Lupus nephritis in Chinese children--a territory-wide cohort study in Hong Kong

We report a multicenter study of Chinese children in Hong Kong with systemic lupus erythematosus (SLE) nephritis. Children were included if: they fulfilled the ACR criteria, had significant proteinuria or casturia, were Chinese and younger than 19 years and had been diagnosed with SLE between January 1990 and December 2003. Investigators in each center retrieved data on clinical features, biopsy reports, treatment and outcome of these patients. There were 128 patients (eight boys, 120 girls; mean age: 11.9+/-2.8 years). About 50% presented with multisystem illness and 40% with nephritic/nephrotic symptoms. Negative anti-dsDNA antibodies were found in 6% of the patients. Renal biopsy revealed WHO Class II, III, IV and V nephritis in 13 (10%), 22 (17%), 69 (54%) and 13 (10%) patients, respectively. The clinical severity of the nephritis did not accurately predict renal biopsy findings. The follow-up period ranged from 1 to 16.5 years (mean+/-SD: 5.76+/-3.61 years). During the study five patients died (two from lupus flare, one from cardiomyopathy, two from infections). Four patients had endstage renal failure (ESRF) (one died during a lupus flare). All deaths and end-stage renal failure occurred in the Class IV nephritis group. Chronic organ damage was infrequent in the survivors. The actuarial patient survival rates at 5, 10 and 15 years of age were 95.3, 91.8, and 91.8%, respectively. For Class IV nephritis patients, the survival rates without ESRF at 5, 10, and 15 years were 91.5, 82.3 and 76%, respectively. The survival and chronic morbidity rates of the Chinese SLE children in the present study are comparable to those of other published studies.postprin

Meta-analysis Followed by Replication Identifies Loci in or near CDKN1B, TET3, CD80, DRAM1, and ARID5B as Associated with Systemic Lupus Erythematosus in Asians

Systemic lupus erythematosus (SLE) is a prototype autoimmune disease with a strong genetic involvement and ethnic differences. Susceptibility genes identified so far only explain a small portion of the genetic heritability of SLE, suggesting that many more loci are yet to be uncovered for this disease. In this study, we performed a meta-analysis of genome-wide association studies on SLE in Chinese Han populations and followed up the findings by replication in four additional Asian cohorts with a total of 5,365 cases and 10,054 corresponding controls. We identified genetic variants in or near CDKN1B, TET3, CD80, DRAM1, and ARID5B as associated with the disease. These findings point to potential roles of cell-cycle regulation, autophagy, and DNA demethylation in SLE pathogenesis. For the region involving TET3 and that involving CDKN1B, multiple independent SNPs were identified, highlighting a phenomenon that might partially explain the missing heritability of complex diseases

Teaching enhancement by using simulated learning aids : interactive 3D animations of the 12 pairs of cranial nerves in the human brain

Teaching neuroanatomy is not an easy task. Students always have difficulty in learning and sometimes they even refuse to take classes that cover brain biology. The major stumbling block in teaching neurobiology more effectively is the complexity of the human nervous system. The brain of a human being, when exposed, looks rather like an enormous walnut; it is made up, like other organs, of cells, and has been mapped in minute detail. The brain is composed of many billions of neurons linked by a unique connectivity; however, the neuronal circuitry within our brain is very abstract, and even some times imaginative. Here we have developed a series of Simulated Learning Aids (SLAs) that contains mainly visualization and simulations of the neuronal connectivity within the nervous system. Students can look at this neuronal connectivity from different angles, such as dorsal, ventral, caudal and rostral views. These different views are usually difficult to illustrate on paper or via slides that present 2D images, or even using a brain model. By using SLAs containing 3D visualizations and simulated neural pathways, students can visualize the connection of nerves between different targets and, therefore, are able to understand the topology and innervations of this connection. Besides demonstrating the SLAs in classroom, students may also access the program on-line through a WebCT course. The existence of these SLAs thus facilitates both teaching and learning of the topic inside and outside the classroom. In addition, the use of multimedia components as well as 2D and 3D computer graphics in the SLAs in illustrating the functions of neuronal circuits also help students learn neurobiology in a fast and enjoyable way. The 12 pairs of cranial nerves in the brain stem are used here for illustration. These cranial nerves are very important in controlling the muscles of the face, mouth, eyes and neck, and their neuronal connectivity is a complex one. Using computer graphics, the neuronal connectivity of the cranial nerves is demonstrated from different angles. Additionally, the functional aspects, motor or sensory, of these nerves are illustrated by a uniform storyboard

Three SNPs in chromosome 11q23.3 are independently associated with systemic lupus erythematosus in Asians

Systemic lupus erythematosus (SLE) has a complex etiology and is affected by both genetic and environmental factors. Althoughmorethan 40 loci haveshownrobust association withSLE, the details of these loci,suchas the independent contributors and the genes involved, are still unclear. In this study, we performed meta-analysis of two existing genome-wide association studies (GWASs) on Chinese Han populations from Hong Kong and Anhui, China, and followed the findings by further replication on three additional Chinese and Thailand cohorts with a total of 4254 cases and 6262 controls matched geographically and ethnically. We discovered multiple susceptibility variants for SLE in the 11q23.3 region, including variants in/near PHLDB1 (rs11603023, P_combined 5 1.25E208, OR 5 1.20), DDX6 (rs638893, P_combined 5 5.19E207, OR 5 1.22) and CXCR5 (rs10892301, P_combined 5 2.51E208, OR 5 0.85). Genetic contributions from the newly identified variants were all independent of SNP rs4639966, whose association was reported from the previous GWAS. In addition, the three newly identified variants all showed independent association with the disease through modeling by both stepwise and conditional logistic regression. The presence of multiple independent variants in this region emphasizes its role in SLE susceptibility, and also hints the possibility that distinct biological mechanisms might be involved in the disease involving this genomic region. © The Author 2013. Published by Oxford University Press. All rights reserved.Link_to_subscribed_fulltex

Meta-analysis of GWAS on two Chinese populations followed by replication identifies novel genetic variants on the X chromosome associated with systemic lupus erythematosus

© The Author 2014. Published by Oxford University Press. All rights reserved. Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease that affects mainly females. What role the X chromosome plays in the disease has always been an intriguing question. In this study, we examined the genetic variants on the X chromosome through meta-analysis of two genome-wide association studies (GWAS) on SLE on Chinese Han populations. Prominent association signals from the meta-analysis were replicated in 4 additional Asian cohorts, with a total of 5373 cases and 9166 matched controls. We identified a novel variant in PRPS2 on Xp22.3 as associated with SLE with genome-wide significance (rs7062536, OR = 0.84, P = 1.00E-08). Association of the L1CAM-MECP2 region with SLE was reported previously. In this study, we identified independent contributors in this region in NAA10 (rs2071128, OR = 0.81, P = 2.19E-13) and TMEM187 (rs17422, OR = 0.75, P = 1.47E-15), in addition to replicating the association from IRAK1-MECP2 region (rs1059702, OR = 0.71, P = 2.40E-18) in Asian cohorts. The X-linked susceptibility variants showed higher effect size in males than that in females, similar to results from a genome-wide survey of associated SNPs on the autosomes. These results suggest that susceptibility genes identified on the X chromosome, while contributing to disease predisposition, might not contribute significantly to the female predominance of this prototype autoimmune disease.Link_to_subscribed_fulltex