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Introduction. The aim of the current study was to evaluate the role of angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism on the prediction of type 2 diabetes in two ethnic populations from Jerba Island, Tunisia. Methods. In this study, we analysed the genotypic and the allelic distributions of the ACE I/D polymorphism and conducted a case/control association study between healthy normoglycaemic controls and diabetic patients in the two studied groups. ACE gene polymorphism was analysed by polymerase chain reaction in 272 individuals consisting of 172 diabetic subjects and 100 controls. Results. The genotype frequencies for DD, ID and II were 75.50%, 19.60% and 4.89% in Arabs and 76.66%, 16.66% and 6.67% in Berbers, respectively, in the case group, and 42.85%, 35.71% and 21.43% in Arabs and 57.50%, 22.50% and 20.00% in Berbers, respectively, in the control group. The DD frequency was significantly higher in the case group than in the control group (p<0.001), suggesting that the DD genotype is associated with an increased susceptibility to type 2 diabetes in our study populations. Conclusions. The current investigation provides new evidence regarding the role of the ACE I/D polymorphism in the pathogenesis of type 2 diabetes in Jerbian populations. Furthermore, it underlines the importance of ethnicity, which should be considered in all studies aiming to test the genetic effects on the susceptibility to type 2 diabetes.

Our data strongly support that the changes of thyroid hormones may be influenced by adiposity and its metabolic consequences, such as insulin resistance. This relationship can be explained by a cross talk between adipose tissue release and thyroid function. Nevertheless, metformin treatment seems to affect thyroid function in diabetic patients by maintaining plasma thyrotropin levels to subnormal levels.

Metastatic brain tumors are the leading cause of central nervous system malignancies in adults, surpassing primary central nervous system with non-small cell lung cancer, accounting for more than 50% of all cases. The emergence of immunotherapies such as antibodies targeting the immune check points has led to significant advancement in the field of cancer treatment since these approaches have overwhelmingly impacted outcomes in patients with metastatic non-small cell lung cancer. Here we report two cases of metastatic non-small cell lung cancer treated with immunotherapy. While one patient achieved an excellent systemic response but developed new metastatic brain lesions, the other showed remarkable systemic as well as central response. These cases highlight variable central nervous system penetration of programmed death 1 (PD-1) antibodies, and we also review the available literature on blood brain barrier permeability of PD-1 antibodies.

The present study is the first meta-analysis to evaluate type 2 diabetes (T2D) -associated polymorphisms in cohorts originated from several Tunisian regions. In fact, we evaluated the effect of seven polymorphisms in the following genes ; PPARg ( Pro12Ala), TNFα (-308A/G), ENPP1(K121Q), TCF7L2(rs7903146 C/T), MTHFR( C677T), ACE(I/D), CAPN10(3R/2R) on T2D risk, through a meta-analysis combining data of previous studies performed on Tunisian populations originating from the north, centre or south of the country. R statistics version 2.12.1 software was used to estimate the heterogeneity between studies. Pooled ORs were computed by the fixed-effects method of Mantel-Haenszel if no heterogeneity between studies exists. Despite the similarities founded in a number of loci, the Woolf test reported that the contributions of ENPP1 and ACE loci in T2D risk are dependent on the geographic origin of concerned groups and this heterogeneity could be attributed not only, to the variable contribution of the variant in T2D risk, but also to diversities of genetic background between tested groups. Interestingly, observed heterogeneity highlighted founding concerning Y chromosome and the mitochondrial DNA about genetic structure of Tunisian population and proves once again that Tunisians, like the north-Africans, are a mosaic of subpopulations, with significant differences in genetic structure. In homogenous groups, we replicated the association of SNPs of TCF7L2, MTHFR, CAPN 10, TNFα and ACE genes with T2D risk in Tunisian population with OR ranging from 1.43 to 6.72. However, we reported an absence of association of PPARg with T2D in Tunisian population.