Heterogeneity of sensitization profiles and clinical phenotypes among patients with seasonal allergic rhinitis in Southern European countries-The @IT.2020 multicenter study

BACKGROUND

Pollen allergy poses a significant health and economic burden in Europe. Disease patterns are relatively homogeneous within Central and Northern European countries. However, no study broadly assessed the features of seasonal allergic rhinitis (SAR) across different Southern European countries with a standardized approach.

OBJECTIVE

To describe sensitization profiles and clinical phenotypes of pollen allergic patients in nine Southern European cities with a uniform methodological approach.

METHODS

Within the @IT.2020 multicenter observational study, pediatric and adult patients suffering from SAR were recruited in nine urban study centers located in seven countries. Clinical questionnaires, skin prick tests (SPT) and specific IgE (sIgE) tests with a customized multiplex assay (Euroimmun Labordiagnostika, Lübeck, Germany) were performed.

RESULTS

Three hundred forty-eight children (mean age 13.1 years, SD: 2.4 years) and 467 adults (mean age 35.7 years SD: 10.0 years) with a predominantly moderate to severe, persistent phenotype of SAR were recruited. Grass pollen major allergenic molecules (Phl p 1 and/or Phl p 5) ranged among the top three sensitizers in all study centers. Sensitization profiles were very heterogeneous, considering that patients in Rome were highly poly-sensitized (sIgE to 3.8 major allergenic molecules per patient), while mono-sensitization was prominent and heterogeneous in other cities, such as Marseille (sIgE to Cup a 1: n = 55/80, 68.8%) and Messina (sIgE to Par j 2: n = 47/82, 57.3%). Co-sensitization to perennial allergens, as well as allergic comorbidities also broadly varied between study centers.

CONCLUSIONS

In Southern European countries, pollen allergy is heterogeneous in terms of sensitization profiles and clinical manifestations. Despite the complexity, a unique molecular, multiplex, and customized in-vitro IgE test detected relevant sensitization in all study centers. Nevertheless, this geographical diversity in pollen allergic patients imposes localized clinical guidelines and study protocols for clinical trials of SAR in this climatically complex region.

SERUM CARBOXYMETHYL-LYSINE AND SOLUBLE RECEPTOR FOR ADVANCED GLYCATION END PRODUCTS IN HYPERTHYROID AND HYPOTHYROID PATIENTS

Purpose

The formation and accumulation of advanced glycation end products (AGEs) are enhanced with increased oxidative stress and inflammatory conditions. A hyperthyroid and hypothyroid state is associated with oxidative stress. This study aimed to evaluate skin AGE deposition, serum carboxymethyl-lysine (CML), and serum soluble receptor for AGEs (sRAGE) levels in hypothyroid and hyperthyroid patients.

Methods

A total of 203 subjects were included in this cross-sectional study. After excluding diabetes mellitus, 103 newly diagnosed hypothyroid patients, 50 newly diagnosed hyperthyroid patients, and 50 control (euthyroid) subjects were enrolled. All tests were done before beginning the appropriate treatment. Accumulated AGEs in the skin collagen were measured by skin autofluorescence (SAF) using an AGE Reader.

Results

SAF measurements were 1.82 ± 0.04, 1.80 ± 0.40, and 1.63 ± 0.30 arbitrary units for the hypothyroid, hyperthyroid, and euthyroid groups, respectively (p = 0.04). Serum CML levels were 8.2 ± 2.8, 10.2 ± 2.0, and 8.0 ± 3.3 ng/mL for the hypothyroid, hyperthyroid, and euthyroid groups, respectively (p = 0.01). sRAGE levels were similar between the groups. Serum thyroid-stimulating hormone and SAF measurements were positively correlated (r = 0.25, p = 0.02) in the hypothyroid group and negatively correlated in the hyperthyroid group (r = -0.36, p = 0.04). There was no correlation between CML and sRAGE levels.

Conclusion

SAF measurements are increased in both hypo- and hyperthyroid normoglycemic patients. Serum CML levels are increased in hyperthyroid patients. Hypo and hyperthyroid states might be associated with acceleration of AGE accumulation and may have a long term effect on metabolic memory.

Weak hybridization and isolated localized magnetic moments in the compounds CeT₂Cd₂₀ (T = Ni, Pd)

We report the physical properties of single crystals of the compounds CeT2Cd20 (T = Ni, Pd) that were grown in a molten Cd flux. Large separations of  ∼6.7-6.8 Å between Ce ions favor the localized magnetic moments that are observed in measurements of the magnetization. The strength of the Ruderman-Kittel-Kasuya-Yosida magnetic exchange interaction between the localized moments is severely limited by the large Ce-Ce separations and by weak hybridization between localized Ce 4 f and itinerant electron states. Measurements of electrical resistivity performed down to 0.138 K were unable to observe evidence for the emergence of magnetic order; however, magnetically-ordered ground states with very low transition temperatures are still expected in these compounds despite the isolated nature of the localized magnetic moments. Such a fragile magnetic order could be highly susceptible to tuning via applied pressure, but evidence for the emergence of magnetic order has not been observed so far in our measurements up to 2.5 GPa.

Enhancement of superconductivity near the pressure-induced semiconductor-metal transition in the BiS₂-based superconductors LnO₀.₅F₀.₅BiS₂ (Ln = La, Ce, Pr, Nd)

Measurements of electrical resistivity were performed between 3 and 300 K at various pressures up to 2.8 GPa on the BiS2-based superconductors LnO0.5F0.5BiS2 (Ln=Pr, Nd). At lower pressures, PrO0.5F0.5BiS2 and NdO0.5F0.5BiS2 exhibit superconductivity with critical temperatures Tc of 3.5 and 3.9 K, respectively. As pressure is increased, both compounds undergo a transition at a pressure Pt from a low Tc superconducting phase to a high Tc superconducting phase in which Tc reaches maximum values of 7.6 and 6.4 K for PrO0.5F0.5BiS2 and NdO0.5F0.5BiS2, respectively. The pressure-induced transition is characterized by a rapid increase in Tc within a small range in pressure of ∼0.3 GPa for both compounds. In the normal state of PrO0.5F0.5BiS2, the transition pressure Pt correlates with the pressure where the suppression of semiconducting behaviour saturates. In the normal state of NdO0.5F0.5BiS2, Pt is coincident with a semiconductor-metal transition. This behaviour is similar to the results recently reported for the LnO0.5F0.5BiS2 (Ln=La, Ce) compounds. We observe that Pt and the size of the jump in Tc between the two superconducting phases both scale with the lanthanide element in LnO0.5F0.5BiS2 (Ln=La, Ce, Pr, Nd).

Vitamin D receptor gene ApaI, TaqI, FokI and BsmI polymorphisms in a group of Turkish patients with Hashimoto's thyroiditis

AIM

Previous studies have suggested an influence of vitamin D receptor polymorphisms on the development of autoimmune thyroid disease in different ethnic populations. We aimed to investigate the distribution of vitamin D receptor (VDR) alleles in a group of Turkish patients with Hashimoto's thyroiditis (HT).

METHODS

One hundred and eleven patients (male/female: 5/106, 47.9±12.8 years) and 159 healthy controls (male/female: 21/138, 30.5±6.3 yrs) were included in the study. VDR gene FokI, BsmI, ApaI TaqI polymorphisms were examined using a polymerase chain reaction (PCR) -based restriction analysis. Serum levels of (thyroid-stimulating hormone) TSH, anti-thyroid peroxidase and anti-thyroglobulin levels were determined.

RESULTS

The VDR TaqI "TT" (59.5% in patients vs. 27.6% in controls; 95% confidence interval [CI]: 0.14-0.46) and FokI 'FF' genotypes (67.6% in patients vs. 44.6% in controls; 95% CI: 0.46-0.81) occurred more frequently in patients, while VDR "Tt" (56.6% in patients vs. 32.4% in controls 95% CI: 1.22-2.14) and "Ff" genotypes (25.2% in patients vs. 49.1% in controls 95% CI: 1.27-2.18) were more common in controls. There were no differences in the genotype frequencies of the ApaI and BsmI polymorphisms in cases and controls. The most common genotypes were "bbAaTTFF" in the thyroiditis group (12.6% patients vs. 5.6% in controls, P>0.05) and "BbAaTtFf" in the control group (6.3% patients vs. 22.2% in controls, P=0.002).

CONCLUSION

VDR gene TaqI TT and FokI FF genotypes are associated with increased risk of HT disease in our group of Turkish patients. BbAaTtFf genotype seems to be protective for HT disease in our population.

Effect of oxidative stress on aorta and tibia osteoprotegerin gene expression in ovariectomized rats

AIM

Atherosclerosis and osteoporosis share some common pathophysiological pathways. Increase in oxidative stress and activation of cytokines that increase osteoclastogenesis were reported in postmenopausal period. The aim of this study was to determine the link between these two states.

METHODS

A total of 32 female adult Wistar albino rats were included in the study. Rats in control group were sham operated, vehicle group were ovariectomized and given 17.5%hydroxypropyl-β-cyclodextrin. Rats in group III and IV were ovariectomized and given 17β-estradiol or raloxifene for 12 weeks, respectively. Aorta and tibia bone samples were collected. Tissue oxidative stress was determined via measurement of malondialdehyde levels and osteoprotegerin gene expression with RT-PCR.

RESULTS

Ovariectomy increased MDA levels both in bone and aorta compared to sham operated rats. Use of 17β-estradiol or raloxifene did not create a significant difference compared to ovariectomized rats. Ovariectomy caused a significant decrease in OPG gene expression in the tibia and aorta compared to sham operated rats. Although 17β-estradiol and raloxifene preserved gene expression in aorta they did not have any effect on bone tissue. OPG mRNA expression was negatively correlated with tissue MDA levels only in ovariectomized rats.

CONCLUSION

This study confirms the increase in ovariectomy-induced oxidative stress and association of it to bone and vascular tissue OPG mRNA expression.

Impact of body mass index on cancer development

PURPOSE

To determine the impact of body mass index (BMI) on cancer in a hospital-based Turkish population.

PATIENTS AND METHODS

The study group consisted of 2015 (1172 females: 423 pre- and 749 postmenopausal; and 843 males) patients with histologically proven cancer who applied to Marmara University Medical School, Medical Oncology Clinic. The control group included 305 healthy caregivers (192 females: 110 pre- and 82 postmenopausal; and 113 males).

RESULTS

Mean BMI of the patients with breast, ovarian and cervical carcinoma was significantly higher than that of the healthy female controls (p<0.001, 0.003, <0.001, respectively). Postmenopausal breast cancer patients had significantly higher BMI than postmenopausal female controls (odds ratio [OR] 1.3; 95% confidence interval [CI], 1.06-1.6; p=0.012), while this was not seen in premenopausal patients. When compared with controls obese postmenopausal female patients had 3.26-fold (95% CI 1.54-6.90) increased risk for breast cancer (p=0.002). Mean BMI of lung, stomach, esophagus, pancreas and head and neck carcinoma patients was significantly lower than that of the healthy controls. Female patients with lung and colorectal carcinoma had higher BMI than female controls.

CONCLUSION

Elevated BMI might be a risk factor for breast cancer in postmenopausal women. Case-control studies may not show the actual association between BMI and cancers that present with pre-diagnosis weight loss and advanced stage.

Temporal effects of low-dose ACE inhibition on endothelial function in Type 1 diabetic patients

AIM

Increased asymmetrical dimethylarginine (ADMA) is known to disturb endothelial function. ACE inhibitors decrease plasma ADMA levels in diseases associated with endothelial dysfunction. The effects of ACE inhibition on endothelial function and plasma ADMA levels in Type 1 diabetic patients was evaluated in the study.

METHODS

Thirty Type 1 diabetic patients [29+/-6 yr; females (F)/males (M): 18/12] and 29 controls (30+/-6 yr; F/M: 16/13) were recruited. Flow-mediated dilatation (FMD), plasma ADMAand thiobarbituric acid reactive substances (TBARs) were determined at baseline, on day 15 and 90 of 0.5 mg qd trandolapril therapy.

RESULTS

Compared to controls, baseline FMD levels were lower (4.7+/-2.0% vs 11.2+/-3.9%) (p<0.001), plasma ADMA (271.1+/-48.1 nmol/l vs 237.5+/-25.1 nmol/l) (p<0.05) and TBARs levels [4517.1+/-2366.9 nmol/malondialdehyde (MDA) vs 1775.9+/-598.7 nmol/MDA] (p<0.001) were higher in diabetic patients. On day 90 of trandolapril treatment, FMD (8.6+/-4.1%) (p<0.01) increased, ADMA levels (229.6+/-42.9 nmol/l) (p<0.001) decreased and TBARs levels (1531.8+/-1036.0 nmol/MDA) (p<0.001) decreased significantly. FMD was negatively correlated with plasma ADMA (r=-0.228, p<0.01), and TBARs levels (r=-0.244, p=0.02), whereas ADMA and TBARs levels were correlated positively (r=0.399, p<0.0001).

CONCLUSIONS

In conclusion, endothelial dysfunction is associated with elevated plasma ADMA levels in Type 1 diabetic patients. Low-dose ACE inhibition improves endothelial dysfunction and reduces ADMA levels. The antioxidant action of ACE inhibitors may play role in this process.