Children developing type 1 diabetes before 6 years of age have increased linear growth independent of HLA genotypes

AIMS/HYPOTHESIS

High birthweight and increased childhood growth are risk factors for type 1 diabetes. Relative birthweight is associated with HLA genotypes that confer a high risk of diabetes. Our aims were to test whether young children prior to clinical onset of type 1 diabetes have increased: (1) birthweight or birth length standard deviation scores (SDS); (2) height development SDS; or (3) BMI SDS during first 18 months of life and whether these parameters are related to HLA genotypes or mid-parental height (MPH).

METHODS

Birthweight, birth length, weight and height were obtained from 58 type 1 diabetes children and 155 controls matched for HLA or not in the Diabetes Prediction in Skåne study.

RESULTS

Birth length SDS corrected for MPH was increased in children developing diabetes compared with all (p < 0.048) and with non-HLA- (p < 0.050) but not with HLA-matched controls. Children developing diabetes had increased height gain at 0 to 18 months of age (p < 0.005). Diabetic children were significantly taller from 6 to 18 months of age when correcting for MPH compared with non-HLA-matched as well as HLA-matched controls, but BMI was not increased.

CONCLUSIONS/INTERPRETATION

Birth length SDS was associated with diabetes risk HLA. When corrected for MPH, children developing diabetes were taller at birth than non-HLA- but not taller than HLA-matched controls. Diabetic children had increased MPH-corrected height up to 18 months of age compared with both HLA- and non-HLA-matched controls. High-risk HLA affects prenatal growth, but other factors may explain the increased postnatal linear growth in children developing diabetes.

Fluticasone and ibuprofen do not add to the effect of salmeterol on organic dust-induced airway inflammation and bronchial hyper-responsiveness

BACKGROUND

Exposure in a pig house causes airway inflammation and bronchial hyper-responsiveness which are not influenced by anti-asthma drugs, including a beta(2)-agonist (salmeterol).

OBJECTIVES

We hypothesized that a glucocorticoid or a cyclo-oxygenase-inhibitor synergistically interacts with salmeterol offering a protection against dust-induced increased bronchial responsiveness and airway inflammation. As data did not confirm previous results a retrospective analysis of pooled data on dust-induced bronchial hyper-responsiveness from four other studies was performed.

DESIGN

Fluticasone or ibuprofen was administered for 1 week and salmeterol or placebo was inhaled 1 h prior to a 3-h exposure in a pig barn in a double-blind, placebo-controlled, cross-over design (2-3 weeks apart) in 12 healthy subjects. Lung function, bronchial responsiveness to methacholine and inflammatory markers were evaluated before and after exposure. Pre- and postexposure bronchial responsiveness in nontreated subjects was retrospectively evaluated from four previous studies.

SUBJECTS

Twelve healthy, nonatopic nonsmokers.

RESULTS

Salmeterol partially protected against bronchial hyper-responsiveness but did not influence inflammatory markers. Fluticasone and ibuprofen did not add to these effects. The retrospective analysis showed that PD(20)FEV(1) after exposure in a pig barn is almost totally independent of pre-exposure PD(20)FEV(1)-level; all subjects end up at the same low postexposure PD(20)FEV(1).

CONCLUSION

Contradictory to our previous results, salmeterol offered partial protection against enhanced bronchial responsiveness induced by exposure in a pig barn. This effect was not modified by fluticasone or ibuprofen. Our data clearly demonstrate that interventions altering bronchial responsiveness must be compared between groups with similar prechallenge bronchial responsiveness or in a cross-over design.

Effect of coadsorbed dopants on diamond initial growth processes: CH3 adsorption

An investigation based on an ultrasoft pseudopotential density functional theory (DFT) method, using the generalized gradient approximation (GGA) under periodic boundary conditions, has been performed in order to investigate how the presence of a neighboring dopant is affecting the CH 3 adsorption reaction (regarded to be an initial growth process). For this study, both the (100) and (111) diamond surface orientations have been considered, and various dopants in two different hydrogenated forms AH X (A = N, B, S, P, or C; X = 0 or 1 for S, X = 1 or 2 for N, B, and P, and X = 2 or 3 for C) were especially scrutinized. For most of the cases studied, the presence of a coadsorbed dopant was found to disfavor CH 3 adsorption with an efficiency that depends on the surface orientation as well as dopant type and position. The NH 2, PH 2, and SH species have the strongest effect in counteracting the CH 3 adsorption to the diamond (111) surface. This is also the situation with the dopants adsorbed on either of two specific surface sites (out of three positions studied) on the diamond (100)-2 x 1 surface. The main reasons for these observations are induced steric hindrances between the two coadsorbates. The BH 2 species, adsorbed to the third type of surface site on diamond (100), has been found to affect the adsorption reaction by formation of a C surf-B bond prior to CH 3 adsorption. The dopants in their radical forms are generally shown to always strongly disfavor the CH 3 adsorption reaction by formation of a C surf-X bond prior to adsorption. However, the NH radical will only form this new bond with the radical surface C site when it is adsorbed to position 3 on the surface.

Treatment of exercise-induced asthma, respiratory and allergic disorders in sports and the relationship to doping: Part II of the report from the Joint Task Force of European Respiratory Society (ERS) and European Academy of Allergy and Clinical Immunology (EAACI) in cooperation with GA(2)LEN

AIM

The aims of part II is to review the current recommended treatment of exercise-induced asthma (EIA), respiratory and allergic disorders in sports, to review the evidence on possible improvement of performance in sports by asthma drugs and to make recommendations for their treatment.

METHODS

The literature cited with respect to the treatment of exercise induced asthma in athletes (and in asthma patients) is mainly based upon the systematic review given by Larsson et al. (Larsson K, Carlsen KH, Bonini S. Anti-asthmatic drugs: treatment of athletes and exercise-induced bronchoconstriction. In: Carlsen KH, Delgado L, Del Giacco S, editors. Diagnosis, prevention and treatment of exercise-related asthma, respiratory and allergic disorders in sports. Sheffield, UK: European Respiratory Journals Ltd, 2005:73-88) during the work of the Task Force. To assess the evidence of the literature regarding use of beta(2)-agonists related to athletic performance, the Task Force searched Medline for relevant papers up to November 2006 using the present search words: asthma, bronchial responsiveness, exercise-induced bronchoconstriction, athletes, sports, performance and beta(2)-agonists. Evidence level and grades of recommendation were assessed according to Sign criteria.

RESULTS

Treatment recommendations for EIA and bronchial hyper-responsiveness in athletes are set forth with special reference to controller and reliever medications. Evidence for lack of improvement of exercise performance by inhaled beta(2)-agonists in healthy athletes serves as a basis for permitting their use. There is a lack of evidence of treatment effects of asthma drugs on EIA and bronchial hyper-responsiveness in athletes whereas extensive documentation exists in treatment of EIA in patients with asthma. The documentation on lack of improvement on performance by common asthma drugs as inhaled beta(2)-agonists with relationship to sports in healthy individuals is of high evidence, level (1+).

CONCLUSIONS

Exercise induced asthma should be treated in athletes along same principles as in ordinary asthma patients with relevance to controller and reliever treatment after careful diagnosis. There is very high level of evidence for the lack of improvement in athletic performance by inhaled beta2-agonists.

Exercise-induced asthma, respiratory and allergic disorders in elite athletes: epidemiology, mechanisms and diagnosis: part I of the report from the Joint Task Force of the European Respiratory Society (ERS) and the European Academy of Allergy and Clinical Immunology (EAACI) in cooperation with GA2LEN

AIMS

To analyze the changes in the prevalence of asthma, bronchial hyperresponsiveness (BHR) and allergies in elite athletes over the past years, to review the specific pathogenetic features of these conditions and to make recommendations for their diagnosis.

METHODS

The Task Force reviewed present literature by searching Medline up to November 2006 for relevant papers by the search words: asthma, bronchial responsiveness, EIB, athletes and sports. Sign criteria were used to assess level of evidence and grades of recommendation.

RESULTS

The problems of sports-related asthma and allergy are outlined. Epidemiological evidence for an increased prevalence of asthma and BHR among competitive athletes, especially in endurance sports, is provided. The mechanisms for development of asthma and bronchial hyperresponsiveness in athletes are outlined. Criteria are given for the diagnosis of asthma and exercise induced asthma in the athlete.

CONCLUSIONS

The prevalence of asthma and bronchial hyperresponsiveness is markedly increased in athletes, especially within endurance sports. Environmental factors often contribute. Recommendations for the diagnosis of asthma in athletes are outlined.

A time-of-flight-Mott apparatus for soft x-ray spin resolved photoemission on solid samples

We describe a new spectrometer for spin resolved photoemission from solids in the soft x-ray energy range. It is mounted on the ID08 beamline at the ESRF light source and consists of a time-of-flight (TOF) energy analyzer coupled to a retarding mini-Mott spin polarimeter. It represents a valid alternative to the spin detection system already available on ID08, especially for the acquisition of wide energy regions, where the TOF technique is extremely efficient. By testing the new spectrometer on the 4f levels of Au and on CuO at the Cu L3 threshold we show that the effective Sherman function and figure of merit achieved are, respectively, Seff approximately 0.16 and eta approximately 1.3x10(-4) and that for certain experiments we obtain a significant gain in intensity with respect to the previous system.

A comprehensive screen for SNP associations on chromosome region 5q31–33 in Swedish/Norwegian celiac disease families

Celiac disease (CD) is a gluten-induced enteropathy, which results from the interplay between environmental and genetic factors. There is a strong human leukocyte antigen (HLA) association with the disease, and HLA-DQ alleles represent a major genetic risk factor. In addition to HLA-DQ, non-HLA genes appear to be crucial for CD development. Chromosomal region 5q31-33 has demonstrated linkage with CD in several genome-wide studies, including in our Swedish/Norwegian cohort. In a European meta-analysis 5q31-33 was the only region that reached a genome-wide level of significance except for the HLA region. To identify the genetic variant(s) responsible for this linkage signal, we performed a comprehensive single nucleotide polymorphism (SNP) association screen in 97 Swedish/Norwegian multiplex families who demonstrate linkage to the region. We selected tag SNPs from a 16 Mb region representing the 95% confidence interval of the linkage peak. A total of 1,404 SNPs were used for the association analysis. We identified several regions with SNPs demonstrating moderate single- or multipoint associations. However, the isolated association signals appeared insufficient to account for the linkage signal seen in our cohort. Collective effects of multiple risk genes within the region, incomplete genetic coverage or effects related to copy number variation are possible explanations for our findings.

Effectiveness of ganciclovir against human herpesvirus-6 excreted in saliva in stem cell transplant recipients

The aim of this study was to evaluate the effect of ganciclovir on human herpesvirus-6 (HHV)-6. Forty allogeneic stem cell transplant recipients were prospectively studied by repeated sampling of the saliva. The saliva samples were assayed for HHV-6 by quantitative polymerase chain reaction. HHV-6 was detected in 33 patients. Ganciclovir was given as preemptive therapy for cytomegalovirus infection during 15 episodes that were compared to 18 episodes without any concomitant antiviral therapy. The mean HHV-6 load decreased 0.49 (s.e. 0.31) log(10)/week in patients receiving ganciclovir whereas it increased 0.15 (s.e. 0.17) log(10)/week in episodes without antiviral therapy (P=0.04). We conclude that ganciclovir can decrease the HHV-6 viral load in saliva.

Impact on the cytomegalovirus (CMV) viral load by CMV-specific T-cell immunity in recipients of allogeneic stem cell transplantation

Patients experience cytomegalovirus (CMV) reactivation after stem cell transplantation (SCT) and need repeated courses of pre-emptive therapy. Analysis of CMV-specific immunity might help to assess the need for antiviral therapy. Forty-eight patients were studied during the first 3 months after SCT. Peripheral blood lymphocytes were stimulated by CMV antigen, and interferon (INF)-gamma production by CD3+ and CD4+ T cells was analysed. Results were correlated to transplant factors and CMV disease. Patients with INF-gamma production by CD3+ cells at 4 weeks after SCT had lower peak viral loads than patients with no such production (P=0.03). There was a similar tendency as regards CD4+ cells (P=0.09). Patients who underwent reduced-intensity conditioning (RIC) more frequently had CD3+ (48%) and CD4+ immunity (56%) 4 weeks after SCT compared with patients who received myeloablative conditioning (CD3+ 25%; CD4+ 35%). There was no effect of stem cell source, donor type or acute graft-versus-host disease. Three of 48 patients developed CMV disease and none of them had detectable INF-gamma production. CMV-specific T-cell response is associated with a lower rate of CMV replication. RIC results in improved T-cell reconstitution. Recovery of CMV-specific immunity might be delayed in patients with CMV disease. These observations suggest that detection of CMV-specific T-cells is useful in assessing the immunity against CMV.

Saliva is one likely source of leukotriene B4 in exhaled breath condensate

Leukotriene (LT)B4 in exhaled breath condensate (EBC) has been reported to be elevated in airway inflammation. The origin of leukotrienes in EBC is, however, not established. The aims of this study are to measure LTB4 levels in EBC collected in two challenges characterised by a strong neutrophilic airway inflammation and to compare LTB4 levels in EBC with levels in sputum and saliva. LTB4 and alpha-amylase were measured in EBC from 34 healthy subjects exposed in a pig confinement building or to a lipopolysaccharide provocation. These markers were also measured in induced sputum in 11 of the subjects. For comparison, LTB4 and alpha-amylase were measured in saliva from healthy subjects. Only four out of 102 EBC samples had detectable LTB4 (28-100 pg x mL(-1)). alpha-amylase activity was detected in the LTB4-positive samples. In contrast, LTB4 was detected in all examined sputum supernatants in the same study (median 1,190 pg x mL(-1)). The median LTB4 level in saliva was 469 pg x mL(-1). High levels of leukotriene B4 in saliva and the presence of leukotriene B4 in exhaled breath condensate only when alpha-amylase was detected, indicate that leukotriene B4 found in exhaled breath condensate is the result of saliva contamination. As leukotriene B4 was consistently present in sputum supernatants, exhaled breath condensate may be inappropriate for monitoring airway leukotriene B4.

Functional and transcriptional profiling of MUTZ-3, a myeloid cell line acting as a model for dendritic cells

The incidence of allergy is steadily increasing, but the molecular mechanisms involved in the allergic immune response are still not fully understood. In particular, further investigations focusing on dendritic cells, which are central in orchestrating the immune response, are needed. The objective of this study was to investigate the ability of myeloid leukaemia-derived cell lines, such as KG-1, THP-1 and MUTZ-3, to serve as in vitro models for dendritic cells. The ability of these cell lines to mature into functional dendritic cells, expressing costimulatory molecules, was assessed by functional and transcriptional profiling and compared with that of monocyte-derived dendritic cells, which are now used as a standard source of dendritic cells. High-density microarray analysis was utilized to study the transcriptional activity and kinetics of activation of the differentiated MUTZ-3 cell line, in response to a cocktail of inflammatory cytokines. The data obtained clearly demonstrate that MUTZ-3 cells have the ability to induce antigen-independent proliferation in CD4(+) CD45RA(+) T cells, whereas KG-1 and THP-1 only induced a marginal response. Furthermore, MUTZ-3 displayed the phenotypic and transcriptional profiles of immature dendritic cells, after differentiation with granulocyte-macrophage colony-stimulating factor and interleukin-4. Upon activation with inflammatory cytokines, MUTZ-3 matured phenotypically and exhibited a gene induction similar to that of monocyte-derived dendritic cells. This delineation of the cellular and transcriptional activity of MUTZ-3, in response to maturational stimuli, demonstrates the significance of this cell line as a model for functional studies of inflammatory responses.

A Western blot and molecular genetic investigation of the estrogen receptor beta in giant cell arteritis

OBJECTIVE

The epidemiology of giant cell arteritis (GCA) may indicate a pathogenetic relationship between GCA and female sex hormone metabolism; GCA is two to four times more common in women compared with men. Our previous analyses gave no support for the hypothesis that the pathogenesis of GCA should be related to somatic mutations in the estrogen receptor alpha (ERalpha) gene. The object of the present study was to investigate the size of the estrogen receptor beta (ERBeta), and the size and nucleotide sequence of the ERBeta gene in temporal arteries in GCA.

METHODS

The ERBeta protein was analyzed by Western blot technique and the ERBeta gene by RT-PCR and direct sequencing of the PCR product.

RESULTS

Western blot analysis revealed an ERBeta of normal size. There were no aberrations in size or nucleotide sequence in the ERBeta gene in the GCA patients.

CONCLUSION

The present observations gave no support for the hypothesis that somatic mutations in the ERBeta gene should be involved in the pathogenesis of GCA.

Are public care and services for older people targeted according to need? Applying the Behavioural Model on longitudinal data of a Swedish urban older population

The objectives were to identify factors that predict the use of home help services and transition into institutional care and to study to what extent care services were targeted according to the individuals' needs. A further objective was to study whether people who had moved into institutional care facilities had received home help prior to institutionalisation. A community-dwelling sample (n=502) aged 81-100 was twice interviewed and assessed with medical examinations. Their use of public elderly care between 1994/1996 and 2000 was studied using survival analyses. Need factors, according to the Andersen Behavioural Model, were the most important predictors for the use of elderly care. Among people living alone, dementia, functional limitations, and depressive symptoms predicted the use of home help services and institutionalisation. Among non-demented cohabiting people, depressive symptoms and dependence in ADLs increased the likelihood of both home help and institutionalisation. Among cohabiting people with dementia, the effect of dementia was difficult to separate from the effects of ADL limitations and depression. Enabling factors were of importance among cohabiting people. A high level of education increased the likelihood of moving into institutional care, and informal extra-residential care increased the likelihood of both outcomes indicating that elderly care resources had not been targeted solely according to need. Predisposing factors such as age and gender were of importance only among people living alone. Basically the same factors predicted both the receipt of home help and institutionalisation. Only 4% of people living alone and 5% of those cohabiting moved to institutions without previously receiving home help.

Nanosphere induced gene expression in human dendritic cells

The molecular mechanisms of nanosphere-induced mucosal immunization are important to decipher, since this can form the basis for novel approaches in, e.g., nasal vaccination. In this study, we have investigated the effect of nanospheres as antigen carriers on immature human dendritic cells. The results clearly indicate that tetanus toxoid immobilized nanospheres have a direct effect on human monocyte derived dendritic cells and induce a specific transcriptional profile involving genes crucial for phagocytosis and a protective immune response.

Electron-Transfer Doping on a (001) Surface of Diamond: Quantum Mechanical Study

The electron-transfer process from an H-terminated diamond (001) surface to an acidic water adlayer, leaving an induced p-type doping in the carbon layers, has been studied using first-principal density functional theory (DFT). The effect of various oxygen-containing species adsorbed to the surface (in the form of an OH group and an oxygen atom in both the ether and ketone positions) on the possibility for electron transfer was also investigated. The results show that a perfect H-termination, as well as the presence of one OH group (equivalent to a surface coverage of approximately 8%), will give an electron transfer of 1.76 and 1.89 e, respectively. There will then be a transfer of electrons from the upper diamond valence band to the lowest unoccupied level in the adsorbate. A corresponding percentage of 8 (Oketone) and 17 (Oether) will effectively hinder the electron-transfer process from occurring.

Expression of TNFalpha and its receptors R1 and R2 in human alveolar epithelial cells exposed to organic dust and the effects of 8-bromo-cAMP and protein kinase A modulation

OBJECTIVE

Expression of tumor necrosis factor alpha (TNF), TNF receptors 1 and 2 and TNFalpha converting enzyme (TACE) was studied in A549 human alveolar epithelial cells exposed to organic dust from a swine barn. Additional objectives were to elucidate whether 8-bromocAMP affected TNF and TNF receptor mRNA expression by activation of protein kinase A (PKA) and whether it increased phosphorylation of cAMP-responsive element-binding protein (CREB).

MATERIALS AND METHODS

Reverse transcriptase- (RT-) PCR was performed on unexposed cells and cells exposed to a dust-suspension, with and without 8-bromo-cAMP (1 mM). H-89 was used to inhibit PKA. To further investigate mRNA expression of TNF, staurosporine was used. Immunolabeling was applied for detection of TNF, TNFR1, TNFR2 and phosphorylation of CREB.

RESULTS

TNF mRNA and protein was expressed after 1-3 h in dust-exposed cells. TNFR2 mRNA and protein expression was induced by dust-exposure, whereas expression of TNFR1 and TACE was constitutive. After 1-1.5 h incubation, mRNA expression of TNF was (PKA-independently) attenuated by 8-bromo-cAMP (p < 0.05), whereas that of TNFR1 was PKA-dependently stimulated (p < 0.05). Staurosporine attenuated mRNA expression of TNF (p < 0.05), but not interleukin (IL)-6, which was detected prior to TNF.

CONCLUSION

Expression of TNF and its receptors in alveolar epithelial cells may contribute to the response to organic dust. 8-bromo-cAMP, which increased the number of cells exhibiting phosphorylation of CREB exerted opposite effects on TNF and TNFR1 mRNA expression. The mechanism by which cAMP attenuates TNF mRNA expression remains to be established. Dust-induced expression of IL-6 precedes that of TNF and the induction pathways differ with regard to staurosporine sensitivity.

Early menopause, low body mass index, and smoking are independent risk factors for developing giant cell arteritis

OBJECTIVE

To assess female sex hormone related variables in a group of women with biopsy positive giant cell arteritis and a control group.

METHODS

49 women with biopsy positive giant cell arteritis, aged 50 to 69 years at the time of diagnosis, answered a questionnaire on hormonal and reproductive factors. The same questions were answered by a large population of women from the same geographical area in connection with routine mammograms. The results were tested statistically, using logistic regression analysis of each variable adjusted for age, and a multivariate logistic regression analysis including age and the variables which differed significantly between giant cell arteritis and controls.

RESULTS

From the multivariate logistic regression analysis, three independent variables were associated with an increased risk of having giant cell arteritis: smoking and being an ex-smoker (odds ratio (OR) = 6.324 (95% confidence interval (CI), 3.503 to 11.418), p<0.0001); body mass index (a reduction of 1.0 kg/m2 increased the risk by 10% (OR = 0.898 (0.846 to 0.952), p = 0.0003); and menopause before the age of 43 (OR = 3.521 (1.717 to 7.220), p = 0.0006).

CONCLUSIONS

There was a significant association between hormonal and reproduction related factors and the risk of developing giant cell arteritis in women given the diagnosis before the age of 70. The results suggest a possible role of oestrogen deficiency in the pathogenesis of giant cell arteritis. To confirm the results, an extended study will be needed, including women older than 70.

Soluble thrombomodulin activity and soluble thrombomodulin antigen in plasma

Endothelial cell membrane-bound thrombomodulin (TM) plays a critical role as a cofactor in the protein C pathway, important in regulating coagulation as well as inflammation. Heterogeneous soluble TM fragments circulate in the plasma and are found at increased levels in various diseases such as cardiovascular disease and diabetes, and in ischemic and/or inflammatory endothelial injuries. The anticoagulant function of these soluble fragments has not been measured in healthy individuals or in patients. Using an immobilized monoclonal antibody against TM and a microtiter plate format, an assay was designed to capture the soluble TM fragments in plasma and measure their cofactor activity in the thrombin-mediated activation of protein C. In addition, soluble TM antigen levels were measured by enzyme-linked immunosorbent assay. Both assays were used to investigate a group of healthy blood donors. TM fragments released into plasma were shown to retain significant cofactor activity, and reference intervals for healthy men and women were established. Furthermore, a statistically significant correlation was observed between soluble TM antigen levels and soluble TM cofactor activity. This notwithstanding, soluble TM activity only accounted for a minor part of all variation in soluble TM antigen levels (R2 = 22% in men and R2 = 16% in women).