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A number of ionic liquids have been shown to be excellent solvents for lignocellulosic biomass processing, and some of these are particularly effective in the production of the versatile chemical building block 5-hydroxymethylfurfural (HMF). In this study, the production of HMF from the simple sugar glucose in ionic liquid media is discussed. Several aspects of the selective catalytic formation of HMF from glucose have been elucidated using metal halide salts in two distinct ionic liquids, 1-butyl-3-methylimidazolium chloride and 1-butyl-3-methylimidazolium hydrogen sulfate as well as mixtures of these, revealing key features for accelerating the desired reaction and suppressing byproduct formation. The choice of ionic liquid anion is revealed to be of particular importance, with low HMF yields in the case of hydrogen sulfate-based salts, which are reported to be effective for HMF production from fructose. The most successful system investigated in this study led to almost quantitative conversion of glucose to HMF (90% in only 30 minutes using 7 mol% catalyst loading at 120°C) in a system which is selective for the desired product, has low energy intensity and is environmentally benign. [ABSTRACT FROM AUTHOR]

Recently, acidic ionic liquid water mixtures based on the hydrogen sulfate anion have been shown to effectively extract lignin from lignocellulosic biomass. This study analyses Miscanthus giganteus lignin isolated after extraction with the protic ionic liquid 1-butylimidazolium hydrogen sulfate ([HC4im][HSO4]) followed by precipitation with the antisolvent water. Several analytical techniques were employed, such as quantitative 13C-NMR, 1H–13C HSQC NMR, 31P-NMR, Py-GC-MS, GPC and elemental analysis. The analysis shows that the ionic liquid pretreatment breaks lignin-hemicellulose linkages and depolymerizes the lignin through the cleavage of glycosidic, ester and β-O-4 ether bonds. This is accompanied by solubilization of the newly generated lignin fragments. At longer pretreatment times, repolymerization of lignin fragments through condensation reactions occurs. The isolated lignins were carbohydrate-free, had low sulfur contents, low molecular weights. Early stage lignins were structurally similar to ball-milled lignin, while more treated lignins were enriched in p-hydroxyphenyl and guaiacyl units and had a high phenolic hydroxyl group content. We conclude that, depending on the treatment conditions, lignins with a variety of characteristics can be isolated using this type of ionic liquid solution. [ABSTRACT FROM AUTHOR]

Congenital hyperinsulinism is the commonest cause of hypoglycemia in childhood. Focal form of congenital hyperinsulinism is present in half of affected patients requiring surgical management. We present the case of two sisters diagnosed with focal form of congenital hyperinsulinism and the impact of diagnostic process on clinical management and postoperative complications. In Older sister subtotal pancreatectomy was performed causing insulin-dependent diabetes and need for pancreatic enzymes substitution. In second case of younger sister the decision about the surgery was made after 18-F-DOPA PET scan and selective resection of identified focal lesion was applied. In effect there were no complications after surgery and complete recovery was observed. 18-F- -DOPA PET imaging allows to differentiate between diffuse and focal form of congenital hyperinsulinism and determines further management. Identification and adequate localization of focal changes allow surgical planning and in effect to perform selective focal surgery that significantly decreases postoperative complications. [ABSTRACT FROM AUTHOR]

The cost of ionic liquids (ILs) is one of the main impediments to IL utilization in the cellulosic biorefinery, especially in the pretreatment step. In this study, a number of ionic liquids were synthesized with the goal of optimizing solvent cost and stability whilst demonstrating promising processing potential. To achieve this, inexpensive feedstocks such as sulfuric acid and simple amines were combined into a range of protic ionic liquids containing the hydrogen sulfate [HSO4]− anion. The performance of these ionic liquids was compared to a benchmark system containing the IL 1-ethyl-3-methylimidazolium acetate [C2C1im][OAc]. The highest saccharification yields were observed for the triethylammonium hydrogen sulfate IL, which was 75% as effective as the benchmark system. Techno-economic modeling revealed that this promising and yet to be optimized yield was achieved at a fraction of the processing cost. This study demonstrates that some ILs can compete with the cheapest pretreatment chemicals, such as ammonia, in terms of effectiveness and process cost, removing IL cost as a barrier to the economic viability of IL-based biorefineries. [ABSTRACT FROM AUTHOR]

The application of the protic ionic liquid 1-butylimidazolium hydrogen sulfate in the deconstruction (aka pretreatment) and fractionation of lignocellulosic biomass has been investigated. A cellulose rich pulp and a lignin fraction were produced. The pulp was subjected to enzymatic saccharification which allowed recovery of up to 90% of the glucan as fermentable glucose. The influence of the solution acidity on the deconstruction of Miscanthus giganteus was examined by varying the 1-butylimidazole to sulfuric acid ratio. Increased acidity led to shorter pretreatment times and resulted in reduced hemicellulose content in the pulp. Addition of water to the ionic liquid resulted in enhanced saccharification yields. The ability to tune acidity through the use of protic ionic liquids offers a significant advantage in flexibility over dialkylimidazolium analogues. [ABSTRACT FROM AUTHOR]

Familial hypercholesterolemia (FH) is the most common monogenic disease. FH is caused by autosomal dominant mutations in the gene encoding the LDL receptor, apolipoprotein B (ApoB) or PCSK9. Aim of the study was to analyze the clinical data of children and adolescents with heterozygous familial hypercholesterolemia confirmed in molecular tests from the Department of Paediatrics, Diabetology and Endocrinology and preliminary assessment of the effects of treatment. Materials and methods. The study included children with elevated cholesterol levels. All patients were excluded secondary causes of hypercholesterolemia. In 127 patients molecular tests for mutation in the LDL receptor and Apo B gene were performed. Results. Currently under the care of the Department of Paediatrics, Diabetology and Endocrinology are 43 patients with genetically confirmed FH and more than 27 patients with suspicion of familial hypercholesterolemia during molecular studies. All patients with FH family history of the cardiovascular system diseases was positive. Patients with FH initially the average total cholesterol level was 281,6±61,6 mg/dl, LDL cholesterol 205,24±70,51 mg/dl. In genetic studies in 74% of patients mutations in the LDL receptor gene and in 26% of patients mutations in the Apo B gene was found. Treatment with statins in 27 patients and with ezetimibe in 2 patients with FH was started. The average level of total cholesterol in the control tests after 6-8 weeks of treatment was 203,7±38,1 mg/dl, LDL cholesterol 128,9±43,4 mg/dl. In the group of patients treated with pharmacological therapy, no adverse side effects of the treatment were reported. It was noticed that with children being treated pharmacological the value of IMT was lower comparing to the children solely on a diet. Conclusions. Lipid disorders should be diagnosed and treated from the earliest years of life, especially in children with a positive family history of the cardiovascular system diseases. Currently, the most effective treatment in children seems to be a therapy with statins. Longer follow up and monitoring of the effectiveness and safety of the treatment is needed. [ABSTRACT FROM AUTHOR]

This paper reviews the application of ionic liquids to the deconstruction and fractionation of lignocellulosic biomass, in a process step that is commonly called pretreatment. It is divided into four parts: the first gives background information on lignocellulosic biomass and ionic liquids; the second focuses on the solubility of lignocellulosic biomass (and the individual biopolymers within it) in ionic liquids; the third emphasises the deconstruction effects brought about by the use of ionic liquids as a solvent; the fourth part deals with practical considerations regarding the design of ionic liquid based deconstruction processes. [ABSTRACT FROM AUTHOR]

Ionic liquids are of great interest as potential solvents/catalysts for the production of fuels and chemicals from lignocellulosic biomass. Attention has focused particularly on the pretreatment of lignocellulose to make the cellulose more accessible to enzymatic hydrolysis. Any biomass processing requires a reduction in the size of the harvested biomass by chipping and/or grinding to make it more amenable to chemical and biological treatments. This paper demonstrates that significant energy savings can be achieved in the grinding of pine wood chips when the ionic liquid is added before the grinding operation. We show that this is due to the lubricating properties of the ionic liquids and not to physico-chemical modifications of the biomass. A brief impregnation of the chipped biomass results in higher savings than a longer treatment. [ABSTRACT FROM AUTHOR]

Ground lignocellulosic biomass (Miscanthus giganteus, pine (Pinus sylvestris) and willow (Salix viminalis)) was pretreated with ionic liquid–water mixtures of 1-butyl-3-methylimidazolium methyl sulfate and 1-butyl-3-methylimidazolium hydrogen sulfate. A solid fraction enriched in cellulose was recovered, which was subjected to enzymatic hydrolysis. Up to 90% of the glucose and 25% of the hemicellulose contained in the original biomass were released by the combined ionic liquid pretreatment and the enzymatic hydrolysis. After the pretreatment, the ionic liquid liquor contained the majority of the lignin and the hemicellulose. The lignin portion was partially precipitated from the liquor upon dilution with water. The amount of hemicellulose monomers in the ionic liquid liquor and their conversion into furfurals was also examined. The performance of ionic liquid–water mixtures containing 1,3-dialkylimidazolium ionic liquids with acetate, methanesulfonate, trifluoromethanesulfonate and chloride anions was investigated. The applicability of the ionic liquid 1-butylimidazolium hydrogensulfate for lignocellulose pretreatment was also examined. It was found that ionic liquid liquors containing methyl sulfate, hydrogen sulfate and methanesulfonate anions were most effective in terms of lignin/cellulose fractionation and enhancement of cellulose digestibility. [ABSTRACT FROM AUTHOR]

Ground lignocellulosic biomass (Miscanthus giganteus, pine (Pinus sylvestris) and willow (Salix viminalis)) was pretreated with ionic liquid–water mixtures of 1-butyl-3-methylimidazolium methyl sulfate and 1-butyl-3-methylimidazolium hydrogen sulfate. A solid fraction enriched in cellulose was recovered, which was subjected to enzymatic hydrolysis. Up to 90% of the glucose and 25% of the hemicellulose contained in the original biomass were released by the combined ionic liquid pretreatment and the enzymatic hydrolysis. After the pretreatment, the ionic liquid liquor contained the majority of the lignin and the hemicellulose. The lignin portion was partially precipitated from the liquor upon dilution with water. The amount of hemicellulose monomers in the ionic liquid liquor and their conversion into furfurals was also examined. The performance of ionic liquid–water mixtures containing 1,3-dialkylimidazolium ionic liquids with acetate, methanesulfonate, trifluoromethanesulfonate and chloride anions was investigated. The applicability of the ionic liquid 1-butylimidazolium hydrogensulfate for lignocellulose pretreatment was also examined. It was found that ionic liquid liquors containing methyl sulfate, hydrogen sulfate and methanesulfonate anions were most effective in terms of lignin/cellulose fractionation and enhancement of cellulose digestibility. [ABSTRACT FROM AUTHOR]

The present study provides insight into the dissolution behavior of renewable materials in ionic liquids. Beech, spruce and rye straw were dissolved in 1-ethyl-3-methylimidazolium acetate as the ionic liquid of choice, which is currently one of the most frequently used cation-anion combinations among ionic liquids for biomaterial processing. The dissolution was followed by selective precipitation of cellulose, hemicelluloses, and lignin. The obtained lignin was analyzed with Curie-point pyrolysis gas chromatography/mass spectrometry (Cu-Py-GC/MS) and the separated cellulose/hemicellulose fractions with gel permeation chromatography (GPC). Time dependence of the dissolution process was studied on rye straw, eucalyptus kraft pulp and beech sulfite pulp. The results show a changing dissolution profile over time, which is due to progressing degradation of the cellulose in the ionic liquid. [ABSTRACT FROM AUTHOR]

Abstract: Carbanions of 3-substituted-3-chloropropyl phenyl sulfones add to carbonyl groups of aldehydes to produce aldol type adducts that undergo 1,5-intramolecular substitution giving 2,3,5-trisubstituted tetrahydrofurans. The effect of substituents in the 3-position of these sulfones on the relative rates of 1,3-intramolecular substitution of the corresponding γ-chlorocarbanions and their intramolecular addition are disclosed. [Copyright &y& Elsevier]

Aims: The presented study was aimed to analyze the influence of IL-33 on regulatory T cells (Tregs) suppressive potential in patients with type 1 diabetes.Methods: We analyzed the ability of IL-33 treated Tregs to inhibit the production of IFN-γ by effector T lymphocytes in an in vitro co-culture. The study group consisted of 22 patients with type 1 diabetes and 12 age and sex-matched healthy individuals.Results: Our findings revealed that in vitro IL-33 treatment of Tregs derived from patients with type 1 diabetes resulted in quantitative as well as qualitative changes in this cell population, confirming immunoregulatory features of IL-33.Conclusion: IL-33 could be considered as a potential therapeutic tool in adoptive therapies of type 1 diabetes. [ABSTRACT FROM AUTHOR]

Background and Aims: The effect of estrogens is mediated by activation of estrogen receptors (ERs), which are expressed in many tissues. Because ER-α gene polymorphisms may exert different effects in childhood, in the present study we analyzed associations between the IVS1 -397T>C polymorphism and indicators of inflammatory response as well as late complications in boys with type 1 diabetes mellitus (DM1).Methods and Results: We examined 108 young boys with DM1 and 64 healthy age-matched control individuals. ER-α genotyping, as well as the CRP and IL-6 serum level and blood pressure, was analyzed. In our study boys with CC genotype had lower blood pressure and IL-6 and CRP serum levels. Similar results were obtained for DM1 boys with microvascular complications - the blood pressure and serum level of IL-6, but not CRP, were still lower in the CC patients.Conclusions: Our findings suggest that the presence of -397T allele may indicate macro- and microvascular complications in DM1 boys, before the occurrence of first clinical symptoms. [ABSTRACT FROM AUTHOR]

Background and aims: The effect of estrogens is mediated by activation of estrogen receptors (ERs), which are expressed in many tissues. Because ER-α gene polymorphisms may exert different effects in childhood, in the present study we analyzed associations between the IVS1 −397T>C polymorphism and indicators of inflammatory response as well as late complications in boys with type 1 diabetes mellitus (DM1). Methods and .Results: We examined 108 young boys with DM1 and 64 healthy age-matched control individuals. ER-α genotyping, as well as the CRP and IL-6 serum level and blood pressure, was analyzed. In our study boys with CC genotype had lower blood pressure and IL-6 and CRP serum levels. Similar results were obtained for DM1 boys with microvascular complications -- the blood pressure and serum level of IL-6, but not CRP, were still lower in the CC patients. Conclusions: Our findings suggest that the presence of −397T allele may indicate macro- and microvascular complications in DM1 boys, before the occurrence of first clinical symptoms. [ABSTRACT FROM AUTHOR]

Purpose. The study aimed to investigate the influence of estrogen receptor α (ER-α) genotypes on inflammatory response and development of microvascular complications in girls with type 1 diabetes. Methods. 152 young regularly menstruating girls with diagnosed type 1 diabetes and 84 young, healthy menstruating girls were recruited. ER-α genotypingwas carried out by PCR. Serum concentrations of 17β-estradiol, as well as IL-6, TNF-α, VEGF, and IL-10, weremeasured.CD4+Foxp3+ TH17 cells were isolated and analyzed by flow cytometry. Results. Type 1 diabetic girls carrying TT genotype were characterized by the lowest serum estradiol level and IL-10 and highest IL-6, TNF-α , and VEGF.The association between the level of certain cytokine and the genetic variant of estrogen receptor α polymorphism was analyzed. Frequencies of CD4+Foxp3+ TH17 cells were also enhanced in TT bearing girls with type 1 diabetes and correlated with the level of analyzed cytokines. In addition, the correlation between serum estradiol level and cytokine concentrations was observed. Conclusions. We propose that TT variant of estrogen receptor α polymorphism may be associated with enhanced inflammatory response, which in turn may lead to acceleration of diabetic retino- and nephropathy in girls with type 1 diabetes. This finding may help the physicians to predict the onset and progression of diabetic microvascular complications. [ABSTRACT FROM AUTHOR]

A Lactobacillus brevis strain with the ability to synthesize butanol from glucose was constructed by metabolic engineering. The genes crt, bcd, etfB, etfA, and hbd, composing the bcs-operon, and the thl gene encode the enzymes of the lower part of the clostridial butanol pathway (crotonase, butyryl-CoA-dehydrogenase, two subunits of the electron transfer flavoprotein, 3-hydroxybutyryl-CoA dehydrogenase, and thiolase) of Clostridium acetobutylicum. They were cloned into the Gram-positive/Gram-negative shuttle plasmid vector pHYc. The two resulting plasmids pHYc- thl-bcs and pHYc- bcs (respectively, with and without the clostridial thl gene) were transferred to Escherichia coli and L. brevis. The recombinant L. brevis strains were able to synthesize up to 300 mg l−1 or 4.1 mM of butanol on a glucose-containing medium. A L. brevis strain carrying the clostridial bcs-operon has the ability to synthesize butanol with participation of its own thiolase, aldehyde dehydrogenase, and alcohol dehydrogenase. The particular role of the enzymes involved in butanol production and the suitability of L. brevis as an n-butanol producer are discussed. [ABSTRACT FROM AUTHOR]

Background/Objective: Recent studies suggest that uric acid (UA) is a mediator of diabetic nephropathy. We hypothesized that serum UA would associate with the prevalence of diabetic nephropathy in youth with type 1 diabetes (T1D), and that this relationship would differ by sex. Methods: We examined 120 young boys and the same number of girls with T1D. C‐reactive protein (CRP), interleukin‐6 (IL‐6), interleukin‐10 (IL‐10), tumor necrosis factor α (TNF‐α), UA, cystatin C serum concentrations, albumin excretion rate and blood pressure were also analyzed. Results: T1D boys had higher serum UA and creatinine concentration, as well as albumin excretion rate and estimated glomerular filtration rate than T1D girls. Moreover, newly diagnosed nephropathy was more common in male subjects in comparison to female patients. Only in T1D boys serum UA was positively correlated with concentrations of subclinical inflammatory markers (CRP, IL‐6, TNF‐α), the indicators of renal function (albumin excretion rate, serum cystatin C level), blood pressure and negatively correlated with anti‐inflammatory IL‐10. In addition, only in T1D girls serum UA concentration was negatively correlated with hemoglobin A1c. Conclusions: Serum UA is associated with nephropathy prevalence, albeit only in boys with T1D and may be an important risk factor for predicting diabetes‐related cardiorenal complications in these patients. [ABSTRACT FROM AUTHOR]

Aim The aim of the study was to assess the relationship between CCR5 -Δ32 polymorphism and the coincidence of celiac and autoimmune thyroid diseases with type 1 diabetes mellitus (T1D) in children. Methods 420 children with T1D aged 15.5 ± 3.0 years and 350 healthy controls were studied. Characterization of CCR5 -Δ32 genotypes (rs333) was analyzed by polymerase chain reaction (PCR). Results The allele frequency was significantly different in diabetic children as compared to the healthy controls (p < 0.0001). We found negative association between T1D and Δ32 allele (OR = 0.383; 95% CI = 0.268–0.549). Besides, we observed alterations in the frequencies of CCR5 -Δ32 genotypes due to celiac and autoimmune thyroid diseases. The risk of celiac disease for patient carriers of the 32-bp deletion was more than threefold higher than for noncarriers (OR = 3.490; 95% CI = 1.357–8.859; p = 0.009). Similar results were obtained in the case of autoimmune thyroiditis. The risk of autoimmune thyroiditis for patient carriers of the 32-bp deletion was also more than threefold higher than for noncarriers (OR = 3.466; 95% CI = 1.754–6.849; p = 0.0004). Conclusions The findings of our studies suggest that the CCR5 -Δ32 polymorphism is associated with type 1 diabetes mellitus and the Δ32 allele increases the risk of celiac disease and autoimmune thyroid disorders in patients with T1D. [ABSTRACT FROM AUTHOR]

Aim The aim of the study was to assess the relationship between the CCR5-Δ32 polymorphism and the risk of diabetic retinopathy (DR) in patients with DM1. Methods We examined 420 patients and 350 healthy controls. The analysis concerned CCR5-Δ32 polymorphism as well as levels of serum inflammatory markers (CRP, TNF-α), adhesion molecules (VCAM, ICAM-1, ICAM-3) and CCR5 ligand (MCP-1). Results We found a negative association between DM1 and Δ32 allele. Moreover, the frequency of Δ32 allele was higher in a group with DR in comparison to control subjects without this complication. We also found that Δ32 carriers had the highest levels of: HbA1c, inflammatory markers, adhesion molecules and CCR5 ligand. Conclusions The findings of our studies suggest that the CCR5-Δ32 polymorphism is associated with DM1 such that the Δ32 allele protects against the development of DM1 and increases the risk of DR in patients who have already developed the disease. [ABSTRACT FROM AUTHOR]

Acidic anions of ionic liquids have been demonstrated as efficient catalysts for the cleavage of the β-O-4 ether linkage prevalent in the lignin superstructure. Through the use of lignin model compounds with varying functionality and by monitoring reaction kinetics, a full mechanistic investigation into the hydrolysis of the β-O-4 linkage in acidic ionic liquid solutions is reported. Hammett acidities are reported for different 1-butyl-3-methylimidazolium hydrogen sulfate [C4C1im][HSO4] ionic liquid systems with varying acid and water concentrations and were correlated to substrate reactivity. Results show that the rate of ether cleavage increases with an increase in acidity and the initial dehydration of the model compound is the rate-determining step of the reaction. The Eyring activation parameters of the reaction in hydrogen sulfate ionic liquids with a variety of cations are reported, indicating a consistent E1 dehydration mechanism. Hydrogen bonding in protic ionic liquids was shown to significantly influence anion–cation interactions, consequently altering the solvation of the protonated starting material and therefore the overall rate of reaction. Comparison of reaction rates in these ionic liquids with results within aqueous or aqueous/organic media indicate that the ionic liquids facilitate more rapid cleavage of the β-O-4 ether linkage even under less acidic conditions. All the reported results give a complete overview of both the mechanistic and solvation effects of acidic ionic liquids on lignin model compounds and provide scope for the appropriate selection and design of ionic liquids for lignin processing. [ABSTRACT FROM AUTHOR]

IL-33 is an IL-1 cytokine family member, with ability to induce both Th1 and Th2 immune responses. It binds to ST2 receptor, whose deficiency is associated with enhanced inflammatory response. The most recent studies have shown the immunoregulatory effect of IL-33 on Tregs in animal models. As type 1 diabetes is an autoimmune, inflammatory disease, where Treg defects have been described, we aimed to analyze the in vitro influence of recombinant IL-33 on quantitative properties of regulatory CD4+CD25highFOXP3+ T cells. CD4+CD25highFOXP3+ as well as CD4+CD25highFOXP3+ST2+ Tregs were analyzed by flow cytometry. In a group of patients with type 1 diabetes in vitro IL-33 treatment induced regulatory CD4+CD25highFOXP3+ cell frequencies as well as upregulating the surface expression of ST2 molecule. In addition, the number of CD4+CD25highFOXP3+ cells carrying ST2 receptor increased significantly. Similar effect was observed in case of the FOXP3 expression. We did not observe any significant changes in IL-33 treated cells of healthy controls. The level of ST2 was higher in serum of patients with type 1 diabetes in comparison to their healthy counterparts. We propose that IL-33 becomes an additional immunostimulatory factor used to induce Treg expansion in future clinical trials of adoptive therapy in type 1 diabetes. [ABSTRACT FROM AUTHOR]

The objective was to compare the impact of clinical and genetic factors on body mass index (BMI) in children with type 1 diabetes (T1DM) without severe obesity. A total of 1,119 children with T1DM (aged 4-18 years) were qualified to take part in the study. All children were genotyped for variants of FTO, MC4R, INSIG2, FASN, NPC1, PTER, SIRT1, MAF, IRT1, and CD36. Results. Variants of FTO showed significant association with BMI-SDS in the T1DM group. The main factors influencing BMI-SDS in children with T1DM included female gender (P = 0.0003), poor metabolic control (P = 0.0001), and carriage of the A allele of the FTO rs9939609 gene (P = 0.02). Conclusion. Our research indicates, when assessing, the risk of overweight and obesity carriage of the A allele in the rs9939609 site of the FTO gene adds to that of female gender and poor metabolic control. This trial is registered with ClinicalTrials.gov (NCT01279161). [ABSTRACT FROM AUTHOR]

Abstract: Type 1 diabetes is considered as pluricausal disease, whose etiology involves genetic predisposition as well as environmental factors that contribute to disease progression and pathogenesis. Women are believed to be more susceptible to develop autoimmune diseases, which may depend in part on the influence of sex hormones on the immune system. It was shown that estrogens may protect against the development of autoimmune disease by inducing the expansion of regulatory T cell pool and upregulating Foxp3 expression. Foxp3 is a transcription factor that controls the development and suppressive function of naturally occurring regulatory T cells CD4+Foxp3+. Longstanding diabetes type 1 has features of low-grade chronic inflammation which may influence regulatory T cell subset by reducing their numbers or/and inhibiting their suppressive potential. As diabetic type 1 patients are differentiated with regard to metabolic factors, level of glycemic control and systemic inflammatory state, we aimed to examine if this can be associated with IVSI-397T>C estrogen receptor α polymorphism. We examined 93 young regularly menstruating girls with diagnosed type 1 diabetes and 49 healthy age-matched control individuals. The PvuII polymorphism of the ER-α gene was analyzed as well as the serum TNF level and the level of CD4+Foxp3+ regulatory T cells in these individuals. Girls with type 1 diabetes had lower level of CD4+Foxp3+ Tregs than their healthy counterparts. Regulatory T cells from these patients showed also lower expression of Foxp3 than Tregs in healthy, control group. In addition, DM1 girls bearing the CC genotypes showed the highest level of CD4+Foxp3+ Tregs and the lowest TNF serum level in comparison to girls carrying CT or TT genotype. The CC DM1 carriers had also higher serum level of estrogens than girls bearing CT or TT genotype. We propose that different variants of IVS1-397 estrogen receptor α polymorphism may become additional genetic factor that influences regulatory conditions during diabetes type 1 in females. [Copyright &y& Elsevier]

Monogenic diabetes caused by mutations in the glucokinase gene (GCK-MODY) is usually characterized by a mild clinical phenotype. The clinical course of diabetes may be, however, highly variable. The authors present a child with diabetes manifesting with ketoacidosis during the neonatal period, born in a large family with ten members bearing a heterozygous p.Gly223Ser mutation in GCK. DNA sequencing and multiplex ligation-dependent probe amplification were used to confirm GCK mutation and exclude other de novo mutations in other known genes associated with monogenic diabetes. Continuous glucose monitoring (CGM) was used to assess daily glycemic profiles. At the onset of diabetes the child had hyperglycemia 765 mg/dl with pH 7.09. Her glycated hemoglobin level was 8.6% (70.5 mmol/mol). The C-peptide level was below normal range (<0.5 pmol/ml) at onset, and the three- and 6-month follow-up examinations. Current evaluation at age 3 still showed unsatisfactory metabolic control with HbA1c level equal to 8.1% (65.0 mmol/mol). CGM data showed glucose concentrations profile similar to poorly controlled type 1 diabetes. The patient was confirmed to be heterozygous for the p.Gly223Ser mutation and did not show any point mutations or deletions within other monogenic diabetes genes. Other family members with p.Gly223Ser mutation had retained C-peptide levels and mild diabetes manageable with diet (five individuals), oral hypoglycemizing agents (five patients), or insulin (one patient). This mutation was absent within all healthy family members. Heterozygous mutations of the GCK gene may result in neonatal diabetes similar to type 1 diabetes, the cause of such phenotype variety is still unknown. The possibility of other additional, unknown mutations seems to be the most likely explanation for the unusual presentation of GCK-MODY. [ABSTRACT FROM AUTHOR]

Background: Estimated monogenic diabetes (MD) prevalence increases as screening programs proceeds. Objective: To estimate prevalence of MD among Polish children. Subjects: Patients and their family members suspected of suffering from MD (defined as causative mutation in one of the Maturity Onset Diabetes of the Young or permanent neonatal diabetes mellitus genes) were recruited between January 2005 and December 2015. Methods: Nationwide prevalence was estimated based on data from 6 administrative provinces (out of 16 in Poland) with high referral rates of patients (>10 per 100 000 children). Results: During the analysis, probands from 322 of 788 screened families tested positive yielding a total of 409 children and 299 family members with MD. An average of 70 probands/year were referred. Screening success rate reached 40% over the study period. We estimated the prevalence of MD in 2015 to 7.52/100 000 children (1 in 13 000). The most frequent MODY in this group was GCK‐ MODY (6.88/100 000). The prevalence estimates increased nearly 2‐fold since our report in 2011 (4.4/100 000). However, the figure reached a plateau because of screening saturation in 2014 what was also proven by lowering of the median age of diagnosis lowered in time (R = −0.73, P = .0172) along with shortening of the delay between clinical and genetic diagnosis (R = −0.65, P = .0417). Conclusions: The screening for childhood MD in Poland reached a plateau phase after 10 years showing a stable prevalence estimate. The true frequency of MD in the overall population may be higher given later onset of reportedly more frequent types of MD than GCK ‐MODY. [ABSTRACT FROM AUTHOR]