Publications by authors named "Kendra A Young"

Background: Chronic Obstructive Pulmonary Disease (COPD) is a complex and heterogeneous disease. Emphysema-predominant and non-emphysema predominant COPD are two major disease subtypes capturing important aspects of COPD heterogeneity. Molecular differences between these COPD subtypes are unknown.

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  • The study explores how a new COPD diagnostic approach that combines respiratory symptoms with imaging findings can identify more individuals at risk for the disease than current guidelines.
  • It utilizes data from two large longitudinal cohorts (COPDGene and CanCOLD) to assess participants over time, focusing on factors such as mortality and respiratory health outcomes.
  • The findings suggest that the new criteria, which consider structural lung changes via CT scans, could help detect COPD in patients who might otherwise go unrecognized.
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Background: Previous work has shown a role of CCL2, a key chemokine governing monocyte trafficking, in atherosclerosis. However, it remains unknown whether targeting CCR2, the cognate receptor of CCL2, provides protection against human atherosclerotic cardiovascular disease.

Methods: Computationally predicted damaging or loss-of-function (REVEL > 0.

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Background: Genome-wide association studies have identified several hundred susceptibility single nucleotide variants for coronary artery disease (CAD). Despite single nucleotide variant-based genome-wide association studies improving our understanding of the genetics of CAD, the contribution of structural variants (SVs) to the risk of CAD remains largely unclear.

Method And Results: We leveraged SVs detected from high-coverage whole genome sequencing data in a diverse group of participants from the National Heart Lung and Blood Institute's Trans-Omics for Precision Medicine program.

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Background: Little information is available on iron with diabetes risk among African Americans, a population where both anemia and elevated ferritin are common. We tested whether plasma proteomic measurements of ferritin and transferrin were associated with increased diabetes risk in a cohort of current and former African American (NHB) and Non-Hispanic White (NHW) smokers.

Methods: NHB and NHW participants from the COPDGene study who were free of diabetes (n = 4693) at baseline were followed for incident diabetes.

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  • Whole genome sequencing (WGS) helps identify rare genetic variants that may explain the missing heritability of coronary artery disease (CAD) by analyzing 4,949 cases and 17,494 controls from the NHLBI TOPMed program.
  • The study estimates that the heritability of CAD is around 34.3%, with ultra-rare variants contributing about 50%, especially those with low linkage disequilibrium.
  • Functional annotations show significant enrichment of CAD heritability, highlighting the importance of ultra-rare variants and specific regulatory mechanisms in different cells as major factors influencing genetic risk for the disease.
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  • Coronary artery calcification (CAC) is linked to heart disease and assessed through a genome-wide association study (GWAS) involving 22,400 participants from various backgrounds.
  • The study confirmed connections with four known genetic loci and discovered two new loci related to CAC, with supportive replication findings for both.
  • Functional tests suggest that ARSE promotes calcification in vascular smooth muscle cells and its variants may influence CAC levels, identifying ARSE as a key target for potential treatments in vascular calcific diseases.
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The genome-wide association studies (GWAS) typically use linear or logistic regression models to identify associations between phenotypes (traits) and genotypes (genetic variants) of interest. However, the use of regression with the additive assumption has potential limitations. First, the normality assumption of residuals is the one that is rarely seen in practice, and deviation from normality increases the Type-I error rate.

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Background: Individuals with type 2 diabetes (T2D) have an increased risk of coronary artery disease (CAD), but questions remain about the underlying pathology. Identifying which CAD loci are modified by T2D in the development of subclinical atherosclerosis (coronary artery calcification [CAC], carotid intima-media thickness, or carotid plaque) may improve our understanding of the mechanisms leading to the increased CAD in T2D.

Methods: We compared the common and rare variant associations of known CAD loci from the literature on CAC, carotid intima-media thickness, and carotid plaque in up to 29 670 participants, including up to 24 157 normoglycemic controls and 5513 T2D cases leveraging whole-genome sequencing data from the Trans-Omics for Precision Medicine program.

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Background: Bronchiectasis in adults with chronic obstructive pulmonary disease (COPD) is associated with greater mortality. However, whether suspected bronchiectasis-defined as incidental bronchiectasis on computed tomography (CT) images plus clinical manifestation-is associated with increased mortality in adults with a history of smoking with normal spirometry and preserved ratio impaired spirometry (PRISm) is unknown.

Objective: To determine the association between suspected bronchiectasis and mortality in adults with normal spirometry, PRISm, and obstructive spirometry.

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Coronary artery calcification (CAC), a measure of subclinical atherosclerosis, predicts future symptomatic coronary artery disease (CAD). Identifying genetic risk factors for CAC may point to new therapeutic avenues for prevention. Currently, there are only four known risk loci for CAC identified from genome-wide association studies (GWAS) in the general population.

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  • Nonalcoholic fatty liver disease (NAFLD) is widespread, partly genetic, and currently lacks effective treatment options.
  • A genome-wide association study (GWAS) identified several genetic variants linked to NAFLD, focusing on genes related to metabolism and liver function.
  • Genetic risk factors can help classify NAFLD into subtypes and significantly increase the risk of severe liver complications, potentially aiding in the development of targeted therapies.
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  • The study investigates the role of CCR2, a receptor for CCL2 involved in monocyte movement, in the risk of atherosclerotic cardiovascular disease, particularly through examining genetic variants in a large population sample from the UK Biobank.
  • Researchers identified 45 harmful genetic variants linked to lower monocyte counts, finding that carriers had a reduced risk of myocardial infarction and coronary artery disease, especially the M249K variant.
  • The M249K variant was associated with significantly lower risks for heart issues without increasing infection risk, suggesting its potential protective role against cardiovascular diseases.
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The identification of early chronic obstructive pulmonary disease (COPD) is essential to appropriately counsel patients regarding smoking cessation, provide symptomatic treatment, and eventually develop disease-modifying treatments. Disease severity in COPD is defined using race-specific spirometry equations. These may disadvantage non-White individuals in diagnosis and care.

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Background: Race-specific spirometry reference equations are used globally to interpret lung function for clinical, research, and occupational purposes, but inclusion of race is under scrutiny.

Research Question: Does including self-identified race in spirometry reference equation formation improve the ability of predicted FEV values to explain quantitative chest CT abnormalities, dyspnea, or Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification?

Study Design And Methods: Using data from healthy adults who have never smoked in both the National Health and Nutrition Survey (2007-2012) and COPDGene study cohorts, race-neutral, race-free, and race-specific prediction equations were generated for FEV Using sensitivity/specificity, multivariable logistic regression, and random forest models, these equations were applied in a cross-sectional analysis to populations of individuals who currently smoke and individuals who formerly smoked to determine how they affected GOLD classification and the fit of models predicting quantitative chest CT phenotypes or dyspnea.

Results: Race-specific equations showed no advantage relative to race-neutral or race-free equations in models of quantitative chest CT phenotypes or dyspnea.

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: Chronic obstructive pulmonary disease (COPD) is usually comorbid with other chronic diseases. We aimed to assess the multimorbidity medication patterns and explore if the patterns are similar for phase 1 (P1) and 5-year follow-up phase 2 (P2) in the COPDGene cohort. Materials and Methods: A total of 5564 out of 10,198 smokers from the COPDGene cohort who completed 2 visits, P1 and P2 visits, with complete medication use history were included in the study.

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While variation in emphysema severity between patients with chronic obstructive pulmonary disease (COPD) is well-recognized, clinically applicable definitions of the emphysema-predominant disease (EPD) and non-emphysema-predominant disease (NEPD) subtypes have not been established. To study the clinical relevance of the EPD and NEPD subtypes, we tested the association of these subtypes with prospective decline in forced expiratory volume in 1 second (FEV1) and mortality among 3,427 subjects with Global Initiative for Chronic Obstructive Lung Disease (GOLD) spirometric grade 2-4 COPD at baseline in the Genetic Epidemiology of COPD (COPDGene) Study, an ongoing national multicenter study that started in 2007. NEPD was defined as airflow obstruction with less than 5% computed tomography (CT) quantitative densitometric emphysema at -950 Hounsfield units, and EPD was defined as airflow obstruction with 10% or greater CT emphysema.

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  • The study reveals that African-Americans (AA) are less frequently diagnosed with COPD using the fixed-ratio spirometry criterion (FEV/FVC < 0.7), with 70% of AA participants classified as non-COPD compared to 49% of non-Hispanic whites (NHW).
  • Younger AA smokers exhibited higher current smoking rates, fewer smoking years, but similar 12-year mortality rates when compared to NHW smokers.
  • The analysis showed that AA with undiagnosed COPD (GOLD 0) experienced greater respiratory symptoms and worse health scores, suggesting that fixed-ratio criteria may underdiagnose COPD in this population.
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  • Recent studies indicate a significant number of people have undiagnosed chronic obstructive pulmonary disease (COPD), which could lead to complications and missed treatment opportunities.
  • The research analyzed data from smokers with at least 10 pack-years of history, excluding those already diagnosed with COPD or related conditions, and identified various risk factors related to abnormal spirometry results.
  • The findings revealed that 21% of participants had undiagnosed airflow obstruction, with factors like age, smoking history, and certain health conditions being key indicators, highlighting the need for early diagnosis and treatment.
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Most transcriptome-wide association studies (TWASs) so far focus on European ancestry and lack diversity. To overcome this limitation, we aggregated genome-wide association study (GWAS) summary statistics, whole-genome sequences and expression quantitative trait locus (eQTL) data from diverse ancestries. We developed a new approach, TESLA (multi-ancestry integrative study using an optimal linear combination of association statistics), to integrate an eQTL dataset with a multi-ancestry GWAS.

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Background CT is the standard method used to assess bronchiectasis. A higher airway-to-artery diameter ratio (AAR) is typically used to identify enlarged bronchi and bronchiectasis; however, current imaging methods are limited in assessing the extent of this metric in CT scans. Purpose To determine the extent of AARs using an artificial intelligence-based chest CT and assess the association of AARs with exacerbations over time.

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  • Tobacco and alcohol use contribute significantly to global mortality rates, with heritability playing a key role in these behaviors.
  • This study utilized genetic data from a diverse population of 3.4 million individuals, including 21% non-European ancestry, to identify genetic variants linked to tobacco and alcohol use.
  • Findings showed that while increased genetic diversity improved the identification of genomic loci, polygenic risk scores were less effective across different ancestries, underscoring the need for larger and more diverse genetic datasets for better predictive outcomes.
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  • Common genetic variants account for less variation in complex traits like tobacco use than previously thought, leading to discussions about "missing heritability."
  • A study of over 26,000 individuals of European descent and nearly 12,000 of African descent found that rare genetic variants contribute significantly to the heritability of smoking behaviors.
  • The research revealed that rare variants could explain up to 74% of the heritability estimates for smoking traits, which are much higher than those based on common variants alone.
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Objective: Higher 25-hydroxyvitamin D (25(OH)D) levels have been associated with reduced risk for autoimmune diseases and are influenced by vitamin D metabolism genes. We estimated genetically-determined vitamin D levels by calculating a genetic risk score (GRS) and investigated whether the vitamin D GRS was associated with the presence of autoantibodies related to rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) in those at increased risk for developing RA and SLE, respectively.

Methods: In this cross-sectional study, we selected autoantibody positive (aAb+) and autoantibody negative (aAb-) individuals from the Studies of the Etiologies of Rheumatoid Arthritis (SERA), a cohort study of first-degree relatives (FDRs) of individuals with RA (189 RA aAb+, 181 RA aAb-), and the Lupus Family Registry and Repository (LFRR), a cohort study of FDRs of individuals with SLE (157 SLE aAb+, 185 SLE aAb-).

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Systemic lupus erythematosus (SLE) is propelled by pathogenic autoantibody (AutoAb) and immune pathway dysregulation. Identifying populations at risk of reaching classified SLE is essential to curtail inflammatory damage. Lupus blood relatives (Rel) have an increased risk of developing SLE.

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