BackgroundAdult survivors of childhood cancers such as acute lymphoblastic leukemia (ALL) have health problems that persist or develop years after cessation of therapy. These late effects include chronic inflammation-related comorbidities such as obesity and type 2 diabetes, but the underlying cause is poorly understood.ResultsWe compared the anal microbiota composition of adult survivors of childhood ALL (N = 73) with healthy control subjects (N = 61). We identified an altered community with reduced microbial diversity in cancer survivors, who also exhibit signs of immune dysregulation including increased T cell activation and chronic inflammation. The bacterial community among cancer survivors was enriched for Actinobacteria (e.g. genus Corynebacterium) and depleted of Faecalibacterium, correlating with plasma concentrations of IL-6 and CRP and HLA-DR+CD4+ and HLA-DR+CD8+ T cells, which are established markers of inflammation and immune activation.ConclusionsWe demonstrated a relationship between microbial dysbiosis and immune dysregulation in adult ALL survivors. These observations suggest that interventions that could restore microbial diversity may ameliorate chronic inflammation and, consequently, development of late effects of childhood cancer survivors.Electronic supplementary materialThe online version of this article (doi:10.1186/s40168-017-0250-1) contains supplementary material, which is available to authorized users.

Asymptomatic young adult survivors of childhood ALL demonstrate a biologic profile of chronic inflammation and telomere attrition, consistent with an early onset of cellular processes that drive accelerated aging. These processes may explain the premature development of age-related chronic conditions in childhood cancer survivors. Understanding their molecular basis may facilitate targeted interventions to disrupt the accelerated aging process and its long-term impact on overall health. Cancer 2017;123:4207-4214. © 2017 American Cancer Society.

Many treatment complications that occur late in childhood cancer survivors resemble age-related comorbidities observed in the elderly. An immune phenotype characterized by increased immune activation, systemic inflammation, and accumulation of latedifferentiated memory CD57 + CD28 − T cells has been associated with comorbidities in the elderly. Here, we explored if this phenotype was present in young adult leukemia survivors following an average of 19 years from chemotherapy and/or radiotherapy completion, and compared this with that in age-matched controls. We found that markers of systemic inflammation-IL-6 and human C-reactive protein and immune activation-CD38 and HLA-DR on T cells, soluble CD (sCD)163 from monocytes and macrophages-were increased in survivors compared to controls. T-cell responses specific to cytomegalovirus (CMV) were also increased in survivors compared to controls while CMV IgG levels in survivors were comparable to levels measured in the elderly (>50years) and correlated with IL-6, human C-reactive protein, sCD163, and CD57 + CD28 − memory T cells.Immune activation and inflammation markers correlated poorly with prior chemotherapy and radiotherapy exposure. These data suggest that CMV infection/reactivation is strongly correlated with the immunological phenotype seen in young childhood leukemia survivors and these changes may be associated with the early onset of age-related comorbidities in this group. Eur. J. Immunol. 2016Immunol. . 46: 1715Immunol. -1726 Introduction Childhood cancer survivors (CCS) have an increased risk of second neoplasms and comorbidities including cardiovascular disease, endocrine dysfunction, renal insufficiency, abnormal lung function, and neurological complications [1,2]. A study in the St. Jude Lifetime cohort also reported that the prevalence of frailty and prefrailty in young CCS (mean age 35 years) were comparable to that of controls who were aged 65 years and older [3]. In addition, CCS have also been associated with an increased risk of multiple infections [4], increased hospital admissions, as well as increased length of hospital stay [5,6]. Collectively, this suggests that the morbidities experienced in young adult CCS are remarkably similar to the spectrum of diseases seen in the elderly. KeywordsThe increased risk of comorbidities in CCS has largely been attributed to chemotherapy-and radiation-induced damage to specific organs [7,8] and thus referred to as long-term complications of cancer treatment. Postulated reasons for the development of these comorbidities include hormone deficiencies as a result of steroid use and damage to the hypothalamus-pituitary axis following cranial radiotherapy; direct chemotherapy-induced organ damage including anthracycline-induced cardiomyopathy and vincristine-induced neuropathy; and reduced physical activity due to poor self-perception (reviewed in [8]). Most studies assessing these long-term complications in CCS have focused predominantly on the association of these comorbidities with prior exposure to specifi...

Background Dengue is a systemic and dynamic disease with symptoms ranging from undifferentiated fever to dengue shock syndrome. Assessment of patients' severity of dehydration is integral to appropriate care and management. Urine colour has been shown to have a high correlation with overall assessment of hydration status. This study tests the feasibility of measuring dehydration severity in dengue fever patients by comparing urine colour captured by mobile phone cameras to established laboratory parameters. Methodology/Principal findings Photos of urine samples were taken in a customized photo booth, then processed using Adobe Photoshop to index urine colour into the red, green, and blue (RGB) colour space and assigned a unique RGB value. The RGB values were then correlated with patients' clinical and laboratory hydration indices using Pearson's correlation and multiple linear regression. There were strong correlations between urine osmolality and the RGB of urine colour, with r =-0.701 (red), r =-0.741 (green), and r =-0.761 (blue) (all p-value <0.05). There were strong correlations between urine specific gravity and the RGB of urine colour, with r =-0.759 (red), r =-0.785 (green), and r =-0.820 (blue) (all p-value <0.05). The blue component had the highest correlations with urine specific gravity and urine osmolality. There were moderate correlations between RGB components and serum urea, at r =-0.338 (red),-0.329 (green),-0.360 (blue). In terms of urine biochemical parameters linked to dehydration, multiple linear regression studies showed that the green colourimetry code was predictive of urine osmolality (β coefficient-0.082, p-value <0.001) while the blue colourimetry code was predictive of urine specific gravity (β coefficient-2,946.255, p-value 0.007). Conclusions/Significance Urine colourimetry using mobile phones was highly correlated with the hydration status of dengue patients, making it a potentially useful hydration status tool.