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the HLA-conferred type 1 diabetes risk.
Multiple genome-wide association studies have identified a strong genetic linkage between the
locus and type 1 diabetes (T1D), but how this leads to disease remains obscure. Here, we characterized the functional consequence of a novel
coding mutation in a patient with T1D to gain further insight into how this impacts immune tolerance.
We identified a 24-year-old individual with T1D and other autoimmune and inflammatory conditions. The proband and first-degree relatives were recruited for whole-exome sequencing. Functional studies of the protein variant were performed using a cell line and primary myeloid immune cells collected from family members.
Sequencing identified a de novo
variant (c.457G>A, p.Gly153Arg) in the proband. selleck kinase inhibitor Assays using monocyte-derived macrophages from the individual revealed enhanced activity of integrin pathways and a migratory phenotype in the absence of chemokine stimulation, consistent with SKAP2 p.Gly153Arg being constitutively active. The p.Gly153Arg variant, located in the well-conserved lipid-binding loop, induced similar phenotypes when expressed in a human macrophage cell line. SKAP2 p.Gly153Arg is a gain-of-function, pathogenic mutation that disrupts myeloid immune cell function, likely resulting in a break in immune tolerance and T1D.
SKAP2 plays a key role in myeloid cell activation and migration. This particular mutation in a patient with T1D and multiple autoimmune conditions implicates a role for activating
variants in autoimmune T1D.
SKAP2 plays a key role in myeloid cell activation and migration. This particular mutation in a patient with T1D and multiple autoimmune conditions implicates a role for activating SKAP2 variants in autoimmune T1D.
To determine the risk of diabetic ketoacidosis (DKA) and all-cause mortality among adolescents and young adults with type 1 diabetes with and without an eating disorder.
With use of population-level health care administrative data covering the entire population of Ontario, Canada, all people with type 1 diabetes aged 10-39 years as of January 2014 were identified. Individuals with a history of eating disorders were age- and sex-matched 101 with individuals without eating disorders. All individuals were followed for 6 years for hospitalization/emergency department visits for DKA and for all-cause mortality.
We studied 168 people with eating disorders and 1,680 age- and sex-matched people without eating disorders. Among adolescents and young adults with type 1 diabetes, 168 (0.8%) had a history of eating disorders. The crude incidence of DKA was 112.5 per 1,000 patient-years in people with eating disorders vs. 30.8 in people without eating disorders. After adjustment for baseline differences, the subdistribution hazard ratio for comparison of people with and without eating disorders was 3.30 (95% CI 2.58-4.23;
< 0.0001). All-cause mortality was 16.0 per 1,000 person-years for people with eating disorders vs. 2.5 for people without eating disorders. The adjusted hazard ratio was 5.80 (95% CI 3.04-11.08;
< 0.0001).
Adolescents and young adults with type 1 diabetes and eating disorders have more than triple the risk of DKA and nearly sixfold increased risk of death compared with their peers without eating disorders.
Adolescents and young adults with type 1 diabetes and eating disorders have more than triple the risk of DKA and nearly sixfold increased risk of death compared with their peers without eating disorders.Active commuting may hold a potential for preventing adverse health outcomes. However, evidence of the association of active commuting and the risk of health outcomes remains debatable. The current study systematically and quantitatively summarised research findings on the association between active commuting and the risk of the mentioned health outcomes. We comprehensively searched four databases (PubMed, EMBASE, Web of Science and Open Grey) from inception to 2 August 2020 for observational studies investigating the associations among adult population. Summary relative risks (RRs) and 95% CIs were estimated for the association. Heterogeneity was investigated using Cochran's Q test and the I 2 statistic. Restricted cubic splines were used to evaluate linear and nonlinear relations. The search yielded 7581 initial references. We included 28 articles in the meta-analysis. Compared with inactive commuting, active commuting reduced the risk of obesity (RR=0.88, 95% CI 0.83 to 0.94, I2=69.1%), hypertension (RR=0.95, 95% CI 0.87 to 1.04, I2=82.2%) and diabetes (RR=0.82, 95% CI 0.76 to 0.90, I2=44.5%). Restricted cubic splines showed linear associations between active commuting and obesity, hypertension and diabetes (P nonlinearity=0.640; P nonlinearity=0.886; P nonlinearity=0.099). As compared with the lowest active commuting group, the risk of obesity, hypertension and diabetes in the highest active commuting group were reduced by 13% (95% CI 0.82 to 0.93, I2=65.2%); 6% (95% CI 0.86 to 1.02, I2=75.2%) and 19% (95% CI 0.73 to 0.91, I2=49.8%) respectively. Active commuting seemed to be associated with lower risk of obesity, hypertension and diabetes. However, the results should be interpreted cautiously because this meta-analysis was based solely on observational studies.PROSPERO registration numberCRD42020202723.
We evaluated a classroom-based sensitisation intervention that was designed to reduce demand-side barriers affecting referrals to a school counselling programme. The sensitisation intervention was offered in the context of a host trial evaluating a low-intensity problem-solving treatment for common adolescent mental health problems.
We conducted a stepped-wedge, cluster randomised controlled trial with 70 classes in 6 secondary schools serving low-income communities in New Delhi, India.The classes were randomised to receive a classroom sensitisation session involving a brief video presentation and moderated group discussion, delivered by a lay counsellor over one class period (intervention condition, IC), in two steps of 4 weeks each. The control condition (CC) was whole-school sensitisation (teacher-meetings and whole-school activities such as poster displays). The primary outcome was the proportion of students referred into the host trial. Secondary outcomes were the proportion of students who met mental health caseness criteria and the proportion of self-referred adolescents.
My Website: https://www.selleckchem.com/products/tak-243-mln243.html
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