RESUMO
Several interleukin 6 gene (IL6) polymorphisms are implicated in susceptibility to rheumatoid arthritis (RA). It has not yet been established with certainty if these polymorphisms are associated with the severe radiographic damage observed in some RA patients, particularly those with the development of joint bone ankylosis (JBA). The objective of the present study was to evaluate the association between severe radiographic damage in hands and the -174G/C and -572G/C IL6 polymorphisms in Mexican Mestizo people with RA. Mestizo adults with RA and long disease duration (>5 years) were classified into two groups according to the radiographic damage in their hands: a) severe radiographic damage (JBA and/or joint bone subluxations) and b) mild or moderate radiographic damage. We compared the differences in genotype and allele frequencies of -174G/C and -572G/C IL6 polymorphisms (genotyped using polymerase chain reaction-restriction fragment length polymorphism) between these two groups. Our findings indicated that the -174G/C polymorphism of IL6 is associated with severe joint radiographic damage [maximum likelihood odds ratios (MLE_OR): 8.03; 95%CI 1.22-187.06; P = 0.03], whereas the -572G/C polymorphism of IL6 exhibited no such association (MLE_OR: 1.5; 95%CI 0.52-4.5; P = 0.44). Higher anti-cyclic citrullinated peptide antibody levels were associated with more severe joint radiographic damage (P = 0.04). We conclude that there is a relevant association between the -174G/C IL6 polymorphism and severe radiographic damage. Future studies in other populations are required to confirm our findings.
Assuntos
Artrite Reumatoide/genética , Traumatismos da Mão/genética , Mãos/efeitos da radiação , Interleucina-6/genética , Polimorfismo de Nucleotídeo Único , Adulto , Artrite Reumatoide/complicações , Artrite Reumatoide/etnologia , Feminino , Predisposição Genética para Doença , Traumatismos da Mão/etnologia , Traumatismos da Mão/etiologia , Humanos , Masculino , México/etnologia , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Modern war ballistics and blast injuries inflict devastating extremity injuries, violating soft tissue, bone, and neurovascular structures. Despite advances in complex wound management, appropriate timing of war wound closure remains subjective. In addition, the pathophysiology of acute wound failure is poorly defined. METHODS: Patients with penetrating extremity wounds sustained during combat were prospectively studied and followed for 30 days after definitive wound closure. The primary outcome was wound healing. Wound dehiscence was defined as spontaneous partial or complete wound disruption after closure. Serum, wound effluent, and wound bed tissue biopsy were collected at each surgical wound debridement. Serum and wound effluent were analyzed with a multiplex array of 22 cytokines and chemokines, and wound tissue for corresponding gene transcript expression. RESULTS: Fifty-two penetrating extremity war wounds in 33 male patients were investigated. Nine (17%) wounds dehisced. Concomitant vascular injury, increased wound size, and higher injury severity score correlated with wound dehiscence. Both serum and wound effluent cytokine and chemokine protein profiles were statistically associated with healing outcome at various time points. Wound biopsy gene transcript expression demonstrated increased tissue inflammation associated with wound failure. Multiple protein and gene transcript biomarkers predictive of wound healing were identified. CONCLUSIONS: The cytokine and chemokine protein and gene transcript expression patterns demonstrate a condition of inflammatory dysregulation associated with war wound failure. A molecular biomarker panel may predict combat wound healing outcome and warrants prospective validation.
Assuntos
Biomarcadores/sangue , Citocinas/sangue , Traumatismos da Mão/sangue , Inflamação/sangue , Traumatismos da Perna/sangue , Cicatrização/fisiologia , Ferimentos Penetrantes/sangue , Campanha Afegã de 2001- , Quimiocinas/sangue , Quimiocinas/genética , Citocinas/genética , Seguimentos , Regulação da Expressão Gênica , Traumatismos da Mão/diagnóstico , Traumatismos da Mão/genética , Humanos , Inflamação/genética , Inflamação/patologia , Guerra do Iraque 2003-2011 , Traumatismos da Perna/diagnóstico , Traumatismos da Perna/genética , Masculino , Militares , Prognóstico , Estudos Prospectivos , RNA/genética , Curva ROC , Índices de Gravidade do Trauma , Cicatrização/genética , Ferimentos Penetrantes/diagnóstico , Ferimentos Penetrantes/genética , Adulto JovemRESUMO
Four hundred eleven individuals who had suffered temporary unilateral hand injuries were assessed on five hand preference behaviors after their recovery. Measures of shifts to contralateral hand use experienced during and after the recovery period were taken. The best predictor of hand use shifts during the injury recovery period was whether the injury was to the preferred or nonpreferred hand. The incidence of postinjury contralateral shifts was low but was greater than that observed over a simulated injury period in a control group of 384 individuals who had not experienced a hand injury.
