Lower frequency of the HLA-G UTR-4 haplotype in women with unexplained recurrent miscarriage.

HLA-G expressed by trophoblasts at the fetal-maternal interface and its soluble form have immunomodulatory effects. HLA-G expression depends on the combination of DNA polymorphisms. We hypothesized that combinations of specific single nucleotide polymorphisms (SNPs) in the 3'untranslated region (3'UTR) of HLA-G play a role in unexplained recurrent miscarriage. In a case control design, 100 cases with at least three unexplained consecutive miscarriages prior to the 20th week of gestation were included. Cases were at time of the third miscarriage younger than 36 years, and they conceived all their pregnancies from the same partner. The control group included 89 women with an uneventful pregnancy. The association of HLA-G 3'UTR SNPs and specific HLA-G haplotype with recurrent miscarriage was studied with logistic regression. Odds ratios (OR) and 95% confidence intervals (95% CI) were reported. Individual SNPs were not significantly associated with recurrent miscarriage after correction for multiple comparisons. However, the presence of the UTR-4 haplotype, which included +3003C, was significantly lower in women with recurrent miscarriage (OR 0.4, 95% CI 0.2-0.8, p = 0.015). In conclusion, this is the first study to perform a comprehensive analysis of HLA-G SNPs and HLA-G haplotypes in a well-defined group of women with recurrent miscarriage and women with uneventful pregnancy. The UTR-4 haplotype was less frequently observed in women with recurrent miscarriage, suggesting an immunoregulatory role of this haplotype for continuation of the pregnancy without complications. Thus, association of HLA-G with recurrent miscarriage is not related to single polymorphisms in the 3'UTR, but is rather dependent on haplotypes.

Collagenous gastritis associated with lymphocytic gastritis and celiac disease.

Collagenous gastritis is a rare disorder, with only 8 cases reported in the literature, 2 in children and 6 in adults. We report an additional case of collagenous gastritis in a 42-year-old man with celiac disease. A thickened (>10 microm) subepithelial collagen band with entrapped capillaries, fibroblasts, and inflammatory cells was seen in the stomach, associated with lymphocytic gastritis. The duodenal mucosa showed severe villous atrophy but no subepithelial collagen deposition. No evidence of lymphocytic or collagenous colitis was found in the colon. The patient became symptom-free on a gluten exclusion diet and showed partial improvement of histopathologic findings after 3 months. Collagenous gastritis is a rare disease, but a wider recognition of its histopathologic features and clinical associations may bring more cases to light and provide additional clues in determining its etiology and pathogenesis.

Results of Sotalol (Darob) therapy in ventricular arrhythmias.

UNLABELLED: The aim of this prospective study was to evaluate the benefit of Sotalol (Darob) use in the therapy of potential malignant ventricular arrhythmias and in the prophylaxis of potential malignant and malignant arrhythmias; the influence on mortality has also been considered. Eighty four patients (pts) diagnosed with ventricular extrasystoles (68 pts., namely 80.95%), ventricular tachycardia (9 pts., namely 10.71%) and ventricular fibrillation (7 pts., namely 8.34%) were included in this study. They have been monitored clinically, electrocardiographically and echocardiographically at 1,3,6 and 12 months (1 year). The drug was given orally in doses 80-320 mg/day in patients with ventricular extrasystoles and in mean doses of 160 mg/day, for 1 year, to prevent recurrencies of ventricular arrhythmias. CONCLUSIONS: 1. In malignant and potential malignant ventricular arrhythmias Darob has been efficient on long term (1 year) in 77.67% cases, while in curative treatment of non-malignant ventricular arrhythmias Darob has been efficient in 68.31% cases. 2. Only minor proarrhythmogenic effects have been noticed for the doses of Darob used in this study. 3. long-term administration of Darob seems to reduce the incidence of cardiovascular deaths (35.30% cardiac deaths and 64.70% non-cardiac deaths have been recorded; p < 0.05). 4. Darob constitutes a drug of choice in postinfarction ventricular arrhythmias therapy, due to the beta-blocking effect, favourable during the ischemic episodes which may trigger arrhythmias.