A coeliakia genetikai es epigenetikai vonatkozasai.

Genetic backround of coeliac disease has been subjects to intensive research since decades. However, only results of HLA phenotyping have been taken over to routine clinical practice. Meanwhile, data on the role of epigenetical factors in the manifestation of diseases have been emerging. In coeliac disease, there are several questions both in the fields of genetics and epigenetics yet to be answered. In this review, a cross section of current knowledge on these issues is presented with special interest regarding the future clinical applications. Orv. Hetil., 2014, 155(3), 83-88

Eosinophil oesophagitis étrendi és gyógyszeres vonatkozásai

Eosinophilic esophagitis is considered to be a chronic antigen-driven disease whereby food and/or aeroallergens induce a chronic inflammatory infiltrate in the esophagus leading to pathological hyperplasia of the epithelial and muscular layers, fibrosis of the lamina propria and symptoms of dysphagia and food impaction. Eosinophilic esophagitis is often associated with other allergic diseases such as asthma or atopic dermatitis. Current first line treatments of the disease include strict dietary modification and topical anti-inflammatory steroids. In this review the authors summarize currently available treatment strategies of eosinophilic esophagitis

Koffein: hagyományos és új terápiás indikációk, valamint felhasználás dermatológiai modellvegyületként = Caffeine: traditional and new therapeutic indications and use as a dermatological model drug

Absztrakt: A kávéfogyasztás a XV. századtól kezdve terjedt el világszerte. Elterjedése nemcsak a kávéital kiváló aromájának, hanem a benne lévő hatóanyagoknak, így elsősorban a koffeinnek köszönhető. Ebben a tanulmányban ismertetjük a koffein komplex teljesítményfokozó hatásának hátterében álló mechanizmusokat, illetve bemutatjuk az utóbbi évtizedekben egyre szélesebb körben folytatott, új indikációs területekre irányuló kutatásokat. Számos vizsgálat foglalkozik a neuroprotektív (Alzheimer- és Parkinson-kór-ellenes) és hepatoprotektív hatásokkal, illetve külön kitérünk az egyik legperspektivikusabb új területre, a bőr tumoros elváltozásainak megelőzésében játszott szerepére. Ez utóbbi mind sejtes rendszerekben, mind pedig in vivo körülmények között bizonyítást nyert. Egyebek mellett ezeken az eredményeken alapul a koffein, illetve a kávé kozmetikai és bőrgyógyászati készítményekben történő alkalmazása. Erősen hidrofil tulajdonsága miatt a koffeint transdermalis kísérletekben modellanyagként is felhasználják. Új gyógyszerformulációk tervezéséhez, összehasonlításához is alkalmazható, bár dermalis felszívódásában a follicularis útvonal is fontos szerepet játszik. Összességében a koffeinmolekula számos újonnan felfedezett kedvező hatással rendelkezik, de vigyázni kell a felelőtlen fogyasztásával. Túlzott bevitele számos nemkívánatos hatást is okozhat, illetve hozzászokott egyéneknél elhagyásakor megvonási tünetek léphetnek fel. Orv Hetil. 2018; 159(10): 384–390. | Abstract: Coffee consumption had already been described in the 15th century. The spreading of coffee drinking was not only a consequence of its delicious aromatic taste, but also of its pharmacological effects, especially due to its caffeine content. In this review, the mechanisms behind its complex stimulatory effects and the latest studies on the possible new therapeutic indications of caffeine are summarized. Several papers reported the neuroprotective (in Alzheimer’s and Parkinson’s disease) and hepatoprotective profiles of caffeine, and we show the most promising new results about its preventive properties in dermal malignancies. These findings were described both in cell cultures and in vivo. The application of caffeine and coffee in cosmetology and dermatological products is based on their antioxidant property and on the above-mentioned beneficial effects. Caffeine is also presented here as a dermatological model drug due to its hydrophilic profile. It can be used for designing and comparing different novel drug formulations, although beside the transcellular route, the follicular and transappendageal pathways play also important roles in its skin penetration. Taken together, caffeine molecule has many recently discovered beneficial pharmacological effects, but one should be careful with its excessive consumption. It can result in several adverse events if overdosed and in case of regular intake of high doses, after abandonment, withdrawal symptoms may appear. Orv Hetil. 2018; 159(10): 384–390

Prevalence of inflammatory bowel disease among coeliac disease patients in a Hungarian coeliac centre

BACKGROUND: Celiac disease, Crohn disease and ulcerative colitis are inflammatory disorders of the gastrointestinal tract with some common genetic, immunological and environmental factors involved in their pathogenesis. Several research shown that patients with celiac disease have increased risk of developing inflammatory bowel disease when compared with that of the general population. The aim of this study is to determine the prevalence of inflammatory bowel disease in our celiac patient cohort over a 15-year-long study period. METHODS: To diagnose celiac disease, serological tests were used, and duodenal biopsy samples were taken to determine the degree of mucosal injury. To set up the diagnosis of inflammatory bowel disease, clinical parameters, imaging techniques, colonoscopy histology were applied. DEXA for measuring bone mineral density was performed on every patient. RESULTS: In our material, 8/245 (3,2 %) coeliac disease patients presented inflammatory bowel disease (four males, mean age 37, range 22-67), 6/8 Crohn's disease, and 2/8 ulcerative colitis. In 7/8 patients the diagnosis of coeliac disease was made first and inflammatory bowel disease was identified during follow-up. The average time period during the set-up of the two diagnosis was 10,7 years. Coeliac disease serology was positive in all cases. The distribution of histology results according to Marsh classification: 1/8 M1, 2/8 M2, 3/8 M3a, 2/8 M3b. The distribution according to the Montreal classification: 4/6 Crohn's disease patients are B1, 2/6 Crohn's disease patients are B2, 2/2 ulcerative colitis patients are S2. Normal bone mineral density was detected in 2/8 case, osteopenia in 4/8 and osteoporosis in 2/8 patients. CONCLUSIONS: Within our cohort of patients with coeliac disease, inflammatory bowel disease was significantly more common (3,2 %) than in the general population

Intestinalis zsírsavkötő fehérje: az enterocytakárosodás markere akut és krónikus gasztroenterológiai kórképekben

Absztrakt Az intestinalis zsírsavkötő fehérje a zsírsavkötő fehérjék családjába tartozó, a vékony- és vastagbél enterocytáinak citoszoljában termelődő, kis molekulasúlyú fehérje. Az enterocytasejtek membránintegritásának megbomlását követően megjelenik a szisztémás keringésben, és a vesék glomerularis szűrőjén keresztül kiválasztódik a vizeletbe. A szerzők akut és krónikus enterocytakárosodással járó gastrointestinalis kórképekben az intestinalis zsírsavkötő fehérje biomarkerként való használatával kapcsolatos vizsgálatokat tekintik át. Orv. Hetil., 2016, 157(2), 59–64

Skin-on-a-Chip Device for Ex Vivo Monitoring of Transdermal Delivery of Drugs—Design, Fabrication, and Testing

To develop proper drug formulations and to optimize the delivery of their active ingredients through the dermal barrier, the Franz diffusion cell system is the most widely used in vitro/ex vivo technique. However, different providers and manufacturers make various types of this equipment (horizontal, vertical, static, flow-through, smaller and larger chambers, etc.) with high variability and not fully comparable and consistent data. Furthermore, a high amount of test drug formulations and large size of diffusion skin surface and membranes are important requirements for the application of these methods. The aim of our study was to develop a novel Microfluidic Diffusion Chamber device and compare it with the traditional techniques. Here the design, fabrication, and a pilot testing of a microfluidic skin-on-a chip device are described. Based on this chip, further developments can also be implemented for industrial purposes to assist the characterization and optimization of drug formulations, dermal pharmacokinetics, and pharmacodynamic studies. The advantages of our device, beside the low costs, are the small drug and skin consumption, low sample volumes, dynamic arrangement with continuous flow mimicking the dermal circulation, as well as rapid and reproducible results