AB0021 VARIABILITY OF THE RS333 IN LUPUS ERYTHEMATOSUS PATIENTS FROM THE POLISH POPULATION

Background:

There are several subtypes ofLupus Erythematosus(LE), which may be limited to the skin (eg.Discoid Lupus Erythematosus, DLE) or involve multiple organ dysfunctions (Systemic Lupus Erythematosus, SLE). LE is an autoimmune disease that is influenced by genetic and environmental factors. Despite some genetic changes between DLE and SLE were previously shown, the complete genetic background of DLE is still unresolved [1]. Functional C-C chemokine receptor 5 (CCR5) receptor can be associated with the inflammation in LE patients. Importantly, the 32 base pairs (bp) deletion inCCR5gene (rs333) leads to a nonfunctional receptor. Previous studies have shown that this mutation may have a protective effect on the development and progression of SLE [2, 3]. Thus it was important to investigate whether 32 bp deletion in rs333 is also associated with DLE development.

Objectives:

The aim of this study was to investigate the variability of theCCR5gene, within a polymorphiclocusrs333 in SLE and DLE patients from the Polish population.

Methods:

120 LE patients (77 SLE patients and 43 DLE patients) and 100 healthy persons were recruited to the study from the Polish population. DNA was isolated from blood or buccal swabs. rs333 was genotyped by using polymerase chain reaction (PCR). Statistical significance of the differences between patient and control groups in both allele and genotype frequencies were calculated using Chi-Squared test with Yates correction or two tailed Fisher’s exact test.

Results:

Deletion allele of the rs333 was significantly less frequent among DLE patients than healthy persons (p = 0.0171). Also the heterozygotes occur significantly less frequent within DLE patients group than in healthy individuals (p = 0.0375). Moreover, homozygotes without deletion in rs333 were found significantly more frequent in persons diagnosed with DLE than in healthy volunteers (p = 0.0214). In contrast, the differences in allele or genotype frequencies between SLE patients and healthy controls were not statistically significant (p > 0.05). Moreover, the rs333 variability was not associated with clinical symptoms of LE patients (p > 0.05).

Conclusion:

Summarizing, the results obtained in this study suggest that the 32 bp deletion within rs333 could be a protective factor, that reduce the risk for DLE but not SLE development in the Polish population. However, due to the low statistical power of the obtained results, further studies on larger groups of patients and controls are needed to acquire more reliable data.

References:

[1]Skonieczna K, Czajkowski R, Kaszewski S, Gawrych M, Jakubowska A, Grzybowski T. (2017) Genetic similarities and differences between discoid and systemic lupus erythematosus patients within the Polish population. Postepy Dermatol Alergol. 34: 228-232.

[2]Schauren JS, Marasca JA, Velt TD, Monticielo OA, Xavier RM, Brenol JCT et al (2013) CCR5 delta32 in systemic lupus erythematosus: implications for disease susceptibility and outcome in a Brazilian population. Lupus 22:802–809.

[3]Martens, H.A., Kallenberg, C.G. & Bijl, M. (2009) Role of CCR5 Delta32 bp deletion in RA and SLE. Autoimmunity, 42, 260.

Acknowledgments:

KS was supported by the “Excellence Initiative - Research University” programme as a member of the team “Bioinformatics in medical & population genomics”.

Disclosure of Interests:

Katarzyna Skonieczna Grant/research support from: KS was supported by the “Excellence Initiative - Research University” programme as a member of the team “Bioinformatics in medical & population genomics”., Dominika Mlicka: None declared, Anna Woźniacka: None declared, Rafał Czajkowski: None declared, Ewa Robak: None declared, Mariusz Gawrych: None declared, Anna Duleba: None declared, Tomasz Grzybowski: None declared

Relationship between 17-hydroxyprogesterone responses to human chorionic gonadotropin and markers of ovarian follicle morphology in women with polycystic ovary syndrome

CONTEXT

Women with polycystic ovary syndrome (PCOS) have increased 17-hydroxyprogesterone (17-OHP) responses to gonadotropin stimulation although individual variability is substantial, as reflected by exaggerated as well as normal responses. The relationship between 17-OHP responses to gonadotropin stimulation and markers of ovarian function has not been assessed.

OBJECTIVE

To determine whether 17-OHP responses are associated with antral follicle count (AFC), anti-Mullerian hormone (AMH), or inhibin B (Inh B) levels in PCOS and normal women.

DESIGN

Prospective study.

SETTING

Research center at an academic medical center.

PARTICIPANTS

Women with PCOS (n = 18) and normal controls (n = 18).

INTERVENTIONS

Blood samples were obtained before and 24 hours after administration of 25 μg recombinant-human chorionic gonadotropin. Ovarian imaging was conducted with three-dimensional pelvic ultrasound.

MAIN OUTCOME MEASURES

Basal and stimulated levels of 17-OHP, androgens, estrogen, AMH, Inh B, and AFC.

RESULTS

In women with PCOS, 17-OHP responses were heterogeneous and inversely correlated with AMH and Inh B levels, but not AFC. In a subgroup of PCOS women with exaggerated 17-OHP responses, AMH levels were equivalent to that of normal women. In PCOS women with normal 17-OHP responses, AMH levels were markedly elevated.

CONCLUSION

Based on heterogeneous 17-OHP responses to human chorionic gonadotropin in women with PCOS, AMH levels are inversely linked to ovarian androgen production while positively correlated with AFC. These findings suggest that in PCOS, AMH production may reflect redistribution of the follicle population or regulation by intraovarian mechanisms.

[The application of mitochondrial genomics to forensic investigations based on human mitochondrial DNA testing]

In this study we present two forensic cases where mitochondrial DNA HVS I and HVS II haplotypes of evidentiary hairs match reference samples. Based on the information retrieved from mtDNA coding region of reference material, we selected single nucleotide polymorphisms (SNPs) located outside the HVS I and HVS II regions that could increase the informativeness of mtDNA analysis. The SNPs were typed via SNaPshot or dideoxy sequencing technology. In both cases the SNP results allowed for unambiguous exlusion of the evidence and for determining that reference samples originated from the same person.

Evidence-based medicine: evaluating diagnostic tests

Physicians have at their disposal a great number of established diagnostic tests, and new ones continue to be developed that are potentially helpful in diagnosing and establishing the prognosis of disease. Many of these tests were either inadequately evaluated or were found, on more careful scrutiny, to be less helpful than first believed. To ensure optimal patient care as well as appropriate use of health care resources, practitioners must be adept in understanding the true efficacy of diagnostic tests that they ask patients to undergo. They must be able to understand the basic language applied in evaluating tests and be able to determine if and when tests are applicable. (J Am Assoc Gynecol Laparosc 6(1):105-112, 1999)

NMR studies of muscle glycogen synthesis in insulin-resistant offspring of parents with non-insulin-dependent diabetes mellitus immediately after glycogen-depleting exercise

To examine the impact of insulin resistance on the insulin-dependent and insulin-independent portions of muscle glycogen synthesis during recovery from exercise, we studied eight young, lean, normoglycemic insulin-resistant (IR) offspring of individuals with non-insulin-dependent diabetes mellitus and eight age-weight matched control (CON) subjects after plantar flexion exercise that lowered muscle glycogen to approximately 25% of resting concentration. After approximately 20 min of exercise, intramuscular glucose 6-phosphate and glycogen were simultaneously monitored with 31P and 13C NMR spectroscopies. The postexercise rate of glycogen resynthesis was nonlinear. Glycogen synthesis rates during the initial insulin independent portion (0-1 hr of recovery) were similar in the two groups (IR, 15.5 +/- 1.3 mM/hr and CON, 15.8 +/- 1.7 mM/hr); however, over the next 4 hr, insulin-dependent glycogen synthesis was significantly reduced in the IR group [IR, 0.1 +/- 0.5 mM/hr and CON, 2.9 +/- 0.2 mM/hr; (P < or = 0.001)]. After exercise there was an initial rise in glucose 6-phosphate concentrations that returned to baseline after the first hour of recovery in both groups. In summary, we found that following muscle glycogen-depleting exercise, IR offspring of parents with non-insulin-dependent diabetes mellitus had (i) normal rates of muscle glycogen synthesis during the insulin-independent phase of recovery from exercise and (ii) severely diminished rates of muscle glycogen synthesis during the subsequent recovery period (2-5 hr), which has previously been shown to be insulin-dependent in normal CON subjects. These data provide evidence that exercise and insulin stimulate muscle glycogen synthesis in humans by different mechanisms and that in the IR subjects the early response to stimulation by exercise is normal.

The effect of endometriosis on implantation: results from the Yale University in vitro fertilization and embryo transfer program

OBJECTIVE

To investigate the effect of endometriosis on implantation.

DESIGN

Case-control study from Yale University IVF-ET program.

PATIENTS

Two hundred eighty-four consecutive IVF cycles were analyzed retrospectively. Patients with endometriosis only (n = 35; 89 cycles) were compared with an age-matched control group with tubal infertility (n = 70; 147 cycles) and also to a group with unexplained infertility (n = 15; 48 cycles). Data from the endometriosis group was analyzed further in subgroups of minimal-mild (43 cycles) and moderate-severe (46 cycles).

RESULTS

No difference was found in the number and the quality of oocytes retrieved and fertilization rates between the endometriosis, the tubal infertility, and the unexplained infertility groups. The quality and the number of embryos transferred in each group were comparable. A trend toward reduced pregnancy rate per transfer (14.8%) in the endometriosis versus tubal or unexplained infertility groups (25.7% and 23.3%, respectively) was observed. Implantation rate (gestational sac per transferred embryo) was significantly lower in the endometriosis versus the tubal infertility group (3.9% versus 8.1%; unexplained infertility group, 7.2%). Analysis of first cycles only across all groups revealed that the implantation rate also was significantly lower in the endometriosis versus the tubal infertility group (3.1% versus 9%; unexplained infertility group, 6.7%). Within the endometriosis group, although the pregnancy rate per cycle and per transfer were similar in subgroups, patients with minimal-mild endometriosis had the lowest implantation rate.

CONCLUSION

We conclude that, in patients with endometriosis, implantation rate is low. Abnormal implantation, which may be secondary to endometrial dysfunction or embryotoxic environment, is a factor in endometriosis-associated subfertility.

Metabolism of testosterone by human granulosa cells in culture: influence of follicle-stimulating hormone and luteinizing hormone

Human granulosa cells were isolated from follicles (8 to 15 mm) and cultivated for 24 hours in the presence or absence of follicle-stimulating hormone (NIH-FSH-HS-1, 1 microgram/ml) and luteinizing hormone (NIAMDD-hLH-1, 1 microgram/ml). Testosterone -4-14C was added subsequently to all cultures for 4-, 6-, and 24-hour periods. Of the seven metabolites of testosterone studied, 17 beta-estradiol (E2) and estrone (E1) were the major products. In all patients, levels of E2 were three to ten times higher than those of E1. Production of E2, but not E1, was stimulated by either follicle-stimulating hormone (FSH) or luteinizing hormone (LH). The cells of the largest follicle (15 mm) showed greater response to LH than to FSH. Production of the other C19 and C18 metabolites was very low or negligible. These results further suggest that FSH regulates the aromatization of testosterone in human granulosa cells, and that LH may have the same effect on the matured follicle during the preovulatory period.