Glutathione redox cycle in small intestinal mucosa and peripheral blood of pediatric celiac disease patients

The celiac disease is an autoimmune gastrointestinal disorder caused by gluten from wheat, rye or barley. In genetically predisposed persons, gluten induces the immune-mediated inflammation of small intestinal mucosa. Histological lesions include intraepithelial lymphocytosis, crypt hypertrophy and villous atrophy, resulting in malabsorption of micro- and macronutrients. The only treatment for celiac patients is a permanent gluten-free diet (GFD). Reactive oxygen species (ROS) and oxidative stress are strongly associated with the celiac disease. Glutathione (GSH) is a main detoxifier of endogenous and exogenous ROS in the intestine. In order to explain the role of glutathione redox cycle in celiac patients, we examined the activities of GSH-related antioxidant (AO) enzymes glutathione peroxidase (GPx) and glutathione reductase (GR), as well as the concentration of GSH in small intestinal biopsies and peripheral blood of children affected by the celiac disease. The concentration of lipid hydroperoxides (LOOH) as markers of oxidative damage was measured in the same samples. The results clearly demonstrate a significant malfunction of GSH redox cycle with a concomitant decrease in the capacity to regenerate GSH and detoxify LOOH in celiac patients, even after several years of GFD. The oral administration of GSH and a diet rich in natural antioxidants, as well as appropriate dietary supplements, could be of great benefit to the patients.A doença celíaca é uma desordem gastrointestinal causada pelo glúten proveniente do trigo, centeio ou cevada. Em pessoas geneticamente predispostas, o glúten induz uma inflamação imune da mucosa do intestino delgado. As lesões histológicas incluem linfocitose intraepitelial, hipertrofia de criptas e atrofia vilosa, resultando em malabsorção de micro- e macronutrientes. O único tratamento para os pacientes celíacos é a restrição permanente de glúten na dieta (GFD).Espécies reativas de oxigênio (ROS) e o estresse oxidativo estão fortemente associados à doença celíaca. O glutatião (GSH) é o principal detoxificante de ROS endógeno ou exógeno no intestino. Para explicar o papel do ciclo redox do glutatião nos pacientes celíacos, nós examinamos as atividades das enzimas GSH-relacionadas e anti-oxidantes (AO) glutatião peroxidase (GPx) e glutatião redutase (GR), assim como a concentração de GHS em biópsias do intestino delgado e sangue periférico de crianças afetadas pela doença celíaca. A concentração dos hidroperóxidos lipídicos (LOOH) como marcadores do dano oxidativo foi medida em várias amostras. Os resultados mostram claramente a mal função significante do ciclo redox do GSH com uma diminuição concomitante da capacidade de regenerar GSH e detoxificar LOOH nos pacientes celíacos, mesmo após vários anos de GFD. A administração oral de GSH e uma dieta rica em anti-oxidantes naturais, assim como de suplementos apropriados na dieta, poderiam ser de grande benefício aos pacientes

DIA1R Is an X-Linked Gene Related to Deleted In Autism-1

Background: Autism spectrum disorders (ASDs) are frequently occurring disorders diagnosed by deficits in three core functional areas: social skills, communication, and behaviours and/or interests. Mental retardation frequently accompanies the most severe forms of ASDs, while overall ASDs are more commonly diagnosed in males. Most ASDs have a genetic origin and one gene recently implicated in the etiology of autism is the Deleted-In-Autism-1 (DIA1) gene. Methodology/Principal Findings: Using a bioinformatics-based approach, we have identified a human gene closely related to DIA1, we term DIA1R (DIA1-Related). While DIA1 is autosomal (chromosome 3, position 3q24), DIA1R localizes to the X chromosome at position Xp11.3 and is known to escape X-inactivation. The gene products are of similar size, with DIA1 encoding 430, and DIA1R 433, residues. At the amino acid level, DIA1 and DIA1R are 62 % similar overall (28 % identical), and both encode signal peptides for targeting to the secretory pathway. Both genes are ubiquitously expressed, including in fetal and adult brain tissue. Conclusions/Significance: Examination of published literature revealed point mutations in DIA1R are associated with X-linked mental retardation (XLMR) and DIA1R deletion is associated with syndromes with ASD-like traits and/or XLMR. Together, these results support a model where the DIA1 and DIA1R gene products regulate molecular traffic through the cellular secretory pathway or affect the function of secreted factors, and functional deficits cause disorders with ASD-lik

Infection prevention at day-care centres: Feasibility and possible effects of intervention

Objective. To study the effect of an educationally oriented intervention programme, with the recommendations from the National Board of Health and Welfare as a base. Design. A prospective intervention study. Setting. Six day-care centres in Vaxjo, Sweden. Three centres comprised the intervention group and three constituted the control group. Subjects and main outcome measures. The parents and personnel completed a questionnaire on their views concerning information about infectious diseases. During a nine-month period, parents of all children reported every episode of absence, the number of days absent, the cause of absence, and any contact with doctors or prescription of antibiotics. Results. The guidelines were implementable in routine child day-care. Parents found regular information valuable and felt better informed about infectious diseases. Multilevel analyses showed no statistically significant results of the intervention. "Infection-prone'' children had more sickness absence, doctor's consultations, and antibiotic prescriptions than those not "infection-prone''. Conclusion. It is possible to implement an educationally oriented intervention programme directed against infectious diseases in child day-care. No significant effect of the intervention was found, which is why a larger intervention study is needed

Use of health care services and pharmaceutical agents in coeliac disease: a prospective nationwide study

<p>Abstract</p> <p>Background</p> <p>Approximately 1% of the population suffer from coeliac disease. However, the disease is heavily underdiagnosed. Unexplained symptoms may lead to incremented medical consultations and productivity losses. The aim here was to estimate the possible concealed burden of untreated coeliac disease and the effects of a gluten-free diet.</p> <p>Methods</p> <p>A nationwide cohort of 700 newly detected adult coeliac patients were prospectively evaluated. Health care service use and sickness absence from work during the year before diagnosis were compared with those in the general population; the data obtained from an earlier study. Additionally, the effect of one year on dietary treatment on the aforementioned parameters and on consumption of pharmaceutical agents was assessed.</p> <p>Results</p> <p>Untreated coeliac patients used primary health care services more frequently than the general population. On a gluten-free diet, visits to primary care decreased significantly from a mean 3.6 to 2.3. The consumption of medicines for dyspepsia (from 3.7 to 2.4 pills/month) and painkillers (6.8-5.5 pills/month) and the number of antibiotic courses (0.6-0.5 prescriptions/year) was reduced. There were no changes in hospitalizations, outpatient visits to secondary and tertiary care, use of other medical services, or sickness absence, but the consumption of nutritional supplements increased on treatment.</p> <p>Conclusions</p> <p>Coeliac disease was associated with excessive health care service use and consumption of drugs before diagnosis. Dietary treatment resulted in a diminished burden to the health care system and lower use of on-demand medicines and antibiotic treatment. The results support an augmented diagnostic approach to reduce underdiagnosis of coeliac disease.</p> <p>Trial registration</p> <p>ClinicalTrials.gov NCT01145287</p