the genome-wide association (GWA) scan has altered our understanding of disease pathogenesis in hundreds of disorders through the successful identification of novel risk loci. With strong evidence for a genetic component in SS as evidenced by familial aggregation of SS as well as similarities between SS and SLE and RA, the application of GWA approaches would likely yield numerous novel risk loci in SS. Here we review the fundamental scientific principles employed in GWA scans as well as the limitations of this tool, and we discuss the application of GWA scans in determining genetic variants at play in complex disease. We also examine the successful application of GWA scans in SLE, which now has more than 40 confirmed risk loci, and consider the possibility for a similar trajectory of SS genetic discovery in the era of GWA scans. Ultimately, the GWA studies that will be performed in SS have the potential to identify a myriad of novel genetic loci that will allow scientists to begin filling in the gaps in our understanding of the SS pathogenesis.
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http://dx.doi.org/10.1016/j.jaut.2012.01.008 | DOI Listing |
Neurology
September 2024
From the Division of Experimental Neurology, Department of Neurosciences (A.W., J.D., R.L.), KU Leuven; Stanford Stroke Center (A.W., P.S., N.Y., M.M., S.K., S.C., G.W.A., M.G.L.), Palo Alto, CA; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM; Neurology Department (P.S.), Hôpital Fondation A. de Rothschild, Paris, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; and Department of Neurology (J.D., R.L.), University Hospitals Leuven, Belgium.
Background And Objectives: Acute ischemic stroke patients with a large vessel occlusion (LVO) who present to a primary stroke center (PSC) often require transfer to a comprehensive stroke center (CSC) for thrombectomy. Not much is known about specific characteristics at the PSC that are associated with infarct growth during transfer. Gaining more insight into these features could aid future trials with cytoprotective agents targeted at slowing infarct growth.
View Article and Find Full Text PDFN Engl J Med
February 2024
From Stanford Stroke Center, Department of Neurology and Neurological Sciences, Stanford University, Palo Alto (G.W.A., N.E.S., M.G.L.), Genentech, South San Francisco (B.P., M.Y., L.M., X.-Y.L., G.A.R.), and the Department of Neurology, Southern California Permanente Medical Group, Los Angeles Medical Center (N.S.), and the Department of Neurology, University of California, Los Angeles (D.S.L.), Los Angeles - all in California; the Department of Neurology, ProMedica Toledo Hospital, University of Toledo, Toledo (M.J., S.F.Z.), and the Department of Emergency Medicine (C.E.K.) and the Department of Neurology and Rehabilitation Medicine, University of Cincinnati Gardner Neuroscience Institute (J.P.B.), College of Medicine, University of Cincinnati, Cincinnati - both in Ohio; the Department of Neurology, University of Minnesota, Minneapolis (C.S.); the Department of Medicine, University of Alberta, Edmonton, Canada (A.S.); the Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago (M.K.); Vanderbilt Cerebrovascular Program, Vanderbilt University Medical Center, Nashville (M.T.F.); Oregon Stroke Center, Oregon Health and Science University, Portland (W.M.C.); the School of Medicine, University of New South Wales, Sydney (K.B.), and the Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, VIC (B.C.V.C.) - both in Australia; the Department of Neurology, Cleveland Clinic Florida, Weston Hospital, Weston (A.N.); the Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (L.H.S.); and the Department of Neurology, Yale School of Medicine, New Haven, CT (L.H.S.).
Background: Thrombolytic agents, including tenecteplase, are generally used within 4.5 hours after the onset of stroke symptoms. Information on whether tenecteplase confers benefit beyond 4.
View Article and Find Full Text PDFStroke
December 2023
Stanford Stroke Center, Palo Alto, CA (S.C., J.J.H., R.D., M.M., G.W.A., M.G.L.).
Background: Acute ischemic infarct identification on noncontrast computed tomography (NCCT) is highly variable between raters. A semiautomated method for segmentation of acute ischemic lesions on NCCT may improve interrater reliability.
Methods: Patients with successful endovascular reperfusion from the DEFUSE 3 trial (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke) were included.
J Neurointerv Surg
September 2024
Radiology, Neuroadiology and Neurointervention Division, Stanford University, Stanford, California, USA
Background: Robust venous outflow (VO) profiles, measured by degree of venous opacification on pre-thrombectomy CT angiography (CTA) studies, are strongly correlated with favorable outcomes in patients with large vessel occlusion acute ischemic stroke treated by thrombectomy. However, VO measurements are laborious and require neuroimaging expertise.
Objective: To develop a semi-automated method to measure VO using CTA and CT perfusion imaging studies.
Radiology
February 2023
From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.), CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D., T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.) and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University, Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A., L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild, Paris, France (M.M.).
Background A target mismatch profile can identify good clinical response to recanalization after acute ischemic stroke, but does not consider region specificities. Purpose To test whether location-weighted infarction core and mismatch, determined from diffusion and perfusion MRI performed in patients with acute stroke, could improve prediction of good clinical response to mechanical thrombectomy compared with a target mismatch profile. Materials and Methods In this secondary analysis, two prospectively collected independent stroke data sets (2012-2015 and 2017-2019) were analyzed.
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