Immunoloogia

Eesti Arst 2015; 94(7):437–43

Puukborrelioos

Viimastel aastatel on Eestis suurenenud puukborrelioosi haigestumine: kui 2005. a leiti 20,9 uut juhtu, siis 2008. a juba 106,0 uut juhtu 100 000 inimese kohta. Kas tegemist on haigestumise tõelise tõusuga või esineb haiguse ülediagnoosimist? Et osal juhtudel on esiplaanil mittespetsiif ilised sümptomid, siis on oluline diferentsiaaldiagnostiliselt arvestada ka teiste haigustega (reumatoloogilised, neuroloogilised) ning diagnoosi panemisel tuleb vaadata lisaks epidemioloogilisi ja laboratoorseid tulemusi koos. Eesti Arst 2009; 88(12):830−83

Preeklampsia riski ennustustesti ja -mudeli väljatöötamine

Eesti Arst 2021; 100(3):173 &nbsp

Mittealkohol-maksarasvtõve hindamise viisid igapäevatöö lihtsustamiseks

Maksarasvtõve kulu ajaliselt järgnevateks avaldusvormideks on maksasteatoos ehk rasvmaks, steatohepatiit ehk rasvhepatiit ja steatohepatiidist maksafibroosi erinevate raskusastmete kaudu kujunenud maksatsirroos. Seega on maksafibroosi raskusaste maksarasvtõve patsiendi haiguskulus oluline, et hinnata maksatsirroosi tekkevõimalust. Enim kasutatud mitteinvasiivsed maksafibroosi hindamise viisid maksarasvtõve korral on fibroosiskoorid NFS ja FIB-4 ning steatoosimäära näitav HSI.Uurimistöös analüüsiti retrospektiivselt elektrooniliste haiguslugude alusel aastatel 2015–2019 Tartu Ülikooli Kliinikumi gastroenteroloogia osakonnas diagnoositud 145 maksarasvtõve patsiendi haiguskulgu. Maksafibroosi hindamisel võivad osutuda otstarbekaks fibroosiskoorid NFS ja FIB-4. Steatoosiskoor HSI tõestas end maksarasvtõve spetsiifilise ja väga hea hindajana. Steatoosiskoori HSI kui kasutuslihtsa hindamisviisi kasutusele võtmine igapäevatöös võimaldab otsustada edasiste uuringute vajalikkuse üle ja anda patsiendile soovitusi, kuidas vältida kroonilise maksahaiguse progresseerumist

Allelic variants in the PHTF1-PTPN22, C12orf30 and CD226 regions as candidate susceptibility factors for the type 1 diabetes in the Estonian population

<p>Abstract</p> <p>Background</p> <p>Type 1 diabetes is a multifactorial disease with a strong genetic component. The aim of the study was to assess the impact of single nucleotide polymorphisms (SNPs) in several genes as susceptible markers in the risk of type 1 diabetes in the Estonian population. Methods: The rs6679677 (1p13), rs17696736 (12q24) and rs763361 (18q22) were genotyped in a total of 230 controls and 154 type 1 diabetes patients of Estonian origin.</p> <p>Results</p> <p>The rs6679677 A (OR = 2.13, 95%CI = 1.48-3.08, p = 0.00001), rs17696736 G (OR = 1.53, 95%CI = 1.14-2.04, p = 0.0046) and rs763361 T (OR = 1.48, 95%CI = 1.11-1.98, p = 0.0084) alleles were associated with risk of type 1 diabetes.</p> <p>Conclusions</p> <p>The current study supports the rs6679677 (PHTF1-PTPN22), rs17696736 (C12orf30) and rs763361 (CD226) SNPs as susceptibility factors for type 1 diabetes outside the major histocompatibility region (MHC) region. The full study had 80% or above to detect an odds ratio of 1.8 under the assumption of an additive model at type 1 error rate, α = 0.05.</p

Demographic associations for autoantibodies in disease-free individuals of a European population

The presence of autoantibodies usually precedes autoimmune disease, but is sometimes considered an incidental finding with no clinical relevance. The prevalence of immune-mediated diseases was studied in a group of individuals from the Estonian Genome Project (n = 51,862), and 6 clinically significant autoantibodies were detected in a subgroup of 994 (auto) immune-mediated disease-free individuals. The overall prevalence of individuals with immune-mediated diseases in the primary cohort was 30.1%. Similarly, 23.6% of the participants in the disease-free subgroup were seropositive for at least one autoantibody. Several phenotypic parameters were associated with autoantibodies. The results suggest that (i) immune-mediated diseases are diagnosed in nearly one-third of a random European population, (ii) 6 common autoantibodies are detectable in almost one-third of individuals without diagnosed autoimmune diseases, (iii) tissue non-specific autoantibodies, especially at high levels, may reflect preclinical disease in symptom-free individuals, and (iv) the incidental positivity of anti-TPO in men with positive familial anamnesis of maternal autoimmune disease deserves further medical attention. These results encourage physicians to evaluate autoantibodies in addition to treating a variety of patient health complaints to detect autoimmune-mediated disease early.Peer reviewe

Novel Early Pregnancy Multimarker Screening Test for Preeclampsia Risk Prediction

Preeclampsia (PE) is a common pregnancy-linked disease, causing preterm births, complicated deliveries, and health consequences for mothers and offspring. We have previously developed 6PLEX, a multiplex assay that measures PE-related maternal serum biomarkers ADAM12, sENG, leptin, PlGF, sFlt-1, and PTX3 in a single test tube. This study investigated the potential of 6PLEX to develop novel PE prediction models for early pregnancy. We analyzed 132 serum samples drawn at 70–275 gestational days (g days) from 53 pregnant women (PE, n = 22; controls, n = 31). PE prediction models were developed using a machine learning strategy based on the stepwise selection of the most significant models and incorporating parameters with optimal resampling. Alternative models included also placental FLT1 rs4769613 T/C genotypes, a high-confidence risk factor for PE. The best performing PE prediction model using samples collected at 70–98 g days comprised of PTX3, sFlt-1, and ADAM12, the subject's parity and gestational age at sampling (AUC 0.94 [95%CI 0.84–0.99]). All cases, that developed PE several months later (onset 257.4 ± 15.2 g days), were correctly identified. The model's specificity was 80% [95%CI 65–100] and the overall accuracy was 88% [95%CI 73–95]. Incorporating additionally the placental FLT1 rs4769613 T/C genotype data increased the prediction accuracy to 93.5% [AUC = 0.97 (95%CI 0.89–1.00)]. However, 6PLEX measurements of samples collected at 100–182 g days were insufficiently informative to develop reliable PE prediction models for mid-pregnancy (accuracy &lt;75%). In summary, the developed model opens new horizons for first-trimester PE screening, combining the easily standardizable 6PLEX assay with routinely collected antenatal care data and resulting in high sensitivity and specificity

Chronic mucocutaneous candidiasis in APECED or thymoma patients correlates with autoimmunity to Th17-associated cytokines

Chronic mucocutaneous candidiasis (CMC) is frequently associated with T cell immunodeficiencies. Specifically, the proinflammatory IL-17A–producing Th17 subset is implicated in protection against fungi at epithelial surfaces. In autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED, or autoimmune polyendocrine syndrome 1), CMC is often the first sign, but the underlying immunodeficiency is a long-standing puzzle. In contrast, the subsequent endocrine features are clearly autoimmune, resulting from defects in thymic self-tolerance induction caused by mutations in the autoimmune regulator (AIRE). We report severely reduced IL-17F and IL-22 responses to both Candida albicans antigens and polyclonal stimulation in APECED patients with CMC. Surprisingly, these reductions are strongly associated with neutralizing autoantibodies to IL-17F and IL-22, whereas responses were normal and autoantibodies infrequent in APECED patients without CMC. Our multicenter survey revealed neutralizing autoantibodies against IL-17A (41%), IL-17F (75%), and/ or IL-22 (91%) in >150 APECED patients, especially those with CMC. We independently found autoantibodies against these Th17-produced cytokines in rare thymoma patients with CMC. The autoantibodies preceded the CMC in all informative cases. We conclude that IL-22 and IL-17F are key natural defenders against CMC and that the immunodeficiency underlying CMC in both patient groups has an autoimmune basis

Borislav Runanine as the Head Mistress (centre left), David Lichine as a cadet (centre middle), Olga Morosova (?) as a junior girl (centre right), Igor Schwezoff as the Old General (front right back to audience), and artists of the company, in Graduation ball, The Original Ballet Russe, Australian tour, His Majesty's Theatre, Melbourne, 1940 [picture] /

From: Graduation ball : ballet in one act / by David Lichine ; music by Johann Strauss ; compiled, arranged and orchestrated by Antal Dorati.; Inscription: "4L/18".; Part of the collection: Hugh P. Hall collection of photographs, 1938-1940.; Performed April - June 1940.; Choreography by David Lichine ; scenery and costumes by Alexandre Benois ; scenery executed by Nadejda Benois ; ladies' costumes executed by O. Larose and Antoinette ; male costumes executed by A. H. Leiser.; Also available in an electronic version via the Internet at: http://nla.gov.au/nla.pic-vn4174724. One of a collection of photographs taken by Hugh P. Hall of 28 ballet productions performed by the Covent Garden Russian Ballet (toured Australia 1938-1939) and the Original Ballet Russe (toured Australia 1939-1940). These are the second and third of the three Ballets Russes companies which toured Australasia between 1936 and 1940. The photographs were taken from the auditorium during a live performance in His Majesty's Theatre, Melbourne and mounted on cardboard for display purposes. For conservation and storage, the photographs have been demounted. The original arrangement of the photographs has been recorded, and details are available from the Pictures Branch of the National Library