CVB3-VP1基因免疫诱导特异性抗病毒免疫应答及保护作用

目的 :构建表达柯萨奇病毒B3(CVB3)主要包膜蛋白VP1的基因疫苗 ,并研究该疫苗诱导CVB3特异性免疫应答及免疫保护的作用。方法 :抽提CVB3RNA ,以RT PCR扩增VP1基因 ,克隆于真核表达载体 pcDNA3中 ,构建质粒pcDNA3 VP1。将该质粒转染Hela细胞 ,观察其表达情况 ;以 5 0 μgpcDNA3 VP1质粒DNA肌注免疫BALB/c小鼠 3次 ,检测CVB3特异性体液和细胞免疫应答。间隔 4wk以 5×LD50 的CVB3攻击小鼠 ,观察攻击后小鼠的存活情况。结果 :构建了重组质粒 pcDNA3 VP1,并在体外获得有效表达。以该质粒肌肉免疫BALB/c小鼠 ,可诱生高水平的IgM和IgG ,VP1多肽特异性淋巴细胞增殖反应及CTL活性均显著高于 pcDNA3免疫的对照组。病毒攻击试验表明 ,pcDNA3 VP1免疫组33.3%小鼠可长期存活 ,其心肌组织未见明显的病理学改变 ;而对照小鼠平均仅存活 6 .7d ,心肌显示大量的局灶性坏死和炎性细胞浸润。结论 :pcDNA3 VP1免疫可诱生CVB3特异性体液及细胞免疫应答 ,保护免疫小鼠抵抗CVB3的致死性攻击     

不同免疫途径对chitosan-DNA疫苗诱导CVB3特异性免疫应答的影响及其意义

目的：确定新型chitosan-DNA疫苗的有效免疫途径。方法：将chitosan-pcDN3-VPI疫分别苗以肌注、口服、滴鼻3种免疫方式免疫Balb/c小鼠；以ELISA检测免疫小鼠血清中IgG、IgM、、IgA，评估其特异性体液免疫应答；以特异性淋巴细胞增殖反应和CTL活性反映其诱导细胞免疫；以5LD50致死剂量CVB3攻击免疫小鼠，评价不同免疫途径的免疫保护效果。结果：①在诱导CVB3特异性体液免疫方面：chitosan-pcDNA3-VPI疫苗肌注组诱生了高水平IgM和IgG，但未能诱生黏膜IgA；口服免疫组仅诱生低水平的黏膜IgA，未能诱生特异性IgM和IgG；滴鼻组可诱生低水平的I埘及高水平的IgG和黏膜IgA。②在诱导CVB3特异性细胞免疫方面：仅滴鼻组诱导了较高水平的淋巴细胞特异性增殖反应和CTL活性；口服组的淋巴细胞增殖活性和CTL活性稍弱；肌注组几乎不能诱导特异性细胞免疫应答。③免疫保护作用：滴鼻组可保护33．3％小鼠长期存活；口服组仅达到16．7％的保护率；肌注组无保护作用。结论：滴鼻免疫途径可能是chitosan-pcDNA3-VPI基因疫苗最合适的诱导全面免疫应答的免疫途径。     

Chitosan-pcDNA3-VP1 DNA疫苗预防病毒性心肌炎的实验研究

为研究新型chitosan DNA疫苗预防CVB3病毒性心肌炎的效果 ,以天然生物多糖chitosan包裹含CVB3主要结构蛋白VP1编码基因的质粒pcDNA3 VP1,制备新型chitosan pcDNA3 VP1疫苗。以含 5 0 μgDNA的该疫苗于 0、 7、 14、 2 1d滴鼻免疫小鼠 4次 ,末次免疫后 3周以 3×LD50 剂量CVB3经腹腔感染小鼠 ,称量小鼠体重、心脏重 ,并行心脏HE染色。结果 :chi tosan pcDNA3 VP1疫苗滴鼻免疫诱生了高水平的血清特异IgG和肠粘膜IgA ;同时诱生了较高强度的特异性CTL活性。以致病毒性心肌炎剂量CVB3感染小鼠 7d后发现 :pcDNA3组小鼠 10 0 %出现病毒性心肌炎 ,其心室壁呈现严重灶性坏死和炎性浸润 ;而chitosan pcDNA3 VP1组仅 16 7%小鼠产生心肌炎 ,坏死灶少且程度轻。其它病毒性心肌炎体征显示 :pcDNA3组体重降幅为 4 5 0 % ;而chitosan pcDNA3 VP1组类似正常小鼠 ,体重略增 1 75 % ;pcDNA3免疫组体重 /心脏重比为 171 75 ;chi tosan pcDNA3 VP1免疫组为 186 36。提示chitosan pcDNA3 VP1疫苗滴鼻可诱生全身及粘膜特异免疫 ,并可有效预防病毒性心肌炎的发生 ,可能成为CVB3及病毒性心肌炎预防性候选疫苗     

接头长度对MDC与CVB3VP1融合基因疫苗免疫效果的影响

目的构建表达不同接头（linker）长度的巨噬细胞源趋化因子（MDC）与CVB3VP1融合基因疫苗，观察接头长度对融合基因疫苗免疫效果的影响。方法构建表达接头长度分别为10、15和19个氨基酸的重组质粒pcDNA3／MDC-L-VP1；将6—8周龄雄性BALB/c小鼠随机分为A-E5组，分别肌肉注射pcDNA3、pcDNA3／VP1、pcDNA3／MDC-L10-VP1、pcDNA3／MDC-L15-VP1和pcDNA3／MDC-L19-VP1，每次接种100μg/只，4周注射1次，共3次，每次免疫后第14天眼眶静脉采血，用微量中和试验滴定血清中和抗体效价。第3次免疫后3周，每组取3只小鼠，制备脾细胞，用CCK-8法检测特异性CTL杀伤活性；每组取3只小鼠以3LD50 CVB3病毒攻击，第7天取血处死，检测血中病毒滴度。结果成功构建了3种不同接头长度的质粒；第3次免疫后，E组中和抗体滴度和小鼠脾淋巴细胞特异性CTL杀伤活性显著高于其他各组，血中病毒滴度显著低于其他各组（P〈0．01）。结论融合基因疫苗pcDNA3／MDC-L19-VP1能诱导小鼠对CVB3VP1产生较强的体液和细胞免疫，有效地抑制了病毒的增殖。     

C家族趋化因子XCL1增强CVB3基因疫苗的抗病毒免疫应答及保护作用

为提高以往构建的基因疫苗pcDNA3.1-VP1的抗B3型柯萨奇病毒(CVB3)感染的免疫效果,以编码C家族趋化因子XCL1的质粒pcDNA3.1-XCL1共注射,观察诱导的CVB3特异性免疫应答及CVB3病毒性心肌炎预防效果。将两种质粒各50μg混合后分别于0、2、4、6周肌注免疫小鼠4次,末次免疫后4周分别以5×LD50剂量CVB3攻击小鼠观察保护率,或以3×LD50剂量CVB3感染小鼠观察病毒性心肌炎的诱生。结果显示,与单纯pcDNA3.1-VP1质粒相比,XCL1质粒共注射可增强血清CVB3特异性IgG以及特异性CTL应答。5×LD50病毒攻击后,共注射组体重降低7.28%,而pcDNA3.1-VP1组体重降低10.97%;共注射组28 d保护率达40%,高于pcDNA3.1-VP1组的30%。3×LD50病毒感染后心肌组织病理显示,共注射组心外膜下仅有轻微炎症,心肌内未见炎症细胞浸润,而pcDNA3.1-VP1组除心外膜下有较多淋巴细胞聚集外,心肌内有少量炎症浸润和坏死灶。提示XCL1质粒共注射可增强CVB3特异性体液和细胞免疫应答及抗病毒保护,可有效预防病毒性心肌炎的发生。     

复合HA-2氨基多肽可增强chitosan-DNA疫苗的免疫保护效果

目的 :以具有促黏膜黏附吸收功能的脱乙酰多糖chitosan包裹质粒DNApcDNA3-VP1构建的新型chitosan-DNA疫苗 ,已证实可诱生CVB3特异性黏膜IgA和抗CVB3保护力 ,在此基础上 ,引入具有内体破坏功能的流感病毒HA 2氨基多肽(融内体多肽 ) ,构建chitosan-DNA HApLys16疫苗 ,以期增强chitosan-DNA疫苗的免疫保护效果。方法 :将融内体多肽与多聚赖氨酸顺序合成为“载体多肽”HA pLys16 ,将其与DNA、chitosan依次复合形成chitosan DNA HApLys16疫苗。以 5 0 μgDNA剂量的chitosan-DNA疫苗滴鼻免疫BALB c小鼠 4次 ,检测CVB3特异性体液和细胞免疫应答 ;隔 4周以致死性 5×LD50 CVB3攻击小鼠 ,观察攻击后存活情况。以免疫组化法检测了小鼠心肌内CVB3载量 ;并检测了黏膜IgA中和效价的改变。结果 :chitosan DNA-HApLys16疫苗滴鼻免疫不仅诱生了高水平的IgG ,而且诱生了高水平的黏膜IgA抗体。其诱生的IgG水平以及特异性CTL杀伤活性与chitosan DNA疫苗无统计差别 ,而其IgA水平显著高于chitosan DNA疫苗。CVB3攻击后 ,chitosan DNA HAp Lys16可保护 5 0 .0 %小鼠长期存活 ,高于chitosan DNA组 4 2. 9%的免疫保护率。病理学研究显示 :chitosan-DNA HApLys16免疫小鼠心肌炎症状况好于chitosan-DNA免疫小鼠。免疫组化结果显示     

人IL-2信号肽基因增强柯萨奇病毒B3型VP1 DNA疫苗诱导的中和抗体应答

目的将人白细胞介素2(hIL-2)信号肽基因与柯萨奇病毒B组3型(CWB3)的VP1基因融合，构建分泌型VP1真核表达质粒pcDNA3／sVP1；免疫小鼠后，通过测定血清特异性中和抗体效价及对致死量CVB3攻击的保护作用，评价疫苗的免疫效果。方法采用重叠区基因扩增法，将hIL-2信号肽基因连同其下游11个氨基酸残基的基因与CVB3 VP1基因拼接，获得分泌型VP1(sVP1)的基因；将sVP1基因克隆至真核表达载体pcDNA3，构建分泌型VP1真核表达质粒pcDNA3／sVP1；肌注免疫小鼠，测定血清中CVB3特异性中和抗体的效价；第3次免疫后2周，腹腔内注射1000TCID50的CVB3，观察小鼠生存情况。结果成功构建了分泌型VP1真核表达质粒pcDNA3／sVP1，插入的sVP1基因中含有hIL-2信号肽及其下游11个氨基酸残基的基因以及VP1基因；pcDNA3／sVP1可比对照质粒pcDNA3／VP1诱导小鼠产生更高水平的中和抗体。结论hIL-2信号肽基因增强了柯萨奇病毒B3型VP1 DNA疫苗诱导的中和抗体应答，为进一步研制高效的CVB3 DNA疫苗提供了实验基础。     

柯萨奇B3病毒结构和非结构蛋白DNA 疫苗诱导小鼠产生免疫应答的研究

目的 制备4种柯萨奇B3病毒（CVB3）结构和非结构蛋白重组质粒DNA疫苗,并探讨其诱导机体产生体液和细胞免疫应答的效果。方法 用基因重组技术构建4种CVB3结构和非结构蛋白重组质粒,将各重组质粒体外转染真核细胞,用Western blot检测表达产物;于BALB／c小鼠后腿胫骨前肌注射免疫,于0、4、8周共免疫3次,100μg/次。免疫后不同时间检测体液和细胞免疫应答指标。结果 4种重组质粒酶切出相应大小的片段,经测序证实为CVB3序列,Western blot证实能够在体外真核细胞中表达。pcDNA3/vp2、pcDNA3/VP1、pcDNA3/2A和pcDNA3/3D均可诱导小鼠产生相应的特异性抗体、细胞毒性T淋巴细胞（CTL）和淋巴细胞增殖反应、迟发型超敏反应（DTH）,并对致死量的CVB3m、CVB5和CVB2攻击具有保护作用,表现为病毒攻击后第3天血中病毒滴度降低,第10天心肌病理变化比对照组明显减轻,且小鼠生存率显著提高。其中以pcDNA/VP1和pcDNA3／3D组保护作用最明显。结论 CVB3结构蛋白VP1和非结构蛋白3D质粒DNA有可能用作CVB DNA疫苗的候选基因,值得进一步深入研究。     

乙肝核酸疫苗诱导BALB/C小鼠的CTL免疫应答

目的：研究携带HBsAg基因的载体质粒pcDHBs诱导小鼠CTL应答效果。方法：将HBsAg基因连接到真核表达载体pcDNA3．1上，构建成载体质粒pcDHBs。将纯化后的质粒pcDRBs和pcDNA3．1肌肉注射免疫小鼠，眼眶采血检测血清中抗体水平。用质粒pcDHBs转染P815细胞制备乙肝疫苗诱导BALB／C小鼠CTL活性检测的靶细胞。免疫后，取脾细胞，按效靶比为10：1、25：1、50：1进行CIL杀伤检测。结果：免疫pcDHBs疫苗后，检测到小鼠血清中的RBsAb。用pcDHBs进行转染的P815细胞能够检测到HBsAg基因片段和蛋白质抗原的表达。用pcDHBs免疫组小鼠的CTL杀伤率均明显高于pcDNA3．1免疫组。结论：质粒pcDHBs作为核酸疫苗能够诱导小鼠体液免疫应答和CTL免疫应答。     

四种靶向因子与柯萨奇病毒B3 VP1融合基因疫苗免疫效果的比较

目的:比较巨噬细胞源趋化因子(MDC)、补体片段C3d3、志贺毒素B亚单位(STxB)和小鼠β-防御素2(mBD2)分别与柯萨奇病毒B3(CVB3)VP1构建的融合基因疫苗及VP1基因疫苗对小鼠的免疫效果。方法:将雄性BALB/c小鼠随机分为6组,每组22只,分别于股四头肌注射pcDNA3、pcDNA3/VP1、pcDNA3/MDC-VP1、pcDNA3/VP1-C3d3、pcD-NA3/STxB-VP1和pcDNA3/mBD2-VP1,接种剂量为每次100μg/只,3周免疫1次,共3次。每次免疫后第14天内眦静脉取血,用微量中和试验滴定血清中和抗体滴度。第3次免疫后第21天,每组随机取3只小鼠,制备脾淋巴细胞,用CCK-8细胞计数法检测特异性CTL的杀伤活性;每组取3只小鼠以3LDLD50CVB3病毒攻击,第7天取血处死,检测血清病毒滴度;其余小鼠以5LDLD50的CVB3攻击,观察各组的生存情况。结果:除了pcDNA3对照组,其他各组的中和抗体滴度均随免疫次数的增加而提高(P0.01),第3次免疫后,pcD-NA3/MDC-VP1、pcDNA3/VP1-C3d3和pcDNA3/mBD2-VP1组的抗体滴度明显高于pcDNA3/VP1组(P0.01);pcDNA3/STxB-VP1和pcDNA3/mBD2-VP1组CTL杀伤活性显著高于其他各组(P0.01)。致死量病毒攻击后,pcDNA3/MDC-VP1、pcDNA3/VP1-C3d3和pcDNA3/mBD2-VP1组小鼠血中病毒滴度显著低于其他组(P0.01);pcDNA3/MDC-VP1和pcD-NA3/VP1-C3d3组小鼠生存率显著高于其他各组(P0.05)。结论:pcDNA3/MDC-VP1和pcDNA3/VP1-C3d3能诱导出较强的体液免疫和细胞免疫,能有效降低血中病毒滴度,获得较高的小鼠生存率;整体效果优于其他组。     

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.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

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.     

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.     

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.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.