In Vitro Digestion of Polyphenolic Compounds and the Antioxidant Activity of Acorn Flour and Pasta Enriched with Acorn Flour.

Acorn flour is a rich source of nutrients and is beneficial to human health due to, among other things, its low glycemic index and polyphenol content. In order to obtain more accurate data on the levels and activities of the substances tested after ingestion and digestion, it may be beneficial to use a simulated in vitro digestion method. Therefore, the objective of the present study was to elucidate the content of polyphenols, individual phenolic acids, flavonoids and antiradical properties of acorn flour and pasta enriched with acorn flour before and after simulated in vitro gastrointestinal digestion. The results indicate that the total polyphenol content (TPC), flavonoid content and radical scavenging activity exhibited an increasing trend following the initial digestion stage and a decreasing trend following the second stage. Nevertheless, the levels of phenolic acids demonstrated an increase in both digestion phases. The digestion processes of polyphenols in acorn flour differ significantly from those in pasta. In the case of pasta, total polyphenols, phenolic acids and flavonoids, as well as free radical scavenging properties, demonstrated a decreasing trend following each digestion stage.

The Effect of In Vitro Digestion on Polyphenolic Compounds and Antioxidant Properties of Sorghum (Sorghum bicolor (L.) Moench) and Sorghum-Enriched Pasta.

The phenol content of sorghum is a unique feature among all cereal grains; hence this fact merits the special attention of scientists. It should be remembered that before polyphenols can be used in the body, they are modified within the digestive tract. In order to obtain more accurate data on the level and activity of tested ingredients after ingestion and digestion in the in vivo digestive tract, in vitro simulated digestion may be used. Thus, the aim of this study was to determine the content of polyphenols, flavonoids, and individual phenolic acids, as well as the antiradical properties, of sorghum and sorghum-enriched pasta before and after in vitro simulated gastrointestinal digestion. We observed that the total content of polyphenols decreased after gastric digestion of sorghum, and slightly increased after duodenal digestion. Moreover, the flavonoid content decreased after the first stage of digestion, while antioxidant properties increased after the first stage of digestion and slightly decreased after the second stage. The digestion of polyphenolics in sorghum is completely different to that in pasta-both in varieties with, and without, the addition of sorghum. For pasta, the content of total polyphenols and flavonoids, and free radical scavenging properties, decrease after each stage of digestion.

The Effect of Fresh Kale (Brassica oleracea var. sabellica) Addition and Processing Conditions on Selected Biological, Physical, and Chemical Properties of Extruded Snack Pellets.

The purpose of this study was to determine the effect of the addition of fresh kale and processing conditions on extruded pellet antioxidant activity and selected physicochemical properties. The results of the applied DPPH, FRAP, and TPC methods indicated that, for both 60 and 100 rpm screw speeds, snack pellet antioxidant activity and phenolic content were strongly linked to the fresh kale content, and these properties increased with the addition of this plant. The amount of fresh kale and the applied processing variables (extruder screw speed and the moisture content of the raw material blends) were also found to significantly affect the water absorption index, water solubility index, fat absorption index, fatty acid profile, and basic chemical composition of the obtained extrudates. The sample with the highest phenolic content (72.8 µg GAE/g d.w.), the most advantageous chemical composition (protein, ash, fat, carbohydrates, and fiber content), and high antioxidant properties was produced at a fresh kale content of 30%, a 36% moisture content, and a 100 rpm screw speed. The following phenolic acids were identified in this sample: protocatechuic, 4-OH-benzoic, vanillic, syringic, salicylic, caffeic, coumaric, ferulic, and sinapic. Sinapic acid was the prevailing phenolic acid.

Body mass index, functional fitness and nutritional behaviours of senior women from the Kraków population.

Background: Body Mass Index (BMI) is dependent on, among others, diet and level of physical activity. Seniors are more prone to nutritional disorders than other population groups. Objective: The aim of the study was to analyse the relationship between BMI and nutritional behaviours as well as the functional fitness level of senior women. Materials and methods: The research was carried out among a group of 120 women aged 60-84, using the TANITA SC-330ST body composition analyser, the HOLTAIN anthropometer, the Fullerton Functional Fitness Test and the authordesigned nutritional behaviour questionnaire for seniors. Statistical analyses were conducted using the IBM SPSS 21 statistical package, applying the Kruskal-Wallis ANOVA tests with comparisons of z tests at the significance level p<0.05. Results: In terms of the relationship between BMI and functional fitness indices, it was shown that women with normal weight obtained higher results for the lower body (p=0.043) and upper body agility tests than obese women (p<0.001). Females with normal BMI also obtained higher results in the endurance test than the overweight women (p=0.038). In terms of the correlation between BMI and nutritional behaviours, it was demonstrated that women with a healthy body mass more often ate varied, low-volume meals than those overweight (p=0.026). Women with correct weight ate fish, eggs and lean meat more often than obese women (p=0.036). Obese women consumed 3-5 portions of fruit and vegetables less frequently during the day than women with normal body mass (p=0.029) and those overweight (p=0.015). Obese women were less likely to eat sea fish at least 1-2 times a week than overweight females (p=0.040) and those with normal BMI (p<0.001). At the same time, women with a normal BMI indicated a higher degree of performed daily physical activity than the overweight women (p=0.028) and those with obesity (p=0.030). Conclusions: Women with normal BMI presented more rational nutrition habits and higher functional fitness than overweight and obese senior women.

Effects of Wet and Dry Micronization on the GC-MS Identification of the Phenolic Compounds and Antioxidant Properties of Freeze-Dried Spinach Leaves and Stems.

Micronization is an emerging technology used in food production, in which the size of particles is reduced to microns in the processing of plant raw materials and by-products, thus making it an interesting research topic. Spinach stems are by-products of spinach leaf processing, but there is little information regarding their processing and possible reuse. In this study, wet and dry ball mill micronization, in combination with freeze drying, was used to process spinach stems and leaves to obtain functional powders. The color and particle size of the micronized spinach leaf and stem powders were evaluated. The antioxidant activity (AA) of the powders and phenolic compounds present in them were determined using GC-MS analysis. The results obtained showed that the dry micronization of leaves and stems resulted in smoother and brighter powders than wet micronization. Significantly smaller particle sizes were achieved using the dry micronization of the leaves and stems (Dv50 = 19.5 and 10.1 µm, respectively) rather than wet micronization (Dv50 = 84.6 and 112.5 µm, respectively). More phenolic compounds, such as o-coumaric acid and gallic acid, were extracted from the dry-micronized powders. The dry micronization of the stems significantly increased the total phenolic content, and the AA of these powders was also increased. These findings demonstrate that spinach leaves and stems subjected to dry micronization can be valuable functional components of food.

The Impact of Formulation on the Content of Phenolic Compounds in Snacks Enriched with Dracocephalum moldavica L. Seeds: Introduction to Receiving a New Functional Food Product.

A new type of multigrain snack has been designed containing varied additions of Moldavian dragonhead (Dracocephalum moldavica L.) seeds. The antioxidant properties and the general health benefits of this plant material have already been widely acknowledged. The research discussed herein aimed to investigate the influence of the formulation and expansion method (frying) on the content of polyphenolic compounds, individual phenolic acids, and antiradical properties of innovative snacks enriched with dragonhead seeds. The highest content of polyphenols (0.685 mg GAE/mL), free phenolic acids (47.052 µg/g of dry matter), and highest radical scavenging activity (96.23% towards DPPH) were found in the fried snacks enriched with 22% of seeds. In these samples, 11 phenolic acids were detected. Strong positive correlations were seen between the addition of dragonhead and the polyphenol content (r = 0.989) and between the quantity of the enriching additive and the content of free phenolic acids (r = 0.953). The research has shown that such innovative snacks have the potential to supply health-benefiting free phenolic acids, e.g., salicylic, isoferulic, ferulic, p-coumaric, vanillic. Our studies provide an introduction to the development of a new range of functional foods.

Opuntia Fruits as Food Enriching Ingredient, the First Step towards New Functional Food Products.

Prickly pear (Opuntia ficus indica (L.) Mill.) is a rich source of vitamins C, B1, B2, A, and E, minerals such as calcium, potassium, magnesium, iron, and phosphorus, as well as bioactive substances, i.e., carotenoids, betalains, and phenolic compounds. Of these, the phenolic acids, betalains, and flavonoids are notable in that they are largely responsible for the health-promoting properties of this plant. The purpose of the presented research was to first determine the antioxidant properties and the content of polyphenolic compounds (including individual phenolic acids) in prickly pear fruit, then to produce an innovative gluten-free pasta from rice-field bean flour enriched with various amounts of pear prickly fruit. The content of free phenolic acids, the sum of polyphenols and antioxidant properties of pasta were subsequently determined in the supplemented pasta. Chromatographic analysis (HPLC-ESI-MS/MS) showed a wide variety of phenolic acids. In the fruit sample, 14 acids were detected, whereas in the pasta sample without additives, 9. The dominant acid was isoferulic. The total content of free phenolic acids and the sum of polyphenols increased with increasing content of the functional additive. Moreover, the content of individual acids generally increased as the Opuntia fruit was added. The antioxidant activity was also positively correlated with the addition of fruit, with the content of free phenolic acids and the sum of polyphenols. Our research has shown that our innovative pasta with the addition of prickly fruit can become a source of the free phenolic acids indispensable for human health.

Polyphenol Composition and Antioxidant Potential of Instant Gruels Enriched with Lycium barbarum L. Fruit.

Goji fruit (Lycium barbarum L.) has been identified as a polyphenolic compound plant source of noted richness. It also contains polysaccharides, carotenoids, vitamins and minerals, fatty and organic acids. The purpose of the presented research was to produce innovative instant corn gruels with various dry goji berry contents (1, 3 and 5%), to determine the level of included polyphenolic compounds (including individual free phenolic acids) and to assess the antioxidant properties of these functional-food products. A further objective was to identify the optimum value of one of the most important production parameter, the rotational speed of the extruder's screw during gruel processing. The undertaken chromatographic analysis (LC-ESI-MS/MS) showed a wide variety of available phenolic acids. In the samples with 5% addition of fruit, eight phenolic acids were detected, whereas in the corn gruel without additives, only five were noted. The antioxidant activity, the content of free phenolic acids and the sum of polyphenols increased with increase of the functional additive. For all goji content, screw speeds of 100 and 120 rpm rather than 80 rpm resulted in higher polyphenol amounts and greater Trolox equivalent antioxidant capacity, as well as higher ability to scavenge DPPH.

Frequency of consuming selected product groups among Polish and Spanish physical education students.

BACKGROUND: Nutritional behaviours are determined by numerous individual and environmental factors. OBJECTIVE: The aim of the study was to analyse the frequency of consuming selected food product groups (with potentially beneficial and potentially detrimental effects on health) among physical education students depending on gender and home country. MATERIALS AND METHODS: The study was conducted among 219 Polish and 280 Spanish physical education students, using a standardised questionnaire for obtaining information on views and eating habits for people aged 16-65 (Kom-PAN). In the statistical analysis, the Mann-Whitney U test and t-test with independent estimation of variance were incorporated,the significance level at α = 0.05. RESULTS: Among Polish and Spanish students, significant differences in the frequency of consuming certain product groups depending on home country were noted, with Polish students significantly more frequently consuming recommended products (fruit, vegetables, whole-grains, milk, fromage frais, and poultry), but also those non-recommended (purified cereals, cheeses with high fat content, butter, fried foods, sweets and alcoholic beverages). Spanish students significantly more often consumed recommended meals including legume seeds and sea fish, but also non-recommended products (red meat, fast food, sweets and energy drinks). Moreover, significant differences in the frequency of consuming selected product groups depending on sex were observed, with an indication of the tendency for less rational food choices among male students than female students, especially regarding the consumption of: high-milled cereal products, processed and red meat, fatty cheeses, fried foods, lard, sweets and energy drinks. On the other hand, women consumed sweets significantly more often than men, and less often legume seeds and fish. CONCLUSIONS: A limited prevalence of rational dietary choices among Polish and Spanish physical education students and their diversity depending on gender and home country have been demonstrated.

Genetic immune and inflammatory markers associated with diabetes in solid organ transplant recipients.

New-onset diabetes mellitus after transplantation (NODAT) is a complication following solid organ transplantation (SOT) and may be related to immune or inflammatory responses. We investigated whether single nucleotide polymorphisms (SNPs) within 158 immune- or inflammation-related genes contribute to NODAT in SOT recipients. The association between 263 SNPs and NODAT was investigated in a discovery sample of SOT recipients from the Swiss Transplant Cohort Study (STCS, n1  = 696). Positive results were tested in a first STCS replication sample (n2  = 489) and SNPs remaining significant after multiple test corrections were tested in a second SOT replication sample (n3  = 156). Associations with diabetic traits were further tested in several large general population-based samples (n > 480 000). Only SP110 rs2114592C>T remained associated with NODAT in the STCS replication sample. Carriers of rs2114592-TT had 9.9 times (95% confidence interval [CI]: 3.22-30.5, P = .00006) higher risk for NODAT in the combined STCS samples (n = 1184). rs2114592C>T was further associated with NODAT in the second SOT sample (odds ratio: 4.8, 95% CI: 1.55-14.6, P = .006). On the other hand, SP110 rs2114592C>T was not associated with diabetic traits in population-based samples, suggesting a specific gene-environment interaction, possibly due to the use of specific medications (ie, immunosuppressants) in transplant patients and/or to the illness that may unmask the gene effect.

The Impact of Processing Parameters on the Content of Phenolic Compounds in New Gluten-Free Precooked Buckwheat Pasta.

Buckwheat is a generous source of phenolic compounds, vitamins and essential amino acids. This paper discusses the procedure of obtaining innovative gluten-free, precooked pastas from roasted buckwheat grains flour, a fertile source of natural antioxidants, among them, phenolic acids. The authors also determined the effect of the extruder screw speed and the level of moisture content in the raw material on the quantity of free phenolic acids. The qualitative and quantitative analysis of phenolic acids in pasta was carried out using high-performance liquid chromatography electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS). The chromatographic method was validated. For extracts with the highest total content of free phenolic acids and unprocessed flour from roasted buckwheat grain, the TLC-DPPH test was also performed to determine the antioxidant properties of the tested pasta. The level of moisture in the raw material had an impact on the content of phenolic acids. All pastas made from buckwheat flour moistened up to 32% exhibited a higher total content of free phenolic acids than other mixes moistened to 30 and 34% of water.

Content of Phenolic Compounds and Antioxidant Activity of New Gluten-Free Pasta with the Addition of Chestnut Flour.

Chestnut fruit abounds in carbohydrates, proteins, unsaturated fatty acids, fiber, polyphenolic compounds, as well as vitamins and micronutrients, that are behind the health-promoting properties of this plant. The purpose of the discussed research was to obtain innovative gluten-free pasta from rice and field bean flour enriched with a various addition of chestnut flour. Regarding the studied pasta, the following were determined: the content of free phenolic acids, total polyphenols, and antioxidant properties. Chromatographic analysis (HPLC-ESI-MS/MS (high-performance liquid chromatography-electrospray ionization tandem mass spectrometry)) revealed a wide variety of phenolic acids. In a sample with 20% and higher content of chestnut flour, as many as 13 acids were detected. Isoferulic acid prevailed. The total content of free phenolic acids and total polyphenols increased along with the increasing chestnut content. Moreover, in most cases, the content of individual acids increased with the addition of chestnut flour. Besides, the antioxidant activity was positively correlated with the addition of chestnut fruit flour, the content of free phenolic acids, and total polyphenols. Our research has demonstrated that our innovative gluten-free pasta, with the addition of chestnut flour, has a potential to be a source of polyphenolic compounds, including free phenolic acids, that are valuable for human health.

[Breasts self examination - everything we want you to know about it - survey study].

OBJECTIVE: Introduction: Breasts self examination is first line prevention in case of breast cancer. It is cheap, it is easy and it can save your life. That is why it is so important that every woman and even man know how to do it. The aim: To estimate the level of knowledge about breasts self examination among women and also among people connected with medicine. PATIENTS AND METHODS: Materials and methods: The data were gathered through the internet questionnaire, which contained of 14 questions. There were 204 respondents : 53% women and 47% men. Among them there were 93% people related with medicine. Average age was 23,5 years. The participation was voluntary and annonymous. RESULTS: Results: Among female respondents 57% admit doing breasts self examination, however only 23% of them do that regularly every month. Also only 36% of the respondents know how to do proper examination. When asked if they ever had their breasts examined by the doctor, only 20% replied positively. We also prepared questions for people connected with medical field: we asked them if doing breasts examination for the patient they would feel confident (61% replied negatively.) and also if they had a chance to do breasts examination during studies most of them replied negatively. CONCLUSION: Conclusions: To conclude, even among women connected with medical field the knowledge is not enough, which is the most concerning since they should educate others and diagnose concerning symptoms. We should put more afford to break the tabu and pay more attention to breast examination.

The influence of Cistus incanus L. leaves on wheat pasta quality.

Modern nutritional trends and looking for functional food and dedicated products for various consumers are a source of inspiration for scientists to develop new pro-health supplemented foods with high quality. Therefore, the present study aimed to determine the selected properties of common wheat pasta fortified with dried Cistus incanus in amount from 1 to 5% as a replacement of wheat flour. Pasta was made with a spaghetti shape and dried. Supplemented pasta was tested for total phenolics content, the total activity against DPPH, the ability to neutralize free radicals to ABTS and the antioxidant capacity reduction power, using various extraction procedures. Selected physicochemical properties of pasta were evaluated: cooking time, cooking weight, cooking loss, hardness and color profile of dry and cooked pasta in CIE-Lab scale, as well as the sensory properties of supplemented products. The addition of C. incanus to fortify wheat pasta increased total phenolics content and antioxidant activity with some significant differences according to the extraction procedure used. Methanolic extraction was more efficient than buffer extraction. Increased addition of dry Cistus herb caused higher cooking weight, cooking loss and increased hardness of cooked pasta. Studies have shown that C. incanus addition had a slight effect on color change with the largest decrease in brightness, especially for cooked products. Finally, it was found that advisable application of C. incanus addition to achieve nutritionally improved composition of pasta should not exceed 3% due to the proper sensory characteristics.

Life satisfaction and other determinants of eating behaviours among women aged 40-65 years with type 2 diabetes from the Krakow population.

INTRODUCTION: A rational dietary model is one of the key aspects in the treatment of type 2 diabetes. AIM OF THE STUDY: The study aimed to analyse the frequency of consuming selected groups of food products among women aged 40-65 years with type 2 diabetes, depending on age, BMI, duration of disease, and level of life satisfaction. MATERIAL AND METHODS: The study was carried out among 276 women using the author's specially designed questionnaire (metric data, duration of diabetes) and the Satisfaction with Life Scale (SWLS). We assessed BMI values on the basis of measurements of somatic indicators (body mass and height). Statistical analysis was performed using Pearson's r and Spearman's R correlation coefficients via the SPSS programme (significance level of α = 0.05). RESULTS: Among the women with type 2 diabetes we observed nutritional deficiencies, in particular a low frequency of consuming the recommended product groups (vegetables, fruit, legume seeds, whole-grain cereals, dairy products with reduced fat content, and nuts). The scale of rational dietary choices among women increased along with age and perceived life satisfaction. As the time from diagnosis passed, this scale decreased. A decrease was also noted along with the increase in BMI. CONCLUSIONS: The frequency of consuming some product groups shows a significant relationship with age, BMI, duration of disease, and the level of life satisfaction among women aged 40-65 years with type 2 diabetes.

Optic nerve disc veins inflammation (papillophlebitis) - case report.

Papillophlebitis is an uncommon disease in clinical practice. We would like to present a case of a 29-year-old patient with atypical orbital pain and flashings, presenting relative afferent pupillary defect and already typical of the disease entity: ophthalmoscopic picture of the fundus and big blind spot in perimetry. We present a complex and interdisciplinary diagnostic process that excludes general diseases such as hypertension, diabetes, coagulation disorders and neurological causes. We leave the only identifiable abnormality and potential source in the inflammatory process of periodontal inflammation and sinus jaw changes. We also describe the process of remitting the changes and finally a favorable end result of the primarily a very disturbing clinical picture that this disease may present.

[testicles self examination - knowledge and abilities - survey study].

OBJECTIVE: Introduction: Testicle cancer is a common malignant cancer among young men (20 to 44 years). In 90% of cases we can feel nodule or change of consistency, which means during testicles self examination we can quickly discover cancer. The aim: To estimate the level of knowledge about testicles self examination among men and also medical stuff and students. PATIENTS AND METHODS: Materials and methods: We gathered the data through the internet questionnaire, which contained of 13 questions. There were 204 respondents (53% women and 47% men). 93% were related with medicine. Average age was 23,5 years old. The participation in the study was voluntary and annonymous. RESULTS: Results: Only 41% of our respondents perform self examination. When asked if They every had Their testicles checked by a doctor only 33% responded positively. Most of the respondents almost correctly point out symtpoms and risk factors of testicles cancer. Only 22% of medical related respondents feel confident while performing testicles examination with the patient and just 12% of them had a chance to do it during studies. We also asked our respondents if They have ever seen a social campaign about priopriate testicles self exmiantion and 80% of them respondet negatively. CONCLUSION: Conclusions: The level of education about testicles examination is on low level. Men are usually aware of the risk, but They neglect it. In most cases doctors do not examine testicles and are not confident about it. We have to put more concern to that case.

Application of Moldavian dragonhead (Dracocephalum moldavica L.) leaves addition as a functional component of nutritionally valuable corn snacks.

Application of Moldavian dragonhead (Dracocephalum moldavica L.) leaves in extruded snacks was evaluated. Directly expanded corn snacks (crisps) were supplemented with 5-20% of dragonhead leaves. The supplemented snacks were characterized to have improved nutritional value and were a good source of dietary fibre. The presence of phenolic compounds, especially rosmarinic acid, showed a high antioxidant potential and a radical scavenging activity of tested snacks, especially if a high content of additive was used. The increasing amount of additive also had an impact on the physical properties of extrudates lowering the expansion ratio, water absorption and solubility, yet increasing bulk density, cutting force and the breaking index of the enriched snacks. The highest viscosity was observed at 5 and 10% addition level. The increasing amount of dragonhead leaves lowered the brightness of snacks and increased the greenness tint significantly. A sensory evaluation showed good acceptability of snacks enriched with up to 15% of dragonhead dried leaves. Dried leaves of the Moldavian dragonhead seem to be a prospective functional additive for extruded crisps with a high nutritional value, especially because of dietary fibre and rosmarinic acid content, a strong antioxidant potential and acceptable sensory properties.

Polymorphisms in the lectin pathway of complement activation influence the incidence of acute rejection and graft outcome after kidney transplantation.

There are conflicting data on the role of the lectin pathway of complement activation and its recognition molecules in acute rejection and outcome after transplantation. To help resolve this we analyzed polymorphisms and serum levels of lectin pathway components in 710 consecutive kidney transplant recipients enrolled in the nationwide Swiss Transplant Cohort Study, together with all biopsy-proven rejection episodes and 1-year graft and patient survival. Functional mannose-binding lectin (MBL) levels were determined in serum samples, and previously described MBL2, ficolin 2, and MBL-associated serine protease 2 polymorphisms were genotyped. Low MBL serum levels and deficient MBL2 diplotypes were associated with a higher incidence of acute cellular rejection during the first year, in particular in recipients of deceased-donor kidneys. This association remained significant (hazard ratio 1.75, 95% confidence interval 1.18-2.60) in a Cox regression model after adjustment for relevant covariates. In contrast, there was no significant association with rates of antibody-mediated rejection, patient death, early graft dysfunction or loss. Thus, results in a prospective multicenter contemporary cohort suggest that MBL2 polymorphisms result in low MBL serum levels and are associated with acute cellular rejection after kidney transplantation. Since MBL deficiency is a relatively frequent trait in the normal population, our findings may lead to individual risk stratification and customized immunosuppression.

Influence of IFNL3/4 polymorphisms on the incidence of cytomegalovirus infection after solid-organ transplantation.

BACKGROUND: Polymorphisms in IFNL3 and IFNL4, the genes encoding interferon λ3 and interferon λ4, respectively, have been associated with reduced hepatitis C virus clearance. We explored the role of such polymorphisms on the incidence of cytomegalovirus (CMV) infection in solid-organ transplant recipients. METHODS: White patients participating in the Swiss Transplant Cohort Study in 2008-2011 were included. A novel functional TT/-G polymorphism (rs368234815) in the CpG region upstream of IFNL3 was investigated. RESULTS: A total of 840 solid-organ transplant recipients at risk for CMV infection were included, among whom 373 (44%) received antiviral prophylaxis. The 12-month cumulative incidence of CMV replication and disease were 0.44 and 0.08 cases, respectively. Patient homozygous for the minor rs368234815 allele (-G/-G) tended to have a higher cumulative incidence of CMV replication (subdistribution hazard ratio [SHR], 1.30 [95% confidence interval {CI}, .97-1.74]; P = .07), compared with other patients (TT/TT or TT/-G). The association was significant among patients followed by a preemptive approach (SHR, 1.46 [95% CI, 1.01-2.12]; P = .047), especially in patients receiving an organ from a seropositive donor (SHR, 1.92 [95% CI, 1.30-2.85]; P = .001), but not among those who received antiviral prophylaxis (SHR, 1.13 [95% CI, .70-1.83]; P = .6). These associations remained significant in multivariate competing risk regression models. CONCLUSIONS: Polymorphisms in the IFNL3/4 region influence susceptibility to CMV replication in solid-organ transplant recipients, particularly in patients not receiving antiviral prophylaxis.