Pentapeptidirakenteiden yleisimmät yhtäläisyydet

Proteiinit ovat elämälle välttämättömiä orgaanisia yhdisteitä, jotka koostuvat yhdestä tai useammasta aminohappoketjusta. Proteiinien toiminnan määrää niiden kolmiulotteinen rakenne, joka taas riippuu pitkälti proteiinien aminohappojärjestyksestä, sekvenssistä. Proteiinien tunnettujen sekvenssien määrä kasvaa DNA-sekvensoinnin tuloksena selvästi nopeammin kuin selvitettyjen kolmiulotteisten rakenteiden, konformaatioiden, määrä. Proteiinien rakenteitakin tunnetaan jo lähes 45 000, joten niiden tilastollisella analyysillä on yhä merkittävämpi osuus uusien proteiinien rakenteen määrittämisessä, ennustamisessa ja suunnittelussa. Työssä etsittiin pentapeptidejä (viiden aminohapon pituisia ketjuja), joilla on sama konformaatio kaikissa tunnetuissa proteiinien rakenteissa. Näitä rakennuspalikoita voisi käyttää suoraviivaisessa proteiinien suunnittelussa halutun kolmiulotteisen rakenteen aikaansaamiseksi. Aineistona käytettiin proteiinitietopankin joulukuussa 2007 sisältämiä rakenteita, joihin kuului lähes 45 000 proteiinin kolmiulotteista rakennetta. Aineiston laajuuden takia rakennuspalikoita etsittiin kahdessa vaiheessa vertailemalla pentapeptidien rakenteen keskeisten atomien (CA, CB, O, C ja N) sijaintia proteiinien aminohappoketjuissa. Työssä löytyi yli 9000 rakennuspalikkaa, pentapeptidiä, joista jokaisella oli sama konformaatio yli 12 eri rakennetiedostossa, niissä ilmoitettujen tarkkuuksien rajoissa. Löydetyistä rakennuspalikoista 48:lla oli täysin sama konformaatio kaikkialla, mistä ne löydettiin. Näistä useimmin esiintyneitä voi käyttää suoraan proteiinien rakenneanalyysissä valmiina kolmiulotteisen rakenteen osina. Eri konformaatioihin laskostuvia identtisiä pentapeptidejä löytyi yli 266 000 kappaletta. Rakennuspalikoiden stabiiliudesta johtuen ne saattavat olla tärkeitä proteiinien fysikaalisen mallinnuksen tutkimus- ja vertailukohteina. Käytännön kannalta työn lupaavin tulos oli se, että rakennuspalikoita löytyi eri vasta-aineiden rakennetiedostoista. Ehkäpä juuri vasta-aineita voitaisiin suunnitella työssä esitetyillä menetelmillä.

Intrahepatic cholestasis of pregnancy : genetic background, epidemiology and hepatobiliary consequences

Intrahepatic cholestasis of pregnancy (ICP) is the most common cholestatic liver disease during pregnancy. The reported incidence varies from 0.4 to 15% of full-term pregnancies. The etiology is heterogeneous but familial clustering is known to occur. Here we have studied the genetic background, epidemiology, and long-term hepatobiliary consequences of ICP. In a register-based nation-wide study (n=1 080 310) the incidence of ICP was 0.94% during 1987-2004. A slightly higher incidence, 1.3%, was found in a hospital-based series (n=5304) among women attending the University Hospital of Helsinki in 1992-1993. Of these 16% (11/69) were familial and showed a higher (92%) recurrence rate than the sporadic (40%) cases. In the register-based epidemiological study, advanced maternal age and, to a lesser degree, parity were identified as new risk factors for ICP. The risk was 3-fold higher in women >39 years of age compared to women <30 years. Multiple pregnancy also associated with an elevated risk. In a genetic study we found no association of ICP with the genes regulating bile salt transport (ABCB4, ABCB11 and ATP8B1). The livers of postmenopausal women with a history of ICP tolerated well the short-term exposure to oral and transdermal estradiol, although the doses used were higher than those in routine clinical use. The response of serum levels of sex hormone-binding globulin (SHBG) to oral estradiol was slightly reduced in the ICP group. Transdermal estradiol had no effect on C-reactive protein (CRP) or SHBG. A number of liver and biliary diseases were found to be associated with ICP. Women with a history of ICP showed elevated risks for non-alcoholic liver cirrhosis (8.2 CI 1.9-36), cholelithiasis and cholecystitis (3.7 CI 3.2-4.2), hepatitis C (3.5 CI 1.6-7.6) and non-alcoholic pancreatitis (3.2 CI 1.7-5.7). In conclusion, ICP complicates around 1% of all full-term pregnancies in Finland and its incidence has remained unchanged since 1987. It is familial in 16% of cases with a higher recurrence rate. Although the cause remains unknown, several risk factors, namely advanced maternal age, parity and multiple pregnancies, can be identified. Both oral and transdermal regimens of postmenopausal hormone therapy (HT) are safe for women with a history of ICP when liver function is considered. Some ICP patients are at risk of other liver and biliary diseases and, contrary to what has been thought, a follow-up is warranted.

Wegener's granulomatosis in Finland in 1981-2000

Objectives: Wegener s granulomatosis (WG) is a vasculitis with a predilection for the airways and kidneys. An increasing incidence and improved prognosis of WG has been shown. The aim of this study was to evaluate the incidence, clinical presentation, diagnostic delay, risk of dialysis-dependent renal insufficiency and mortality of WG in 1981-2000. Patients and methods: Data was retrieved from the Finnish hospital discharge register and hospital case reports. Patients diagnosed with WG in 1981-2000 were included, and their demographic and clinical data recorded. The patients were crossed with the national kidney dialysis register and the national mortality statistics. Results: A total of 492 patients (243 ♂ , 249 ♀) were diagnosed at a mean age of 54 years (SD 18). The incidence increased from 1.9 to 9.3/ million/ year. The median diagnostic delay decreased from 17 to 4 months. Patients presented most often with symptoms of the ear, nose and throat (ENT) (45%), lung (36%), musculoskeletal system (22%) and kidney (11%). Initial lung involvement, constitutional symptoms, high erythrocyte sedimentation rate (ESR) and high ELK scores [(number of simultaneously involved organ groups (ENT, Lung, Kidney)] were associated with a shorter diagnostic delay. Medical treatment of WG patients remained similar in the 1980s and 1990s. Almost 90% of patients received cyclophosphamide (CYC) and more than 90% glucocorticoid medication at some point during the course of the disease. Eighty-four patients (17%) needed dialysis. Initial renal involvement and elevated serum creatinine values were related to an increased risk of dialysis-dependent kidney disease. In two-thirds of the patients, renal impairment was reversible. Dialysis became chronic (>3 months) in 32 patients (6.5%). Nineteen patients (3.9%) received a kidney transplant. Altogether 203 patients (99 men, 104 women) died before 30 June 2005. WG was the underlying cause of death in 37%. The crude one-year and five-year survival rates were 83.3% and 74.2%, respectively. The standardized mortality ratio was 3.43 (95% CI = 2.98 to 3.94). Older age and elevated creatinine level at diagnosis predicted shorter survival. ENT symptoms at presentation and treatment with CYC were associated with better outcome. There was no additional risk associated with male gender or with either of the decades (1981-1990 and 1991-2000) Conclusions: In 1981-2000, the incidence of WG increased ca. 4.5-fold and diagnostic delay decreased to ca. one-fourth, reflecting increased recognition of the disease and improved diagnostic means. WG patients are at great risk of developing dialysis-dependent renal insufficiency and an increased risk of dying. During the study period the treatment of WG did not change markedly, nor did the prognosis improve.