Characterization of Changes in Serum Anti-Glycan Antibodies in Crohn's Disease – a Longitudinal Analysis

INTRODUCTION: Anti-glycan antibodies are a promising tool for differential diagnosis and disease stratification of patients with Crohn's disease (CD). We longitudinally assessed level and status changes of anti-glycan antibodies over time in individual CD patients as well as determinants of this phenomenon. METHODS: 859 serum samples derived from a cohort of 253 inflammatory bowel disease (IBD) patients (207 CD, 46 ulcerative colitis (UC)) were tested for the presence of anti-laminarin (Anti-L), anti-chitin (Anti-C), anti-chitobioside (ACCA), anti-laminaribioside (ALCA), anti-mannobioside (AMCA) and anti-Saccharomyces cerevisiae (gASCA) antibodies by ELISA. All patients had at least two and up to eleven serum samples taken during the disease course. RESULTS: Median follow-up time for CD was 17.4 months (Interquartile range (IQR) 8.0, 31.6 months) and for UC 10.9 months (IQR 4.9, 21.0 months). In a subgroup of CD subjects marked changes in the overall immune response (quartile sum score) and levels of individual markers were observed over time. The marker status (positive versus negative) remained widely stable. Neither clinical phenotype nor NOD2 genotype was associated with the observed fluctuations. In a longitudinal analysis neither changes in disease activity nor CD behavior led to alterations in the levels of the glycan markers. The ability of the panel to discriminate CD from UC or its association with CD phenotypes remained stable during follow-up. In the serum of UC patients neither significant level nor status changes were observed. CONCLUSIONS: While the levels of anti-glycan antibodies fluctuate in a subgroup of CD patients the antibody status is widely stable over time

Serological Markers for Inflammatory Bowel Disease in AIDS Patients with Evidence of Microbial Translocation

Background: Breakdown of the gut mucosal barrier during chronic HIV infection allows translocation of bacterial products such as lipopolysaccharides (LPS) from the gut into the circulation. Microbial translocation also occurs in inflammatory bowel disease (IBD). IBD serological markers are useful in the diagnosis of IBD and to differentiate between Crohn's disease (CD) and ulcerative colitis (UC). Here, we evaluate detection of IBD serological markers in HIV-infected patients with advanced disease and their relationship to HIV disease markers.Methods IBD serological markers (ASCA, pANCA, anti-OmpC, and anti-CBir1) were measured by ELISA in plasma from AIDS patients (n = 26) with low CD4 counts (<300 cells/$\mu$l) and high plasma LPS levels, and results correlated with clinical data. For meta-analysis, relevant data were abstracted from 20 articles. Results: IBD serological markers were detected in approximately 65% of AIDS patients with evidence of microbial translocation. An antibody pattern consistent with IBD was detected in 46%; of these, 75% had a CD-like pattern. Meta-analysis of data from 20 published studies on IBD serological markers in CD, UC, and non-IBD control subjects indicated that IBD serological markers are detected more frequently in AIDS patients than in non-IBD disease controls and healthy controls, but less frequently than in CD patients. There was no association between IBD serological markers and HIV disease markers (plasma viral load and CD4 counts) in the study cohort. Conclusions: IBD serological markers may provide a non-invasive approach to monitor HIV-related inflammatory gut disease. Further studies to investigate their clinical significance in HIV-infected individuals are warranted

Inflammatory bowel disease: past, present, and future

Crohn’s disease and ulcerative colitis, collectively known as the inflammatory bowel diseases (IBD), are largely diseases of the twentieth century, and are associated with the rise of modern, Westernized industrial society. Although the causes of these diseases remain incompletely understood, the prevailing model is that the intestinal flora drives an unmitigated intestinal immune response and inflammation in the genetically susceptible host. A review of the past and present of these diseases shows that detailed description preceded more fundamental elucidation of the disease processes. Working out the details of disease pathogenesis, in turn, has yielded dividends in more focused and effective therapy for IBD. This article highlights the key descriptions of the past, and the pivotal findings of current studies in disease pathogenesis and its connection to medical therapy. Future directions in the IBD will likely explicate the inhomogeneous causes of these diseases, with implications for individualized therapy

Food Use and Health Effects of Soybean and Sunflower Oils

This review provides a scientific assessment of current knowledge of health effects of soybean oil (SBO) and sunflower oil (SFO). SBO and SFO both contain high levels of polyunsaturated fatty acids (PUFA) (60.8 and 69%, respectively), with a PUFA:saturated fat ratio of 4.0 for SBO and 6.4 for SFO. SFO contains 69% C18:2n-6 and less than 0.1% C18:3n-3, while SBO contains 54% C18:2n-6 and 7.2% C18:3n-3. Thus, SFO and SBO each provide adequate amounts of C18:2n-6, but of the two, SBO provides C18:3n-3 with a C18:2n-6:C18:3n-3 ratio of 7.1. Epidemiological evidence has suggested an inverse relationship between the consumption of diets high in vegetable fat and blood pressure, although clinical findings have been inconclusive. Recent dietary guidelines suggest the desirability of decreasing consumption of total and saturated fat and cholesterol, an objective that can be achieved by substituting such oils as SFO and SBO for animal fats. Such changes have consistently resulted in decreased total and low-density-lipoprotein cholesterol, which is thought to be favorable with respect to decreasing risk of cardiovascular disease. Also, decreases in high-density-lipoprotein cholesterol have raised some concern. Use of vegetable oils such as SFO and SBO increases C18:2n-6, decreases C20:4n-6, and slightly elevated C20:5n-3 and C22:6n-3 in platelets, changes that slightly inhibit platelet generation of thromboxane and ex vivo aggregation. Whether chronic use of these oils will effectively block thrombosis at sites of vascular injury, inhibit pathologic platelet vascular interactions associated with atherosclerosis, or reduce the incidence of acute vascular occlusion in the coronary or cerebral circulation is uncertain. Linoleic acid is needed for normal immune response, and essential fatty acid (EFA) deficiency impairs B and T cell-mediated responses. SBO and SFO can provide adequate linoleic acid for maintenance of the immune response. Excess linoleic acid has supported tumor growth in animals, an effect not verified by data from diverse human studies of risk, incidence, or progression of cancers of the breast and colon. Areas yet to be investigated include the differential effects of n-6- and n-3-containing oil on tumor development in humans and whether shorter-chain n-3 PUFA of plant origin such as found in SBO will modulate these actions of linoleic acid, as has been shown for the longer-chain n-3 PUFA of marine oil

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Co (II) porphyrin adsorbed on SiO2/SnO2/phosphate prepared by the sol-gel method

This paper describes the immobilization procedure of 5,10,15,20-tetrakis(1-methyl-4-pyridyl)-21-H,23-H-porphyrin ion on SiO2/SnO2/phosphate, obtained by the sol-gel processing method. P 2p X-ray photoelectron and the P-31 MAS NMR spectra revealed that dihydrogen phosphate is the species present on the surface. The porphyrin was adsorbed on the surface of the modified material and furthermore metallized in situ with Co (H) ion. The porphyrin metallation process was followed with UV-vis spectroscopy by inspecting the Q bands of the free and metallated porphyrin. The free porphyrin presented four Q bands associated to a D-2h local symmetry and the metallated one, two bands related to a D-4h local symmetry. The amount of electroactive species adsorbed on the material was estimated by integrating the area under the peak of Co (II) -> Co (I) reduction by using the pulse differential voltammetric technique. The amount of the metallated porphyrin was 2.3 x 10(-10) Mol cm(-2). A carbon paste electrode of the modified material containing metallated porphyrin was used to study the electrocatalytic reduction of dissolved dioxygen by means of cyclic voltammetry, chronoamperometry and linear sweeping voltammetry. The modified electrode was very stable and exhibited the electrocatalytic reduction of dissolved dioxygen at -180mV versus SCE by a two-electron mechanism, producing hydrogen peroxide at pH 5.4. The electroactive species was strongly retained on the material surface, presumably inside the pores of the material, since in a test of various oxidation-reduction cycles no significant decrease of the current densities was detected, indicating that it was not leached off during the experiment. (c) 2005 Elsevier Ltd. All rights reserved.50224378438

Surface modification with phosphoric acid of SiO2/Nb2O5 prepared by the sol-gel method: Structural-textural and acid sites studies and an ion exchange model

In this work, the structural and textural properties of the SiO2/Nb2O5 system prepared by the sol-gel method and then modified by phosphoric acid were studied. The different materials were prepared, with three different mol % Nb2O5 (2.5, 5.0, and 7.5 mol %), and calcined in the temperature range of 423-1273 K. BET specific surface area determinations, scanning electron microscopy connected to a X-ray emission analyzer, Fourier transform infrared spectroscopy, and X-ray photoelectron spectroscopy (XPS) were used for the investigation. For the lowest temperature of calcination (423 K), the mesopores and micropores of the modified material were blocked, resulting in a decrease of the specific surface area compared to the S-BET values obtained for the SiNb matrix. Under intermediate temperatures of calcination (423-873 K), the modified material acquired textural stability. By XPS analysis, the presence of the dihydrogenphosphate species was identified, the P/Nb atomic ratios being independent of the thermal treatment. P-31 magic angle spinning NMR confirmed the XPS data and also showed that the chemical shift of the (H2PO4)(-) ions strongly depended on the crystallization degree of the Nb2O5. Structural thermal stability was also shown by the presence of Bronsted acid sites in the modified material calcined at high temperature (1273 K). The thermal stability is directly associated with obtainment of the same value for K+ exchange capacity (0.74 mmol g(-1), average value) for the modified materials calcined at 423 and 1273 K. The chemical analyses of phosphorus for the modified materials were made by using the inductively coupled plasma. The value was 0.36 mmol g(-1), corroborating the presence of (H2PO4)(-) ions. The ion exchange isotherms presented an S-shaped form characteristic of energetically heterogeneous ion exchangers, permitting application of a model of fixed polydentate centers, in which ion exchange took place.20208707871