Estudio genético HLA en poblaciones iraníes: epidemiología, antropología y farmacogenética

The HLA system is the most polymorphic genetic system described in humans. It consists of several closely linked loci encoding cell surface glycoproteins whose best known function is activating immune system response through antigenic presentation. New loci and new alleles have been described since the discovery of this genetic system and the presently available DNA typing and sequencing of these new alleles have increased the variety of HLA allelism. Due to the fact that HLA gene frequencies have a large degree of variability and a remarkable geographical correlation, HLA genes are an important and useful tool to infer genetic background and ethnical composition of modern human populations and also for tracing migration of ancient ones. In addition, certain combinations of contiguous alleles due to the strong linkage disequilibrium between HLA neighbouring loci show a characteristic frequency or are distinctive in many present day populations. Thus, HLA genetic system is a unique tool for studying the origin of relatively isolated groups, like Turkmen, Azeri and Kurd people, the populations under study, living in North Iran, in the surrounding area of Caspian Sea. Finally, HLA polymorphism is crucial for the compatibility between donor and receptor in organ transplantation and several HLA alleles have been linked to diseases and to response to drug treatments, which accomplishes relationships of certain variants with different pathologies treatment including AIDS. This is important in personalized treatments design. Turkmen could be descendants of Oghuz tribes from Seljuq branch coming from Transoxiana region (Central Asia) contemporarily to the foundation of the Seljuk Empire in 10th century AD. Conversely, this people could belong to another group within the Oghuz, arriving to Iran five centuries later. Migrations of this people were initially developed peacefully, being vassals of the Safavid Empire, and later by violent raids. They speak a language belonging to the Turkish-Oghuz group. In Iran, Turkmen live in Golestan province, mainly in Türkmensähra (“Turkmen plain”) area and amount 1.5 million people (2% of Iranian population). Most of this people are Sunni Muslims...

Revisión sistemática y metanálisis del rendimiento diagnóstico de los hallazgos ecográficos componentes del sonograma genético realizado en el segundo trimestre de gestación para la detección de Síndrome de Down

El impacto que tienen los defectos congénitos sobre la salud de las personas afectadas, sus familias y sobre la sociedad en su conjunto es muy considerable. En España se estima que existe una prevalencia de anomalías cromosómicas hasta 2010 de 1,49% de los recién nacidos vivos. El Síndrome de Down (SD) es la tercera causa de defecto congénito y la primera de cromosomopatía, con una prevalencia de 23 por cada 10000 nacidos vivos. La importante morbilidad asociada en los individuos con síndrome de Down se acompaña de un alto coste económico, estimándose en 329750,63 euros por cada nuevo caso, constituyendo un cargo a lo largo de la vida de 1316 millones de euros. Por todo ello, la detección de esta alteración es la indicación más frecuente de diagnóstico prenatal invasivo. Las pruebas invasivas, como amniocentesis, biopsia de vellosidades coriales y cordocentesis, se asocian con un aumento del 1% del riesgo de aborto y, por tanto, sólo se realizan cuando se considera que hay una probabilidad elevada de que el feto tenga un defecto cromosómico, siendo por tanto fundamental una buena selección del grupo de gestantes de alto riesgo...