Study of relationship between IL-1Ra gene polymorphism and GVHD in HLA – identical sibling allogenic transplants

Introduction: The interleukin-1 (IL-1) gene family includes three members (IL-1a, IL-1b and IL-1Ra) that mediate immune and inflammatory responses. Interleukin-1 (IL-1) is an inflammatory cytokine involved in various autoimmune and inflammatory diseases. IL-1 receptor antagonist (IL-1Ra) is the naturally occurring antagonist to IL-1a and IL-1b. A variable number tandem repeat (VNTR) polymorphism in the IL-1Ra gene has been associated with increased IL-1Ra production and affects the severity of aGVHD. Material and methods: Three hundred and fifty pairs (175 HSCT recipients and their donors) were analyzed by VNTR/PCR. Because of haematological disorders all patients were transplanted. All genotypes were screened blind to the clinical outcome of the transplants. GVHD was graded using Glucksberg criteria. Results: The influence of different alleles on incidence of aGVHD was investigated with univariate analysis. None of them showed an association with aGVHD, but possession of allele 2 in donors was associated with less severe aGVHD, although the frequency of allele 2 in our study population was low. However, aGVHD correlated with recipient age, donor age and recipient disease, particularly thalassaemia. Conclusions: No significant correlation was observed between the IL-1Ra polymorphism and incidence of aGVHD. In addition there was a powerful association between diagnosis, particularly thalassaemia, and GVHD (26 out of 30 thalassaemia patients). These findings may help to predict the risk/severity of GVHD, which may contribute to selecting strategies for treatment/prevention in thalassaemia patients

Mapping routine measles vaccination in low- and middle-income countries

The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs)1–4. Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19)5–8. Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km2 pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children