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Meira  Epplein

Meira Epplein, PhD

Associate Professor of Medicine (Epidemiology)
Cancer Epidemiologist

Contact Information:

2525 West End Ave.
Nashville, TN 37203
615-936-2145
Fax: 615-936-8291

Profile

Meira Epplein is a cancer epidemiologist interested in modifiable risk factors in under-served populations, with a focus on the association of infection and cancer.  Specifically, her research program has centered around the bacteria Helicobacter pylori, a spiral, gram-negative bacterium that infects approximately 50% of the world’s population, and is the leading carcinogenic infectious agent.  Her research seeks to understand the heterogeneity of H. pylori, to determine the most toxigenic forms of the bacteria so to identify the highest risk populations which can then be targeted for antibiotic therapy, which has been shown to be effective for risk reduction. At the same time, she is committed to furthering our understanding of the co-factors involved in both H. pylori-associated disease risk and benefit, as the bacteria has inhabited the stomachs of humans for over 100,000 years, and so very likely also confers certain biological advantages to its hosts.

As Principal Investigator, she has obtained three large NIH-funded grants to further explore the epidemiology of H. pylori heterogeneity: a 5-year career development award (K07) from NCI that focuses on infection, inflammation, and cancer; a 5-year R01 from NCI to develop an H. pylori blood biomarker for gastric cancer risk in East Asia; and a 4-year R01, again funded by NCI, to further investigate, in a large consortium of prospective cohorts across the United States, the novel preliminary finding of H. pylori protein-specific antibodies and the risk of colorectal cancer. She also serves as a Co-Investigator and lead gastric cancer and H. pylori researcher for the Southern Community Cohort Study (SCCS).

 

Education
  • PhD Epidemiology, University of Washington 2007
  • MS Epidemiology, University of Washington 2005
  • MA International Studies/China, University of Washington 1997
  • BA East Asian Studies, University of North Carolina 1994
Research Description

As a cancer epidemiologist with a focus on modifiable risk factors, particularly among ethnically diverse populations, I seek to understand the variations in lifestyle including, but not limited to, prevalence of infection, aspirin use, diet, physical activity, and anthropometry among groups of individuals with differing risks of disease. Currently my work is focused on Helicobacter pylori, a bacteria that lives in the lining of the stomach of approximately half of the world's population, and the dual nature of its relationship with disease. Specifically, infection with H. pylori is the most well-established risk factor for gastric cancer, but only a fraction of infected individuals will develop cancer, and there is evidence that carriage of the bacteria is inversely related with esophageal adenocarcinoma, a very fatal cancer that is currently increasing in incidence, and possibly with asthma, allergies, and gastroesophageal reflux disease as well. H. pylori prevalence varies widely by geographic region (30% in the United States compared to 80-90% in East Asia and Africa, for example), and by racial/ethnic group within regions as well (minorities in the United States, including African Americans and Asian Americans, have infection rates as high as seen in developing countries). Currently I am exploring the epidemiologic triangle of bacteria-host-environment through studies investigating H. pylori genetic diversity, host characteristics (including race and ancestry and individual inflammatory response) and lifestyle factors (such as diet and medication use) to better pinpoint who is at highest risk of disease, so that we make take preventive measures, especially among groups of under-served individuals who may be at particularly high risk.

Publications
  • Xu HL, Tan YT, Epplein M, Li HL, Gao J, Gao YT, Zheng W, Shu XO, Xiang YB. Population-based cohort studies of type 2 diabetes and stomach cancer risk in Chinese men and women. Cancer Sci [print-electronic]. 2015 Mar; 106(3): 294-8. PMID: 25557005, PMCID: PMC4374033, DOI: 10.1111/cas.12597, ISSN: 1349-7006.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/25557005.
  • Epplein M, Bostick RM, Mu L, Ogino S, Braithwaite D, Kanetsky PA. Challenges and opportunities in international molecular cancer prevention research: An ASPO Molecular Epidemiology and the Environment and International Cancer Prevention Interest Groups Report. Cancer Epidemiol. Biomarkers Prev [print-electronic]. 2014 Nov; 23(11): 2613-7. PMID: 25277796, PMCID: PMC4221505, PII: 1055-9965.EPI-14-0848, DOI: 10.1158/1055-9965.EPI-14-0848, ISSN: 1538-7755.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/25277796.
  • Epplein M, Burk RF, Cai Q, Hargreaves MK, Blot WJ. A prospective study of plasma Selenoprotein P and lung cancer risk among low-income adults. Cancer Epidemiol. Biomarkers Prev [print-electronic]. 2014 Jul; 23(7): 1238-44. PMID: 24762559, PMCID: PMC4082447, PII: 1055-9965.EPI-13-1308, DOI: 10.1158/1055-9965.EPI-13-1308, ISSN: 1538-7755.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/24762559.
  • Epplein M, Burk RF, Cai Q, Hargreaves MK, Blot WJ. A prospective study of plasma Selenoprotein P and lung cancer risk among low-income adults. Cancer Epidemiol. Biomarkers Prev [print-electronic]. 2014 Jul; 23(7): 1238-44. PMID: 24762559, PMCID: PMC4082447, PII: 1055-9965.EPI-13-1308, DOI: 10.1158/1055-9965.EPI-13-1308, ISSN: 1538-7755.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/24762559.
  • Epplein M, Peek RM, Blot WJ. Helicobacter pylori Biomarkers and Risk of Colorectal Oncogenesis--Response [letter]. Cancer Epidemiol. Biomarkers Prev [print-electronic]. 2014 Feb; 23(2): 366. PMID: 24285842, PMCID: PMC3946073, PII: 1055-9965.EPI-13-1191, DOI: 10.1158/1055-9965.EPI-13-1191, ISSN: 1538-7755.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/24285842.
  • Epplein M, Peek RM, Blot WJ. Helicobacter pylori Biomarkers and Risk of Colorectal Oncogenesis--Response [letter]. Cancer Epidemiol. Biomarkers Prev [print-electronic]. 2014 Feb; 23(2): 366. PMID: 24285842, PMCID: PMC3946073, PII: 1055-9965.EPI-13-1191, DOI: 10.1158/1055-9965.EPI-13-1191, ISSN: 1538-7755.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/24285842.
  • Epplein M, Zheng W, Li H, Peek RM, Correa P, Gao J, Michel A, Pawlita M, Cai Q, Xiang YB, Shu XO. Diet, Helicobacter pylori strain-specific infection, and gastric cancer risk among Chinese men. Nutr Cancer [print-electronic]. 2014; 66(4): 550-7. PMID: 24666234, PMCID: PMC4068395, DOI: 10.1080/01635581.2014.894096, ISSN: 1532-7914.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/24666234.
  • Epplein M, Zheng W, Li H, Peek RM, Correa P, Gao J, Michel A, Pawlita M, Cai Q, Xiang YB, Shu XO. Diet, Helicobacter pylori strain-specific infection, and gastric cancer risk among Chinese men. Nutr Cancer [print-electronic]. 2014; 66(4): 550-7. PMID: 24666234, PMCID: PMC4068395, DOI: 10.1080/01635581.2014.894096, ISSN: 1532-7914.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/24666234.
  • Epplein M, Xiang YB, Cai Q, Peek RM, Li H, Correa P, Gao J, Wu J, Michel A, Pawlita M, Zheng W, Shu XO. Circulating cytokines and gastric cancer risk. Cancer Causes Control [print-electronic]. 2013 Dec; 24(12): 2245-50. PMID: 24052422, PMCID: PMC3828746, DOI: 10.1007/s10552-013-0284-z, ISSN: 1573-7225.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/24052422.
  • Epplein M, Pawlita M, Michel A, Peek RM, Cai Q, Blot WJ. Helicobacter pylori protein-specific antibodies and risk of colorectal cancer. Cancer Epidemiol. Biomarkers Prev [print-electronic]. 2013 Nov; 22(11): 1964-74. PMID: 24045925, PMCID: PMC3828745, PII: 1055-9965.EPI-13-0702, DOI: 10.1158/1055-9965.EPI-13-0702, ISSN: 1538-7755.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/24045925.
  • Kweon SS, Shu XO, Xiang Y, Cai H, Yang G, Ji BT, Li H, Gao YT, Zheng W, Epplein M. Intake of specific nonfermented soy foods may be inversely associated with risk of distal gastric cancer in a Chinese population. J. Nutr [print-electronic]. 2013 Nov; 143(11): 1736-42. PMID: 23986366, PMCID: PMC3796344, PII: jn.113.177675, DOI: 10.3945/jn.113.177675, ISSN: 1541-6100.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/23986366.
  • Epplein M, Zheng W, Xiang YB, Peek RM, Li H, Correa P, Gao J, Michel A, Pawlita M, Cai Q, Shu XO. Prospective study of Helicobacter pylori biomarkers for gastric cancer risk among Chinese men. Cancer Epidemiol. Biomarkers Prev [print-electronic]. 2012 Dec; 21(12): 2185-92. PMID: 23035179, PMCID: PMC3518572, PII: 1055-9965.EPI-12-0792-T, DOI: 10.1158/1055-9965.EPI-12-0792-T, ISSN: 1538-7755.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/23035179.
  • Epplein M, Cohen SS, Sonderman JS, Zheng W, Williams SM, Blot WJ, Signorello LB. Neighborhood socio-economic characteristics, African ancestry, and Helicobacter pylori sero-prevalence. Cancer Causes Control [print-electronic]. 2012 Jun; 23(6): 897-906. PMID: 22527167, PMCID: PMC3475203, DOI: 10.1007/s10552-012-9960-7, ISSN: 1573-7225.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/22527167.
  • Nomura AM, Wilkens LR, Henderson BE, Epplein M, Kolonel LN. The association of cigarette smoking with gastric cancer: the multiethnic cohort study. Cancer Causes Control [print-electronic]. 2012 Jan; 23(1): 51-8. PMID: 22037905, PMCID: PMC4166441, DOI: 10.1007/s10552-011-9854-0, ISSN: 1573-7225.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/22037905.
  • Epplein M, Signorello LB, Zheng W, Cai Q, Hargreaves MK, Michel A, Pawlita M, Fowke JH, Correa P, Blot WJ. Helicobacter pylori prevalence and circulating micronutrient levels in a low-income United States population. Cancer Prev Res (Phila) [print-electronic]. 2011 Jun; 4(6): 871-8. PMID: 21436385, PMCID: PMC3107911, PII: 1940-6207.CAPR-10-0398, DOI: 10.1158/1940-6207.CAPR-10-0398, ISSN: 1940-6215.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/21436385.
  • Epplein M, Signorello LB, Zheng W, Peek RM, Michel A, Williams SM, Pawlita M, Correa P, Cai Q, Blot WJ. Race, African ancestry, and Helicobacter pylori infection in a low-income United States population. Cancer Epidemiol. Biomarkers Prev [print-electronic]. 2011 May; 20(5): 826-34. PMID: 21357376, PMCID: PMC3089670, PII: 1055-9965.EPI-10-1258, DOI: 10.1158/1055-9965.EPI-10-1258, ISSN: 1538-7755.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/21357376.
  • Epplein M, Zheng Y, Zheng W, Chen Z, Gu K, Penson D, Lu W, Shu XO. Quality of life after breast cancer diagnosis and survival. J. Clin. Oncol [print-electronic]. 2011 Feb 2/1/2011; 29(4): 406-12. PMID: 21172892, PMCID: PMC3058286, PII: JCO.2010.30.6951, DOI: 10.1200/JCO.2010.30.6951, ISSN: 1527-7755.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/21172892.
  • Piazuelo MB, Epplein M, Correa P. Gastric cancer: an infectious disease. Infect. Dis. Clin. North Am. 2010 Dec; 24(4): 853-69, vii. PMID: 20937454, PMCID: PMC2954127, PII: S0891-5520(10)00065-6, DOI: 10.1016/j.idc.2010.07.010, ISSN: 1557-9824.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/20937454.
  • Epplein M, Shu XO, Xiang YB, Chow WH, Yang G, Li HL, Ji BT, Cai H, Gao YT, Zheng W. Fruit and vegetable consumption and risk of distal gastric cancer in the Shanghai Women's and Men's Health studies. Am. J. Epidemiol [print-electronic]. 2010 Aug 8/15/2010; 172(4): 397-406. PMID: 20647333, PMCID: PMC2950795, PII: kwq144, DOI: 10.1093/aje/kwq144, ISSN: 1476-6256.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/20647333.
  • Reed SD, Newton KM, Garcia RL, Allison KH, Voigt LF, Jordan CD, Epplein M, Swisher E, Upson K, Ehrlich KJ, Weiss NS. Complex hyperplasia with and without atypia: clinical outcomes and implications of progestin therapy. Obstet Gynecol. 2010 Aug; 116(2 Pt 1): 365-73. PMID: 20664397, PMCID: PMC2949551, PII: 00006250-201008000-00018, DOI: 10.1097/AOG.0b013e3181e93330, ISSN: 1873-233X.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/20664397.
  • Epplein M, Novotny R, Daida Y, Vijayadeva V, Onaka AT, Le Marchand L. Association of maternal and intrauterine characteristics with age at menarche in a multiethnic population in Hawaii. Cancer Causes Control [print-electronic]. 2010 Feb; 21(2): 259-68. PMID: 19862633, PMCID: PMC2811221, DOI: 10.1007/s10552-009-9457-1, ISSN: 1573-7225.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/19862633.
  • Epplein M, Nomura AM, Wilkens LR, Henderson BE, Kolonel LN. Nonsteroidal antiinflammatory drugs and risk of gastric adenocarcinoma: the multiethnic cohort study. Am. J. Epidemiol [print-electronic]. 2009 Aug 8/15/2009; 170(4): 507-14. PMID: 19584132, PMCID: PMC2727180, PII: kwp162, DOI: 10.1093/aje/kwp162, ISSN: 1476-6256.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/19584132.
  • Epplein M, Franke AA, Cooney RV, Morris JS, Wilkens LR, Goodman MT, Murphy SP, Henderson BE, Kolonel LN, Le Marchand L. Association of plasma micronutrient levels and urinary isoprostane with risk of lung cancer: the multiethnic cohort study. Cancer Epidemiol. Biomarkers Prev [print-electronic]. 2009 Jul; 18(7): 1962-70. PMID: 19531680, PMCID: PMC2755047, PII: 1055-9965.EPI-09-0003, DOI: 10.1158/1055-9965.EPI-09-0003, ISSN: 1538-7755.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/19531680.
  • Reed SD, Newton KM, Clinton WL, Epplein M, Garcia R, Allison K, Voigt LF, Weiss NS. Incidence of endometrial hyperplasia. Am. J. Obstet. Gynecol [print-electronic]. 2009 Jun; 200(6): 678.e1-6. PMID: 19393600, PMCID: PMC2692753, PII: S0002-9378(09)00223-3, DOI: 10.1016/j.ajog.2009.02.032, ISSN: 1097-6868.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/19393600.
  • Reed SD, Voigt LF, Newton KM, Garcia RH, Allison HK, Epplein M, Jordan D, Swisher E, Weiss NS. Progestin therapy of complex endometrial hyperplasia with and without atypia. Obstet Gynecol. 2009 Mar; 113(3): 655-62. PMID: 19300331, PMCID: PMC2680496, PII: 00006250-200903000-00014, DOI: 10.1097/AOG.0b013e318198a10a, ISSN: 0029-7844.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/19300331.
  • Epplein M, Reed SD, Voigt LF, Newton KM, Holt VL, Weiss NS. Endometrial hyperplasia risk in relation to recent use of oral contraceptives and hormone therapy. Ann Epidemiol. 2009 Jan; 19(1): 1-7. PMID: 19064186, PMCID: PMC2615384, PII: S1047-2797(08)00284-6, DOI: 10.1016/j.annepidem.2008.08.099, ISSN: 1873-2585.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/19064186.
  • Epplein M, Wilkens LR, Tiirikainen M, Dyba M, Chung FL, Goodman MT, Murphy SP, Henderson BE, Kolonel LN, Le Marchand L. Urinary isothiocyanates; glutathione S-transferase M1, T1, and P1 polymorphisms; and risk of colorectal cancer: the Multiethnic Cohort Study. Cancer Epidemiol. Biomarkers Prev. 2009 Jan; 18(1): 314-20. PMID: 19124514, PMCID: PMC2715873, PII: 18/1/314, DOI: 10.1158/1055-9965.EPI-08-0627, ISSN: 1055-9965.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/19124514.
  • Epplein M, Shvetsov YB, Wilkens LR, Franke AA, Cooney RV, Le Marchand L, Henderson BE, Kolonel LN, Goodman MT. Plasma carotenoids, retinol, and tocopherols and postmenopausal breast cancer risk in the Multiethnic Cohort Study: a nested case-control study. Breast Cancer Res [print-electronic]. 2009; 11(4): R49. PMID: 19619335, PMCID: PMC2750110, PII: bcr2338, DOI: 10.1186/bcr2338, ISSN: 1465-542X.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/19619335.
  • Epplein M, Nomura AM, Hankin JH, Blaser MJ, Perez-Perez G, Stemmermann GN, Wilkens LR, Kolonel LN. Association of Helicobacter pylori infection and diet on the risk of gastric cancer: a case-control study in Hawaii. Cancer Causes Control [print-electronic]. 2008 Oct; 19(8): 869-77. PMID: 18369531, PMCID: PMC2799111, DOI: 10.1007/s10552-008-9149-2, ISSN: 1573-7225.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/18369531.
  • Epplein M, Reed SD, Voigt LF, Newton KM, Holt VL, Weiss NS. Risk of complex and atypical endometrial hyperplasia in relation to anthropometric measures and reproductive history. Am. J. Epidemiol [print-electronic]. 2008 Sep 9/15/2008; 168(6): 563-70; discussion 571. PMID: 18682485, PMCID: PMC2727194, PII: kwn168, DOI: 10.1093/aje/kwn168, ISSN: 1476-6256.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/18682485.
  • Sun LM, Epplein M, Li CI, Vaughan TL, Weiss NS. Trends in the incidence rates of nasopharyngeal carcinoma among Chinese Americans living in Los Angeles County and the San Francisco metropolitan area, 1992-2002. Am. J. Epidemiol [print-electronic]. 2005 Dec 12/15/2005; 162(12): 1174-8. PMID: 16282240, PII: kwi345, DOI: 10.1093/aje/kwi345, ISSN: 0002-9262.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/16282240.
  • Epplein M, Schwartz SM, Potter JD, Weiss NS. Smoking-adjusted lung cancer incidence among Asian-Americans (United States). Cancer Causes Control. 2005 Nov; 16(9): 1085-90. PMID: 16184474, DOI: 10.1007/s10552-005-0330-6, ISSN: 0957-5243.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/16184474.
  • Carr DB, Epplein M, Johnson CO, Easterling TR, Critchlow CW. A sister's risk: family history as a predictor of preeclampsia. Am. J. Obstet. Gynecol. 2005 Sep; 193(3 Pt 2): 965-72. PMID: 16157095, PII: S0002-9378(05)00878-1, DOI: 10.1016/j.ajog.2005.06.034, ISSN: 0002-9378.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/16157095.
  • Epplein M, Koon KP, Ramsey SD, Potter JD. Genetic services for familial cancer patients: a follow-up survey of National Cancer Institute Cancer Centers. J. Clin. Oncol. 2005 Jul 7/20/2005; 23(21): 4713-8. PMID: 16034046, PII: 23/21/4713, DOI: 10.1200/JCO.2005.00.133, ISSN: 0732-183X.
    Available from: http://www.ncbi.nlm.nih.gov/pubmed/16034046.