Immune phenotype in children with therapy-nave remitted and relapsed Crohn’s disease

AIM: To characterize the prevalence of subpopulations of CD4+ cells along with that of major inhibitor or stimulator cell types in therapy-nave childhood Crohn's disease (CD) and to test whether abnormalities of immune phenotype are normalized with the improvement of clinical signs and symptoms of disease. METHODS: We enrolled 26 pediatric patients with CD. 14 therapy-nave CD children; of those, 10 children remitted on conventional therapy and formed the remission group. We also tested another group of 12...     

Sleep Apnea Is Associated with Cardiovascular Risk Factors among Kidney Transplant Patients

Background and objectives: We assessed the prevalence of obstructive sleep apnea (OSA) and its clinical correlates in a large sample of patients who received a kidney transplant (Tx). We also compared the prevalence of the disorder between dialysis patients who were on the waiting list for a Tx (WL) and Tx patients.Design, setting, participants, & measurements: This was a cross-sectional study of 100 Tx and 50 WL patients who underwent one-night polysomnography (SLeep disorders Evaluation in Patients after kidney Transplantation [SLEPT] Study). Sociodemographic information and data about medication, comorbidity, and laboratory parameters were collected.Results: The prevalence of mild (apnea-hypopnea index [AHI] ≥5/h and <15/h), moderate (AHI ≥15/h and <30/h), and severe OSA (AHI ≥30/h) was 18, 11, and 14% in the Tx group and 28, 16, and 10% in the WL group, respectively. The AHI was significantly correlated with age (ρ = 0.34), body mass index (ρ = 0.45), neck circumference (ρ = 0.4), abdominal circumference (ρ = 0.51), and hemoglobin (ρ = 0.24) in the Tx group. The proportion of Tx patients who were treated with three or more antihypertensive drugs was significantly higher in the OSA group (56 versus 31%; P = 0.022). Despite taking significantly more antihypertensive drugs, the average systolic BP was still higher in patients with versus without OSA (147 ± 21 versus 139 ± 18 mmHg; P = 0.059).Conclusions: The prevalence of OSA is similar in Tx and WL patients and it may contribute to presence of hypertension in patients who receive a Tx.Obstructive sleep apnea (OSA) is the most clinically important form of sleep-related breathing disorders. The severity of OSA is generally characterized by the apnea-hypopnea index (AHI), which is the number of apneic and hypopneic events per hour of sleep.The prevalence of moderate and severe OSA syndrome (OSAS; AHI ≥15 and the presence of daytime symptoms of OSA) is 2 to 4% in the general population (1) and is associated with increased cardiovascular morbidity and mortality (2,3). OSAS is reportedly associated with higher risk for stroke, hypertension, diabetes, congestive hearth failure, arrhythmias, and the metabolic syndrome and also with fatal and nonfatal cardiovascular events (4–7)Previous studies have shown high prevalence of OSA (16 to 54%) in patients with chronic kidney disease (CKD) (8,9). Unruh et al. (10) showed that OSA is more common in hemodialysis patients than in general population.Although OSA may contribute to the increased cardiovascular risk seen in Tx patients, consistent information about OSA in patients who have received a kidney transplant (Tx) is scarce. Previously, we found that the prevalence of high risk for OSAS is approximately 30% in both WL and Tx patients (11). A case series indicated that AHI did not change after transplantation in 73% of the patients (12). Conversely, Mallamaci et al. (13) recently reported that 22% of renal Tx recipients had a respiratory disturbance index >5, which was similar to results seen in the general population.We designed this cross-sectional study to determine the prevalence and clinical correlates of OSA in a large, randomly selected sample of Tx patients using polysomnography. On the basis of our previous findings, we hypothesized that the prevalence of OSA would be similarly high in Tx and WL patients. Finally, we expected to find an increased cardio- and cerebrovascular risk in patients with versus without OSA in the Tx population.     

Gene polymorphisms in prodynorphin (PDYN) are associated with episodic memory in the elderly

Cognitive functions show large variation in elderly people and are substantially heritable. Animal studies revealed that dynorphins influence cognition and memory, especially in aged animals. Thus, we tested the effect of four SNPs (rs7272891, rs1997794, rs2235751 and rs910080) and the VNTR promoter polymorphism in the prodynorphin gene (PDYN) on episodic memory and verbal fluency in a large (n = 1619) sample of elderly people (mean age: 80 ± 3.39 years; range 75–90 years) recruited through the German study on ageing, cognition and dementia in primary care patients (AgeCoDe). We found that carriers of the minor alleles of rs1997794 (P < 0.002) and rs910080 (P < 0.005) presented with higher episodic memory scores than homozygote carriers of the major allele. Also, a three marker haplotype including these two SNPs and rs2235751 was associated with better episodic memory scores. Verbal fluency scores were non-significantly better in carriers of these respective alleles. Thus, our results suggest a role of PDYN gene variations in determining memory function also in elderly humans.