7 research outputs found
Common Inflammation-Related Candidate Gene Variants and Acute Kidney Injury in 2647 Critically Ill Finnish Patients
Acute kidney injury (AKI) is a syndrome with high incidence among the critically ill. Because the clinical variables and currently used biomarkers have failed to predict the individual susceptibility to AKI, candidate gene variants for the trait have been studied. Studies about genetic predisposition to AKI have been mainly underpowered and of moderate quality. We report the association study of 27 genetic variants in a cohort of Finnish critically ill patients, focusing on the replication of associations detected with variants in genes related to inflammation, cell survival, or circulation. In this prospective, observational Finnish Acute Kidney Injury (FINNAKI) study, 2647 patients without chronic kidney disease were genotyped. We defined AKI according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. We compared severe AKI (Stages 2 and 3, n = 625) to controls (Stage 0, n = 1582). For genotyping we used iPLEX(TM) Assay (Agena Bioscience). We performed the association analyses with PLINK software, using an additive genetic model in logistic regression. Despite the numerous, although contradictory, studies about association between polymorphisms rs1800629 in TNFA and rs1800896 in IL10 and AKI, we found no association (odds ratios 1.06 (95% CI 0.89-1.28, p = 0.51) and 0.92 (95% CI 0.80-1.05, p = 0.20), respectively). Adjusting for confounders did not change the results. To conclude, we could not confirm the associations reported in previous studies in a cohort of critically ill patients.Peer reviewe
Heme oxygenase-1 repeat polymorphism in septic acute kidney injury
Acute kidney injury (AKI) is a syndrome that frequently affects the critically ill. Recently, an increased number of dinucleotide repeats in the HMOX1 gene were reported to associate with development of AKI in cardiac surgery. We aimed to test the replicability of this finding in a Finnish cohort of critically ill septic patients. This multicenter study was part of the national FINNAKI study. We genotyped 300 patients with severe AKI (KDIGO 2 or 3) and 353 controls without AKI (KDIGO 0) for the guanine-thymine (GTn) repeat in the promoter region of the HMOX1 gene. The allele calling was based on the number of repeats, the cut off being 27 repeats in the S-L (short to long) classification, and 27 and 34 repeats for the S-M-L2 (short to medium to very long) classification. The plasma concentrations of heme oxygenase-1 (HO-1) enzyme were measured on admission. The allele distribution in our patients was similar to that published previously, with peaks at 23 and 30 repeats. The S-allele increases AKI risk. An adjusted OR was 1.30 for each S-allele in an additive genetic model (95% CI 1.01-1.66; p = 0.041). Alleles with a repeat number greater than 34 were significantly associated with lower HO-1 concentration (p<0.001). In septic patients, we report an association between a short repeat in HMOX1 and AKI risk
Lapsen ja nuoren siitepölyallergian siedÀtyshoidon vaikutukset elÀmÀnlaatuun
Allergisten hengitystiesairauksien esiintyvyys on lisÀÀntynyt maailmanlaajuisesti. LapsuusiÀn yleisin krooninen sairaus on astma. Allergeenispesifinen immunoterapia voi muuttaa allergisten sairauksien luonnollista kulkua sÀÀtelemÀllÀ lapsuusiÀssÀ immuunijÀrjestelmÀn toimintaa.
OpinnÀytetyön tarkoituksena oli tutkia lasten ja nuorten siitepölyallergian siedÀtyksen vaikutuksia elÀmÀnlaatuun ja hoidon tehokkuutta. Tavoitteena oli, ettÀ hoitohenkilökunta ymmÀrtÀÀ paremmin siedÀtyshoidon tuloksia ja siten motivoituvat kannustamaan lapsia, nuoria ja heidÀn huoltajiaan siedÀtyshoidon aloittamiseen.
Kuvailevan kirjallisuuskatsauksen aineistoksi valikoitui 9 artikkelia sisÀÀnottokriteereiden perusteella ja jotka vastasivat tutkimuskysymykseen. Aineiston keruussa kÀytettiin tarkkaan valittuja hakusanoja. Tutkimuksista luokiteltiin tuloksiin allergiaoireiden vÀheneminen, oirelÀÀkkeiden kÀytön vÀheneminen, vaikutus astman kehittymiseen, siedÀtyshoidon helppous ja siedÀtyshoidon haittavaikutukset.
KielenalussiedÀtyshoito on erityisesti Keski-Euroopassa ohittanut pistossiedÀtyshoidon. Hoito on helppo toteuttaa kotona ja sivuvaikutuksia on vÀhÀn. Siitepölyallergisten lasten ja nuorten siedÀtyshoito osoitti allergiaoireiden mÀÀrÀn ja oireenmukaisen lÀÀkityksen tarpeen merkittÀvÀsti vÀhenevÀn. Hoitotyön nÀkökulmasta tulokset antavat hyvÀn pohjan suositella lapsille, nuorille ja heidÀn huoltajilleen siedÀtyshoidon aloittamista
Koululaisten sosiaaliset hierarkiat ja koulumyönteisyys
Sosiaalisen aseman mittaamisella pyritaÌaÌn tavoittamaan yhteiskunnallisia luokituksia, jotka ovat yhteydessaÌ, selittaÌvaÌt tai ennustavat elinoloissa tai hyvinvoinnissa havaittavia eroja. Sosiaalisen aseman mittaaminen on luokkayhteiskuntaa koskevan keskustelun myoÌtaÌ laventunut useammille ulottuvuuksille ja korostanut myoÌs yksiloÌiden oman naÌkemyksen, subjektiivisen sosiaalisen aseman merkitystaÌ luokituksissa. Lapsia ja nuoria koskevassa tutkimuksessa on myoÌs otettu huomioon yhaÌ enemmaÌn sosiaalisen aseman muotoutumisen hetki: oman subjektiivisen aseman ja kasvuperheen sosiaalisen aseman sekaÌ erottautuminen ettaÌ kytkeytyminen toisiinsa. Artikkelissa tarkastellaan helsinkilaÌisille peruskoulun 9-luokkalaisille suunnatun kyselylomakeaineiston (n=2369) avulla subjektiivisten ja objektiivisten sosiaalisen aseman mittareiden yhteyksiaÌ. Artikkelissa tutkitaan, miten oppilaan arvio perheensaÌ yhteiskunta-asemasta, oppilaan arvio asemastaan kouluyhteisoÌn hierarkiassa ja oppilaan objektiivisesti mitattu sosiaalinen asema ovat yhteydessaÌ toisiinsa. LisaÌksi tarkastellaan, miten naÌmaÌ erilaiset tavat mitata sosiaalista asemaa selittaÌvaÌt yhtaÌ koulutuksen saavutuksiin vaikuttavaa asennetekijaÌaÌ, koulumyoÌnteisyyttaÌ. Artikkelin tulokset osoittavat, ettaÌ subjektiivisilla sosiaalisen aseman mittareilla voidaan tavoittaa nuorten sosiaalisten hierarkioiden merkitys perheen sosiaalista asemaa ja objektiivisia mittareita kattavammin
Intestinal stroma guides monocyte differentiation to macrophages through GM-CSF
Abstract Stromal cells support epithelial cell and immune cell homeostasis and play an important role in inflammatory bowel disease (IBD) pathogenesis. Here, we quantify the stromal response to inflammation in pediatric IBD and reveal subset-specific inflammatory responses across colon segments and intestinal layers. Using data from a murine dynamic gut injury model and human ex vivo transcriptomic, protein and spatial analyses, we report that PDGFRA+CD142â /low fibroblasts and monocytes/macrophages co-localize in the intestine. In primary human fibroblast-monocyte co-cultures, intestinal PDGFRA+CD142â /low fibroblasts foster monocyte transition to CCR2+CD206+ macrophages through granulocyte-macrophage colony-stimulating factor (GM-CSF). Monocyte-derived CCR2+CD206+ cells from co-cultures have a phenotype similar to intestinal CCR2+CD206+ macrophages from newly diagnosed pediatric IBD patients, with high levels of PD-L1 and low levels of GM-CSF receptor. The study describes subset-specific changes in stromal responses to inflammation and suggests that the intestinal stroma guides intestinal macrophage differentiation
Association of oliguria with the development of acute kidney injury in the critically ill
Heme oxygenase-1 repeat polymorphism in septic acute kidney injury
Abstract
Acute kidney injury (AKI) is a syndrome that frequently affects the critically ill. Recently, an increased number of dinucleotide repeats in the HMOX1 gene were reported to associate with development of AKI in cardiac surgery. We aimed to test the replicability of this finding in a Finnish cohort of critically ill septic patients. This multicenter study was part of the national FINNAKI study. We genotyped 300 patients with severe AKI (KDIGO 2 or 3) and 353 controls without AKI (KDIGO 0) for the guanineâthymine (GTn) repeat in the promoter region of the HMOX1 gene. The allele calling was based on the number of repeats, the cut off being 27 repeats in the SâL (short to long) classification, and 27 and 34 repeats for the SâMâLâ (short to medium to very long) classification. The plasma concentrations of heme oxygenase-1 (HO-1) enzyme were measured on admission. The allele distribution in our patients was similar to that published previously, with peaks at 23 and 30 repeats. The S-allele increases AKI risk. An adjusted OR was 1.30 for each S-allele in an additive genetic model (95% CI 1.01â1.66; p = 0.041). Alleles with a repeat number greater than 34 were significantly associated with lower HO-1 concentration (p<0.001). In septic patients, we report an association between a short repeat in HMOX1 and AKI risk