RESUMEN
BACKGROUND AND OBJECTIVES: Vitamin D has been studied primarily for its involvement in calcium and phosphate absorption and bone metabolism. The active form of vitamin D-1,25(OH)2 D-has also been investigated for its immune modulatory properties. We explored associations between serum levels of 25(OH)D and 1,25(OH)2 D and periodontal health. SUBJECTS AND METHODS: This case-control study included 55 subjects with chronic periodontitis (cases) and 30 periodontally healthy subjects (controls). Their serum levels of 25(OH)D, 1,25(OH)2 D, ultrasensitive C-reactive protein and high-density lipoprotein cholesterol were determined. Associations between vitamin D and periodontal health status were studied using logistic regression analysis. RESULTS: A statistically significant association was found between serum 1,25(OH)2 D level and periodontal health status; in that subjects with a low 1,25(OH)2 D were more likely to belong to the periodontitis group (OR = 0.97, 95% CI = 0.95-1.00). There was practically no association between 25(OH)D level and periodontal health status. CONCLUSION: In this case-control study low serum 1,25(OH)2 D level appeared to be associated with periodontitis, which was in line with the previously reported associations between serum 1,25(OH)2 D levels and other inflammatory diseases. Whether this association is causal in nature, remains to be confirmed in future studies.
Asunto(s)
Periodontitis Crónica/sangre , Vitamina D/análogos & derivados , Vitaminas/sangre , Adulto , Factores de Edad , Índice de Masa Corporal , Proteína C-Reactiva/análisis , Estudios de Casos y Controles , HDL-Colesterol/sangre , Índice de Placa Dental , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/sangre , Índice Periodontal , Bolsa Periodontal/sangre , Factores Sexuales , Fumar , Vitamina D/sangreRESUMEN
BACKGROUND AND AIMS: CD14 is a co-receptor involved in the recognition of Gram-negative and positive bacteria. Infections are known to influence serum sCD14 levels, and CD14 gene promoter polymorphism (CD14 C-260T) has been reported to be associated with many infectious diseases. Our aim was to investigate whether serum sCD14 concentration is associated with periodontal infection and the CD14(-260) genotype. SUBJECTS AND METHODS: The periodontal status of 56 subjects with chronic periodontitis and 28 controls was clinically examined. Serum sCD14 concentration was analyzed using ELISA and CD14(-260) genotype using polymerase chain reaction (PCR). RESULTS: The mean concentration of sCD14 in serum was significantly higher in subjects with periodontitis than in control subjects (4.9 microg ml(-1)vs 3.8 microg ml(-1), P < 0.001). Serum sCD14 concentration associated significantly with the extent of advanced periodontal disease. In a regression analysis including both subject groups, the CD14(-260) genotype was a significant determinant for serum sCD14 concentration. After stratification by periodontal health status (periodontitis vs controls), the influence of the CD14(-260) genotype on serum sCD14 concentration was seen only in the control group. CONCLUSIONS: Periodontal infection is associated with the serum concentration of sCD14. Moderate to severe periodontal infection overshadows the influence of the genotype on serum sCD14 concentration.
Asunto(s)
Periodontitis Crónica/sangre , Receptores de Lipopolisacáridos/sangre , Receptores de Lipopolisacáridos/genética , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Adulto JovenRESUMEN
BACKGROUND: Respiratory syncytial virus (RSV) infection may influence the development of recurrent wheezing and atopy, but the mechanisms are unclear. OBJECTIVE: The purpose was to evaluate serum concentrations of soluble intercellular adhesion molecule-1 (sICAM-1), CD14, IgE, IL-5 and IFN-gamma in children 6-10 years after an RSV infection and their correlation with subsequent asthma and atopy. METHODS: Fifty-one subjects admitted to hospital for RSV infection during the first year of life and controls matched for birth date and sex underwent clinical examinations including lung function, skin prick and blood tests. RESULTS: The RSV subjects had significantly higher serum concentrations of IFN-gamma and sICAM-1 than the controls (for IFN-gamma 224.9 pg/mL (standard deviation (SD) 271.3) vs. 187.1 pg/mL (372.9), difference 37.8 pg/mL, 95% confidence interval (CI) -90.3 to 166.0, P = 0.05; for sICAM-1 170.2 ng/mL (SD 63) vs. 147.8 ng/mL (SD 57), difference 22.4 ng/mL, 95% CI -1.4 to 46.1, P = 0.04). The RSV subjects with asthma had significantly higher concentrations of IFN-gamma than the controls with asthma, and the RSV subjects with wheezing during the previous 12 months had significantly higher concentrations of both IFN-gamma and sICAM-1 than the controls with wheezing. CONCLUSIONS: Children hospitalized for RSV infection in infancy still differ in IFN-gamma and sICAM-1 production 6-10 years after the infection. The data suggest that the pathomechanism of asthma and wheezing after an early RSV infection may be different from that of children without an early RSV infection.
Asunto(s)
Asma/inmunología , Molécula 1 de Adhesión Intercelular/sangre , Interferón gamma/sangre , Infecciones por Virus Sincitial Respiratorio/inmunología , Virus Sincitiales Respiratorios , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Niño , Humanos , Inmunoglobulina E/inmunología , Recién Nacido , Interleucina-5/inmunología , Receptores de Lipopolisacáridos/inmunología , Ruidos Respiratorios , Pruebas CutáneasRESUMEN
AIM: To find out the extent to which children at 10-11 y of age suffer from various gastrointestinal complaints and how often a food-induced or other diagnostic disorder might be assessed behind them, we carried out a population-based survey of 404 children in a rural Finnish town. METHODS: A questionnaire filled in retrospectively by their parents was used to describe the frequency of various abdominal symptoms during the previous 2 y and to select the symptomatic subjects for closer clinical examination. In the clinical investigation of the children, an elimination challenge with milk protein and lactose intolerance tests, as well as endoscopic examinations in selected cases and blood tests, were performed. RESULTS: In all, 110 (27%) subjects reported some gastrointestinal (GI) complaints during the last 2 y; 64 (16%) meeting the Apley criteria for recurrent abdominal pain. A specific organic or functional disorder was found in 26 subjects (6%), two having no GI symptoms. Milk protein intolerance was the most common specific disorder diagnosed in nine subjects (2.2%), followed by lactose intolerance in eight (2%), coeliac disease in five (1.2%) and Helicobacter pylori infection in three (0.7%). An endoscopic examination performed on 17 subjects (4.2%) and a colonoscopy on three revealed significant findings in 11; lymphonodular changes being most common, occurring in five subjects. Subjects with milk protein-induced disorders showed significantly lower IgA-class antibodies to milk and its fractions than the non-symptomatic controls. Chronic diseases, short breastfeeding, GI problems and food intolerance during the first year of life were observed as significant risk factors in determining whether a subject belonged to the group experiencing any GI complaints. CONCLUSION: We conclude that in one in five of those with any, even mild, GI complaints we were able to assess a specific organic disease; milk-induced disorders being most common. A milk protein and/or lactose load test, completed in some cases with an endoscopic examination, would help in assessing a proper individual diagnosis.
Asunto(s)
Hipersensibilidad a los Alimentos/complicaciones , Enfermedades Gastrointestinales/diagnóstico , Dolor Abdominal/etiología , Niño , Diarrea/etiología , Endoscopios Gastrointestinales , Finlandia/epidemiología , Enfermedades Gastrointestinales/epidemiología , Enfermedades Gastrointestinales/etiología , Humanos , Inmunoglobulina G/sangre , Hipersensibilidad a la Leche/complicaciones , Estudios Retrospectivos , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
The mechanisms of virus-induced airway hyperresponsiveness in asthma and allergy and the failure of host defence in patients suffering from secondary airway infections are still largely unknown. The aim of this study was to examine whether the presence of allergic rhinitis or susceptibility to recurrent sinusitis affects the structural and cellular changes in nasal mucosa during natural colds and convalescence. We compared the mucosal changes in biopsy samples during acute natural colds (days 2-4 of illness) and convalescence (3 weeks later) in patients with allergic rhinitis (n = 9), patients with susceptibility to sinusitis (n = 19) and healthy controls (n = 20). We saw similarly increased numbers of mucosal T and B lymphocytes and mast cells and increased vascular density during the acute colds compared to convalescence in all the three groups. The allergic subjects had elevated levels of eosinophils in the acute phase (P = 0.03), and the allergic and sinusitis-prone subjects had elevated levels of epithelial T cells (P = 0.04) and low levels of mast cells (P = 0.005) in convalescence compared to the control group. The sinusitis-prone subjects lacked intraepithelial cytotoxic cells in convalescence. In the allergic subjects, the reticular basement membrane was thicker in the acute phase compared to the convalescence (P = 0.05). These results suggest that various cells of the airways, including inflammatory and structural cells, are involved during viral respiratory infections in subjects with allergic rhinitis. The small numbers of mast cells and cytotoxic lymphocytes in the sinusitis-prone subjects may be related to their susceptibility to bacterial complications.
Asunto(s)
Resfriado Común/inmunología , Mucosa Nasal/inmunología , Rinitis Alérgica Perenne/inmunología , Rinitis Alérgica Estacional/inmunología , Sinusitis/inmunología , Enfermedad Aguda , Adolescente , Adulto , Resfriado Común/complicaciones , Resfriado Común/patología , Susceptibilidad a Enfermedades , Femenino , Humanos , Inmunidad Celular , Inmunidad Mucosa , Masculino , Persona de Mediana Edad , Mucosa Nasal/patología , Recurrencia , Rinitis Alérgica Perenne/complicaciones , Rinitis Alérgica Perenne/patología , Rinitis Alérgica Estacional/complicaciones , Rinitis Alérgica Estacional/patología , Sinusitis/complicaciones , Sinusitis/patologíaRESUMEN
BACKGROUND: Viral cold is thought to be the major contributing factor in the pathogenesis of sinusitis, as it causes ostiomeatal obstruction. The aim was to evaluate whether paranasal sinus functioning during viral colds is similar in subjects with and without allergic rhinitis. METHODS: Forty-eight volunteers were examined during an early (2-4 days) natural cold and again 3 weeks later. The examinations included computed tomography (CT) scans, nasal mucosal biopsies, and viral and bacterial specimens. Subjects with positive skin prick tests and persistent or intermittent rhinitis were considered to have allergic immunoglobulin E (IgE)-mediated rhinitis. In addition, specific IgE antibodies to staphylococcal enterotoxin B (SEB) were measured. RESULTS: Nine subjects (19%) had allergic rhinitis. The allergic subjects were significantly more often IgE sensitized to SEB than the nonallergic subjects (33%vs 3%, P = 0.02). Viral etiology of the cold was identified in 32 (67%) subjects. The subjects with allergic rhinitis had significantly higher CT scores compared with nonallergic subjects during the colds (median (range) scores 16 (6-22) vs 6 (0-17), P = 0.004). In both groups, the median scores declined markedly during convalescence, but the difference remained significant (P = 0.009). Among the allergic subjects, those who were IgE sensitized to SEB tended to have the highest CT scores [median (range) 16 (16-22)]. Total serum IgE and the nasal subepithelial eosinophil counts correlated with the CT scores during the cold (rs = 0.38, P = 0.008 and rs = 0.46, P = 0.001, respectively). CONCLUSIONS: Subjects with allergic IgE-mediated rhinitis had more severe paranasal sinus changes in CT scans than nonallergic subjects during viral colds. These changes indicate impaired sinus functioning and may increase the risk of bacterial sinusitis.
Asunto(s)
Resfriado Común/complicaciones , Mucosa Nasal/patología , Senos Paranasales/diagnóstico por imagen , Rinitis Alérgica Perenne/complicaciones , Rinitis Alérgica Perenne/diagnóstico por imagen , Rinitis Alérgica Estacional/complicaciones , Rinitis Alérgica Estacional/diagnóstico por imagen , Adulto , Resfriado Común/virología , Femenino , Humanos , Inmunoglobulina E/sangre , Masculino , Rinitis Alérgica Perenne/inmunología , Rinitis Alérgica Perenne/patología , Rinitis Alérgica Estacional/inmunología , Rinitis Alérgica Estacional/patología , Sinusitis/etiología , Tomografía Computarizada por Rayos XRESUMEN
Knowledge of the virus-induced immune response is important in understanding the pathophysiology of respiratory virus infections. Data on the cellular immune response is still limited and based mainly on experimental studies. Natural colds may differ in their pathophysiology from experimentally induced ones. To evaluate the inflammatory cell responses in the upper respiratory tract during natural colds we counted the number of lymphocytes, mast cells and macrophages in the nasal mucosa. Nasal biopsies were taken from 22 adult volunteers during the acute (2-4 days of symptoms) and convalescent phases (day 21) of the cold, and the numbers of cells were counted with immunohistochemical methods. Viral aetiology was identified in 14 (64%) subjects by using viral isolation, antigen detection and rhino-polymerase chain reaction assays. The number of T lymphocytes was increased in the nasal epithelium and that of T and B lymphocytes and mast cells in the subepithelial layer in the acute phase compared to the convalescent phase. Intraepithelial T lymphocyte counts were significantly higher in the subjects who had a proven viral infection or a finding of pathogenic bacteria in the nasopharynx compared to the subjects without such findings (P = 0.005 and P = 0.04, respectively). Contrary to the earlier experimental studies, we found that viruses cause accumulation of T and B lymphocytes and mast cells during the first days of a symptomatic naturally acquired respiratory infection.
Asunto(s)
Resfriado Común/inmunología , Infecciones Comunitarias Adquiridas/inmunología , Linfocitos/inmunología , Mastocitos/inmunología , Mucosa Nasal/inmunología , Enfermedad Aguda , Adulto , Linfocitos B/inmunología , Recuento de Células , Humanos , Recuento de Linfocitos , Macrófagos/inmunología , Estadísticas no Paramétricas , Linfocitos T/inmunologíaRESUMEN
BACKGROUND: Intestinal metaplasia (IM) in the oesophagus is a known risk factor for adenocarcinoma of the oesophagus. The incidence of adenocarcinoma of the cardia and oesophagus has increased in Western countries simultaneously with a decrease in Helicobacter pylori prevalence. AIMS: To determine the association of H pylori infection with inflammation and IM at the squamocolumnar junction (SCJ) in young individuals. PATIENTS: A total of 168 (121 women; 72%) consecutive outpatients, =45 years, undergoing gastroscopy, and with no prior H pylori eradication treatment. METHODS: Biopsy specimens taken from the antrum, corpus, SCJ, and oesophagus were assessed according to the updated Sydney system, and type of IM (complete or incomplete) was determined. Serum samples from H pylori positive patients were studied for CagA antibodies. RESULTS: In 86% of 37 patients with gastritis in the antrum and/or corpus (24 histologically H pylori positive) and in 23% of 125 patients with a healthy stomach, inflammation was present in the glandular mucosa at the SCJ. In the latter, cardiac mucosa more often than fundic mucosa at the SCJ was inflamed (p<0.001), the inflammation was usually milder in nature, and was associated with signs of reflux disease. IM (incomplete or complete) at the SCJ was evident in nine of those 24 with a healthy stomach and inflamed cardiac mucosa at the SCJ but in none of those with H pylori gastritis. CONCLUSIONS: IM at the SCJ can also appear in young individuals in whom it seems to be associated with reflux related isolated inflammation in cardiac mucosa at the SCJ but not with H pylori gastritis.
Asunto(s)
Unión Esofagogástrica/patología , Infecciones por Helicobacter/patología , Helicobacter pylori , Adolescente , Adulto , Biopsia , Esofagitis/microbiología , Esofagitis/patología , Femenino , Mucosa Gástrica/microbiología , Mucosa Gástrica/patología , Gastritis/microbiología , Gastritis/patología , Gastroscopía , Humanos , Masculino , Metaplasia/microbiología , Metaplasia/patología , Persona de Mediana EdadRESUMEN
BACKGROUND: Interleukin-1 receptor antagonist genotype 2/2 is associated with a prolonged and enhanced inflammatory response. It is suspected of being a risk factor for atrophic gastritis and gastric cancer and for some autoimmune diseases. No specific genetic risk factors for oesophagitis have been identified so far and there are no reports of IL-1 polymorphism in relation to oesophageal disease. METHODS: We studied the IL-1RN, IL-1beta-511 and IL-1beta + 3953 polymorphisms in an unselected series of 142 adult patients scheduled for gastrointestinal endoscopy because of dyspepsia. The control group consisted of university staff and students (n = 179). Helicobacter pylori status was determined by antibody testing and bacterial detection. RESULTS: Endoscopic oesophagitis was noted in 40 patients. The IL-1RN 2/2 genotype was significantly more prevalent in the patients with H. pylori-negative oesophagitis than in the control subjects (27% versus 9%; OR 3.574, CI 1.23-10.35, P = 0.034) or in the dyspeptic patients (27% versus 7%; OR 5.089. CI 1.51-17.11, P = 0.009). IL-1beta-511 T/T genotype tended to be more frequent in the H. pylori-negative patients with oesophagitis than in the control subjects (P = 0.071). The strongest association was between the simultaneous carriage of genotypes IL-1RN 2/2 and IL-1beta -511 T/T and H. pylori-negative oesophagitis. where the combined genotype was more prevalent than in the control subjects (23% versus 6%; OR 4.492, CI 1.40-14.46, P = 0.012) or the dyspeptic patients without oesophagitis (23% versus 3%: OR 9.706. CI 2.12-44.42, P = 0.003). CONCLUSIONS: The results indicate that the IL-1RN 2/2 genotype and the carriage of combined genotypes IL-1RN 2/2 + IL-1beta-511 T/T are associated with H. pylori-negative oesophagitis. This is the first report on the association between IL-1 gene polymorphism and oesophagitis.
Asunto(s)
Esofagitis/genética , Helicobacter pylori/aislamiento & purificación , Interleucina-1/genética , Polimorfismo Genético , Receptores de Interleucina-1/antagonistas & inhibidores , Sialoglicoproteínas/genética , Adulto , Anticuerpos Antibacterianos/sangre , Dispepsia/complicaciones , Dispepsia/genética , Esofagitis/complicaciones , Esofagitis/microbiología , Femenino , Predisposición Genética a la Enfermedad , Genotipo , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/inmunología , Humanos , Proteína Antagonista del Receptor de Interleucina 1 , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: The relationship between Chlamydia trachomatis tubal factor infertility (TFI) and the host's immunoregulatory genes was studied. METHODS: Cell-mediated immune responses to C. trachomatis and chlamydial heat shock protein (CHSP60) were determined by lymphocyte proliferation assay. HLA-DQ alleles and interleukin-10 (IL-10) promoter polymorphism (-1082 A/G) were analysed in 52 TFI cases and in 61 controls by PCR. RESULTS: HLA-DQB1 or DQA1 alleles did not significantly differ between the TFI group and the control group. However, DQA1*0102 and DQB1*0602 alleles together with IL-10 -1082AA genotype were found significantly more frequently in the TFI patients than in the controls (0.18 and 0.02 respectively; P = 0.005). Five (22%) of the 23 patients who had a positive lymphocyte proliferative response to CHSP60 were positive also for IL-10 -1082AA and for the HLA-DQA1*0102 and HLA-DQB1*0602 alleles. CONCLUSIONS: Our results reveal an association of a cellular immune response to CHSP60, HLA class II alleles and IL-10 promoter genotypes in patients with chlamydial TFI.
Asunto(s)
Infecciones por Chlamydia/complicaciones , Enfermedades de las Trompas Uterinas/complicaciones , Antígenos HLA-DQ/genética , Infertilidad Femenina/genética , Interleucina-10/genética , Polimorfismo Genético/fisiología , Adulto , Alelos , Formación de Anticuerpos , Estudios de Casos y Controles , Infecciones por Chlamydia/inmunología , Chlamydia trachomatis/inmunología , Enfermedades de las Trompas Uterinas/microbiología , Femenino , Cadenas alfa de HLA-DQ , Cadenas beta de HLA-DQ , Humanos , Infertilidad Femenina/etiología , Regiones Promotoras Genéticas/genéticaRESUMEN
OBJECTIVES: Home hemodialysis (HHD) has been used only in a minority of patients over past years although it may offer significant advantages over the other renal replacement therapies. This study describes the systems for and the initial results of starting a HHD program. MATERIAL AND METHODS: A program for HHD was instituted at a university hospital having more than 20 years of experience in training patients for self-care hemodialysis. A working group designed the patient and partner education program, installations, water quality assurance, logistics, and control systems. RESULTS: Between May 1998 and May 2001, 37 patients with a mean age of 48.3 +/- 12.5 (24-71) years were trained for HHD (1.0 patient/month) the mean training time being 2.0 +/- 0.6 (1-3) months. Four patients had no helper at home. The dialysis schedules (timing, frequency, duration) were individualized at home 41% of the patients having more frequent and/or longer treatments (including long-slow night and daily short HHD). The weekly dialysis time increased from 13.9 +/- 1.5 (CI 13.4-14.4) initially to 15.5 +/- 3.7 (CI 14.2-16.7) h (p = 0.008) at the end of follow-up. Significantly (p < 0.05) increased serum creatinine concentration was observed during the follow-up suggesting for an increased muscle mass. Initially 32% and at the end of follow-up 60% of the patients required no antihypertensive drugs (p < 0.05). Seventeen of the 21 drop-outs were caused by renal transplantation and the most common causes necessitating hospital back-up were related to vascular access. CONCLUSIONS: In conclusion the HHD program started in a unit having experience on and commitment for training self-care hemodialysis enabled individualization of the dialysis schedules resulting in the institution of long-slow (night) and alternate day as well as daily HHD therapies. It improved the control of hypertension renal transplantation being the single most common cause of drop-out.
Asunto(s)
Hemodiálisis en el Domicilio/normas , Fallo Renal Crónico/terapia , Adulto , Anciano , Femenino , Hemodiálisis en el Domicilio/estadística & datos numéricos , Servicios de Atención a Domicilio Provisto por Hospital , Hospitales Universitarios , Humanos , Hipertensión/prevención & control , Masculino , Persona de Mediana Edad , Estado Nutricional , Diálisis Peritoneal , AutocuidadoRESUMEN
The etiology of chronic gastric erosions is unknown. We have evaluated the significance of Helicobacter pylori and herpes simplex virus (HSV) infections, the use of nonsteroidal antiinflammatory drugs (NSAIDs), alcohol, and smoking in a prospective long term follow-up study. A prospective series of 117 patients with gastric erosions and 117 controls were studied in 1974-1981, and invited for reendoscopy in 1996. At both visits, H. pylori infection was diagnosed by histology, serum HSV antibodies were measured, and the use of NSAIDs, alcohol, and smoking was evaluated by interview. Biopsies from erosions from the latter visit were studied for HSV by immunohistochemistry and polymerase chain reaction (PCR). In the follow-up visit, 16 of 42 patients had still gastric erosions while six of 47 controls had developed erosions. No HSV antigen or DNA could be detected in biopsy specimens. However, only high antibody titers (> or = 32) against HSV at the first visit predicted persistence of erosions (P = 0.000), while H. pylori infection, use of NSAIDs, alcohol, or smoking were not associated with chronic erosions. High HSV titers at the follow-up visit were also significantly associated with concurrent erosions in the patient group. In conclusion, the results suggest that a significant proportion of chronic gastric erosions are related to HSV infection.
Asunto(s)
Infecciones por Helicobacter/complicaciones , Helicobacter pylori , Gastropatías/microbiología , Anciano , Antiinflamatorios no Esteroideos/efectos adversos , Enfermedad Crónica , Femenino , Estudios de Seguimiento , Herpes Simple/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Análisis de Regresión , Gastropatías/inducido químicamenteRESUMEN
CD14 is a pattern recognition receptor on the membranes of monocytes and macrophages for several microbial products, of which lipopolysaccharide (LPS) is the best known. A shed form of CD14 is present in serum. As the CD14 gene promoter polymorphism -159C/T and some bacterial infections may affect the sCD14 levels, we compared the impact of both the CD14 promoter polymorphism and Helicobacter pylori infection on serum sCD14 levels in 201 dyspeptic patients (group 1) who had undergone gastroscopy, and 127 staff members (group 2) with no endoscopy. sCD14 was measured from the sera by a commercial enzyme immunoassay (EIA), and CD14 genotyping was carried out with PCR. Helicobacter pylori infection was detected by serology and/or culture or PCR. sCD14 levels were elevated in the subjects carrying the T allele (CT or TT genotype) in both groups when compared with subjects with the CC genotype. Overall, H. pylori-positive subjects tended to have higher sCD14 levels compared with H. pylori-negative subjects. In group 1 consisting of dyspeptic patients, those with gastric ulcer, gastric erosion or duodenal ulcer had significantly elevated levels of sCD14 compared with the patients with normal endoscopic findings or macroscopic gastritis. The recent use of NSAIDs was also associated with enhanced sCD14. Thus, we were able to show several factors, one genetic and the other environmental (H. pylori infection and mucosal lesion), to have an impact on sCD14.
Asunto(s)
Infecciones por Helicobacter/inmunología , Helicobacter pylori , Receptores de Lipopolisacáridos/genética , Receptores de Lipopolisacáridos/inmunología , Polimorfismo Genético , Adulto , Anciano , Secuencia de Bases , Femenino , Infecciones por Helicobacter/sangre , Infecciones por Helicobacter/fisiopatología , Humanos , Receptores de Lipopolisacáridos/sangre , Lipopolisacáridos/inmunología , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Monocitos/inmunología , Regiones Promotoras Genéticas/genética , Regiones Promotoras Genéticas/inmunologíaRESUMEN
Keratinocytes of psoriatic skin show aberrant expression of membrane-bound CD14 (mCD14). In addition, soluble CD14 (sCD14) is elevated in the sera of psoriatic patients. The mechanisms leading to increased CD14 expression and secretion in psoriasis are poorly understood. A bi-allelic polymorphism in the promoter region of the CD14 gene controls CD14 expression on monocytes and sCD14 levels in the sera of healthy subjects. In this context, we explored the CD14 promoter region genotypes of 63 Finnish patients with psoriasis and 126 non-psoriatic controls using a new ARMS-PCR method. No differences in the CD14 genotype frequencies were found between the groups. Thus, our results suggest that the enhanced CD14 expression in psoriasis is not attributable to functional variants of CD14 (-159C/T).
Asunto(s)
Receptores de Lipopolisacáridos/genética , Polimorfismo Genético , Regiones Promotoras Genéticas , Psoriasis/genética , Finlandia , Predisposición Genética a la Enfermedad , HumanosRESUMEN
Thirty consecutive patients scheduled for elective colorectal surgery were prospectively randomized to receive either filgrastim [the recombinant human form of granulocyte colony-stimulating factor (r-metHu-G-CSF)] or placebo blindly. The levels of interleukin (IL-)1beta, tumour necrosis factor-alpha (TNF-alpha), IL-6, IL-8, transforming growth factor-beta (TGF-beta), and IL-10 were determined 5 and 24 h postoperatively from peripheral blood, peritoneal fluid, and wound fluid. The concentrations of all the measured cytokines were enormously higher locally at the operative site than in the systemic circulation. The only difference between the two medication groups was the lower concentration of IL-8 in peripheral blood in the filgrastim-treated patients. The present study shows abundant release of pro- and anti-inflammatory cytokines into the wound and the peritoneal cavity after abdominal surgery. The systemic response to surgery seems to be a secondary and minor reflection of local events. Filgrastim did not have any effect on the studied local cytokine levels at the operative site.
Asunto(s)
Cirugía Colorrectal , Citocinas/biosíntesis , Factor Estimulante de Colonias de Granulocitos/administración & dosificación , Atención Perioperativa , Cirugía Colorrectal/métodos , Citocinas/sangre , Citocinas/metabolismo , Método Doble Ciego , Esquema de Medicación , Femenino , Filgrastim , Factor Estimulante de Colonias de Granulocitos/farmacología , Humanos , Inyecciones Subcutáneas , Masculino , Persona de Mediana Edad , Atención Perioperativa/métodos , Placebos , Periodo Posoperatorio , Estudios Prospectivos , Proteínas RecombinantesRESUMEN
A simple bidirectional allele-specific PCR method is described for determining the -1082 A and G alleles in the interleukin-10 (IL-10) promoter region. This polymorphism is associated with IL-10 production capacity, and it is thus interesting to see whether different infectious and autoimmune conditions are associated with it. With our method, the A and G alleles may be studied simultaneously in a single PCR reaction, as amplification of the different alleles is performed by using 3'-mismatched and partly overlapping allele-specific upstream and downstream primers around the -1082 site. The fast and simple method described here is especially suitable for large-scale association studies.
Asunto(s)
Alelos , Interleucina-10/genética , Reacción en Cadena de la Polimerasa/métodos , Regiones Promotoras Genéticas , Secuencia de Bases , Genotipo , Humanos , Interleucina-10/clasificación , Datos de Secuencia MolecularRESUMEN
Enhanced secretion of anti-inflammatory Th2 cytokines is a characteristic feature in normal physiological pregnancy. In recurrent spontaneous abortions (RSA), however, defective production of interleukin-10 (IL-10) and other Th2 cytokines has been shown in humans. Association studies have shown that a base exchange polymorphism (guanine-->adenine) at position -1082 of the IL-10 promoter is associated with differential IL-10 production. Since factors contributing to IL-10 production appear to be important in RSA, we studied the IL-10 genotypes of 38 Finnish women with a history of three or more consecutive abortions and 131 ethnically matched healthy controls. No significant differences in the -1082 allele or genotype frequencies were found between the controls and the RSA women. The present study suggests that the IL-10 -1082 (G-->A) polymorphism is not a major genetic regulator in RSA.
Asunto(s)
Aborto Habitual/genética , Aborto Habitual/inmunología , Interleucina-10/genética , Polimorfismo de Nucleótido Simple , Regiones Promotoras Genéticas , Adulto , Anciano , Alelos , Secuencia de Bases , Estudios de Casos y Controles , Cartilla de ADN/genética , Femenino , Frecuencia de los Genes , Genotipo , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: To assess whether the postoperative expression of neutrophil adhesion molecules CD11b/CD18 (Mac-1) and CD62L (L-selectin) would differ in peripheral blood, peritoneal fluid and wound fluid in patients operated on for colorectal conditions, and to analyse the effect of perioperative filgrastim on their expression. DESIGN: Prospective randomised double-blind placebo-controlled clinical study. SETTING: University hospital, Finland. SUBJECTS: Thirty consecutive patients undergoing elective colorectal operations (15 in each group). INTERVENTIONS: The patients were prospectively randomised to receive either filgrastim or placebo. Expression of neutrophil adhesion molecules was measured 48 hours postoperatively in peripheral blood, peritoneal fluid, and wound fluid by flow cytometry. RESULTS: Postoperative neutrophil CD11b/CD18 expression was higher in both wound fluid and peritoneal fluid than in peripheral blood in the placebo group. Simultaneously, the expression of neutrophil CD62L was higher in peripheral blood than in peritoneal fluid or wound fluid in both groups. Filgrastim caused increased postoperative expression of neutrophil CD11b/CD18 in peripheral blood but not in peritoneal fluid or wound fluid. CONCLUSIONS: Postoperative expression of neutrophil adhesion molecules differs at the local operation site from that in peripheral blood. Filgrastim increases only blood neutrophil CD11b/CD18 expression.
Asunto(s)
Moléculas de Adhesión Celular/análisis , Cirugía Colorrectal , Factor Estimulante de Colonias de Granulocitos/farmacología , Método Doble Ciego , Filgrastim , Humanos , Selectina L/análisis , Antígeno de Macrófago-1/análisis , Activación Neutrófila , Estudios Prospectivos , Proteínas Recombinantes , Estadísticas no ParamétricasRESUMEN
BACKGROUND: The mechanisms for the observed low prevalence of Helicobacter pylori infection in inflammatory bowel disease (IBD) are unknown, but might be important for the pathogenesis of IBD. We have studied the seroprevalence of H. pylori in different categories of IBD and evaluated the role of medical therapy, smoking and social status. We also analysed the effect of seropositivity on the age of onset of IBD in order to find possible evidence for the protective effect of the infection. METHODS: We studied 296 (mean age 43 years, range 18-79; women 144) unselected patients with IBD, including 185 with ulcerative colitis (UC). 94 with Crohn disease (CD), and 17 with indeterminate colitis (IC). Seventy healthy age- and sex-matched subjects served as controls. Serum samples were studied for H. pylori antibodies. Detailed clinical history was obtained from patient records and by face-to-face interview. RESULTS: The prevalence of H. pylori infection was lower in IBD patients (24%) than in controls (37%; P = 0.029), and in CD lower (13%) than in UC (30%; P = 0.002). Seropositivity was not related to sulphasalazine treatment or smoking. Age of onset of IBD was higher in seropositive (mean 40 years) than in seronegative patients (30 years: P < 0.001). The age of onset of IBD showed unimodal distribution in H. pylori seronegative patients, with a peak between 30 and 40 years, although there was some evidence of bimodality in CD. In contrast, H. pylori seropositive patients had clear bimodal pattern with peaks at 20-40 and 50-60 years of age. CONCLUSIONS: Our results confirm the low prevalence of H. pylori infection in IBD, and in particular in CD. The significantly higher age of onset and bimodal pattern of age-specific incidence in seropositive IBD patients suggest that H. pylori infection significantly modifies the development of IBD and may have a protective effect.
Asunto(s)
Colitis Ulcerosa/microbiología , Enfermedad de Crohn/microbiología , Infecciones por Helicobacter/epidemiología , Helicobacter pylori , Adulto , Edad de Inicio , Estudios de Casos y Controles , Colitis/epidemiología , Colitis/microbiología , Colitis/prevención & control , Colitis Ulcerosa/epidemiología , Colitis Ulcerosa/prevención & control , Enfermedad de Crohn/epidemiología , Enfermedad de Crohn/prevención & control , Femenino , Infecciones por Helicobacter/complicaciones , Humanos , Incidencia , Masculino , Estudios Seroepidemiológicos , Fumar/epidemiología , Clase SocialRESUMEN
cagA, vacA s and m genotypes and iceA alleles were analyzed from Helicobacter pylori strains isolated from 17 Finnish children and 32 children of non-Finnish origin living in Finland. Twelve children in the latter group were eastern European and 15 were of African origin. Only three children of non-Finnish origin were born in Finland. The vacA sla subtype was more prevalent in the isolates from Finnish children than African children (76% vs. 7%, P<0.001); vacA s1b frequencies were 5% and 67%, respectively (P<0.001). The iceA1 allele was significantly more prevalent in African than Finnish isolates (93% vs. 35%, P< 0.01). Considerable variation was noted in the frequency of vacA s1 subtypes and iceA alleles in children originating from different geographic regions, but the geographic variation of s1 subtypes resembled that described in other reports.