Ассоциация полиморфных вариантов гена мозгового нейротрофического фактора (BDNF rs6265) и гена переносчика глутамата второго типа (SLC1A2 rs4354668) с течением рассеянного склероза у пациентов, проживающих в Томской области

Background: Multiple sclerosis (MS) is an autoimmune disease of the central nervous system that affects people of working age and ultimately leads to disability. This disease is of polygenic origin. The role of factors related to the pathogenesis of the disease and affecting both neuroinflammation and remyelination is studied. Aims: Our goal was to investigate the association of single nucleotide polymorphisms BDNF rs6265 and SLC1A2 rs4354668 with the risk of occurrence, clinical manifestations and the course of MS.Materials and methods: The study included 302 patients with MS, 268 healthy volunteers were enrolled in a control group. The obtained blood was used for DNA extraction by standard phenol-chloroform method. The identification of allelic variants of genes SLC1A2 (rs4354668) and BDNF (rs6265) was performed by polymerase chain reaction.Results: When comparing the frequencies of genotypes and alleles of polymorphic variants of BDNF and SLC1A2 genes between the groups of MS patients and the control group, no statistically significant differences were revealed. Comparison of genotype and allele frequencies of patients depending on sex, age of onset of the disease also did not reveal statistically significant differences. The study of the association of polymorphic variant of the gene BDNF (rs6265) with clinical manifestations of the disease revealed the association of genotype CC with oculomotor and trigeminal disorders at the onset of the disease (F=7, p=0.017). The study of the polymorphic variant rs4354668 of the glutamate transporter gene SLC1A2 revealed the association of allele G with an earlier (within 5 years from the moment of debut) transition of the disease to the stage of secondary progression, despite the therapy with DMT (χ2=5.940; p=0.010; OR 1.58; 95% CI 1.09−2.29). Homozygous genotype of TT (χ2=6.393; p=0.041; OR 0.50; 95% CI 0.28−0.88) and allele T (χ2=5.940; p=0.010; OR 0.63; 95% CI 0.44−0.92) of the polymorphism rs4354668 of the glutamate transporter gene SLC1A2 are significantly more common in the group of patients with late transition (15 years or more from the moment of debut) to the secondary progressive course.Conclusions: In our study we revealed the relationship of the studied polymorphic variants of genes with clinical signs at the onset of the disease and with the clinical manifestations of MS in patients living in the Tomsk region.Обоснование. Рассеянный склероз ― аутоиммунное заболевание нервной системы, поражающее людей трудоспособного возраста и приводящее в конечном итоге к инвалидизации. В последние годы наблюдается рост числа больных, связанный как с истинным увеличением заболеваемости, так и с качеством диагностики.Цель исследования ― оценка ассоциации однонуклеотидных полиморфных вариантов генов BDNF rs6265 и SLC1A2 rs4354668 с риском возникновения, клиническими проявлениями и течением рассеянного склероза.Методы. В исследование было включено 302 пациента с рассеянным склерозом, 268 здоровых добровольцев составили группу контроля. Пациенты находились на лечении в неврологической клинике Сибирского государственного медицинского университета. Определение аллельных вариантов генов SLC1A2 (rs4354668) и BDNF (rs6265) проводили методом полимеразной цепной реакции. Амплификацию и анализ результатов осуществляли с помощью приборов StepOnePlus и Quant Studio 5 (Applied Biosystems, США).Результаты. При сравнении частоты генотипов и аллелей полиморфных вариантов генов BDNF и SLC1A2 между группами пациентов с рассеянным склерозом и группой контроля статистически значимых различий не выявлено. Сравнение частоты генотипов и аллелей пациентов в зависимости от пола, возраста начала заболевания также статистически значимых различий не выявило. При исследовании связи полиморфного варианта гена BDNF (rs6265) с клиническими проявлениями болезни найдена ассоциация генотипа СС с глазодвигательными и тригеминальными расстройствами в дебюте заболевания (F=7; p=0,017). При исследовании полиморфного варианта rs4354668 гена глутаматного транспортера SLC1A2 выявлена ассоциация аллеля G с более ранним (в течение 5 лет от момента дебюта) переходом заболевания в стадию вторичного прогрессирования, несмотря на терапию препаратами, изменяющими течение рассеянного склероза (χ2=5,940; р=0,010; OR 1,58; 95% CI 1,09−2,29). Гомозиготный генотип ТТ (χ2=6,393; р=0,041; OR 0,50; 95% CI 0,28−0,88) и аллель Т (χ2=5,940; р=0,010; OR 0,63; 95% CI 0,44−0,92) полиморфизма rs4354668 гена глутаматного транспортера SLC1A2 статистически значимо чаще встречаются в группе пациентов с поздним переходом (через 15 и более лет от момента дебюта) во вторично-прогрессирующее течение.Заключение. В нашем исследовании выявлена связь изучаемых полиморфных вариантов генов с клиническими признаками в дебюте заболевания и с особенностью течения заболевания у пациентов, проживающих на территории Томской области

Autoantibodies against type I IFNs in patients with life-threatening COVID-19

Interindividual clinical variability in the course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is vast. We report that at least 101 of 987 patients with life-threatening coronavirus disease 2019 (COVID-19) pneumonia had neutralizing immunoglobulin G (IgG) autoantibodies (auto-Abs) against interferon-w (IFN-w) (13 patients), against the 13 types of IFN-a (36), or against both (52) at the onset of critical disease; a few also had auto-Abs against the other three type I IFNs. The auto-Abs neutralize the ability of the corresponding type I IFNs to block SARS-CoV-2 infection in vitro. These auto-Abs were not found in 663 individuals with asymptomatic or mild SARS-CoV-2 infection and were present in only 4 of 1227 healthy individuals. Patients with auto-Abs were aged 25 to 87 years and 95 of the 101 were men. A B cell autoimmune phenocopy of inborn errors of type I IFN immunity accounts for life-threatening COVID-19 pneumonia in at least 2.6% of women and 12.5% of men

Contemporary Presentation and Management of Valvular Heart Disease The EURObservational Research Programme Valvular Heart Disease II Survey

International audienceBackground: Valvular heart disease (VHD) is an important cause of mortality and morbidity and has been subject to important changes in management. The VHD II survey was designed by the EURObservational Research Programme of the European Society of Cardiology to analyze actual management of VHD and to compare practice with guidelines. Methods: Patients with severe native VHD or previous valvular intervention were enrolled prospectively across 28 countries over a 3-month period in 2017. Indications for intervention were considered concordant if the intervention was performed or scheduled in symptomatic patients, corresponding to Class I recommendations specified in the 2012 European Society of Cardiology and in the 2014 American Heart Association/American College of Cardiology VHD guidelines. Results: A total of 7247 patients (4483 hospitalized, 2764 outpatients) were included in 222 centers. Median age was 71 years (interquartile range, 62-80 years); 1917 patients (26.5%) were >= 80 years; and 3416 were female (47.1%). Severe native VHD was present in 5219 patients (72.0%): aortic stenosis in 2152 (41.2% of native VHD), aortic regurgitation in 279 (5.3%), mitral stenosis in 234 (4.5%), mitral regurgitation in 1114 (21.3%; primary in 746 and secondary in 368), multiple left-sided VHD in 1297 (24.9%), and right-sided VHD in 143 (2.7%). Two thousand twenty-eight patients (28.0%) had undergone previous valvular intervention. Intervention was performed in 37.0% and scheduled in 26.8% of patients with native VHD. The decision for intervention was concordant with Class I recommendations in symptomatic patients with severe single left-sided native VHD in 79.4% (95% CI, 77.1-81.6) for aortic stenosis, 77.6% (95% CI, 69.9-84.0) for aortic regurgitation, 68.5% (95% CI, 60.8-75.4) for mitral stenosis, and 71.0% (95% CI, 66.4-75.3) for primary mitral regurgitation. Valvular interventions were performed in 2150 patients during the survey; of them, 47.8% of patients with single left-sided native VHD were in New York Heart Association class III or IV. Transcatheter procedures were performed in 38.7% of patients with aortic stenosis and 16.7% of those with mitral regurgitation. Conclusions: Despite good concordance between Class I recommendations and practice in patients with aortic VHD, the suboptimal number in mitral VHD and late referral for valvular interventions suggest the need to improve further guideline implementation