转化生长因子胞内信号蛋白Smad2/3在糖尿病大鼠肾脏表达的动态观察及意义研究

目的:动态观察大鼠糖尿病肾病发生发展过程中TGF-β1及其下游信号分子Sm ad2/3在肾脏的表达及定位变化,探讨TGF-β1-Sm ad2/3信号通路在糖尿病肾病(DN)肾纤维化发病机制中的作用。方法:链脲菌素诱导大鼠糖尿病肾病,以免疫组化、W estern b lotting及荧光实时定量PCR(RT-PCR)的方法动态观察糖尿病肾病发生发展过程中大鼠肾脏TGF-β1、Sm ad2/3蛋白及mRNA表达,并以RT-PCR方法观察结缔组织生长因子(CTGF)、胶原-3(COL-Ⅲ)、纤溶酶原激活剂抑制因子-1(PAI-1)mRNA表达。结果:TGF-β1在糖尿病肾病(DN)大鼠肾小管表达明显多于正常组(P<0.05);Sm ad2/3蛋白主要以胞浆表达阳性为主,部分呈胞核表达阳性;Sm ad2/3蛋白及mRNA从2周起表达明显多于正常对照组(P<0.05),且随着糖尿病进展有逐渐增加的趋势。16周DN组大鼠肾脏TGF-β1、Sm ad2、CTGF、COL-Ⅲ、PAI mRNA表达显著高于正常对照组(P<0.05)。结论:TGF-β1-Sm ad2/3信号转导通路参与了糖尿病肾病肾脏纤维化形成的信号转导过程,伴随着Sm ad2/3信号蛋白表达的增多及入核增加,CTGF、COL-Ⅲ、PAI-1等基因转录增加,导致肾脏细胞外基质的大量沉积,这是细胞因子TGF-β1导致糖尿病肾病肾纤维化进展可能的信号转导途径之一。     

p27和TGF-β在大鼠肾间质纤维化中的表达及关系

目的:研究单侧输尿管梗阻(UUO)大鼠肾组织p27的表达, 同时观察TGF-βmRNA在各组的变化, 探讨UUO模型中 TGF-β与p27的关系.方法:60只SD大鼠随机分成假手术组(SOR)、 UUO模型组.于术后第7、 14、 21天分别处死各组大鼠10只.用HE染色动态观察肾脏病理变化, 免疫组织化学法测定p27的蛋白表达及动态变化, RT-PCR法测定p27mRNA和TGF-βmRNA的水平.结果:SOR组肾小管上皮细胞p27蛋白及肾皮质p27mRNA的表达均强, UUO组随着间质纤维化程度的加重, p27的表达逐渐减弱, 而TGF-βmRNA随着肾间质纤维化程度的加重, 其表达呈上升趋势;UUO组TGF-βmRNA与p27mRNA成负相关.结论:p27参与了UUO大鼠肾间质纤维化的发病过程;UUO大鼠肾间质纤维化模型中TGF-β促纤维化机制可能与p27的下调相关.     

结缔组织生长因子在单侧输尿管梗阻大鼠肾组织中的表达

目的：检测大鼠单侧输尿管梗阻（UUO）模型不同时期，肾组织中结缔组织生长因子（CTGF）、转化生长因子β1（TGF-β1）和α-平滑肌肌动蛋白（α-SMA）的表达，观察比较在间质纤维化不同阶段，3者的动态变化及关系。 方法： 采用雄性SD大鼠36只，分为假手术组和模型组，模型组行左侧输尿管结扎术，再分3、7、14、21和28 d共6组，每组6只，于各时点处死大鼠，取肾组织，常规HE、Masson染色，按小管间质损害的特征进行半定量评分。免疫组化检测CTGF、TGF-β1和α-SMA表达。 结果： 随梗阻时间的延长，小管间质纤维化加重，28 d间质已基本被纤维化组织所代替。随间质纤维化程度的加重，CTGF和α-SMA表达逐渐增加，两者与小管间质损害积分呈正相关，CTGF与α-SMA的表达之间也呈正相关。TGF-β1表达在7-14 d达高峰后，逐渐减少，但仍高于对照组。 结论： UUO致CTGF表达增加可能与TGF-β升高有关，CTGF可能通过促进间质中肌成纤维细胞的形成而参与肾间质纤维化。     

抗纤灵方对单侧输尿管梗阻大鼠TGF-β1-Smad通路的影响

目的： 研究中药复方抗纤灵对单侧输尿管梗阻（UUO）所致肾纤维化大鼠TGF-β₁-Smad通路的影响，借以初步探讨其发挥疗效的作用机制。方法: 雄性SD大鼠18只随机分为3组，假手术组、模型组、中药治疗组。用单侧输尿管结扎术建立大鼠肾纤维化模型，抗纤灵治疗两周后检测梗阻肾羟脯氨酸含量；HE染色和电镜观察肾组织病变；采用RT-PCR检测肾组织TGF-β₁ mRNA水平；蛋白免疫印迹法检测肾组织转化生长因子I型受体（TβRI）、转化生长因子II型受体（TβRII）、Smad2蛋白表达及磷酸化变化。结果: 与假手术组比较，模型组大鼠梗阻肾羟脯氨酸含量明显增多；病理观察可见肾小球毛细血管基底膜明显增厚，间质成纤维细胞和胶原沉积明显增多；肾组织TGF-β₁ mRNA及TβRI、TβRII蛋白表达显著增多，Smad2蛋白磷酸化及总蛋白表达水平均显著增多。与模型组比较，中药干预组大鼠梗阻肾羟脯氨酸含量明显减少；肾小球和肾小管基底膜仅见轻度增厚，间质成纤维细胞和胶原沉积较模型组减轻；肾组织TβRI、TβRII蛋白表达明显下调，Smad2蛋白磷酸化及总蛋白表达水平均明显下调。结论: 抗纤灵可抑制单侧输尿管梗阻大鼠TGF-β₁-Smad通路，抑制梗阻肾TβRI、TβRII、Smad2蛋白表达及Smad2蛋白磷酸化，从而改善梗阻性大鼠的肾间质纤维化，减少纤维化肾脏中胶原蛋白含量。     

抗纤灵方对单侧输尿管梗阻大鼠TGF-β1-Smad通路的影响

目的:研究中药复方抗纤灵对单侧输尿管梗阻(UUO)所致肾纤维化大鼠TGF-β1-Smad通路的影响,借以初步探讨其发挥疗效的作用机制。方法:雄性SD大鼠18只随机分为3组,假手术组、模型组、中药治疗组。用单侧输尿管结扎术建立大鼠肾纤维化模型,抗纤灵治疗两周后检测梗阻肾羟脯氨酸含量;HE染色和电镜观察肾组织病变;采用RT-PCR检测肾组织TGF-β1 mRNA水平;蛋白免疫印迹法检测肾组织转化生长因子I型受体(TβRI)、转化生长因子II型受体(TβRII)、Smad2蛋白表达及磷酸化变化。结果:与假手术组比较,模型组大鼠梗阻肾羟脯氨酸含量明显增多;病理观察可见肾小球毛细血管基底膜明显增厚,间质成纤维细胞和胶原沉积明显增多;肾组织TGF-β1mRNA及TβRI、TβRII蛋白表达显著增多,Smad2蛋白磷酸化及总蛋白表达水平均显著增多。与模型组比较,中药干预组大鼠梗阻肾羟脯氨酸含量明显减少;肾小球和肾小管基底膜仅见轻度增厚,间质成纤维细胞和胶原沉积较模型组减轻;肾组织TβRI、TβRII蛋白表达明显下调,Smad2蛋白磷酸化及总蛋白表达水平均明显下调。结论:抗纤灵可抑制单侧输尿管梗阻大鼠TGF-β1-Smad通路,抑制梗阻肾TβRI、TβRII、Smad2蛋白表达及Smad2蛋白磷酸化,从而改善梗阻性大鼠的肾间质纤维化,减少纤维化肾脏中胶原蛋白含量。     

CXXC5 对心房颤动大鼠心肌纤维化的影响及机制

目的:探讨锌指蛋白5(CXXC5)在心房颤动大鼠心肌纤维化中的表达及其对心肌纤维化的影响及可能机制。方法:将40只大鼠分为对照组(正常大鼠组)、空白对照组(心房颤动模型大鼠组)、阴性对照组(心房颤动大鼠尾静脉注射阴性对照病毒组)和过表达CXXC5组(心房颤动大鼠尾静脉注射过表达CXXC5病毒),每组10只。空白对照组、阴性对照组和过表达CXXC5组大鼠建立心房颤动心肌纤维化模型(腹部皮下注射异丙肾上腺素建立心房颤动心肌纤维化模型)。伊红-苏木素(HE)染色和Masson染色观察心肌组织形态学变化,并测定胶原容积分数(CVF);采用荧光定量聚合酶链反应(qPCR)测定心肌组织中Ⅰ型胶原、CXXC5、转化生长因子β1(TGF-β1)、Smad7 mRNA水平;采用Western blot法测定大鼠心肌组织中Ⅰ型胶原、CXXC5、TGF-β1、Smad7蛋白水平。结果:HE染色和Masson染色显示:对照组大鼠心肌组织形态学正常;空白对照组和阴性对照组大鼠心肌细胞排列紊乱,间质胶原纤维增多,心肌纤维化严重;过表达CXXC5组大鼠心肌细胞排列稍紊乱,心肌纤维化较轻;模型组大鼠CVF明显高于对照组(P0.05)。与对照组相比,其他3组大鼠CVF升高(P0.05),CXXC5、Smad7 mRNA和蛋白水平升高(P0.05),Ⅰ型胶原、TGF-β1 mRNA和蛋白水平降低(P0.05);与空白对照组和阴性对照组相比,过表达CXXC5组大鼠CVF降低(P0.05),心肌组织中CXXC5、Smad7 mRNA和蛋白水平升高(P0.05),Ⅰ型胶原、TGF-β1 mRNA和蛋白水平降低(P0.05);空白对照组和阴性对照组大鼠心肌组织中Ⅰ型胶原、CXXC5、TGF-β1、Smad7 mRNA和蛋白水平差异无统计学意义(P0.05)。结论:心房颤动心肌纤维化大鼠心肌组织CXXC5水平降低,TGF-β1/Smad7信号通路激活;过表达CXXC5可通过抑制TGF-β1/Smad7信号通路抑制心房颤动大鼠心肌纤维化。     

IL-17在肾间质纤维化中的作用初探

探讨白细胞介素17(IL-17)在肾间质纤维化发生发展中的作用。采用的体内实验为,以单侧输尿管梗阻(unilateral ureteric obstruction,UUO)启动纤维化病理过程。将C57BL/6小鼠分为假手术组(Sham)和单侧输尿管梗阻(unilateral ureteric obstruction,UUO)组,分别于术后第1、3、7天处死,留取手术侧肾组织。采用HE、PAS、PASM、Masson染色评价肾间质组织病理变化。以免疫组化、实时荧光定量PCR(qRT-PCR)法检测α平滑肌肌动蛋白(α-SMA)表达水平;酶联免疫吸附试验(ELISA)检测IL-17在肾组织中的表达情况。体外实验为,分离培养C57BL/6小鼠肾成纤维细胞,转化生长因子β1(TGF-β1)刺激使其转化为肌成纤维细胞,继而用蛋白免疫印迹法(western blotting)检测IL-17的刺激下α-SMA表达水平。结果显示,组织病理学检查显示随着梗阻时间延长,炎性细胞浸润明显,肾小管萎缩,间质面积增大,Ⅰ型胶原和α-SMA增多。PCR检测显示α-SMA mRNA表达增多。但ELISA结果显示肾组织中IL-17含量呈下降趋势。Western blot结果表明肌成纤维细胞在IL-17的刺激下,α-SMA蛋白水平显著下降。实验说明,单侧输尿管梗阻手术可导致相应侧肾组织发生纤维化病变,但肾组织中IL-17含量与纤维化病变并不一致,在体外实验中IL-17可下调肌成纤维细胞表达的α-SMA。     

5-氟尿嘧啶抑制TGF-β1诱导人肝内胆管上皮细胞间质化

目的探讨5-氟尿嘧啶对TGF-β1诱导人肝内胆管上皮细胞间质化的抑制作用,并探讨其作用机制。方法原代培养人肝内胆管上皮细胞,角蛋白19荧光染色鉴定;细胞分为:对照(normal)组,TGF-β1(TGF-β1)组,5-氟尿嘧啶(TGF-β1+5-FU)组;免疫荧光染色观察CK-19、E-cadherin、vimentin和α-SMA标记蛋白;Western blot检测细胞标记蛋白及TGF-β1表达量;Real-time PCR检测细胞Ⅰ、Ⅲ型胶原及TGF-β1 mRNA含量。结果原代培养的人肝内胆管上皮细胞呈多边形或者锥形,CK-19荧光染色为胞质着色;TGF-β1诱导72 h后,胆管上皮出现间质化表现,与正常组比较,vimentin、α-SMA和TGF-β1表达明显增强(P0.05),CK-19和E-cadherin表达显著减弱(P0.05),Ⅰ、Ⅲ型胶原及TGF-β1 mRNA含量显著升高(P0.05);5-FU抑制胆管上皮间质化,与TGF-β1组比较,CK-19和E-cadherin表达增强(P0.05),vimentin、α-SMA和TGF-β1表达明显减弱(P0.05),TGF-β1 mRNA和Ⅲ型胶原mRNA含量明显降低(P0.05)。结论 5-FU通过下调TGF-β1的表达抑制胆管上皮细胞间质化。     

莪术醇通过上调miR-214抑制TGF-β诱导的RL-95细胞生长及纤维化相关蛋白表达

目的:探讨莪术醇对转化生长因子β(TGF-β)诱导的子宫内膜癌RL-95细胞生长及纤维化相关蛋白表达的影响,并探讨其机制是否与调控微小RNA-214(miR-214)表达有关。方法:以TGF-β诱导RL-95细胞纤维化作为子宫内膜异位症细胞模型。设置对照(control)组、TGF-β组、TGF-β+低剂量莪术醇组、TGF-β+中剂量莪术醇组、TGF-β+高剂量莪术醇组、TGF-β+高剂量莪术醇+anti-miR-NC组和TGF-β+高剂量莪术醇+anti-miR-214组。运用CCK-8法、流式细胞术、RT-qPCR和Western blot检测细胞活力、细胞周期分布、miR-214表达以及α-平滑肌肌动蛋白(α-SMA)和Ⅰ型胶原(Col I)蛋白表达。结果:与control组比较,TGF-β组RL-95细胞活力、S期细胞比例及α-SMA和Col I蛋白表达显著升高,G₀-G₁期细胞比例和miR-214表达显著降低(P<0.05)。与TGF-β组比较,TGF-β+中剂量莪术醇组和TGF-β+高剂量莪术醇组RL-95细胞活力、S期细胞比例及α-SMA和Col I蛋白表达显著降低,G₀-G₁期细胞比例和miR-214表达显著升高(P<0.05)。与TGF-β+高剂量莪术醇+anti-miR-NC组比较,TGF-β+高剂量莪术醇+anti-miR-214组RL-95细胞活力、S期细胞比例及α-SMA和Col I蛋白表达显著升高,G₀-G₁期细胞比例显著降低(P<0.05)。结论:莪术醇通过上调miR-214表达抑制TGF-β诱导的RL-95细胞生长和纤维化相关蛋白表达,进而对子宫内膜异位症纤维化具有潜在治疗作用。     

IgA肾病PTEN表达及其对肾间质纤维化的影响

目的： 探讨IgA肾病（IgAN）肾组织中染色体10上缺失的磷酸酶与张力蛋白同源物基因（PTEN）表达及其对肾间质纤维化的影响。方法: 选择IgAN患者47例,并详细收集资料;10例肾脏肿瘤切除后正常远端肾组织作对照。肾小管间质病变程度用Katafuchi等标准分为4组。应用免疫组化SP法检测PTEN、转化生长因子-β1（TGF-β1）、α-平滑肌肌动蛋白（α-SMA）、Ⅲ型胶原（Col Ⅲ）以及原位杂交法检测PTEN mRNA表达。结果: ①IgAN和对照肾组织中PTEN及PTEN mRNA表达部位主要在肾小管上皮细胞胞浆中,肾小球内无或仅有极少量表达。IgAN随肾小管间质病变程度加重,PTEN与PTEN mRNA表达逐渐减少,无病变组明显高于其它3组（均P<0.05）。②IgAN肾组织PTEN与PTEN mRNA表达正相关（P<0.05）;两者分别与eGFR、尿渗透压正相关（P<0.01）,与TGF-β1、α-SMA、ColⅢ、24 h尿蛋白排泄量、硬化肾小球数以及血管积分负相关（均P<0.01）。结论: IgAN中TGF-β1可能在基因转录水平下调PTEN表达,诱导肾小管上皮转分化以及细胞外基质的沉积,从而在肾小管间质纤维化过程中起到重要作用。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

HLA genes in Amerindians from Mexico San Vicente Tancuayalab Teenek/Huastecos

Huastecos or Teenek Amerindians are presently living at North East Mexico (San Luis Potosi State). They have probably one of the most ancient culture of Mexico and Central America together with Mayas and Olmec groups with which also show close relationships. Proximity to Atlantic Ocean/Mexican Gulf originated that Spaniards had very early contact with them at about 1519 CE or before. In the present paper we have aimed to study HLA gene profile which may be useful for HLA and disease epidemiology and transplant programs in Teeneks. HLA-DRB1*04:07, -DRB1*14:06 and -DRB1*04:11 have been found in high frequency like in other Amerindian groups. High frequency typical Amerindians HLA extended haplotypes have been found, such as A*02-B*35-DRB1*04:07-DQB1*03:02; A*68-B*39-DRB1*04:07-DQB1*03:02 and A*02-B*39-DRB1*04:07-DQB1*03:02; also new haplotypes have been described, like A*02-B*52-DRB1*04:11-DQB1*03:02, A*68-B*35-DRB1*14:02-DQB1*03:01 and A*68-B*40-DRB1*16:02-DQB1*03:01. Genetic proximity is observed not only to linguistically close Mayans, but also to Mazatecans, Mixtecans and Zapotecans, who speak an altogether different languages; it shows once more that genes and languages do not correlate. This population was greatly diminished after European contact between 1500 and 1600 years CE; in fact, North and South America First Inhabitants population was brought from 80 down to 8 million people because of diseases (i.e.: measles, smallpox or influenza), slavery and war.     

État de l’art : nouveaux anticoagulants et transfusion

Direct oral anticoagulants (DOAC) are indicated for stroke prevention in atrial fibrillation and for the prevention and treatment of venous thromboembolism. As any anticoagulant, they are associated with a bleeding risk. Management of DOAC-induced bleeding is challenging. Idarucizumab, antidote for dabigatran, is currently available and is part of the therapeutic strategy, whereas antidotes for anti-Xa agents are under development. Activated or non-activated prothrombin concentrates are proposed, although their efficacy to reverse DOAC is uncertain. We propose an update on DOAC-associated bleeding management, integrating the availability of idarucizumab and the critical place of DOAC concentration measurements.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.