骨组织工程支架材料与纳米技术

<正>1气电纺纳米羟基磷灰石/聚羟基丁酸酯复合纤维支架对大鼠骨髓基质细胞成骨分化的影响管东华(广东省口腔医院,南方医科大学附属口腔医院修复科,广东省广州市510280)     

电纺纳米羟基磷灰石/聚酯酰胺复合支架材料的制备及其细胞相容性

背景：采用静电纺丝技术将功能性无机纳米微粒复合高分子超细纤维,形成类细胞外基质结构和功能的复合支架材料是骨组织工程支架领域一个新的研究方向。 目的：通过静电纺丝法构建纳米羟基磷灰石/脂肪族聚酯酰胺复合纤维支架材料,并初步考察其细胞相容性。 方法：以静电纺丝法制备纳米羟基磷灰石/脂肪族聚酯酰胺超细纤维支架材料,通过扫描电镜、原子能谱等表面形貌的物相分析,进行细胞在复合材料上的形态学观察。 结果与结论：通过静电纺丝法成功制备出纳米羟基磷灰石/脂肪族聚酯酰胺超细纤维复合材料,成骨细胞直接培养于材料上呈现良好生长行为,初步证实了复合支架材料的细胞相容性。说明静电纺丝技术在构建类骨细胞外基质结构和功能的仿生复合材料方面具有独特优势,电纺超细纤维复合材料有望成为新型的骨组织工程支架。     

低温快速成型亲水改性复合人工骨支架的性能测定

背景：低温快速成型技术具有支架成型可控性、保持材料生物学活性和易于实现支架材料的三维多孔立体结构等优势,被迅速用于骨组织工程支架的制备。 目的：采用低温快速成型制备聚乙二醇改性聚乳酸-乙醇酸/纳米羟基磷灰石复合支架,并检测其性能。 方法：采用低温快速成型设备分别制备聚乙二醇改性聚乳酸-乙醇酸/纳米羟基磷灰石与聚乳酸-乙醇酸/纳米羟基磷灰石复合支架,通过电镜观察支架超微结构,以介质(乙醇)浸泡法测定支架孔隙率,采用电子试验机检测支架力学性能;将两种支架材料分别与大鼠成骨细胞共培养,培养12 h采用沉淀法检测细胞黏附率,培养1,3,5,7,9,12 d采用CCK-8法检测细胞增殖。 结果与结论：两组支架孔径均在理想范围内并具有较高孔隙率,但聚乙二醇改性聚乳酸-乙醇酸/纳米羟基磷灰石支架的孔径波动范围大,孔径均值较聚乳酸-乙醇酸/纳米羟基磷灰石支架小且部分有闭塞现象。聚乙二醇改性聚乳酸-乙醇酸/纳米羟基磷灰石支架的细胞黏附率及表面细胞增殖活性高于聚乳酸-乙醇酸/纳米羟基磷灰石支架(P < 0.05),力学性能低于聚乳酸-乙醇酸/纳米羟基磷灰石支架(P < 0.05)。表明聚乙二醇改性聚乳酸-乙醇酸/纳米羟基磷灰石复合支架具有良好的细胞相容性。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：     

3D打印聚己内酯/纳米羟基磷灰石复合支架与骨髓间充质干细胞的体外生物相容性

文题释义： 3D打印技术：是通过计算机设计3D模型,按照某一坐标轴切成无限多个剖面,然后层层打印堆叠形成一个实体的立体模型,使用3D打印技术制备的骨组织工程支架能对支架的内部结构和外形进行自由可控的构建,在支架个性化、精确性、机械强度、孔隙调节、空间结构复杂性方面有独特优势。 纳米羟基磷灰石/聚己内酯复合材料：羟基磷灰石是人体和动物骨骼的主要无机成分,具有良好的骨诱导性,纳米羟基磷灰石由于良好的生物相容性和骨整合能力被广泛用作骨缺损的修复材料;聚己内酯是一种已被FDA批准的生物材料,具有良好的机械性能、生物相容性及降解性。两种材料复合物的多孔结构能够为细胞生长、组织再生及血管化提供有利条件。 背景：聚己内酯/纳米羟基磷灰石复合材料是在常用骨组织工程材料基础上结合3D打印技术制备的新型复合支架材料,目前对于该复合材料的体外生物相容性研究较少。 目的：通过体外实验探讨3D打印聚己内酯/纳米羟基磷灰石复合支架材料的细胞相容性。 方法：利用3D打印技术分别制备聚己内酯及聚己内酯/纳米羟基磷灰石复合支架,表征两组材料的微观结构、孔隙率及力学性能。将大鼠骨髓间充质干细胞分别接种于两组支架表面,CCK-8法检测细胞增殖率,扫描电镜和Live/Dead染色观察细胞在支架上的生长情况。 结果与结论：①两组支架均呈三维网状相互连通结构,纤维呈规律有序的排列、相互交错,纤维表面无空隙,纤维间距、直径较为均一;两组支架的孔隙率比较差异无显著性意义(P > 0.05);复合支架的弹性模量高于单纯聚己内酯支架(P < 0.05);②两组支架表面培养1 d的细胞增殖比较差异无显著性意义(P > 0.05),复合支架表面培养4,7 d的细胞增殖快于单纯聚己内酯支架(P < 0.05);③Live/Dead染色结果显示,两组材料均具有良好的细胞相容性,细胞活性较高,同时复合支架上的贴壁细胞更多一些;④扫描电镜显示,细胞在两种材料上生长形态良好,并紧密黏附于支架表面及微孔附近,同时可见分泌的细胞外基质呈丝状包绕于细胞周围;⑤结果表明,3D打印技术制备的聚己内酯/纳米羟基磷灰石复合支架孔隙较丰富,具备良好的力学性能,细胞相容性良好,可作为骨组织工程的支架材料。 ORCID: 0000-0002-7083-6458(胡超然) 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

无纺网与多孔海绵状材料作为软骨组织工程支架的适用性及体内降解性

背景：聚羟基乙酸无纺网与聚羟基丁酸酯-聚羟基己酸酯共聚物多孔海绵具有良好的塑形适应性、生物降解性与生物相容性。 目的：观察聚羟基乙酸无纺网与聚羟基丁酸酯-聚羟基己酸酯共聚物多孔海绵作为软骨组织工程支架的适用性及体内降解性。 方法：分别制备乳兔软骨细胞-聚羟基乙酸无纺网复合物、乳兔软骨细胞-聚羟基丁酸酯-聚羟基己酸酯共聚物多孔海绵复合物。在实验组成年兔两侧背部皮下分别植入制备的两种复合物,在对照组成年兔两侧背部皮下分别植入聚羟基乙酸无纺网与聚羟基丁酸酯-聚羟基己酸酯共聚物。 结果与结论：组织学观察显示,以聚羟基乙酸无纺网获取的组织工程软骨,植入4 周时软骨细胞较小,软骨内有较多聚羟基乙酸纤维残留,8周时软骨细胞较成熟,包埋在陷窝内,聚羟基乙酸纤维消失,12周时软骨细胞成熟,基质分泌丰富,无聚羟基乙酸存留;以聚羟基丁酸酯-聚羟基己酸酯共聚物多孔海绵获取的组织工程软骨,植入4周时软骨细胞不成熟,软骨基质内似“杂质”样材料残留物较多,8周时软骨细胞较成熟,软骨基质内仍可见材料残留,12周时软骨基质材料残留基本消失。两组组织工程软骨特殊染色与免疫组织化学检测均显示再生软骨胶原与基质黏多糖生成良好,软骨中均检测出Ⅱ型胶原。表明两种材料作为软骨组织工程支架具有良好的适用性,其降解时间均达到组织工程软骨构建的要求。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：     

羟基丁酸-羟基辛酸聚合物/胶原软骨组织工程支架的细胞亲和性

背景：已有很多实验证明,单独高分子材料或生物性材料制备的组织工程支架无法满足组织工程研究。 目的：评价羟基丁酸-羟基辛酸聚合物/胶原组织工程支架的生物学特性及细胞亲和性。 方法：以羟基丁酸-羟基辛酸聚合物作为主体材料,按质量分数复合不同比例(2%,4%,6%,8%,10%)的胶原,采用溶剂浇铸-颗粒沥滤法制备组织工程支架。通过扫描电镜观察材料内部结构及孔径大小,液体位移法测定材料孔隙率。将羟基丁酸-羟基辛酸聚合物/胶原支架、羟基丁酸-羟基辛酸聚合物支架分别与兔软骨细胞复合培养,MTT法测定细胞的生长曲线,扫描电镜观察细胞在材料上的生长黏附情况。 结果与结论：羟基丁酸-羟基辛酸聚合物/胶原复合软骨组织工程支架孔径大小200 μm左右,孔隙率为(85±2)%,细胞亲水性随加入胶原比例的增加而升高。与羟基丁酸-羟基辛酸聚合物支架比较,不同比例的羟基丁酸-羟基辛酸聚合物/胶原支架可明显促进软骨细胞的黏附、增殖。证实羟基丁酸-羟基辛酸聚合物/胶原复合支架具备更好的细胞亲和性。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：     

以羟基丁酸酯与羟基已酸酯共聚物为支架材料构建组织工程喉形态软骨

背景：再生预定形态组织工程软骨的研究为喉软骨病损的修复与重建提供了新思路与新方法。然而,由于喉软骨形态、部位与功能的特殊性,迄今在此领域软骨组织工程研究并未呈现出其应有的优势。目的：探讨带蒂肌筋膜组织瓣构建组织工程喉支架形态软骨方法,为肌筋膜瓣复合组织工程化软骨修复重建喉软骨支架功能提供实验依据。方法：采用溶剂浇铸、模压成形和颗粒滤沥方法制备喉支架形态聚羟基丁酸酯与聚羟基己酸酯共聚物聚羟基丁酸酯与聚羟基己酸酯共聚物聚羟基丁酸酯与聚羟基己酸酯共聚物生物材料塑形物,接种软骨细胞形成细胞-聚羟基丁酸酯与聚羟基己酸酯共聚物复合物,体外共同培养1周后用于体内植入。将新西兰白兔脊背部一侧骶棘肌及其筋膜制备肌筋膜组织瓣,采用筋膜衬里方法充填与包裹软骨细胞聚羟基丁酸酯与聚羟基己酸酯共聚物喉支架形态复合物,原位植入。将单纯聚羟基丁酸酯与聚羟基己酸酯共聚物喉支架体内植入的兔作为对照组。分别于术后6,12和18周取材,行大体形态观察、组织学和免疫组化检测评估喉支架形态组织工程化软骨成形与再生情况。结果与结论：制备的聚羟基丁酸酯与聚羟基己酸酯共聚物多孔生物材料塑形物呈中空半面喇叭状,形似喉支架形态,乙醇静态容积测定孔隙率>90%。筋膜衬里的带蒂肌筋膜组织瓣血运丰富,可有效充填与包裹喉支架形态塑形物。不同时间点均获取形态维持良好的喉支架形态组织工程软骨,组织学和免疫组化检测均证实体内植入6周即可形成软骨组织,12周及18软骨组织进一步成熟,而对照组体内植入未检测到软骨组织。结果证实,带蒂肌筋膜组织瓣可保障血运,采用筋膜衬里的肌筋膜组织瓣充填与包裹方法可构建喉支架形态组织工程软骨。 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

纳米羟基磷灰石/壳聚糖/半水硫酸钙为可注射骨组织工程支架材料的可行性

背景：前期实验采用仿生学原理制备了可注射性纳米羟基磷灰石/壳聚糖/半水硫酸钙复合材料,但其与骨髓间充质干细胞的生物相容性还不十分清楚。目的：探讨纳米羟基磷灰石/壳聚糖/半水硫酸钙作为注射型骨组织工程支架材料的可行性。方法：将第3代兔骨髓间充质干细胞与可注射纳米羟基磷灰石/壳聚糖/半水硫酸钙支架复合培养,作为实验组;以单纯接种培养的骨髓间充质干细胞为对照组,倒置显微镜下观察细胞生长情况,MTT法检测细胞增殖,扫描电镜观察细胞在材料表面生长与增殖。将纳米羟基磷灰石/壳聚糖/半水硫酸钙支架埋植在家兔背部肌袋内,埋植后2,4,6,8周进行病理学观察。结果与结论：实验组细胞生长、增殖良好,与对照组无明显差异。支架埋植后2周,材料周围有中等量中性粒细胞、淋巴细胞和巨细胞浸润,可见小血管与纤维母细胞增生,材料已被炎性细胞分割、围绕散碎;埋植后4周,可见少量淋巴细胞、纤维母细胞聚集,炎症反应进一步消退,肌纤维排列、形态正常;埋植后6周,材料周围炎症反应轻微,组织水肿不明显;埋植后8周,炎症反应基本消退,材料基本降解完成,肌纤维形态基本正常。表明纳米羟基磷灰石/壳聚糖/半水硫酸钙复合物具有良好的细胞相容性和生物降解性,可作为注射型支架材料。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：     

热致相分离法制备聚羟基丁酸酯-羟基戊酸酯纳米纤维支架及其表征***

背景：由微生物合成的聚羟基丁酸酯-羟基戊酸酯(polyhydroxybutyrate-hydroxyvalerate,PHBV)是聚羟基脂肪酸酯的一种,具有良好的生物相容性和机械强度。目的：探讨热致相分离法制备PHBV纳米纤维支架的方法及结晶行为。方法：采用扫描电镜、广角X射线衍射、红外光谱和差示扫描量热分析分析基质的结构。结果与结论：凝胶温度对纳米纤维的结晶和热性质有很大的影响。当凝胶温度较高时,PHBV纳米纤维的结晶度和晶粒尺寸随着凝胶温度的降低而减小,而且随着凝胶温度的降低,其结晶的有序性增加。说明温度对PHBV支架形貌和结构的影响可能对PHBV支架的性质-包括生物降解性和对细胞活性的生物应答反应有一定的积极意义。关键词：聚羟基丁酸酯-羟基戊酸酯;纳米纤维;基质;支架;生物相容性doi:10.3969/j.issn.1673-8225.2012.03.002     

纳米羟基磷灰石/聚己内酯复合大鼠骨髓间充质干细胞的生物相容性

背景：纳米羟基磷灰石/聚己内酯是一种具有优良生物相容性和生物活性的典型生物复合材料。 目的：分析纳米羟基磷灰石/聚己内酯电纺薄膜作为组织工程骨支架的可行性。 方法：采用静电纺丝技术制备纳米羟基磷灰石/聚己内酯电纺薄膜,将其与第3代SD大鼠骨髓间充质干细胞复合培养,在地塞米松、β-磷酸甘油钠、维生素C成骨诱导剂诱导下,诱导骨髓间充质干细胞向成骨细胞转化。 结果与结论：纳米羟基磷灰石/聚己内酯支架具有合适的微孔结构,且孔道相互贯通。①倒置显微镜观察：复合培养 7 d后细胞大部分为梭形,细胞开始分裂;14 d后,细胞生长比较旺盛,数量明显增多,细胞分泌基质并黏附于支架上。②扫描电镜观察：复合培养7 d后大量细胞位于支架孔隙内生长,增殖良好,细胞大多呈梭形,双极突起,形态较佳,呈立体状生长,并分泌基质,有纤维连接蛋白生成。表明纳米羟基磷灰石/聚己内酯支架具有良好的生物相容性,是骨组织工程的良好载体。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

HLA genes in Amerindians from Mexico San Vicente Tancuayalab Teenek/Huastecos

Huastecos or Teenek Amerindians are presently living at North East Mexico (San Luis Potosi State). They have probably one of the most ancient culture of Mexico and Central America together with Mayas and Olmec groups with which also show close relationships. Proximity to Atlantic Ocean/Mexican Gulf originated that Spaniards had very early contact with them at about 1519 CE or before. In the present paper we have aimed to study HLA gene profile which may be useful for HLA and disease epidemiology and transplant programs in Teeneks. HLA-DRB1*04:07, -DRB1*14:06 and -DRB1*04:11 have been found in high frequency like in other Amerindian groups. High frequency typical Amerindians HLA extended haplotypes have been found, such as A*02-B*35-DRB1*04:07-DQB1*03:02; A*68-B*39-DRB1*04:07-DQB1*03:02 and A*02-B*39-DRB1*04:07-DQB1*03:02; also new haplotypes have been described, like A*02-B*52-DRB1*04:11-DQB1*03:02, A*68-B*35-DRB1*14:02-DQB1*03:01 and A*68-B*40-DRB1*16:02-DQB1*03:01. Genetic proximity is observed not only to linguistically close Mayans, but also to Mazatecans, Mixtecans and Zapotecans, who speak an altogether different languages; it shows once more that genes and languages do not correlate. This population was greatly diminished after European contact between 1500 and 1600 years CE; in fact, North and South America First Inhabitants population was brought from 80 down to 8 million people because of diseases (i.e.: measles, smallpox or influenza), slavery and war.