[Polymorphisms of the Toll-like receptor 4 gene and their potential role in infectious diseases and chronic inflammatory disorders]

[Study of the Toll-like receptor 4 gene polymorphisms in diseases presenting with subclinical and chronic inflammation]

Toll-like receptor 4, a central mediator of the innate immune response has been shown to play an important role not only in the defense mechanism against microorganism, but also other non-infectious inflammatory diseases such as atherosclerosis. The Asp299Gly and Thr399Ile, which are common co-segregation polymorphisms of the Toll-like receptor 4 gene have been shown to be associated with increased susceptibility for Gram-negative infections, but with a lower risk of carotid atherosclerosis and a reduced level of certain proinflammatory cytokines.

AIM

The role of these polymorphisms in diabetes mellitus with its late microvascular complications, in ischemic stroke, and in chronic periodontitis was investigated in three independent studies.

METHODS

In all studies the alleles of both polymorphisms were detected by polymerase chain reaction and subsequent cleavage by restriction endonucleases followed by gel electrophoresis.

RESULTS

In patients with type 2 diabetes, heterozygote carriers of the Asp299Gly and Thr399Ile polymorphisms of the Toll-like receptor 4 gene had a significantly reduced prevalence of peripheral neuropathy, while there was no association with any other diabetic microvascular complication, or with cerebral ischemia or with chronic periodontitis.

CONCLUSIONS

Toll-like receptor 4 gene polymorphisms are not enough sensitive genetic markers for risk stratification either in diabetes mellitus or in cerebral ischemia or in chronic periodontitis.

[The role of Orvosi Hetilap in the development of contemporary Hungarian gastroenterology. Part 4: 1989-2008]

The editions of Orvosi Hetilap published between 1948 and 1989 easily exceeded the number of publications in the previous period. Most of the knowledge was transferred from English literature.

AIM

Evaluate the papers dealing with diseases of the gastrointestinal tract published in Orvosi Hetilap between 1989 and 2008.

METHOD

The author manually reviewed the journal volumes published between 1989 and 1208. The original articles, journal and book reviews were identified and classified according to their subject and origin. The publication rates of the editorial periods 1948-1989 and 1989-2008 were statistically compared.

RESULTS

Between 1989 and 2008 a total of 2817 publications appeared on the diseases of the gastrointestinal tract (1067 original articles, 1698 journal and 52 book reviews), constituting 10.1% of all publications. The annual rate of the original articles in the periods studied was similar (p = 0.82), while that of journal and book reviews decreased significantly (p = 0.006 and p = 0.01, respectively). The online version of Orvosi Hetilap and the English version of the journal, entitled Hungarian Medical Journal , became available from 2007. Liver (17.8%) and biliary tract diseases were studied the most (4.3%), especially viral hepatitis (7%). Laparoscopic surgery was studied in 27 articles (1.8%), while liver transplantation achieved a figure of 39 (2.6%). The genetics of gastrointestinal diseases were studied in 61 (4.0%) articles. 1,698 articles were reviewed from 131 journals, which constitutes a significant decrease as compared to the previous period. 65.4% of the reviews were published in 15 core journals. 62.4% of the journals were English, 31.5% were German and only 1.6% French, thus te previous dominance of the English literature was enhanced. The number of book reviews decreased from 211 to 52 (p = 0.01). The Hungarian experience in laparoscopic surgery was published in part in Orvosi Hetilap . The journal was the main forum for the articles on liver transplantation. After 2000, university research groups published their studies on the genetics of liver, inflammatory bowel diseases and other topics mainly in Orvosi Hetilap .

CONCLUSION

In the past two decades, Orvosi Hetilap successfully fulfilled its traditional role in providing professional information of Hungarian specialists and played a leading role in the adoption of new findings in the contemporary gastroenterology (laparoscopic surgery, liver transplantation, genetics).