RESUMO
Schizophrenia diagnosis and admission history were associated with a polygenic score (PGS) for schizophrenia based on a subset of variants that act by modifying the expression of genes whose expression is also modified by antipsychotics. This gene set was enriched in cytokine production. Interleukin-6 (IL-6) is the only cytokine whose plasma levels were associated both with schizophrenia diagnosis and with acute decompensations in the largest meta-analysis. Therefore, we hypothesized that an IL-6 PGS, but not other cytokines PGSs, would be associated with schizophrenia chronicity/psychiatric admissions. Using the IL-6 PGS model from The PGS Catalog, IL-6 PGS was calculated in 427 patients with schizophrenia and data regarding admission history. Association between IL-6 PGS and chronicity, measured as number and duration of psychiatric admissions, or ever readmission was analyzed by multivariate ordinal and logistic regression, respectively. Specificity of results was assessed by analysis of PGSs from the other cytokines at The PGS Catalog with meta-analytic evidence of association with schizophrenia diagnosis or acute decompensations, IL-1RA, IL-4, IL-8, and IL-12. IL-6 PGS was associated with schizophrenia chronicity, explaining 1.51% of variability (OR = 1.29, 95% CI 1.07-1.55, P = 0.007). There was no association with ever readmission. Other cytokines PGSs were not associated with chronicity. Association with IL-6 PGS was independent of association with schizophrenia PGS. Our results provide evidence that genetically regulated higher levels of IL-6 are involved in schizophrenia chronicity, highlighting the relevance of immunity processes for a subgroup of patients.
Assuntos
Interleucina-6 , Herança Multifatorial , Esquizofrenia , Humanos , Esquizofrenia/sangue , Interleucina-6/sangue , Feminino , Masculino , Adulto , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Suicide is a major public health problem, especially among individuals over 50 years old. Despite the suitability of this life stage for prevention, research on the efficacy of psychological interventions is scarce and methodologically limited, affecting their clinical utility and efficacy. Brief, flexible interventions that can be applied both in-person and remotely are needed. This study aims to evaluate the efficacy of a brief problem-solving-based suicide prevention program applied through various modalities to individuals over 50 years old. METHODS: A randomized controlled trial will be conducted. A sample of 212 adults aged 50 or older with suicidal ideation will be randomly assigned to a problem-solving-based psychological intervention administered face-to-face (PSPI-P; n = 53), by telephone multiconference (PSPI-M; n = 53), via a smartphone app (PSPI-A; n = 53), or to a usual care control group (UCCG; n = 53). The intervention will be delivered in 7 sessions or modules of 90 min each. Blind trained evaluators will conduct assessments at pre-intervention, post-intervention, and follow-ups at 3, 6, and 12 months. The primary outcome will be suicidal ideation evaluated using the Suicidal Ideation Scale (SSI) and the Columbia Suicide Severity Rating Scale (C-SSRS). Secondary outcomes will include hopelessness, anxiety and depression symptoms, reasons for living, impulsivity, problem-solving skills, social support, anger syndrome, gratitude, personality, dropouts, treatment adherence, and satisfaction with the intervention. DISCUSSION: This study will provide evidence of the efficacy of a brief problem-solving-based intervention for suicide prevention in individuals over 50 years old, administered face-to-face, by telephone multiconference, and via a smartphone app. If results are favorable, it will indicate that an effective, accessible, clinically and socially useful suicide prevention intervention has been developed for affected individuals, families, and communities. TRIAL REGISTRATION: ClinicalTrials.gov NCT06338904. Registered April 1, 2024.
Assuntos
Resolução de Problemas , Prevenção do Suicídio , Humanos , Pessoa de Meia-Idade , Masculino , Feminino , Ideação Suicida , Intervenção Psicossocial/métodos , Psicoterapia Breve/métodos , Idoso , Aplicativos MóveisRESUMO
Systemic lupus erythematosus (SLE) is a multisystem disease considered a prototype of the main autoimmune disease and presents serious complications, such as lupus nephritis (LN), which generates a significant impact on morbidity and mortality. The SPP1 gene encodes the osteopontin (OPN) protein, which plays a crucial role in the regulation of inflammation and immunity. The variants rs1126616 and rs9138 of this gene have been associated with the inflammatory response. The study aims to analyze the association of the rs1126616 and rs9138 variants of the SPP1 gene in SLE Mexican-Mestizo patients without LN (SLE-LN). In this cross-sectional study, a total of 171 genomic DNA samples from SLE patients were clinically confirmed, of which 111 were SLE without LN, 60 were SLE with LN, and 100 healthy individuals were included as reference group. The rs1126616 variant was genotyped using PCR-RFLPs, and the rs9138 variant was genotyped using qPCR TaqMan. The TT genotype, the recessive model [OR 2.76 (95% CI 1.31-5.82), p = 0.011], and the T allele [OR 2.0 (95% CI 1.26-3.16), p = 0.003] of the rs1126616 variant are risk factors for SLE with LN. By contrast, the rs9138 variant did not show statistically significant differences among SLE patients stratified by LN. In our study of SLE Mexican-Mestizo patients with and without NL, demographic and clinical characteristics do not differ from other SLE populations, and the TT genotype of the rs1126616 variant of the SPP1 gene confers a risk factor for the presentation of LN. Otherwise, the rs9138 variant did not show association with NL.
Assuntos
Lúpus Eritematoso Sistêmico , Nefrite Lúpica , Humanos , Nefrite Lúpica/genética , Estudos Transversais , Lúpus Eritematoso Sistêmico/genética , Alelos , Genótipo , OsteopontinaRESUMO
Head and neck squamous cell carcinoma (H&NSCC) is an anatomic, biological, and genetic complex disease. It involves more than 1000 genes implied in its oncogenesis; for this review, we limit our search and description to the genes implied in the onco-ontogeny of the derivates from the first pharyngeal arch during embryo development. They can be grouped as transcription factors and signaling molecules (that act as growth factors that bind to receptors). Finally, we propose the term embryo-oncogenesis to refer to the activation, reactivation, and use of the genes involved in the embryo's development during the oncogenesis or malignant tumor invasion and metastasis events as part of an onco-ontogenic inverse process.
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Região Branquial , Humanos , Região Branquial/metabolismo , Região Branquial/patologia , Neoplasias de Cabeça e Pescoço/genética , Neoplasias de Cabeça e Pescoço/patologia , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/genética , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/metabolismo , Animais , Carcinogênese/genética , Carcinogênese/patologia , Regulação Neoplásica da Expressão Gênica , Transdução de SinaisRESUMO
Th17 cells are known for producing IL-17 and their role in the pathogenesis of various autoimmune diseases, including myositis. Likewise, the participation of the IL-23/IL-17 pathway in autoimmunity has been confirmed. In this study, we aimed to evaluate the behavior of cytokines in myositis, focusing on the autoantibodies profile and the myositis core set measures. Twenty-five myositis patients were enrolled in this cross-sectional study. An expert rheumatologist evaluated the myositis core set measures. Serum levels of cytokines and chemokines were quantified using the LEGENDplex Multi-Analyte Flow Assay Kit from BioLegend. The autoantibodies detection was carried out using the line-blot assay kit Euroline: Autoimmune Inflammatory Myopathies from EUROIMMUN. We found higher serum levels of IL-33, CXCL8, IL-6, IL-23, and IL-12p70 in seronegative patients. A multiple linear regression analysis revealed that MYOACT scores could be predicted by the increment of IL-23 and the decrement of CCL2, IL-10, and CXCL8 serum levels. These findings suggest that the immune response in seronegative myositis patients exhibits an IL-23-driven Th17 immune response. The relevance of this discovery lies in its potential therapeutic implications. Insights into the IL-23-driven Th17 immune response in seronegative patients highlight the potential for targeted therapies aimed at modulating Th17 activity.
Assuntos
Citocinas , Miosite , Células Th17 , Humanos , Miosite/imunologia , Miosite/sangue , Feminino , Masculino , Células Th17/imunologia , Células Th17/metabolismo , Pessoa de Meia-Idade , Citocinas/sangue , Adulto , Estudos Transversais , Autoanticorpos/sangue , Autoanticorpos/imunologia , Interleucina-23/sangue , IdosoRESUMO
OBJECTIVE: To test whether a schizophrenia polygenic risk score (PRS) based on the subset of polymorphisms that affect brain expression of genes with altered expression by antipsychotics (exprAP PRS) is associated with psychiatric readmission of patients with schizophrenia. METHODS: The study involved 427 patients with schizophrenia. Genes with altered expression by antipsychotics were extracted from the Comparative Toxigenomics Database. ExprAP PRS was estimated using the clumping and thresholding (p < 0.05) method. Two additional PRS were tested based on subsets of exprAP polymorphisms whose schizophrenia risk allele has the same (unrestored PRS) or opposite (restored PRS) direction of effect on gene expression than antipsychotics. A general SCZ PRS was tested for comparison. Logistic and ordinal regression were used to test for association of each PRS with ever readmission and admission history, an outcome based on length and number of admissions, respectively. Webgestalt was used for Gene Ontology enrichment analysis. RESULTS: ExprAP PRS was associated with ever readmission (OR = 1.48, 95%CI:1.10-1.97) and admission history (OR = 1.30, 95%CI 1.07-1.57). SCZ PRS (OR = 1.22, 95%CI: 1.01-1.48) and unrestored PRS (OR = 1.26, 95%CI 1.04-1.53) were only associated with admission history. Genes at exprAP PRS were enriched in regulation of cytokine production. CONCLUSION: Our findings suggest that PRS based on genes with altered expression by antipsychotics may be better predictors of readmission than SCZ PRS, warranting further investigation in larger cohorts of patients. The action of antipsychotics may be related to brain gene expression, mainly in genes involved in immunity.
Assuntos
Antipsicóticos , Esquizofrenia , Antipsicóticos/uso terapêutico , Predisposição Genética para Doença/genética , Estudo de Associação Genômica Ampla , Hospitalização , Humanos , Herança Multifatorial , Fatores de Risco , Esquizofrenia/tratamento farmacológico , Esquizofrenia/genéticaRESUMO
Smoking prevalence in schizophrenia is considerably larger than in general population, playing an important role in early mortality. We compared the polygenic contribution to smoking in schizophrenic patients and controls to assess if genetic factors may explain the different prevalence. Polygenic risk scores (PRSs) for smoking initiation and four genetically correlated traits were calculated in 1108 schizophrenic patients (64.4% smokers) and 1584 controls (31.1% smokers). PRSs for smoking initiation, educational attainment, body mass index and age at first birth were associated with smoking in patients and controls, explaining a similar percentage of variance in both groups. Attention-deficit hyperactivity disorder (ADHD) PRS was associated with smoking only in schizophrenia. This association remained significant after adjustment by psychiatric cross-disorder PRS. A PRS combining all the traits was more explanative than smoking initiation PRS alone, indicating that genetic susceptibility to the other traits plays an additional role in smoking behaviour. Smoking initiation PRS was also associated with schizophrenia in the whole sample, but the significance was lost after adjustment for smoking status. This same pattern was observed in the analysis of specific SNPs at the CHRNA5-CHRNA3-CHRNB4 cluster associated with both traits. Overall, the results indicate that the same genetic factors are involved in smoking susceptibility in schizophrenia and in general population and are compatible with smoking acting, directly or indirectly, as a risk factor for schizophrenia that contributes to the high prevalence of smoking in these patients. The contrasting results for ADHD PRS may be related to higher ADHD symptomatology in schizophrenic patients.
Assuntos
Esquizofrenia/genética , Fumar Tabaco/genética , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/genética , Índice de Massa Corporal , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Humanos , Pessoa de Meia-Idade , Herança Multifatorial , Proteínas do Tecido Nervoso/genética , Fenótipo , Receptores Nicotínicos/genética , Fatores de Risco , Fatores SociodemográficosRESUMO
Copy number variants (CNVs) conferring risk of schizophrenia present incomplete penetrance, suggesting the existence of second genetic hits. Identification of second hits may help to find genes with rare variants of susceptibility to schizophrenia. The aim of this work was to search for second hits of moderate/high risk in schizophrenia carriers of risk CNVs and resequencing of the relevant genes in additional samples. To this end, ten patients with risk CNVs at cytobands 15q11.2, 15q11.2-13.1, 16p11.2, or 16p13.11, were subjected to whole-exome sequencing. Rare single nucleotide variants, defined as those absent from main public databases, were classified according to bioinformatic prediction of pathogenicity by CADD scores. The average number of rare predicted pathogenic variants per sample was 13.6 (SD 2.01). Two genes, BFAR and SYNJ1, presented rare predicted pathogenic variants in more than one sample. Follow-up resequencing of these genes in 432 additional cases and 432 controls identified a significant excess of rare predicted pathogenic variants in case samples at SYNJ1. Taking into account its function in clathrin-mediated synaptic vesicle endocytosis at presynaptic terminals, our results suggest an impairment of this process in schizophrenia.
Assuntos
Variações do Número de Cópias de DNA/genética , Sequenciamento do Exoma/métodos , Heterozigoto , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Monoéster Fosfórico Hidrolases/genética , Esquizofrenia/genética , Predisposição Genética para Doença , Humanos , RiscoRESUMO
INTRODUCTION: The role that emotion regulation plays in Conversion Disorders (CD) is not well known. This research deepens in this subject and describes the main differences between a group of conversion patients and a control group on different measures of emotion regulation and other clinical variables. METHODS: A case-control study was conducted including 43 patients suffering from CD and 42 healthy controls. Both groups went thought two psychiatric interviews and fulfilled 6 questionnaires assessing depression, anxiety, alexithymia, emotion dysregulation, affect intensity, psychoform and somatoform dissociation. RESULTS: Patients suffering from CD scored significantly higher on all the six questionnaires (p<0.001). Negative reactivity and negative intensity were also higher in patients (p<0.01), while cases and controls did not show any significant differences on positive affectivity and serenity. Anxiety, alexithymia and emotional dysregulation were the most relevant factors (OR=5.85/3.50/3.23 respectively). Anxiety and difficulties in emotion regulation were the most explicative variables for conversion in the regression analysis performed. Within the five factors assessing difficulties in emotion regulation, lack of emotional control and interference in goal directed behaviors were the most relevant. Positive and negative conversion where correlated to different emotional impairments. CONCLUSIONS: People suffering from CD show several emotional impairments when compared to healthy controls. Emotion dysregulation can be considered a relevant aspect in CD. The existence of specific emotional patterns for different conversion manifestations is suspected.
Assuntos
Sintomas Afetivos/complicações , Transtorno Conversivo/etiologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A systematic analysis of beta-lactamases based on comparative proteomics has not been performed thus far. In this report, we searched for the presence of beta-lactam-related proteins in 591 bacterial proteomes belonging to 52 species that are pathogenic to humans. The amino acid sequences for 19 different types of beta-lactamases (ACT, CARB, CifA, CMY, CTX, FOX, GES, GOB, IMP, IND, KPC, LEN, OKP, OXA, OXY, SHV, TEM, NDM, and VIM) were obtained from the ARG-ANNOT database and were used to construct 19 HMM profiles, which were used to identify potential beta-lactamases in the completely sequenced bacterial proteomes. A total of 2877 matches that included the word "beta-lactamase" and/or "penicillin" in the functional annotation and/or in any of its regions were obtained. These enzymes were mainly described as "penicillin-binding proteins," "beta-lactamases," and "metallo-beta-lactamases" and were observed in 47 of the 52 species studied. In addition, proteins classified as "beta-lactamases" were observed in 39 of the species included. A positive correlation between the number of beta-lactam-related proteins per species and the proteome size was observed (R 0.78, P < 0.00001). This correlation partially explains the high presence of beta-lactam-related proteins in large proteomes, such as Nocardia brasiliensis, Bacillus anthracis, and Mycobacterium tuberculosis, along with their absence in small proteomes, such as Chlamydia spp. and Mycoplasma spp. We detected only five types of beta-lactamases (TEM, SHV, CTX, IMP, and OXA) and other related proteins in particular species that corresponded with those reported in the literature. We additionally detected other potential species-specific beta-lactamases that have not yet been reported. In the future, better results will be achieved due to more accurate sequence annotations and a greater number of sequenced genomes.
Assuntos
Bactérias/enzimologia , Biologia Computacional/métodos , Genoma Bacteriano , Proteínas de Ligação às Penicilinas/genética , beta-Lactamases/genética , Bactérias/genéticaRESUMO
Macrophage migration inhibitory factor (MIF) and tumor necrosis factor alpha (TNFα) play a pivotal role in rheumatoid arthritis (RA). MIF is considered a relevant cytokine because it appears before TNFα in the inflammatory cascade thus stimulating TNFα production and MIF's relationship with traditional synthetic disease modifying antirheumatic drugs (sDMARDs) is unknown. In this cross-sectional study, we investigated the association of MIF and TNFα serum levels with methotrexate (MTX) and in combination with chloroquine (CLQ) and sulfasalazine (SSZ) in RA patients classified according to the ACR/EULAR 2010 criteria. Patients were divided into three groups: MTX-monotherapy group (n = 40), MTX combination therapy groups: MTX + CLQ (n = 41), and MTX + CLQ + SSZ (n = 42). MIF and TNFα serum levels were determined by ELISA. We found high levels of ESR, CRP, RF, and anti-CCP in all therapy groups. Furthermore, we subclassified 97 patients with established RA (≥2 years of disease duration) and found that TNFα serum levels were lower in the combination therapy group (MTX + CLQ + SSZ) in comparison with the monotherapy MTX group (16.7 pg/mL versus 13.6 pg/mL, p = 0.02). However, we did not find differences between sDMARD therapies in MIF serum levels. We did find a significant reduction in MIF serum levels in patients treated with oral steroids compared with patients without oral steroids (1.7 ng/mL versus 4.3 ng/mL, p < 0.001). In conclusion, this study supports the role of sDMARDs in modifying TNFα serum levels and oral steroids MIF serum levels. Nevertheless, we found that MIF serum levels are not modified by sDMARD treatment.
Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/sangue , Artrite Reumatoide/tratamento farmacológico , Oxirredutases Intramoleculares/sangue , Fatores Inibidores da Migração de Macrófagos/sangue , Fator de Necrose Tumoral alfa/sangue , Adulto , Idoso , Artrite Reumatoide/diagnóstico , Biomarcadores/sangue , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
BACKGROUND: Breast cancer is the second most common malignancy diagnosed in pregnancy. Breast cancer in pregnancy represents a challenge in diagnosis as well as in treatment. OBJECTIVE: To evaluate clinically patients with breast cancer in pregnancy. METERIAL AND METHODS: Retrospective, transversal, descriptive study was done in which we enrolled women with breast cancer and pregnancy from the outpatient clinic of medical oncology of a tertiary care center hospital. Statistical analysis: descriptive statistics. RESULTS: The variables of 15 clinical records were examined, median age 33.3 ± 5.5 years, tobacco use 3/15, oral contraceptives use 2/15, age at first birth 25.8 ± 7 years, breastfed 4/15. The initial medical evaluation was done 7.5 ± 7.7 months after the onset of symptoms, the diagnosis was made with trucut biopsy in 9/15 of patients, excisional biopsy 4/15 and fine needle aspiration biopsy 2/15. Clinical stage was IIA 3/15, IIIA 8/15, IIIB 3/15 and IV 1/15. Six patients were treated with chemotherapy during pregnancy in the second and third trimester and three with surgical treatment. There were no fetal deaths related to treatment. Response to treatment: 8/15 are disease-free, 5/15 progressed to death and 2/15 had bone metastasis. CONCLUSION: Even major cancer centers have limited experience with breast cancer in pregnancy. Medical and surgical treatment should not be differed. More prospective studies are needed to assess factors related to treatment and prognosis.
Assuntos
Neoplasias da Mama/diagnóstico , Complicações Neoplásicas na Gravidez/diagnóstico , Adulto , Estudos Transversais , Feminino , Humanos , Gravidez , Estudos RetrospectivosRESUMO
Schizophrenia may be considered a human-specific disorder arisen as a maladaptive by-product of human-specific brain evolution. Therefore, genetic variants involved in susceptibility to schizophrenia may be identified among those genes related to acquisition of human-specific traits. NPAS3, a transcription factor involved in central nervous system development and neurogenesis, seems to be implicated in the evolution of human brain, as it is the human gene with most human-specific accelerated elements (HAEs), i.e., .mammalian conserved regulatory sequences with accelerated evolution in the lineage leading to humans after human-chimpanzee split. We hypothesize that any nucleotide variant at the NPAS3 HAEs may lead to altered susceptibility to schizophrenia. Twenty-one variants at these HAEs detected by the 1000 genomes Project, as well as five additional variants taken from psychiatric genome-wide association studies, were genotyped in 538 schizophrenic patients and 539 controls from Galicia. Analyses at the haplotype level or based on the cumulative role of the variants assuming different susceptibility models did not find any significant association in spite of enough power under several plausible scenarios regarding direction of effect and the specific role of rare and common variants. These results suggest that, contrary to our hypothesis, the special evolution of the NPAS3 HAEs in Homo relaxed the strong constraint on sequence that characterized these regions during mammalian evolution, allowing some sequence changes without any effect on schizophrenia risk.
Assuntos
Proteínas do Tecido Nervoso/genética , Esquizofrenia/genética , Fatores de Transcrição/genética , Fatores de Transcrição Hélice-Alça-Hélice Básicos , Estudos de Casos e Controles , Evolução Molecular , Feminino , Frequência do Gene , Estudos de Associação Genética , Predisposição Genética para Doença , Variação Genética , Genótipo , Haplótipos , Humanos , Masculino , Neurogênese/genética , Polimorfismo de Nucleotídeo ÚnicoRESUMO
BACKGROUND: Ambulatory blood pressure monitoring during 24 hours shows a blood pressure variability. The prevalence of chronic hypertension in pregnant women is 1-5%, so it is important to know the changes in blood pressure and cardiovascular risk and prevent complications to the mother and fetus. OBJECTIVE: To know the circadian rhythm of the blood pressure in the chronic hypertensive pregnant patients, through the ambulatory blood pressure monitoring. MATERIAL AND METHODS: A cross-sectional and descriptive study included chronic hypertensive pregnant patients, with > 20 weeks of gestation. Assessment of factors related to gynaecologic characteristics, according to the inclusion criteria underwent a washout period of two weeks and they were monitored with a Spacelabs 90207 monitor blood pressure. Quantitative variables by Student t test, one-way ANOVA and Pearson correlation were analysed. RESULTS: 16 chronic hypertensive pregnant patients were included, whose ambulatory blood pressure monitoring for the systolic blood pressure in 24 hours averaged 117.12 ± 5.85 mmHg; 24 hours diastolic blood pressure 71.31 ± 5.89 mmHg; daytime systolic blood pressure 120.18 ± 5.75 mmHg, nocturnal systolic blood pressure 110.31 ± 8.41 mmHg; daytime diastolic blood pressure 75.43 ± 7.32 mmHg, nocturnal diastolic blood pressure 64.25 ± 8.27 mmHg. Significant differences between daytime and night time were found. CONCLUSION: 56% of chronic hypertensive pregnant patients had no nocturnal reduction in systolic blood pressure and 43.75% had no nocturnal changes on diastolic blood pressure. The fact that 50% of patients were non-dippers force us to use long-action antihypertensive therapy and obtain control of the blood pressure for 24 hours.
Assuntos
Pressão Sanguínea/fisiologia , Ritmo Circadiano , Hipertensão/fisiopatologia , Complicações Cardiovasculares na Gravidez/fisiopatologia , Adulto , Anti-Hipertensivos/uso terapêutico , Monitorização Ambulatorial da Pressão Arterial , Índice de Massa Corporal , Doença Crônica , Estudos Transversais , Diástole , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertensão Induzida pela Gravidez/fisiopatologia , Idade Materna , Paridade , Gravidez , Complicações Cardiovasculares na Gravidez/tratamento farmacológico , Sono/fisiologia , Sístole , Adulto JovemRESUMO
Tacrolimus (TAC) is an immunosuppressant drug that prevents organ rejection after transplantation. This drug is transported from cells via P-glycoprotein (ABCB1) and is a metabolic substrate for cytochrome P450 (CYP) 3A enzymes, particularly CYP3A4 and CYP3A5. Several single-nucleotide polymorphisms (SNPs) have been identified in the genes encoding CYP3A4, CYP3A5, and ABCB1, including CYP3A4-392A/G (rs2740574), CYP3A5 6986A/G (rs776746), and ABCB1 3435C/T (rs1045642). This study aims to evaluate the association among CYP3A4-392A/G, CYP3A5-6986A/G, and ABCB1-3435C/T polymorphisms and TAC, serum concentration, and biochemical parameters that may affect TAC pharmacokinetics in Mexican kidney transplant (KT) patients. METHODS: Forty-six kidney transplant recipients (KTR) receiving immunosuppressive treatment with TAC in different combinations were included. CYP3A4, CYP3A5, and ABCB1 gene polymorphisms were genotyped using qPCR TaqMan. Serum TAC concentration (as measured) and intervening variables were assessed. Logistic regression analyses were performed at baseline and after one month to assess the extent of the association between the polymorphisms, intervening variables, and TAC concentration. RESULTS: The GG genotype of CYP3A5-6986 A/G polymorphism is associated with TAC pharmacokinetic variability OR 4.35 (95%CI: 1.13-21.9; p = 0.0458) at one month of evolution; in multivariate logistic regression, CYP3A5-6986GG genotype OR 9.32 (95%CI: 1.54-93.08; p = 0.028) and the use of medications or drugs that increase serum TAC concentration OR 9.52 (95%CI: 1.79-88.23; p = 0.018) were strongly associated with TAC pharmacokinetic variability. CONCLUSION: The findings of this study of the Mexican population showed that CYP3A5-6986 A/G GG genotype is associated with a four-fold increase in the likelihood of encountering a TAC concentration of more than 15 ng/dL. The co-occurrence of the CYP3A5-6986GG genotype and the use of drugs that increase TAC concentration correlates with a nine-fold increased risk of experiencing a TAC at a level above 15 ng/mL. Therefore, these patients have an increased susceptibility to TAC-associated toxicity.
Assuntos
Subfamília B de Transportador de Cassetes de Ligação de ATP , Citocromo P-450 CYP3A , Imunossupressores , Transplante de Rim , Polimorfismo de Nucleotídeo Único , Tacrolimo , Humanos , Citocromo P-450 CYP3A/genética , Transplante de Rim/efeitos adversos , Tacrolimo/sangue , Tacrolimo/farmacocinética , Tacrolimo/administração & dosagem , Subfamília B de Transportador de Cassetes de Ligação de ATP/genética , Feminino , Masculino , Polimorfismo de Nucleotídeo Único/genética , Adulto , México , Imunossupressores/farmacocinética , Imunossupressores/sangue , Imunossupressores/administração & dosagem , Pessoa de Meia-Idade , Genótipo , Rejeição de Enxerto/genéticaRESUMO
A poorly studied issue in women with breast cancer is the role of incretins (GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1)) in the quantity and quality of muscle mass in lean and obese individuals. The current report aims to analyze the patterns of association and the role of incretin in muscle functionality and body composition in women with cancer compared with healthy women (mammography BI-RADS I or II) to elucidate whether GIP and GLP-1 can be used to estimate the risk, in conjunction with overweight or obesity, for breast cancer. We designed a case-control study in women with a breast cancer diagnosis confirmed by biopsy in different clinical stages (CS; n = 87) and healthy women with a mastography BI-RADS I or II within the last year (n = 69). The women were grouped according to body mass index (BMI): lean (<25 kg/m2BS), overweight (≥25-<30 kg/m2BS), and obese (≥30 kg/m2BS). We found that GLP-1 and GIP levels over 18 pg/mL were associated with a risk of breast cancer (GIP OR = 36.5 and GLP-1 OR = 4.16, for the entire sample), particularly in obese women (GIP OR = 8.8 and GLP-1 OR = 6.5), and coincidentally with low muscle quality indexes, showed an association between obesity, cancer, incretin defects, and loss of muscle functionality.
RESUMO
A balanced translocation affecting DISC1 cosegregates with several psychiatric disorders, including schizophrenia, in a Scottish family. DISC1 is a hub protein of a network of protein-protein interactions involved in multiple developmental pathways within the brain. Gene set-based analysis has been proposed as an alternative to individual analysis of single nucleotide polymorphisms (SNPs) to get information from genome-wide association studies. In this work, we tested for an overrepresentation of the DISC1 interacting proteins within the top results of our ranked list of genes based on our previous genome-wide association study of missense SNPs in schizophrenia. Our data set consisted of 5100 common missense SNPs genotyped in 476 schizophrenic patients and 447 control subjects from Galicia, NW Spain. We used a modification of the Gene Set Enrichment Analysis adapted for SNPs, as implemented in the GenGen software. The analysis detected an overrepresentation of the DISC1 interacting proteins (permuted P-value=0.0158), indicative of the role of this gene set in schizophrenia risk. We identified seven leading-edge genes, MACF1, UTRN, DST, DISC1, KIF3A, SYNE1, and AKAP9, responsible for the overrepresentation. These genes are involved in neuronal cytoskeleton organization and intracellular transport through the microtubule cytoskeleton, suggesting that these processes may be impaired in schizophrenia.
Assuntos
Proteínas de Transporte/metabolismo , Estudo de Associação Genômica Ampla , Mutação de Sentido Incorreto , Proteínas do Tecido Nervoso/genética , Proteínas do Tecido Nervoso/metabolismo , Polimorfismo de Nucleotídeo Único , Esquizofrenia/genética , Esquizofrenia/metabolismo , Biologia Computacional , Conjuntos de Dados como Assunto , Epistasia Genética , Predisposição Genética para Doença , Genótipo , Humanos , Ligação Proteica , RiscoRESUMO
Peptidyl arginine deiminase IV (PAD 4) is the responsible enzyme for a posttranslational modification called citrullination, originating the antigenic determinant recognized by anti-cyclic citrullinated peptide antibodies (ACPA). Four SNPs (single nucleotide polymorphisms) have been described in PADI4 gene to form a susceptibility haplotype for rheumatoid arthritis (RA); nevertheless, results in association studies appear contradictory in different populations. The aim of the study was to analyze if the presence of three SNPs in PADI4 gene susceptibility haplotype (GTG) is associated with ACPA positivity in patients with RA. This was a cross-sectional study that included 86 RA patients and 98 healthy controls. Polymorphisms PADI4_89, PADI4_90, and PADI4_92 in the PADI4 gene were genotyped. The susceptibility haplotype (GTG) was more frequent in RA patients; interestingly, we found a new haplotype associated with RA with a higher frequency (GTC). There were no associations between polymorphisms and high scores in Spanish HAQ-DI and DAS-28, but we did find an association between RARBIS index and PADI4_89, PADI4_90 polymorphisms. We could not confirm an association between susceptibility haplotype presence and ACPA positivity. Further evidence about proteomic expression of this gene will determine its participation in antigenic generation and autoimmunity.
Assuntos
Artrite Reumatoide/genética , Artrite Reumatoide/imunologia , Predisposição Genética para Doença , Haplótipos , Hidrolases/genética , Adulto , Alelos , Artrite Reumatoide/tratamento farmacológico , Autoanticorpos/sangue , Autoanticorpos/imunologia , Estudos de Casos e Controles , Estudos Transversais , Frequência do Gene , Genótipo , Humanos , México , Pessoa de Meia-Idade , Peptídeos Cíclicos/imunologia , Polimorfismo de Nucleotídeo Único , Proteína-Arginina Desiminase do Tipo 4 , Desiminases de Arginina em Proteínas , Fatores de RiscoRESUMO
UNLABELLED: The angiotensin (Ang)-converting enzyme (ACE) insertion/deletion (I/D) polymorphism determines Ang II levels, but its relationship with lupus nephritis (LN) in different populations is controversial. OBJECTIVE: To describe the allelic and genotypic distribution of the I/D polymorphism in Mexican mestizos with LN and assess an association with histological classes. METHODS: We included 24 patients with systemic lupus erythematosus (SLE) without nephropathy, 41 with LN, 144 healthy subjects, and 36 with primary glomerulonephritis (GMN). Three ACE I/D polymorphism genotypes-ID, DD, and II--were detected by PCR using peripheral blood genomic DNA. RESULTS: Frequencies for II, ID, and DD were 0.29, 0.46, and 0.25 in the SLE group; 0.17, 0.63, and 0.20 in the LN group; 0.14, 0.5, and 0.36 in the GMN group; and 0.26, 0.52, and 0.22 among healthy subjects. The I/D polymorphism distribution according to histological class was class II: 1 II, 3 ID, and 1 DD; class III: 2 II, 10 ID, and 1 DD; class IV: 2 II, 9 ID, and 2 DD; class V: 2 II, 3 ID, and 4 DD; and class VI, 1 II. The histological classes with at least three patients had ID genotype as the most frequent except for class V. CONCLUSION: No association was identified between I/D polymorphisms of ACE and SLE, LN, or GMN in a Mexican population.
Assuntos
Nefrite Lúpica/enzimologia , Nefrite Lúpica/genética , Americanos Mexicanos/genética , Peptidil Dipeptidase A/genética , Deleção de Sequência , Adulto , Alelos , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Nefrite Lúpica/etnologia , Masculino , Mutagênese Insercional , Polimorfismo GenéticoRESUMO
Due to the limited availability of in-person interventions for caregivers, the development of effective programs that use new technologies to prevent depression is needed. The goal of this research was to assess the efficacy of a cognitive behavioral intervention for the prevention of depression, administered to nonprofessional caregivers through a smartphone application (app). One hundred and seventy-five caregivers were randomly assigned to either an app-based cognitive behavioral intervention (CBIA), the CBIA intervention plus a telephone conference call (CBIA + CC), or an attention control group (ACG). At post-intervention, the incidence of depression was lower in the CBIA and CBIA + CC compared to the ACG (1.7% and 0.0% vs. 7.9%, respectively). The absolute risk, relative risk, and number needed to treat compared to the ACG were 6.2%, 21.6%, and 16 for the CBIA, whilst they were 8%, 0.0%, and 13 for the CBIA + CC. Depressive symptomatology was significantly lower in the CBIA and CBIA + CC compared to the ACG (d = 0.84, Cliff's δ = 0.49; d = 1.56, Cliff's δ = 0.72), as well as in the CBIA + CC compared to the CBIA (d = 0.72, Cliff's δ = 0.44). The prevention of depression was more likely in participants who received the CBIA, and adding the conference call in the CBIA + CC group improved the likelihood of this.