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Tag: Mailman School of Public Health

  • Microbiome disturbances reported as signature of chronic fatigue syndrome/myalgic encephalomyelitis

    Microbiome disturbances reported as signature of chronic fatigue syndrome/myalgic encephalomyelitis

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    Newswise — New research reveals differences in the gut microbiomes of people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) compared to those of healthy controls.

    ME/CFS is characterized by unexplained debilitating fatigue, cognitive dysfunction, gastrointestinal disturbances, among other symptoms.

    The study was led by scientists at the Center for Infection and Immunity (CII) at Columbia University Mailman School of Public Health, as part of the Center for Solutions for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, an inter-disciplinary, inter-institutional research group dedicated to understanding the biology of the disease in order to develop effective means to diagnose, treat and prevent it. Findings appear in the journal Cell Host & Microbe.

    The researchers conducted metagenomic and metabolomic analyses of fecal samples collected from geographically diverse cohort of 106 cases and 91 healthy controls. Results revealed differences in gut microbiome diversity, abundances, functional biological pathways, and interactions between bacteria. Cases and controls were matched for age, sex, geography, and socioeconomic status.

    Gut bacteria Faecalibacterium prausnitzii and Eubacterium rectale, which are both normally abundant and health-promoting, were reduced in ME/CFS participants. For both bacteria, researchers also found a deficient microbial capacity for synthesizing butyrate, the main fuel for the body’s colon cell, with ME/CFS. The abundance of Faecalibacterium prausnitzii was inversely associated with fatigue severity.

    The only other species identified with reduced relative abundance in ME/CFS was C. secundus, an acetate-producer, that could contribute to the net acetate deficiency the researchers found in ME/CFS subjects. Acetate is used by butyrate-producing bacteria to produce butyrate.

    An additional nine species had increased relative abundance in ME/CFS compared to healthy controls, including C. bolteae which in other research has correlated with fatigue in multiple sclerosis. Another, R. gnavus, has been associated with inflammatory bowel disease.

    “The gut microbiome is a complex ecological community teeming with diverse inter-species interactions that can be beneficial or harmful. Our research finds that in people with ME/CFS, there can be extensive rewiring of the networks of bacteria in this system,” says study senior author Brent Williams, PhD, assistant professor of epidemiology in CII at Columbia Mailman School of Public Health.

    “Understanding the connection between ME/CFS and disturbances in the gut microbiome may lead to ways to classify the disease and targets for therapeutic trials,” adds co-author W. Ian Lipkin, MD, CII director and John Snow Professor of Epidemiology at Columbia Mailman School.

    The study’s first author is Cheng Guo, PhD, senior programmer analyst at CII. Additional co-authors are listed in the publication.

    The research was funded by the National Institutes of Health grant to the Center for Solutions for ME/CFS at Columbia University (grant number 1U54AI138370), NIH grant R56AI120724, and anonymous donors through the Crowdfunding Microbe Discovery Project.

    The authors declare no competing interests.

    About ME/CFS

    Experts estimate there are between 800,000 and 2 million Americans with ME/CFS, a complex, debilitating disorder characterized by extreme fatigue after exertion and other symptoms including muscle and joint pain, cognitive dysfunction, sleep disturbance, and orthostatic intolerance. Currently, there is no diagnostic test for the disease; instead, patients are diagnosed based on a clinical examination and history and an exclusion of other disorders.

    Prior Research on ME/CFS

    In a 2017 study, CII scientists reported discovered abnormal levels of specific gut bacteria related to ME/CFS in patients with and without concurrent irritable bowel syndrome, IBS. A year later, another study identified a constellation of metabolites related to ME/CFS, providing the ability to predict whether or not someone has the disorder with a confidence of 84 percent.

    In a 2015 study, CII researchers identified distinct immune changes in patients diagnosed with ME/CFS. These immune signatures represented the first robust physical evidence that ME/CFS is a biological illness as opposed to a psychological disorder, and the first evidence that the disease has distinct stages. In a 2012 study, researchers ruled out a purported link between a mouse retrovirus called XMRV and ME/CFS.

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    Columbia University, Mailman School of Public Health

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  • COVID is changing how we are exposed to household health risks

    COVID is changing how we are exposed to household health risks

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    Newswise — COVID-19 is changing household behaviors related to how we are exposed to various household chemicals linked to poor health outcomes. People surveyed earlier in the pandemic were using less personal care products but more household cleaners, eating less fast food and restaurant food but more ultra-processed food. These changes which occurred since the pandemic onset are also linked to pandemic-related traumatic stress, which itself may worsen health outcomes.

    Researchers at Columbia University Mailman School of Public Health along with partners from Dartmouth College, as part of the Environmental influences on Child Health Outcomes (ECHO) consortium, analyzed responses to a survey from 1,535 adults in six states. Results are published in the journal PLOS ONE.

    Personal care products. Overall, participants reported using fewer personal care products, including hair products (perms or relaxers, hair dye, hair sprays, hair gels) and makeup/body products (nail polish, make-up, perfume, lotion) since the start of the pandemic. Participants who experienced more pandemic-related traumatic stress were more likely to report using fewer hair products and cosmetics. Approximately half of all respondents reported using more liquid soaps (52%) and antibacterial soaps (48%) and 81 percent of respondents reported using more hand sanitizer gels. The use of all three products was associated with pandemic-related traumatic stress symptoms.

    Household cleansers. Two-thirds of respondents reported using more antibacterial cleaners and 54 percent reported using more bleach-containing cleaning products—changes made more likely among those experiencing more pandemic-related traumatic stress.

    Food-related behaviors. Nearly half (49%) of respondents said they eat more home-cooked meals because of the pandemic. One-third (34%) of respondents reported eating less fast food since the start of the pandemic. Both of these behavior changes were more common among those with more symptoms of pandemic-related traumatic stress. In all, 12 percent reported eating more ultra-processed foods, and 24 percent reported eating less processed foods, with the latter more likely among those with symptoms of pandemic-related traumatic stress.

    The Upshot

    While the study did not include measurements of environmental exposures, the researchers say that the scientific literature suggests that these behavior changes likely reflect changes in their exposures to environmental chemicals. They also likely reflect changes—both good and bad—to health outcomes linked to these chemicals.

    “We can infer that some behaviors like less consumption of fast foods and less use of personal care products might lower exposures to some phthalates and phenols, while greater use of personal and household cleansers may be associated with higher exposure to quaternary ammonium compounds and glycol ethers; and more frequent consumption of ultra-processed food could increase exposure to phthalates and phenols,” says lead author Julie Herbstman, PhD, director of the Columbia Center for Children’s Environmental Health (CCCEH) and professor of environmental health sciences.

    Phthalates are linked asthma, attention-deficit hyperactivity disorder, breast cancer, obesity and type II diabetes and neurodevelopmental and behavioral issues. Phenols like BPA are linked to reproductive dysfunction, reduced birth size, cognitive and/or behavior outcomes, asthma, and obesity. Quaternary ammonium compounds are skin irritants and can also lead to asthma exacerbations. Exposure to glycol ethers may also irritate skin, eyes, nose, and throat and may also lead to anemia and/or adverse reproductive outcomes like birth defects.  

    A Roadmap to Interventions

    The study identifies several factors that make some of these behavior changes more likely, including symptoms of pandemic-related traumatic stress and living in a household where someone tested positive for COVID-19, as well as race/ethnicity. Going forward, the researchers plan to repeat their analysis, adding a biological measure of chemical exposures to assess whether the trends in pandemic-related behavior change reported here do, in fact, result in shifts in exposures measured through biomarkers of internal dose. They also say it is important to continue to monitor pandemic-related behavior change as pandemic severity waxes and wanes.

    The researchers say their study could lead to an intervention to reduce exposure to harmful environmental chemicals.

    “Interventions and campaigns targeting the reduction of environmental exposures, pandemic-related traumatic stress, as well as those that facilitate behavior change can help improve health outcomes that are indirectly related to the pandemic,” says Herbstman.

    The study’s senior authors are Frederica Perera, director of the translational research program at CCCEH and professor of environmental health sciences at Columbia Mailman School of Public Health, and Margaret R. Karagas, professor and chair of epidemiology at the Geisel School of Medicine at Dartmouth. A full list of co-authors is available in the journal article.

    Funding for the research was provided by grants from the National Institutes of Heath (U2COD023375, U24OD023382, U24OD023382, U24OD023319, UH3OD023290, UH3OD023275, UH3OD023272, UH3OD023271, UH3OD023313).

    The authors declare no conflicts.

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    Columbia University, Mailman School of Public Health

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  • Highest metal concentrations in US public water systems found among Hispanic/Latino and American Indian communities

    Highest metal concentrations in US public water systems found among Hispanic/Latino and American Indian communities

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    Newswise — December 14, 2022–Significantly higher arsenic and uranium concentrations in public drinking water have been linked to communities with higher proportions of Hispanic/Latino, American Indian/Alaskan Native, and non-Hispanic Black residents, according to a new study at Columbia University Mailman School of Public Health. Arsenic and uranium were higher for Hispanic/Latino and American Indian communities nationwide, while higher proportions of non-Hispanic Black residents were associated with higher arsenic and uranium only in the West and Midwest regions where water arsenic and uranium are the highest.

    Until now studies evaluating these associations were not possible because estimates of nationwide contaminant concentrations were not publicly available for the majority of public water systems. The findings are published online in the journal Nature Communications.

    In many U.S. communities, drinking water is a significant source of exposure to arsenic and uranium, which are major environmental exposures associated with cancer, cardiovascular disease and other adverse health outcomes. The EPA sets a maximum contaminant level (MCL) of 30 µg/L for uranium and 10 µg/L for arsenic. However, EPA’s non-enforceable maximum contaminant level goal for both is 0 µg/L because there is no known safe level of exposure to either.

    “Our findings are particularly relevant to public health because there is no safe level of exposure to inorganic arsenic and uranium,” noted Irene Martinez-Morata, MD, PhD candidate in Environmental Health Sciences at Columbia University Mailman School of Public Health and first author. “These findings support that inequalities in public water contaminant exposures are more severe in regions with more residents from communities of color relying on public drinking water and higher concentrations of specific contaminants in source water.”

    “All communities, regardless of racial/ethnic makeup, deserve access to clean, high quality drinking water,” said Anne Nigra, PhD, Assistant Professor of Environmental Health Sciences at Columbia University Mailman School of Public Health. “Our analysis indicates that this is not currently the case in the US. Even after accounting for socioeconomic status, communities of color have higher arsenic and uranium in their regulated public drinking water.”

    The researchers used county-level, population-weighted concentration estimates of arsenic and uranium concentrations in public water systems across the U.S. — estimates based on the most recent publicly available nationwide monitoring data gathered by the U.S. Environmental Protection Agency. Water metal concentrations were available for a total of 2,585 counties for arsenic and 1,174 counties for uranium. Parallel analyses were conducted for each of these racial and ethnic groups: non-Hispanic Black, American Indian/Alaskan Native, Hispanic/Latino, and non-Hispanic White.

    “The quality of your drinking water should not be related to the racial/ethnic makeup of your community,” remarks Martinez-Morata. “Our findings can advance environmental justice initiatives by informing federal regulatory action and financial and technical support to protect communities of color.”

    An interactive map of county-level CWS metal concentrations is also available at: https://msph.shinyapps.io/drinking-water-dashboard/. 

    Co-authors are Dustin Duncan, Maya Spaur, Kevin Patterson, Seth Prins, and Ana Navas-Acien, Columbia Mailman School; Benjamin C. Bostick, Columbia Climate School; Otakuye Conroy-Ben, Arizona State University; and Miranda Jones, Johns Hopkins University.

    The study was supported by National Institute of Dental & Craniofacial Research (DP5OD031849), National Institute of Environmental Health Sciences (2T32ES007322, P300ES009089, P42 ES033719); and by a fellowship from La Caixa Foundation (ID100010434).

    Columbia University Mailman School of Public Health

    Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the fourth largest recipient of NIH grants among schools of public health. Its nearly 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change and health, and public health preparedness. It is a leader in public health education with more than 1,300 graduate students from 55 nations pursuing a variety of master’s and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit www.mailman.columbia.edu.

     

     

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    Columbia University, Mailman School of Public Health

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  • COVID lockdown did not lead to a rush on opioid prescriptions

    COVID lockdown did not lead to a rush on opioid prescriptions

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    Newswise — While some feared that New Yorkers would re-fill prescriptions to stockpile opioid medications in the early weeks of the COVID-19 lockdown much in the way people hoarded toilet paper, in fact, New York State opioid prescriptions declined in the period around the March 20, 2020 “PAUSE” order, according to new research. Meanwhile, prescriptions for medications for opioid use disorder (MOUD) were steady, likely thanks to policies to ensure their availability during the same period.

    The study was led by researchers at Columbia University Mailman School of Public Health and appears in the journal Addiction, the journal of the Society for the Study of Addiction.

    The researchers used a database from the health information technology and clinical research company IQVIA to examine trends in the dispensing of opioid prescriptions as New York State implemented various emergency policies to prevent the spread of COVID-19. These orders included pharmacy guidance permitting early refills of controlled and non-controlled medications (March 7); a suspension of elective surgeries in New York City (March 16); and a “New York State on PAUSE” order that greatly reduced trips outside the home (March 20). A concern with the recommendation for patients to refill their prescriptions early was that it would increase the quantities of opioids in households and increase the risk of opioid misuse and overdose. During the same period, the Substance Abuse and Mental Health Services Administration initiated a series of policy responses to support access to MOUD, such as expanding telemedicine and allowing online prescribing of buprenorphine.

    They found that prescriptions for non-MOUD opioids steadily declined between the weeks of March 21 and April 17 with only a small transient increase in early refills. The morphine milligram equivalents/day (MME/day) prescribed were 17 percent lower than in the four weeks before March 21—almost entirely due to a drop in opioids dispensed for prescriptions of a week or less, suggesting the driving cause was the suspension of elective surgeries. (Another possible explanation is reduced demand for opioids related to a decline in accidents and injuries during the lockdown period.) There was no discernable drop in MOUD dispensing associated with the period of the Emergency Orders with only a slight increase in the count of dispensed prescriptions in the week of March 14. These trends were evident statewide, with no disparities between ZIP codes with higher or lower poverty rates.

    The findings are in line with an earlier study that found the lockdown Texas similarly did not lead to a spike in prescriptions for non-MOUD opioids.

    “Our findings add to the evidence showing that the pandemic emergency orders did not cause a mass surge in dispensing of opioids and policy initiatives to ensure access to medications for opioid use disorder were likely effective,” says Andrew Rundle, DrPH, professor of epidemiology at Columbia University Mailman School of Public Health. “The research suggests that critical access to treatments for opioid use disorder can be maintained during future emergency ‘stay at home’ type orders and such orders are unlikely to cause mass early refills of opioid prescriptions and heightened risk of misuse.”

    The study’s first author is Abhinav Suri, who conducted the research as an MPH student in epidemiology at Columbia Mailman School and is now a medical student at the David Geffen School of Medicine, UCLA. Additional authors include Daniel J. Feaster and Raymond R. Balise, University of Miami Miller School of Medicine; Edward V. Nunes, Columbia University Irving Medical Center; Louisa Gilbert and Nabila El-Bassel, Columbia University School of Social Work.

    This research was supported by the National Institutes of Health through the NIH HEAL Initiative (UM1DA049412).  Access to IQVIA data was provided as part of the IQVIA Institute’s Human Data Science Research Collaborative in support of research activities related to important health system issues arising in the era of COVID-19.

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    Columbia University, Mailman School of Public Health

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