Virulence in the chick model and stress tolerance of Salmonella enterica serovar Orion var. 15+

Three Salmonella enterica serovar Orion var. 15+ isolates of distinct provenance were tested for survival in various stress assays. All were less able to survive desiccation than a virulent S. Enreritidis strain, with levels of survival similar to a rpoS mutant of the S. Enteritidis strain, whereas one isolate (F3720) was significantly more acid tolerant. The S. Orion var. 15+ isolates were motile by flagellae and elaborated type-1 and curli-like fimbriae; surface organelles that are considered virulence determinants in Salmonella pathogenesis. Each adhered and invaded HEp-2 tissue culture cells with similar proficiency to the S. Enteritidis control but were significantly less virulent than S. En teritidis in the one-day-old and seven-day-old chick model. Given an oral dose of 1 x 10(3) cfu to one-day-old chicken, S. Orion var. 15+ isolates colonised 25% of liver and spleens examined at 24 h whereas S. Enteritidis colonised 100% of organs by the same with the same dose. Given an oral dose of 1 x 10(7) cfu at seven-day old, S. Orion var. 15+ failed to colonise livers and spleens in any bird examined at 24 h whereas S. Enteritidis colonised 50% of organs by the same with the same dose. Based on the number of internal organs colonised, one of the three S. Orion var. 15+ isolates tested (strain F3720) was significantly more invasive than the other two (B1 and B7). Also, strain F3720 was shed less than either B1 or B7 supporting the concept that there may be an inverse relationship between the ability to colonise deep tissues and to persist in the gut. These data are discussed in the light that S. Orion var. 15+ is associated with sporadic outbreaks of human infection rather than epidemics.

Binding properties and adhesion-mediating regions of the major sheath protein of Treponema denticola ATCC 35405

There is growing evidence that a number of oral Treponema species, in particular Treponema denticola, are associated with the progression of human periodontal disease. The major sheath (or surface) protein (Msp) of T. denticola is implicated in adhesion of bacteria to host cells and tissue proteins and is likely to be an important virulence factor. However, the binding regions of the Msp are not known. We have purified from Escherichia coli recombinant Msp (rMsp) polypeptides corresponding to the following: full-length Msp (rMsp) minus 13 N-terminal amino acid (aa) residues, an amino-terminal fragment (rN-Msp, 189 aa residues), a 57-aa residue segment from the central region (rV-Msp), and a C-terminal fragment (rC-Msp, 272 aa residues). rMsp (530 aa residues) bound to immobilized fibronectin, keratin, laminin, collagen type 1, fibrinogen, hyaluronic acid, and heparin. The N- and V-region polypeptides, but not rC-Msp, also bound to these substrates. Binding of rMsp to fibronectin was targeted to the N-terminal heparin I/fibrin I domain. Antibodies to the N-region or V-region polypeptides, but not antibodies to the rC-Msp fragment, blocked adhesion of T. denticola ATCC 35405 cells to a range of host protein molecules. These results suggest that the N-terminal half of Msp carries epitopes that are surface exposed and that are involved in mediating adhesion. Binding of rMsp onto the cell surface of low-level fibronectin-binding Treponema isolates conferred a 10-fold increase in fibronectin binding. This confirms that Msp functions autonomously as an adhesin and raises the possibility that phenotypic complementation of virulence functions might occur within mixed populations of Treponema species.

Nonpsychotropic plant cannabinoids, cannabidivarin (CBDV) and cannabidiol (CBD), activate and desensitize transient receptor potential vanilloid 1 (TRPV1) channels in vitro: potential for the treatment of neuronal hyperexcitability

Epilepsy is the most common neurological disorder, with over 50 million people worldwide affected. Recent evidence suggests that the transient receptor potential cation channel subfamily V member 1 (TRPV1) may contribute to the onset and progression of some forms of epilepsy. Since the two nonpsychotropic cannabinoids cannabidivarin (CBDV) and cannabidiol (CBD) exert anticonvulsant activity in vivo and produce TRPV1-mediated intracellular calcium elevation in vitro, we evaluated the effects of these two compounds on TRPV1 channel activation and desensitization and in an in vitro model of epileptiform activity. Patch clamp analysis in transfected HEK293 cells demonstrated that CBD and CBDV dose-dependently activate and rapidly desensitize TRPV1, as well as TRP channels of subfamily V type 2 (TRPV2) and subfamily A type 1 (TRPA1). TRPV1 and TRPV2 transcripts were shown to be expressed in rat hippocampal tissue. When tested on epileptiform neuronal spike activity in hippocampal brain slices exposed to a Mg2+-free solution using multielectrode arrays (MEAs), CBDV reduced both epileptiform burst amplitude and duration. The prototypical TRPV1 agonist, capsaicin, produced similar, although not identical effects. Capsaicin, but not CBDV, effects on burst amplitude were reversed by IRTX, a selective TRPV1 antagonist. These data suggest that CBDV antiepileptiform effects in the Mg2+-free model are not uniquely mediated via activation of TRPV1. However, TRPV1 was strongly phosphorylated (and hence likely sensitized) in Mg2+-free solution-treated hippocampal tissue, and both capsaicin and CBDV caused TRPV1 dephosphorylation, consistent with TRPV1 desensitization. We propose that CBDV effects on TRP channels should be studied further in different in vitro and in vivo models of epilepsy.

Lifetime Overproduction of Circulating Angiotensin-(1-7) Attenuates Deoxycorticosterone Acetate-Salt Hypertension-Induced Cardiac Dysfunction and Remodeling

We evaluated the development of arterial hypertension, cardiac function, and collagen deposition, as well as the level of components of the renin-angiotensin system in the heart of transgenic rats that overexpress an angiotensin (Ang)-(1-7)-producing fusion protein, TGR(A1-7)3292 (TG), which induces a lifetime increase in circulating levels of this peptide. After 30 days of the induction of the deoxycorticosterone acetate (DOCA)-salt hypertension model, DOCA-TG rats were hypertensive but presented a lower systolic arterial pressure in comparison with DOCA-Sprague-Dawley (SD) rats. In contrast to DOCA-SD rats that presented left ventricle (LV) hypertrophy and diastolic dysfunction, DOCA-TG rats did not develop cardiac hypertrophy or changes in ventricular function. In addition, DOCA-TG rats showed attenuation in mRNA expression for collagen type I and III compared with the increased levels of DOCA-SD rats. Ang II plasma and LV levels were reduced in SD and TG hypertensive rats in comparison with normotensive animals. DOCA-TG rats presented a reduction in plasma Ang-(1-7) levels; however, there was a great increase in Ang-(1-7) (approximate to 3-fold) accompanied by a decrease in mRNA expression of both angiotensin-converting enzyme and angiotensin-converting enzyme 2 in the LV. The mRNA expression of Mas and Ang II type 1 receptors in the LV was not significantly changed in DOCA-SD or DOCA-TG rats. This study showed that TG rats with increased circulating levels of Ang-(1-7) are protected against cardiac dysfunction and fibrosis and also present an attenuated increase in blood pressure after DOCA-salt hypertension. In addition, DOCA-TG rats showed an important local increase in Ang-(1-7) levels in the LV, which might have contributed to the attenuation of cardiac dysfunction and prefibrotic lesions. (Hypertension. 2010;55:889-896.)

Blockage of Angiotensin II type 2 receptor prevents thyroxine-mediated cardiac hypertrophy by blocking Akt activation

Although most of effects of Angiotensin II (Ang II) related to cardiac remodelling can be attributed to type 1 Ang II receptor (AT(1)R), the type 2 receptor (AT(2)R) has been shown to be involved in the development of some cardiac hypertrophy models. In the present study, we investigated whether the thyroid hormone (TH) action leading to cardiac hypertrophy is also mediated by increased Ang II levels or by change on AT(1)R and AT(2)R expression, which could contribute to this effect. In addition, we also evaluated the possible contribution of AT(2)R in the activation of Akt and in the development of TH-induced cardiac hypertrophy. To address these questions, Wistar rats were treated with thyroxine (T(4), 0.1 mg/kg BW/day, i.p.), with or without AT(2)R blocker (PD123319), for 14 days. Cardiac hypertrophy was identified based on heart/body weight ratio and confirmed by analysis of atrial natriuretic factor mRNA expression. Cardiomyocyte cultures were used to exclude the influence of TH-related hemodynamic effects. Our results demonstrate that the cardiac Ang II levels were significantly increased (80%, P < 0.001) as well as the AT(2)R expression (50%, P < 0.05) in TH-induced cardiac hypertrophy. The critical involvement of AT(2)R to the development of this cardiac hypertrophy in vivo was evidenced after administration of AT(2) blocker, which was able to prevent in 40% (P < 0.01) the cardiac mass gain and the Akt activation induced by TH. The role of AT(2)R to the TH-induced cardiomyocyte hypertrophy was also confirmed after using PD123319 in the in vitro studies. These findings improve understanding of the cardiac hypertrophy observed in hyperthyroidism and provide new insights into the generation of future therapeutic strategies.

Na+-glucose transporter-2 messenger ribonucleic acid expression in kidney of diabetic rats correlates with glycemic levels: Involvement of hepatocyte nuclear factor-1 alpha expression and activity

Mutations in Na+-glucose transporters (SGLT)-2 and hepatocyte nuclear factor (HNF)-1 alpha genes have been related to renal glycosuria and maturity-onset diabetes of the young 3, respectively. However, the expression of these genes have not been investigated in type 1 and type 2 diabetes. Here in kidney of diabetic rats, we tested the hypotheses that SGLT2 mRNA expression is altered; HNF-1 alpha is involved in this regulation; and glycemic homeostasis is a related mechanism. The in vivo binding of HNF-1 alpha into the SGLT2 promoter region in renal cortex was confirmed by chromatin immunoprecipitation assay. SGLT2 and HNF-1 alpha mRNA expression (by Northern and RT-PCR analysis) and HNF-1 binding activity of nuclear proteins (by EMSA) were investigated in diabetic rats and treated or not with insulin or phlorizin (an inhibitor of SGLT2). Results showed that diabetes increases SGLT2 and HNF-1 alpha mRNA expression (similar to 50%) and binding of nuclear proteins to a HNF-1 consensus motif (similar to 100%). Six days of insulin or phlorizin treatment restores these parameters to nondiabetic-rat levels. Moreover, both treatments similarly reduced glycemia, despite the differences in plasma insulin and urinary glucose concentrations, highlighting the plasma glucose levels as involved in the observed modulations. This study shows that SGLT2 mRNA expression and HNF-1 alpha expression and activity correlate positively in kidney of diabetic rats. It also shows that diabetes-induced changes are reversed by lowering glycemia, independently of insulinemia. Our demonstration that HNF-1 alpha binds DNA that encodes SGLT2 supports the hypothesis that HNF-1 alpha, as a modulator of SGLT2 expression, may be involved in diabetic kidney disease.

Comparison of signal-to-cutoff values in first, second, and third generation enzyme immunoassays for the diagnosis of HTLV-1/2 infection in ""at-risk"" individuals from Sao Paulo, Brazil

Data obtained during routine diagnosis of human T-cell lymphotropic virus type 1 (HTLV-1) and 2 (HTLV-2) in ""at-risk"" individuals from Sao Paulo, Brazil using signal-to-cutoff (S/C) values obtained by first, second, and third generation enzyme immunoassay (EIA) kits, were compared. The highest S/C values were obtained with third generation EIA kits, but no correlation was detected between these values and specific antibody reactivity to HTLV-1, HTLV-2, or untyped HTLV (p = 0.302). In addition, use of these third generation kits resulted in HTLV-1/2 false-positive samples. In contrast, first and second generation EIA kits showed high specificity, and the second generation EIA kits showed the highest efficiency, despite lower S/C values. Using first and second generation EIA kits, significant differences in specific antibody detection of HTLV-1, relative to HTLV-2 (p = 0.019 for first generation and p < 0.001 for second generation EIA kits) and relative to untyped HTLV (p = 0.025 for first generation EIA kits), were observed. These results were explained by the composition and format of the assays. In addition, using receiver operating characteristics (ROC) analysis, a slight adjustment in cutoff values for third generation EIA kits improved their specificities and should be used when HTLV ""at-risk"" populations from this geographic area are to be evaluated. (C) 2009 Elsevier B.V. All rights reserved.

Occurrence of herpes simplex virus 1 and three periodontal bacteria in patients with chronic periodontitis and necrotic pulp

Viral and bacterial associations appear to be implicated in the development of periodontal infections. Little information is available describing the periodontopathic agents in root canals with necrotic pulp. In this study, the occurrence and the combinations among herpes simplex virus type 1 (HSV-1) and Dialister pneumosintes, Tannerella forsythia.. and Treponema denticola in patients with chronic periodontitis and necrotic pulp were evaluated. Clinical samples from healthy subjects and patients with periodontal or pulp infections were analyzed using a nested polymerase chain reaction PCR to detect HSV and PCR to detect the 3 periodontal bacteria. The presence of Tannerella forsythia and Treponema denticola was observed in healthy, periodontitis, and necrotic pulp patients. HSV was observed in periodontitis and necrotic pulp patients, and no healthy subject harbored D. pneumosintes or HSV. The occurrence of Tannerella forsythia was not statistically significant in patients with necrotic pulp (P = 0.704). Periodontal bacteria were observed varying from 10.3% to 20.7% in periodontitis and necrotic pulp patients. The presence of Treponema denticola - HSV association was predominant in patients showing necrotic pulp (24.1%); however, HSV alone was observed in one patient with periodontitis and in another patient with necrotic pulp. The presence of double association among bacteria or bacteria - HSV could indicate a role in both periodontitis and necrotic pulp, and Tannerella forsythia - Treponenta denticola - HSV and Tannerella forsythia - D. pneumosintes - Treponema denticola - HSV associations might be important in periodontitis.

Immune Responses and Therapeutic Antitumor Effects of an Experimental DNA Vaccine Encoding Human Papillomavirus Type 16 Oncoproteins Genetically Fused to Herpesvirus Glycoprotein D

Recombinant adenovirus or DNA vaccines encoding herpes simplex virus type 1 (HSV-1) glycoprotein D (gD) genetically fused to human papillomavirus type 16 (HPV-16) oncoproteins (E5, E6, and E7) induce antigen-specific CD8(+) T-cell responses and confer preventive resistance to transplantable murine tumor cells (TC-1 cells). In the present report, we characterized some previously uncovered aspects concerning the induction of CD8(+) T-cell responses and the therapeutic anticancer effects achieved in C57BL/6 mice immunized with pgD-E7E6E5 previously challenged with TC-1 cells. Concerning the characterization of the immune responses elicited in mice vaccinated with pgD-E7E6E5, we determined the effect of the CD4(+) T-cell requirement, longevity, and dose-dependent activation on the E7-specific CD8(+) T-cell responses. In addition, we determined the priming/boosting properties of pgD-E7E6E5 when used in combination with a recombinant serotype 68 adenovirus (AdC68) vector encoding the same chimeric antigen. Mice challenged with TC-1 cells and then immunized with three doses of pgD-E7E6E5 elicited CD8(+) T-cell responses, measured by intracellular gamma interferon (IFN-gamma) and CD107a accumulation, to the three HPV-16 oncoproteins and displayed in vivo antigen-specific cytolytic activity, as demonstrated with carboxyfluorescein diacetate succinimidyl ester (CFSE)-labeled target cells pulsed with oligopeptides corresponding to the H-2D(b)-restricted immunodominant epitopes of the E7, E6, or E5 oncoprotein. Up to 70% of the mice challenged with 5 x 10(5) TC-1 cells and immunized with pgD-E7E6E5 controlled tumor development even after 3 days of tumor cell challenge. In addition, coadministration of pgD-E7E6E5 with DNA vectors encoding pGM-CSF or interleukin-12 (IL-12) enhanced the therapeutic antitumor effects for all mice challenged with TC-1 cells. In conclusion, the present results expand our previous knowledge on the immune modulation properties of the pgD-E7E6E5 vector and demonstrate, for the first time, the strong antitumor effects of the DNA vaccine, raising promising perspectives regarding the development of immunotherapeutic reagents for the control of HPV-16-associated tumors.

The Crystal Complex of Phosphofructokinase-2 of Escherichia coli with Fructose-6-phosphate KINETIC AND STRUCTURAL ANALYSIS OF THE ALLOSTERIC ATP INHIBITION

Substrate inhibition by ATP is a regulatory feature of the phosphofructokinases isoenzymes from Escherichia coli (Pfk-1 and Pfk-2). Under gluconeogenic conditions, the loss of this regulation in Pfk-2 causes substrate cycling of fructose-6-phosphate (fructose-6-P) and futile consumption of ATP delaying growth. In the present work, we have broached the mechanism of ATP-induced inhibition of Pfk-2 from both structural and kinetic perspectives. The crystal structure of Pfk-2 in complex with fructose-6-P is reported to a resolution of 2 angstrom. The comparison of this structure with the previously reported inhibited form of the enzyme suggests a negative interplay between fructose-6-P binding and allosteric binding of MgATP. Initial velocity experiments show a linear increase of the apparent K(0.5) for fructose-6-P and a decrease in the apparent k(cat) as a function of MgATP concentration. These effects occur simultaneously with the induction of a sigmoidal kinetic behavior (n(H) of approximately 2). Differences and resemblances in the patterns of fructose-6-P binding and the mechanism of inhibition are discussed for Pfk-1 and Pfk-2, as an example of evolutionary convergence, because these enzymes do not share a common ancestor.

Barns upplevelser av att leva med diabetes mellitus typ 1 : samt sjuksköterskans betydelse i deras omvårdnad

Syftet med denna studie har varit att beskriva hur barn med diagnosen diabetes mellitus typ 1 upplever sin sjukdom samt vilken betydelse sjuksköterskan kunde ha i omvårdnaden av dessa barn. Studien har utförts som en systematisk litteraturstudie och tillvägagångssättet har varit att systematiskt söka, kritiskt granska och sammanställa resultat inom det valda ämnesområdet från olika studier. Sökningen har skett i databaserna Elin@Dalarna, Cinahl och Blackwell Synergy. Sökorden som har använts var: diabetes mellitus type 1, diabetes mellitus, children, adolescents, experiences, perspective, nurs* och care i olika kombinationer. Sammanställningen från resultatet visade att barn med diagnosen diabetes mellitus typ 1 upplever sin sjukdom olika utifrån sina egna förutsättningar, kön eller ålder. Det framkom även att sjuksköterskan hade en viktig roll när det gällde att fånga upp barnens upplevelser kring den förändrade livssituationen som uppstått och utifrån detta kartlägga barnens resurser att hantera denna situation. Att då kunna bemöta barnen och deras familjer utifrån egna förutsättningar och att motivera dessa till att sköta den livslånga behandlingen, kan vara avgörande för att få en bra kontroll över diabetes och på så sätt en ökad livskvalité och ett gott välbefinnande.

Att leva med diabetes typ 1- En litteraturöversikt om barn och ungdomar samt deras föräldrars upplevelser

Bakgrund: Diabetes typ 1 ökar bland barn och ungdomar, Sverige har den näst högsta insjuknandefrekvensen i hela världen. Diabetes typ 1 är en kronisk autoimmun sjukdom vilket innebär att kroppens immunförsvar angriper de egna insulinproducerande cellerna i pankreas. Patienter med diabetes typ 1 löper stor risk att drabbas av komplikationer och följdsjukdomar. Syfte: Syftet med denna studie är att beskriva barn och ungdomar samt deras föräldrars upplevelser av att leva med diabetes typ 1. Metod: En litteraturstudie genomfördes med totalt 15 artiklar utifrån studiens syfte, sökningarna har skett i databaserna Cinahl och PubMed. Artiklarna poängsattes med hjälp av Högskolan Dalarnas modifierade version av granskningsmallar för kvantitativa och kvalitativa artiklar. Resultat: Analysen av artiklarna resulterade i fyra kategorier som beskriver barn och ungdomars upplevelser: begränsningar i vardagen, stöd från föräldrar och sjukvården var centralt, rädsla för komplikationer samt att vara annorlunda. Två kategorier beskriver föräldrarnas upplevelser: oro rädsla och frustration samt att våga släppa kontrollen. Slutsats: Barn och ungdomar med diabetes typ 1 upplevde sitt liv som begränsat. Sjukdomen påverkar dem i skolan, under fysisk aktivitet, tillsammans med vänner, och i sociala sammanhang. Föräldrar till barn och ungdomar med diabetes typ 1 upplevde rädsla och oro över sitt barns sjukdom.

Upplevelser av stöd från diabetessjuksköterskan hos personer med diabetes typ 1 : – Sekundäranalys av en kvalitativ intervjustudie

Introduction: Type 1 diabetes is a chronic disease that affects the individual in everyday life. The diabetes team sets the treatment goals together with the patient aiming for a good quality of life and to prevent complications. The diabetes nurse should include in-depth knowledge of the daily life of people with diabetes, and have respect for the individual's choices and life situation. Aim: To describe how people with type 1 diabetes experience the support from the diabetes nurse. Method: A qualitative content analysis with an inductive approach has been used. A secondary analysis including semi-structured interviews with 15 adults (> 18 years) with type 1 diabetes was conducted. Result: The result was summarized with an overall theme "At the clinic - experience of the support offered" describes how people experience the support from their diabetes nurse. The theme constituted three categories "Access to the diabetes nurse", "The diabetes nurse - a source of information and knowledge that might need to be complemented with the support from other professionals" and,"Mutual trust - the patient's experience of the district nurse as a discussion partner and support". Conclusion: The results showed that the accessibility to diabetes nurses was experienced as good. It was simple and easy to make contact. The diabetes nurses were experienced to be engaged and provide good support to the patients. A good dialogue with the diabetes nurse and commitment from the diabetes nurse were mentioned as important factors that made the visits to be experienced as good and important. There were requests for greater access and expanded opportunities for help from counselors, as well as an increased focus on how the person is feeling.

Anhörigperspektivet utifrån föräldrars erfarenheter då barnet har diabetes typ 1 : En litteraturöversikt

Bakgrund: Den största delen av behandlingen vid diabetes typ 1 är egenvård. När ett barn insjuknar i diabetes är det föräldrarna som huvudsakligen ansvarar för egenvården. Detta kan vara både psykiskt och fysiskt påfrestande. Det behövs mer kunskap om föräldrars upplevelser och deras erfarenheter av att vårda ett barn med diabetes. Syfte: Syftet med denna litteraturstudie är att belysa anhörigperspektivet utifrån föräldrars erfarenheter då barnet har diabetes typ 1 samt hur sjuksköterskan kan ge stöd till anhöriga. Metod: En litteraturöversikt. Resultat: Resultatet visar att egenvården skiljer sig mellan små barn och ungdomar, att föräldrar upplever känslor av oro och stress när deras barn fått diagnosen och att sjuksköterskan kan hjälpa och öka sin förståelse genom att stödja. Slutsats: Författarna kan dra slutsatsen att ökad kunskap och förståelse om egenvård vid diabetes typ 1 hos barn, kan bidra till en hjälp för sjuksköterskor att ge föräldrarna ett bra stöd och bemötande i vården.

Polimorfismos de inserção/deleção do gene da ECA e K121Q do gene PC-1 em pacientes com Diabete Mellito tipo 1 normoalbuminúricos : estudo com 10 anos de acompanhamento

O objetivo deste estudo foi analisar o papel do polimorfismo de I/D do gene da Enzima Conversora de Angiotensina (ECA) e o polimorfismo K121Q da PC-1 nas modificações das taxas de filtração glomerular (TFG), excreção urinária de albumina (EUA) e pressão arterial em uma coorte de pacientes diabéticos tipo 1 normoalbuminúricos (EUA<20μg/min) em um estudo com seguimento de 10,2 ± 2,0anos (6,5 a 13,3 anos). A EUA (imunoturbidimetria), TFG (técnica da injeção única de 51Cr-EDTA), HbA1c (cromatografia de troca iônica) e pressão arterial foram medidas no início do estudo e a intervalos de 1,7 ± 0,6 anos. O polimorfismo I/D e K121Q foram determinados através da PCR e restrição enzimática. Onze pacientes apresentaram o genótipo II, 13 o ID e 6 apresentaram o genótipo DD. Pacientes com o alelo D (ID/DD) desenvolveram mais freqüentemente hipertensão arterial e retinopatia diabética. Os 3 pacientes do estudo que desenvolveram nefropatia diabética apresentaram o alelo D. Nos pacientes ID/DD (n=19) ocorreu maior redução da TFG quando comparados com os pacientes II (n=11) (-0,39 ± 0,29 vs – 0,12 ± 0,37 ml/min/mês; P=0,035). A presença do alelo D, em análise de regressão múltipla linear (R2=0,15; F=4,92; P=0,035) foi o único fator associado à redução da TFG (-0,29 ± 0,34 ml/min/mês; P<0,05). Já o aumento da EUA (log EUA = 0,0275 ± 0,042 μg/min/mês; P=0,002) foi associado somente aos níveis iniciais de EUA (R2=0,17; F=5,72; P=0,024). Um aumento significativo (P<0,05) no desenvolvimento de hipertensão arterial e de novos casos de retinopatia diabética foi observado somente nos pacientes com os genótipos ID/DD. Vinte e dois pacientes apresentaram genótipo KK, 7 KQ e 1 apresentou genótipo QQ. Pacientes com os genótipos KQ/QQ apresentaram um aumento significativo (P=0,045) de novos casos de retinopatia diabética. Em conclusão a presença do alelo D nesta amostra de pacientes DM tipo 1 normoalbuminúricos e normotensos está associada com aumento na proporção de complicações microvasculares e hipertensão arterial.