Deletions in VANGL1 are a risk factor for antibody-mediated kidney disease

We identify an intronic deletion in VANGL1 that predisposes to renal injury in high risk populations through a kidney-intrinsic process. Half of all SLE patients develop nephritis, yet the predisposing mechanisms to kidney damage remain poorly understood. There is limited evidence of genetic contribution to specific organ involvement in SLE.(1,2) We identify a large deletion in intron 7 of Van Gogh Like 1 (VANGL1), which associates with nephritis in SLE patients. The same deletion occurs at increased frequency in an indigenous population (Tiwi Islanders) with 10-fold higher rates of kidney disease compared with non-indigenous populations. Vangl1 hemizygosity in mice results in spontaneous IgA and IgG deposition within the glomerular mesangium in the absence of autoimmune nephritis. Serum transfer into B cell-deficient Vangl1(+/-) mice results in mesangial IgG deposition indicating that Ig deposits occur in a kidney-intrinsic fashion in the absence of Vangl1. These results suggest that Vangl1 acts in the kidney to prevent Ig deposits and its deficiency may trigger nephritis in individuals with SLE

Tuberculosis in renal transplant recipients

Infective complications are common after renal transplantation. Tuberculosis (TB) is one of the leading infections following renal transplantation. Reactivation is the most common mode of infection. The factors responsible for this reactivation are chronic liver disease, other coexisting infections, particularly deep mycoses, pneumocystis pneumonia, nocardia, and CMV infections. Cyclosporine use advances the onset of TB to an earlier date. The median onset following transplantation is estimated to be 26 months for those who receive azathioprine and prednisolone as immunosuppression and 11 months for those who receive cyclosporine along with other immunosuppressive agents. Lung is the major site of involvement. Pyrexia of unknown origin is another common presentation. Culture and sensitivity has to be done in all possible cases. Amongst the serological techniques, Interferon alpha production is emerging as the most important. Rifampicin has to be avoided in allograft recipients as it activates cytochrome-P450 enzymes and thereby decreases the therapeutic levels of cyclosporine and prednisolone. The duration of treatment is usually extended for 18 months followed by secondary prophylaxis with isoniazid. Adverse effects of drugs are more often reported in organ recipients and have to be monitored for. Drug resistance is emerging as a problem and appropriate changes in the management have to be carried out

Alcohol Use and STI among Men in India: Evidences from a National Household Survey

Background: Alcohol use has been found to correlate with risky sexual behavior as well as with sexually transmitted infections (STI) among populations with high-risk behavior in India. Objective: To examine the correlates of alcohol use and its association with STI among adult men in India. Materials and Methods: Data from a national representative large-scale household sample survey in the country were used. It included information on sociodemographic characteristics and alcohol use as a part of substance use. Clinical as well laboratory testing was done to ascertain the STI. Results: The overall STI prevalence among adult males was found to be 2.5% (95% confidence interval (CI): 1.9-3.1). Over 26% adult men were found to have been using alcohol in the study population. It was higher among men who were illiterate and unskilled industrial workers/drivers. The men who consumed alcohol had higher prevalence of STI (3.6%; 95% CI: 2.9-5.1) than those who did not consume alcohol (2.1%; 95% CI: 1.5-2.6). The degree of association between alcoholism and STI was slightly reduced after adjusting for various sociodemographic characteristics (adjusted odds ratio: 1.5; 95% CI: 0.9-2.3; P=0.06). Conclusions: The findings of present study suggest integrating alcohol risk reduction into STI/HIV prevention programmes