Construction and evaluation of the functional polygenic risk score for gastric cancer in a prospective cohort of the European population / 中华医学杂志(英文版)

BACKGROUND@#A polygenic risk score (PRS) derived from 112 single-nucleotide polymorphisms (SNPs) for gastric cancer has been reported in Chinese populations (PRS-112). However, its performance in other populations is unknown. A functional PRS (fPRS) using functional SNPs (fSNPs) may improve the generalizability of the PRS across populations with distinct ethnicities.@*METHODS@#We performed functional annotations on SNPs in strong linkage disequilibrium (LD) with the 112 previously reported SNPs to identify fSNPs that affect protein-coding or transcriptional regulation. Subsequently, we constructed an fPRS based on the fSNPs by using the LDpred2-infinitesimal model and then analyzed the performance of the PRS-112 and fPRS in the risk prediction of gastric cancer in 457,521 European participants of the UK Biobank cohort. Finally, the performance of the fPRS in combination with lifestyle factors were evaluated in predicting the risk of gastric cancer.@*RESULTS@#During 4,582,045 person-years of follow-up with a total of 623 incident gastric cancer cases, we found no significant association between the PRS-112 and gastric cancer risk in the European population (hazard ratio [HR] = 1.00 [95% confidence interval (CI) 0.93-1.09], P = 0.846). We identified 125 fSNPs, including seven deleterious protein-coding SNPs and 118 regulatory non-coding SNPs, and used them to construct the fPRS-125. Our result showed that the fPRS-125 was significantly associated with gastric cancer risk (HR = 1.11 [95% CI, 1.03-1.20], P = 0.009). Compared to participants with a low fPRS-125 (bottom quintile), those with a high fPRS-125 (top quintile) had a higher risk of incident gastric cancer (HR = 1.43 [95% CI, 1.12-1.84], P = 0.005). Moreover, we observed that participants with both an unfavorable lifestyle and a high genetic risk had the highest risk of incident gastric cancer (HR = 4.99 [95% CI, 1.55-16.10], P = 0.007) compared to those with both a favorable lifestyle and a low genetic risk.@*CONCLUSION@#These results indicate that the fPRS-125 derived from fSNPs may act as an indicator to measure the genetic risk of gastric cancer in the European population.

El concepto de umbral craneofacial y su código de lectura ABC / The concept of craniofacial threshold and its ABC reading code

Durante el crecimiento y desarrollo de la cabeza, ésta lo hace en diferentes direcciones y proporciones, habiendo un límite entre la armonía /desarmonía conocido como umbral. Se hace referencia a este concepto, la forma de escribirlo y leerlo por medio de un código que lo simboliza. Objetivo: Poner al alcance de la comunidad médica un código de lectura e identificación de fenotipos craneofaciales sindrómicos y no sindrómicos. Conclusiones: Se considera que este concepto de umbral craneofacial y su código de lectura pueden ser usados en la enseñanza e investigación de la armonía-desarmonía durante el crecimiento y desarrollo de la cabeza, resultando ser de gran utilidad en la comprensión rápida y sencilla de la lectura del fenotipo craneofacial (AU)

During the growth and development of the head, it does so in different directions and proportions, there being a limit between the harmony / disharmony known as threshold. Reference is made to this concept, the way of writing it and reading it by means of a code that symbolizes it. Objective: To put within reach of the medical community, a code of reading and identification of syndromic and non-syndromic craniofacial phenotypes. Conclusions: It is considered that this concept of a craniofacial threshold and its reading code can be used in the teaching and research of harmony / disharmony during the growth and development of the head, being very useful in the quick and easy comprehension of the reading of the craniofacial phenotype (AU)

Omic Approach in Non-smoker Female with Lung Squamous Cell Carcinoma Pinpoints to Germline Susceptibility and Personalized Medicine / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Lung cancer is strongly associated to tobacco smoking. However, global statistics estimate that in females the proportion of lung cancer cases that is unrelated to tobacco smoking reaches fifty percent, making questionable the etiology of the disease. MATERIALS AND METHODS: A never-smoker female with primary EGFR/KRAS/ALK-negative squamous cell carcinoma of the lung and their normal sibswere subjected to a novel integrative “omic” approach using a pedigree-based model for discovering genetic factors leading to cancer in the absence of well-known environmental trigger. A first-stepwhole-exome sequencing on tumor and normal tissue did not identify mutations in known driver genes. Building on the idea of a germline oligogenic origin of lung cancer, we performed whole-exome sequencing of DNA from patients' peripheral blood and their unaffected sibs. Finally, RNA-sequencing analysis in tumoral and matched non-tumoral tissues was carried out in order to investigate the clonal profile and the pathogenic role of the identified variants. RESULTS: Filtering for rare variants with Combined Annotation Dependent Depletion (CADD) > 25 and potentially damaging effect, we identified rare/private germline deleterious variants in 11 cancer-associated genes, none ofwhich, except one, sharedwith the healthy sib, pinpointing to a “private” oligogenic germline signature. Noteworthy, among these, two mutated genes, namely ACACA and DEPTOR, turned to be potential targets for therapy because related to known drivers, such as BRCA1 and EGFR. CONCLUSION: In the era of precision medicine, this report emphasizes the importance of an “omic” approach to uncover oligogenic germline signature underlying cancer development and to identify suitable therapeutic targets as well.

Análisis de la causalidad en el estudio genético de los trastornos neuropsiquiátricos: revisión narrativa / Causal analysis in the genetic study of neuropsychiatric disorders: Narrative review / Análise da causalidade no estudo genético dos transtornos neuropsiquiátricos: revisão narrativa

Los trastornos neuropsiquiátricos se caracterizan por formas complejas de transmisión genética. El conocimiento de los aspectos básicos de los diseños metodológicos más usados en la investigación sobre la genética de estos trastornos permite al clínico una búsqueda más eficaz de la literatura disponible, así como una mejor lectura crítica y aplicación práctica de los artículos sobre esta área del conocimiento. Esta revisión tiene como objetivo describir los diseños estadísticos-epidemiológicos más utilizados en este ámbito e ilustrar dicha descripción con algunos ejemplos. En concreto, se revisan aspectos metodológicos generales sobre los estudios de gemelos, los estudios de adopción, análisis de pedigríes, estudios de asociación (casos y controles) y análisis de ligamiento genético.

Neuropsychiatric disorders are characterized by complex forms of genetic transmission. Knowledge of the basic aspects of the most commonly used methodological designs used in research on the genetics of these disorders allows the clinician to perform a more effective search of the literature available as well as a better critical reading and practical application of the articles in this field of knowledge. The objectives of this review are to describe the statistical-epidemiological designs that are most commonly used in this field and to illustrate this description with several examples. Specifically, we review the general methodological aspects of twin studies, adoption studies, pedigree analysis, association studies (case-control), and genetic linkage analysis.

Os transtornos neuropsiquiátricos se caracterizam por formas complexas de transmissão genética. O conhecimento dos aspectos básicos dos desenhos metodológicos mais usados na investigação sobre a genética destes transtornos permite ao clínico uma busca mais eficaz da literatura disponível, assim como uma melhora na leitura crítica e na aplicação prática dos artigos sobre esta área do conhecimento. Esta revisão tem como objetivo descrever os desenhos estatísticos-epidemiológicos mais utilizados neste âmbito e ilustrar dita descrição com alguns exemplos. Em concreto, se revisam aspectos metodológicos gerais sobre os estudos de gêmeos, os estudos de adoção, análise de pedigrees, estudos de associação (casos e controles) e análise de ligamento genético.

Agregación familiar en pacientes con hipertensión arterial / Family Aggregation in Patients with Arterial Hypertension

Introducción: actualmente, la hipertensión arterial es considerada como un trastorno poligénico y multifactorial, en el cual la interacción de múltiples genes entre sí y con el medio ambiente es importante. Objetivos: describir el comportamiento de la agregación familiar de la hipertensión arterial. Métodos: se realizó un estudio observacional, descriptivo, de corte transversal en el Policlínico Alex Urquiola en el periodo de enero a agosto de 2016. El universo de estudio estuvo constituido por los 54 pacientes y la muestra por 20, seleccionados a través de muestreo de tipo probabilístico aleatorio simple. Se les aplicó una encuesta estructurada y se realizó análisis informático de los resultados. Resultados: el grupo etario predominante fue el de 50 a 59 años (55 por ciento); mientras que el grupo menos representado fue el de 30 a 39 años (10 por ciento). En cuanto al grado de parentesco con los familiares hipertensos, predominaron los que tenían familiares de II grado (55 por ciento). El sedentarismo predominó como factor de riesgo. Conclusiones: se demostró agregación familiar para la hipertensión arterial en estas familias. Predominaron el grado de parentesco II y el factor de riesgo sedentarismo. Considerándose importante la prevención primaria en cada área de salud, para poder modificar factores de riesgo(AU)

Introduction: Hypertension is nowadays considered a polygenic and multifactorial disorder, in which the interaction of multiple genes with one other and with the environment is important. Objectives: To describe the behavior of family aggregation of arterial hypertension. Methods: An observational, descriptive, cross-sectional study was performed Alex Urquiola Polyclinic, from January to August 2016. The study universe consisted of 54 patients and the sample consisted of 20 patients, chosen by simple probabilistic randomization. They were given a structured survey, after which we carried out the computerized analysis of the results. Results: The predominant age group was 50-59 years (55 percent), while the least represented group corresponded to the ages 30-39 years (10 percent). As for the degree of kinship to hypertensive relatives, there was a predominance of those who had relatives of grade II (55 percent). The sedentary lifestyle predominated as a risk factor. Conclusions: Family aggregation for hypertension was proved in these families. The was a predominance of the second degree of relation and sedentary risk factors. We consider that primary prevention is important in each health area, for the modification of risk factors(AU)

Refinando o diagnóstico de Transtorno de Oposição e Desafio na infância e adolescência: validação e caracterização da dimensão irritável / Refining Oppositional Defiant Disorder diagnosis in children and adolescents: validation and characterization of the irritable dimension

O Transtorno de Oposição e Desafio (TOD) é definido por um padrão recorrente de comportamento desafiante, desobediente e hostil com início na infância e adolescência e caracteriza-se por uma alta taxa de comorbidades. Estudos longitudinais apontam o TOD na infância como um dos principais preditores de psicopatologia na idade adulta. Uma possível explicação para a grande heterogeneidade de comorbidades e trajetórias longitudinais é de que o diagnóstico de TOD abrange distintas dimensões de sintomas, cada qual com seu desfecho. O primeiro objetivo desta tese foi a validação das distintas dimensões do TOD em uma amostra comunitária Brasileira composta de 2512 sujeitos. Através de análise fatorial confirmatória, demonstramos que o modelo que melhor representa a heterogeneidade do TOD é composto por três dimensões: a dimensão "argumentative/defiant" que está associada com transtorno de déficit de atenção/hiperatividade (TDAH); a dimensão "vindictiveness" que possui associação com transtorno de conduta (TC); e a dimensão "angry/irritable mood" onde predominam as associações com transtornos depressivos e de ansiedade. O objetivo seguinte foi investigar o papel da dimensão irritável na classificação nosológica dos transtornos mentais na infância e adolescência. A apresentação da irritabilidade é um aspecto crucial: irritabilidade crônica caracterizada por baixa tolerância à frustração e frequentes explosões de raiva, que é distinta da apresentação episódica, associada ao diagnóstico Transtorno de Humor Bipolar (TB). "Severe mood dysregulation", "disruptive mood dysregulation disorder", ou dimensão irritável do TOD são formas distintas de classificar o fenótipo de irritabilidade crônica. Entretanto, independente da classificação utilizada, a alta taxa de comorbidades é invariavelmente o denominador comum em estudos sobre irritabilidade. Neste sentido, examinamos o impacto da irritabilidade como uma dimensão subjacente a vários transtornos. Para tanto, avaliamos o...

The Oppositional Defiant Disorder (ODD) is defined as a pattern of disobedient, hostile and defiant behavior beginning in childhood or adolescence and often accompanied by a wide range of comorbidities. Longitudinal studies support ODD as a predictor of psychopathology in adulthood. A potential explanation for such heterogeneity of comorbidities and longitudinal trajectories is that ODD diagnosis encompasses distinct clusters of symptoms, each with its outcome. The first aim of this work was the validation of ODD dimensions in a Brazilian community sample of 2512 subjects. Confirmatory factorial analysis showed that the best model for ODD comprised three dimensions: an "argumentative/defiant" dimension, which associates with attention deficit/hyperactivity disorder (ADHD); a "vindictiveness" dimension, which associates with conduct disorder (CD); and an "angry/irritable" dimension where emotional disorders such as depression and anxiety are the most common associations. The next step was the investigation of the role of the irritable dimension of oppositionality in diagnostic classifications of childhood mental disorders. The pattern of irritability is a crucial point: its chronic presentation as easy annoyance and frequent temper outbursts should be differentiated from the episodic course of irritability associated with the specific diagnosis of Bipolar Disorder (BD). "Severe mood dysregulation", "disruptive mood dysregulation disorder", and the irritable dimension of oppositionality are different ways to classify the chronic irritability phenotype. However, regardless of the classification, the high rate of comorbidities is invariably the common denominator in studies of irritability. Therefore, we examined the impact of irritability as a dimension cutting across multiple settings: individuals without any diagnosis, subjects with ADHD, and also those with emotional disorders. For that we used two samples, one from Brazil, with 2.512 subjects, and one...

Reduced penetrance in human inherited disease

For many inherited diseases, the same mutation is not always expressed in all persons who care it, moreover, when the mutation is expressed, it is not always expressed in the same way. These findings are the basis for the concepts of penetrance and expressivity. Understanding the factors that control penetrance of disease genes will provide insight into the fundamental disease processes and will help in genetic counselling. With the advancement of molecular genetics over the last few years, some of the underlying mechanisms of reduced penetrance have been elucidated. These include, mutation type, allelic variations in gene expression, epigenetic factors, gene-environment interplay, influence of age and sex, allele dosage, oligogenic and modifier genes, copy number variations as well as the influence of additional gene variants and the effect of single nucleotide polymorphisms. The aim of this review is to clarify factors affecting gene penetrance as well as some of the underlying molecular mechanisms in some genetic disorders

Febrile seizures / 소아과

Febrile seizure (FS) is the most common seizure disorder of childhood, and occurs in an age-related manner. FS are classified into simple and complex. FS has a multifactorial inheritance, suggesting that both genetic and environmental factors are causative. Various animal models have elucidated the pathophysiological mechanisms of FS. Risk factors for a first FS are a family history of the disorder and a developmental delay. Risk factors for recurrent FS are a family history, age below 18 months at seizure onset, maximum temperature, and duration of fever. Risk factors for subsequent development of epilepsy are neurodevelopmental abnormality and complex FS. Clinicians evaluating children after a simple FS should concentrate on identifying the cause of the child's fever. Meningitis should be considered in the differential diagnosis for any febrile child. A simple FS does not usually require further evaluation such as ordering electroencephalography, neuroimaging, or other studies. Treatment is acute rescue therapy for prolonged FS. Antipyretics are not proven to reduce the recurrence risk for FS. Some evidence shows that both intermittent therapy with oral/rectal diazepam and continuous prophylaxis with oral phenobarbital or valproate are effective in reducing the risk of recurrence, but there is no evidence that these medications reduce the risk of subsequent epilepsy. Vaccine-induced FS is a rare event that does not lead to deleterious outcomes, but could affect patient and physician attitudes toward the safety of vaccination.

Descriptive study of 20 patients with schizophrenia in Boyacá, Colombia / Estudio descriptivo de una muestra de pacientes con esquizofrenia residentes en el departamento de Boyacá, Colombia

Schizophrenia is a multifactorial disease with high genetic heterogeneity and complex inheritance. In Boyacá, Colombia, we studied a group of 20 schizophrenic patients (16 men and 4 women) to establish their sociodemographic and clinical characteristics as well as their genetic and precipitating factors. The patients were analyzed using cytogenetic studies and a descriptive analysis of qualitative and quantitative variables. The disease frequently first manifested in young adults (average age of initiation: 22.5 years). The predominant subtype (8/20) was paranoid schizophrenia, and the onset was typically gradual (14/20). Precipitating factors were found in 15 patients: physical factors in nine patients, social factors in five patients and economic factor in one patient. All karyotypes were normal. Clinical features did not associate with either the sociodemographic characteristics or the genetic and predisposing factors, supporting the clinical heterogeneity of schizophrenia. Patients and their families received genetic counseling and explanations of the study's results, the possibility of recurrences and the risk of suffering the disease given an affected relative. Further and larger studies are required to determine if the factors evaluated in this study influence the development of the disease.

La esquizofrenia, enfermedad multifactorial, tiene gran heterogeneidad genética y herencia compleja. En Boyacá, Colombia, se estudió un grupo de 20 pacientes esquizofrénicos (16 hombres y cuatro mujeres) y se establecieron las características sociodemográficas y clínicas y los factores genéticos y precipitantes. Se hicieron estudio citogenético y un análisis descriptivo de las variables cualitativas y cuantitativas. Hubo predominio del comienzo de la enfermedad en adultos jóvenes (promedio de edad en el momento de la aparición: 22,5 años). Predominaron la esquizofrenia paranoide (8/20) con modo de aparición progresivo (14/20). Se hallaron factores precipitantes en 15 pacientes: físicos en nueve, sociales en cinco y económicos en uno. Todos los cariotipos fueron normales. Los rasgos clínicos no se asociaron con las características sociodemográficas ni con los factores genéticos y precipitantes, lo que evidencia gran heterogeneidad en las formas de manifestación de la enfermedad. Se dio asesoría genética a los pacientes y sus familias y se les explicaron los resultados, el riesgo de recurrencias y el de padecer la enfermedad cuando se tiene un pariente afectado. Es necesario analizar una serie mayor de casos, para poder determinar si los factores evaluados influyen en el desarrollo de la enfermedad.

Transcriptomic regulation and molecular mechanism of polygenic tumor at different stages / 中南大学学报(医学版)

The research team on the National Key Scientific Program of China: "Transcriptomic regulation and molecular mechanism research of polygenic tumor at different stages" has focused on the field of transcriptomics of 4 common polygenic tumors, including nasopharyngeal carcinoma(NPC), breast cancer, colorectal cancer, and glioma. Extensive laboratory work has been carried out on the expression and regulation of tumor transcriptomics; identification of tumor suppressor/susceptible genes; mechanism of tumor epigenetics including miRNAs, and comparative study of specific gene/protein cluster of tumor transcriptomics and proteomics. Genes including SPLUNC1, LTF, BRD7, NOR1, BRCA1/2, PALB2, AF1Q, SOX17, NGX6, SOX7, and LRRC4 have been identified as the key transcriptional regulation genes during the stage of tumor initiation and invasion. Accordingly,the NPC gene signal regulation network of "SPLUNC1-miR-141-target genes", the breast cancer interaction signal pathway of "miR-193b-uPA",the glioma signal network of "miR-381- LRRC4-MEK/ERK/AKT", and the miRNA-target gene network of colorectal cancer metastasis related gene NGX6 have been thoroughly elucidated. These fruitful Results imply that the changes of key molecules in crucial signal pathway will cause severe dysfunction in signal transduction and gene regulation network in polygenic tumors, indicating that in the category of pathogenesis,these tumors may further classify as the "Disease of gene signal transduction and gene regulation network disorder". The researches have laid solid foundation for revealing the molecular mechanism and transcriptomic regulation of polygenic tumors at different stages.

Genética del desarrollo y la conducta / Genetics of development and behaviour

La genética cuantitativa contribuye a discriminar la influencia relativa de los factores genéticos y medioambientales en el desarrollo humano. El cálculo de coeficientes de correlación del cociente intelectual, entre hermanos, o gemelos monocigóticos y dicigóticos, criados juntos o separados, permite efectuar estimaciones de la heredabilidad, que mide la contribución de la genética a la varianza de un rasgo del desarrollo. Muchos aspectos del desarrollo intelectual normal, tienen una heredabilidad de aproximadamente el 50%. El resto es atribuible a factores medioambientales. La influencia de la genética en el desarrollo no implica un destino programado e inexorable, sino una propensión, una tendencia, más queuna certeza.

Quantitative genetics can make a significant contribution to disentangle the relative influence of genetics and environment on human developmentand its disorders. Estimates of Pearson'scorrelation coefficients between siblings, mono and dizogotic twins reared together or apart, allows the calculation of heredability, that is,the contribution of genetics to the variance of a given trait. In the case of many aspects of intellectual development, heredability is around50%. The rests is attributable to the influence of environment. The influence of genetics on development should be considered as a trend, a risk, rather than a programmed fate.

Síndrome de pterigium múltiple: recurrencia en una familia / Multiple pterygium syndrome: recurrence in a family

En el presente trabajo se describe un caso de síndrome de pterigium múltiple recurrente familiar de particulares características clínicas. Esta descripción se presenta a continuación del artículo “Síndrome de Escobar: a propósito de un caso” para mostrar la heterogeneidad fenotípica y genotípica de esta entidad. El diagnóstico presuntivo se realizó en el primer hijo a los 5 días de vida y el confirmatorio a los dos meses; sobrevivió hasta los 8 meses con desnutrición, ceguera, retraso global del desarrollo y patología renal crónica. Las manifestaciones clínicas incluían fijación generalizada de articulaciones, pterigium de axila, codo y región poplítea, cifosis dorsal, desviación cubital de las manos, pie bot talo-valgo, pabellones auriculares de implantación baja y micrognatia. El diagnóstico presuntivo del segundo hijo fue ecográfico- genealógico, a las 20 semanas de gestación por síndrome de hipoquinesia fetal y fijación articular. El feto obitó a las 21 semanas de edad gestacional. La anatomía- patológica confirmó los hallazgos ecográficos, constatándose un fenotipo muy similar al de su hermano.

A recurrent and familiar case of pterygium multiple syndrome with particular clinical features is presented. This description comes after the article “Escobar syndrome: a case report” in order to show the phenotypic and genotypic heterogeneity of these cases. A preliminary diagnosis was made at 5 days of age in the first child of the couple; the definitive diagnosis was made at 2 months of age. The patient lived 8 months with malnutrition, blindness, developmental delay and chronic renal pathology. Clinical manifestations included joint contractures; elbow, armpit and popliteal region pterygium; dorsal kyphosis; cubital deviation of hands; club foot deformity; low outer ear and micrognathia. The preliminary diagnosis of the second child was ecographic, at 20 weeks of gestation by Hypokinesia fetal and joint contracture. The pregnancy was ended at 21 weeks. The anatomy pathology confirmed the ecographic findings with a phenotype very similar to the first case.

Mapeamento genético do locus 1q 24.2 – 1q31.3 em famílias segregando periodontite agressiva / Genetic mapping of locus 1q 24.2 – 1q 3.3 in families segregating aggressive periodontitis

Um estudo sugere que o fenótipo da periodontite agressiva localizada está ligado a região 1q25. O objetivo do presente estudo foi aperfeiçoar o mapeamento genético da periodontite agressiva na região cromossômica supracitada em famílias clinicamente bem caracterizadas segregando a doença. A hipótese deste estudo é que variações genéticas localizadas no cromossomo 1 entre as regiões 1q 24.2 e 1q 31.3 contribuem para o fenótipo da periodontite agressiva. Como objetivos específicos, determinamos o modo de herança da periodontite agressiva através de análise de segregação, e verificamos a existência de ligação e/ou associação entre a região 1q 24.2-1q 31.3 e a periodontite agressiva. A análise de segregação foi executada no programa SEGREG do pacote SAGE versão 5.4.2 com base nos dados dos pedigrees das primeiras 74 famílias recrutadas neste estudo, totalizando 475 indivíduos (média de 6.4 indivíduos por família) de origem geográfica similar. Assumiu-se a herança Mendeliana como um locus autossômico com 2 alelos A e B, onde o alelo A estava associado ao fenótipo relevante. Cinco modos de transmissão (não homogêneo, Mendeliano homogêneo, homogêneo geral, semigeral, heterogêneo geral) foram testados assumindo que a prevalência da periodontite agressiva é de 1% sob o Equilíbrio de Hardy-Weinberg. Foram coletadas amostras de saliva de 54 das 74 famílias recrutadas, totalizando 371 amostras de saliva para a extração do DNA genômico. 21 polimorfismos de um único nucleotídeo (SNPs) foram selecionados dentro da região proposta e analisados por reação em cadeia da polimerase (PCR). Os genótipos foram obtidos pelo método TaqMan. A análise não paramétrica de ligação familial foi executada com o Programa Merlin. As detecções de transmissão (associação) foram executadas com os programas FBAT e PLINK. O modo de herança mais adequado para cada teste de susceptibilidade dos alelos executado foi o modelo semigeral (p=0,31)...

It has been suggested that the localized aggressive periodontitis phenotype is linked to the region 1q25. The aim of this study was to fine map the chromosome interval suggested as containing a localized aggressive periodontitis locus in clinically well characterized group of families segregating aggressive periodontitis. The hypothesis of this study is that genetic variation located between 1q24.2 to 1q31.3 contributes to the phenotype of aggressive periodontitis. As specific aims, we evaluated the inheritance mode of aggressive periodontitis performing segregation analysis and, we tested the presence of linkage and or association between the target region of chromosome 1 and aggressive periodontitis. Segregation analysis was performed in pedigree data from the first 74 families, comprised of 475 individuals (average of 6.4 individuals per family) with similar geographic origin by the use of the SEGREG program of SAGE v.5.4.2. Mendelian inheritance was assumed to be through an autosomal locus with two alleles A and B, where the A allele was associated with the relevant phenotype. Five inheritance modes (homogeneous no transmission, homogeneous Mendelian transmission, homogeneous general transmission, semi-general transmission, heterogeneous general transmission) were tested assuming the prevalence of aggressive periodontitis as 1% and no deviations from Hardy-Weinberg equilibrium. Saliva samples were collected from 54 families, 371 individuals and DNA was extracted from this biological material. Twenty-one single nucleotide polymorphisms (SNPs) were selected and analyzed by standard polymerase chain reaction. The genotypes were obtained by the TaqMan method. The non-parametric analysis of familial linkage was performed with Merlin software. Analyses of transmission detection (association) were performed by FBAT and PLINK programs. The most parsimonious mode of inheritance in each susceptibility type tested was the semi-general transmission mode (p=0,31)...

Pathogenesis of Type 1 Diabetes / 한양의대학술지

Type 1 diabetes mellitus (T1D) is a chronic autoimmune disease characterized by selective destruction of pancreatic islet betacells causing insulin deficiency. T1D has been shown to be a polygenic trait, associated with several loci, among which the human leukocyte antigen (HLA) region accounts for 40% of the genetic risk to develop T1D. The betacell autoimmune response is triggered by environmental or unknown events in the predisposing genetic background. The triggers of autoimmunity can lead to a localized imbalance between regulatory T cells and autoimmune effector T cells. The macrophages and autoreactive lymphocytes infiltrate the islets and the interaction of betacells and immune cells leads to inductionamplification of insulitis and loss of betacells. T cells destroy betacells in a direct cytotoxic manner or influence the induction of betacell apoptosis through the release of cytotoxic molecules, such as cytokines. The autoimmune process progresses subclinically for many years in the majority of patients, and clinical symptom do not appear until more than 80% of betacells have been destroyed. Although no current "cure" exists, there is a major effort to develop immunotherapies to prevent or halt the disorder that still requires much research to fully understand exact triggering events leading toautoimmune activation. Other strategies involve beta- cell replacement by islet transplantation, but researchs to enhance the islet mass transplanted and preserve beta-cell function are necessary.

Agassiz e Gobineau: as ciências contra o Brasil mestiço / Agassiz and Gobineau: science against Brazil mixed

O presente trabalho trata da visita de dois personagens ao Impériobrasileiro na segunda metade do século XIX. Ambos chegaram ao Brasilconvencidos de que a mistura entre as raças propiciava a degenerescênciado ser humano. Dessa forma, os dois produziram um mau prognósticoacerca da nação, baseados em crenças raciais que permeavam as ciências daépoca. O primeiro visitante, Louis Agassiz veio ao Brasil em 1865. Erasuíço e adotou os Estados Unidos da América como segunda pátria.Agassiz era um naturalista com sólida formação. Teve contato estreito comfiguras emblemáticas como von Martius, Georges Cuvier e Alexander vonHumboldt. Na América, tornou-se um arauto do poligenismo. O segundo visitante foi Joseph Arthur de Gobineau - o Conde Gobineau, que chegou ao Brasil em 1869 em missão diplomática. Gobineau era um literato com vasta produção, mas a obra pela qual atualmente é mais conhecido é o Essai sur l’Inégalité des Races Humaines, em que procurava compreender a causa da ascensão e queda de todas as grandes civilizações e chegava à conclusão que a questão étnica era a mola propulsora da história da humanidade. Nosso trabalho procura investigar as vinculações científicas destes dois personagens que, investidos da autoridade de suas convicções científicas, produziram um prognóstico negativo para o Brasil mestiço.

A contribuição de fatores genéticos e ambientais para a ocorrência das fissuras lábio-palatinas não-sindrômicas é a mesma em diferentes regiões do país? / Is the contribuition of genetics and environmental factors to the occurence of non syndromic cleft lip with or without cleft palate the same in different regions of the country?

Fissura labial com ou sem fissura de palato (FL/P) não-sindrômica, uma das malformações congênita mais prevalentes, é determinda por um modelo de herança multifuncionale, portanto, fatores genéticos e ambientais contribuem para a ocorrência desta malformação. O presente estudo avaliou se os fatores de predisposição as FL/Ps são semelhantes em três regiões do Brasil (Santarém-PA; Fortaleza e Barbalha-CE), por meio de estimativas das proporções de casos familiais, bem como da taxa de consagüinidade entre os pais de afetados por FL/P. Ainda, avaliamos se a distribuição dos tipos de FL/Ps difere nestas 3 regiões. Um total de 460 casos foi avaliado durante missões da Operação Sorriso realizadas em 2007-2008. Não observamos diferenças bos subtipos de fissuras nas 3 regiões. Contudo, verificamos que a proporção de casos familiares e da taxa de consagüinidade foi significantemente maior entre os pais dos fissurados averiguados em Santarém e Fortaleza do que na população geral. Estes resultados corroboram que a consagüinidade é um fator de risco para a ocorrência das FL/Ps e sugerem que os fatores de predisposição, ambientais ou genéticos para Fl/P são diferentes na população de Santarém A confirmação destes resultados um uma amostra maior poderá fornecer subsídios para o estabelecimento de futuras políticas de prevenção das FL/Ps nas diferentes regiões do Brasil.

Farmacoterapia da obesidade / Pharmacotherapy of obesity

A obesidade apresenta uma das mais elevadas taxas de morbimortalidade no mundo. O controle alimentar e a atividade física são as bases do tratamento dessa doença, mas é muito difícil para a maioria dos obesos conseguir a desejada mudança definitiva do estilo de vida. Como acontece com outras doenças crônicas, o uso de medicamentos é frequentemente indicado. O artigo é uma revisão das drogas antiobesidade aprovadas para uso e das perspectivas terapêuticas atuais. Tendo em vista o uso abusivo de fórmulas chamadas mágicas e de drogas ineficazes, a autora apela para uma conduta eticamente aceitável por parte do médico que se propõe a tratar do obeso.

Obesity is a major cause of elevated morbidity and mortality in the world. The control of food and physical activity are the foundations of the treatment of this condition, but it is very difficult for most obese patients to achieve the desired final change of lifestyle. As with other chronic diseases, the use of drugs is often indicated. The article is a review of antiobesity drug approved for therapeutic use and the current outlook. Considering the abuse of so-called magic formulas and ineffective drugs, the author calls for an ethically acceptable conduct by the doctor who proposes to treat the obese.

Prevalencia de malformaciones congénitas gastrointestinales en el hospital del niño Doctor Francisco de Ycaza Bustamante, período junio de 2002 a mayo de 2004 / Prevalence of gastrointestinal congenital malformations in Doctor Francisco de Ycaza Bustamante chidren hospital from june/2002 to may/2004

Se realizó un estudio retrospectivo, longitudinal, descriptivo, analítico. Se revisaron las historias clínicas de los pacientes diagnosticados con malformaciones congénitas gastrointestinales, en el departamento de estadística del hospital del niño “Dr. Francisco de Ycaza Bustamante”, durante el período comprendido entre junio de 2002 a mayo de 2004; como resultado se obtuvo que dicha prevalencia corresponde a un 18; este estudio demuestra que a pesar de que las madres no presentaron factores predisponentes causantes de malformaciones congénitas (MFC), tuvieron hijos malformados; habrá que tener en cuenta la herencia multifactorial ya que está relacionada con las MFC de mayor prevalencia y como factor de riesgo. La mortalidad en estas patologías es baja ya que la mayoría son susceptibles a resolución quirúrgica.

A retrospective, longitudinal, descriptive, analytical study has been made. Case histories of diagnosed patients with congenital malformations of the gastrointestinal type in the period from june/2002 to may/2004 were revised in the Statistics Department of the children’s hospital “Dr. Francisco de Ycaza Bustamante”. The result is that their prevalence is 18. This study shows that even though mothers did not present predisposition factors as a cause of congenital malformations, they had children with malformations; it will be necessary to consider multifactorial heredity since it is related to congenital malformations of higher prevalence and as a risk factor. Mortality is low in these pathologies since most of them are solved through surgical procedures.

Molecular Genetics of Cholesterol Gallstone Disease; LITH Genes / 한양의대학술지

Cholesterol gallstone formation is influenced by environmental and genetic factors. Cholesterol gallstone susceptible genes (Lith genes) are complex and show polygenic traits. Quantitative trait locus (QTL) analysis in inbred mice is a powerful method for identifying these genetic defects. More than 20 Lith genes were discovered by QTL in inbred mice models. The co-localized, candidate genes responsible for gallstone susceptible QTL can lead to the discovery of pathophysiologic functions of Lith (gallstone) genes. These genetic studies may reveal novel molecular targets for prevention and medical therapy. Presently, the only effective treament for gallstone is cholecystectomy. In the future, new drugs targeting Lith genes can be available not only for the treatment of gallstone disease, but also for "pre-stone" diagnosis.