Human papillomavirus (HPV) is the most important causative agent of cervical cancers worldwide. However, our understanding of how the vaginal microbiota might be associated with HPV infection is limited. In addition, the influence of human genetic and physiological factors on the vaginal microbiota is unclear. Studies on twins and their families provide the ideal settings to investigate the complicated nature of human microbiota. This study investigated the vaginal microbiota of 68 HPV-infected or uninfected female twins and their families using 454-pyrosequencing analysis targeting the variable region (V2–V3) of the bacterial 16S rRNA gene. Analysis of the vaginal microbiota from both premenopausal women and HPV-discordant twins indicated that HPV-positive women had significantly higher microbial diversity with a lower proportion of Lactobacillus spp. than HPV-negative women. Fusobacteria, including Sneathia spp., were identified as a possible microbiological marker associated with HPV infection. The vaginal microbiotas of twin pairs were significantly more similar to each other than to those from unrelated individuals. In addition, there were marked significant differences from those of their mother, possibly due to differences in menopausal status. Postmenopausal women had a lower proportion of Lactobacillus spp. and a significantly higher microbiota diversity. This study indicated that HPV infection was associated with the composition of the vaginal microbiota, which is influenced by multiple host factors such as genetics and menopause. The potential biological markers identified in this study could provide insight into HPV pathogenesis and may represent biological targets for diagnostics.

Our results suggest that an altered microbiota composition mediated by a specific host genotype can contribute to the development of MetS.

No abstract

BackgroundImprovements in mobile telecommunication technologies have enabled clinicians to collect patient-reported outcome (PRO) data more frequently, but there is as yet limited evidence regarding the frequency with which PRO data can be collected via smartphone applications (apps) in breast cancer patients receiving chemotherapy.ObjectiveThe primary objective of this study was to determine the feasibility of an app for sleep disturbance-related data collection from breast cancer patients receiving chemotherapy. A secondary objective was to identify the variables associated with better compliance in order to identify the optimal subgroups to include in future studies of smartphone-based interventions.MethodsBetween March 2013 and July 2013, patients who planned to receive neoadjuvant chemotherapy for breast cancer at Asan Medical Center who had access to a smartphone app were enrolled just before the start of their chemotherapy and asked to self-report their sleep patterns, anxiety severity, and mood status via a smartphone app on a daily basis during the 90-day study period. Push notifications were sent to participants daily at 9 am and 7 pm. Data regarding the patients’ demographics, interval from enrollment to first self-report, baseline Beck’s Depression Inventory (BDI) score, and health-related quality of life score (as assessed using the EuroQol Five Dimensional [EQ5D-3L] questionnaire) were collected to ascertain the factors associated with compliance with the self-reporting process.ResultsA total of 30 participants (mean age 45 years, SD 6; range 35-65 years) were analyzed in this study. In total, 2700 daily push notifications were sent to these 30 participants over the 90-day study period via their smartphones, resulting in the collection of 1215 self-reporting sleep-disturbance data items (overall compliance rate=45.0%, 1215/2700). The median value of individual patient-level reporting rates was 41.1% (range 6.7-95.6%). The longitudinal day-level compliance curve fell to 50.0% at day 34 and reached a nadir of 13.3% at day 90. The cumulative longitudinal compliance curve exhibited a steady decrease by about 50% at day 70 and continued to fall to 45% on day 90. Women without any form of employment exhibited the higher compliance rate. There was no association between any of the other patient characteristics (ie, demographics, and BDI and EQ5D-3L scores) and compliance. The mean individual patient-level reporting rate was higher for the subgroup with a 1-day lag time, defined as starting to self-report on the day immediately after enrollment, than for those with a lag of 2 or more days (51.6%, SD 24.0 and 29.6%, SD 25.3, respectively; P=.03).ConclusionsThe 90-day longitudinal collection of daily self-reporting sleep-disturbance data via a smartphone app was found to be feasible. Further research should focus on how to sustain compliance with this self-reporting for a longer time and select subpopulations with higher rates of compliance for mobile health care.

Background and Purpose-The association between obesity and stroke remains controversial, with earlier studies suggesting that differences might stem from heterogeneous stroke subtype compositions. The association between body mass index (BMI) and stroke subtypes was examined prospectively in a large cohort study. Methods-A total of 234 863 Korean men aged 40 to 64 years without substantial weight loss over 4 years after baseline examination in 1986 were divided into 8 categories of BMI and were followed up between 1991 and 2000 for fatal and nonfatal stroke events. Results-There was a positive association across the whole range of BMI and ischemic stroke, with a confounder-adjusted hazard of 11% (95% CI, 1.09 to 1.12) for 1 kg/m 2 higher BMI. A J-shaped association was observed between BMI and hemorrhagic stroke; groups with a higher BMI than the reference category (22 to 23 kg/m 2 ) had significantly increased risks. Full adjustment for confounders and variables potentially on the causal pathway (ie, blood pressure, blood glucose, and cholesterol) attenuated the association between BMI and stroke subtypes only for those with BMI greater than the reference category. Exclusion of deaths during the first 8 years or stratified analysis according to smoking habit did not change the relation between BMI and stroke subtypes. Conclusions-BMI is a risk factor for both ischemic and hemorrhagic stroke but shows different relationships with each.When the total burden of stroke is considered, there is an urgent need to find better ways of reducing the trend toward growing obesity in both Western and Asian countries.

Human personality is 30-60% heritable according to twin and adoption studies. Hundreds of genetic variants are expected to influence its complex development, but few have been identified. We used a machine learning method for genome-wide association studies (GWAS) to uncover complex genotypic-phenotypic networks and environmental interactions. The Temperament and Character Inventory (TCI) measured the self-regulatory components of personality critical for health (i.e., the character traits of self-directedness, cooperativeness, and self-transcendence). In a discovery sample of 2149 healthy Finns, we identified sets of single-nucleotide polymorphisms (SNPs) that cluster within particular individuals (i.e., SNP sets) regardless of phenotype. Second, we identified five clusters of people with distinct profiles of character traits regardless of genotype. Third, we found 42 SNP sets that identified 727 gene loci and were significantly associated with one or more of the character profiles. Each character profile was related to different SNP sets with distinct molecular processes and neuronal functions. Environmental influences measured in childhood and adulthood had small but significant effects. We confirmed the replicability of 95% of the 42 SNP sets in healthy Korean and German samples, as well as their associations with character. The identified SNPs explained nearly all the heritability expected for character in each sample (50 to 58%). We conclude that self-regulatory personality traits are strongly influenced by organized interactions among more than 700 genes despite variable cultures and environments. These gene sets modulate specific molecular processes in brain for intentional goal-setting, self-reflection, empathy, and episodic learning and memory.

To evaluate the association between height and risk of cancer in an East Asian, middle-income population, the authors followed up a cohort of 788,789 Koreans (449,214 men and 339,575 women) aged 40-64 years for cancer incidence between 1994 and 2003. Cox proportional hazards regression analysis was used to evaluate the association. Each 5-cm increment in height was associated with 5% and 7% higher risk of all-sites cancer in men and women, respectively, after adjustment for age, body mass index, and behavioral and socioeconomic factors. When the associations were evaluated for site-specific cancers, a positive association was observed for cancer of the colon and thyroid in both men and women. Among gender-specific cancers, prostate cancer was positively associated with height in men. In women, there was a positive association between height and cancers of the breast and ovary, which did not change even after additional adjustment for reproductive factors. Although more clarification is needed for some site-specific cancers, the same positive association of height with cancer in a middle-income Korean population as found in high-income Western populations supports the influence of early life environment on cancer development in adulthood.

BackgroundObesity and type 2 diabetes (T2D) are linked both with host genetics and with environmental factors, including dysbioses of the gut microbiota. However, it is unclear whether these microbial changes precede disease onset. Twin cohorts present a unique genetically-controlled opportunity to study the relationships between lifestyle factors and the microbiome. In particular, we hypothesized that family-independent changes in microbial composition and metabolic function during the sub-clinical state of T2D could be either causal or early biomarkers of progression.MethodsWe collected fecal samples and clinical metadata from 20 monozygotic Korean twins at up to two time points, resulting in 36 stool shotgun metagenomes. While the participants were neither obese nor diabetic, they spanned the entire range of healthy to near-clinical values and thus enabled the study of microbial associations during sub-clinical disease while accounting for genetic background.ResultsWe found changes both in composition and in function of the sub-clinical gut microbiome, including a decrease in Akkermansia muciniphila suggesting a role prior to the onset of disease, and functional changes reflecting a response to oxidative stress comparable to that previously observed in chronic T2D and inflammatory bowel diseases. Finally, our unique study design allowed us to examine the strain similarity between twins, and we found that twins demonstrate strain-level differences in composition despite species-level similarities.ConclusionsThese changes in the microbiome might be used for the early diagnosis of an inflamed gut and T2D prior to clinical onset of the disease and will help to advance toward microbial interventions.Electronic supplementary materialThe online version of this article (doi:10.1186/s13073-016-0271-6) contains supplementary material, which is available to authorized users.