Polymorphisms and haplotypes of TOLLIP and MUC5B are associated with susceptibility and survival in patients with fibrotic hypersensitivity pneumonitis

INTRODUCTION AND OBJECTIVES

Hypersensitivity pneumonitis (HP) is an interstitial lung disease with diverse clinical features that can present a fibrotic phenotype similar to idiopathic pulmonary fibrosis (IPF) in genetically predisposed individuals. While several single nucleotide polymorphisms (SNPs) have been associated with IPF, the genetic factors contributing to fibrotic HP (fHP) remain poorly understood. This study investigated the association of MUC5B and TOLLIP variants with susceptibility, clinical presentation and survival in Portuguese patients with fHP.

MATERIAL AND METHODS

A case-control study was undertaken with 97 fHP patients and 112 controls. Six SNPs residing in the MUC5B and TOLLIP genes and their haplotypes were analyzed. Associations with risk, survival, and clinical, radiographic, and pathological features of fHP were probed through comparisons among patients and controls.

RESULTS

MUC5B rs35705950 and three neighboring TOLLIP variants (rs3750920, rs111521887, and rs5743894) were associated with increased susceptibility to fHP. Minor allele frequencies were greater among fHP patients than in controls (40.7% vs 12.1%, P<0.0001; 52.6% vs 40.2%, P = 0.011; 22.7% vs 13.4%, P = 0.013; and 23.2% vs 12.9%, P = 0.006, respectively). Haplotypes formed by these variants were also linked to fHP susceptibility. Moreover, carriers of a specific haplotype (G-T-G-C) had a significant decrease in survival (adjusted hazard ratio 6.92, 95% CI 1.73-27.64, P = 0.006). Additional associations were found between TOLLIP rs111521887 and rs5743894 variants and decreased lung function at baseline, and the MUC5B SNP and radiographic features, further highlighting the influence of genetic factors in fHP.

CONCLUSION

These findings suggest that TOLLIP and MUC5B variants and haplotypes may serve as valuable tools for risk assessment and prognosis in fibrotic hypersensitivity pneumonitis, potentially contributing to its patient stratification, and offer insights into the genetic factors influencing the clinical course of the condition.

Intrinsic thermal resistance of the canine brain

Hyperthermia above a critical threshold results in multisystemic changes that include neurological manifestations of heat stroke. It is unknown if the latter represents an intrinsic thermal sensitivity of the CNS or whether injury is secondary to physiological responses of non-CNS origin. To address this issue, the present work examined functional, structural, and biochemical changes in the CNS of dogs subjected to a thermal dosage immediately below that which induces disseminated intravascular coagulation with secondary multiple organ injury. The experimental approach is previously reported, inducing a 42.5 degrees C, 90 min, whole body hyperthermia while preventing other physiological responses to treatment, including respiratory alkalosis and significant reductions in mean arterial pressure. Functional analyses included neurologic examinations and brainstem auditory evoked potential recordings in the post-treatment interval in both hyperthermic and euthermic control populations. Biochemical and structural analyses examined the expression of 70-kDa heat shock proteins, cytokines, markers of astroglial and microglial injury/activation, evidence of vascular endothelial damage, and evidence of neuronal and axonal injury in brain between 0.5 h and 8 days from the end of the treatment. The only significant change associated with treatment was induction of the major inducible 70-kDa heat shock protein, this being most prominent in the cerebellum with maximal expression at 6 h and a return to baseline by 8 days.Collectively, from these results we suggest that the canine brain is intrinsically resistant to sublethal hyperthermia such that when CNS lesions occur, they do so in the presence of other physiological derangements.

The cellular stress response increases measles virus-induced cytopathic effect

Plaque area is a measure of the degree of cytopathic effect and a predictor of neurovirulence for tissue culture adapted morbilliviruses. In the present work, the cellular stress response was shown to be a determinant of the expression of distinct measles virus large plaque phenotypes in Vero cells. The emergence of these large plaque phenotypes was associated with increased mean viral transcriptional activity and expression of the viral fusion glycoprotein, but not upregulation of the virus receptor CD46.

Interferon-alpha inhibits the emergence of cellular stress response-dependent morbillivirus large plaque variants

Cellular levels of heat shock proteins (HSPs) are elevated in response to physiologic states accompanying acute virus infection (e.g. fever). The objective of the present work was to define the antiviral effect of purified human lymphoblastoid IFN in the presence of HSP over-expression. For this purpose, canine distemper virus (CDV) was used since the response of CDV transcription and persistent infection phenotype to elevated HSP is characterized. First, the effect of elevated HSP on CDV lytic infection phenotype in Vero and CV1 cells was defined, and results extended to the closely related measles virus (MV). Cells expressing elevated levels of the major inducible 70-kDa HSP (hsp72) supported the emergence of large plaque variants of both CDV and MV from small plaque purified inocula. IFN treatment concurrent with infection caused a dosage-dependent reduction in the expression of large plaque variants without affecting hsp72 levels or total plaque number. In contrast to the stress response-induced large plaque variant, small plaques were resistant to the antiviral effects of IFN. These data demonstrate the ability of IFN to selectively abrogate the pro-viral effects of HSP over-expression, inhibiting the formation of a plaque phenotype that is correlated to enhanced virulence in animal models of morbillivirus encephalitis.

[Alzheimer's disease. Considerations for its clinical diagnosis]

This paper present features for identifying, on a clinical basis, the syndromatic complex "primary degenerative dementia of Alzheimer's disease type". Data are included which aid in the identification among the broad picture of dementia disorders. Information is presented about the most recent histopathological findings, the study proceedings and therapeutic trends.

Lesions caused by natural infection with Streptococcus suis type 9 in weaned pigs

In this paper we report on the spectrum and frequency of lesions observed in a prospective study of naturally occurring infections with Streptococcus suis type 9 (SS-9) in weaned pigs. SS-9 produced arthritis, meningitis, interstitial pneumonia, and endocarditis in 100%, 91%, 73%, and 42%, respectively, of pigs dying from the disease. The lesions were similar to those caused by S. suis type 2 (SS-2), however, SS-9 produced a different frequency of lesions. In SS-2 infections, bronchopneumonia is the most commonly observed lesion; meningitis, arthritis, and endocarditis are less frequently observed. Thus, SS-9 produced a different distribution of lesions from that reported for SS-2. Possible explanations for the differences found are discussed.

[Alzheimer's disease]

The primary degenerative dementia of Alzheimer type, present denomination, represents a medical, social and economical problem. The early diagnosis, based on medical criteria, might improve some aspects of the expected evolution of these, up to date, hopeless patients.

[From cyst to cysticercus granuloma using cranial computerized tomography]

Report of one case of neurocysticercosis, treated and followed for three years, that provides a useful clinical-tomographic correlation for judging the pathologic stage of the disease, on the basis of an image-sequence.

[Epileptic seizures as initial symptom of intracranial tumors. A prospective study in adults]

A prospective study of 125 patients with late-onset epileptic crisis: Group G I with 65 cases between 20 and 50 years of age, and Group G II, including 60 patients older than 50 years at the time of the first crisis. Brain tumors were diagnosed in fourteen cases, four (6.1%) in G I and ten (16.6%) in G II. In decreasing order of frequency, the ictal pattern was tonic-clonic, status epilepticus, partial simple, partial complex and "drop-attacks". The lesions were located as follows:frontal in seven subjects, parietal in four, multiple in two and temporo-basal in one. Histologically, the tumors were three meningiomas, two gliomas, one astrocytoma, and three metastatic lesions. These findings agree with those of other series, in terms of predominant type of crisis, site and histologic type; but they differ in the age of first symptoms, and in the fact that tumors occupy only a third place as cause of epileptic crisis.

Selective indications for the use of praziquantel in the treatment of brain cysticercosis

The selective use of praziquantel for the treatment of brain cysticercosis in human beings is described, based upon the results of clinical tests conducted during a 2 year period. Forty patients with clinical diagnosis of cysticercosis, confirmed and documented by CT, were treated. They are divided into four groups, representative of the various forms of the disease. The results assessed by clinical evaluation and sequential CT, give a ten point criterion of the indications for praziquantel.