BK virus associated meningoencephalitis in an AIDS patient treated with HAART

A severely immune-suppressed AIDS patient was suspected of suffering from BK virus (BKV) meningoencephalitis, after being studied for common causes of neurological complications of co-infectious origin. Polymerase chain reaction (PCR) and sequence analysis of cerebrospinal fluid and brain samples, confirmed the presence of BKV. His clinical condition improved along with the regression of brain lesions, after modifications on his antiretroviral regime. Five months after discharge, the patient was readmitted because of frequent headaches, and a marked inflammatory reaction was evidenced by a new magnetic resonance imaging (MRI). The symptoms paralleled a rising CD4+ lymphocyte count, and immune reconstitution syndrome was suspected. This is the first non-postmortem report of BKV meningoencephalitis in an AIDS patient, showing clinical and radiographic improvement solely under HAART.

Oral antibacterial effect of chlorhexidine treatments and professional prophylaxis in children

Aim: The primary aim of this longitudinal study was to evaluate additional effects of 4-week chlorhexidine digluconate (CHX) gel treatments to control Aggregatibacter actinomycetemcomitans counts in children after professional dental prophylaxis. Porphyromonas gingivalis and Streptococcus mutans counts were also determined to evaluate the secondary effects of anti-plaque treatments on microbial shifts. Methods: Twenty-six children with A. actinomycetemcomitans counts >4 log10/ mL of saliva and/or Quigley-Hein plaque index >3.0 were enrolled in this study. Patients were randomly assigned to groups GI (placebo gel), GII (0.5% CHX gel), GIII (1% CHX gel), and GIV (2% CHX gel). Four sessions of treatment were performed during 4 weeks after a session of professional dental prophylaxis. Real-Time polymerase chain reaction (PCR) was used to determine viable microorganism counts in non-stimulated whole saliva samples collected at baseline, one week, one month and three months after interruption of treatments. Results: A reduction of all bacterial counts was detected after the 3-month follow-up in all groups. Lower counts of P. gingivalis were achieved from 1 week on after treatments. The 2% CHX concentration seemed to contribute to lower A. actinomycetemcomitans levels and increase S. mutans levels. Conclusions: Professional dental prophylaxis was effective to control salivary levels of A. actinomycetemcomitans, P. gingivalis and S. mutans. Additional antimicrobial effects, however, were not observed by the combination of professional dental prophylaxis and 4-week chlorhexidine gel treatments.

Assessing malaria transmission in a low endemicity area of north-western Peru

Background Where malaria endemicity is low, control programmes need increasingly sensitive tools for monitoring malaria transmission intensity (MTI) and to better define health priorities. A cross-sectional survey was conducted in a low endemicity area of the Peruvian north-western coast to assess the MTI using both molecular and serological tools. Methods Epidemiological, parasitological and serological data were collected from 2,667 individuals in three settlements of Bellavista district, in May 2010. Parasite infection was detected using microscopy and polymerase chain reaction (PCR). Antibodies to Plasmodium vivax merozoite surface protein-119 (PvMSP119) and to Plasmodium falciparum glutamate-rich protein (PfGLURP) were detected by ELISA. Risk factors for exposure to malaria (seropositivity) were assessed by multivariate survey logistic regression models. Age-specific antibody prevalence of both P. falciparum and P. vivax were analysed using a previously published catalytic conversion model based on maximum likelihood for generating seroconversion rates (SCR). Results The overall parasite prevalence by microscopy and PCR were extremely low: 0.3 and 0.9%, respectively for P. vivax, and 0 and 0.04%, respectively for P. falciparum, while seroprevalence was much higher, 13.6% for P. vivax and 9.8% for P. falciparum. Settlement, age and occupation as moto-taxi driver during previous year were significantly associated with P. falciparum exposure, while age and distance to the water drain were associated with P. vivax exposure. Likelihood ratio tests supported age seroprevalence curves with two SCR for both P. vivax and P. falciparum indicating significant changes in the MTI over time. The SCR for PfGLURP was 19-fold lower after 2002 as compared to before (λ1 = 0.022 versus λ2 = 0.431), and the SCR for PvMSP119 was four-fold higher after 2006 as compared to before (λ1 = 0.024 versus λ2 = 0.006). Conclusion Combining molecular and serological tools considerably enhanced the capacity of detecting current and past exposure to malaria infections and related risks factors in this very low endemicity area. This allowed for an improved characterization of the current human reservoir of infections, largely hidden and heterogeneous, as well as providing insights into recent changes in species specific MTIs. This approach will be of key importance for evaluating and monitoring future malaria elimination strategies.

Detection of porcine circovirus genotypes 2a and 2b in aborted foetuses from infected swine herds in the State of São Paulo, Brazil

Background Porcine circovirus type 2 (PCV2) has been associated with several disease complexes, including reproductive failure. The aim of this study was to identify the subtypes of PCV2 that are associated with reproductive failure in pigs from the State of São Paulo, Brazil and to investigate co-infections with other infectious organisms. Findings Samples of 168 aborted foetuses or mummified foetuses from five farrow-to-finish swine farms known to be infected with PCV2 and located in the State of São Paulo were tested for PCV2 by polymerase chain reaction (PCR). Positive samples were additionally tested for porcine parvovirus (PPV), Leptospira spp. and Brucella spp. by PCR. PCV2 was detected in 18 of the samples (10.7%). PPV, Brucella spp. and Leptospira spp were found in 2, 10 and 0 cases, respectively. Eleven PCV2 strains were sequenced and determined to be either genotype 2a (n = 1) or 2b (n = 10). Conclusions The findings indicate that the frequency of PCV2 infections in aborted porcine foetuses from the State of São Paulo is rather low (10.7%) and that co-infection with other pathogens is common and may be involved in PCV2 associated reproductive failure. No repeatable, characteristic amino acid motifs for regions of the PCV2 capsid protein seemed to be associated with abortion in sows.

In vitro evaluation of the odontogenic potential of mouse undifferentiated pulp cells

The aim of this study was to evaluate the odontogenic potential of undifferentiated pulp cells (OD-21 cell line) through chemical stimuli in vitro. Cells were divided into uninduced cells (OD-21), induced cells (OD-21 cultured in supplemented medium/OD-21+OM) and odontoblast-like cells (MDPC-23 cell line). After 3, 7, 10 and 14 days of culture, it was evaluated: proliferation and cell viability, alkaline phosphatase activity, total protein content, mineralization, immunolocalization of dentin matrix acidic phosphoprotein 1 (DMP1), alkaline phosphatase (ALP) and osteopontin (OPN) and quantification of genes ALP, OSTERIX (Osx), DMP1 and runt-related transcription factor 2 (RUNX2) through real-time polymerase chain reaction (PCR). Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests (p<0.05). There was a decrease in cell proliferation in OD-21 + OM, whereas cell viability was similar in all groups, except at 7 days. The amount of total protein was higher in group OD-21 + OM in all periods; the same occurred with ALP activity after 10 days when compared with OD-21, with no significant differences from the MDPC-23 group. Mineralization was higher in OD-21+OM when compared with the negative control. Immunolocalization demonstrated that DMP1 and ALP were highly expressed in MDPC-23 cells and OD-21 + OM cells, whereas OPN was high in all groups. Real-time PCR revealed that DMP1 and ALP expression was higher in MDPC-23 cell cultures, whereas RUNX2 was lower for these cells and higher for OD-21 negative control. Osx expression was lower for OD-21 + OM. These results suggest that OD-21 undifferentiated pulp cells have odontogenic potential and could be used in dental tissue engineering.

Molecular typing of Clostridium perfringens isolated from swine in slaughterhouses from São Paulo State, Brazil

Clostridium perfringens is an anaerobic Gram-positive bacterium known as common pathogen for humans, for domestic and wildlife animals. Although infections caused by C. perfringens type C and A in swine are well studied, just a few reports describe the genetic relationship among strains in the epidemiological chain of swine clostridioses, as well as the presence of the microorganism in the slaughterhouses. The aim of the present study was to isolate C. perfringens from feces and carcasses from swine slaughterhouses, characterize the strains in relation to the presence of enterotoxin, alpha, beta, epsilon, iota and beta-2 toxins genes, using polymerase chain reaction (PCR) and comparing strains by means of Pulsed field gel electrophoresis (PFGE). Clostridium perfringens isolation frequencies in carcasses and finishing pig intestines were of 58.8% in both types of samples. According to the polymerase chain reaction assay, only alfa toxin was detected, being all isolates also negative to enterotoxin and beta2 toxin. Through PFGE technique, the strains were characterized in 35 pulsotypes. In only one pulsotype, the isolate from carcass sample was grouped with fecal isolate of the same animal, suggesting that the risk of cross-contamination was low. Despite the high prevalence of C. perfringens in swine carcasses from the slaughterhouses assessed, the risk of food poisoning to Brazilian pork consumers is low, since all strains were negative to cpe-gene, codifying enterotoxin.

Detection of Genetic characterization of Porcine circovirus 2 (PCV2) in Brazilian wildlife boars

A semi-intensive wildlife boars farm presented a clinical history of high mortality in 70 - 90 days-old pigs (> 50 %). Two 90 days-old animals with weight loss and wasting were necropsied and the samples tested for PCV2 by polymerase chain reaction (PCR). The genetic material of PCV2 was sequenced and classified into the PCV2a genotype together with PCV2 sequences obtained from samples of Poland, Brazil, Slovenia and Greece wild boars.

Emergence of enteric viruses in production chickens is a concern for avian health

Several viruses have been identified in recent years in the intestinal contents of chickens and turkeys with enteric problems, which have been observed in commercial farms worldwide, including Brazil. Molecular detection of these viruses in Brazil can transform to a big threat for poultry production due to risk for intestinal integrity. This disease is characterized by severely delayed growth, low uniformity, lethargy, watery diarrhea, delayed feed consumption, and a decreased conversion rate. Chicken astrovirus (CAstV), rotavirus, reovirus, chicken parvovirus (ChPV), fowl adenovirus of subgroup I (FAdV-1), and avian nephritis virus (ANV) were investigated using the conventional polymerase chain reaction (PCR) and the reverse transcription polymerase chain reaction (RT-PCR). In addition, the infectious bronchitis virus (IBV), which may play a role in enteric disease, was included. The viruses most frequently detected, either alone or in concomitance with other viruses, were IBV, ANV, rotavirus, and CAstV followed by parvovirus, reovirus, and adenovirus. This study demonstrates the diversity of viruses in Brazilian chicken flocks presenting enteric problems characterized by diarrhea, growth retard, loss weight, and mortality, which reflects the multicausal etiology of this disease

Survey of Bancroftian filariasis infection in humans and Culex mosquitoes in the western Brazilian Amazon region: implications for transmission and control

Introduction: The aim of this work was to identify possible lymphatic filariasis foci in the western Brazilian Amazonian that could be established from the reports of Rachou in the 1950s. The study was conducted in three cities of the western Brazilian Amazon region - Porto Velho and Guajará-Mirim (State of Rondônia) and Humaitá (State of Amazonas). Methods: For human infection evaluation thick blood smear stained with Giemsa was used to analyze samples collected from 10pm to 1am. Polymerase chain reaction (PCR) was used to examine mosquito vectors for the presence of Wuchereria bancrofti DNA. Humans were randomly sampled from night schools students and from inhabitants in neighborhoods lacking sanitation. Mosquitoes were collected from residences only. Results: A total 2,709 night students enrolled in the Program for Education of Young Adults (EJA), and 935 people registered in the residences near the schools were examined, being 641 from Porto Velho, 214 from Guajará-Mirim and 80 from Humaitá. No individual examined was positive for the presence of microfilariae in the blood stream. A total of 7,860 female Culex quinquefasciatus specimens examined were negative by PCR. Conclusions: This survey including human and mosquito examinations indicates that the western Amazon region of Brazil is not a focus of Bancroftian filariasis infection or transmission. Therefore, there is no need to be included in the Brazilian lymphatic filariasis control program.

Photobiological effect of low-level laser irradiation in bovine embryo production system

The objectives of this study were to evaluate the effect of low-level laser irradiation (LLLI) on bovine oocyte and granulosa cells metabolism during in vitro maturation (IVM) and further embryo development. Cumulus-oocytes complexes (COCs) were subjected (experimental group) or not (control group) to irradiation with LLLI in a 633-nm wavelength and 1 J/cm2 fluency. The COCs were evaluated after 30 min, 8, 16, and 24 h of IVM. Cumulus cells were evaluated for cell cycle status, mitochondrial activity, and viability (flow cytometry). Oocytes were assessed for meiotic progression status (nuclear staining), cell cycle genes content [real-time polymerase chain reaction (PCR)], and signal transduction status (western blot). The COCs were also in vitro fertilized, and the cleavage and blastocyst rates were assessed. Comparisons among groups were statistically performed with 5% significance level. For cumulus cells, a significant increase in mitochondrial membrane potential and the number of cells progressing through the cycle could be observed. Significant increases on cyclin B and cyclin-dependent kinase (CDK4) levels were also observed. Concerning the oocytes, a significantly higher amount of total mitogen-activated protein kinase was found after 8 h of irradiation, followed by a decrease in all cell cycle genes transcripts, exception made for the CDK4. However, no differences were observed in meiotic progression or embryo production. In conclusion, LLLI is an efficient tool to modulate the granulosa cells and oocyte metabolism

Breakpoint analysis of human chromosome 3 inversions during hominoid evolution

Comparative fluorescence in situ hybridization (FISH) mapping revealed four large DNA segments which have been conserved in their entirety between human chromosome 3 and Bornean orangutan chromosome 2 as well as three evolutionary breakpoints which distinguish between the human and Bornean orangutan chromosome forms. Examination of the structural and functional features of evolutionary breakpoints provides new insights into the possible effects of evolutionary rearrangements on genome function and the relationship between human chromosome pathology and evolution. FISH of human BAC clones which were assesssed in human genomic sequence to primate chromosomes, combined with precise breakpoint localizations by polymerase chain reaction (PCR) analysis of flow-sorted chromosomes and in silico analysis, were used to characterize the evolutionary breakpoints. None of the three breakpoints studied disrupts a validated gene(s), however they are all associated with segmental duplications. At least eleven DNA segments (&a

Caratterizzazione della flora microbica orale in diverse categorie di pazienti sindromici in età evolutiva.

La salute orale dei soggetti affetti da patologie sistemiche responsabili di disabilità fisiche e/o psichiche, in particolare in età evolutiva, è un obiettivo da perseguire di primaria importanza al fine di migliorare la qualità della vita del bambino e garantirgli un buon inserimento nel contesto sociale. Ricerche sperimentali e cliniche hanno individuato i momenti eziopatogenetici delle diverse problematiche che si riscontrano a carico del cavo orale, con una frequenza superiore nei pazienti disabili rispetto alla restante popolazione, attribuendo ai batteri formanti la placca e a quelli con la capacità di indurre un danno parodontale un ruolo chiave. Diversi sono stati i protocolli di prevenzione e terapia proposti nel tempo, costruiti proprio in relazione all’età del soggetto ed alla tipologia della disabilità; tuttavia risulta di fondamentale importanza chiarire il complesso rapporto tra la popolazione microbica orale e l'ospite nello stato di malattia. In un contesto del genere, intento del lavoro di ricerca è proprio quello di portare a termine un progetto di bonifica dentaria su un gruppo di pazienti in età compresa tra i 2 e i 17 anni, affetti da patologie sistemiche e patologie del cavo orale, sulla base di un profilo microbiologico, a partire da tamponi salivari e prelievi parodontali. Stilando il profilo microbiologico del “gruppo campione” e confrontandolo con quello di un gruppo di pazienti di controllo, lo studio si propone di riuscire a delineare i miglioramenti, qualora ci fossero, post terapia odontostomatologica e di riuscire a trovare una base microbiologica alle patologie extra -orali annesse.

Strukturbildung durch Selbstorganisation von Oligonukleotiden

Die DNA-Doppelhelix ist eine relativ dicke (Ø ≈ 2 nm), kompakte und dadurch auf kurzen Längenskalen relativ steife Verbindung (lp[dsDNA] ≈ 50-60 nm), mit einer klar definierten Struktur, die durch biologische Methoden sehr präzise manipuliert werden kann. Die Auswirkungen der primären Sequenz auf die dreidimensionale Strukturbildung ist gut verstanden und exakt vorhersagbar. Des Weiteren kann DNA an verschiedenen Stellen mit anderen Molekülen verknüpft werden, ohne dass ihre Selbsterkennung gestört wird. Durch die helikale Struktur besteht außerdem ein Zusammenhang zwischen der Lage und der räumlichen Orientierung von eingeführten Modifikationen. Durch moderne Syntheseverfahren lassen sich beliebige Oligonukleotidsequenzen im Bereich bis etwa 150-200 Basen relativ preiswert im Milligrammmaßstab herstellen. Diese Eigenschaften machen die DNA zu einem idealen Kandidaten zur Erzeugung komplexer Strukturen, die durch Selbsterkennung der entsprechenden Sequenzen gebildet werden. In der hier vorgelegten Arbeit wurden einzelsträngige DNA-Abschnitte (ssDNA) als adressierbare Verknüpfungsstellen eingesetzt, um verschiedene molekulare Bausteine zu diskreten nicht periodischen Strukturen zu verbinden. Als Bausteine dienten flexible synthetische Polymerblöcke und semiflexible Doppelstrang-DNA-Abschnitte (dsDNA), die an beiden Enden mit unterschiedlichen Oligonukleotidsequenzen „funktionalisiert“ sind. Die zur Verknüpfung genutzten Oligonukleotidabschnitte wurden so gewählt (n > 20 Basen), dass ihre Hybridisierung zu einer bei Raumtemperatur stabilen Doppelstrangbildung führt. Durch Kombination der Phosphoramiditsynthese von DNA mit einer festkörpergestützten Blockkopplungsreaktion konnte am Beispiel von Polyethylenoxiden ein sehr effektiver Syntheseweg zur Herstellung von ssDNA1-PEO-ssDNA2-Triblockcopolymeren entwickelt werden, der sich problemlos auf andere Polymere übertragen lassen sollte. Die Längen und Basenabfolgen der beiden Oligonukleotidsequenzen können dabei unabhängig voneinander frei gewählt werden. Somit wurden die Voraussetzungen geschaffen, um die Selbsterkennung von Oligonukleotiden durch Kombination verschiedener Triblockcopolymere zur Erzeugung von Multiblockcopolymeren zu nutzen, die mit klassischen Synthesetechniken nicht zugänglich sind. Semiflexible Strukturelemente lassen sich durch die Synthese von Doppelstrangfragmenten mit langen überstehenden Enden (sticky-ends) realisieren. Die klassischen Ansätze der molekularen Genetik zur Erzeugung von sticky-ends sind in diesem Fall nicht praktikabel, da sie zu Einschränkungen im Bezug auf Länge und Sequenz der überhängenden Enden führen. Als Methode der Wahl haben sich zwei verschiedene Varianten der Polymerase Kettenreaktion (PCR) erwiesen, die auf der Verwendung von teilkomplementären Primern beruhen. Die eigentlichen Primersequenzen wurden am 5´-Ende entweder über ein 2´-Desoxyuridin oder über einen kurzen Polyethylenoxid-Spacer (n = 6) mit einer frei wählbaren „sticky-end-Sequenz“ verknüpft. Mit diesen Methoden sind sowohl 3´- als auch 5´-Überhänge zugänglich und die Länge der Doppelstrangabschnitte kann über einen breiten Molmassenbereich sehr exakt eingestellt werden. Durch Kombination derartiger Doppelstrangfragmente mit den biosynthetischen Triblockcopolymeren lassen sich Strukturen erzeugen, die als Modellsysteme zur Untersuchung verschiedener Biomoleküle genutzt werden können, die in Form eines mehrfach gebrochenen Stäbchens vorliegen. Im letzten Abschnitt wurde gezeigt, dass durch geeignete Wahl der überstehenden Enden bzw. durch Hybridisierung der Doppelstrangfragmente mit passenden Oligonukleotiden verzweigte DNA-Strukturen mit Armlängen von einigen hundert Nanometern zugänglich sind. Im Vergleich zu den bisher veröffentlichten Methoden bietet diese Herangehensweise zwei entscheidende Vorteile: Zum einen konnte der Syntheseaufwand auf ein Minimum reduziert werden, zum anderen ist es auf diesem Weg möglich die Längen der einzelnen Arme, unabhängig voneinander, über einen breiten Molmassenbereich zu variieren.

DNA-Polymer-Hybride als molekulare Bausteine

Die DNA hat sich durch die herausstechende Eigenschaft zur Selbstorganisation in den Naturwissenschaften zu einem beliebten Werkzeug entwickelt. In dieser Arbeit wurde die Oligonukleotidselbsterkennung zum Aufbau komplexer Multiblockcopolymere genutzt. Dabei dienten komplementäre einzelsträngige Oligonukleotidsequenzen (ssDNA) als adressierbare Verbindungsstücke zwischen synthetischen Blöcken. Als Bausteine wurden asymmetrische Dreiblockcopolymere der Form DNA1-Polymer-DNA2 aus einer flexiblen Polymereinheit (PEO bzw. PPO) die an beiden Enden mit unterschiedlichen Oligonukleotidsequenzen „funktionalisiert“ ist, verwendet. Diese Bausteine konnten durch die Kombination von Festphasensynthese der Oligonukleotide und Blockkopplung dargestellt werden. Die Oligonukleotidsequenzen wurden so gewählt, dass deren Hybridisierung zu einer bei Raumtemperatur stabilen Verbindung führt. Durch die Verwendung dieser Bausteine erhält man ein modulares System, dass sich durch seine hohe Flexibilität auszeichnet. Aus den dargestellten Dreiblockcopolymeren konnten verschiedene alternierende Multiblockcopolymere aufgebaut werden, wobei die Anzahl der Blöcke (von 11 bis 15) und das PEO / PPO- Verhältnis variiert wurden. Derartige Strukturen sind auf der Grundlage chemischer Synthesen unerreichbar. Die Flexibilität dieses modularen Systems konnte gezeigt werden, indem einzelne Blockbausteine zur Strukturaufklärung einfach ausgetauscht oder weggelassen werden konnten. Durch geeignete Wahl der DNA-Sequenzen konnte zusätzlich das Polymerisationsverhalten dieser Bauelemente untersucht werden. Die Integration längerer kettensteifer DNA-Abschnitte in die Multiblockstrukturen erfolgte durch die Verwendung teilkomplementärer Oligonukleotide. Diese bieten den Vorteil, dass bis zu einer Größe von etwa 150 bp sowohl die Länge als auch die Sequenz der Doppelstrangabschnitte und sticky-ends frei variiert werden können. Die biosynthetischen Dreiblockcopolymere dienten hier als Linkermoleküle zwischen den einzelnen dsDNA-Blöcken. Nach diesem Konzept wurde ein Nonamer als Modellsystem eines mehrfach gebrochenen Stäbchens synthetisiert. Außerdem wurden mit Hilfe der Polymerase Kettenreaktion (PCR) semiflexible DNA Abschnitte erzeugt. Durch die Wahl des Synthesewegs konnte sowohl die Länge der semiflexiblen Einheit als auch die Länge und die Sequenz des sticky-ends variiert werden. Anhand dieser Modellverbindungen wurde dann das Hybridisierungsverhalten in Abhängigkeit der Linker- und Segmentlängen untersucht.

Untersuchungen zur autoimmunen Genese der thrombotisch thrombozytopenischen Purpura

Untersuchungen zur autoimmunen Genese der thrombotisch thrombozytopenischen Purpura. rnEinführung: Die idiopathische thrombotisch thrombozytopenische Purpura (TTP) ist eine lebensbedrohliche Mikroangiopathie und wird durch ein Autoantikörper-induziertes Defizit der ADAMTS13-Protease ausgelöst. Eine Assoziation zwischen Krankheitsprädisposition und Vorliegen bestimmter humaner Leukozytenantigene (HLA) wird vermutet. Untersuchungen zu diesem Zusammenhang stellen einen Teil dieser Arbeit dar. rnAutoimmunkrankheiten tendieren zum gemeinsamen Auftreten innerhalb eines Individuums. Im zweiten Teil dieser Arbeit wird untersucht, ob eine solche Kookkurrenz verschiedener Autoimmunkrankheiten auch bei Patienten mit idiopathischer TTP beobachtet werden kann.rnMethodik: Zur Untersuchung der ersten Fragestellung werden die HLA-Klasse I und II-Merkmale von 54 deutschen TTP-Patienten bestimmt. Alle Patienten weisen Autoantikörper gegen ADAMTS13 und eine Protease-Aktivität <5% vor. Die Blutproben werden mittels Sequence Specific Primer-Polymerase Chain Reaction (PCR) und Sequence Specific Oligonucleotid-PCR auf HLA-DRB1, -DRB3-5 und –DQB1 untersucht. Als Referenz dienen die Werte deutscher Knochenmark- und Blutspender, erhalten über www.allelefrequencies.net. Die statistische Auswertung erfolgt mittels zweiseitigem Binomialtest und die resultierenden p-Werte werden nach Benjamini-Hochberg korrigiert.rnZur Beantwortung der zweiten Fragestellung werden 76 deutsche TTP-Patienten anhand eines standardisierten Fragebogens nach Begleiterkrankungen befragt. Als Vergleichswerte dient die Prävalenz der jeweiligen Erkrankung in der Allgemeinbevölkerung. Die statistische Auswertung erfolgt mittels zweiseitigem Binomialtest. Da die p-Werte nicht korrigiert werden, sind die Ergebnisse nur deskriptiv zu verstehen.rnErgebnis: Der Vergleich der HLA-Frequenzen ergibt ein signifikant gehäuftes Vorkommen von HLA-DQB1*02:02 (p<0,001) und -DRB1*11 (p=0,003) innerhalb des Patientenkollektivs. 20% (DQB1*02:02) bzw. 48,1% (DRB1*11) der TTP-Patienten sind im Gegensatz zu nur 1,2% (DQB1*02:02) bzw. 23,5% (DRB1*11) innerhalb der Vergleichsgruppe für das jeweilige HLA-Merkmal positiv.rnDie Befragung der TTP-Patienten bezüglich weiterer Erkrankungen ergab im Vergleich mit der Allgemeinbevölkerung fünf auffällig häufig im Patientenkollektiv vorkommende Autoimmunkrankheiten: Hashimoto Thyreoiditis (23,5% in der Patientengruppe zu 0,7% in der Allgemeinbevölkerung; p<0,001), systemischer Lupus erythematodes (6,5% der Patienten im Gegensatz zu 0,025% in der Allgemeinbevölkerung, p<0,001), Immunthrombozytopenie (6,3% der Patienten zu 0,02% in der Allgemeinbevölkerung; p<0,001), Psoriasis (9,4% der Patienten zu 2,5% in der Allgemeinbevölkerung; p=0,005) und glutensensitive Enteropathie (3,1% der Patienten zu 0,2% in der Allgemeinbevölkerung; p=0,007). rnSchlussfolgerung: Das vermehrte Vorkommen bestimmter HLA-Merkmale im Patientenkollektiv spricht für eine prädisponierende Wirkung dieser Antigene im Krankheitsgeschehen. Eine mögliche HLA-vermittelte Assoziation zwischen TTP und den genannten Autoimmunkrankheiten wird vermutet, kann jedoch nicht in allen Fällen die beobachtete Kookkurrenz ausreichend erklären. Insgesamt bestätigt die vorliegende Arbeit die Assoziation verschiedener Autoimmunkrankheiten untereinander und spricht für eine genetische Prädisposition zur Ausbildung autoimmuner Störungen. rn