Autoimmune hepatitis-specific antibodies against soluble liver antigen and liver cytosol type 1 in patients with chronic viral hepatitis

BACKGROUND: Non-organ specific autoantibodies are highly prevalent in patients with chronic hepatitis C (HCV). Among them, anti-liver kidney microsomal type 1 (LKM1) antibody – the serological marker of type 2 autoimmune hepatitis (AIH-2)- is detected in up to 11% of the HCV-infected subjects. On the other hand, anti-liver cytosol type 1 antibodies (anti-LC1) – either in association with anti-LKM1, or in isolation- and anti-soluble liver antigen antibodies (anti-SLA) have been considered as useful and specific diagnostic markers for AIH. However, their specificity for AIH has been questioned by some recent studies, which have shown the detection of anti-LC1 and anti-SLA by immunoprecipitation assays in HCV patients irrespective of their anti-LKM1 status. The aim of the present study was to test the anti-LC1 and anti-SLA presence by specific enzyme linked immunosorbent assays (ELISAs), in a large group of Greek HCV-infected patients with or without anti-LKM1 reactivity as firstly, immunoprecipitation assays are limited to few specialized laboratories worldwide and cannot be used routinely and secondly, to assess whether application of such tests has any relevance in the context of patients with viral hepatitis since antibody detection based on such ELISAs has not been described in detail in large groups of HCV patients. METHODS: One hundred and thirty eight consecutive HCV patients (120 anti-LKM1 negative and 18 anti-LKM1 positive) were investigated for the presence of anti-LC1 and anti-SLA by commercial ELISAs. A similar number (120) of chronic hepatitis B virus (HBV) infected patients seronegative for anti-LKM1 was also tested as pathological controls. RESULTS: Six out of 18 (33%) anti-LKM(pos)/HCV(pos )patients tested positive for anti-LC1 compared to 1/120 (0.83%) anti-LKM(neg)/HCV(pos )patients and 0/120 (0%) of the anti-LKM1(neg)/HBV(pos )patients (p < 0.001 for both comparisons). Anti-SLA antibodies were not present in any of the HCV (with or without anti-LKM1) or HBV-infected patients. CONCLUSION: We showed that anti-LC1 and anti-SLA autoantibodies are not detected by conventional assays in a large group of anti-LKM1 negative patients with chronic hepatitis B and C infections. Based on these results we cannot find any justification for the application of anti-LC1 and anti-SLA tests in the routine laboratory testing of viral hepatitis-related autoantibody serology with the only potential exception being the anti-LC1 screening in anti-LKM1(pos)/HCV(pos )patients

Assessing the validity of the modified Mediterranean diet Scores in workplace population

Objective: The Mediterranean diet is associated with multiple health benefits as it is well-evidenced in the literature. This has led to an increased interest to implement the Mediterranean diet in the prevention of non-communicable diseases. To measure the adherence to the Mediterranean diet, we used Mediterranean diet scores; however, collecting dietary intake data can be challenging due to the subjective nature of self-administered instruments and the cultural differences between Mediterranean and non- Mediterranean populations. Aim: The aim of this thesis is to validate the modified Mediterranean Diet Score (mMDS) on a sample of career firefighters within the Indianapolis Fire Department, USA. Material and Methods: The study population consisted of 413 firefighters (94.2% were men, 27 to 66 years old with a mean age 48.46 ± 8.27 years) who participated in the research study "Feeding America's Bravest". For the assessment of the concurrent and predictive validity, we examined the correlation of the values of the mMDS with the already validated PREDIMED-14; and for the assessment of the constructive validity, we examined the between the mMDS and the anthropometric indices, blood pressure and biochemical parameters of the participants. Results: The mMDS was significantly positively correlated with PREDIMED score (r=0.736, p<0.001; ICC=0.593, 95% CI=0.479-0.681, p<0.001) and there was a moderate agreement between these two dietary assessment methods (κ=0.44, p<0.001). The participants were classified into categories based on their adherence to the Mediterranean diet according to these two scores. There was 62.4% (258 firefighters) correct agreement between the classifications of the two scores. After adjusting for gender and age of the individuals, the multiple linear regression analysis showed that the mMDS had a statistically significant negative association with the BMI (p=0.019), the body fat percentage (p=0.001), the waist circumference (p=0.014), the total/HDL-cholesterol ratio (p<0.001), the triglycerides (p=0.020) and it had also statistically significant positive correlation with HDL-cholesterol (p=0.020). A trend was also observed for lower levels of total cholesterol (p=0.093), LDL-cholesterol (p=0.088) and sugar levels (p=0.057) with increasing mMDS score. No statistically significant correlation was observed between the mMDS score and systolic blood pressure (p=0.330) or diastolic pressure (p=0.122). Conclusion: The mMDS is a valid instrument to measure adherence to Mediterranean diet in a working non-Mediterranean population, such as US firefighters, and may be useful in research and clinical practice for the assessment of the adherence to the Mediterranean diet and can be used as a predictive instrument to assess the risk of chronic non-communicable diseases.Εισαγωγή: Η Μεσογειακή Διατροφή έχει αποδειχθεί με πληθώρα ερευνών ότι σχετίζεται με πολλαπλά οφέλη για την υγεία. Το γεγονός αυτό προκαλεί αυξημένο ενδιαφέρον για εφαρμογή της Μεσογειακής Διατροφής ως μέσο πρόληψης χρόνιων μη μεταδοτικών νοσημάτων. Για να μετρηθεί η προσκόλληση στη Μεσογειακή Διατροφή χρησιμοποιούνται τα σκορ Μεσογειακής Διατροφής, ωστόσο η καταγραφή της προσκόλλησης στη Μεσογειακή Διατροφή μέσω αυτών των σκορ μπορεί να είναι δύσκολη λόγω της υποκειμενικής φύσης των ερωτηματολογίων που καταγράφουν την προσκόλληση σε ένα διατροφικό μοτίβο με αυτόματη συμπλήρωση από τους συμμετέχοντες καθώς και λόγω των πολιτιστικών διαφορών μεταξύ των Μεσογειακών και των μη Μεσογειακών πληθυσμών. Σκοπός: Σκοπός αυτής της διατριβής είναι η αξιολόγηση της εγκυρότητας του τροποποιημένου σκορ Μεσογειακής διατροφής mMDS (modified Mediterranean Diet score) σε δείγμα επαγγελματιών πυροσβεστών στο Πυροσβεστικό Σώμα της Ινδιανάπολης, ΗΠΑ.Υλικό και Μέθοδοι: Το υλικό της μελέτης αποτέλεσαν 413 πυροσβέστες (94,2% άνδρες, ηλικίας από 27 έως 66 έτη με μέση ηλικία τα 48,46 ± 8,27 έτη) που συμμετείχαν στη μελέτη "Feeding America's Bravest". Για τη διερεύνηση της συγκλίνουσας εγκυρότητας εξετάσθηκε ο βαθμός συσχέτισης των τιμών του mMDS με την ήδη επικυρωμένη κλίμακα Μεσογειακής διατροφής PREDIMED, ενώ για τη διερεύνηση της δομικής εγκυρότητας συσχετίσθηκαν οι τιμές του mMDS με τα ανθρωπομετρικά χαρακτηριστικά, τις μετρήσεις αρτηριακής πίεσης και τους βιοχημικούς δείκτες καρδιαγγειακού κινδύνου των συμμετεχόντων. Αποτελέσματα: Το mMDS σκορ παρουσίασε στατιστικά σημαντική θετική συσχέτιση με το PREDIMED σκορ (r=0,736, p<0,001; ICC=0,593, 95% CI = 0,479- 0,681, p<0,001), ήταν στις αναμενόμενες κατευθύνσεις με τις διατροφικές προσλήψεις των τροφίμων που περιλαμβάνονται στο PREDIMED και επίσης διαπιστώθηκε μια μέτρια συμφωνία μεταξύ αυτών των δύο μεθόδων διατροφικής αξιολόγησης (κ=0,44, p<0,001). Κατά την ταξινόμηση των συμμετεχόντων σε κατηγορίες προσκόλλησης στη Μεσογειακή διατροφή με τα δύο αυτά ερωτηματολόγια, παρατηρήθηκε ποσοστό ορθής ταξινόμησης της τάξης του 62,4% (258 πυροσβέστες). Μετά από προσαρμογή ως προς το φύλο και την ηλικία των ατόμων, η πολλαπλή γραμμική παλινδρόμηση έδειξε ότι το mMDS παρουσίασε στατιστικά σημαντική αρνητική συσχέτιση με τον Δ.Μ.Σ. (p=0,019), το ποσοστό σωματικού λίπους (p=0,001), την περιφέρεια μέσης (p=0,014), την αναλογία ολικής/HDL χοληστερόλης (p<0,001), των επιπέδων τριγλυκεριδίων (p=0,020) και στατιστικά σημαντική θετική συσχέτιση με την ΗDL χοληστερόλη (p=0,020). Παρατηρήθηκε επίσης μία τάση για χαμηλότερα επίπεδα της ολικής χοληστερόλης (p=0,093), της LDL χοληστερόλης (p=0,088) και των επιπέδων σακχάρου (p=0,057) με την αύξηση του mMDS σκορ. Δεν παρατηρήθηκε στατιστικά σημαντική συσχέτιση του mMDS σκορ με την συστολική (p=0,330) και τη διαστολική πίεση (p=0,122).Συμπεράσματα: To σκορ mMDS είναι ένα έγκυρο εργαλείο για τη μέτρηση της προσκόλλησης στη Μεσογειακή Διατροφή σε εργαζόμενο μη Μεσογειακό πληθυσμό, όπως οι πυροσβέστες των ΗΠΑ, και μπορεί να είναι χρήσιμο στην έρευνα και στην κλινική πράξη για την αξιολόγηση της προσκόλλησης της Μεσογειακής διατροφής κα- θώς και να χρησιμοποιηθεί ως προβλεπτικό εργαλείο για την αξιολόγηση του κινδύνου χρόνιων μη μεταδοτικών νοσημάτων

Adherence to the Mediterranean Diet and Healthy Aging: A Narrative Review over the Last Decade.

Objective: Even though modern medicine has significantly contributed to the extension of human lifespan, it has failed to delay the upsurge of chronic diseases. Health benefits of the Mediterranean diet are well established. Thus, adherence to this diet pattern may be the key to healthy aging. Ôhe aim of this review is to investigate the potential benefits of the Mediterranean diet on healthy aging. Methods: A literature search of three databases (ScienceDirect, MEDLINE and The Cochrane Library) was conducted in order to trace all relevant studies published between January 1st 2010 and June 6th 2020 that focused on the impact of adherence to the Mediterranean diet on the physical and mental well-being of individuals aged 60 or older. Results:Twenty-two studies fulfilled the selection criteria and were classified into six groups, according to the main outcome of each study: mental health (eight studies), frailty (6), cardiovascular risk factors (3), plasma levels of uric acid (1), length of hospital stay (1), and aging mechanisms (3). Based on these studies, the protective role of Mediterranean diet on depression, cardiovascular and frailty risk was established. Moreover, adherence to the Mediterranean diet resulted in reduced plasma uric acid levels as well as decreased length of hospital stay and mortality risk among patients who were urgently admitted for any cause in a tertiary hospital. In contrast, results on the effect of Mediterranean diet on cognition were controversial, as studies presented positive or neutral correlations. Conclusions: This review provides evidence on the association between adherence to the Mediterranean diet and healthy aging and highlights the importance of conducting more studies among seniors in order to provide further insight into this matter

Study of Antiphospholipid Antibodies in Patients with Arterial Hypertension

Antiphospholipid syndrome (APS) is a multifactorial, autoantibody-mediated disease. Antiphospholipid antibodies (aPL) directed against negatively charged phospholipids or various combinations of phospholipid-binding proteins seem to be an independent pathogenic factor that plays a critical role in APS. Unfortunately, their role in hypertension is not fully elucidated. The aim of our study was to determine aPL titers in hypertension patients and investigate the association of aPL with renal impairment parameters. Forty-seven patients with arterial hypertension (22 males, 46.8% and 25 females, 53.2%), aged 41&#8315;85 years old (mean 65.9 &#177; 10.1 years), and 21 age-sex-matched subjects without severe hypertension as control group (8 males, 13 females, 38.1% vs. 61.9%), mean age 61 &#177; 11.3 years, were enrolled in this study. Patients with other risk factors like Rheumatoid Arthritis and Systematic Lupus Erythematosus (SLE), both viral and bacterial acute infections, and cancer were excluded from the study. The aPL (anticardiolipin (ACA) and anti-b2GPI antibodies, IgG and IgM) were measured by ELISA (Aesculisa, Aesku Diagnostics, Wendelsheim, Germany) with a cutoff of 15 GPL/MPL for ACA and 15 U/mL for b2GPI. Serum Neutrophil gelatinase-associated lipocalin (sNGAL) was measured by ELISA kits (BioVendor, Brno, Czech Republic). Biochemical analysis such as serum creatinine (Cr), were measured by automated analyzer and finally estimated glomerular filtration rate (e-GFR) was calculated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Fifteen patients were positive for ACA IgG (31.9%), two for anti-b2GPI IgM (4.2%), and three for anti-b2GPI IgG (6.3%). Furthermore, three persons from control group were positive in anti-b2GPI IgG (14.27%). The serum level of anti-b2GPI IgG was significantly higher in patients compared to healthy controls (p = 0.013). The level of sNGAL (59.63 &#177; 41.5 ng/mL vs. 45.5 &#177; 21.5 ng/mL, p = 0.14) was not higher in hypertensive patients than in the age-sex-matched control group. Additionally, the sNGAL level was found to be directly and positively correlated in patients with positive ACA IgG (r2 = 0,945, p &lt; 0.0001). These results demonstrate that autoimmunity may be one of the pathogenetic factors of hypertension and aPL antibodies might be a potential marker of renal involvement

Association of the Modified Mediterranean Diet Score (mMDS) with Anthropometric and Biochemical Indices in US Career Firefighters

The Mediterranean diet is associated with multiple health benefits, and the modified Mediterranean Diet Score (mMDS) has been previously validated as a measure of Mediterranean diet adherence. The aim of this study was to examine associations between the mMDS and anthropometric indices, blood pressure, and biochemical parameters in a sample of career firefighters. The participants were from Indiana Fire Departments, taking part in the "Feeding America's Bravest" study, a cluster-randomized controlled trial that aimed to assess the efficacy of a Mediterranean diet intervention. We measured Mediterranean diet adherence using the mMDS. Anthropometric, blood pressure, and biochemical measurements were also collected. Univariate and multivariate linear regression models were used. In unadjusted analyses, many expected favorable associations between the mMDS and cardiovascular disease risk factors were found among the 460 firefighters. After adjustment for age, gender, ethnicity, physical activity, and smoking, a unitary increase in the mMDS remained associated with a decrease of the total cholesterol/HDL ratio (β-coefficient -0.028, p = 0.002) and an increase of HDL-cholesterol (β-coefficient 0.254, p = 0.004). In conclusion, greater adherence to the Mediterranean diet was associated with markers of decreased cardiometabolic risk. The mMDS score is a valid instrument for measuring adherence to the Mediterranean diet and may have additional utility in research and clinical practice

Dietary Habits Are Related to Phase Angle in Male Patients with Non-Small-Cell Lung Cancer

Introduction: Lung cancer constitutes the most common cause of cancer death. Phase angle (PhA) has been related to lung cancer prognosis, which implies that the identification of dietary or other factors that could predict or modify PhA may have beneficial effects. &Nu;utritional interventions have been linked with positive changes in PhA in certain types of cancer. Aim: The present study aimed to investigate the relationships between dietary habits/nutrition and PhA in NSCLC patients. Methods: The sample consisted of 82 male patients with non-small-cell lung cancer (NSCLC; stage IV) from the &lsquo;Theageneio&rsquo; Cancer Hospital (Thessaloniki, Greece). Several parameters were assessed, such as body mass index (BMI), lean mass, PhA, Mediterranean diet score (MedDietScore), dietary patterns, smoking, resting metabolic rate, resting oxygen consumption (VO2), ventilation rate, and physical activity. Results: According to our results, a dietary pattern rich in potatoes and animal proteins (meat and poultry) was a significant determinant of PhA (B &plusmn; SE, p: 0.165 &plusmn; 0.08, p = 0.05) in multiple linear regression models after adjusting for age, smoking, lean tissue, and MedDietScore. Conclusion: In conclusion, dietary patterns may affect PhA, suggesting the crucial role of protein in cancer management and the prevention of sarcopenia