ABSTRACT
La obesidad es una enfermedad crónica que afecta a un gran número de pacientes, con un número que va en aumento año con año. Los pacientes buscan opciones de tratamiento rápidas, mientras que los profesionales de la salud prefieren que sean duraderos. Las dietas milagro y productos reductores abundan en el mercado, así también, la intención de los profesionales de la salud por ofrecer tratamientos que satisfagan las necesidades de sus pacientes. El presente análisis tiene la intención de hacer una reflexión sobre la ética de la intervención terapéutica en el tratamiento de la obesidad, así como el brindar herramientas para que los profesionales de la salud sepan si van por el camino correcto (AU)
Obesity is a chronic disease that affects a large number of patients, with an increasing rate every year. Patients seek quick treatment options, meanwhile physicians prefer lasting ones. Miracle diets and reducing products are abundant in the market, as for the intention of health professionals to offer treatments that can satisfy their patients. The present analysis has the intention of making a reflection about the ethics of the therapeutic intervention in obesity, as well as to facilitate some tools so that healthcare providers can know if they are in the right track (AU)
Subject(s)
Humans , Obesity/therapy , Bariatrics/ethics , Principle-Based Ethics , Evaluation of Results of Therapeutic Interventions , Bioethical IssuesABSTRACT
OBJECTIVE: Since 1972, the relationship between HLA alleles and the susceptibility for Takayasu arteritis (TA) has been studied on different populations. Hence the results up to date are heterogeneous, the objective of the present review is to analyze the relationship between the presence of HLA alleles and the susceptibility for the development of TA considering the ethnic origin of the studied populations. MATERIAL AND METHODS: We carried out a bibliographic review from clinical articles of case and controls studies on different populations on which the relationship between HLA alleles and the susceptibility for TA was studied, published since 1972 until February 2000. RESULTS: We reviewed articles of studies on Asian, Arab, North-American and Mexican Mestizo populations. On Asian populations TA was associated with HLA-A31, -B52, -B39, -B5 and -DR2, on Arabs with HLA-A2, -A9, -B35 and -DR7, on North-Americans with HLA-DR4 and on Mexican Mestizo with HLA-B5, -B52 and -DR6. On the other hand, recent reports establish that several HLA-B alleles (HLA-B52 and HLA-B39) associated with the disease share some residues important on the antigen presentation. CONCLUSIONS: Hence the heterogeneity of the results obtained up to date, it stands out the increase on HLA-B52 and HLA-DR4 reported on ethnically different populations. More recent data point the possible participation of an epitope located on the peptide-binding site of the HLA-B molecule (positions 63 and 67) that seems to be shared by several alleles associated with the disease. These residues might be participating on the presentation of an unknown antigen that would unchain the disease on the genetically susceptible individuals group.
Subject(s)
Alleles , Major Histocompatibility Complex/immunology , Takayasu Arteritis/genetics , Takayasu Arteritis/immunology , Haplotypes , HumansABSTRACT
OBJECTIVE: Since 1972, the relationship between HLA alleles and the susceptibility for Takayasu arteritis (TA) has been studied on different populations. Hence the results up to date are heterogeneous, the objective of the present review is to analyze the relationship between the presence of HLA alleles and the susceptibility for the development of TA considering the ethnic origin of the studied populations. MATERIAL AND METHODS: We carried out a bibliographic review from clinical articles of case and controls studies on different populations on which the relationship between HLA alleles and the susceptibility for TA was studied, published since 1972 until February 2000. RESULTS: We reviewed articles of studies on Asian, Arab, North-American and Mexican Mestizo populations. On Asian populations TA was associated with HLA-A31, -B52, -B39, -B5 and -DR2, on Arabs with HLA-A2, -A9, -B35 and -DR7, on North-Americans with HLA-DR4 and on Mexican Mestizo with HLA-B5, -B52 and -DR6. On the other hand, recent reports establish that several HLA-B alleles (HLA-B52 and HLA-B39) associated with the disease share some residues important on the antigen presentation. CONCLUSIONS: Hence the heterogeneity of the results obtained up to date, it stands out the increase on HLA-B52 and HLA-DR4 reported on ethnically different populations. More recent data point the possible participation of an epitope located on the peptide-binding site of the HLA-B molecule (positions 63 and 67) that seems to be shared by several alleles associated with the disease. These residues might be participating on the presentation of an unknown antigen that would unchain the disease on the genetically susceptible individuals group.
Subject(s)
Humans , Alleles , Major Histocompatibility Complex , Takayasu Arteritis , HaplotypesABSTRACT
OBJECTIVE: The aim of the present work was to study the association between HLA alleles and Takayasu's arteritis in Mexican Mestizo patients. METHODS: The study included 26 Mexican Mestizo patients with Takayasu's arteritis and 99 healthy unrelated individuals. HLA-A, -B and -DR alleles were determined by polymerase chain reaction PCR-SSP RESULTS: Increased gene frequencies were demonstrated for HLA-B15(p=0.009,pC=0.020,OR=3.24,EF=11.9%) and HLA-B52 (p=0.008, pC=0.027, OR=5.16, EF=7.7%), and a decreased frequency for the HLA-A24 allele in patients compared to normal controls (p=0.035, pC=NS, PF=11.1%). When HLA typing was correlated to clinicalfeatures in 24 cases, wefound an increasedfrequencies of HLA-DR14 in patients with systemic arterial hypertension (p=0.005, pC=0.004, OR=24.6, EF=38.3%) and HLA-A2 on patients with pulmonary involvement (p=0.034, pC=0.036, OR=3.67, EF=40.4%) when compared to patients without these clinical manifestations. CONCLUSION: These data confirm HLA-B52 as a relevant susceptibility allele for Takayasu's arteritis and suggest that HLA-B15 could be important as a marker of the disease in Mexican patients. Other class I and/or class II alleles could also be relevant as markers for the clinical features present in these patients.
