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1.
Blood ; 2024 04 05.
Article in English | MEDLINE | ID: mdl-38579284

ABSTRACT

WAS is a multifaceted monogenic disorder with a broad disease spectrum and variable disease severity and a variety of treatment options including allogeneic hematopoietic stem cell transplantation (HSCT) and gene therapy (GT). No reliable biomarker exists to predict disease course and outcome for individual patients. A total of 577 patients with a WAS variant from 26 countries and a median follow-up of 8.9 years (0.3-71.1), totaling 6118 patient-years, were included in this international retrospective study. Overall survival (OS) of the cohort (censored at HSCT or GT) was 82% (95% CI 78-87) at 15 years and 70% (61-80) at 30 years of age. The type of variant was predictive of outcome: patients with a missense variant in exons 1 or 2 or with the intronic hotspot variant c.559+5G>A (class I variants) had a 15-year OS of 93% (89-98) and a 30-year OS of 91% (86-97), compared to 71% (62-81) and 48% (34-68) in patients with any other variant (class II; p<0.0001). The cumulative incidence rates of disease-related complications such as severe bleeding (p=0.007), life-threatening infection (p<0.0001), and autoimmunity (p=0.004) occurred significantly later in patients with a class I variant. The cumulative incidence of malignancy (p=0.6) was not different between classes I and II. This study represents the largest cohort of WAS patients studied so far. It confirms the spectrum of disease severity and quantifies the risk for specific disease-related complications. The class of variant is a biomarker to predict the outcome for WAS patients.

2.
Blood ; 2024 Apr 21.
Article in English | MEDLINE | ID: mdl-38643511

ABSTRACT

Selecting the most suitable alternative donor becomes challenging in severe aplastic anemia (SAA) when a matched sibling donor (MSD) is unavailable. We compared outcomes in SAA patients undergoing SCT from matched unrelated donors (MUD, n=1106), mismatched unrelated donors (MMUD, n=340), and haploidentical donors (Haplo, n=206) registered in the EBMT database (2012-2021). For Haplo-SCT, only those receiving post-transplant cyclophosphamide (PT-Cy) for graft-versus-host disease (GVHD) prophylaxis were included. Median age was 20 years, and the median time from diagnosis to transplantation 8.7 months. Compared to MUD, MMUD (HR, 2.93; 95% CI, 1.52-5.6) and Haplo (HR, 5.15; 95% CI, 2.5-10.58) showed significantly higher risks of primary graft failure. MUD had lower rates of acute GVHD compared to MMUD and Haplo, grade II-IV (13%, 22%, and 19%, respectively, p<0.001) and III-IV (5%, 9%, and 7%, respectively, p=0.028). The 3-year non-relapse mortality was 14% for MUD, 19% for MMUD, and 27% for Haplo (p<0.001), while overall survival (OS) and GVHD and relapse-free survival (GRFS) were 81% and 73% for MUD, 74% and 65% for MMUD, and 63% and 54% for Haplo, respectively (p<0.001). In addition to donor type, multivariable analysis identified other factors like patient age, performance status, and interval between diagnosis and transplant associated with GRFS. For SAA patients lacking an MSD, our findings support MUD transplantation as the preferable alternative donor. However, selecting between a MMUD or Haplo donor remains uncertain and requires further exploration.

3.
Front Cell Dev Biol ; 9: 643769, 2021.
Article in English | MEDLINE | ID: mdl-33718385

ABSTRACT

Lysosomal degradation of ubiquitinated transmembrane protein receptors (cargo) relies on the function of Endosomal Sorting Complex Required for Transport (ESCRT) protein complexes. The ESCRT machinery is comprised of five unique oligomeric complexes with distinct functions. Target of Myb1 (TOM1) is an ESCRT protein involved in the initial steps of endosomal cargo sorting. To exert its function, TOM1 associates with ubiquitin moieties on the cargo via its VHS and GAT domains. Several ESCRT proteins, including TOLLIP, Endofin, and Hrs, have been reported to form a complex with TOM1 at early endosomal membrane surfaces, which may potentiate the role of TOM1 in cargo sorting. More recently, it was found that TOM1 is involved in other physiological processes, including autophagy, immune responses, and neuroinflammation, which crosstalk with its endosomal cargo sorting function. Alteration of TOM1 function has emerged as a phosphoinositide-dependent survival mechanism for bacterial infections and cancer progression. Based on current knowledge of TOM1-dependent cellular processes, this review illustrates how TOM1 functions in coordination with an array of protein partners under physiological and pathological scenarios.

4.
J Clin Endocrinol Metab ; 105(12)2020 12 01.
Article in English | MEDLINE | ID: mdl-32882033

ABSTRACT

CONTEXT: We set out to characterize the dynamics of islet autoantibodies over the first 15 years of life in children carrying genetic susceptibility to type 1 diabetes (T1D). We also assessed systematically the role of zinc transporter 8 autoantibodies (ZnT8A) in this context. DESIGN: HLA-predisposed children (N = 1006, 53.0% boys) recruited from the general population during 1994 to 1997 were observed from birth over a median time of 14.9 years (range, 1.9-15.5 years) for ZnT8A, islet cell (ICA), insulin (IAA), glutamate decarboxylase (GADA), and islet antigen-2 (IA-2A) antibodies, and for T1D. RESULTS: By age 15.5 years, 35 (3.5%) children had progressed to T1D. Islet autoimmunity developed in 275 (27.3%) children at a median age of 7.4 years (range, 0.3-15.1 years). The ICA seroconversion rate increased toward puberty, but the biochemically defined autoantibodies peaked at a young age. Before age 2 years, ZnT8A and IAA appeared commonly as the first autoantibody, but in the preschool years IA-2A- and especially GADA-initiated autoimmunity increased. Thereafter, GADA-positive seroconversions continued to appear steadily until ages 10 to 15 years. Inverse IAA seroconversions occurred frequently (49.3% turned negative) and marked a prolonged delay from seroconversion to diagnosis compared to persistent IAA (8.2 vs 3.4 years; P = .01). CONCLUSIONS: In HLA-predisposed children, the primary autoantibody is characteristic of age and might reflect the events driving the disease process toward clinical T1D. Autoantibody persistence affects the risk of T1D. These findings provide a framework for identifying disease subpopulations and for personalizing the efforts to predict and prevent T1D.


Subject(s)
Autoantibodies/blood , Autoimmunity/genetics , Diabetes Mellitus, Type 1/genetics , Islets of Langerhans/immunology , Adolescent , Autoantibodies/analysis , Child , Child Development/physiology , Child, Preschool , Diabetes Mellitus, Type 1/diagnosis , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/immunology , Female , Finland/epidemiology , Follow-Up Studies , Genetic Predisposition to Disease , Glutamate Decarboxylase/immunology , HLA Antigens/genetics , Humans , Infant , Infant, Newborn , Insulin Antibodies/analysis , Insulin Antibodies/blood , Male , Prognosis , Prospective Studies , Receptor-Like Protein Tyrosine Phosphatases, Class 8/immunology , Time Factors , Zinc Transporter 8/genetics , Zinc Transporter 8/immunology
5.
Hamostaseologie ; 39(1): 87-94, 2019 Feb.
Article in English | MEDLINE | ID: mdl-29996171

ABSTRACT

MYH9-related disease (MYH9-RD) is an autosomal-dominant thrombocytopenia caused by mutations in the gene for non-muscle myosin heavy chain IIA (NMMHC-IIA). Patients present congenital macrothrombocytopenia and inclusions of NMMHC-IIA in leukocytes, and have a variable risk of developing kidney damage, sensorineural deafness, presenile cataracts and/or liver enzymes abnormalities. The spectrum of mutations found in MYH9-RD patients is limited and the incidence and severity of the non-congenital features are predicted by the causative MYH9 variant. In particular, different alterations of the C-terminal tail domain of NMMHC-IIA associate with remarkably different disease evolution. We report four novel MYH9 mutations affecting the tail domain of NMMHC-IIA and responsible for MYH9-RD in four families. Two variants cause amino acid substitutions in the coiled-coil region of NMMHC-IIA, while the other two are a splicing variant and a single nucleotide deletion both resulting in frameshift alterations of the short non-helical tailpiece. Characterization of phenotypes of affected individuals shows that all of these novel variants are associated with a mild clinical evolution of the disease.


Subject(s)
Chromosome Disorders/genetics , Molecular Motor Proteins/genetics , Mutation , Myosin Heavy Chains/genetics , Thrombocytopenia/congenital , Adolescent , Adult , Aged , Amino Acid Substitution , Chromosome Breakage , Chromosome Disorders/pathology , Female , Frameshift Mutation , Humans , Male , Middle Aged , Molecular Motor Proteins/chemistry , Myosin Heavy Chains/chemistry , Pedigree , Phenotype , Protein Domains , Protein Isoforms/chemistry , Protein Isoforms/genetics , Thrombocytopenia/genetics , Thrombocytopenia/pathology , Young Adult
6.
Pediatr Diabetes ; 19(2): 305-313, 2018 03.
Article in English | MEDLINE | ID: mdl-28745034

ABSTRACT

OBJECTIVES: We set out to determine the prevalence of tissue transglutaminase antibodies (anti-tTG) and celiac disease (CD) in children with newly diagnosed type 1 diabetes (T1D) and their first-degree relatives (FDR). The hypothesis was that the individuals with both diabetes and CD form a distinct subgroup in terms of human leukocyte antigen (HLA) class II genetics, islet autoantibodies, and clinical characteristics at diabetes diagnosis. SUBJECTS AND METHODS: This population-based observational study included 745 index children with T1D and their 2692 FDR from the Finnish Pediatric Diabetes Register. CD was ascertained by registers, patient records, and screening anti-tTG positive individuals for further testing. RESULTS: Among the index children, 4.8% had anti-tTG at diabetes diagnosis, and at the end of the study 3.2% had CD. Among the relatives, 2.9% had anti-tTG (4.8% mothers, 2.4% fathers, and 2.1% siblings), and 2.5% had CD (4.6% mothers, 2.1% fathers, and 1.4% siblings). Anti-tTG and CD associated with the HLA DR3-DQ2 haplotype. The usual female predominance of CD patients was observed in relatives (70%) but not among index children (46%). The index children with both diseases had a lower number of detectable islet autoantibodies than those with diabetes alone. CONCLUSIONS: The children with double diagnosis differed from those with diabetes alone in HLA genetics, humoral islet autoimmunity directed against fewer antigens, and in the lack of usual female preponderance among CD patients. Compared with 61% of the anti-tTG positive relatives, only 36% of anti-tTG positive index children developed CD implicating transient anti-tTG positivity at diagnosis of T1D.


Subject(s)
Autoantibodies/analysis , Autoimmunity , Celiac Disease/immunology , Diabetes Mellitus, Type 1/immunology , Family Health , GTP-Binding Proteins/antagonists & inhibitors , Transglutaminases/antagonists & inhibitors , Biomarkers/blood , Celiac Disease/complications , Celiac Disease/epidemiology , Celiac Disease/genetics , Child , Diabetes Mellitus, Type 1/blood , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/genetics , Female , Finland/epidemiology , GTP-Binding Proteins/metabolism , Genetic Association Studies , Genetic Predisposition to Disease , HLA-DQ Antigens/chemistry , HLA-DQ Antigens/genetics , HLA-DR3 Antigen/chemistry , HLA-DR3 Antigen/genetics , Haplotypes , Humans , Male , Medical Records , Prevalence , Protein Glutamine gamma Glutamyltransferase 2 , Registries , Sex Factors , Transglutaminases/metabolism
7.
Duodecim ; 133(3): 251-8, 2017.
Article in English | MEDLINE | ID: mdl-29205023

ABSTRACT

Graft-versus-host disease (GvHD) remains a major treatment-related risk in patients undergoing stem cell transplantation. Although advances in HLA-typing and graft types have reduced the risk of GvHD, a breakthrough in the treatment of severe GvHD is still lacking. Allogenic stem cell transplant has potentially beneficial immunological effects on the malignant disease necessitating transplantation, and the importance of these effects must be considered when treating GvHD.


Subject(s)
Graft vs Host Disease/immunology , Graft vs Host Disease/therapy , Stem Cell Transplantation , Humans , Risk Factors
8.
PLoS One ; 12(11): e0188402, 2017.
Article in English | MEDLINE | ID: mdl-29182645

ABSTRACT

Genetic predisposition could be assumed to be causing clustering of autoimmunity in individuals and families. We tested whether HLA and non-HLA loci associate with such clustering of autoimmunity. We included 1,745 children with type 1 diabetes from the Finnish Pediatric Diabetes Register. Data on personal or family history of autoimmune diseases were collected with a structured questionnaire and, for a subset, with a detailed search for celiac disease and autoimmune thyroid disease. Children with multiple autoimmune diseases or with multiple affected first- or second-degree relatives were identified. We analysed type 1 diabetes related HLA class II haplotypes and genotyped 41 single nucleotide polymorphisms (SNPs) outside the HLA region. The HLA-DR4-DQ8 haplotype was associated with having type 1 diabetes only whereas the HLA-DR3-DQ2 haplotype was more common in children with multiple autoimmune diseases. Children with multiple autoimmune diseases showed nominal association with RGS1 (rs2816316), and children coming from an autoimmune family with rs11711054 (CCR3-CCR5). In multivariate analyses, the overall effect of non-HLA SNPs on both phenotypes was evident, associations with RGS1 and CCR3-CCR5 region were confirmed and additional associations were implicated: NRP1, FUT2, and CD69 for children with multiple autoimmune diseases. In conclusion, HLA-DR3-DQ2 haplotype and some non-HLA SNPs contribute to the clustering of autoimmune diseases in children with type 1 diabetes and in their families.


Subject(s)
Autoimmune Diseases/genetics , Diabetes Mellitus, Type 1/genetics , Genetic Predisposition to Disease , HLA Antigens/genetics , Child , Child, Preschool , Female , Haplotypes , Humans , Male , Polymorphism, Single Nucleotide
9.
Nat Commun ; 8: 14858, 2017 03 31.
Article in English | MEDLINE | ID: mdl-28361956

ABSTRACT

Lipid droplets (LDs) are cellular organelles specialized in triacylglycerol (TG) storage undergoing homotypic clustering and fusion. In non-adipocytic cells with numerous LDs this is balanced by poorly understood droplet dissociation mechanisms. We identify non-muscle myosin IIa (NMIIa/MYH-9) and formin-like 1 (FMNL1) in the LD proteome. NMIIa and actin filaments concentrate around LDs, and form transient foci between dissociating LDs. NMIIa depletion results in decreased LD dissociations, enlarged LDs, decreased hydrolysis and increased storage of TGs. FMNL1 is required for actin assembly on LDs in vitro and for NMIIa recruitment to LDs in cells. We propose a novel acto-myosin structure regulating lipid storage: FMNL1-dependent assembly of myosin II-functionalized actin filaments on LDs facilitates their dissociation, thereby affecting LD surface-to-volume ratio and enzyme accessibility to TGs. In neutrophilic leucocytes from MYH9-related disease patients NMIIa inclusions are accompanied by increased lipid storage in droplets, suggesting that NMIIa dysfunction may contribute to lipid imbalance in man.


Subject(s)
Actin Cytoskeleton/metabolism , Cytoskeletal Proteins/metabolism , Hearing Loss, Sensorineural/metabolism , Intracellular Signaling Peptides and Proteins/metabolism , Lipid Droplets/metabolism , Molecular Motor Proteins/metabolism , Myosin Heavy Chains/metabolism , Nonmuscle Myosin Type IIA/metabolism , Thrombocytopenia/congenital , Triglycerides/metabolism , Actomyosin , Animals , Formins , Humans , In Vitro Techniques , Lipid Metabolism , Mice , Neutrophils/metabolism , Proteome , RAW 264.7 Cells , Thrombocytopenia/metabolism
10.
Sci Transl Med ; 8(343): 343ra81, 2016 06 15.
Article in English | MEDLINE | ID: mdl-27306663

ABSTRACT

The gut microbial community is dynamic during the first 3 years of life, before stabilizing to an adult-like state. However, little is known about the impact of environmental factors on the developing human gut microbiome. We report a longitudinal study of the gut microbiome based on DNA sequence analysis of monthly stool samples and clinical information from 39 children, about half of whom received multiple courses of antibiotics during the first 3 years of life. Whereas the gut microbiome of most children born by vaginal delivery was dominated by Bacteroides species, the four children born by cesarean section and about 20% of vaginally born children lacked Bacteroides in the first 6 to 18 months of life. Longitudinal sampling, coupled with whole-genome shotgun sequencing, allowed detection of strain-level variation as well as the abundance of antibiotic resistance genes. The microbiota of antibiotic-treated children was less diverse in terms of both bacterial species and strains, with some species often dominated by single strains. In addition, we observed short-term composition changes between consecutive samples from children treated with antibiotics. Antibiotic resistance genes carried on microbial chromosomes showed a peak in abundance after antibiotic treatment followed by a sharp decline, whereas some genes carried on mobile elements persisted longer after antibiotic therapy ended. Our results highlight the value of high-density longitudinal sampling studies with high-resolution strain profiling for studying the establishment and response to perturbation of the infant gut microbiome.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Gastrointestinal Microbiome/drug effects , Bacteroides/drug effects , Bacteroides/genetics , Cesarean Section , Child, Preschool , Drug Resistance, Microbial/genetics , Female , Gastrointestinal Microbiome/genetics , Gastrointestinal Tract/microbiology , Humans , Infant , Infant, Newborn , Longitudinal Studies , Male
11.
Duodecim ; 131(9): 871-4, 2015.
Article in Finnish | MEDLINE | ID: mdl-26237886

ABSTRACT

We describe an autosomal dominant hereditary thrombocytopenia syndrome caused by a defect in the MYH9 gene. Of our three patients, all have thrombocytopenia from birth, and their thrombocytes are large in size. The hemorrhagic tendency caused by thrombocytopenia is often mild. Approximately 60% of the patients develop sensorineural hearing loss and approx. 30% develop renal insufficiency that frequently progresses to require hemodialysis. It is of particular importance to recognize the thrombocytopenia as being hereditary and permanent in order to save the patients from useless and harmful therapeutic efforts.


Subject(s)
Hearing Loss, Sensorineural/genetics , Thrombocytopenia/congenital , Hearing Loss, Sensorineural/congenital , Humans , Renal Insufficiency/genetics , Thrombocytopenia/genetics
12.
Diabetes Care ; 38(4): 665-70, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25573878

ABSTRACT

OBJECTIVE: Dietary advanced glycation end products (AGEs) and their interactions with the receptor for AGEs (RAGE) may play a role in the pathogenesis of type 1 diabetes. This study set out to assess whether there is any association of circulating concentrations of soluble RAGE (sRAGE), AGEs, and their ratio with the appearance of diabetes-associated autoantibodies in children progressing to clinical diabetes. RESEARCH DESIGN AND METHODS: Serum concentrations of sRAGE, N-ε(carboxymethyl)lysine (CML) adducts, and the sRAGE/CML ratio were analyzed in children who progressed to type 1 diabetes. The samples were taken at four time points: before seroconversion, at the time of the first autoantibody-positive sample, at the time of the first sample positive for multiple (>2) autoantibodies, and close to the disease diagnosis. Samples of autoantibody-negative controls matched for age, sex, and HLA-conferred diabetes risk were analyzed at corresponding time points. RESULTS: The prediabetic children had higher sRAGE concentrations before seroconversion (Pc = 0.03), at the appearance of multiple autoantibodies (Pc = 0.008), and close to diagnosis (Pc = 0.04). Close to diagnosis, the cases had lower CML concentrations than the controls (Pc = 0.004). Prediabetic children had a higher sRAGE/CML ratio than the controls before seroconversion (Pc = 0.008) and at diagnosis (Pc < 0.001). CONCLUSIONS: Prediabetic children have higher concentrations of sRAGE and a higher sRAGE/CML ratio than healthy controls. Circulating sRAGE concentrations seem to decline with the appearance of diabetes-predictive autoantibodies in children progressing to type 1 diabetes. The higher sRAGE/CML ratio in prediabetic children may reflect a higher AGE scavenger capacity.


Subject(s)
Autoantibodies/blood , Diabetes Mellitus, Type 1/blood , Prediabetic State/blood , Receptors, Immunologic/blood , Case-Control Studies , Child , Child, Preschool , Diabetes Mellitus, Type 1/epidemiology , Disease Progression , Down-Regulation , Female , Humans , Infant , Infant, Newborn , Lysine/analogs & derivatives , Lysine/blood , Male , Prediabetic State/epidemiology , Prediabetic State/pathology , Receptor for Advanced Glycation End Products
13.
Diabetes Care ; 37(7): 1975-81, 2014 Jul.
Article in English | MEDLINE | ID: mdl-24742661

ABSTRACT

OBJECTIVE: We analyzed the relationship among soluble receptor for advanced glycation end products (sRAGEs), the clinical phenotype, HLA genotype, and risk-associated single nucleotide polymorphisms (SNPs) in the AGER gene in a large population of Finnish children with newly diagnosed type 1 diabetes. RESEARCH DESIGN AND METHODS: Samples from 2,115 clinically phenotyped children <15 years of age in whom type 1 diabetes was diagnosed and 316 control subjects were analyzed for sRAGEs. Three SNPs of AGER, previously associated with HLA-DR/DQ haplotype independent diabetes risk (rs2070600, rs9469089, and rs17493811), were analyzed in 1,390 affected subjects. RESULTS: Children with type 1 diabetes and control subjects had similar sRAGE concentrations (1,171 vs. 1,153 pg/mL, P = 0.48). There was a correlation between age at diagnosis and serum sRAGE concentrations (r = 0.10, P < 0.001) among the patients but not among the control subjects. Children <2 years of age had the lowest concentrations in the diabetic population (1,027 vs. 1,181 pg/mL, P < 0.001) and the highest among the control subjects (1,329 vs. 1,140 pg/mL, P = 0.04). Ketoacidosis at diagnosis was associated with reduced concentrations (1,086 vs. 1,190 pg/mL, P < 0.001). HLA DR3/DR4 heterozygosity and the DR3 allele were associated with reduced sRAGE concentrations. The predisposing AA genotype of rs2070600 was associated with decreased sRAGE concentrations, while the protective CC genotype of rs9469089 was linked to increased concentrations. CONCLUSIONS: Age and AGER polymorphisms are associated with the circulating sRAGE concentration among children with type 1 diabetes. The observations of reduced sRAGE concentrations in young children, in those with ketoacidosis, and in carriers of the high-risk HLA DR3/DR4 genotype suggest that decreased sRAGE concentration reflects a more aggressive disease phenotype.


Subject(s)
Diabetes Mellitus, Type 1/genetics , Glycation End Products, Advanced/genetics , Receptors, Immunologic/genetics , Adolescent , Age Factors , Alleles , Case-Control Studies , Child , Child, Preschool , Female , Genotype , HLA-DR Antigens/genetics , HLA-DR4 Antigen/genetics , Haplotypes , Humans , Infant , Male , Phenotype , Polymorphism, Single Nucleotide , Receptor for Advanced Glycation End Products
14.
Eur J Endocrinol ; 169(2): 171-8, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23698601

ABSTRACT

OBJECTIVE: Based on the concept of clustering autoimmunity, children with a positive family history of autoimmunity could be expected to have a different pathogenetic form of type 1 diabetes (T1D) and thus a stronger autoimmune reactivity against ß-cells and an increased prevalence of the HLA-DR3-DQ2 haplotype. DESIGN AND METHODS: We tested this hypothesis in a cross-sectional observational study from the Finnish Pediatric Diabetes Register. HLA class II genotypes and ß-cell autoantibodies were analyzed, and data on the extended family history of autoimmunity and clinical markers at diagnosis were collected with a structured questionnaire from 1488 children diagnosed with T1D under the age of 15 years (57% males). RESULTS: Only 23 children (1.5%) had another autoimmune disease (AID) known at diagnosis, and they had a milder metabolic decompensation at diabetes presentation. One-third (31.4%) had at least one relative with an AID other than T1D with affected mothers being overrepresented (8.2%) compared with fathers (2.8%). The children with a positive family history of other AIDs had higher levels of islet cell antibodies (P=0.003), and the HLA-DR3-DQ2 haplotype in the children was associated with celiac disease in the extended family (P<0.001), but not with an increased frequency of autoimmune disorders, in general. CONCLUSIONS: Approximately one-third of children with newly diagnosed T1D have a first- and/or second-degree relative affected by an AID. Our data do not consistently support the hypothesis of differential pathogenetic mechanisms in such children.


Subject(s)
Diabetes Mellitus, Type 1/genetics , Diabetes Mellitus, Type 1/immunology , HLA-DQ Antigens/genetics , HLA-DR3 Antigen/genetics , Adolescent , Autoantibodies/blood , Child , Child, Preschool , Cohort Studies , Cross-Sectional Studies , Diabetes Mellitus, Type 1/epidemiology , Family , Female , Finland/epidemiology , HLA-DQ Antigens/immunology , HLA-DR3 Antigen/immunology , Haplotypes/genetics , Haplotypes/immunology , Humans , Infant , Male , Registries , Regression Analysis
15.
Diabetes Care ; 36(2): 348-54, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23033245

ABSTRACT

OBJECTIVE: To determine the frequency of newly diagnosed diabetic children with first- and second-degree relatives affected by type 1 diabetes and to characterize the effects of this positive family history on clinical markers, signs of ß-cell autoimmunity, and HLA genotype in the index case. RESEARCH DESIGN AND METHODS: Children (n = 1,488) with type 1 diabetes diagnosed under 15 years of age were included in a cross-sectional study from the Finnish Pediatric Diabetes Register. Data on family history of diabetes and metabolic decompensation at diagnosis were collected using a questionnaire. Antibodies to ß-cell autoantigens (islet cell antibodies, insulin autoantibodies, GAD antibodies, and antibodies to the islet antigen 2 molecule) and HLA genotypes were analyzed. RESULTS: A total of 12.2% of the subjects had a first-degree relative with type 1 diabetes (father 6.2%, mother 3.2%, and sibling 4.8%) and 11.9% had an affected second-degree relative. Children without affected relatives had lower pH (P < 0.001), higher plasma glucose (P < 0.001) and ß-hydroxybutyrate concentrations (P < 0.001), a higher rate of impaired consciousness (P = 0.02), and greater weight loss (P < 0.001). There were no differences in signs of ß-cell autoimmunity. The familial cases carried the HLA DR4-DQ8 haplotype more frequently than sporadic cases (74.0 vs. 67.0%, P = 0.02). CONCLUSIONS: When the extended family history of type 1 diabetes is considered, the proportion of sporadic diabetes cases may be reduced to <80%. A positive family history for type 1 diabetes associates with a less severe metabolic decompensation at diagnosis, even when only second-degree relatives are affected. Autoantibody profiles are similar in familial and sporadic type 1 diabetes, suggesting similar pathogenetic mechanisms.


Subject(s)
Diabetes Mellitus, Type 1/blood , Diabetes Mellitus, Type 1/diagnosis , Family , 3-Hydroxybutyric Acid/blood , Adolescent , Autoantibodies/blood , Autoimmunity/physiology , Blood Glucose/metabolism , Child , Child, Preschool , Diabetes Mellitus, Type 1/genetics , Female , Genotype , HLA-DQ Antigens/blood , Humans , Infant , Infant, Newborn , Male , Phenotype
16.
Diabetes Care ; 34(6): 1383-8, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21515841

ABSTRACT

OBJECTIVE: Despite promising results from studies on mouse models, intranasal insulin failed to prevent or delay the development of type 1 diabetes in autoantibody-positive children with HLA-conferred disease susceptibility. To analyze whether the insulin dose was inadequate to elicit an immunomodulatory response, we compared the changes observed in insulin antibody (IA) affinity and isotypes after treatment with nasal insulin or placebo. RESEARCH DESIGN AND METHODS: Ninety-five children (47 in the placebo group and 48 in the insulin group of the total of 224 children randomized for the trial) with HLA-conferred susceptibility to type 1 diabetes derived from the intervention arm of the Finnish Type 1 Diabetes Prediction and Prevention study were included in these analyses. Blood samples drawn before or at the beginning of the treatment and after treatment for 3 and 6 months were analyzed for IA affinity and isotype-specific IAs (IgG1-4, IgA, IgM, and IgE). RESULTS: IgG3- and IgA-IA levels (P = 0.031 and 0.015, respectively) and the number of IgG3-IA-positive subjects (P = 0.022) were significantly higher at 6 months after the initiation of the treatment in the insulin group. No significant differences were observed between the two groups in IA affinity or other IA isotypes. CONCLUSIONS: The insulin dose administered induced a modest change in the IA isotype profile. The lack of impact of nasal insulin on IA affinity implies that the immune response of study subjects was already mature at the beginning of the intervention.


Subject(s)
Diabetes Mellitus, Type 1/prevention & control , Insulin Antibodies/immunology , Insulin/administration & dosage , Administration, Intranasal , Child, Preschool , Diabetes Mellitus, Type 1/genetics , Female , Genetic Predisposition to Disease , HLA-DQ Antigens/immunology , HLA-DQ beta-Chains , Humans , Insulin Antibodies/analysis , Male , Membrane Glycoproteins/immunology
17.
Biomacromolecules ; 8(6): 1999-2003, 2007 Jun.
Article in English | MEDLINE | ID: mdl-17518442

ABSTRACT

The impact of the length of gemini surfactant spacer on complexation and condensation of calf thymus DNA by cationic mixed phospholipid/gemini liposomes was investigated by monitoring the conformational changes of DNA by circular dichroism and the lipid hydration level by the emission characteristics of the fluorescent probe laurdan included in the lipid bilayer. The length of the spacer was shown to influence, on one hand, the hydration level and the organization of the corresponding liposomes and, on the other, the variation of lipid hydration level and the DNA conformation upon complexation. In fact, in correspondence with the longest spacer we observed more hydrated liposomes, probably organized in domains, a higher extent of dehydration promoted by the addition of DNA, and a minor extent of DNA conformational change. The physicochemical features of lipoplexes were shown to depend on the [cationic headgroup]/[DNA single base] ratio.


Subject(s)
DNA/chemistry , Liposomes/chemistry , Surface-Active Agents/chemistry , Animals , Cations , Cattle , Circular Dichroism , Lipid Bilayers/chemistry , Models, Chemical , Molecular Conformation , Nucleic Acid Conformation , Spectrometry, Fluorescence , Thymus Gland/metabolism , Transfection , Water/chemistry
18.
J Am Chem Soc ; 128(26): 8659-63, 2006 Jul 05.
Article in English | MEDLINE | ID: mdl-16802832

ABSTRACT

While much is known about the self-assembly of lipids on nanoscale, our understanding of their biologically relevant mesoscale organization remains incomplete. Here, we show for a cationic gemini lipid a sharp and reversible transition from small vesicles with an average diameter of approximately 40 nm to giant vesicles (GVs) with an average diameter of approximately 11 microm. This transition is dependent on proper [NaCl] and specific temperature. Below this transition and in the vicinity of the air/water interface, a series of mesoscale morphological transitions was observed, revealing complex structures resembling biological membranes. On the basis of microscopy experiments, a tentative [NaCl] versus temperature shape/size phase diagram was constructed. To explain this unprecedented transition, we propose a novel mechanism whereby a specific interaction of Cl(-) counterion with the cationic gemini surfactant initiates the formation of a commensurate solute counterion lattice with low spontaneous curvature. In keeping with the high bending rigidity of NaCl crystal, this tightly associated ionic lattice enslaves membrane curvature and the mesoscale 3-D organization of this lipid.


Subject(s)
Lipids/chemistry , Quaternary Ammonium Compounds/chemistry , Surface-Active Agents/chemistry , Cations/chemistry , Models, Biological , Molecular Conformation , Sodium Chloride/chemistry , Temperature
19.
Langmuir ; 22(3): 956-62, 2006 Jan 31.
Article in English | MEDLINE | ID: mdl-16430254

ABSTRACT

The properties of a novel disulfide-bond-containing gemini surfactant bis[N,N-dimethyl-N-hexadecyl-N-(2-mercaptoethyl)ammonium bromide] disulfide (DSP) were studied using a Langmuir balance, supported monolayers, differential scanning calorimetry, giant vesicles, and LUVs. In 150 mM NaCl the cmc for DSP was 7.5 microM whereas that of the monomer N,N-dimethyl-N-hexadecyl-N-(2-mercaptoethyl)ammonium bromide (MSP) was 12.1 microM. Both surfactants exhibited single endotherms upon DSC, with peak temperatures Tm at 21.7 and 20.1 degrees C for DSP and MSP, respectively. The endotherm for MSP was significantly broader indicating less cooperative melting. Both in monolayers and in vesicles reductive cleavage of the disulfide bond of DSP could be obtained by glutathione (GSH). For Langmuir films of DSP the addition of GSH into the subphase led to a decrease in surface pressure pi as well as surface dipole potential psi. Although the cleavage by GSH was significantly slower in the presence of a charge saturating concentration of DNA, it did not prevent the reaction. The resulting monomers detached from supported monolayers, leading to loss of affinity of the surface for DNA. Disruption of giant vesicles containing DSP within approximately 30 s following a local injection of GSH was observed, revealing membrane destabilization.


Subject(s)
Disulfides/chemistry , Surface-Active Agents/chemistry , Calorimetry, Differential Scanning , Oxidation-Reduction , Surface Plasmon Resonance
20.
J Phys Condens Matter ; 18(28): S1139-50, 2006 Jul 19.
Article in English | MEDLINE | ID: mdl-21690834

ABSTRACT

Lipids bearing net electric charges in their hydrophilic headgroups are ubiquitous in biological membranes. Recently, the interest in cationic lipids has surged because of their potential as non-viral transfection vectors. In order to utilize cationic lipids in transfer of nucleic acids and to elucidate the role of charged lipids in cellular membranes in general, their complex interactions within the membrane and with the molecules in the surrounding media need to be thoroughly characterized. Yet, even interactions between monovalent counter-ions and charged lipids are inadequately understood. We studied the interactions of the cationic gemini surfactant (2R,3R)-2,3-dimethoxy-1,4- bis(N-hexadecyl-N,N-dimethylammonium)butane dibromide (RR-1) with chloride, bromide, fluoride, and iodide as counter-ions by differential scanning calorimetry and Langmuir balance. Chloride interacts avidly with RR-1, efficiently condensing the monolayer, decreasing the collapse pressure, and elevating the main transition temperature. With bromide and iodide clearly different behaviour was observed, indicating specific interactions between RR-1 and these counter-ions. Moreover, with fluoride as a counter-ion and in pure water identical results were obtained, demonstrating inefficient electrostatic screening of the headgroups of RR-1 and suggesting fluoride being depleted on the surface of RR-1 membranes.

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