Association of CRP Haplotypes in Rheumatoid Arthritis and their Correlation with Severity of the Disease

Background: Rheumatoid arthritis is a heterogenous autoimmune disorder of unknown cause with variable clinical expression. Genetic factors play an important role and likely account for about 60% of disease susceptibility and expression. The aim of this study to find out the association of CRP haplotypes in rheumatoid arthritis and their correlation with severity of the disease. Material and Methods: This was case control study where in all available patients and volunteers (only for blood samples) were recruited. Peripheral blood samples of patients were collected at Rheumatology Clinic and Medicine Department of S.P. Medical College, Bikaner in collaboration with Department of Biological Sciences, BITS, Pilani-Hyderabad during July 2009 to January 2012. 100 control subjects with no known history of disease and 135 cases were recruited as per pre-decided inclusion and exclusion criteria. A tag SNP approach captured common variation at the CRP locus and the relationship between genotype and serum CRP was explored by linear modelling. Results: Cases comprised of 98 females (Mean age 43.01+13.23 yrs) and 37 (mean age 47.4+14.9 years) males. The Control group comprised of 100 unrelated healthy controls. The cases and controls did not differ significantly for any of the clinical parameters, except for serum CRP levels. The allele distribution of rs1205 polymorphism among the studied cases and controls, which was statistical non-significant. The rs3093066 polymorphism located at the 3` position of the gene in the UTR at position number 157949723. The rs3116640 polymorphism located at 157948938 position on chromosome1 and the allele distribution of rs3116637 polymorphism among cases and controls which was also found to be monomorphic respectively. Conclusion: Extending the studies to a larger cohort will also allow genetic analyses of clinically defined endophenotypes observed in the patients of this chronic metabolic disease with attributes of autoimmune disorder and multiple symptoms in patients. Genetic studies can also impact strategies adopted for effective personalized treatment for this progressively debilitating disease.

Phosphorus balance and prostate cancer.

Prostatic diseases affect men over the age of 45 and increase in frequency with age so that by the eighth decade more than 90% of men have Benign Prostatic Hyperplasia, (BPH), of which some progress to Carcinoma of Prostate (CaP). CaP, the most common malignancy in men, is also the second most common cause of death in men. Over the last three decades the mortality rate for CaP has steadily increased. There, however, are scant clues to the aetiology/pathogenesis of CaP. As treatment failures of advanced carcinoma continue to frustrate clinicians, emphasis has recently been focused on possible preventive strategies. Several studies support the view that higher levels of 1,25-(OH)2D, the active metabolite of vitamin D, reduce the risk of BPH and CaP. Men with high serum levels of 1,25-(OH)2D have a reduced risk of poorly differentiated and clinically advanced CaP. Hypercalcemic activity of 1,25-(OH)2D or its analogues, however, thwart their use for therapy in humans. Incidentally, a low dietary intake of phosphorus has been reported to increase serum levels of 1,25-(OH)2D. In addition, dietary fructose reduces plasma phosphate levels by 30 to 50% for more than 3 hr. Fruit intake has, indeed, been shown to be associated with reduced risk of CaP, particularly the advanced type. These observations, taken together, support that dietary determinants of hypophosphatemia, leading to increased plasma levels of 1,25-(OH)2D, could reduce the risk of ageing men to develop prostatic diseases, both BPH and/or carcinoma of Prostate.

Incidence of HIV infection & its predictors in blood donors in Delhi.

The concurrence of human immunodeficiency virus (HIV) infection with hepatitis B virus (HBV) and syphilis and the trend that these infections have followed in blood donors during the last eight years from 1989 to 1997 were studied at a Zonal Blood Testing Centre in New Delhi. Overall, HIV was positive in 0.068 per cent blood donors in this period. A significant rise was found in HIV infection (particularly in a small subgroup of voluntary donors) after 1995 and in VDRL reactivity after 1993. However, no significant increase was found in hepatitis B surface antigen (HBsAg) positivity. HIV seroprevalence in replacement donors, which represents the low risk general population, increased gradually from 0 in 1991 to an average of 0.060 per cent in 1997. HbsAg and VDRL reactivity was present in 12.2 and 11.8 per cent of HIV positive cases while it was present in 1.2 and 2.3 per cent of HIV negative cases respectively. HBsAg was found 10.4 times and VDRL reactivity 5.9 times more often in HIV positive donors as compared to HIV negative donors. Thus, HIV infection is likely to be more prevalent in communities with a high HBsAg positivity and VDRL reactivity.

Screening for genital chlamydial infection in symptomatic women.

During a two year period, the prevalence of genital chlamydial infection was assessed by Papanicolaou and Giemsa cytology of endocervical specimens from 396 women attending a gynaecology outpatient department in a Delhi hospital, with symptoms of lower genital tract infection and primary or secondary infertility. The results of cytological examination were confirmed by isolation in a cell culture system. Prevalence was found to be 41 per cent (93 of 227) in patients presenting with vaginal discharge and 36 per cent (61 of 169) in infertility women. Genital chlamydial infection is prevalent in gynaecological patients in this region.