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  1. Article ; Online: Immunolocalization of the mechanogated ion channels PIEZO1 and PIEZO2 in human and mouse dental pulp and periodontal ligament.

    Gaite, Juan J / Solé-Magdalena, Antonio / García-Mesa, Yolanda / Cuendias, Patricia / Martin-Cruces, José / García-Suárez, Olivia / Cobo, Teresa / Vega, José A / Martín-Biedma, Benjamín

    Anatomical record (Hoboken, N.J. : 2007)

    2023  Volume 307, Issue 5, Page(s) 1960–1968

    Abstract: PIEZO1 and PIEZO2 are essential components of mechanogated ion channels, which are required for mechanotransduction and biological processes associated with mechanical stimuli. There is evidence for the presence of PIEZO1 and PIEZO2 in teeth and ... ...

    Abstract PIEZO1 and PIEZO2 are essential components of mechanogated ion channels, which are required for mechanotransduction and biological processes associated with mechanical stimuli. There is evidence for the presence of PIEZO1 and PIEZO2 in teeth and periodontal ligaments, especially in cell lines and mice, but human studies are almost nonexistent. Decalcified permanent human teeth and mouse molars were processed for immunohistochemical detection of PIEZO1 and PIEZO2. Confocal laser microscopy was used to examine the co-localization of PIEZO 1 and PIEZO2 with vimentin (a marker of differentiated odontoblasts) in human teeth. In the outer layer of the human dental pulp, abundant PIEZO1- and PIEZO2-positive cells were found that had no odontoblast morphology and were vimentin-negative. Based on their morphology, location, and the absence of vimentin positivity, they were identified as dental pulp stem cells or pre-odontoblasts. However, in mice, PIEZO1 and PIEZO2 were ubiquitously detected and colocalized in odontoblasts. Intense immunoreactivity of PIEZO1 and PIEZO2 has been observed in human and murine periodontal ligaments. Our findings suggest that PIEZO1 and PIEZO2 may be mechanosensors/mechanotransducers in murine odontoblasts, as well as in the transmission of forces by the periodontal ligament in humans and mice.
    MeSH term(s) Humans ; Mice ; Animals ; Periodontal Ligament/metabolism ; Vimentin/metabolism ; Mechanotransduction, Cellular ; Dental Pulp ; Ion Channels/metabolism
    Chemical Substances Vimentin ; Ion Channels ; PIEZO1 protein, human ; PIEZO2 protein, human
    Language English
    Publishing date 2023-11-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2269667-2
    ISSN 1932-8494 ; 1932-8486
    ISSN (online) 1932-8494
    ISSN 1932-8486
    DOI 10.1002/ar.25351
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Los trabajadores sanitarios y la alergia al látex.

    Magdalena Díaz, María Luz / Solé Magdalena, Antonio / Caragol Urgellés, Luisa

    Archivos de prevencion de riesgos laborales

    2015  Volume 18, Issue 1, Page(s) 20

    Title translation Health workers and latex allergy.
    Language Spanish
    Publishing date 2015-01
    Publishing country Spain
    Document type Letter
    ISSN 1138-9672
    ISSN 1138-9672
    DOI 10.12961/aprl.2015.18.1.05
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  3. Article ; Online: Human odontoblasts express transient receptor protein and acid-sensing ion channel mechanosensor proteins.

    Solé-Magdalena, Antonio / Revuelta, Enrique G / Menénez-Díaz, Ivan / Calavia, Marta G / Cobo, Teresa / García-Suárez, Olivia / Pérez-Piñera, Pablo / De Carlos, Felix / Cobo, Juan / Vega, Jose A

    Microscopy research and technique

    2011  Volume 74, Issue 5, Page(s) 457–463

    Abstract: Diverse proteins of the denegerin/epithelial sodium channel (DEG/ENa(+) C) superfamily, in particular those belonging to the acid-sensing ion channel (ASIC) family, as well as some members of the transient receptor protein (TRP) channel, function as ... ...

    Abstract Diverse proteins of the denegerin/epithelial sodium channel (DEG/ENa(+) C) superfamily, in particular those belonging to the acid-sensing ion channel (ASIC) family, as well as some members of the transient receptor protein (TRP) channel, function as mechanosensors or may be required for mechanosensation in a diverse range of species and cell types. Therefore, we investigated the putative mechanosensitive function of human odontoblasts using immunohistochemistry to detect ENa(+) C subunits (α, β, and γ) and ASIC (1, 2, 3, and 4) proteins, as well as TRPV4, in these cells. Positive and specific immunoreactivity in the odontoblast soma and/or processes was detected for all proteins studied except α-ENa(+) C. The intensity of immunostaining was high for β-ENa(+) C and ASIC2, whereas it was low for ASIC1, ASIC3, γ-ENa(+) C, and TRPV4, being absent for α-ENa(+) C and ASIC4. These results suggest that human odontoblasts in situ express proteins related to mechanosensitive channels that probably participate in the mechanisms involved in teeth sensory transmission.
    MeSH term(s) Acid Sensing Ion Channels ; Adult ; Female ; Fluorescent Antibody Technique ; Gene Expression ; Humans ; Immunohistochemistry ; Male ; Membrane Proteins/biosynthesis ; Microscopy ; Middle Aged ; Nerve Tissue Proteins/biosynthesis ; Odontoblasts/metabolism ; Sodium Channels/biosynthesis ; TRPV Cation Channels/biosynthesis
    Chemical Substances ASIC1 protein, human ; ASIC4 protein, human ; Acid Sensing Ion Channels ; Membrane Proteins ; Nerve Tissue Proteins ; Sodium Channels ; TRPV Cation Channels ; TRPV4 protein, human
    Language English
    Publishing date 2011-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1099714-3
    ISSN 1097-0029 ; 1059-910X
    ISSN (online) 1097-0029
    ISSN 1059-910X
    DOI 10.1002/jemt.20931
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Comparison of two analgesic protocols for post-tonsillectomy pain control in outpatient adults.

    Magdalena, María Luz / Caragol, Luisa / Solé, Antonio / Rodrigo, Juan Pablo

    Acta otorrinolaringologica espanola

    2014  Volume 65, Issue 2, Page(s) 102–108

    Abstract: Introduction and objectives: Tonsillectomy causes a moderate to severe postoperative pain, and its treatment is an unsolved problem. The objective of this study was to compare the effectiveness of 2 analgesic protocols and their related complications.!## ...

    Abstract Introduction and objectives: Tonsillectomy causes a moderate to severe postoperative pain, and its treatment is an unsolved problem. The objective of this study was to compare the effectiveness of 2 analgesic protocols and their related complications.
    Methods: Two groups of adult patients submitted to ambulatory tonsillectomy were studied. In group 1, 52 patients received a combination of tramadol and NSAIDs postoperatively; in group 2, 60 patients were treated with prednisone and NSAIDs. Two surgical techniques were used: cold dissection or dissection with electrocautery. Pain was recorded on days 4, 7 and 15, using a numerical scale from 0 to 10.
    Results: Both groups showed similar pain at postoperative day 4. At day 7, pain was higher in group 2 (P=.049), while at day 15 both groups showed only some discomfort. Sickness and vomiting was more frequent in group 1, and haemorrhage and hospitalisation in group 2. Cold dissection patients showed lower levels of pain at days 4 and 7, independently of analgesic protocol, and had lower haemorrhage and emergency visit rates.
    Conclusions: The efficacy of both protocols was similar in terms of control of pain, with the exception of day 7; however, the protocol with prednisone showed fewer secondary effects. Patients operated using cold dissection had less pain and fewer complications.
    MeSH term(s) Adult ; Ambulatory Surgical Procedures ; Analgesics/therapeutic use ; Analgesics, Opioid/administration & dosage ; Anti-Inflammatory Agents, Non-Steroidal/administration & dosage ; Clinical Protocols ; Female ; Glucocorticoids/administration & dosage ; Humans ; Male ; Pain, Postoperative/prevention & control ; Prednisone/administration & dosage ; Prospective Studies ; Tonsillectomy ; Tramadol/administration & dosage ; Young Adult
    Chemical Substances Analgesics ; Analgesics, Opioid ; Anti-Inflammatory Agents, Non-Steroidal ; Glucocorticoids ; Tramadol (39J1LGJ30J) ; Prednisone (VB0R961HZT)
    Language Spanish
    Publishing date 2014-03
    Publishing country Spain
    Document type Clinical Trial ; Journal Article ; Observational Study
    ZDB-ID 730022-0
    ISSN 1988-3013 ; 0001-6519
    ISSN (online) 1988-3013
    ISSN 0001-6519
    DOI 10.1016/j.otorri.2013.10.006
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  5. Article ; Online: Risk factors for developing ventilator-associated lower respiratory tract infection in patients with severe COVID-19: a multinational, multicentre study, prospective, observational study.

    Reyes, Luis Felipe / Rodriguez, Alejandro / Fuentes, Yuli V / Duque, Sara / García-Gallo, Esteban / Bastidas, Alirio / Serrano-Mayorga, Cristian C / Ibáñez-Prada, Elsa D / Moreno, Gerard / Ramirez-Valbuena, Paula C / Ospina-Tascon, Gustavo / Hernandez, Glenn / Silva, Edwin / Díaz, Ana Maria / Jibaja, Manuel / Vera-Alarcon, Magdalena / Díaz, Emili / Bodí, María / Solé-Violán, Jordi /
    Ferrer, Ricard / Albaya-Moreno, Antonio / Socias, Lorenzo / Figueroa, William / Lozano-Villanueva, Jose L / Varón-Vega, Fabio / Estella, Ángel / Loza-Vazquez, Ana / Jorge-García, Ruth / Sancho, Isabel / Shankar-Hari, Manu / Martin-Loeches, Ignacio

    Scientific reports

    2023  Volume 13, Issue 1, Page(s) 6553

    Abstract: Around one-third of patients diagnosed with COVID-19 develop a severe illness that requires admission to the Intensive Care Unit (ICU). In clinical practice, clinicians have learned that patients admitted to the ICU due to severe COVID-19 frequently ... ...

    Abstract Around one-third of patients diagnosed with COVID-19 develop a severe illness that requires admission to the Intensive Care Unit (ICU). In clinical practice, clinicians have learned that patients admitted to the ICU due to severe COVID-19 frequently develop ventilator-associated lower respiratory tract infections (VA-LRTI). This study aims to describe the clinical characteristics, the factors associated with VA-LRTI, and its impact on clinical outcomes in patients with severe COVID-19. This was a multicentre, observational cohort study conducted in ten countries in Latin America and Europe. We included patients with confirmed rtPCR for SARS-CoV-2 requiring ICU admission and endotracheal intubation. Only patients with a microbiological and clinical diagnosis of VA-LRTI were included. Multivariate Logistic regression analyses and Random Forest were conducted to determine the risk factors for VA-LRTI and its clinical impact in patients with severe COVID-19. In our study cohort of 3287 patients, VA-LRTI was diagnosed in 28.8% [948/3287]. The cumulative incidence of ventilator-associated pneumonia (VAP) was 18.6% [610/3287], followed by ventilator-associated tracheobronchitis (VAT) 10.3% [338/3287]. A total of 1252 bacteria species were isolated. The most frequently isolated pathogens were Pseudomonas aeruginosa (21.2% [266/1252]), followed by Klebsiella pneumoniae (19.1% [239/1252]) and Staphylococcus aureus (15.5% [194/1,252]). The factors independently associated with the development of VA-LRTI were prolonged stay under invasive mechanical ventilation, AKI during ICU stay, and the number of comorbidities. Regarding the clinical impact of VA-LRTI, patients with VAP had an increased risk of hospital mortality (OR [95% CI] of 1.81 [1.40-2.34]), while VAT was not associated with increased hospital mortality (OR [95% CI] of 1.34 [0.98-1.83]). VA-LRTI, often with difficult-to-treat bacteria, is frequent in patients admitted to the ICU due to severe COVID-19 and is associated with worse clinical outcomes, including higher mortality. Identifying risk factors for VA-LRTI might allow the early patient diagnosis to improve clinical outcomes.Trial registration: This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable.
    MeSH term(s) Humans ; Prospective Studies ; COVID-19/complications ; SARS-CoV-2 ; Respiration, Artificial/adverse effects ; Respiratory Tract Infections/complications ; Pneumonia, Ventilator-Associated/drug therapy ; Bronchitis/drug therapy ; Ventilators, Mechanical/adverse effects ; Risk Factors ; Intensive Care Units
    Language English
    Publishing date 2023-04-21
    Publishing country England
    Document type Observational Study ; Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-023-32265-5
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  6. Article ; Online: Protocol for post-tonsillectomy pain control in outpatient adults.

    Magdalena, María L / Caragol, Luisa / Solé, Antonio / Suárez, Vanesa / Cillero, José A / Rodrigo, Juan P

    Acta otorrinolaringologica espanola

    2013  Volume 64, Issue 3, Page(s) 211–216

    Abstract: Introduction: Even though notable advances in anaesthetic and surgical techniques have appeared in recent years, morbidity, and especially pain, associated with tonsillectomy is still an important clinical problem.: Objectives: Assess the influence ... ...

    Abstract Introduction: Even though notable advances in anaesthetic and surgical techniques have appeared in recent years, morbidity, and especially pain, associated with tonsillectomy is still an important clinical problem.
    Objectives: Assess the influence of a specific protocol for the control of postoperative pain and compare the frequency of complications in patients with and without it.
    Methods: This was a descriptive, observational and prospective study on adult tonsillectomy patients in outpatient surgery. There were 2 groups: group 1, with 65 patients to whom a variable analgesic treatment was given; and group 2, with 50 patients with analgesic protocol and preoperative nursing interview. For the evaluation of pain, a numerical scale from 0 to 10 was used. The surgical techniques used were cold dissection or electric dissection.
    Results: On the 4(th) day, group 1 (without protocol) presented a mean pain of 4.8 points on a numerical scale from 0 to 10, while group 2 (with protocol) presented mean of 3 (P=.0002). From group 1, 22 patients (36%) had to go to the emergency service, while 8 (16%) in group 2 did so (P=.019). On the 4(th) day, patients operated with cold dissection presented 3.7 points, as opposed to those operated with electric dissection, who presented 4.4 points.
    Conclusions: A specific protocol applied to adult tonsillectomy patients in outpatient surgery is useful to obtain less pain and fewer complications.
    MeSH term(s) Adult ; Ambulatory Surgical Procedures ; Clinical Protocols ; Female ; Humans ; Male ; Pain, Postoperative/prevention & control ; Postoperative Complications/epidemiology ; Prospective Studies ; Tonsillectomy ; Young Adult
    Language Spanish
    Publishing date 2013-05
    Publishing country Spain
    Document type Comparative Study ; Journal Article ; Observational Study
    ZDB-ID 730022-0
    ISSN 1988-3013 ; 0001-6519
    ISSN (online) 1988-3013
    ISSN 0001-6519
    DOI 10.1016/j.otorri.2012.11.007
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  7. Article ; Online: Dexamethasone as risk-factor for ICU-acquired respiratory tract infections in severe COVID-19.

    Reyes, Luis Felipe / Rodriguez, Alejandro / Bastidas, Alirio / Parra-Tanoux, Daniela / Fuentes, Yuli V / García-Gallo, Esteban / Moreno, Gerard / Ospina-Tascon, Gustavo / Hernandez, Glenn / Silva, Edwin / Díaz, Ana Maria / Jibaja, Manuel / Vera, Magdalena / Díaz, Emilio / Bodí, María / Solé-Violán, Jordi / Ferrer, Ricard / Albaya-Moreno, Antonio / Socias, Lorenzo /
    Estella, Ángel / Loza-Vazquez, Ana / Jorge-García, Ruth / Sancho, Isabel / Martin-Loeches, Ignacio

    Journal of critical care

    2022  Volume 69, Page(s) 154014

    Abstract: Purpose: Dexamethasone is the only drug that has consistently reduced mortality in patients with COVID-19, especially in patients needing oxygen or invasive mechanical ventilation. However, there is a growing concern about the relation of dexamethasone ... ...

    Abstract Purpose: Dexamethasone is the only drug that has consistently reduced mortality in patients with COVID-19, especially in patients needing oxygen or invasive mechanical ventilation. However, there is a growing concern about the relation of dexamethasone with the unprecedented rates of ICU-acquired respiratory tract infections (ICU-RTI) observed in patients with severe COVID-19.
    Methods: This was a multicenter, prospective cohort study; conducted in ten countries in Latin America and Europe. We included patients older than 18 with confirmed SARS-CoV-2 requiring ICU admission. A multivariate logistic regression and propensity score matching (PSM) analysis was conducted to determine the relation between dexamethasone treatment and ICU-RTI.
    Results: A total of 3777 patients were included. 2065 (54.7%) were treated with dexamethasone within the first 24 h of admission. After performing the PSM, patients treated with dexamethasone showed significantly higher proportions of VAP (282/1652 [17.1%] Vs. 218/1652 [13.2%], p = 0.014). Also, dexamethasone treatment was identified as an adjusted risk factor of ICU-RTI in the multivariate logistic regression model (OR 1.64; 95%CI: 1.37-1.97; p < 0.001).
    Conclusion: Patients treated with dexamethasone for severe COVID-19 had a higher risk of developing ICU-acquired respiratory tract infections after adjusting for days of invasive mechanical ventilation and ICU length of stay, suggesting a cautious use of this treatment.
    MeSH term(s) COVID-19/drug therapy ; Dexamethasone/adverse effects ; Humans ; Intensive Care Units ; Prospective Studies ; Risk Factors ; SARS-CoV-2
    Chemical Substances Dexamethasone (7S5I7G3JQL)
    Language English
    Publishing date 2022-02-23
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 632818-0
    ISSN 1557-8615 ; 0883-9441
    ISSN (online) 1557-8615
    ISSN 0883-9441
    DOI 10.1016/j.jcrc.2022.154014
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  8. Article ; Online: A Sardinian founder mutation in glycoprotein Ib platelet subunit beta (GP1BB) that impacts thrombocytopenia.

    Busonero, Fabio / Steri, Maristella / Orrù, Valeria / Sole, Gabriella / Olla, Stefania / Marongiu, Michele / Maschio, Andrea / Sidore, Carlo / Lai, Sandra / Mulas, Antonella / Zoledziewska, Magdalena / Floris, Matteo / Pala, Mauro / Forabosco, Paola / Asunis, Isadora / Pitzalis, Maristella / Deidda, Francesca / Masala, Marco / Caria, Cristian Antonio /
    Barella, Susanna / Abecasis, Goncalo R / Schlessinger, David / Sanna, Serena / Fiorillo, Edoardo / Cucca, Francesco

    British journal of haematology

    2020  Volume 191, Issue 5, Page(s) e124–e128

    MeSH term(s) Female ; Founder Effect ; Humans ; Italy ; Male ; Mutation ; Platelet Glycoprotein GPIb-IX Complex/genetics ; Thrombocytopenia/genetics
    Chemical Substances Platelet Glycoprotein GPIb-IX Complex ; adhesion receptor
    Language English
    Publishing date 2020-11-20
    Publishing country England
    Document type Letter ; Research Support, N.I.H., Extramural
    ZDB-ID 80077-6
    ISSN 1365-2141 ; 0007-1048
    ISSN (online) 1365-2141
    ISSN 0007-1048
    DOI 10.1111/bjh.17090
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  9. Article ; Online: Plasmablastic transformation of low-grade B-cell lymphomas: report on 6 cases.

    Martinez, Daniel / Valera, Alexandra / Perez, Nhora Silva / Sua Villegas, Luz Fernanda / Gonzalez-Farre, Blanca / Sole, Carla / Gine, Eva / Lopez-Guillermo, Armando / Roue, Gaël / Martinez, Salome / Sant, Francesc / Warzocha, Krzysztof / Robak, Tadeusz / Czader, Magdalena / Villamor, Neus / Colomo, Lluis / Campo, Elias / Martinez, Antonio

    The American journal of surgical pathology

    2013  Volume 37, Issue 2, Page(s) 272–281

    Abstract: Histologic transformation of low-grade B-cell lymphoma to diffuse large B-cell lymphoma is associated with poor prognosis. Although plasma cell differentiation is common in these lymphomas, an overt plasmablastic transformation (PBL-T) has been only ... ...

    Abstract Histologic transformation of low-grade B-cell lymphoma to diffuse large B-cell lymphoma is associated with poor prognosis. Although plasma cell differentiation is common in these lymphomas, an overt plasmablastic transformation (PBL-T) has been only rarely reported. We report 6 cases of PBL-T occurring in 3 chronic lymphocytic leukemias (CLL) and 3 follicular lymphomas. Five patients were men, and the mean age was 65 years (range, 52 to 72 y). None of them had history of immunodeficiency. In 3 cases the PBL-T occurred 34 to 85 months after the initial diagnosis, and in 3 it was detected simultaneously with the small cell component at diagnosis. All patients received chemotherapy after transformation, and 4 died 4 to 24 months after this diagnosis. In 3 cases, PBL-T occurred in an extranodal site. All PBL-Ts had immunoblastic morphology with admixed plasma cells, were CD20 and PAX5 negative, expressed λ light chain, and 5 were CD138 positive. All cases were negative for HHV8, and only 1 PBL-T was Epstein-Barr virus positive. Evidence of a clonal relationship between the small cell and PBL-T components was found in 5 cases. In 2 CLL cases, both components had 13q deletions, and in all follicular lymphoma cases both components harbored the t(14;18) translocation. MYC translocations were observed in 2 cases transformed from a CLL. In conclusion, PBL-T expands the clinicopathologic spectrum of the transformation of low-grade B-cell lymphomas. These transformed tumors are clinically, histologically, and phenotypically similar to primary plasmablastic lymphomas, but they are not associated with immunodeficiency and rarely have Epstein-Barr virus infection or MYC alterations.
    MeSH term(s) Aged ; Cell Transformation, Neoplastic/pathology ; Chromosome Aberrations ; Clone Cells ; DNA, Neoplasm/analysis ; Fatal Outcome ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Lymphoma, B-Cell/genetics ; Lymphoma, B-Cell/mortality ; Lymphoma, B-Cell/pathology ; Male ; Middle Aged ; Plasmacytoma/pathology
    Chemical Substances DNA, Neoplasm
    Language English
    Publishing date 2013-02
    Publishing country United States
    Document type Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 752964-8
    ISSN 1532-0979 ; 0147-5185
    ISSN (online) 1532-0979
    ISSN 0147-5185
    DOI 10.1097/PAS.0b013e31826cb1d1
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  10. Article ; Online: Overexpression of the Cytokine BAFF and Autoimmunity Risk.

    Steri, Maristella / Orrù, Valeria / Idda, M Laura / Pitzalis, Maristella / Pala, Mauro / Zara, Ilenia / Sidore, Carlo / Faà, Valeria / Floris, Matteo / Deiana, Manila / Asunis, Isadora / Porcu, Eleonora / Mulas, Antonella / Piras, Maria G / Lobina, Monia / Lai, Sandra / Marongiu, Mara / Serra, Valentina / Marongiu, Michele /
    Sole, Gabriella / Busonero, Fabio / Maschio, Andrea / Cusano, Roberto / Cuccuru, Gianmauro / Deidda, Francesca / Poddie, Fausto / Farina, Gabriele / Dei, Mariano / Virdis, Francesca / Olla, Stefania / Satta, Maria A / Pani, Mario / Delitala, Alessandro / Cocco, Eleonora / Frau, Jessica / Coghe, Giancarlo / Lorefice, Lorena / Fenu, Giuseppe / Ferrigno, Paola / Ban, Maria / Barizzone, Nadia / Leone, Maurizio / Guerini, Franca R / Piga, Matteo / Firinu, Davide / Kockum, Ingrid / Lima Bomfim, Izaura / Olsson, Tomas / Alfredsson, Lars / Suarez, Ana / Carreira, Patricia E / Castillo-Palma, Maria J / Marcus, Joseph H / Congia, Mauro / Angius, Andrea / Melis, Maurizio / Gonzalez, Antonio / Alarcón Riquelme, Marta E / da Silva, Berta M / Marchini, Maurizio / Danieli, Maria G / Del Giacco, Stefano / Mathieu, Alessandro / Pani, Antonello / Montgomery, Stephen B / Rosati, Giulio / Hillert, Jan / Sawcer, Stephen / D'Alfonso, Sandra / Todd, John A / Novembre, John / Abecasis, Gonçalo R / Whalen, Michael B / Marrosu, Maria G / Meloni, Alessandra / Sanna, Serena / Gorospe, Myriam / Schlessinger, David / Fiorillo, Edoardo / Zoledziewska, Magdalena / Cucca, Francesco

    The New England journal of medicine

    2017  Volume 376, Issue 17, Page(s) 1615–1626

    Abstract: Background: Genomewide association studies of autoimmune diseases have mapped hundreds of susceptibility regions in the genome. However, only for a few association signals has the causal gene been identified, and for even fewer have the causal variant ... ...

    Abstract Background: Genomewide association studies of autoimmune diseases have mapped hundreds of susceptibility regions in the genome. However, only for a few association signals has the causal gene been identified, and for even fewer have the causal variant and underlying mechanism been defined. Coincident associations of DNA variants affecting both the risk of autoimmune disease and quantitative immune variables provide an informative route to explore disease mechanisms and drug-targetable pathways.
    Methods: Using case-control samples from Sardinia, Italy, we performed a genomewide association study in multiple sclerosis followed by TNFSF13B locus-specific association testing in systemic lupus erythematosus (SLE). Extensive phenotyping of quantitative immune variables, sequence-based fine mapping, cross-population and cross-phenotype analyses, and gene-expression studies were used to identify the causal variant and elucidate its mechanism of action. Signatures of positive selection were also investigated.
    Results: A variant in TNFSF13B, encoding the cytokine and drug target B-cell activating factor (BAFF), was associated with multiple sclerosis as well as SLE. The disease-risk allele was also associated with up-regulated humoral immunity through increased levels of soluble BAFF, B lymphocytes, and immunoglobulins. The causal variant was identified: an insertion-deletion variant, GCTGT→A (in which A is the risk allele), yielded a shorter transcript that escaped microRNA inhibition and increased production of soluble BAFF, which in turn up-regulated humoral immunity. Population genetic signatures indicated that this autoimmunity variant has been evolutionarily advantageous, most likely by augmenting resistance to malaria.
    Conclusions: A TNFSF13B variant was associated with multiple sclerosis and SLE, and its effects were clarified at the population, cellular, and molecular levels. (Funded by the Italian Foundation for Multiple Sclerosis and others.).
    MeSH term(s) Autoimmunity ; B-Cell Activating Factor/genetics ; B-Cell Activating Factor/metabolism ; Case-Control Studies ; Gene Expression ; Genome-Wide Association Study ; Humans ; INDEL Mutation ; Italy ; Lupus Erythematosus, Systemic/genetics ; Lupus Erythematosus, Systemic/immunology ; MicroRNAs ; Multiple Sclerosis/genetics ; Multiple Sclerosis/immunology ; Phenotype ; Polymorphism, Single Nucleotide ; Risk ; Sequence Analysis, RNA ; Transcription, Genetic
    Chemical Substances B-Cell Activating Factor ; MicroRNAs ; TNFSF13B protein, human
    Language English
    Publishing date 2017-05-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMoa1610528
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