Transcripts
DR. LINGWOOD:
And if we can turn the lights
down a bit, this is another glomerulus, here,
with a tubule coming off, again, expressing a
receptor in a child under one.
So what we see then is that the
distribution of receptors in some respects,
mirrors the incidence of HUS in that children
have the receptor in the kidney's glomeruli.
Whereas adults, you and I do not. We haven't
exactly identified the transition. We've
certainly seen that some teenagers are also
positive but some are negative in their
glomeruli, but most adults 30, 40, 50 years old
have no -- do not express the receptor in their
renal glomeruli. And we think this is why
adults do not get HUS.
SPEAKER:
Excuse me, you stated
a figure and I missed it. About how many cases
was it in children under three?
DR. LINGWOOD:
Yes, about 90
percent of the cases are children under three.
SPEAKER:
Is that what you're
referring to when you said everybody knows about
age, because I'm one of the ones that --
DR. LINGWOOD:
Yes, everyone
knows about age because it's children who get
HUS, primarily, rather than adults.
SPEAKER:
Is this hereditary in
family members?
DR. LINGWOOD:
No, no. Well,
there is a subset, a very small subset of people
who get recurrent HUS, and they are less than --
less than one percent of the HUS cases. And
there may be a hereditary factor, but they are a
very, very minor subset and indistinct.
SPEAKER:
I have one follow-up
question. You've obviously made a big
distinction with children under three and adults
30 to 40 years old. How significant would the
difference in age between say two and eight be,
because I'm involved in a situation where a two
year old and an eight year old ate the same
exact hamburger at Burger King and one got very,
very ill and one got somewhat ill.
DR. LINGWOOD:
Well, I think
you have to come back to cases. What we've
seen is that under two year olds, all the
samples we've looked at are positive. We've had
cases who have been three years old where some
of their glomeruli have been positive and some
negative.
But then again we've had
cases of eight years old have been positive and
we've had cases of ten years old negative. And
we've had cases of 14 year olds who have been
positive.
We haven't actually got enough
numbers to say exactly where the cutoff is. But
we do see biopsies of three to four year olds
which are negative. So in that regard, I would
say the cutoff is somewhere between two, two to
four, but it's not sharp. There are exceptions.
Some people still express the receptor in their
glomeruli at eight and even older.
SPEAKER:
What I hear you
saying is statistically the eight year old is
much more likely to be negative than the two
year old?
DR. LINGWOOD:
Oh, yes, very
much so, yes.
MS. ORRBINE:
If I can just
add, we've done some clinical trials that will
support very strongly the information that Dr.
Lingwood is presenting, but the mean age of
children who developed HUS from a cohort of
about 700 children with uncomplicated E.
coli subsequently was about 2.6 years of age. So, in
fact, it very strongly correlates with the
information Dr. Lingwood is presenting.
