Daniela Kantárová

Triggering receptor expressed on myeloid cells‐1 and 2 in bronchoalveolar lavage fluid in pulmonary sarcoidosis

Pulmonary sarcoidosis (PS) is characterized by the formation of granulomas in the lungs and has been associated with infection by microorganisms. Triggering receptor expressed on the surface of myeloid cells (TREM)‐1 is overexpressed in response to infection while TREM‐2 is involved in granuloma formation. We hypothesized that these receptors are overexpressed in PS and might be useful for diagnostic testing.

The association of HLA-DRB1 and HLA-DQB1 alleles with genetic susceptibility to multiple sclerosis in the Slovak population

Objective: The aim of the present study was to assess the association between HLA-DRB1 and -DQB1 allele groups with the genetic predisposition to multiple sclerosis (MS) in the Caucasian Central European Slovak population. Methods: A total of 282 unrelated patients with sporadic MS were enrolled in this case-control study. HLA-DRB1 and HLA-DQB1 allele groups were genotyped using a polymerase chain reaction with sequence-specific primers. The DRB1 and DQB1 allele carrier frequencies, genotypes and haplotype frequencies were compared between MS cases and healthy controls. Results: Positive association with MS was found for alleles HLA-DRB1*15 (OR = 3.64; Pcor = 6.9x10–11), DRB1*03 (after elimination of carriers of DRB1*15, OR = 2.8; Pcor = 0.0029), DQB1*06 (OR = 1.99; Pcor = 7.0x10–4), genotypes HLA-DRB1*15/*15 (OR = 7.6; Pcor = 0.001) and DQB1*06/*06 (OR = 3.81; Pcor = 4.0x10–4) and for haplotype DRB1*15-DQB1*06 (OR = 3.03; Pcor = 0.001). Carriage of alleles DRB1*07 (OR = 0.53; Pcor = 0.04), DRB1*13 (OR = 0.39; Pcor = 4.0x10–4), DQB1*03 (OR = 0.46; Pcor = 1.0x10–4), genotypes HLA-DRB1*13/*11 (OR = 0.12; Pcor = 0.004), DQB1*05/*03 (OR = 0.39; Pcor = 0.035), DQB1*03/*03 (OR = 0.38; Pcor = 0.029) and haplotypes DRB1*13-DQB1*06 (OR = 0.47; Pcor = 0.0128) and DRB1*11-DQB1*03 (OR = 0.58; Pcor = 0.0352) was found to be protective against MS development. Discussion: This is the first study performed to analyse the association of HLA-DRB1/DQB1 with susceptibility to MS in Slovakia. The results of our study confirm that HLA class II alleles, genotypes and haplotypes are associated with MS risk.

Genetic Determination and Immunopathogenesis of Type 1 Diabetes Mellitus in Humans

Genetic Determination and Immunopathogenesis of Type 1 Diabetes Mellitus in Humans Type 1 diabetes comprises autoimmune-mediated and idiopathic beta-cell destruction of the pancreatic islets of Langerhans resulting to absolute insulin deficiency. Susceptibility to T1D is influenced by both genetic and environmental factors. It is generally believed that environmental agents, such as viral infections, dietary factors in early infancy or climatic influences, trigger disease development in genetically susceptible individuals. Many candidate regions for diabetes genes have been reported, the insulin, glutamic acid 65, insuloma associated antigen 2, and zinc transporter ZnT8 genes being among the most important. The destruction of b cells is mediated mainly by cellular mechanisms; antibodies seem to reflect the ongoing autoimmune process only, not being directly involved in tissue damage. They, however, appear prior to the onset of insulin deficiency what makes us to profit from in prevention of the disease.

Metabolic Syndrome in Rheumatoid Arthritis

Abstract Inflammation is a key component of obesity and type 2 diabetes mellitus also as risk factors of cardiovascular disease. Patients with chronic inflammatory diseases such as rheumatoid arthritis or systemic lupus erythematosus have an increased risk of cardiovascular diseases. The expected higher prevalence of metabolic syndrome and its components in rheumatic diseases (such as possible cause of increased cardiovascular risk) was confirmed in rheumatoid arthritis, systemic lupus, ankylosing spondylitis and psoriatic arthritis. The aim of our study was to assess the relationship of rheumatoid arthritis to increased cardiovascular risk in the presence of risk factors involved in complex of metabolic syndrome, including prediabetic state, central obesity, atherogenic dyslipidemia, and hypertension. In the sample of patients with rheumatoid arthritis, the prevalence of the metabolic syndrome according to IDF, AHA/NHLBI and also NCEP ATPIII criteria compared with the Slovak population in all age groups is higher. In patients older than 60 years according to IDF criteria was more than 55 %. Patients treated with methotrexate had the lowest prevalence of metabolic syndrome, even lower than the control population. The most frequented component of the metabolic syndrome was obesity (whether in the evaluation of waist circumference or BMI). Also, patients with higher inflammatory activity (evaluated by CRP) had a higher prevalence of metabolic syndrome.

Leptin – A new marker for development of post-transplant diabetes mellitus?

INTRODUCTION Obese patients have increased leptin production and selective resistance to its central anti-adipogenic effects, yet its pro-inflammatory immunostimulating effects persist. MATERIAL AND METHODS In a group of 70 patients who underwent primary kidney transplantation (KT) we examined adiponectin and leptin levels at the time of KT and 6 months post-transplantation. Patients with diabetes mellitus type 1 or type 2 at the time of KT were excluded from the study. RESULTS We found that leptin levels significantly increased during the post-transplant period (P = 0.0065). Overall, leptin levels were positively correlated with the level of triacylglycerols, post-transplant diabetes mellitus (PTDM) development and acute rejection (AR). We discovered that, in particular, high leptin levels were associated with AR [OR 2.1273; 95% CI 1.0130-4.4671 (P = 0.0461)] and PTDM development [OR 7.200; 95% CI 1.0310-50.2836 (P = 0.0465)], whereas, low adiponectin levels represent a risk factor for the development of insulin resistance [HR 38.6135; 95% CI 13.3844-67.7699 (P < 0.0001)] and obesity [HR 3.0821; 95% CI 0.8700-10.9192 (P = 0.0053)]. CONCLUSION We found that a high serum concentration of leptin before KT is associated with both PTDM development and AR and merits further investigation in relation to KT.

Correlation between CMV Infection and NODAT

Purpose: New-onset diabetes mellitus after transplantation (NODAT) is a well-known complication of transplantation. Materials and methods: Retrospectively, we detected CMV replication (PCR) in every month after transplantation of kidney in the first 12 months after transplantation in patients in a homogenous group from the aspect of immunosuppresion. Results: In the group of 167 patients (control group: n = 103, NODAT group: n = 64), the average value of CMV viremia was without any significant difference between the NODAT group and the control group (P = 0.9285). In the 10th month after kidney transplantation, we recorded significantly higher CMV viremia in the NODAT group (p < 0.0001), however, in the multi variant analysis, that difference was not confirmed. Thus, in our group, CMV is of no relevance with the development of NODAT in the monitored period. The survival of patients and graft was 12 months after kidney transplantation without any statistically significant difference between the monitored groups (P = 0.6113 - survival of the patient; P = 0.5381 – survival of the graft). Conclusion: Our analysis shows that in regular monitoring of CMV viremia and applying chemoprophylaxison the risk recipeints, CMV is not the risk factor for NODAT.