POS0780 MONOGENIC SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) IN NORTHERN ISRAEL

Background

Systemic Lupus erythematous (SLE) is a heterogenic clinical syndrome with a multifactorial etiology including diverse environmental, immunological and genetic causes and modifiers. Increasingly, utilizing next generation sequencing tooIs, monogenic forms of SLE have been identified.

Objectives

The aim of our study was to identify monogenic causes of SLE in the unique pediatric population of Northern Israel.

Methods

A retrospective and prospective study was carried out between 2010-2021 in a single tertiary pediatric medical center. Genetic testing including Whole exome sequencing (WES) was performed for select patients including family history of SLE, consanguinity and\or clinical findings suggestive of specific disorder.

Results

75 children were diagnosed with SLE. 13/75 had one or more relatives with SLE, including a pedigree with 4 affected members. Mean age at presentation was 10.1±4.7. A monogenic disorder was identified in total of 7/75 of pedigrees. Four patients were diagnosed with Prolidase deficiency, one patient with ADAR1 mutation related to Aicardi–Goutières syndrome and one pedegree with APC5 mutations. Candidate variants in genes related to immune system were identified in one proband and her father requiring further study. Additional WES results are pending

Conclusion

We detected monogenic causes of SLE in a select cohort of patient in Northern Israel. Identification of a genetic basis for disease has direct clinical implication for patients and families and can also enhance our understanding of the pathogenesis and disease mechanisms involved in the more common sporadic forms of SLE.

Disclosure of Interests

ilia spivak: None declared, Tova Hershkovitz1 Grant/research support from: Regeneron Genetics center, Tarrytown, NY, USA, Rinat Zaid Grant/research support from: Regeneron Genetics center, Tarrytown, NY, USA, Karin Weiss Grant/research support from: Regeneron Genetics center, Tarrytown, NY, USA, Yonatan Butbul Aviel: None declared

[PUBLIC CONTROL AS A MEAN OF ENSURING THE REALIZATION OF THE RIGHT TO HEALTH CARE]

The purpose of the article is to reveal the essence and specific features of public control as a mean of ensuring the realization of the right to health care, taking into account the existing scientific points of view and reasoning. The research materials were scientific works of Ukrainian scholars, analytical materials, political and legal opinion-based journalism, Internet resources and Ukrainian legislation regulating the activities of public control (supervision) in the health care sector. Generally scientific (systemic, structural and functional, comparative, etc.) and specially legal methods of scientific cognition (formal and legal, comparative and legal, method of studying legal practice, etc.) were used in the course of the study. The author has provided characteristics of public control in the health care sector and has formulated own definition of such a control. The author has studied the powers of the subjects of public control in the health care sector, where control over the observance of legislation in the activities of a certain authority or health institution is the main one. It has been noted that the activities of subjects, exercising public control, have the organizational nature and do not lead to legally significant consequences, although they contribute to the implementation of legal forms of ensuring relations in the health care sector. It has been emphasized that the subjects, exercising public control, do not have authoritative powers, but contribute to the realization of civil right to participate in the healthcare management.

Relative Human Telomere Length Quantification by Real-Time PCR

Telomere measurement by quantitative PCR amplification is a well-known simple method to detect telomere length that involves large numbers of samples. The method has been developed by Cawthon in 2002 (Cawthon, Nucleic Acids Res 30:47e-47, 2002) and remains the most frequently used technique either in original or modified version. Telomere length is estimated by comparing the amount of telomere repeat amplification product (T) to a single copy gene (S) product. The T/S ratio correlates with the average telomere length. Cawthon suggested and recommended the use of 36B4 (RPLP0) as a single copy gene. However, Cawthon's suggestion was no longer considered a single copy gene and the gene was not suitable and appropriate for normalization.We thereby introduced a simple method for relative measurement of average human telomere length using quantitative real-time PCR. Our protocol was based on Cawthon's initial technique (Cawthon, Nucleic Acids Res 30:47e-47, 2002), modified by single-copy gene (SCG) primers and optimized.This technique is rapid, low cost, not demanding on DNA amount (or live cells), and can be used for a high-throughput screening and time monitoring.

[Detection of papillomavirus DNA in the prostate: a virus with underestimated clinical relevance?]

BACKGROUND

Human papillomaviruses (HPV) are the most frequent pathogens of sexually transmitted diseases. They have been associated with an increased incidence of several anogenital tumors. Whether oncogenic HPV are involved in the pathogenesis of prostate cancer has been a subject of great controversy. This study's purpose was to investigate the association between HPV infection and prostate cancer (PCA).

MATERIAL AND METHODS

The study included 213 consecutive patients with an average age of 65.7 (+/-8.4) years. Within the framework of transrectal, ultrasonic-guided multibiopsy of the prostate, one additional core was examined by means of polymerase chain reaction (PCR) in relation to bacterial, fungal, and viral (including HPV) DNA, with subsequent DNA sequencing. The collected data were correlated with the histological results and with diverse clinical variables. The influence of several predictors for the existence of PCA was verified with a logistic regression model.

RESULTS

No general bacterial DNA (16S rDNA) was detected. Of the 213 patients, 145 (68.1%) showed HPV DNA. In 64% (n=137), high-risk HPV DNA were depicted; these were 18% of the total in each case of HPV genotypes 16 and 18. From our examinations, no significant positive correlation existed between the HPV evidence and the histologically verified PCA that was found in 23.5% of the patients (n=50; odds ratio 1.45; 95% confidence interval 0.71-2.91). The BK virus was not found in any of the cores confirmed through PCR.

CONCLUSION

Although no positive correlation between HPV infection and PCA existed in our study, data from the literature suggest an influence of the papillomavirus on PCA oncogenesis. Future studies should highlight to what extent HPV DNA is inserted in the genome of prostate cells and is able to cause subsequent malignant transformation of particular genes.

Mini-dose of thalidomide for treatment of primary myelofibrosis. Report of a case with complete reversal of bone marrow fibrosis and splenomegaly

We report a patient with very advanced myelofibrosis and huge splenomegaly who showed a complete hematological response to low dose thalidomide with reversal of splenomegaly and bone narrow fibrosis after 30 months of the treatment.

Electrophysiological studies on the effects on single cells of silver electrodes implanted in the visual cortex of cats

We have studied whether the presence of an artificial metal conductor in the visual cortex has an effect on the responsiveness pattern of the cells there. The physiological properties of single cells have been characterized in the mammalian primary visual cortex, following the acute and chronic implantation of silver wire electrodes. The Experimental group was Chronic and Acute operated and implanted adult cats. The Control group consisted of operated, but not implanted, adult cats and intact (Normal) adult cats. A sagittal incision was unilaterally made in the primary visual cortex (area 17) and a silver wire was implanted. Single cells were extracellularly recorded in the pre- and postincision regions following anesthesia and paralysis, 4-8 weeks following the implantation in the Chronic and immediately in the Acute group. The responsiveness, ocular dominance, receptive field properties, orientation, and direction selectively of the cells were examined. The responsiveness level was different in the preincision (afferented) regions of all operated groups. I was consistently affected compared with their deafferented region. The main effect was found on the binocularity of cells in all operated groups. The following are the differences found between the preincision and postincision regions. Our findings show that although a metal wire conductor implanted in the mammalian visual cortex has an effect on the efficiency of the cells there, chemically inert metals may serve in the future as artificial conductors in the brain.

Alteration of p53 protein in C3H/10T1/2 cells morphologically transformed by gamma-rays in stationary phase

The panel of 70 transformed clones was isolated after exposure of C3H/10T1/2 cells in stationary phase to low-moderate doses (1-4 Gy) of 137Cs gamma-rays. Two widely different dose rates were used: high (HDR, 0.66 Gy/min) and low (LDR, 4.8 x 10(-4) Gy/min). Immunohistochemical analyses were performed by cellular staining with three types of monoclonal anti-p53 antibodies, Ab-1 (PAb421), Ab-3 (PAb240) and Ab-4 (PAb246) in order to identify wild-type and altered conformation of the p53 protein in cell nuclei. The gamma-ray exposure led to induction of altered p53 protein in the majority of morphologically transformed clones. For LDR exposure the percentage of clones with changed p53 protein was 79 (11/14), 71 (12/17) and 100 (6/6) for the exposure doses of 2, 3 and 3.6 Gy, respectively. For HDR exposure the percentage of such clones was 60 (3/5), 40 (4/10) and 87 (13/15) for 1, 2 and 3 Gy, respectively. Moreover, in some transformed clones, especially in those induced by higher gamma-ray doses, p53 protein in cell nuclei was not found. It was demonstrated by lack of the staining with Ab-1 antibody which can detect both mutant and wild-type of p53 protein. An altered conformation of p53 protein was detected, using Ab-3 antibody which does not react with its native conformation, in 27% (18/67) of all radiation-induced clones. A native conformation of p53 protein was recognized by Ab-4 antibody in 33% (10/30) of clones induced by HDR, and in 22% (8/37) of clones induced by LDR exposure. Our study shows that alterations of p53 protein in cell nuclei is a frequent feature of morphological transformations induced by ionizing radiation in C3H/10T1/2 cells, and that these alterations occur independently of dose rate.

Rejoining of DNA strand breaks induced by propylene oxide and epichlorohydrin in human diploid fibroblasts

The repair kinetics of DNA single- and double-strand breaks (SSBs, DSBs) induced with two carcinogenic epoxides, propylene oxide (PO) and epichlorohydrin (ECH), was studied in human diploid fibroblasts. The methods used were: alkaline DNA unwinding (ADU), the comet assay, and pulsed field gel electrophoresis (PFGE). About 70% of SSBs, measured by ADU, were rejoined after the treatment with 5 mMh and 10 mMh of PO within 20 hr, and the half-life was estimated to be approximately 15 hr. On the other hand, effective rejoining of SSBs after ECH treatment was observed only at a dose of 1 mMh (a half-life of approximately 15 hr), whereas after 2 mMh treatment, only 26% of SSBs could be rejoined within 20 hr. Furthermore, the use of the comet assay demonstrated that DNA strand breaks were effectively rejoined after PO and ECH treatment at doses of 5-10 mMh and 0.5-1 mMh, respectively. About 76% and 83% of DSBs induced by 5 and 10 mMh of PO, respectively, were rejoined within 4 hr after the treatment (a half-life of approximately 2.5 hr), with little further repair thereafter. At lower dose of ECH (1 mMh) a half-life for DSBs rejoining was estimated to be approximately 2 hr; however, only 29% of DSBs were rejoined within 2 hr at the higher dose of 2 mMh. After 18 hr, the rejoining following treatment with a lower dose was negligible. At a higher dose, a rapid accumulation of DSBs was observed, probably as the result of cell death and DNA degradation. The results demonstrate the capability of human diploid fibroblasts to repair DNA SSBs and DSBs at low-to-moderate doses of the epoxides. A weak capacity to rejoin DNA strand breaks induced by higher doses of ECH may be a consequence of its higher DNA alkylation activity and approximately 10 times higher toxicity compared to PO.

Lymphoma with multi gene rearrangement on the level of immunoglobulin heavy chain, light chains, and T-cell receptor beta chain

A unique case with diffuse mixed malignant lymphoma was investigated for gene rearrangement on the level of T-cell receptor (TCR), heavy chain immunoglobulin (Ig), and both light chains. Cell phenotype was examined with immunofluorescence techniques using antibodies against surface immunoglobulins (SIg) and the kappa and lambda light chains. Monoclonal antibodies were used against CD3, CD4, CD5, CD8, CD10, CD19, CD22, HLA-DR, and TdT. Gene rearrangement analysis for monoclonality determination was carried out with restricted DNA (EcoR I and Hind III) hybridized with one of the following 32P-labelled probes: T-cell receptor (TCR beta), immunoglobulin heavy chain (JH), k light chain, and lambda light chain. Phenotyping of the cell population from the excised lymph node (LN) revealed the presence of 66% B-cells and 35% T-cells. Most of the B cells (94%) expressed mu heavy chain only. Expression of both light chains was negligible (k = 7% and lambda = 2%). Gene rearrangement, which indicates monoclonality, was positive on the level of TCR, Ig heavy chain, and both light chains. The data obtained suggests a neoplastic transforming event in lymphoid stem cells, which preceded the subsequent differentiation process into either B or T lymphoma.

Propylene oxide and epichlorohydrin induce DNA strand breaks in human diploid fibroblasts

The induction of DNA strand breaks in human diploid fibroblasts (VH-10) was demonstrated after in vitro exposure with two carcinogenic epoxides, propylene oxide (PO) and epichlorohydrin (ECH). Alkaline DNA unwinding (ADU), pulsed field gel electropharosis (PFGE), and the comet assay were used to measure DNA single. (SSBs) and double-strand breaks (DSBs). A dose-dependent increase of DNA strand breaks, measured by ADU, was observed in the dose range 2.5-20 mMh of PO and 0.25-2 mMh of ECH. The dose-response of ECH was about five times higher compared with that of PO (211 vs. 41 SSBs. 100 Mbp-1.mMh-1). The induction rates of DSBs, measured by PFGE, were found to be 18 times higher for ECH compared to PO (4.8 and 0.27 DSBs.100 Mbp-1.mMh-1 for ECH and PO, respectively). Using these two methods, the SSBs/ DSBs ratio was estimated to be 148 for PO and 44 for ECH. The data obtained by the comet assay also demonstrated a dose-dependent ability of PO and ECH to induce DNA damage. It was found that ECH was about six times more effective as an inducer of DNA strand breaks compared to PO (200 and 32x100 Mbp-1.mMh-1 for ECH and PO, respectively). The SSBs/DSBs ratios calculated using comet assay and PFGE data were 125 for ECH and 41 for PO. In addition, ECH is about 10 times more toxic than PO with respect to survival. These properties of ECH can at least in part be explained by its higher chemical reactivity connected with a higher rate of DNA alkylation.