No abstract

In this study, 60 HLA-B27+ve SSA patients and 17 healthy controls belonging to North India were analyzed to ascertain heterogeneity of the B27 molecule in this population. ID-IEF and PCR-SSOP technologies were used to analyze polymorphism in exon 2 and 3 of the HLA-B27 gene. Four different subtypes were encountered: B*2702,04,05 and 07. Other subtypes of B27 viz B*2701,03,06 and 08 were not encountered. B*2704 (common oriental subtype) and B*2705 (common Caucasian subtype) were the most common subtypes in the control and patient groups. B*2707 was less frequently encountered in both groups and B*2702 was found in only one AAU patient. B*2704 was the predominant subtype in the AS group (70.8%) compared to its frequency of 47% in healthy controls (RR = 2.73) while in the undiff SpA group, B*2705 occurred most frequently (73.1%, RR = 3.05). B27 subtypes segregated differently in males and females. 12 of the 17 male AS patients carried B*2704 as compared to 1 of 8 healthy males (X2 = 3.9, P < 0.05). On the other hand, in the undiff SpA, B*2705 was significantly raised in female patients (100%) as compared to healthy females (22.2%, X2 = 4.9, P < 0.05). Subtype distribution is indicative of racial admixture in the Asian Indian population.

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still mix up CKD with chronic kidney insufficiency or failure, For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus, health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is “solved” by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated aging and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal COVID-19 and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality which is 10- o 100-fold higher than similar age peers, and life expectancy is shortened by around 40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth global cause of death by 2040 and the second cause of death in Spain before the end of the century, a time when 1 in 4 Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded CIBER network research structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients (AAKP) and the European Kidney Health Alliance (EKHA). Leading Spanish kidney researchers grouped in the kidney collaborative research network REDINREN have now applied for the RICORS call of collaborative research in Spain with the support of the Spanish Society of Nephrology, ALCER and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true.

A child developed steroid-responsive nephrotic syndrome at the age of 3 years. 6 years later, he developed insulin-dependent diabetes mellitus. At this time renal biopsy disclosed minimal-change disease. After multiple relapses requiring cyclophosphamide or repeated courses of steroid therapy, a second renal biopsy, 5 years after the first, revealed early diabetic changes with associated exudative lesions. The nephrotic syndrome remains responsive to steroids and cyclophosphamide, and the patient maintains an increased glomerular filtration rate and normal blood pressure 3.5 years afterwards. His HLA typing showed DR4 and DR7. Since DR4 and DR7 are associated with diabetes and minimal-change disease, respectively, we speculate that he could carry the genetic predisposition for the development of both diseases.

Background Exercise induces a series of changes on the immune system depending on their intensity and duration. 1 2 In fact, transient states of immunosuppression are induced after intense physical activity 3 and yet beneficial exercise antiinflammatory effects have been described over many diseases and longevity. 1 Methods To study the impact of intense exercise for long periods of life on adaptive immunity at different ages we compared phenotypical and functional features of T lymphocytes of young (n=27) and elderly athletes (n=15) with young (n=30) and elderly non-athletes (n=30). We characterized leukocyte and lymphocyte subpopulations by flow cytometry and measured the T cell proliferation and activation response (CD69) against anti-CD3. We also studied the percentage of recent thymic emigrants (RTEs) by quantification of TREC by real-time PCR. Specific antibody titers against CMV were determined by ELISA. Results Leucopenia was found in both groups of athletes, mainly explained by low levels of neutrophils and lymphocytes. Exercise induced higher frequencies of NK, B lymphocytes and CD8+ T cells, whereas CD4+ T lymphocytes showed significant lower levels in the elderly athletes. Moreover, young athletes showed significant differences in all parameters that define the immune risk profile (IRP), with characteristics of an aging immune system, but we did not find differences between elderly groups. Less differentiated subsets of T lymphocytes were more frequents in non-athletes, with the exception of CD8+ T lymphocytes in young individuals. The analysis of TREC content in the elderly groups showed no significant difference in either the CD4+ or CD8+ T lymphocytes. In the young non-athletes group we observe an increase in the content of TREC in CD8+ T cells, but not in CD4+ T cells. Moreover, functional response of CD4+ and CD8+ T lymphocytes was significantly impaired only in young but no in elderly athletes. Conclusions Intensive training for long periods throughout life induces important phenotypical and functional changes on the adaptive immune response. These changes are most striking in young individuals and they damped with physiologic immune aging.