渗透压制剂对人腹膜间皮细胞透明质酸合成酶的调节作用

目的: 了解不同渗透压制剂对人腹膜间皮细胞(humanperitonealmesothelialcells,HPMCs)透明质酸合成酶(hyaluronansynthase,HAS)的调节作用及对透明质酸(hyaluronan,HA)合成的影响。方法: 分离培养的HPMCs随机分为5组:正常对照组(对照组);90mmol/L葡萄糖组(高糖组);30mmol/L葡萄糖组(低糖组);5%缩合葡萄糖(缩合葡萄糖组)及90mmol/L甘露醇组(甘露醇组)。给予上述刺激后继续培养24h,以RT-PCR法检测HAS-2mRNA和HAS-3mRNA的表达;收集细胞培养上清液,以放射免疫法检测HA浓度;以微粒排除法观察细胞胞衣样结构的面积。结果: 高糖组、低糖组、缩合葡萄糖组、甘露醇组HAS-2mRNA的表达均显著高于对照组(P均<0.05);高糖组HAS-3mRNA的表达亦明显增加(P<0.05),低糖组、缩合葡萄糖组、甘露醇组HAS-3mRNA表达与对照组相比差异无显著(P>0.05)。各实验组细胞胞衣样结构面积与细胞体面积的比值无显著差异(P均>0.05)。对照组、高糖组、低糖组、缩合葡萄糖组、甘露醇组细胞培养上清液HA的浓度均显著高于对照组(P均<0.05);高糖组HA浓度显著高于低糖组、缩合葡萄糖组和甘露醇组(P<0.05)。结论: 与高浓度葡萄糖相比,缩合葡萄糖虽增强HPMCsHAS-2mRNA表达,但对与炎症反应相关的HAS-3mRNA表达无影响,提示缩合葡萄糖可能在对腹膜组织生物相容性方面优于高浓度葡萄糖。     

霉酚酸酯对高糖培养下人肾小球系膜细胞MCP-1和FN表达的影响

目的:探讨高糖以及霉酚酸酯(MMF)对人肾小球系膜细胞(HMCs)单核细胞趋化蛋白-1(MCP-1)和纤维连接蛋白(FN)表达的影响。方法:将培养的HMCs分为正常对照组(5 mmol/L葡萄糖);高糖组(30 mmol/L葡萄糖);甘露醇渗透压对照组(5 mmol/L葡萄糖+25 mmol/L甘露醇);高糖+MMF-10组(30 mmol/L葡萄糖+10μg/mL MMF);高糖+MMF-100组(30 mmol/L葡萄糖+100μg/mL MMF),采用RT-PCR检测每组不同时间点(24、48、72 h)MCP-1 mRNA的表达,ELISA法检测培养上清液MCP-1及FN蛋白的表达。结果:高糖组HMCs MCP-1 mRNA、蛋白的表达及FN的分泌较正常对照组显著增加(P<0.01),且48 h表达最高;不同浓度的MMF均能下调MCP-1 mRNA、蛋白及FN的表达(P<0.01);不同浓度的MMF对MCP-1 mRNA、蛋白的表达及FN分泌的抑制程度不同,呈时间剂量依赖性(P<0.05)。结论:MMF可以阻抑MCP-1的表达及FN的分泌,可能对延缓肾小球硬化及间质纤维化有一定作用。     

抑制S1PR2的活性可下调高糖培养的大鼠肾小球系膜细胞SphK1和MCP-1的表达

目的观察高糖及1-磷酸鞘氨醇受体2(S1PR2)特异性拮抗剂JTE-013对体外培养的大鼠肾小球系膜细胞(GMC)鞘氨醇激酶1(Sph K1)、S1PR2、单核细胞趋化蛋白1(MCP-1)表达的影响。方法将培养的大鼠GMC分为正常糖对照组(NG,含5.5 mmol/L葡萄糖)、甘露醇渗透压对照组(HM,含5.5 mmol/L葡萄糖、24.5 mmol/L甘露醇)、高糖组(HG,含30 mmol/L葡萄糖)、JTE-013干预组(HJ,含30 mmol/L葡萄糖、10μmol/L JTE-013)。实时定量PCR检测培养0、12、24、48 h的细胞中Sph K1、S1PR2、MCP-1 mRNA的表达,ELISA检测培养细胞上清中MCP-1的蛋白表达。结果与NG组相比,高糖培养下的大鼠GMC中Sph K1、S1PR2 mRNA的表达在12 h下降,之后随着时间延长基因的表达量升高,48 h达最高。MCP-1 mRNA的表达随培养时间的延长而升高,12 h表达已升高,24 h表达为最高,48 h的表达下降。高糖诱导大鼠GMC的MCP-1蛋白分泌增加,呈时间依赖性。GMC经JTE-013处理后,高糖继续培养24 h,与HG组相比,HJ组Sph K1、S1PR2、MCP-1 mRNA及MCP-1蛋白的表达明显下降。结论抑制S1PR2的活性可引起高糖培养下的大鼠GMC中Sph K1、MCP-1表达下调。     

核转录因子κB抑制剂PDTC对高糖培养大鼠肾成纤维细胞VEGF和PEDF表达的影响

目的:探讨核转录因子κB(NF-κB)抑制剂吡咯烷二硫氨基甲酸(PDTC)对高糖培养大鼠肾成纤维细胞(NRK)血管内皮生长因子(VEGF)及色素上皮衍生因子(PEDF)表达的影响。方法:NRK按培养条件分为常糖组:5.6mmol/L葡萄糖;高糖A组:15mmol/L葡萄糖;高糖B组:30mmol/L葡萄糖;PDTC对照组:5.6mmol/L葡萄糖+5.0μmol/LPDTC;PDTCA组:15mmol/L葡萄糖+10μmol/LPDTC;PDTCB组:30mmol/L葡萄糖+20μmmol/LPT-DC。采用半定量RT-PCR方法及ELISA测定各组培养24h、48h后NRK的VEGF及PEDFmRNA及蛋白的表达。结果:与常糖组相比,高糖各组NRK的VEGF蛋白含量及mRNA表达明显升高(P<0.01,P<0.05);与高糖B组相比,PDTC干预各组NRK的VEGF蛋白含量及mRNA表达呈下降趋势(P<0.01,P<0.05)。与常糖组相比,高糖各组NRK的PEDF蛋白含量及mRNA表达明显下降(P<0.01,P<0.05);与高糖B组相比,PDTCB组NRK的PEDF蛋白含量及mRNA表达明显升高(P<0.01)。结论:PDTC能明显抑制高糖培养大鼠NRK的VEGF表达并明显上调PEDF的表达,间接提示NF-κB可能通过参与VEGF和PEDF的表达失衡导致糖尿病肾病(DN)的发生。     

一氧化氮抑制剂对腹膜透析大鼠腹膜形态及表面层的影响

目的:探讨高糖透析液对大鼠腹膜巨噬细胞一氧化氮(NO)的产生、诱导型一氧化氮合酶(iNOS)的表达和腹膜透析通透性的影响以及NO抑制剂的保护作用。方法: 培养生理盐水、1.5％和4.25％葡萄糖透析液透析下的大鼠腹腔内的巨噬细胞, 检测细胞培养上清液NO的浓度和巨噬细胞iNOS的表达, 并观察1.5％及4.25％葡萄糖透析液和NO抑制剂透析下大鼠的液体超滤量和腹膜形态的变化。结果:大鼠腹腔内巨噬细胞NO的产生随透析液中葡萄糖含量增加而增加;腹腔巨噬细胞iNOS的表达, 葡萄糖透析组明显高于生理盐水组;NO抑制剂对光镜下腹膜形态无影响, 但明显减轻4.25%葡萄糖透析液对超滤量和腹膜表面层的减少作用。结论:一氧化氮抑制剂可明显改善高糖透析大鼠的腹膜通透性, 并减轻高糖对腹膜表面层的损伤。     

SnoN对高糖诱导大鼠原代肾小管上皮细胞纤维连接蛋白合成的影响

目的: 观察核转录共抑制因子SnoN (Ski-related novel protein N)对高糖诱导大鼠原代肾小管上皮细胞(RTECs)纤维连接蛋白(FN)合成的影响。方法: 原代培养大鼠RTECs,免疫荧光细胞化学和Western blotting检测培养细胞的上皮性钙黏蛋白、 角蛋白-18和α-平滑肌肌动蛋白表达,鉴定培养细胞;正常糖(5.5 mmol/L)、高糖(25 mmol/L)和相同渗透压的甘露醇分别培养RTECs 30 min、2 h、12 h、24 h、48 h、72 h和96 h;SnoN siRNA转染RTECs,分为对照组、高糖组、control siRNA组和SnoN siRNA组;Western blotting和免疫细胞化学检测不同处理组RTECs中SnoN和FN蛋白的表达;RT-PCR检测FN mRNA。结果: 与正常糖培养组相比,高糖刺激能抑制 RTECs中SnoN蛋白表达,且呈时间依赖性;高糖刺激能使RTECs中FN蛋白和mRNA表达增加;与单纯高糖培养组相比,转染SnoN siRNA 能进一步促进高糖诱导的RTECs中FN蛋白表达(P<0.05)。结论: SnoN表达减少参与了高糖诱导的RTECs中FN合成过程。     

PDTC对高糖培养大鼠肾成纤维细胞中MCP-1表达的影响

目的:探讨核因子-κB(NF-κB)抑制剂吡咯烷二硫氨基甲酸(PDTC)对高糖培养大鼠肾成纤维细胞(NRK)中单核细胞趋化蛋白-1(MCP-1)表达的影响。方法:将NRK分4组进行体外培养:(1)正常组:5.6mmol/L的葡萄糖;(2)高糖组:30mmol/L葡萄糖;(3)高糖+PDTC1组:30mmo/L葡萄糖+5μmol/LPDTC;(4)高糖+PDTC2组:30mmo/L葡萄糖+10μmol/LPDTC,分别于培养24h、48h取各组NRK采用RT-PCR检测其MCP-1mRNA表达水平,采用WesternBlot检测MCP-1蛋白表达水平。结果:与正常组相比,高糖组MCP-1mRNA和蛋白表达水平显著升高(P<0.05),不同浓度PDTC干预后,MCP-1mRNA和蛋白表达水平显著下降(P<0.05),且随PDTC浓度增大,下降更明显。结论:高糖可使NRK中MCP-1表达增高,PDTC能抑制NRK中MCP-1表达。     

高糖作用的肾小球系膜细胞SnoN/Ski蛋白表达及泛素化降解

目的: 观察高糖作用的大鼠肾小球系膜细胞内核转录共抑制因子SnoN/Ski及泛素连接酶Arkadia的表达变化,初步探讨SnoN/Ski泛素化降解在糖尿病肾病中的作用。方法: 将体外培养的大鼠肾小球系膜细胞分别设正常对照组 、高糖甲组(培养基含20 mmol/L葡萄糖)、高糖乙组(培养基含30 mmol/L葡萄糖)、高糖+MG132组(30 mmol/L葡萄糖培养基中预先加入0.5 μmol/L特异性泛素蛋白酶体抑制剂MG132)和甘露醇组。用蛋白免疫印迹技术和免疫荧光染色-激光共聚焦显微镜检测各组细胞SnoN/Ski及Arkadia蛋白的表达。结果: (1)正常系膜细胞中SnoN/Ski蛋白大量表达,Arkadia蛋白表达较弱。(2)高糖作用后SnoN/Ski蛋白表达减弱,Arkadia蛋白表达增强(P<0.05)。(3)与高糖组比较,高糖加入MG132后SnoN/Ski蛋白表达增加,Arkadia蛋白表达减弱(P<0.01)。(4)甘露醇组与正常组比较SnoN/Ski及Arkadia蛋白表达均无明显差异(P>0.05)。结论: (1)高糖可通过泛素蛋白酶体途径降解SnoN/Ski蛋白致其低表达。(2)E3连接酶Arkadia参与了高糖诱导的SnoN/Ski的泛素化降解 。     

高糖预处理影响单核细胞对热灭活金黄色葡萄球菌刺激的反应

目的 观察高糖状态下热灭活金黄色葡萄球菌(HKSA)诱导的人单核细胞株THP-1凋亡特点,以及表达诱导型一氧化氮合酶(iNOS)、白细胞介素(IL)-1β mRNA和IL-1β蛋白分泌规律.方法 体外培养THP-1单核细胞,分别以5.5 mmol/L葡萄糖(LG)和25.0 mmol/L葡萄糖(HG)培养12h～8d.将HG和LG培养6d的单核细胞加入HKSA.分别于HKSA加入前和加入后2～48 h提取单核细胞,检测细胞凋亡、IL-1β蛋白、iNOS和IL-1β mRNA表达.细胞凋亡采用Annexin V与PI双染法,流式细胞技术检测;IL-1β蛋白分泌采用ELISA法检测;提取细胞总RNA,反转录生成cDNA后采用实时定量逆转录聚合酶链反应(real-time quantitative PCR)法,检测iNOS和IL-1β mRNA表达情况.结果 (1)高糖刺激THP-1单核细胞12 ～48 h后IL-1β蛋白、iNOS和IL-1β mRNA表达较刺激前显著增加(P＜0.05),iNOS和IL-1β mRNA表达在24 h达最高值,IL-1β蛋白分泌48 h达高峰.细胞凋亡在高糖刺激48 h～4 d较刺激前显著增加(P＜0.05).(2)两组细胞加入HKSA后6～48 h表达iNOS和L-1β显著高于刺激前(P＜0.01),24h达高峰,48 h表达下降;IL-1β蛋白分泌在48 h达最高值.两组细胞凋亡率在加入HKSA后12h、24h、48 h逐渐增加(P＜0.01).单核细胞加入HKSA前和加入HKSA后12h,高糖组与低糖组比较,高糖组IL-1β蛋白、iNOS和IL-1β mRNA表达均低于低糖组,凋亡率高于低糖组(P＜0.05).结论 高糖和HKSA对单核细胞分泌IL-1β蛋白、表达iNOS和IL-1β mRNA的影响与刺激时间有关;单核细胞处于持续高糖状态时,高糖可以增加细胞凋亡率,降低IL-1β蛋白分泌、iNOS和IL-1β表达.     

氯沙坦通过ERK1/2 MAPK途径抑制高糖诱导小鼠系膜细胞CTGF表达

目的: 研究高糖环境下, 氯沙坦对CTGF的影响以及其作用机制.方法: 体外培养小鼠系膜细胞株(MMCs), 用高糖(25 mmol/L葡萄糖)刺激细胞分别作用24 h、 48 h、 72 h, 用Western blot方法检测磷酸化ERK1/2的表达.再将细胞分为低糖组(5.6 mmol/L葡萄糖), 山梨醇组(5.6 mmol/L葡萄糖+19.4 mmol/L山梨醇), 高糖组(25 mmol/L葡萄糖), 氯沙坦组(25 mmol/L葡萄糖+10-5 mol/L氯沙坦)以及 ERK抑制剂组(25 mmol/L葡萄糖+ 25 μmol/L PD98059), 48 h后采用Western blot方法检测磷酸化ERK1/2的表达, 72 h后采用Real-time PCR方法及Western blot分别检测 CTGF mRNA表达量以及蛋白的表达.结果: 高糖刺激小鼠系膜细胞后, ERK1/2磷酸化的蛋白表达逐渐增高, 呈现一定时间依赖性.与低糖组相比, 高糖组磷酸化ERK1/2、 CTGF的蛋白表达明显增加(P<0.01), 而与高糖组相比, 氯沙坦组以及ERK抑制剂组磷酸化ERK1/2的蛋白表达以及CTGF的蛋白均明显下降有统计学意义(P<0.05).与低糖组相比, 高糖组CTGF mRNA表达量明显增加(P<0.01), 而与高糖组相比, 氯沙坦组以及ERK抑制剂组CTGF mRNA表达量明显下降, 且有统计学意义(P<0.01).结论: 氯沙坦可抑制高糖对CTGF的诱导作用, 其机制可能与抑制ERK1/2 MAPK途径有关.     

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.     

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.