[0007] HLA-DQ2 (DQ2) is a serotype group within HLA-DQ (DQ) serotyping system. The serotype is determined by the antibody recognition of )32 subset of DQ fl-chains. DQ2
represents the second highest risk factor for coeliac disease, the highest risk is a close family member with disease. Due to its link to coeliac disease, DQ2 has the highest association of any HLA serotype with ออโตอิมมูน disease, close to 95% of all celiacs have DQ2, of that 30%
have 2 copies of DQ2. Of the DQ2 homozygotes who eat wheat, lifelong risk is between 20 and 40% for coeliac disease. Juvenile diabetes (T1D) has a high association with DQ2.5 and there appears to be link between GSE and early onset male T1D. Anti-tTG antibodies are found
elevated in a one-third of T1D patients, and there are indicators that Triticeae may be involved but the gluten protein is a type of globulin (G1b1). Recent studies indicate a combination of
DQ2.5 and DQ8 (both acid peptide presenters) greatly increase the risk of adult onset Type 1 Diabetes and ambiguous type I/II Diabetes. HLA-DR3 plays a prominent role in ออโตอิมมูน diabetes. However, DQ2 presence with DR3 decreases the age of onset and the severity of the ออโตอิมมูน disorder.
[0008] HLA-DQ8 (DQ8) is a human leukocyte antigen serotype within the HLA-DQ (DQ) serotype group. DQ8 is a split antigen of the DQ3 broad antigen. DQ8 is determined by the antibody recognition of /38 and this generally detects the gene product of DQB1*0302. DQ8 is commonly linked to ออโตอิมมูน disease in the human population. DQ8 is the second most predominant isoform linked to coeliac disease and the DQ most linked to juvenile diabetes. DQ8 increases the risk for rheumatoid arthritis and is linked to the primary risk locus for RA,
HLA-DR4. DR4 also plays an important role in juvenile diabetes. While the DQ8.1 haplotype is associated with disease, there is no known association with the DQB1*0305, DQ8.4 or DQ8.5 haplotypes with ออโตอิมมูน disease; however, this may be the result of lack of study in
populations that carry these and the very low frequency. In Europe, DQ8 is associated with
juvenile diabetes and coeliac disease. The highest risk factor for type 1 diabetes is the HLA DQ8/DQ2.5 phenotype. In parts of eastern Scandinavia both DQ2.5 and DQ8 are high
increases frequencies of late onset Type I and ambiguous Type I/II diabetes. DQ8 is also found in many indigenous peoples of Asia, it was detected early on in the Bedoin population of Arabia where DQ2.5 is frequently absent, and in these instances DQ8 is solely associated HLA in
Coeliac Disease.
[0008] Crohn's disease, also known as Crohn syndrome and regional enteritis, is a type of inflammatory bowel disease that may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms. It primarily causes abdominal pain, diarrhea (which may be bloody if inflammation is at its worst), vomiting (can be continuous), or weight loss, but may also cause complications outside the gastrointestinal tract such as skin rashes, arthritis, inflammation of the eye, tiredness, and lack of concentration. Crohn's disease is caused by
interactions between environmental, immunological and bacterial factors in genetically
susceptible individuals. This results in a chronic inflammatory disorder, in which the body's
immune system attacks the gastrointestinal tract possibly directed at microbial antigens. There is a genetic association with Crohn's disease, primarily with variations of the NOD2 gene and its protein, which senses bacterial cell walls. Siblings of affected individuals are at higher risk.
Males and females are equally affected. Smokers are two times more likely to develop Crohn's disease than nonsmokers. Crohn's disease affects between 400,000 and 600,000 people in
North America. Prevalence estimates for Northern Europe have ranged from 27-48 per
100,000.Crohn's disease tends to present initially in the teens and twenties, with another peak incidence in the fifties to seventies, although the disease can occur at any age. There is no
known pharmaceutical or surgical cure for Crohn's disease. Treatment options are restricted to controlling symptoms, maintaining remission, and preventing relapse.
[0009] Ulcerative colitis (Colitis ulcerosa, UC) is a form of inflammatory bowel disease (IBD). Ulcerative colitis is a form of colitis, a disease of the colon (large intestine), that includes
characteristic ulcers, or open sores. The main symptom of active disease is usually constant diarrhea mixed with blood, of gradual onset. IBD is often confused with irritable bowel
syndrome (IBS), a troublesome, but much less serious, condition. Ulcerative colitis has
similarities to Crohn's disease, another form of IBD. Ulcerative colitis is an intermittent disease, with periods of exacerbated symptoms, and periods that are relatively symptom-free. Although the symptoms of ulcerative colitis can sometimes diminish on their own, the disease usually requires treatment to go into remission. Ulcerative colitis has an incidence of 1 to 20 cases per 100,000 individuals per year, and a prevalence of 8 to 246 per 100,000 individuals per year. The disease is more prevalent in northern countries of the world, as well as in northern areas of individual countries or other regions. Rates tend to be higher in more affluent countries, which may indicate the increased prevalence is due to increased rates of diagnosis. Although
ulcerative colitis has no known cause, there is a presumed genetic component to susceptibility. The disease may be triggered in a susceptible person by environmental factors. Although
dietary modification may reduce the discomfort of a person with the disease, ulcerative colitis is not thought to be caused by dietary factors. Ulcerative colitis is treated as an ออโตอิมมูน
disease. Treatment is with anti-inflammatory drugs, immunosuppression, and biological therapy targeting specific components of the immune response. Colectomy (partial or total removal of the large bowel through surgery) is occasionally necessary if the disease is severe, doesn't
respond to treatment, or if significant complications develop. A total proctocolectomy (removal of the entirety of the large bowel) can be curative, but it may be associated with complications. [0010] Metabolic syndrome is a combination of medical disorders that, when occurring
together, increase the risk of developing cardiovascular disease and diabetes. Some studies have shown the prevalence in the USA to be an estimated 25% of the population, and
prevalence increases with age. Metabolic syndrome is also known as metabolic syndrome X, cardiometabolic syndrome, syndrome X, insulin resistance syndrome, Reaven's syndrome
(named for Gerald Reaven), and CHAOS (in Australia). The exact mechanisms of the complex pathways of metabolic syndrome are not yet completely known. The pathophysiology is
extremely complex and has been only partially elucidated. Most patients are older, obese,
sedentary, and have a degree of insulin resistance. Stress can also be a contributing factor. The most important factors are weight, genetics, endocrine disorders (such as polycystic ovary syndrome in women of reproductive age), aging, and sedentary lifestyle, (i.e., low physical
activity and excess caloric intake). There is debate regarding whether obesity or insulin
resistance is the cause of the metabolic syndrome or if they are consequences of a more far-
reaching metabolic derangement. A number of markers of systemic inflammation, ที่รวมถึง C-
reactive protein, are often increased, as are fibrinogen, อินเตอร์ลิวคิน 6, tumor necrosis factor-
alpha (TNFa), and others. Some have pointed to a variety of causes, ที่รวมถึง increased uric acid levels caused by dietary fructose. Central obesity is a key feature of the syndrome,
reflecting the fact that the syndrome's prevalence is driven by the strong relationship between waist circumference and increasing adiposity. However, despite the importance of obesity,
patients who are of normal weight may also be insulin-resistant and have the syndrome. An estimated 75% of British patients with type 2 diabetes or impaired glucose tolerance (IGT) have metabolic syndrome. The presence of metabolic syndrome in these populations is associated
with a higher prevalence of CVD than found in patients with type 2 diabetes or IGT without the syndrome.
[0011] Hypoadiponectinemia has been shown to increase insulin resistance, and is
considered to be a risk factor for developing metabolic syndrome. The approximate prevalence of the metabolic syndrome in patients with coronary heart disease (CHD) is 50%, with a
prevalence of 37% in patients with premature coronary artery disease (age 45), particularly in women. With appropriate cardiac rehabilitation and changes in lifestyle (e.g., nutrition, physical activity, weight reduction, and, in some cases, drugs), the prevalence of the syndrome can be reduced. Lipodystrophic disorders in general are associated with metabolic syndrome. Both genetic (e.g., Berardinelli-Seip congenital lipodystrophy, Dunnigan familial partial lipodystrophy) and acquired (e.g., HIV-related lipodystrophy in patients treated with highly active antiretroviral therapy) forms of lipodystrophy may give rise to severe insulin resistance and many of
metabolic syndrome's components.
[00012] For many of these inflammatory diseases there is no cure yet. It would be beneficial if the proinflammatory response is suppressed in these inflammatory disease , or to treat or ameliorate the symptoms of inflammatory disease.
[0013] It has been surprisingly found that peptides selected from a casein ไฮโดรไลเซต suppresses the proinflammatory response.