Molecular evidence of Babesia equi transmission in Haemaphysalis longicornis

We studied the tick, Haemaphysalis longicornis, to determine the possibility of both transovarial and transstadial transmission of Babesia equi. We also studied the usefulness of the needle injection method for pathogenic tick-transmitted organisms including Babesia parasites. Erythrocytes infected with B. equi were injected into the midgut of engorged adults or nymphs using a hypodermic needle passed through the integument. DNA of B. equi in ticks was detected using nested polymerase chain reaction (PCR). B. equi DNA was present in adults, eggs, and larvae, indicating that transovarial transmission occurred. B. equi DNA was present in adults that developed from infected nymphs, and the B. equi antigen was present in their salivary glands, indicating that transstadial transmission occurred. These findings suggest that H. longicornis may play a role in the transmission of B. equi.     

Biostable agonists that match or exceed activity of native insect kinins on recombinant arthropod GPCRs

The multifunctional arthropod ‘insect kinins’ share the evolutionarily conserved C-terminal pentapeptide motif Phe-X¹-X²-Trp-Gly-NH₂, where X¹ = His, Asn, Ser, or Tyr and X² = Ser, Pro, or Ala. Insect kinins regulate diuresis in many species of insects. Compounds with similar biological activity could be exploited for the control of arthropod pest populations such as the mosquito Aedes aegypti (L.) and the southern cattle tick Rhipicephalus (Boophilus) microplus (Canestrini), vectors of human and animal pathogens, respectively. Insect kinins, however, are susceptible to fast enzymatic degradation by endogenous peptidases that severely limit their use as tools for pest control or for endocrinological studies. To enhance resistance to peptidases, analogs of the insect kinins incorporating bulky α,α-disubstituted amino acids in positions adjacent to both primary and secondary peptidase hydrolysis sites were synthesized. In comparison with a control insect kinin, several of these analogs are highly stable to hydrolysis by degradative enzymes ANCE, neprilysin and Leucine aminopeptidase. Six analogs were evaluated by calcium bioluminescence assay on recombinant receptors from mosquito and tick. Four of these analogs either matched or exceeded the potency of the control kinin peptide agonist. One of these was about 5-fold more potent than the control agonist on the tick receptor. This analog was 8-fold more potent than the control agonist on the mosquito receptor, and twice more potent than the endogenous Aedes kinin-II. The analog also demonstrated potent activity in an in vitroAedes Malpighian tubule fluid secretion assay. Similar comparisons of analog potency cannot be made to tick kinins because no endogenous kinin has yet been identified. These potent, biostable analogs represent ideal new tools for endocrinologists studying arthropod kinin-regulated processes in vivo, particularly for ticks in which their role remains to be established.     

Identification,characterization and analysis of expression of gene encoding carboxypeptidase A in Anopheles culicifacies A (Diptera: culicidae)

Carboxypeptidases are the digestive enzymes which cleave single amino acid residue from c-terminus of the protein. Digestive carboxypeptidase A gene regulatory elements in insects have shown their efficiency to drive midgut specific expression in transgenic mosquitoes. However no endogenous promoter has been reported for Indian malaria vector Anopheles culicifacies which is major vector in Indian subcontinent. Here we report cloning of carboxypeptidase A gene in the An. culicifacies A including its 5′ upstream regions and named AcCP. In the upstream region of the gene an arthropod initiator sequence and two repeat sequences of the particular importance TTATC and GTTTT were also identified. The 1290 base pairs open reading frame encodes a protein of 48.5 kDa. The coding region of the gene shares 82% and 72% similarity at nucleotide level with Anopheles gambiae and Ae. aegypti carboxypeptidase A gene, respectively. The peak expression of the gene was found to be at 3 h after blood feeding and this is limited to midgut only. Based on the protein sequence, 3D structure of the AcCP was predicted and the active centre of the enzyme was predicted to consist of GLN 183, GLU 186, HIS 308 and Ser 309 amino acid residues. Comparison of the protein sequence among different genera revealed the conservation of zinc binding residues. Phylogenetically, AcCP was found most closely related to An. gambiae.     

First molecular detection of Theileria ovis in Rhipicephalus sanguineus tick in Iran

ObjectiveTo determine tick infestation of domestic ruminants and their infection to ovine theileriosis in northern Iran.MethodsAbout 425 domestic ruminants in Ghaemshahr city in northern Iran were inspected for tick infestations. Twenty tick specimens (13 females and 7 males) of Rhipicephalus sanguineus (R. sanguineus), the most common tick in the study area, were tested by PCR amplification against 18s rRNA genome of Theileria spp using specie specific primers and then the PCR products were sequenced for species identification by comparison with data base available in GenBank.ResultsAbout 323 ticks were collected from 102 animals (88 sheep, 12 goats and 2 cattle). The prevalence of ticks infesting animals was R. sanguineus (82.35%), Rhipicephalus bursa (R. bursa) (0.3%), Ixodes ricinus (I. ricinus) (15.2%), Boophilus annulatus (B. annulatus) (1.2%), Haemaphysalis punctata (H. punctata) (0.3%) and Haemaphysalis numidiana (H. numidiana) (0.6%). Eleven (55%) tick specimens were PCR positive against genome of Theileria ovis (T. ovis). Sequence analysis of the PCR products confirmed presence of T. ovis in one R. sanguinus.ConclusionsThis is the first report of tick infection to T. ovis in Iran. Due to dominant prevalence of R. sanguineus as well as its infection to T. ovis, it is postulated this tick is the main vector of ovine theileriosis in northern Iran.     

Evaluation of Vector Competence of Ixodes Ticks for Kemerovo Virus

Tick-borne viruses are responsible for various symptoms in humans and animals, ranging from simple fever to neurological disorders or haemorrhagic fevers. The Kemerovo virus (KEMV) is a tick-borne orbivirus, and it has been suspected to be responsible for human encephalitis cases in Russia and central Europe. It has been isolated from Ixodes persulcatus and Ixodes ricinus ticks. In a previous study, we assessed the vector competence of I. ricinus larvae from Slovakia for KEMV, using an artificial feeding system. In the current study, we used the same system to infect different tick population/species, including I. ricinus larvae from France and nymphs from Slovakia, and I. persulcatus larvae from Russia. We successfully confirmed the first two criteria of vector competence, namely, virus acquisition and trans-stadial transmission, for both tick species that we tested. The estimated infection rates of engorged and moulted ticks suggest specificities between viral strains and tick species/developmental stages.     

Culture-dependent and culture-independent characterization of microorganisms associated with Aedes aegypti (Diptera: Culicidae) (L.) and dynamics of bacterial colonization in the midgut

In this work we show that the lumen of Aedes aegypti midgut is highly colonized by bacteria that were identified by culture-dependent and culture-independent methods. rDNA sequences obtained were compared with those from GenBank and the main bacterial genera identified were: Serratia, Klebsiella, Asaia, Bacillus, Enterococcus, Enterobacter,Kluyvera and Pantoea. All genera were identified in midgut except Enterobacter that was observed only in eggs. Asaia and Pantoea were also identified in eggs and ovary, respectively. In addition two yeast genera were observed in A. aegypti: Pichia isolated from midgut and Candida identified in midgut and ovary. The genus Serratia was dominant in all isolation assays representing 54.5% of the total of microorganisms. Thirty-nine and 24 bacterial clones were successfully obtained from midguts 24 and 48 h after blood feeding (ABF), respectively. The majority of clones obtained were from Serratia sp. (48.7% and 50% for 24 and 48 h ABF, respectively). Light microscopy showed that bacteria were located preferentially in the posterior midgut, around the blood meal and associated with peritrophic matrix. Scanning electron microscopy images showed a high number of bacteria in midgut during blood digestion and the peak of bacterial enumeration was reached 48 h ABF, stage in which lumen was almost totally occupied by bacteria that were also interacting with epithelial microvilli. Our results show the dynamics of microbial colonization and their distribution in midgut during blood digestion.     

Observations on the feeding habits of Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera: Psychodidae: Phlebotominae) in Campo Grande, an endemic area of visceral leishmaniasis in Mato Grosso do Sul, Brazil

Sand flies were captured weekly with CDC light traps from December 2003 to November 2005 in three areas of Campo Grande, in the Brazilian state of Mato Grosso do Sul. These areas incorporated two patches of remnant forest and five houses. The blood meals of engorged female sand flies were identified using the avidin-biotin system of immunoenzymatic ELISA capture. Most (327/355) of the females analysed were Lutzomyia longipalpis, of which 66.4% reacted with human blood, 64.8% with that of birds and 8.9% with that of dogs. Females that had taken human blood predominated in the residential areas and two forest patches. The following combinations of blood were also detected for L. longipalpis in some of the samples analysed: bird + human (43.4%), bird + human + dog (6.1%). The combination bird + human + dog + pig was also found for Nyssomyia whitmani. Dogs and pigs appear to have little attractiveness for L. longipalpis. The results obtained demonstrate the eclecticism and high anthropophily of L. longipalpis and raise new questions with regard to the importance of dogs in VL epidemiology and the possible role of man as a source of infection for sand flies.     

Ontogeny and distribution of cholecystokinin-immuno reactive cells in the digestive tract of sharpsnout sea bream, Diplodus puntazzo (Cetti, 1777), during larval development

The appearance and regional distribution of cholecystokinin-immuno reactive cells (CCK-IR) in the developing gut of larval Diplodus puntazzo were studied by means of immunohistochemistry, with the aim of understanding the role of this peptide hormone in the acquisition of digestive capacity. Immunohistochemical reaction showed CCK-IR cells from 10 days after hatching (DAH), near the pyloric sphincter and past the first bend in the midgut, as well as in the hindgut. At 25 DAH CCK-IR cells were scattered throughout the midgut, as well as in the hindgut. Since gastric glands appeared at 30 DAH, CCK-IR cells were most abundant in the anterior midgut, near and including the pyloric caeca, and just afore the ileo-rectal sphincter in the posterior midgut, as well as in the hindgut. In older larvae (39 DAH), CCK-IR cells were mainly distributed in the anterior midgut, including the pyloric caeca, as well as in the hindgut. No CCK-IR cells were detected in the foregut at any stage. The distribution pattern of CCK-IR cells differed from other species which also possess a rotated gut as D. puntazzo. In fact, although cells were abundant in regions where the ingested food is retained, so that they can be stimulated to modulating the release of digestive enzymes, a large number of cells occurred also in the hindgut.     

Genetic analysis of ticks belonging to the Rhipicephalus sanguineus group in Latin America

Phylogenetic analyses based on mitochondrial 16S rDNA sequences were generated from Rhipicephalus sanguineus group specimens collected in 29 localities among 9 Latin-American countries, plus ticks collected in South Africa, Spain, and Italy. Sequences from Latin America generated six different haplotypes (A, B, C, D, E, and F). Phylogenetic analyses generated trees that segregated our tick sequences into two distinct clades: one is represented by haplotypes A–C, and South African R. sanguineus and Rhipicephalus turanicus ticks; the second clade is represented by haplotypes D–F, and European R. sanguineus and R. turanicus ticks. When haplotypes A–F are plotted in the Latin America map according to their geographical coordinates, it is clearly seen that haplotypes D–F are restricted to the southern portion of this continent, whereas haplotypes A–C are distributed in areas between northern Mexico and Brazil (except for the extreme south of this last country, where haplotype E was present). Hence, our phylogenetic analyses separated New World specimens of R. sanguineus into two distinct clades, one represented by tropical and subtropical populations (haplotypes A–C), here designated as the ‘tropical’ species. On the other hand, haplotypes D–F are here designated as the ‘temperate’ species because of their distribution in the southern portion of South America. Until recently, it was assumed that the R. sanguineus group was represented by a single species in the New World, namely R. sanguineus. While the present results coupled with recent studies support the presence of at least two species under the taxon R. sanguineus in the New World, they also show that even in the Old World, the taxon R. sanguineus might be represented by more than one species, since our phylogenetic analysis segregated European and South African R. sanguineus ticks into two distinct clades. The same can be applied for Spanish and South African R. turanicus.     

Epidermis as the source of ecdysone in an argasid tick.

Various tissues excised from nymphs of the tick Ornithodoros parkeri at the time of epicuticle deposition were incubated in vitro. The medium from the incubation of salivary glands, coxal glands, synganglion, testis, midgut, and fat body associated with tracheal trunk showed little or no ecdysteroid immunoreactivity. Only medium from incubated integument contained ecdysteroids. The following evidence indicated that epidermal cells are the source of ecdysone: (i) when dorsal and/or ventral integuments were incubated separately, both produced ecdysteroid immunoreactive material during the course of incubation. As compared with the ecdysteroid content in the integument before incubation, the amount of ecdysteroids produced after a 24-h incubation increased 4- to 7-fold; (ii) enzymatic hydrolysis showed that neither highly polar ecdysteroid conjugates nor apolar conjugates were stored in the integument; (iii) histological and scanning electron microscope observations demonstrated that these excised integuments consisted of newly deposited epicuticle and epidermis as well as some fat body cells; (iv) HPLC RIA showed that the integument with associated fat body produced ecdysone and 20-hydroxyecdysone, while the integument produced only ecdysone after removing fat body. Presumably, ecdysone secreted by epidermis was converted into 20-hydroxyecdysone by fat body.     

Ecology of Amblyomma neumanni (Acari: Ixodidae)

The life cycle of Amblyomma neumanni was described studying the seasonal distribution of free-living stages and parasitic phases during two consecutive years. Development periods of engorged ticks under different photoperiod conditions were recorded. Larvae of A. neumanni have the peak of abundance in autumn. Nymphs reach the peak in winter. Females were collected on cattle from autumn to late spring. The seasonal distribution pattern of females showed a bimodal curve, with a peak in autumn and other during early and middle spring. The engorged females exposed at shortest photoperiod regimen (10 h light-14 h dark) under both laboratory and field conditions undergo morphogenetic diapause, expressed as a delay in the oviposition. It is concluded that females of A. neumanni that feed and copulate in autumn undergo morphogenetic diapause, and they will lay eggs in spring, simultaneously with the females that feed and copulate in this season. Climate niche analysis shows that adequate suitability for A. neumanni depends mainly from temperature (mean, absolute maximum and minimum, and mean temperature in wettest and driest quarters) as well as from rainfall in warmest and coldest quarters. Sequences of 16S rDNA gene belonging to different populations of A. neumanni, showed no intraspecific genetic differentiation.     

Adult Ixodes dammini on rabbits: development of acute inflammation in the skin and immune responses to salivary gland, midgut, and spirochetal components

Rabbits exposed to female Ixodes dammini (both uninfected and infected with Borrelia burgdorferi) or injected with B. burgdorferi showed an acute inflammatory response in the skin. Granulocytes and monocyte-histiocytes were the predominant infiltrating cells. Spirochetes were detected in the tick feeding cavities in the deep dermis. The inflammatory process was accompanied by polyclonal antibody responses to tick salivary gland components. Western blots showed that immune rabbit serum reacted with proteins of molecular masses of 8, 24, and 36-41 kilodaltons in both unengorged and engorged tick salivary glands. Additional reacting bands in the immunoblot of the engorged salivary gland indicated that new antigenic components of the salivary gland are synthesized during engorgement. Rabbits did not produce antibodies to tick midgut components. Murine monoclonal antibody 11G1 detected outer surface protein A of B. burgdorferi in immunoblots of midguts from unengorged ticks, faintly in engorged salivary gland, and seldomly in unengorged salivary gland, findings suggesting that the spirochete is transmitted to the host via tick saliva during the later stages of feeding.     

Aumento de la expresión de las moléculas CD11c y CD103 en neutrófilos de sangre periférica tratados con una formulación de ribosomas bacterianos y proteoglicanos de Klebsiella pneumoniae

Aim

To evaluate the effect of a preparation with bacterial ribosomes and proteoglycans from Klebsiella pneumoniae «R» on the in vitro expression of CD11c and CD103 molecules in neutrophils from peripheral blood.

Methods

Isolation of neutrophils from peripheral blood with Ficoll-Paque, incubation with R and detection of CD11c and CD103 through flow cytometry.

Results

Six hours after the incubation period, CD11c expression increased significantly compared with the control with 125 and 500 μg/ml of R (P = .017 and P = .006, respectively). CD103 expression induced with 125 μg/ml of R after 6 hours was significantly higher than that observed after 4 hours at the same concentration (P = .014) and that found with 62.5 μg/ml (P = .017) of R.

Conclusions

The increased expression of CD11c and CD103 induced by R in the neutrophils could contribute to the R mechanism against respiratory pathogens.     

Survivin: A novel player in insulin cardioprotection against myocardial ischemia/reperfusion injury

Insulin inhibits ischemia/reperfusion-induced myocardial apoptosis through the activation of a survival signaling cascade including the phosphatidylinositol 3-kinase (PI3K)-Akt pathway. However, the down-stream mechanism of PI3K remains elusive. This study is aimed at investigating whether survivin (SVV) plays a role in the insulin-induced anti-apoptotic effect in the ischemic/reperfused (I/R) hearts, and if so, further determining the signaling mechanism involved. Isolated adult rat hearts were subjected to 30 min regional ischemia followed by reperfusion with or without insulin (10^− 7 mol/L) at the onset of reperfusion. Reperfusion with insulin inhibited myocardial apoptosis and reduced infarct size, along with significantly up-regulated myocardial SVV expression (5.9 ± 0.3 Group MI/R + Ins vs. 2.1 ± 0.1 Group MI/R, p < 0.05) and increased phosphorylations of mTOR and p70S6K compared with I/R group, which was blocked by pretreatment of PI3K inhibitor LY294002. Rapamycin, a specific mTOR inhibitor, did not alter insulin-induced Akt phosphorylation but significantly inhibited SVV expression (from 6.1 ± 0.3 to 3.0 ± 0.15, p < 0.05). Moreover, rapamycin blunted insulin-induced anti-apoptosis in the I/R hearts (8.1 ± 0.4% vs. 16.5 ± 1.8%, p < 0.05). To further ascertain the role of SVV in insulin-induced cardioprotection, cardiomyocytes were transfected with adenovirus encoding SVV (gain-of-function) or siRNA targeting SVV (loss-of-function). Overexpression of SVV decreased I/R-induced cardiomyocyte apoptosis in vitro, while siRNA targeting SVV significantly blunted the anti-apoptotic effect of insulin. Taken together, these results suggest a novel role of PI3K/Akt/mTOR/SVV signaling in the cardioprotective effect of insulin.     

Endothelial nitric oxide synthase is not necessary for the early phase of ischemic preconditioning in the mouse

It has been proposed that constitutive expression of endothelial NO synthase (eNOS) protects against myocardial ischemia/reperfusion injury in the naive (unstressed) state and that eNOS plays a critical role in the early phase of ischemic preconditioning (PC). We addressed these issues using both a genetic approach (i.e., eNOS null [eNOS^−/−]) mice and a pharmacologic approach (with the NOS inhibitor N(omega)-nitro-l-arginine [L-NA]). We found that in the nonpreconditioned state, both of the available strains of eNOS^−/− mice (C57BL6 and B6129) exhibited infarct sizes similar to the corresponding wild-type (WT) mice (63.3 ± 2.2% [group I, n = 15] vs. 59.7 ± 1.4% [group VI, n = 10] of the risk region and 60.9 ± 3.6% [group IX, n = 14] vs. 68.2 ± 2.5% [group X, n = 9], respectively). When WT mice were preconditioned with either one or six cycles of 4-min coronary occlusion (O)/reperfusion (R) 10 min prior to the 30-min O, infarct size was markedly reduced (28.5 ± 3.3% [group II, one O/R cycle, n = 10] and 19.7 ± 2.6% [group III, six O/R cycles, n = 7] of the risk region, respectively), indicating the development of a robust early PC effect. In eNOS^−/− mice preconditioned with the same protocol, the reduction in infarct size was similar (24.9 ± 2.9% and 15.3 ± 2.4% of the risk region, after one [group VII, n = 9] or six O/R cycles [group VIII, n = 10], respectively), indicating that the PC effect was intact. When WT mice were pretreated with L-NA 30 min before sham PC (group IV, n = 7) or PC (group V, six O/R cycles, n = 7), infarct size was not different from untreated control and PC groups. We conclude that, in the mouse, basal eNOS activity does not modulate infarct size in the nonpreconditioned state and is not necessary for the cardioprotective effects of early PC. Early PC is not eNOS-dependent, at least in this species.     

Experimental studies on the replication and dissemination of Qalyub virus (Bunyaviridae: Nairovirus) in the putative tick vector, Ornithodoros (Pavlovskyella) erraticus

A study was undertaken to determine if the argasid tick, Ornithodoros (Pavlovskyella) erraticus, can serve as a biological vector of Qalyub (QYB) virus. The suckling mice used as viremic vertebrate hosts were acceptable hosts for all feeding stages of this tick and developed relatively high titered viremias (4.4-6.5 log10PFU/ml) 24-120 hr post intracerebral inoculation. Larval, nymphal, and adult ticks became orally infected with QYB virus after ingesting 4.4-6.4 log10PFU/ml. The overall infection rate for all experiments was 67/205 and virus was recovered up to day 179 postfeeding. Incubation of known quantities of QYB virus with uninfected triturated tick tissues did not result in any appreciable virus inactivation. QYB viral antigen was detected by immunofluorescence primarily in the tick midgut posterior diverticula cells. First and second instar nymphs orally infected as larvae did not individually transmit QYB virus to suckling mice; however they successfully transmitted the virus when feeding in groups of 11-20 per mouse. Three out of fourteen of the orally-infected male and female ticks individually transmitted QYB virus orally to suckling mice. Organ titrations of ticks orally exposed to QYB virus demonstrated virus primarily in midgut tissues; dissemination to other organ systems was discovered in only 1 tick after 142 days extrinsic incubation. Vertical transmission of virus from infected female ticks to progeny was not demonstrated. Four of the 39 ticks in our colony were infected with a spirochete; presumably, Borrelia crocidurae. O. (P.) erraticus apparently satisfies the conditions that would implicate this species as a biological vector of QYB virus and is the only known arthropod from which this virus has been isolated in nature.     

Ticks infesting wild and domestic animals and humans of Sri Lanka with new host records

An island-wide collection of tick species infesting humans, domesticated and wild animals and questing ticks in domestic and peridomestic environments was carried out during 2009–2011. A total of 30,461 ticks were collected from 30 different hosts and free living stages from the ground. The collection consisted of 22 tick species from 30 different hosts recording 12 tick species from humans, 19 from domesticated animals and 21 from wild animals, with a total of 97 new host records. The most common tick species on humans were Dermacentor auratus and Amblyomma testudinairum, while Haemaphysalis intermedia, Rhipicephalus microplus and Rhipicephalus sanguineus were common in domesticated and wild animals sharing 20 host species. Among the questing ticks, immature D. auratus was the most abundant. Humans and domesticated animals were mostly infested by the nymphal stages while adult ticks were found on wild animals. High number of new host records could be due to domestic animals picking tick species from wildlife and vise versa at the human/animal interface. Habitat destruction due to forest fragmentation has lead to wild animals roaming in urban and semi-urban neighbourhoods increasing the interactions of wild animals with domesticated animals. Wild animals play a significant role as a reservoir of many tick borne infections which can easily be spread to domesticated animals and then to humans via tick infestations. Data in this paper are useful for those interested in tick infesting wild and domestic animals and humans in describing the zoonotic potential of tick borne infections.     

Association of angiotensin II type 1 receptor gene A1166C polymorphism with the presence of diabetes mellitus and metabolic syndrome in patients with documented coronary artery disease

Background

There are relatively limited data available on the genetic susceptibility to diabetes mellitus and metabolic syndrome in the Iranian population. We have therefore investigated the association between the angiotensin II type I receptor gene polymorphism (AT₁R/A1166C) and the presence of diabetes mellitus and metabolic syndrome in a well defined group of patients.

Methods

Patients with angiographically defined coronary artery disease (CAD) (n = 309) were evaluated for the presence of AT₁R/A1166C polymorphism. These patients were classified into subgroups with (n = 164, M/F: 109/55) and without (n = 145, M/F: 84/61) diabetes mellitus. The AT₁R polymorphism was assessed using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) based method.

Results

There was a higher frequency of polymorphic genotypes (AC + CC) in the diabetic compared with the non-diabetic group (p = 0.01). When determined for each gender separately, this difference remained significant in the males (p = 0.04) but not in females (p = 0.09). With regard to the allele frequencies, the C allele was significantly higher and the A allele frequency was lower in the diabetic group (p = 0.01). This remained significant after gender segregation for males (p = 0.01) but not females. In the binary logistic regression analysis, only serum fasting glucose was found as the independent predictor for the presence of diabetes in the CAD patients (β = 1.16, p < 0.001 for total population and β = 1.29, p < 0.001 for male subjects). There was no significant difference in genotype or allele frequencies between subgroups with and without metabolic syndrome, this being unaffected by gender or the definition of metabolic syndrome used apart from a significantly lower frequency of C allele in male subjects with metabolic syndrome defined by the NCEP ATP III criteria (p = 0.04).

Conclusion

The AT₁R/A1166C polymorphism may be associated with the presence of diabetes mellitus in male subjects with documented CAD.