The Variants in the 3′ Untranslated Region of the Matrix Metalloproteinase 9 Gene as Modulators of Treatment Outcome in Children with Asthma

Purpose

The maintaining of asthma control is difficult due to high variability in response to therapy among patients. Since matrix metalloproteinase 9 (MMP9) is implicated in inflammation and remodeling of asthmatic airways, it could be associated with adequate response to asthma therapy. The aim of this study was to investigate whether variants in 3′ end of the MMP9 gene are associated with clinical phenotype and responsiveness to treatment in children with asthma.

Methods

The study included 127 asthmatic children from Slovenia. Variants in the 3′ end of the MMP9 gene were analyzed by direct DNA sequencing and the obtained results were correlated with clinical parameters.

Results

Two variants were detected, rs13925 and rs20544. For the variant rs20544, statistically significant difference in airway hyperresponsiveness (p?=?0.011) and asthma control (p?=?0.049) between genotypes was found. Patients with TT genotype had lower airway sensitivity, and after 12 months of treatment showed significant improvement in Asthma Control Test (ACT) scores compared to CC and CT genotype. For the variant rs13925, the association with lung function was observed. The carriers of A allele showed noticeable improvement of lung function after the first 6 months of treatment in comparison to the carriers of G allele (p?=?0.046).

Conclusion

The main finding of our study is the association of MMP9 genotypes rs20544 TT and rs13925 AA and AG with better asthma control, and indirectly better response to treatment. Based on these results, MMP9 deserves further research as a potential predictive biomarker for asthma.

     

Heritability of the Human Craniofacial Complex

Quantifying normal variation and the genetic underpinnings of anatomical structures is one of the main goals of modern morphological studies. However, the extent of genetic contributions to normal variation in craniofacial morphology in humans is still unclear. The current study addresses this gap by investigating the genetic underpinnings of normal craniofacial morphology. The sample under investigation consists of 75 linear and angular measurements spanning the entire craniofacial complex, recorded from lateral cephalographs of 1,379 participants in the Fels Longitudinal Study. Heritabilities for each trait were estimated using SOLAR, a maximum‐likelihood variance components approach utilizing all pedigree information for parameter estimation. Trait means and mean effects of the covariates age, sex, age², sex × age, and sex × age² were simultaneously estimated in the analytic models. All traits of the craniofacial complex were significantly heritable. Heritability estimates ranged from 0.10 to 0.60, with the majority being moderate. It is important to note that we found similar ranges of heritability occurring across the different functional/developmental components of the craniofacial complex, the splanchnocranium, the basicranium, and the neurocranium. This suggests that traits from different regions of the craniofacial complex are of comparable utility for the purposes of population history and phylogeny reconstruction. At the same time, this genetic influence on craniofacial morphology signals a caution to researchers of nongenetic studies to consider the implications of this finding when selecting samples for study given their project design and goals. Anat Rec, 298:1535–1547, 2015. © 2015 Wiley Periodicals, Inc.     

Functional Anatomy of the Syrinx of the Chukar Partridge (Galliformes: Alectoris chukar) as a Model for Phonation Research

The phonation process of vertebrates is influenced by the material characteristics of the participating structures, ranging from molecular to macroscopic dimensions. Good animal models for phonation research are still lacking. Due to easy availability and relatively simple structure, the syrinx of birds might serve as a good animal model for this purpose. Our aim was therefore to determine structural features of the syrinx and obtain insights into its mucus layer characteristics. Epithelium and glands were analyzed using histological, histochemical, and immunohistochemical methods and conclusions were drawn on the use of the syrinx as a model for phonation research by comparing the epithelium and its mucus characteristics to human laryngeal secretions. Ten adult partridges were analyzed. The tympanum of the syrinx developed from the last two tracheal cartilages, whereas the caudal part of the syrinx was formed from eight pieces of bronchial cartilages. The tracheal and bronchial epithelia and the pessulus of the syrinx were lined by pseudo‐stratified columnar epithelium in which goblet cells and intraepithelial glands were localized. Collagen fibers were distributed in the lamina propria of all parts of the syringeal mucosa. Elastic fibers in the membranes of the syrinx showed evident distribution. All glandular epithelial cells and goblet cells were positive for neutral, acidic and carboxylated mucins were dominant in particular. Epithelium and glands revealed positive reactivity with antibodies to the mucins MUC1, MUC2, and MUC5AC. Of these, MUC2 and MUC5AC were dominant. The syrinx of partridge can serve as a good ex vivo model for phonation research. Anat Rec, 298:602–617, 2015. © 2014 Wiley Periodicals, Inc.     

Interaction between warfarin and cannabis

Delta‐9‐tetrahydrocannabinol (THC), the main psychoactive cannabinoid in cannabis, may inhibit the cytochrome P450 enzyme CYP2C9. Consequently, cannabis use might infer a risk of drug‐drug interaction with substrates for this enzyme, which includes drugs known to have a narrow therapeutic window. In this study, we describe a case report of a 27‐year‐old man treated with warfarin due to mechanical heart valve replacement who presented with elevated international normalized ratio (INR) value (INR = 4.6) following recreational cannabis use. We conducted a review of the available literature, using the PubMed and EMBASE databases while following PRISMA guidelines. Following screening of 85 articles, three eligible articles were identified, including one in vitro study and two case reports. The in vitro study indicated that THC inhibits the CYP2C9‐mediated metabolism of warfarin. One case study reported of a man who on two occasions of increased marijuana use experienced INR values above 10 as well as bleeding. The other case study reported of a patient who initiated treatment with a liquid formulation of cannabidiol for the management of epilepsy, ultimately necessitating a 30% reduction in warfarin dose to maintain therapeutic INR values. The available, although sparse, data suggest that use of cannabinoids increases INR values in patients receiving warfarin. Until further data are available, we suggest patients receiving warfarin be warned against cannabis use.