A polymorphism in the macrophage migration inhibitory factor gene is involved in the genetic predisposition of Crohn's disease and associated with cumulative steroid doses.

BACKGROUND/AIMS: Macrophage migration inhibitory factor (MIF) is an important cytokine involved in the regulation of the innate immune system in IBD. Secreted MIF is able to induce the production of pro-inflammatory cytokines and counteracts anti-inflammatory effects of steroids. We evaluated whether the single nucleotide polymorphism (SNP) G/C at position -173 of the MIF gene contributes to the predisposition to IBD and higher amounts of steroid therapy. METHODOLOGY: We genotyped the SNP G/C at position -173 of the MIF gene in 157 patients with Crohn's disease (CD), 102 patients with ulcerative colitis (UC) and 489 healthy controls. Allele frequencies and cumulative steroid doses were compared. RESULTS: C allele and CC genotype frequencies were significantly decreased in CD patients compared to controls (p < 0.012 and p < 0.022, respectively). No significant differences were found in UC patients compared to controls. Cumulative corticosteroid dose was significantly higher in CD patients with the CC genotype [12300mg/yr (0-40000mg/yr), p < 0.021] compared with the GC genotype [220mg/yr (0-450mg/yr) and the GG genotype (310mg/yr (100-500mg/yr)]. In contrast, there were no significant differences between the genotypes in UC patients. CONCLUSIONS: Our data demonstrate the counterregulatory effects of MIF in CD patients and indicate the important role of the SNP G/C at position -173 of the MIF gene for the anti-inflammatory therapy with glucocorticoids.

Deaf education and bridging social capital: a theoretical approach.

The authors use elements of social capital theory to explore the rapidly changing landscape of deaf education in America. They suggest that the formation of relationships, and networks of relationships, between deaf students and adults has a value that often goes undetected or underappreciated in deaf education. The authors point out that social capital theory, as applied to deaf education, generates a number of potentially productive areas for improving outcomes among deaf students, and for future research in the field. The article includes discussion of a number of positive steps to promote bridging social capital among deaf students.

Cardiomyopathy in Friedreich's ataxia-assessment by cardiac MRI.

Cardiomyopathy is an important and frequently life limiting manifestation of Friedreich's ataxia (FA), the most prevalent form of autosomal recessive ataxia. Left ventricular mass is used as primary outcome measure in recent intervention studies but systematic analyses of FA cardiomyopathy are sparse. To assess cardiac hypertrophy by cardiac magnetic resonance imaging (MRI) in vivo, we assessed 41 adult patients with genetically confirmed FA and 33 age- and sex-matched healthy controls by cardiac MRI and echocardiogarphy. Septal hypertrophy and left ventricular mass index were determined by two independent raters. MRI revealed hypertrophy of the interventricular septum in 40% and increased left ventricular mass index in 29% of patients. Interobserver variability was less than 5% for both measures. GAA repeat length had only minor influence on interventricular septum thickness. Left ventricular mass index decreased with age. Severity of ataxia did not correlate with cardiac disease. In echocardiography wall diameter was assessable only in 31 of 41 FA patients with 32% of patients presenting septal hypertrophy and 6% increased left ventricular mass index. We conclude that cardiac hypertrophy is present only in a minority of adult FA patients. If despite this limitation intervention studies use left ventricular mass as outcome measure, MRI is recommended as the most accurate assessment of cardiac anatomy in vivo.