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M Trucco

Publications and source records attributed to M Trucco.

At least 73 records · Page 4Linked to original sources
PubMed1997

HLA and cross-reactive antigen group matching for cadaver kidney allocation.

BACKGROUND: Allocation of cadaver kidneys by graded human leukocyte antigen (HLA) compatibility scoring arguably has had little effect on overall survival while prejudicing the transplant candidacy of African-American and other hard to match populations. Consequently, matching has been proposed of deduced amino acid residues of the individual HLA molecules shared by cross-reactive antigen groups (CREGs). We have examined the circumstances under which compatibility with either method impacted graft survival. METHODS: Using Cox proportional hazards regression modeling, we studied the relationship between levels of conventional HLA mismatch and other donor and recipient factors on primary cadaver kidney survival between 1981 and 1995 at the University of Pittsburgh (n=1,780) and in the United Network for Organ Sharing (UNOS) Scientific Registry during 1991-1995 (n=31,291). The results were compared with those obtained by the matching of amino acid residues that identified CREG-compatible cases with as many as four (but not five and six) HLA mismatches. RESULTS: With more than one HLA mismatch (> 85% of patients in both series), most of the survival advantage of a zero mismatch was lost. None of the HLA loci were "weak." In the UNOS (but not Pittsburgh) category of one-HLA mismatch (n=1334), a subgroup of CREG-matched recipients (35.3%) had better graft survival than the remaining 64.7%, who were CREG-mismatched. There was no advantage of a CREG match in the two- to four-HLA incompatibility tiers. Better graft survival with tacrolimus was observed in both the Pittsburgh and UNOS series. CONCLUSIONS: Obligatory national sharing of cadaver kidneys is justifiable only for zero-HLA-mismatched kidneys. The potential value of CREG matching observed in the one-HLA-mismatched recipients of the UNOS (but not the Pittsburgh) experience deserves further study.

Adolescent↗
PubMed1997

Negative association of schizophrenia with HLA DQB1*0602: evidence from a second African-American cohort.

The authors attempted a replication of an earlier study of African-Americans, in which they detected a negative association of schizophrenia with HLA DQB1*0602. Patients with schizophrenia (n = 75, DSM-III-R criteria) and screened adult controls of African-American ethnicity (n = 66) were genotyped with respect to HLA DQB1*0602 using a combination of two polymerase chain reaction (PCR) based assays: amplification with sequence specific primers and a dot blot assay. A significant negative association with HLA DQB1 was not noted overall, but was present among women (female patients vs. female controls: odds ratio, OR = 0.42, 95% confidence intervals, CI = 0.32, 0.55). Reanalysis of the earlier study also revealed a gender related association. When the present and earlier samples from both genders were combined, the association persisted (OR 0.48; 95% CI: 0.12, 0.52). The present findings support and association between schizophrenia and the HLA DQB1 gene locus among African-Americans.

Adult↗
PubMed1997

The next stage: molecular epidemiology.

The traditional approach in epidemiology of relating exposure to an environmental agent such as a drug or infective agent has been to measure an overall risk (i.e., average and then "adjust risk for demographic variables and other confounders"). An attempt is sometimes made to define a "susceptible" subgroup. The analyses are usually based on good statistical methodology rather than an understanding of the interaction of body of host and agent. A twofold risk for 1000 exposed versus nonexposed people could be an average twofold risk for all 1000 exposed or a 20-fold risk for 100 exposed individuals (i.e., a drug-host interaction). Clearly, finding the 100 individuals with a 20-fold risk has much greater clinical importance than a twofold risk for 1000 people. The world of epidemiology may be changing-we may soon be able to define risk based on genetic susceptibility, at least sometimes.

Apolipoproteins E↗
PubMed1997

Sequence-specific Priming and Exonuclease-released Fluorescence Assay for Rapid and Reliable HLA-A Molecular Typing.

Background: The rapid and sensitive method described for low-resolution DNA typing of alleles at the HLA-A locus is based on a sequence-specific primer polymerase chain reaction approach that eliminates post-polymerase chain reaction gel electrophoresis to analyze the results. Methods and Results: This method takes advantage of the 5' --> 3' exonuclease activity of the Taq polymerase normally present during polymerase chain reaction. This sequence-specific priming and exonuclease-released fluorescence assay was conducted on 40 DNA samples derived from homozygous cell lines and peripheral blood lymphocytes that represented the majority of the HLA-A alleles. There was 100% condordance with the results obtained by serologic typing of these same samples. Conclusions: The advantages of this system are that assays can be performed in 2 hours, the results are easy to interpret, and no gel electrophoresis is required. The same strategy can be used for high-resolution DNA typing once appropriate primer pairs are added to the panel used for first-level discrimination.

Journal Article↗
PubMed1997

Chimerism after organ transplantation.

Recent evidence suggests that passenger leukocytes migrate after organ transplantation and produce persistent chimerism, which is essential for sustained survival of the allograft. Here, we describe how this hematolymphopoietic chimerism provides an important framework for interpretation of post-transplant phenomena and for initiation of therapeutically oriented transplantation research.

Animals↗
PubMed1997

Evidence for a heterozygote advantage in congenital adrenal hyperplasia due to 21-hydroxylase deficiency.

21-Hydroxylase deficiency is one of the most common inherited disorders, with carrier frequencies of approximately 10% in all world populations studied to date. The high prevalence of the mutant gene is probably due to a flanking pseudogene serving as a reservoir for mutations. Despite the potential for a high rate of de novo mutations, a founder effect for specific gene conversions is observed in most populations. We hypothesized that there was a survival advantage to 21-hydroxylase heterozygotes, and here we report endocrinological and molecular investigations to test this hypothesis. We defined 28 carriers and 22 mutation-negative controls by molecular genotyping and determined ACTH-stimulated adrenal hormone responses. We found significantly elevated cortisol responses in the carriers compared to controls (30 min cortisol levels: normal, 24.2 +/- 4.6 micrograms/dL; carrier, 28.1 +/- 4.2 micrograms/dL; P < 0.005). Cortisol has a crucial role in maintaining homeostasis, influencing differentiation, suppressing inflammation, and effecting cross-talk among the immune, nervous, and endocrine systems. The brisk cortisol response we have documented in carriers of 21-hydroxylase may enable a rapid return to homeostasis in response to infectious, inflammatory, or other environmental stresses and may protect from inappropriate immune responses, such as autoimmune diseases.

17-alpha-Hydroxyprogesterone↗
PubMed1997

Double-labeled fluorescent probes for 5' nuclease assays: purification and performance evaluation.

An inexpensive method for the purification and evaluation of user-synthesized or crude commercially prepared double-labeled fluorescent probes is presented. These probes exhibit the characteristics required for use in 5'-nuclease assays, including efficient reporter dye quenching, target specificity and susceptibility to cleavage by Taq DNA polymerase during PCR amplification. The method is suitable for research laboratories that wish to develop 5' nuclease assays for the detection of PCR-amplified target sequences to eliminate the requirement for agarose gels and to advance throughput.

5'-Nucleotidase↗
PubMed1997

Molecular epidemiology of autoimmune thyroid disease.

This paper presents preliminary data regarding the prevalence and risk factors for autoimmune thyroid disease in IDDM probands ascertained from the Children's Hospital of Pittsburgh IDDM Registry for 1950-1965 (n = 669). Living IDDM probands who participated in the 1990 follow-up survey (n = 380) were recruited for the Familial Autoimmune and Diabetes Study. Siblings and parents were also invited to participate. To date, 255 IDDM probands and 597 parents and siblings have been evaluated. The diagnosis of autoimmune thyroid disease was based on a clinical evaluation, medical history, and laboratory determinations. Graves disease was rare in this cohort (n = 5). However, Hashimoto's thyroiditis was common among women. Prevalence rates ranged from 54% for IDDM women age < 40 years to 75% for those > 50 years. Corresponding age-specific estimates for female relatives were 22% and 44%, respectively. Approximately one-half of the Hashimoto's individuals were euthyroid; they were more likely to have other autoantibodies and a positive family history than those who were hypothyroid or had no thyroid disease. Genetic analyses revealed a 2-fold increase in DQA1*0501-DQB1*0201 among the Hashimoto's compared to the non-Hashimoto's haplotypes. These findings suggested that Hashimoto's thyroiditis was common in IDDM families, which may be due, in part, to common disease susceptibility genes.

Adolescent↗
PubMed1996

Who is a carrier? Detection of unsuspected mutations in 21-hydroxylase deficiency.

Congenital adrenal hyperplasia due to 21-hydroxylase deficiency is a common autosomal-recessive disorder. During our routine genotyping of affected individuals and their relatives using allele-specific oligonucleotide hybridization and single-strand conformational polymorphism analysis, we identified two families each segregating three mutations. In both families, a mutation known to be associated with 21-hydroxylase deficiency was identified in healthy individuals but was not detected in the propositus. The propositus in family 1 was shown to be a homozygous carrier for G at nucleotide 655, which alters the splice acceptor site at exon 3. The propositus in family 2 carried the same splicing mutation on the maternal allele and a gene deletion/conversion on the paternal allele. In both families, other clinically unaffected relatives carried the Q318X mutation in exon 8. If molecular diagnostic studies had been limited to the mutation carried by the propositi, relatives would have been misinformed regarding their status as carriers or mildly affected individuals. The findings in these two families emphasize the high frequency of alleles causing 21-hydroxylase deficiency in the population.

Adrenal Hyperplasia, Congenital↗
PubMed1996

The two-way paradigm of transplantation immunology.

The events following organ transplantation require a reciprocal cell interaction which includes both the conventional host-versus-graft reaction and a graft-versus-host component. With all successful transplantation, both graft and recipient become genetic composites. Where donors were available, chimerism has been confirmed in 30-year kidney-recipient survivors, as well as in several liver and lung recipients. A majority of liver recipients have been able to acquire an immunosuppressant-free state after 10-year survival. Animal models suggest that donor-derived cells may exert a tolerogenic effect.

Animals↗
PubMed1996

Low prevalence of immunogenetic markers of IDDM in adult Koreans with diabetes detected on OGTT.

In the Asian populations, it is not uncommon for adult patients with NIDDM to eventually lose beta-cell function and develop IDDM. Accepting that IDDM is an autoimmune disease, which occurs on a genetic background, it could by hypothesized that by measuring autoantibody prevalence and HLA DQ gene polymorphism, known important prediagnostic markers of IDDM, the prevalence of adult-onset IDDM in patients with previously undiagnosed NIDDM patients could be estimated. To do this, anti-GAD prevalence and HLA DQ A1 and DQ B1 polymorphisms after PCR amplification of genomic DNA were analyzed in 121 newly diagnosed diabetic patients of Yonchon cohort and compared to the results with those of 100 matched health control subjects. We also compared the results with those of other populations to assess the difference of genotype distribution. The overall prevalence of anti-GAD antibodies was 1.7% (2 of 121) in patients with previously undiagnosed NIDDM, whereas 1 of 100 controls had positive antibodies. Among those who were positive, their titer of antibodies to GAD were not high. No statistically significant differences in the distribution of either mean levels of anti-GAD or DQA1 and DQB1 alleles were found comparing NIDDM patients to controls. Interestingly, the frequency of DQB1*non-Asp-57 and DQA1*Arg-52 alleles in the Korean adult control population was similar to that of US Caucasians (DQB1*non-Asp-57: 0.431 vs. 0.475; DQA1*Arg-52: 0.492 vs. 0.463). The low prevalence of anti-GAD antibodies and HLA-DQA1 and DQB1 susceptibility alleles among recent-onset NIDDM patients, not different compared to controls suggests that diabetes in Korean adults is unlikely to have an autoimmune component to its pathogenesis.

Adult↗
PubMed1996

Molecular IDDM epidemiology: international studies. WHO DiaMond Molecular Epidemiology Sub-Project Group.

The WHO DiaMond Molecular Epidemiology Sub-Project is testing the hypothesis that the geographic differences in IDDM incidence reflect population variation in the frequency of IDDM susceptibility genes (i.e., DQA1 and DQB1 alleles with sequences coding for arginine (R) in position 52 of the DQ alpha-chain, and an amino acid other than aspartic acid (ND) in position 57 of the DQ beta-chain, respectively) using a standardized case-control design. Data from twelve populations which have completed (or have nearly completed) recruitment and HLA molecular analyses are presented. There was an approximate 2-fold increase in the frequencies of DGA1*0301, DQB1*0201 and DQB11*0302 among IDDM cases compared to non-diabetic controls in most populations. Interestingly, DQA*0301 was more common in low versus moderate-high incidence countries. DQB1*0201 and DQB1*0302 were more prevalent in the moderate-high incidence areas. DQA1*R and DQB1*ND were both consistent markers of IDDM risk, with stronger associations in moderate-high versus low incidence areas. In general, individuals homozygous for both DQA1*R and DQB1*ND had the highest genotype-specific IDDM incidence rates, which approximated risk estimates for first degree relatives in several countries. These data revealed considerable variation in the frequencies of DQB1 and DQA1 alleles across countries, which likely contribute to the global patterns of IDDM incidence.

Alleles↗
PubMed1996

Emotional and psychosocial factors in burn patients during hospitalization.

This is a preliminary study of psychological symptoms, prior psychosocial adjustment and severity of injury in 25 consecutive burn patients. All had suffered burns in work-related accidents and were evaluated by the psychiatric consulation-liaison team during their initial hospitalization in the Burn Unit of the Hospital del Trabajador, Santiago. All patients were clinically evaluated and the following instruments were applied: Hamilton Scales of Anxiety (HAM-A) and Depression (HAM-D), Goldberg's General Health Questionnaire (GHQ-28), Cloninger's Tridimensional Personality Questionnaire (TPQ) and a modified version of a Schooler's Adjustment Scale. No significant correlation was found between extent and severity of burns and anxious or depressive symptoms. However, all patients had burns that varied from mild to moderate; there were no severe and extensive injuries. A significant correlation was found between anxiety and the harm avoidance dimension in the TPQ, as would be expected. Patients with poor psychosocial adjustment presented with greater anxiety symptoms. A significant negative correlation was also found between degree of anxiety symptoms and income level. The main findings are in agreement with current literature. They emphasize the relevance of prior psychosocial adjustment and personality as probable factors of psychological symptoms. The need to control pain as a variable is also pointed out.

Accidents, Occupational↗
PubMed1996

Exonuclease-released Fluorescence Detection of Human Parvovirus B19 DNA.

Background: The 5;-->3;-exonuclease activity of Thermus aquaticus (Taq) DNA polymerase permits polymerase chain reaction (PCR) product detection immediately after amplification using a fluorogenic probe. This approach eliminates the requirement for gel electrophoresis or enzyme immunoassays (EIA). The ligonucleotide probe is labeled with a reporter dye at its 5' terminus and a quencher dye at its 3' terminus and is present during DNA amplification. The exonuclease cleaves the reporter molecule from the probe-template hybrid, releasing it from the influence of the quencher molecule. The result is an increase in reporter fluorescence that can be read directly in a fluorescence spectormeter. In contrast to time-consuming gel electrophoresis and Southern blot hybridization or an EIA, this method can produce results from an entire 96-well microtiter plate in 15 minutes. Methods and Results: A B19-specific fluorogenic probe was synthesized containing a 5'-FAM label and a 3'-TAMRA label. Thirty clinical samples were analyzed for Human parvovirus B19 DNA by PCR amplification using both the fluorogenic and EIA method. Conclusions: Results generated with the fluorogenic probe correlated perfectly with those of the EIA, and the method would be particularly useful for high-volume work loads where gel or EIA-based approaches would be cumbersome.

Journal Article↗
PubMed1996

Sequence-specific priming and exonuclease-released fluorescence detection of HLA-DQB1 alleles.

Molecular typing of HLA DQB1 alleles, employing sequence-specific primers (SSP) for PCR amplification, was used to test a novel method that eliminates the requirement for subsequent gel electrophoresis or additional hybridization steps by directly detecting positive reactions. We have evaluated the performance of this fluorescence-based oligonucleotide probe assay to assign the most common DQB1 alleles on DNA from 14 homozygous cell lines and in a blind study of 50 diabetic patient samples that had been previously typed at the DQB1 locus using SSOP and conventional SSP-based approaches. We used a panel of 14 DQB1 SSP primer pairs, internal control primers, and a combination of 4 fluorescent oligonucleotide probes to detect 14 alleles or groups of alleles and controls. We can reliably detect single-base allelic differences, observe 100% concordance with the results obtained using both of the standard methods, and are able to further subtype several alleles that are not easily distinguished using SSOP (e.g. DQB1 *0401/0402 and DQB1 *0302/ 0303). Sequence-specific priming and exonuclease-released fluorescence (SSPERF) detection is technically simple and can be performed in less than 2 hours, including DNA extraction, PCR amplification, data analysis and allele identification. This method is particularly useful for the analysis of large numbers of samples, for which high throughput is critical and for which gel-based approaches are difficult to perform. This technique may also be useful for small-scale class I and class II molecular typing in clinically oriented laboratories.

Alleles↗