2.9.2005

Socioeconomic status as a cause and consequence of psychosomatic symptoms from adolescence to adulthood

Huurre, T; Rahkonen, O; Komulainen, E; Aro, H

SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY, 40 (7): 580-587 JUL 2005

Background Few follow-up studies have investigated psychosomatic health and socioeconomic status (SES) and associations between them at different life stages. The aim of this study was to investigate differences in psychosomatic symptoms by SES in adolescence, early adulthood and adulthood and to examine whether lower SES leads to higher levels of symptoms (social causation) or higher levels of symptoms to lower SES (health selection) or both. Methods All 16-year-old ninth-grade school pupils of one Finnish city completed questionnaires at school. Subjects were followed up using postal questionnaires when aged 22 and 32 years. Results Females reported significantly higher scores of psychosomatic symptoms than males at 16, 22 and 32 years of age. Higher rates of psychosomatic symptoms were found among females of manual class origin at 16 years. In addition, at 22 years, both females and males with only comprehensive school education and, at 32 years, those who worked in manual jobs had higher scores of symptoms. When low SES both as a cause and consequence of symptoms was investigated, the findings supported both these paths among females and more the health selection among males. In both genders, especially the path from psychosomatic symptoms in adolescence to lower education in early adulthood was strong. Conclusions The results highlight the need of greater consideration of psychosomatic symptoms, particularly in adolescence, in later socioeconomic outcomes.

ISSN:0933-7954
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Evaluation of SLC2A10 (GLUT10) as a candidate gene for type 2 diabetes and related traits in Finns

Mohlke, KL; Skol, AD; Scott, LJ; Valle, TT; Bergman, RN; Tuomilehto, J; Boehnke, M; Collins, FS
Group Author: FUSION Study Grp

MOLECULAR GENETICS AND METABOLISM, 85 (4): 323-327 AUG 2005

The SLC2A10 gene encodes a glucose transporter and is located on chromosome 20q13, where evidence has been found for linkage to type 2 diabetes (T2D) in multiple studies. We investigated SLC2A10 as a T2D candidate gene in Finns. We did not confirm the previously reported association between Ala206Thr and fasting insulin and we observed no statistically significant evidence for T2D association with any single marker. We tested haplotypes for association with diabetes-related traits and observed no excess of significant results. Published by Elsevier Inc.

ISSN: 1096-7192

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Illness perceptions in coronary heart disease - Sociodemographic, illness-related, and psychosocial correlates

Aalto, AM; Heijmans, M; Weinman, J; Aro, MR

JOURNAL OF PSYCHOSOMATIC RESEARCH, 58 (5): 393-402 MAY 2005

Objectives: This study examined illness perceptions (IP) and their correlates in coronary heart disease (CHD).
Methods: The sample of the questionnaire study (n=3130 at baseline and n=2745 at 1-year follow-up, aged 45-74 years) was drawn from the drug reimbursement register, which covers persons with various drug-treated conditions. Independent variables were CHD severity and history, vicarious experiences, and psychosocial resources.
Results: Men attributed their CHD more often to risk behaviours and internal factors (own attitude/behaviour), while women perceived stress as the cause of their CHD more often. Women also perceived more symptoms associated with CHD but reported less severe consequences. CHD severity was the most important correlate of IP and also predicted change in IP at the follow-up. Stronger perceived competence was related to weaker illness identity, stronger control/cure, and less severe consequences.
Conclusions: Although disease-related factors are powerful correlates of CHD-related illness cognitions, also social and psychosocial factors are related to IP. (c) 2005 Elsevier Inc. All rights reserved.

ISSN: 0022-3999

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Association of criteria pollutants with plasma hemostatic/inflammatory markers: a population-based study

Liao, DP; Heiss, G; Chinchilli, VM; Duan, YK; Folsom, AR; Lin, HM; Salomaa, V

JOURNAL OF EXPOSURE ANALYSIS AND ENVIRONMENTAL EPIDEMIOLOGY, 15 (4): 319-328 JUL 2005

To elucidate the health effects of air pollution, the short-term association of criteria pollutants (particles < 10 mu m in diameter [PM10], O-3, CO, NO2, and SO2) with hemostatic and inflammatory markers were examined using a population-based sample of 10,208 middle-age males and females of the biracial cohort of Atherosclerosis Risk in Communities (ARIC) study. For each participant, we calculated the following pollutant exposures 1 - 3 days prior to the randomly allocated cohort examination date: PM10, CO, NO2, and SO2 as 24-h averages, and O-3 as an 8-h average of the hourly measures. The hemostatic/inflammatory factors included fibrinogen, factor VIII-C, von Willebrand factor (vWF), albumin, and white blood cell count (WBC). Linear regression models were used to adjust for cardiovascular disease (CVD) risk factors, demographic and socioeconomic variables, and relevant meteorological variables. One standard deviation (SD) increment of PM10 (12.8 mu g/m(3)) was significantly (P < 0.05) associated with 3.93% higher of vWF among diabetics and 0.006 g/dl lower of serum albumin among persons with a history of CVD. One SD increment of CO(0.60 p.p.m.) was significantly (P < 0.01) associated with 0.018 g/dl lower of serum albumin. Significant curvilinear associations, indicative of threshold effects, for PM10 with factor VIII-C, O-3 with fibrinogen and vWF, and SO2 with factor VIII-C, WBC, and serum albumin were found. This population-based study suggest that the hemostasis/inmflammation markers analyzed, which are linked to higher risk of CHD, are associated adversely with environmentally relevant ambient pollutants, with the strongest associations in the upper range of the pollutant distributions, and in persons with a positive history of diabetes and CHD.

ISSN: 1053-4245

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Strain variation among Bordetella pertussis isolates in Finland, where the whole-cell pertussis vaccine has been used for 50 years

Elomaa, A; Advani, A; Donnelly, D; Antila, M; Mertsola, J; Hallander, H; He, QS

JOURNAL OF CLINICAL MICROBIOLOGY, 43 (8): 3681-3687 AUG 2005
Open Access Article

Pertussis is an infectious disease of the respiratory tract caused by Bordetella pertussis. Despite the introduction of mass vaccination against pertussis in Finland in 1952, pertussis has remained an endemic disease with regular epidemics. To monitor changes in the Finnish B. pertussis population, 101 isolates selected from 1991 to 2003 and 21 isolates selected from 1953 to 1982 were studied together with two Finnish vaccine strains. The analyses included serotyping of fimbriae (Fim), genotyping of the pertussis toxin S1 subunit (ptxA) and pertactin (prn), and pulsed-field gel electrophoresis (PFGE) after digestion of B. pertussis genomic DNA with XbaI restriction enzyme. Strains isolated before 1977 were found to harbor the same ptxA as the strains used in the Finnish whole-cell pertussis vaccine, and strains isolated before 1982 harbored the same prn as the strains used in the Finnish whole-cell pertussis vaccine. All recent isolates, however, represented genotypes distinct from those of the two vaccine strains. A marked shift of predominant serotype from Fim serotype 2 (Fim2) to Fim3 has been observed since the late 1990s. Temporal changes were seen in the genome of B. pertussis by PFGE analysis. Three PFGE profiles (BpSR1, BpSR11, and BpSR147) were distinguished by their prevalence between 1991 and 2003. The yearly emergence of the three profiles was distributed periodically. Our study stresses the importance of the continuous monitoring of emerging strains of B. pertussis and the need to obtain a better understanding of the relationship of the evolution of B. pertussis in vaccinated populations.

ISSN:0095-1137

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Genetic diversity among type emm28 group A Streptococcus strains causing invasive infections and pharyngitis

Green, NM; Beres, SB; Graviss, EA; Allison, JE; McGeer, AJ; Vuopio-Varkila, J; LeFebvre, RB; Musser, JM

JOURNAL OF CLINICAL MICROBIOLOGY, 43 (8): 4083-4091 AUG 2005
Open Access Article

Genome sequencing of group A Streptococcus (GAS) has revealed that prophages account for the vast majority of gene content differences between strains. Serotype M28 strains are a leading cause of pharyngitis and invasive infections, but little is known about genetic diversity present in natural populations of these organisms. To study this issue, population-based samples of 568 strains from Ontario, Canada; Finland; and Houston, Texas, were analyzed. Special attention was given to analysis of variation in prophage-encoded virulence gene content by a PCR-based method. Thirty and 29 distinct prophage-encoded virulence gene profiles were identified among pharyngitis and invasive infection isolates. Thirteen profiles, representing the majority of the strains, were shared between these two classes of isolates. Significant differences were observed in the frequency of occurrence of certain prophage toxin gene profiles and infection type. M28 strains are highly diverse in prophage-encoded virulence gene content and integration site, supporting the key concept that prophages are critical contributors to GAS genetic diversity and population biology. Nucleotide sequence variation in the emm gene (encodes M protein) was also examined. Only three allelic variants were identified in the hypervariable portion of the emm28 gene. All but one strain had the same inferred amino acid sequence in the first 100 amino acids of the mature M28 protein. In contrast, size differences in the emm28 gene and inferred protein due to variable numbers of C-terminal repeats were common. The presence of macrolide resistance genes (mefA, ermB, and ermTR) was analyzed by PCR, and less than 2% of the strains were positive.

ISSN: 0095-1137

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Expression of human pim family genes is selectively up-regulated by cytokines promoting T helper type 1, but not T helper type 2, cell differentiation

Aho, TLT; Lund, RJ; Ylikoski, EK; Matikainen, S; Lahesmaa, R; Koskinen, PJ

IMMUNOLOGY, 116 (1): 82-88 SEP 2005

Cytokines are the most important inducers of T helper (Th) cell differentiation. Interleukin-12 (IL-12) and interferon-alpha (IFN-alpha) are responsible for human Th1-cell differentiation, while IL-4 is the critical cytokine promoting Th2-cell development. These two subsets of cells co-ordinate immunological responses to pathogens as well as autoimmune or allergic reactions. The pim family of proto-oncogenes encodes serine/threonine-specific kinases involved in cytokine-mediated signalling pathways in haematopoietic cells. Here we demonstrate that expression of pim-1 and pim-2 mRNAs is selectively up- or down-regulated in human cord-blood-derived CD4(+) cells freshly induced to polarize towards Th1 or Th2 cells, respectively, whereas their expression is inhibited in both cell types by the immunosuppressive transforming growth factor beta (TGF-beta). Moreover, the Th1-specific cytokines IL-12 and IFN-alpha, but not the Th2-specific cytokine IL-4, transiently up-regulate pim-1 and pim-2 mRNA expression in human peripheral blood T cells and natural killer cells. In addition, the Pim-1 protein levels are strongly up-regulated by Th1-specific cytokines in all of these cell types. Taken together, our results suggest that pim genes and their protein products are involved in the early differentiation process of T helper cells.

ISSN: 0019-2805

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A large outbreak of campylobacteriosis associated with a municipal water supply in Finland

Kuusi, M; Nuorti, JP; Hanninen, ML; Koskela, M; Jussila, V; Kela, E; Miettinen, I; Ruutu, P

EPIDEMIOLOGY AND INFECTION, 133 (4): 593-601 AUG 2005

In August 1998, an outbreak of campylobacteriosis occurred in one municipality in northern Finland. A 10% random sample of residents (population 15 000) was selected through the National Population Registry for a survey conducted by using postal questionnaires. Cases were defined as residents of the municipality with onset of acute gastroenteritis from I to 20 August 1998. Of 1167 respondents (response rate 78%), 218 (18.7%) met the case definition. Drinking non-chlorinated municipal tap water was strongly associated with illness (OR 34.4). The estimated total number of ill persons was 2700. Campylobacter jejuni was isolated from stool samples of 45 (61%) out of 74 patients tested. All five isolates tested had indistinguishable PFGE patterns. Water samples were negative for campylobacter and coliforms. Epidemiological and environmental evidence suggested mains repair as the source of contamination. Non-chlorinated ground-water systems may be susceptible to contamination and can cause large outbreaks.

ISSN: 0950-2688

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Work-related symptoms and Salmonella antibodies among wastewater treatment plant workers

Seuri, M; Koivunen, J; Granfors, K; Heinonen-Tanski, H

EPIDEMIOLOGY AND INFECTION, 133 (4): 603-609 AUG 2005

Wastewater treatment plant workers are exposed to microbes, including Salmonella, but the prevalence of antibodies against Salmonella species or serovars in their serum samples has not been studied. Antibodies against Salmonella Infantis and lipopolysaccharide antigen common to S. Enteritidis and S. Typhimurium in immunoglobulin classes IgA, IgM and IgG were measured from 79 serum samples of wastewater treatment plant workers and from 79 blood donor samples. Faecal samples for Salmonella and Campylobacter were studied. Gastrointestinal, dermal and other symptoms were compared between 81 wastewater treatment plant workers and 89 food-processing workers. The blood donors had more antibodies against all of the tested antigens expect for S. Infantis in IgM and IgA classes, even though the wastewater treatment plant workers had more gastrointestinal symptoms than the controls. No Salmonella or Campylobacter were found in any faecal samples. Salmonella is not a probable cause of symptoms among wastewater treatment plant workers.

ISSN: 0950-2688

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Urinary sodium and potassium excretion and the risk of type 2 diabetes: a prospective study in Finland

Hu, G; Jousilahti, P; Peltonen, M; Lindstrom, J; Tuomilehto, J

DIABETOLOGIA, 48 (8): 1477-1483 AUG 2005

Aims/hypothesis: No previous studies on the association between salt intake and the risk of type 2 diabetes have been reported. The aim of this study was to assess whether high salt intake, measured by 24-h urinary sodium excretion, is an independent risk factor for type 2 diabetes. Methods: We followed prospectively 932 Finnish men and 1,003 women aged 35-64 years with complete data on 24-h urinary sodium and potassium excretion and other study parameters. Hazard ratios for the incidence of type 2 diabetes were estimated for different levels of 24-h urinary sodium and potassium excretion. Results: During a mean follow-up of 18.1 years, there were 129 incident cases of type 2 diabetes. The multivariate-adjusted (age, sex, study year, body mass index, physical activity, systolic blood pressure, antihypertensive drug treatment, education, smoking and coffee, alcohol, fruit, vegetable, sausage, bread and saturated fat consumption) hazard ratio for diabetes for the highest vs combined lower quartiles of 24-h urinary sodium excretion was 2.05 (95% CI, 1.43-2.96). This positive association persisted in non-obese and obese subjects, in normotensive and hypertensive subjects, as well as in men and women. Potassium excretion was not associated with the risk of type 2 diabetes. Conclusion/Interpretation: High sodium intake predicted the risk of type 2 diabetes, independently of other risk factors including physical inactivity, obesity and hypertension. These results provide direct evidence of the harmful effects of high salt intake in the adult population, although the confounding effect of other dietary factors cannot be fully excluded.

ISSN: 0012-186X

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Global profiling of coxsackievirus- and cytokine-induced gene expression in human pancreatic islets

Ylipaasto, P; Kutlu, B; Rasilainen, S; Rasschaert, J; Salmela, K; Teerijoki, H; Korsgren, O; Lahesmaa, R; Hovi, T; Eizirik, DL; Otonkoski, T; Roivainen, M

DIABETOLOGIA, 48 (8): 1510-1522 AUG 2005

Aims/hypothesis: It is thought that enterovirus infections initiate or facilitate the pathogenetic processes leading to type 1 diabetes. Exposure of cultured human islets to cytolytic enterovirus strains kills beta cells after a protracted period, suggesting a role for secondary virus-induced factors such as cytokines. Method: To clarify the molecular mechanisms involved in virus-induced beta cell destruction, we analysed the global pattern of gene expression in human islets. After 48 h, RNA was extracted from three independent human islet preparations infected with coxsackievirus B5 or exposed to interleukin 1 beta (50 U/ml) plus interferon gamma (1,000 U/ml), and gene expression profiles were analysed using Affymetrix HG-U133A gene chips, which enable simultaneous analysis of 22,000 probe sets. Results: As many as 13,077 genes were detected in control human islets, and 945 and 1293 single genes were found to be modified by exposure to viral infection and the indicated cytokines, respectively. Four hundred and eighty-four genes were similarly modified by the cytokines and viral infection. Conclusion/interpretation: The large number of modified genes observed emphasises the complex responses of human islet cells to agents potentially involved in insulitis. Notably, both cytokines and viral infection significantly (p < 0.02) increased the expression of several chemokines, the cytokine IL-15 and the intercellular adhesion molecule ICAM-1, which might contribute to the homing and activation of mononuclear cells in the islets during infection and/or an early autoimmune response. The present results provide novel insights into the molecular mechanisms involved in viral- and cytokine-induced human beta cell dysfunction and death.

ISSN: 0012-186X

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Dietary manipulation of beta cell autoimmunity in infants at increased risk of type 1 diabetes: a pilot study (vol 48, pg 829, 2005)

Akerblom, HK; Virtanen, SM; Ilonen, J; Savilahti, E; Vaarala, O; Reunanen, A; Teramo, K; Hamalainen, AM; Paronen, J; Riikjarv, MA; Ormisson, A; Ludvigsson, J; Dosch, HM; Hakulinen, T; Knip, M
Group Author: Natl TRIGR Stugy Grp

DIABETOLOGIA, 48 (8): 1676-1676 AUG 2005

ISSN: 0012-186X

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Salivary antibodies induced by the seven-valent PncOMPC conjugate vaccine in the Finnish Otitis Media Vaccine Trial

Nurkka, A; Lahdenkari, M; Palmu, AAI; Kayhty, H
Group Author: FinOM Study Grp

BMC INFECTIOUS DISEASES, 5: Art. No. 41 MAY 27 2005
Open Access Article

Background: Mucosal antibodies have been suggested to have a role in defence against pneumococcal infections. We investigated here the ability of a seven-valent pneumococcal conjugate vaccine, PncOMPC, to induce mucosal immune response.
Methods: Healthy Finnish children (n = 111), a subcohort of the Finnish Otitis Media Vaccine Trial, were recruited and 56 of them were immunised with the PncOMPC at the age of 2, 4, and 6 months. At 12 months of age, 49 of them received the PncOMPC and 7 were vaccinated with the pneumococcal polysaccharide vaccine (PncPS) as a booster. The control group of 55 children received a hepatitis B vaccine at the same ages. Salivary anti-Pnc IgG, IgA, IgA1, and IgA2 antibodies to serotypes 6B, 14, 19F, and 23F were measured in both groups at the age of 7 and 13 months.
Results: Salivary anti-Pnc IgG and IgA were detected more often in the PncOMPC than in the control group. However, the difference between groups was significant only for 19F and 23F IgA concentrations at the age of 7 months. At the age of 13 months, antibody concentrations did not differ between PncOMPC and control groups. The rises in IgA concentrations between 7 and 13 months of age were mainly of subclass IgA1. Further, there is a clear trend that PncPS booster induces higher salivary anti-Pnc PS antibody concentrations than the PncOMPC.
Conclusion: We found that PncOMPC can induce a mucosal IgA response. However, the actual impact of mucosal antibodies in protection against pneumococcal infections is not clear.

ISSN: 1471-2334

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Comparison between cultured small-intestinal and fecal microbiotas in beagle dogs

Mentula, S; Harmoinen, J; Heikkila, M; Westermarck, E; Rautio, M; Huovinen, P; Kononen, E

APPLIED AND ENVIRONMENTAL MICROBIOLOGY, 71 (8): 4169-4175 AUG 2005
Open Access Article

The microbiota the small intestine is poorly known because of difficulties in sampling. In this study, we examined whether the organisms cultured from the jejunum and feces resemble each other. Small-intestinal fluid samples were collected from 22 beagle dogs with a permanent jejunal fistula in parallel with fecal samples. In addition, corresponding samples from seven of the dogs were collected during a 4-week period (days 4, 10, 14, and 28) to examine the stability of the microbiota. In the jejunal samples, aerobic/facultative and anaerobic bacteria were equally represented, whereas anaerobes dominated in the fecal samples. Despite lower numbers of bacteria in the jejunum (range, 10(2) to 10(6) CFU/g) than in feces (range, 10(8) to 10(11) CFU/g), some microbial groups were more prevalent in the small intestine: staphylococci, 64% versus 36%; nonfermentative gram-negative rods, 27% versus 9%; and yeasts, 27% versus 5%, respectively. In contrast, part of the fecal dominant microbiota (bile-resistant Bacteroides spp., Clostridium hiranonis-like organisms, and lactobacilli) was practically absent in the jejunum. Many species were seldom isolated simultaneously from both sample types, regardless of their overall prevalence. In conclusion, the small intestine contains a few bacterial species at a time with vastly fluctuating counts, opposite to the results obtained for the colon, where the major bacterial groups remain relatively constant over time. Qualitative and quantitative differences between the corresponding jejunal and fecal samples indicate the inability of fecal samples to represent the microbiotas present in the upper gut.

ISSN: 0099-2240
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