抑制mTOR通路对局灶性脑缺血再灌注损伤大鼠自噬的影响

目的:应用哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin,m TOR)抑制剂Cystatin C,探讨其对局灶性脑缺血再灌注大鼠自噬的影响。方法:成年雄性SD大鼠60只(体质量260~280 g),随机分为假手术组(sham)、缺血再灌注组(I/R)、Cystatin C组(根据不同浓度分为低、中、高3个亚组Ⅰ、Ⅱ、Ⅲ),每组12只。I/R组和Cystatin C组采用线栓法制备大鼠右侧脑缺血再灌注损伤模型。缺血2 h再灌注24 h,观察神经功能缺损评分、测定脑梗死体积;应用Western Blot技术检测损伤脑皮质中自噬标志物LC3-Ⅱ、LC3-Ⅰ和Beclin-1的变化。结果:与I/R组相比,Cystatin CⅠ、Ⅱ组大鼠神经功能缺损评分和脑梗死体积减少,而Cystatin CⅢ组大鼠神经功能缺损评分和脑梗死体积增大。I/R组脑皮质中自噬标志物LC3-Ⅱ/LC3-Ⅰ比值和Beclin-1表达明显升高(P0.05);Cystatin C各组脑皮质中LC3-Ⅱ/LC3-Ⅰ和Beclin-1的表达逐步升高,且与浓度呈正相关。结论:m TOR抑制剂Cystatin C干预脑缺血再灌注大鼠可诱导脑皮质组织自噬,Cystatin CⅠ、Ⅱ组可减轻脑组织损伤,而Cystatin CⅢ组则加重脑组织损伤。     

黄芪甲苷对脑缺血/再灌注损伤大鼠细胞自噬的影响

目的:探讨黄芪甲苷对脑缺血/再灌注损伤大鼠细胞自噬的影响。方法:选取清洁级雄性SD大鼠70只随机分为假手术组、脑缺血/再灌注组、溶剂对照组、黄芪甲苷组、黄芪甲苷+自噬抑制剂组、自噬抑制剂组和自噬激活剂组。采用线栓法建立大鼠局灶性脑缺血/再灌注损伤模型。观察大鼠神经缺损症状,根据Zea Longa评分标准挑选模型成功的大鼠;采用TTC染色法检测大鼠脑梗死体积;尼氏染色观察大鼠神经细胞形态学变化;透射电子显微镜观察细胞自噬现象;Western blot检测beclin-1和LC3-Ⅱ蛋白表达量的变化。结果:假手术组无神经缺损症状,未出现脑梗死灶,尼氏体丰富、染色均匀。与假手术组相比,脑缺血/再灌注组出现明显的脑梗死灶,神经细胞坏死增多,尼氏体数量减少、着色较浅,透射电镜下可见典型的自噬体,自噬标志蛋白beclin-1和LC3-Ⅱ表达增加(P 0. 05)。与脑缺血/再灌注组相比,黄芪甲苷组和自噬激活剂组可明显减小脑梗死体积,神经细胞有不同程度的恢复,尼氏体稍增多,自噬体数量、beclin-1和LC3-Ⅱ表达量均增加(P 0. 05);自噬抑制剂组脑梗死体积增大,神经细胞坏死严重,尼氏体减少,着色变浅,自噬体数量、beclin-1和LC3-Ⅱ表达量均减少(P 0. 05);溶剂对照组无明显变化。与黄芪甲苷组比较,黄芪甲苷+自噬抑制剂组和自噬抑制剂组脑梗死体积增加,神经细胞坏死增多,尼氏体数量减少,自噬体数量、beclin-1和LC3-Ⅱ表达量降低(P 0. 05)。结论:黄芪甲苷可通过激活自噬而减轻脑缺血/再灌注损伤,从而发挥神经保护作用。     

缺血后适应对大鼠局灶性脑缺血再灌注所致自噬的抑制作用

目的:探讨缺血后适应对大鼠局灶性脑缺血再灌注所致自噬的影响。方法:取健康雄性SD大鼠30只,随机分为假手术(sham)组、缺血再灌注(I/R)组、缺血后适应(IPC)组,每组各10只。Sham组仅单纯暴露右侧颈总、颈内和颈外动脉;I/R组采用Longa改良线栓法制备大鼠右侧大脑中动脉缺血2 h、再灌注24 h模型;IPC组大鼠缺血2 h后,同侧颈总动脉再通10 s/闭塞10 s,循环5次,然后全面恢复血流再灌注24 h。采用透射电镜观察脑细胞自噬情况;Western blot法测定各组大鼠脑组织中哺乳动物雷帕霉素靶蛋白(m TOR)、磷酸化m TOR(pm TOR)和微管相关蛋白轻链3(LC3)-Ⅱ的蛋白表达水平;TTC法检测脑梗死面积;干湿称重法测定脑组织含水量;HE染色观察脑组织病理学变化。结果:IPC组m TOR、p-m TOR均显著高于I/R组(P0.05),LC3-Ⅱ显著低于I/R组(P0.01)。IPC组脑梗死面积、脑组织含水量均显著低于I/R组(P0.01)。HE染色显示,IPC组神经元变性、坏死较I/R组明显减轻。透射电镜显示IPC组神经元损伤程度明显减轻,自噬泡明显减少。结论:IPC通过减少细胞内自噬而减轻脑缺血再灌注损伤,可能与增强m TOR作用有关。     

比较热休克蛋白A5和3-甲基腺嘌呤和介导小鼠脑缺血再灌注损伤的保护作用

目的:比较研究热休克蛋白A5(HSPA5)和3-甲基腺嘌呤(3-MA)介导小鼠脑缺血再灌注(I/R)损伤性自噬的保护作用。方法:成年雄性BALB/c小鼠30只,分为6组:sham组、缺血再灌注组(I/R组)、vehicle+I/R组、3-甲基腺嘌呤(3-MA)+I/R组、scramble siRNA+I/R组和HSPA5 siRNA+I/R组,每组5只。采用大脑中动脉阻塞(MCAO)60 min后再灌注24 h制作小鼠I/R模型。Vehicle+I/R组和3-MA+I/R将5μl 0.9%Na Cl或3-MA(30 mg/ml)在MCAO前30 min侧脑室注射;scramble siRNA+I/R group组和HSPA5 siRNA+I/R组将5μl scramble siRNA或HSPA5 siRNA(2μg/μl)在MCAO前24 h侧脑室注射。通过小鼠I/R后神经功能评分确定运动功能障碍程度。小鼠神经细胞内自噬体形成用透射电子显微镜测定,再灌注24 h缺血大脑皮层(LC3)-II/LC3-I表达用Western Blot方法检测。小鼠I/R后缺血大脑神经细胞损伤用Nissl染色进行观察。结果:HSPA5和3-MA可以影响I/R小鼠行为学改变并使脑缺血性损伤和神经症状加重(P0.05)。透射电子显微镜检测可见,sham组小鼠大脑皮层神经细胞形态正常,I/R组小鼠缺血大脑皮层神经元胞质中细胞器减少,形成自噬体。与sham组小鼠比较,I/R组小鼠缺血大脑皮层LC3-II蛋白表达水平显著增高(P0.05);3-MA+I/R或HSPA5 siRNA+I/R小鼠缺血大脑皮层LC3-II蛋白表达水平明显低于I/R小鼠(P0.05)。结论:HSPA5和3-MA在介导小鼠脑缺血再灌注损伤导致的自噬可发挥相同的保护作用,并且促进神经细胞凋亡。     

白藜芦醇通过抑制内质网应激减轻大鼠脑缺血/再灌注损伤

目的:探讨白藜芦醇(Resveratrol,Res)对大鼠脑缺血/再灌注诱导的内质网应激反应的调控作用。方法:将72只健康雄性SD大鼠,采用随机数字表法分为3组(n=24):假手术组(S组)、脑缺血/再灌注模型组(I/R组)、Res组(R组)。采用阻断左侧大脑中动脉并阻断双侧颈总动脉30 min恢复灌注的方法制备大鼠脑缺血/再灌注模型。R组于缺血前7d给予腹腔注射Res(50 mg/kg),1次/日。对大鼠进行神经功能缺损评分后留取脑组织,采用TTC法检测脑梗死体积,干湿重法测定脑组织含水量,免疫组织化学及Western blot法检测大脑皮层内质网应激相关蛋白GRP78、p-PERK、CHOP的表达变化。结果:与S组比较,I/R组大鼠神经功能评分及脑含水量升高(P0.05),脑梗死体积增大(P0.05),皮层GRP78、p-PERK和CHOP蛋白表达均显著上调(P0.05)。与I/R组比较,P组大鼠神经功能评分及脑含水量降低(P0.05),脑梗死体积减小(P0.05),GRP78表达上调(P0.05),p-PERK和CHOP蛋白表达下调(P0.05)。结论:白藜芦醇通过抑制内质网应激反应,对大鼠脑缺血/再灌注损伤发挥保护作用。     

重组人生长停滞特异性蛋白6预处理对大鼠局灶性脑缺血再灌注PI3K/AKT的影响

目的研究生长停滞特异性蛋白6(Gas 6)对Wistar大鼠局灶性脑缺血再灌注损伤的影响,探讨其与PI3K/Akt通路的关系。方法线栓法制作大鼠局灶性脑缺血再灌注模型,将大鼠随机分成4组:假手术组(Sham组)、缺血再灌注组(I/R组)、Gas6预处理组(Gas6组)、Gas6预处理联合PI3K抑制剂Wortmannin组(Gas6+W组)。按Zea-Longa 5分制法测定各组神经功能评分,干湿重法测定脑组织含水量、TTC染色测定脑梗死面积、Western-blot法检测脑组织p-Akt的蛋白表达。结果 I/R组较Sham组神经功能缺损、脑含水量和梗死区均增加,p-Akt表达上调;Gas6组较I/R组,神经功能缺血损伤、脑含水量和梗死面积显著减少,p-Akt表达进一步上调;而给与PI3K抑制剂后,Gas6+W组与Gas6组比较,神经功能缺损、脑含水量和梗死面积显著增加,p-Akt的表达显著下调。结论 Gas6对于大鼠脑缺血再灌注损伤具有保护作用,可能与激活PI3K/Akt信号通路相关。     

排斥性导向分子a抑制剂6FNⅢ对大鼠大脑皮质神经元缺血再灌注后自噬的作用

目的 探讨排斥性导向分子a(RGMa)特异性抑制剂6FNⅢ对大鼠大脑皮质神经元缺血再灌注引发的自噬及对神经功能恢复的影响。 方法 雄性成年SD大鼠立体定位侧脑室注射不同浓度6FNⅢ后建立大脑中动脉闭塞（MCAO）/再灌注模型,Western blotting检测RGMa下游分子脑衰反应调节蛋白-2（CRMP-2）蛋白表达水平,确定最佳6FNⅢ干预浓度。将72只雄性成年SD大鼠随机分成4组：假手术组（sham）、脑缺血再灌注组（I/R）、生理盐水干预组（I/R+NS）、6FNⅢ干预组（I/R+6FNⅢ）,每组18只。缺血2h再灌注后24h,采用神经功能缺损评分评估各组大鼠神经功能恢复情况;Western blotting检测自噬相关蛋白LC3Ⅱ/Ⅰ水平;免疫荧光双标检测LC3在神经元内的表达情况;透射电子显微镜观察自噬体的形成情况。 结果 根据各浓度6FNⅢ干预组CRMP-2表达,确定中浓度（0.5 g/L）为本实验的最适浓度。缺血再灌注后24h,I/R组较sham组神经功能评分降低(P＜0.05)、自噬相关蛋白LC3Ⅱ/Ⅰ水平升高(P＜0.05)、自噬体形成增多;I/R+6FNⅢ组较I/R组神经功能评分增高(P＜0.05)、自噬相关蛋白LC3Ⅱ/Ⅰ水平降低(P＜0.05)、自噬体形成减少;而I/R+NS组与I/R组以上各项均无统计学意义(P＞0.05)。 结论 RGMa特异性抑制剂6FNⅡ可在缺血再灌注急性期抑制自噬发生,促进神经功能恢复。     

氟伐他汀对大鼠脑缺血再灌注损伤后Fas和FasL表达的研究

目的:探讨氟伐他汀预处理对脑缺血再灌注损伤大鼠脑组织中Fas、FasL表达的影响。方法:实验大鼠随机分为假手术组(Sham组)、脑缺血再灌注组(I/R组)和氟伐他汀预处理组(Flu组)。线栓法制作大脑中动脉脑缺血再灌注模型,Flu组在模型制备前用氟伐他汀连续灌胃14 d。缺血2 h再灌注24 h后断头取脑,免疫组织化学法和半定量PCR法检测缺血区脑组织中Fas、FasL的表达。结果:通过免疫组织化学法和半定量PCR法检测大鼠缺血区脑组织中Fas和FasL阳性细胞,Sham组仅见少量表达,I/R组表达显著增多(P<0.05),Flu组表达显著减少(P<0.05)。大鼠缺血侧皮质区Fas mRNA和FasL mRNA表达为,Sham组有微弱的表达,I/R组表达显著增高(P<0.05),Flu组表达则显著降低(P<0.05)。结论:氟伐他汀对大鼠脑缺血再灌注损伤发挥保护作用的机制可能与下调Fas、FasL的表达有关。     

长托宁抑制JAK2/STAT3信号通路缓解脑缺血再灌注大鼠脑内炎症反应

目的 探讨长托宁对脑缺血性再灌注大鼠脑损伤的保护作用及对JAK2/STAT3信号通路的影响.方法 采用线栓法制备脑缺血性再灌注(I/R)大鼠模型,随机分为假手术组(sham)、脑缺血再灌注模型组(I/R)、长托宁治疗组(PH);对各组大鼠的神经功能障碍进行评分;检测各组大鼠脑梗死体积以及脑含水量;Nissl染色各组大鼠脑组织神经细胞的数量;ELISA检测各组大鼠脑组织IL-1 β、IL-6及TNF-α蛋白的表达;Western blot法检测脑组织p-JAK2、JAK2、p-STAT3和STAT3蛋白表达.结果 长托宁明显改善I/R大鼠神经功能障碍,缩小脑梗死体积,降低脑含水量,增强脑内神经元的数量,显著降低IL-1β、IL-6及TNF-o蛋白表达水平,抑制p-JAK2和p-STAT3的蛋白表达.结论 长托宁抑制I/R大鼠炎症反应,促进神经元的存活,与抑制JAK2-STAT3信号通路相关.     

细胞自噬水平在大鼠缺血/再灌注肺组织内变化及其作用

目的 探讨大鼠肺缺血再灌注后肺组织内自噬水平的变化和自噬在肺缺血再灌注损伤中的作用.方法 大鼠分为假手术组和缺血1 h再灌注0、2、6 和24 h组,免疫印迹法检测自噬标志蛋白LC3-Ⅱ的表达,电子显微镜观察细胞内自噬体.自噬抑制剂3-甲基腺嘌呤(3-MA)和安慰剂分别预处理假手术组和缺血再灌注2 h组大鼠,HE染色和血气分析检测肺组织损伤程度.结果 LC3-Ⅱ/Actin比值在缺血1h时即有升高,再灌注2～6h达高峰(P＜0.01),再灌注24 h恢复至接近假手术组水平.主要在Ⅰ型肺泡上皮细胞和血管内皮细胞内观察到自噬体.3-MA预处理降低肺组织损伤评分,升高血氧分压,减轻肺缺血再灌注损伤(P＜0.05).结果证实,肺缺血及再灌注诱发肺组织呼吸膜细胞自噬激活,3-MA预处理通过抑制自噬改善肺缺血再灌注损伤.结论 细胞自噬可能是肺缺血再灌注病理生理过程中加重损伤的因素.     

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.     

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.     

État de l’art : nouveaux anticoagulants et transfusion

Direct oral anticoagulants (DOAC) are indicated for stroke prevention in atrial fibrillation and for the prevention and treatment of venous thromboembolism. As any anticoagulant, they are associated with a bleeding risk. Management of DOAC-induced bleeding is challenging. Idarucizumab, antidote for dabigatran, is currently available and is part of the therapeutic strategy, whereas antidotes for anti-Xa agents are under development. Activated or non-activated prothrombin concentrates are proposed, although their efficacy to reverse DOAC is uncertain. We propose an update on DOAC-associated bleeding management, integrating the availability of idarucizumab and the critical place of DOAC concentration measurements.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.