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Biomedical subjects

C Swider

Publications and source records attributed to C Swider.

7 recordsLinked to original sources

TNF-alpha and HLA-DR genotyping as potential prognostic markers in pulmonary sarcoidosis.

We have analyzed the HLA-DRB1 alleles and -308 TNF-alpha gene polymorphism in 78 sarcoidosis patients and 50 controls. The sarcoidosis group as a whole did not show any significant correlation with the TNF-A or the HLA-DR alleles compared to the control group. However, the patient subgroups of Löfgren and non-Löfgren sarcoidosis exhibited significant allele associations. In the Löfgren patient group, the TNF-A2 and the HLA-DR3 alleles were represented significantly higher, with a highly significant relative risk resulting from the presence of the TNF-A2 or the HLA-DR3 allele or both. In the non-Löfgren patient group, the phenotype expressing HLA-DR2 and lacking TNF-A2 was significantly higher than in the Löfgren patient group. Due to these significant genetic differences in the subgroups of Löfgren and non-Löfgren sarcoidosis patients, we conclude that the genotyping of these two loci (-308 TNF-alpha promoter polymorphism and HLA-DR) may be of prognostic value for the course of disease in sarcoidosis.

Acute Disease↗

Tumour necrosis factor alpha promoter gene polymorphism in sarcoidosis.

Biallelic polymorphisms in the promoter region of the TNF-alpha gene (TNFA) and in the first intron of the TNF-beta gene (TNFB) have been associated with variation in TNF-alpha production and with susceptibility to severe diseases. Among other functions, TNF-alpha plays a pivotal role in regulatory aspects of granuloma formation and sustenance. In sarcoidosis, a systemic granulomatous disorder of unknown aetiology, the clinical course of the disease has been associated with the patient's individual capacity of spontaneous TNF-alpha production by alveolar macrophages. We determined the TNFA and TNFB polymorphisms in 101 patients with pulmonary sarcoidosis and 216 healthy blood donors. A highly significant shift to the more uncommon TNFA2 allele was found in the Löfgren syndrome patient group, which represents the acute form of the disease with frequent spontaneous remission. The results show that gene frequencies of the TNFA gene variation are significantly different within the clinical forms of sarcoidosis, indicating that genetic predisposition for TNF-alpha production may play a role in the pathogenesis of the disease.

Humans↗

Presence of mRNA for interferon-gamma (IFN-gamma) in blood mononuclear cells is associated with an active stage I sarcoidosis.

Peripheral blood mononuclear cells (PBMC) and bronchoalveolar lavage (BAL) cells obtained from sarcoidosis patients were investigated for the presence of mRNA for IFN-gamma. RNA was extracted from freshly obtained cells. In 12 cases PBMC were studied and in seven cases BAL cells were also available for concomitant investigation. In eight patients mRNA for IFN-gamma was present in blood and was significantly associated with stage I disease (P = 0.030). By comparison, BAL cells were less frequently positive for IFN-gamma transcripts (P = 0.039). Only one patient had simultaneous expression of IFN-gamma gene in blood and BAL cells. All other patients including four positive in blood were negative in BAL. The presence of IFN-gamma transcripts in PBMC was significantly associated with the capacity of these cells to generate IFN-gamma in unstimulated cultures. PBMC from patients showing IFN-gamma mRNA in blood were frequently high IFN-gamma producers in anti-CD3 MoAb-stimulated cultures.

Adult↗

Evaluation of computer-based diet education in persons with diabetes mellitus and limited educational background.

A study was conducted to determine whether computer-based techniques for meal planning and diet education could be an effective supplement to diabetes diet counseling in a group of inner-city subjects with limited educational background. Sixteen individuals with diabetes mellitus who were newly referred to an inner-city outpatient diet clinic and who demonstrated ninth-grade reading ability were given computer-based nutritional education. They received meal planning information through use of individualized computer-planned menus and education about the diabetes diet by computer-assisted instruction (CAI) combined with an interactive videodisc system (VIDEO). Total contact time was 180 min of CAI/VIDEO, 50 min of dietitian/patient education, and 20 min of dietitian/patient computer time (the last function could have been performed by a clerk). At the end of 4 wk, the group performance was improved in Exchange Lists knowledge (P less than 0.001), recognition of foods containing concentrated carbohydrate (P less than 0.05), and reduction of reported fat intake (P less than 0.05). In addition, average group weight declined by 4.6 lb (P less than 0.005). No improvement was found in food-measuring skills or in calorie-consumption compliance during a standardized buffet lunch. It appears that computer-based techniques are an acceptable supplement to traditional methods of education in this patient group and can improve the effectiveness of diabetes education programs without a significant increase in dietitian time.

Adult↗