MPO G-463A Gene Polymorphism and Circulating Matrix Metalloproteinase-9, Myeloperoxidase Levels in Coronary Artery Disease Patients

Objective: Coronary artery disease(CAD) patients living in Elazığ region is to assess the levels of matrix metalloproteinase-9(MMP-9) and myeloperoxidase(MPO), polymorphisms MPO gene. Research Design and Methods: Eighty-eight patients with angiographically diagnosed coronary artery disease between the ages of 18-80 who applied to Department of Cardiology, Faculty of Medicine, Firat University were enrolled in this study. MPO, MMP-9 levels in plasma samples of individuals were determined by enzyme-linked immuno sorbent assay (ELISA) according to the kit procedure. MPO polymorphism was studied using the PCR-RFLP technique. Results: When plasma MPO and MMP-9 levels were compared in the control and CAD groups; MPO levels were statistically significant (p <0.05). MMP-9 levels were not statistically significant. MPO gene polymorphism was not found statistically significant in CAD. Conclusion: MPO gene polymorphism is thought to be associated with greater population populations in CAD and may be used in the future as a biomarker for plasma MPO enzyme levels in CAD.Key words: MPO, coronary artery disease, MMP-9DOI: 10.7176/JHMN/83-0

Dynamics of the gut microbiome, IgA response, and plasma metabolome in the development of pediatric celiac disease

Abstract Background Celiac disease (CD) is an autoimmune disorder triggered by gluten consumption. Almost all CD patients possess human leukocyte antigen (HLA) DQ2/DQ8 haplotypes; however, only a small subset of individuals carrying these alleles develop CD, indicating the role of environmental factors in CD pathogenesis. The main objective of this study was to determine the contributory role of gut microbiota and microbial metabolites in CD onset. To this end, we obtained fecal samples from a prospective cohort study (ABIS) at ages 2.5 and 5 years. Samples were collected from children who developed CD after the final sample collection (CD progressors) and healthy children matched by age, HLA genotype, breastfeeding duration, and gluten-exposure time (n=15–16). We first used 16S sequencing and immunoglobulin-A sequencing (IgA-seq) using fecal samples obtained from the same children (i) 16 controls and 15 CD progressors at age 2.5 and (ii) 13 controls and 9 CD progressors at age 5. We completed the cytokine profiling, and plasma metabolomics using plasma samples obtained at age 5 (n=7–9). We also determined the effects of one microbiota-derived metabolite, taurodeoxycholic acid (TDCA), on the small intestines and immune cell composition in vivo. Results CD progressors have a distinct gut microbiota composition, an increased IgA response, and unique IgA targets compared to healthy subjects. Notably, 26 plasma metabolites, five cytokines, and one chemokine were significantly altered in CD progressors at age 5. Among 26 metabolites, we identified a 2-fold increase in TDCA. TDCA treatment alone caused villous atrophy, increased CD4+ T cells, Natural Killer cells, and two important immunoregulatory proteins, Qa-1 and NKG2D expression on T cells while decreasing T-regulatory cells in intraepithelial lymphocytes (IELs) in C57BL/6J mice. Conclusions Pediatric CD progressors have a distinct gut microbiota composition, plasma metabolome, and cytokine profile before diagnosis. Furthermore, CD progressors have more IgA-coated bacteria and unique targets of IgA in their gut microbiota. TDCA feeding alone stimulates an inflammatory immune response in the small intestines of C57BJ/6 mice and causes villous atrophy, the hallmark of CD. Thus, a microbiota-derived metabolite, TDCA, enriched in CD progressors’ plasma, has the potential to drive inflammation in the small intestines and enhance CD pathogenesis. Video Abstrac

Characteristics of Turkish children with Type 2 diabetes at onset: a multicentre, cross-sectional study

Aims To describe the baseline clinical and laboratory findings and treatment modalities of 367 children and adolescents diagnosed with Type 2 diabetes in various paediatric endocrinology centres in Turkey. Methods A standard questionnaire regarding clinical and laboratory characteristics at onset was uploaded to an online national database system. Data for 367 children (aged 6-18 years) newly diagnosed with Type 2 diabetes at 37 different paediatric endocrinology centres were analysed. Results After exclusion of the children with a BMI Z-score 50% of the children were asymptomatic at diagnosis. The other important result of our study was the high rate of exclusion from the initial registration (38%), suggesting that accurate diagnosis of Type 2 diabetes in youth is still problematic, even for paediatric endocrinologists

Characteristics of Turkish children with Type 2 diabetes at onset: a multicentre, cross-sectional study

Aims To describe the baseline clinical and laboratory findings and treatment modalities of 367 children and adolescents diagnosed with Type 2 diabetes in various paediatric endocrinology centres in Turkey. Methods A standard questionnaire regarding clinical and laboratory characteristics at onset was uploaded to an online national database system. Data for 367 children (aged 6-18 years) newly diagnosed with Type 2 diabetes at 37 different paediatric endocrinology centres were analysed. Results After exclusion of the children with a BMI Z-score < 1 SD, those with genetic syndromes associated with Type 2 diabetes, and those whose C-peptide and/or insulin levels were not available, 227 cases were included in the study. Mean age was 13.8 +/- 2.2 (range 6.5-17.8) years, with female preponderance (68\%). Family history of Type 2 diabetes was positive in 86\% of the children. The mean BMI was 31.3 +/- 6.5 kg/m(2) (range 18.7-61) and BMI Z-score was 2.4 +/- 0.8 (range 1-5). More than half (57\%) of the children were identified by an opportunistic diabetes screening due to existing risk markers without typical symptoms of diabetes. Only 13\% (n = 29) were treated solely by lifestyle modification, while 40.5\% (n = 92) were treated with metformin, 13\% (n = 30) were treated with insulin, and 33.5\% (n = 76) were treated with a combination of insulin and metformin initially. Mean HbA(1C) levels of the insulin and combination of insulin and metformin groups were 98 (11.1\%) and 102 mmol/mol (11.5\%), respectively, and also were significantly higher than the lifestyle modification only and metformin groups mean HbA(1C) levels (70(8.6\%) and 67 mmol/mol (8.3\%), respectively). Conclusions An opportunistic screening of children who are at high risk of Type 2 diabetes is essential, as our data showed that > 50\% of the children were asymptomatic at diagnosis. The other important result of our study was the high rate of exclusion from the initial registration (38\%), suggesting that accurate diagnosis of Type 2 diabetes in youth is still problematic, even for paediatric endocrinologists