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14. Personalized Medicine Approach in Treating Parkinson’s Disease, Using Oral Administration of Levodopa/Carbidopa Microtablets in Clinical Practice

Author

Gretarsdottir, Helga Maria, Widman, Erik, Johansson, Anders, and Nyholm, Dag

Subjects
Neurology, Neurologi, microtablets, dose dispenser, Parkinson's disease, Parkinson’s disease, Medicine, carbidopa, levodopa, Article
Abstract

Background: The most effective symptomatic treatment in Parkinson's disease (PD) is levodopa in standard doses. However, as the disease progresses, there may be a need for a more personalized approach and fine tuning, in accordance with the patients' needs. This study aims to evaluate the individual experience of levodopa/carbidopa 5/1.25 mg microtablets (LC-5) in clinical practice with respect to efficacy, tolerability, and usability. The method used was as follows: patients answered a questionnaire concerning the effect and usability of LC-5, and their medical records were reviewed. Regarding results, thirty-five survey responses were obtained, and 29 patients' medical records were reviewed. The LC-5 dose dispenser usability was generally rated positively and facilitated medication adherence. The majority (85%) of patients reported symptom improvement while using LC-5, compared with previous standard treatments. These results suggest that LC-5 therapy is generally well-tolerated, with favorable patient-reported efficacy and user friendliness, as well as the possibility for an individualized, fine-tuned PD treatment. Further studies with a prospective design and larger study population are needed to confirm the results.

Published
2021

15. Does Information from the Parkinson KinetiGraph™ (PKG) Influence the Neurologist’s Treatment Decisions?—An Observational Study in Routine Clinical Care of People with Parkinson’s Disease

Author

Sundgren, Mathias, Andréasson, Mattias, Svenningsson, Per, Noori, Rose-Marie, and Johansson, Anders

Subjects
treatment, cardiovascular system, Parkinson’s disease, PKG, Medicine, device, Article, objective measurement
Abstract

Management of Parkinson’s disease traditionally relies solely on clinical assessment. The PKG objectively measures affected persons’ movements in daily life. The present study evaluated how often PKG data changed treatment decisions in routine clinical care and to what extent the clinical assessment and the PKG interpretation differed. PKG recordings were performed before routine visits. The neurologist first made a clinical assessment without reviewing the PKG. Signs and symptoms were recorded, and a treatment plan was documented. Afterward, the PKG was evaluated. Then, the neurologist decided whether to change the initial treatment plan or not. PKG review resulted in a change in the initial treatment plan in 21 of 66 participants (31.8%). The clinical assessment and the PKG review differed frequently, mainly regarding individual overall presence of motor problems (67%), profile of bradykinesia/wearing off (79%), dyskinesia (35%) and sleep (55%). PKG improved the dialogue with the participant in 88% of cases. PKG and clinical variables were stable when they were repeated after 3–6 months. In conclusion, PKG information changes treatment decisions in nearly a third of people with Parkinson’s disease in routine care. Standard clinical assessment and PKG evaluation are often non-identical. Objective measurements in people living with Parkinson’s disease can add therapeutically relevant information.

Published
2021

17. Reorganized Genomic Taxonomy of Francisellaceae Enables Design of Robust Environmental PCR Assays for Detection of Francisella tularensis

Author

Öhrman, Caroline, primary, Sahl, Jason W., additional, Sjödin, Andreas, additional, Uneklint, Ingrid, additional, Ballard, Rebecca, additional, Karlsson, Linda, additional, McDonough, Ryelan F., additional, Sundell, David, additional, Soria, Kathleen, additional, Bäckman, Stina, additional, Chase, Kitty, additional, Brindefalk, Björn, additional, Sozhamannan, Shanmuga, additional, Vallesi, Adriana, additional, Hägglund, Emil, additional, Ramirez-Paredes, Jose Gustavo, additional, Thelaus, Johanna, additional, Colquhoun, Duncan, additional, Myrtennäs, Kerstin, additional, Birdsell, Dawn, additional, Johansson, Anders, additional, Wagner, David M., additional, and Forsman, Mats, additional

Published
2021
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30. Saliva and Serum Immune Responses in Apical Periodontitis

Author

Pietiäinen, Milla, primary, Liljestrand, John M., additional, Akhi, Ramin, additional, Buhlin, Kåre, additional, Johansson, Anders, additional, Paju, Susanna, additional, Salminen, Aino, additional, Mäntylä, Päivi, additional, Sinisalo, Juha, additional, Tjäderhane, Leo, additional, Hörkkö, Sohvi, additional, and Pussinen, Pirkko J., additional

Published
2019
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32. Automatic Spiral Analysis for Objective Assessment of Motor Symptoms in Parkinson’s Disease

Author

Memedi, Mevludin, Sadikov, Aleksander, Groznik, Vida, Zabkar, Jure, Mozina, Martin, Bergquist, Filip, Johansson, Anders, Haubenberger, Deitrich, Nyholm, Dag, Memedi, Mevludin, Sadikov, Aleksander, Groznik, Vida, Zabkar, Jure, Mozina, Martin, Bergquist, Filip, Johansson, Anders, Haubenberger, Deitrich, and Nyholm, Dag

Abstract

A challenge for the clinical management of advanced Parkinson’s disease (PD) patients is the emergence of fluctuations in motor performance, which represents a significant source of disability during activities of daily living of the patients. There is a lack of objective measurement of treatment effects for in-clinic and at-home use that can provide an overview of the treatment response. The objective of this paper was to develop a method for objective quantification of advanced PD motor symptoms related to off episodes and peak dose dyskinesia, using spiral data gathered by a touch screen telemetry device. More specifically, the aim was to objectively characterize motor symptoms (bradykinesia and dyskinesia), to help in automating the process of visual interpretation of movement anomalies in spirals as rated by movement disorder specialists. Digitized upper limb movement data of 65 advanced PD patients and 10 healthy (HE) subjects were recorded as they performed spiral drawing tasks on a touch screen device in their home environment settings. Several spatiotemporal features were extracted from the time series and used as inputs to machine learning methods. The methods were validated against ratings on animated spirals scored by four movement disorder specialists who visually assessed a set of kinematic features and the motor symptom. The ability of the method to discriminate between PD patients and HE subjects and the test-retest reliability of the computed scores were also evaluated. Computed scores correlated well with mean visual ratings of individual kinematic features. The best performing classifier (Multilayer Perceptron) classified the motor symptom (bradykinesia or dyskinesia) with an accuracy of 84% and area under the receiver operating characteristics curve of 0.86 in relation to visual classifications of the raters. In addition, the method provided high discriminating power when distinguishing between PD patients and HE subjects as well as had good test, Funding Agencies:Nordforce Technology AB Animech AB Dalarna University 20130041 Slovenian Research Agency Slovenian Ministry of Education, Science and Sport European Regional Development Fund (PARKINSCHECK project)

Published
2015
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36. Leukotoxin A Production and Release by JP2 and Non-JP2 Genotype Aggregatibacter actinomycetemcomitans in Relation to Culture Conditions.

Author

Kalfas S, Pour ZK, Claesson R, and Johansson A

Abstract

Aggressive forms of periodontitis, especially in young patients, are often associated with an increased proportion of the Gram-negative bacterium Aggregatibacter actinomycetemcomitans of the microbiota of the affected periodontal sites. One of the virulence factors of A. actinomycetemcomitans is a leukotoxin (LtxA) that induces a pro-inflammatory cell death process in leukocytes. A. actinomycetemcomitans exhibits a large genetic diversity and different genotypes vary in LtxA production capacity. The genotype JP2 is a heavy LtxA producer due to a 530-base pair deletion in the promoter for the toxin genes, and this trait has been associated with an increased pathogenic potential. The present study focused on the production and release of LtxA by different A. actinomycetemcomitans genotypes and serotypes under various growth conditions. Four different strains of this bacterium were cultured in two different culture broths, and the amount of LtxA bound to the bacterial surface or released into the broths was determined. The cultures were examined during the logarithmic and the early stationary phases of growth. The JP2 genotype exhibited the highest LtxA production among the strains tested, and production was not affected by the growth phase. The opposite was observed with the other strains. The composition of the culture broth had no effect on the growth pattern of the tested strains. However, the abundant release of LtxA from the bacterial surface into the culture broth was found in the presence of horse serum. Besides confirming the enhanced leucotoxicity of the JP2 genotype, the study provides new data on LtxA production in the logarithmic and stationary phases of growth and the effect of media composition on the release of the toxin from the bacterial membrane.

Published
2024
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37. Prevalence of Subgingival Aggregatibacter actinomycetemcomitans : Descriptive Cross-Sectional Study.

Author

Khzam N, Kujan O, Haubek D, Arslan A, Johansson A, Oscarsson J, Razooqi Z, and Miranda LA

Abstract

This paper aims to investigate the presence of Aggregatibacter actinomycetemcomitans and to assess potential indicators of the risk of severe form(s) of periodontitis. A descriptive cross-sectional study of 156 consecutive patients with periodontitis was conducted. Subgingival plaque samples were collected from the participants. The identification of A. actinomycetemcomitans was performed using quantitative polymerase chain reaction. A descriptive analysis, a chi-square test, and a binary logistic regression statistical evaluation were performed. The prevalence of A. actinomycetemcomitans in this population of 156 participants was 17.30% (27 patients). The prevalence of stage-III periodontitis was 75.6% and greater in older men, while the prevalence of stage-IV periodontitis was 22.4% and greater in younger women. We observed a significant relation between the risk of severe periodontitis (stage-IV) and poor oral hygiene ( p = 0.006), attendance at dental appointments ( p ≤ 0.001), and familial history of periodontitis ( p = 0.032). In conclusion, twenty-seven individuals were positive for A. actinomycetemcomitans . Poor oral hygiene, family history of periodontitis, and irregular attendance at dental appointments were identified as potential risk factors for severe periodontitis in this cohort.

Published
2024
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38. Virulence and Pathogenicity Properties of Aggregatibacter actinomycetemcomitans .

Author

Belibasakis GN, Maula T, Bao K, Lindholm M, Bostanci N, Oscarsson J, Ihalin R, and Johansson A

Abstract

Aggregatibacter actinomycetemcomitans is a periodontal pathogen colonizing the oral cavity of a large proportion of the human population. It is equipped with several potent virulence factors that can cause cell death and induce or evade inflammation. Because of the large genetic diversity within the species, both harmless and highly virulent genotypes of the bacterium have emerged. The oral condition and age, as well as the geographic origin of the individual, influence the risk to be colonized by a virulent genotype of the bacterium. In the present review, the virulence and pathogenicity properties of A. actinomycetemcomitans will be addressed., Competing Interests: The authors declare no conflict of interest.

Published
2019
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39. Comment from the Editor to the Special Issue: "Periodontitis: From Dysbiotic Microbial Immune Response to Systemic Inflammation".

Author

Oscarsson J and Johansson A

Abstract

The human oral cavity contains a large number of different microbial habitats. When microbes from the oral indigenous flora colonize the interspace between the tooth and the connective tissue, they induce an inflammatory response. If the microbes are in sufficient numbers, and release components that cause an imbalance in the host inflammatory response, degenerative processes in the surrounding tissues are induced, ultimately resulting in periodontal disease. The disease progress depends on bacterial load, the composition of the microbial community, and host genetic factors. The two most studied periodontal pathogens, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans express virulence factors, including proteases and exotoxins. Periodontal infections are also linked to the risk pattern of several systemic diseases. We would like to shed light on the mechanisms behind periodontitis and the associations of periodontal infections with systemic inflammation. Seven articles are included in this Special Issue and cover several pathogenic processes in the periodontal infection with capacity to cause imbalance in the host response. Highlights from each of the published papers are summarized and discussed below., Competing Interests: The authors declare no conflict of interest.

Published
2019
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