AB0502 STRESS AS POTENTIAL PATHOGENIC FACTOR IN PRIMARY SJOGREN’S SYNDROME

Background

Sjogren’s Syndrome (SS) is a common autoimmunological disorder characterized by infiltration of exocrine glands by autoreactive immune cells that lead to the disease’s two most common symptoms — dry eyes and a dry mouth, also known as sicca syndrome. The etiopathogenesis considers the coexistence of genetic predisposition and environmental factors, such as viral infections or sex hormones imbalance.

Objectives

The aim of the study was to determine whether major stressful life events are also risk factors for developing SS.

Methods

We performed a matched case-control study. Cases were patients with an established diagnosis of primary SS (pSS) within the previous five years. Controls were patients with osteoarthritis in whom systemic connective tissue disease has been ruled out. Data on major stressful life events were collected using the modified Holmes-Rahe stress scale. Data were collected for the period of the year before the disease onset.

Results

100 patients were enrolled in the study (pSS group = 50, control group = 50), mean age was 55.8±10.4 years for pSS and 61.3±9.59 years for control group, in both groups 96 % of patients were female. pSS patients had significantly higher total score on Holmes-Rahe stress scale within the preceding 1 year before the onset of disease symptoms than control group (pSS group = 152±66.3 vs control group = 50±54.6; p<0.001). In pSS group 50 % of patients reported the subjective impression that the symptoms were caused by stress, while in control group it was 12 % (p<0.001). The most frequently mentioned life events in the pSS group were divorce or marital separation, death or change in health of family member and stress related to work.

Conclusion

Patients with pSS are significantly more likely to have had a major stressful life event within the preceding 1 year before the disease onset. The relationship between stress and the occurrence of many diseases and their exacerbations is well documented, especially within autoimmune diseases. Stress is a ubiquitous problem these days, therefore it is of fundamental importance to understand the biological mechanisms underlying its influence on the development of diseases. It is crucial to properly recognize the stressful situation in the patient’s life and undertake appropriate interventions in order to prevent health consequences.

References

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Disclosure of Interests

None declared

Molecular heterogeneity of meningioma with INI1 mutation

BACKGROUND

INI1 (hSNF5) mutations are linked to rhabdoid tumours, but mutations in meningiomas with hot spot mutations in position 377 have also been reported.

AIMS

To analyse the INI1 gene in meningioma.

METHODS

Exons 1, 4, 5, and 9 of the INI1 gene were analysed by the polymerase chain reaction and direct sequencing in 80 meningiomas. For all cases, western blotting of the INI1 protein was performed.

RESULTS

Only one of the 80 samples showed a cytosine insertion in codon 376. This mutation changed the open reading frame in almost the whole exon 9 and resulted in a longer hSNF5 protein. Complex analysis of the above described tumour sample by western blotting, DNA sequencing, and loss of heterozygosity (LOH) analysis showed that this particular meningioma consisted of heterogeneic cellular components. One of these components had a mutated INI1 gene, whereas in the other component INI1 was intact.

CONCLUSIONS

INI1 mutation is a rare event in the molecular pathology of meningiomas. It is possible for the INI1 gene to be mutated in only a proportion of meningioma cells.

Recombinant human thyroid peroxidase produced in insect cells has similar properties to native human thyroid peroxidase

Purified native human thyroid peroxidase (nTPO) isolated from thyroid tissue and recombinant (r)TPO produced in High Five insect cells have been compared. nTPO and rTPO were purified to about 95% homogeneity and showed similar UV and visual spectra and similar 412 nm per 280 nm absorbance ratios (0.4 for nTPO and 0.4 for rTPO). The nTPO and rTPO guaiacol oxidation enzyme activities were about 1,000 guaiacol units per milligram of protein. TPO autoantibody binding characteristics of nTPO and rTPO were analyzed in an assay based on 125I-labeled nTPO and precipitation with protein A. In the assay, the effect of unlabeled nTPO or rTPO on TPO autoantibody binding from 25 patients sera was studied. Unlabeled nTPO or rTPO (from 0 to 160 ng/mL) inhibited the binding of TPO autoantibodies in a dose-dependent manner in the case of each serum studied (from 100% in the absence of unlabeled TPO to 5%-10% in the presence of 160 ng/mL of TPO). The inhibition profile for each serum was essentially identical in the case of both TPO preparations. The effect of TPO autoantibodies on enzyme activity of rTPO was analyzed after incubation of rTPO with TPO autoantibody-positive serum immunoglobulin G (IgG) (n = 12), TPO monoclonal antibodies reactive with two different epitopes on the TPO, IgG (n = 3) from glutamic acid decarboxylase autoantibody positive patient sera, and IgG (n = 3) from healthy blood donors. Effective complexing of TPO by TPO autoantibodies was tested by precipitating the complexes with solid phase protein A and measuring the TPO enzyme activity in the resulting supernatants. These studies showed that the TPO enzyme activity was not affected by incubation with TPO autoantibody-positive IgG or monoclonal antibodies despite effective complexing of the autoantibodies with TPO. Overall, our studies demonstrate that nTPO and rTPO produced in insect cells are very similar in terms of enzyme activity, UV and visible spectra, and reactivity with autoantibodies. Furthermore, in our study, TPO autoantibodies did not appear to inhibit TPO enzyme activity.

The interaction of TSH receptor autoantibodies with 125I-labelled TSH receptor

Detergent-solubilized porcine TSH receptor (TSHR) has been labeled with 125I using a monoclonal antibody to the C-terminal domain of the receptor. The ability of sera containing TSHR autoantibody to immunoprecipitate the labeled receptor was then investigated. Sera negative for TSHR autoantibody (as judged by assays based on inhibition of labeled TSH binding to detergent-solubilized porcine TSHR) immunoprecipitated about 4% of the labeled receptor, whereas sera with high levels of receptor autoantibody immunoprecipitated more than 25% of the labeled receptor. The ability to immunoprecipitate labeled TSHR correlated well with ability of the sera to inhibit labeled TSH binding to the receptor (r = 0.92; n = 63), and this is consistent with TSHR autoantibodies in these samples being directed principally to a region of the receptor closely related to the TSH binding site. Preincubation of labeled TSHR with unlabeled TSH before reaction with test sera inhibited the immunoprecipitation reaction, providing further evidence for a close relationship between the TSHR autoantibody binding site(s) and the TSH binding site. This was the case whether the sera had TSH agonist (i.e., thyroid stimulating) or TSH antagonist (i.e., blocking) activities, thus, providing no clear evidence for different regions of the TSHR being involved in forming the binding site(s) for TSHR autoantibodies with stimulating and with blocking activities. The ability of TSHR autoantibodies to stimulate cyclic AMP production in isolated porcine thyroid cells was compared with their ability to immunoprecipitate labeled porcine TSHR. A significant correlation was observed (r = 0.58; n = 50; P < 0.001) and the correlation was improved when stimulation of cyclic AMP production was compared with inhibition of labeled TSH binding to porcine TSHR (r = 0.76). Overall, our results indicate that TSHR autoantibodies bind principally to a region on the TSHR closely related to the TSH binding site, and this seems to be the case whether the autoantibodies act as TSH agonists or antagonists.

Vanadium inhibition of human parietal lobe ATPases

In vitro influence of vanadate and vanadyl ions on the activities of Na,K- and Ca,Mg-ATPase from synaptosomal membranes of the parietal lobe of the human brain were compared. 1. Vanadate and vanadyl inhibit the enzymes activities in the investigated fraction. 2. Vanadate is a more effective inhibitor of both ATPases in the concentrations above 50 microM and vanadyl is an effective inhibitor in a very low concentration (10 nM). 3. Vanadate seems to be an uncompetitive inhibitor of Na,K-ATPase (K1 = 880 nM).

[Effect of nimodipine on the results of surgical treatment of intracranial aneurysms--preliminary report]

The authors give a preliminary report on the outcome of surgery in 65 patients with ruptured intracranial aneurysms treated with nimodipine. A control group consisted of 137 subjects. The number of patients is too small to reach unequivocal conclusions. However, it seems that in patients operated on for ruptured cerebral aneurysm the treatment with nimodipine gave best results in cases in which it was administered before the onset of ischaemic neurological deficit.