Influence of Genetic Variation in the C-Reactive Protein Gene on the Inflammatory Response During and After Acute Coronary Ischemia

The aim of this research was to assess whether common genetic variants within the C-reactive protein gene ( CRP ) are related to the degree of acute rise in plasma C-reactive protein (CRP) levels following an acute coronary syndrome (ACS). While polymorphisms within CRP are associated with basal CRP levels in healthy men and women, less is known about the relationship of such genetic variants and the degree of CRP rise during and after acute ischemia. Plasma CRP is associated with increased rates of recurrent coronary events. We evaluated seven common genetic variants within CRP and assessed their relationship to the degree of rise in CRP levels immediately following an acute coronary syndrome in 1827 European American patients. Variants in the putative promoter region, −757T > C and −286C > T > A, were associated with the highest CRP elevations after ACS. Patients with two copies of the A allele of SNP −286C > T > A had median CRP values of 76.6 mg/L, compared to 11.1 mg/L in patients with no copies of the rare variant (p-value <0.0001), post ACS. The lowest CRP values were found for patients with minor alleles of the exonic 1059G > C and the 3'untranslated region 1846G > A SNPs. For example, patients homozygous for the minor allele of 1059G > C had 71% lower median CRP values than those homozygous for the major allele [3.5 vs 12.0 mg/L, p < 0.0001]. These trends persisted in the chronic stable phase after ischemia had resolved, and after adjustment for infarct size by peak creatinine kinase levels and clinical status by Killip class. Assessment of CRP genetic variants identified patients with higher and lower CRP elevation after acute coronary syndrome.     

Differences in SLE disease activity between patients of Caucasian and South‐East Asian/Chinese background in an Australian hospital

Aim: We performed a semiprospective and retrospective review of all admissions to a single institution of systemic lupus erythematosus (SLE) patients, admitted due to active disease. The aim was to describe differences in disease activity as a cause of hospital admissions between patients originating from South‐East Asia/China (SAC) and Caucasians. Method: There were 210 patients admitted for active disease, with a total of 567 admissions for active SLE over a 16‐year period. Allowing for patients who had left our database, there was a total of 3415 patient years of observation. Results: Patients from SAC with a flare requiring admission presented earlier in their disease course and with more active disease than did Caucasians (median SLE Disease Activity Index 13 vs. 8, P= 0.002). They had longer inpatient stays (7 vs. 5 days P = 0.03). There was a trend to higher rates of re‐presentation to hospital for flare (59% in SAC patients vs. 41% in Caucasians, P = 0.09) with more subsequent admissions (3 vs. 2 P = 0.06) despite a shorter period of observation. Conclusions: South‐East Asian/Chinese were more likely to be diagnosed with class III/IV glomerulonephritis and require cyclophosphamide both at presentation and subsequent admissions. More patients from SAC were readmitted to hospital for severe central nervous system disease after their first hospital admission. In this population, lupus patients had more severe flares and more frequently required admission for these than Caucasians.     

The inhibitory effect of polysaccharide on mumps virus multiplication

Polysaccharides derived from type-specific Friedl?nder bacilli cause inhibition of the multiplication of mumps virus in the allantoic sac of the chick embryo. As little as 5 microg. of polysaccharide is effective as an inhibitor. Inhibition of multiplication is obtained when polysaccharide is injected as long as 4 days after inoculation of virus. Chemical studies have shown that the structural configurations of the polysaccharide responsible for specific serological activity are not identical with those which determine the inhibitory effect relative to mumps virus. The possible mechanisms of the inhibition of viral multiplication by means of polysaccharides are discussed.     

A study of the relationship between the fever caused by bacterial pyrogens and the fever accompanying acute infections

The relationship between the fever of acute infection and that following injection of bacterial pyrogen was studied by administering pyrogens to animals convalescent from acute infections. Rabbits surviving dermal pneumococcal infections or peritonitis due to Escherichia coli were given intravenous injections of typhoid or E. coli vaccine. They showed no evidence of tolerance to the fever-promoting effect of these pyrogenic materials. Tolerance did develop in infected animals given daily pyrogen injections during the course of the infection. Certain previous observations upon the ability of rabbits to develop tolerance to pyrogens, the broad nature of the tolerance, and its duration were confirmed. It is concluded that the pyrogen produced by certain bacteria plays little or no r?le in the production of the fever of infection. These findings are compatible with the hypothesis that there is a common factor, perhaps a product of cell injury, underlying the fever accompanying diseases of various types.