Einfluss des Nikotinkonsums auf die Aussagekraft urinbasierter Marker in der Diagnostik des Harnblasenkarzinoms

Risikofaktor Nummer eins für die Entwicklung eines BC stellt das Konsumieren von Tabakrauch da. Dessen kanzerogene Wirkung auf die Urothelzellen und deren DNA ist in diversen Studien belegt. In der Diagnostik und Rezidiv-Kontrolle des BC kommen neben der Urinzytologie u.a. die Harnmarker UroVysion/FISH™, uCyt+/ImmunoCyt™ und NMP22™ zum Einsatz. Da die Störanfälligkeit dieser Methoden bekannt ist, stellt sich die Frage, ob Tabakrauch auch einen Einfluss auf die Ergebnisse dieser Methoden der Urindiagnostik hat. Ziel der vorliegenden Arbeit war, diese Frage zu beantworten. Hierzu wurde ein Kollektiv von 723 Patienten zusammengestellt, welche im Zeitraum von September 2006 bis Dezember 2012 in der Klinik für Urologie des Universitätsklinikums Tübingen eine BC-Diagnostik durchführen ließen. Zusätzlich erfüllten diese Patienten vorab festgelegte Ein- und Ausschlusskriterien. Es erfolgte eine rein retrospektive Analyse der relevanten klinischen Daten dieses Patientenkollektivs. Für die vier genannten Urintests (Urinzytologie, UroVysion/FISH™, uCyt+/ImmunoCyt™, NMP22™) wurden jeweils Kontingenztabellen erstellt und anhand der Vierfeldertafel wurden die Ergebnisse für Sensitivität, Spezifität, PPW und NPW errechnet, sowie falsch-positive- und falsch-negativ-Raten ermittelt. Mithilfe von Trendtests wurde geprüft, ob die drei Gruppen Nichtraucher, ehemalige Raucher und Raucher statistisch signifikante Unterschiede bei den falsch-positiv bzw. falsch-negativ-Raten bei den einzelnen Methoden aufwiesen. Dabei zeigte sich, dass bei keiner der untersuchten Methoden statistisch signifikante Unterschiede zwischen den drei Gruppen mit unterschiedlichem Raucherverhalten detektiert werden konnten, sodass davon ausgegangen werden kann, dass das Rauchverhalten keinen Einfluss auf die Qualität der Urinzytologie-, der uCyt+/ImmunoCyt™-, der NMP22™- oder der UroVysion/FISH™-Methode hat

Frequency of Tongue Cleaning Impacts the Human Tongue Microbiome Composition and Enterosalivary Circulation of Nitrate

The oral microbiome has the potential to provide an important symbiotic function in human blood pressure physiology by contributing to the generation of nitric oxide (NO), an essential cardiovascular signaling molecule. NO is produced by the human body via conversion of arginine to NO by endogenous nitric oxide synthase (eNOS) but eNOS activity varies by subject. Oral microbial communities are proposed to supplement host NO production by reducing dietary nitrate to nitrite via bacterial nitrate reductases. Unreduced dietary nitrate is delivered to the oral cavity in saliva, a physiological process termed the enterosalivary circulation of nitrate. Previous studies demonstrated that disruption of enterosalivary circulation via use of oral antiseptics resulted in increases in systolic blood pressure. These previous studies did not include detailed information on the oral health of enrolled subjects. Using 16S rRNA gene sequencing and analysis, we determined whether introduction of chlorhexidine antiseptic mouthwash for 1 week was associated with changes in tongue bacterial communities and resting systolic blood pressure in healthy normotensive individuals with documented oral hygiene behaviors and free of oral disease. Tongue cleaning frequency was a predictor of chlorhexidine-induced changes in systolic blood pressure and tongue microbiome composition. Twice-daily chlorhexidine usage was associated with a significant increase in systolic blood pressure after 1 week of use and recovery from use resulted in an enrichment in nitrate-reducing bacteria on the tongue. Individuals with relatively high levels of bacterial nitrite reductases had lower resting systolic blood pressure. These results further support the concept of a symbiotic oral microbiome contributing to human health via the enterosalivary nitrate-nitrite-NO pathway. These data suggest that management of the tongue microbiome by regular cleaning together with adequate dietary intake of nitrate provide an opportunity for the improvement of resting systolic blood pressure

Irritable bowel syndrome, inflammatory bowel disease and the microbiome

PURPOSE OF REVIEW: The review aims to update the reader on current developments in our understanding of how the gut microbiota impact on inflammatory bowel disease and the irritable bowel syndrome. It will also consider current efforts to modulate the microbiota for therapeutic effect. RECENT FINDINGS: Gene polymorphisms associated with inflammatory bowel disease increasingly suggest that interaction with the microbiota drives pathogenesis. This may be through modulation of the immune response, mucosal permeability or the products of microbial metabolism. Similar findings in irritable bowel syndrome have reinforced the role of gut-specific factors in this ‘functional’ disorder. Metagenomic analysis has identified alterations in pathways and interactions with the ecosystem of the microbiome that may not be recognized by taxonomic description alone, particularly in carbohydrate metabolism. Treatments targeted at the microbial stimulus with antibiotics, probiotics or prebiotics have all progressed in the past year. Studies on the long-term effects of treatment on the microbiome suggest that dietary intervention may be needed for prolonged efficacy. SUMMARY: The microbiome represents ‘the other genome’, and to appreciate its role in health and disease will be as challenging as with our own genome. Intestinal diseases occur at the front line of our interaction with the microbiome and their future treatment will be shaped as we unravel our relationship with it

Microbiota of De-Novo Pediatric IBD : Increased Faecalibacterium Prausnitzii and Reduced Bacterial Diversity in Crohn's But Not in Ulcerative Colitis

ACKNOWLEDGMENTS We are grateful for the expertise of our sequencing provider NewGene and in particular for the support and help of Dr Jonathan Coxhead.Mrs Karen McIntyre and Dr Dagmar Kastner were invaluable in identifying patients for recruitment in Dundee. Mrs Ann Morrice provided administrative support in Aberdeen. Dr Paul Henderson gave helpful comments on the manuscript. We appreciate the generosity of the families who freely gave their time and samples to make this study possible and the theatre staff of all centers who allowed time for sample collection during busy endoscopy lists.Peer reviewedPublisher PD