Association of diverse bacterial communities in human bile samples with biliary tract disorders: a survey using culture and polymerase chain reaction-denaturing gradient gel electrophoresis methods

Bacterial infection is considered a predisposing factor for disorders of the biliary tract. This study aimed to determine the diversity of bacterial communities in bile samples and their involvement in the occurrence of biliary tract diseases. A total of 102 bile samples were collected during endoscopic retrograde cholangiopancreatography (ERCP). Characterization of bacteria was done using culture and polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) methods. Antimicrobial susceptibility of the isolates was determined based on the Clinical and Laboratory Standards Institute (CLSI) guidelines and identity of the nucleotide sequences of differentiated bands from the DGGE gels was determined based on GenBank data. In total, 41.2 (42/102) of the patients showed bacterial infection in their bile samples. This infection was detected in 21 (4/19), 45.4 (5/11), 53.5 (15/28), and 54.5 (24/44) of patients with common bile duct stone, microlithiasis, malignancy, and gallbladder stone, respectively. Escherichia coli showed a significant association with gallstones. Polymicrobial infection was detected in 48 of the patients. While results of the culture method established coexistence of biofilm-forming bacteria (Pseudomonas aeruginosa, E. coli, Klebsiella pneumoniae, Enterococcus spp., and Acinetobacter spp.) in different combinations, the presence of Capnocytophaga spp., Lactococcus spp., Bacillus spp., Staphylococcus haemolyticus, Enterobacter or Citrobacter spp., Morganella spp., Salmonella spp., and Helicobacter pylori was also characterized in these samples by the PCR-DGGE method. Multidrug resistance phenotypes (87.5 ) and resistance to third- and fourth-generation cephalosporins and quinolones were common in these strains, which could evolve through their selection by bile components. Ability for biofilm formation seems to be a need for polymicrobial infection in this organ. © 2016 Springer-Verlag Berlin Heidelber

Sentinel hospital-based surveillance of Rotavirus diarrhea in Iran

Background. Rotavirus is the most common causes of severe, acute diarrhea during childhood and is an important cause of morbidity and mortality in developing countries. We established active hospital-based surveillance of childhood diarrhea to assess the scope of severe rotavirus disease in Iran. Methods. From May 2006 through April 2007, prospective surveillance of rotavirus diarrhea among children aged <5 years was conducted in 5 sentinel hospitals in Iran. Stool samples were tested for rotavirus using a commercially available enzyme immunoassay, and rotavirus-positive samples were genotyped using reverse-transcriptase polymerase chain reaction. Results. Of 2198 children admitted to the hospital for acute gastroenteritis, 1298 (59.1%) had stool samples test positive for rotavirus by enzyme immunoassay. Of the rotavirus episodes, 85% occurred during the first 2 years of life, with the peak prevalence of severe rotavirus disease occurring from September through January. Among the 110 rotavirus-positive samples that were genotyped, G4P[8] was the most commonly detected rotavirus genotype (30.9% of strains). Other commonly detected genotypes included P[8] with G nontypeable (21.8%), G4 with P nontypeable (13.6%), G1[P8] (10.9%), and G2[P4] (5.5%). Conclusions. Rotavirus is the most common cause of severe diarrhea in Iran, which indicates that safe and effective rotavirus vaccination in Iran is a public health priority. © 2009 by the Infectious Diseases Society of America. All rights reserved

Nitazoxanide and doxycycline sensitivity among metronidazole resistant helicobacter pylori isolates from patients with gastritis

Background: Antibiotic therapy should be done based on resistance characteristics of Helicobacter pylori strains to commonly prescribed antibiotics in areas with higher resistance rates. Objectives: This study examined antibacterial activity of nitazoxanide and doxycycline against clinical H. pylori isolates showing different metronidazole resistance levels. Methods: A total of 122 patients, who underwent endoscopy were enrolled in this study from 3 hospitals of Tehran, during November 2014 to July 2015. Helicobacter pylori isolates were obtained from gastric biopsies of the patients after culture in specific culture medium and characterization by both biochemical and molecular methods. Antimicrobial susceptibility to metronidazole was detected using the agar dilution method and minimum inhibitory concentrations of nitazoxanide and doxycycline were determined for metronidazole resistant strains. Results: From a total of 122 gastric biopsy specimens, 55 H. pylori strains were recovered (45). Thirty-three of these strains (60.0) were resistance to metronidazole. MIC50 and MIC90 values for metronidazole were 32 and 64 µg/mL, respectively. MIC50 and MIC90 values for doxycycline and nitazoxanide were measured as 4 and �8 µg/mL, and 8 and �32 µg/mL, respectively. Conclusions: Dominance of high level metronidazole resistance H. pylori strains among the studied patients questioned its usefulness for first-line therapy in Iran. Nitazoxanide and doxycycline showed superior activity against H. pylori strains in comparison to metronidazole, which should be considered for alternative therapies. © 2018, Kowsar Medical Publishing Company. All rights reserved

Adeno-associated virus as a gene therapy vector: strategies to neutralize the neutralizing antibodies

Adeno-associated virus (AAV)-derived vectors are currently the most common type of viral vectors used in gene therapy clinical trials. The presence of neutralizing antibodies (NAbs) against wild-type AAVs in the host body is one of the limitations for the successful use of AAV vectors. AAV capsid manipulation, by which recombinant vectors lose their ability to interact with NAbs, can help overcome this obstacle. Various methods can be used for this purpose, including directed evolution as well as conjugation of certain chemical groups to AAV epitopes. The present review concisely explains the use of AAV vectors in the clinic for gene therapy of some diseases, their limitations, and solutions to these limitations. © 2019, Springer Nature Switzerland AG

Nitazoxanide and doxycycline sensitivity among metronidazole resistant helicobacter pylori isolates from patients with gastritis

Background: Antibiotic therapy should be done based on resistance characteristics of Helicobacter pylori strains to commonly prescribed antibiotics in areas with higher resistance rates. Objectives: This study examined antibacterial activity of nitazoxanide and doxycycline against clinical H. pylori isolates showing different metronidazole resistance levels. Methods: A total of 122 patients, who underwent endoscopy were enrolled in this study from 3 hospitals of Tehran, during November 2014 to July 2015. Helicobacter pylori isolates were obtained from gastric biopsies of the patients after culture in specific culture medium and characterization by both biochemical and molecular methods. Antimicrobial susceptibility to metronidazole was detected using the agar dilution method and minimum inhibitory concentrations of nitazoxanide and doxycycline were determined for metronidazole resistant strains. Results: From a total of 122 gastric biopsy specimens, 55 H. pylori strains were recovered (45). Thirty-three of these strains (60.0) were resistance to metronidazole. MIC50 and MIC90 values for metronidazole were 32 and 64 µg/mL, respectively. MIC50 and MIC90 values for doxycycline and nitazoxanide were measured as 4 and �8 µg/mL, and 8 and �32 µg/mL, respectively. Conclusions: Dominance of high level metronidazole resistance H. pylori strains among the studied patients questioned its usefulness for first-line therapy in Iran. Nitazoxanide and doxycycline showed superior activity against H. pylori strains in comparison to metronidazole, which should be considered for alternative therapies. © 2018, Kowsar Medical Publishing Company. All rights reserved

Proinflammatory cytokines and thrombomodulin in patients with peptic ulcer disease and gastric cancer, infected with Helicobacter pylori

Backgrounds: Helicobacter pylori infect more than half of the global population. It is suggested to be related with gastritis, peptic ulcer disease (PUD), and gastric cancer. Aims: The aim of this present study was to evaluate proinflammatory cytokines including interleukin 1, 6, 8, 10, and thrombomodulin in H. pylori-infected patients with PUD and gastric cancer. Patients: This cross-sectional study was conducted in Taleghani Hospital on 111 patients with H. pylori infection. Materials and Methods: Patients were divided into three groups of PUD, cancer, and control (normal on endoscopy), according to the results of endoscopy. The serum levels of interleukins 1, 6, 8, and 10 and thrombomodulin was determined using enzyme-linked immunosorbent assay (ELISA) technique. H. pylori infection was diagnosed by histological examination of the endoscopic biopsy. Results: One hundred eleven patients were included in the study; 30 as PUD group, 30 as gastric cancer group, and 51 as controls. There was no significant difference between the means of IL-1 and IL-10 levels among the three groups (P = 0.744 and 0.383, respectively). IL-6, IL-8, and thrombomodulin levels were found to be statically different among the three groups (P < 0.05). The level of IL-6, IL-8, and thrombomodulin in cancer group was significantly higher than PUD and control groups (P < 0.05). Conclusion: There is a significant association between H. pylori infection and serum IL-6, IL-8, and thrombomodulin but such relation is not present between H. pylori and IL-1 and IL-10. Immunity response (IL-6, IL-8 and thrombomodulin) is more severe in cancer patient than PUD

Evaluation of the effects of pycnogenol (French maritime pine bark extract) supplementation on inflammatory biomarkers and nutritional and clinical status in traumatic brain injury patients in an intensive care unit: A randomized clinical trial protocol

Background: Traumatic brain injury (TBI) is one of the major health and socioeconomic problems in the world. Immune-enhancing enteral formula has been proven to significantly reduce infection rate in TBI patients. One of the ingredients that can be used in immunonutrition formulas to reduce inflammation and oxidative stress is pycnogenol. Objective: The objective of this work is to survey the effect of pycnogenol on the clinical, nutritional, and inflammatory status of TBI patients. Methods: This is a double-blind, randomized controlled trial. Block randomization will be used. An intervention group will receive pycnogenol supplementation of 150 mg for 10 days and a control group will receive a placebo for the same duration. Inflammatory status (IL-6, IL- 1β, C-reactive protein) and oxidative stress status (malondialdehyde, total antioxidant capacity), at the baseline, at the 5th day, and at the end of the study (10th day) will be measured. Clinical and nutritional status will be assessed three times during the intervention. The Sequential Organ Failure Assessment (SOFA) questionnaire for assessment of organ failure will be filled out every other day. The mortality rate will be calculated within 28 days of the start of the intervention. Weight, body mass index, and body composition will be measured. All analyses will be conducted by an initially assigned study arm in an intention-to-treat analysis. Discussion: We expect that supplementation of 150 mg pycnogenol for 10 days will improve clinical and nutritional status and reduce the inflammation and oxidative stress of the TBI patients. Trial registration: This trial is registered at clinicaltrials.gov (ref: NCT03777683) at 12/13/2018. © 2020 The Author(s)

Insulin and insulin receptor gene polymorphisms and susceptibility to nonalcoholic fatty liver disease Insulina e polimorfismos do gene do receptor de insulina e a suscetibilidade à doença hepática gordurosa não alcoólica

Background � Nonalcoholic fatty liver disease (NAFLD) is an increasing global health concern defined by excessive hepatic fat content in the absence of excessive alcohol consumption. Objective � Given the pivotal role of insulin resistance in NAFLD, we hypothesized that insulin (INS) and insulin receptor (INSR) gene polymorphisms may be associated with NAFLD risk. Methods � A total of 312 subjects, including 153 cases with biopsy-proven NAFLD and 159 controls were enrolled in this case-control study. Four polymorphisms in INS (rs3842752, rs689) and INSR (rs1052371, rs1799817) genes were genotyped using PCR-RFLP method. Results � The cases with NAFLD were older and had higher BMI, systolic blood pressure, diastolic blood pressure, as well as higher serum levels of aspartate aminotransferase, alanine aminotransferase, and gamma glutamyl transferase than the controls (P<0.001). The �TT� genotype of INSR rs1799817 compared with �CC� genotype occurred more frequently in the controls than the cases with NAFLD and the difference remained significant after adjustment for confounding factors (P=0.018; OR=0.10, 95CI=0.02�0.76). However, no significant difference was found for INS rs3842752, INS rs689, and INSR rs1052371 gene polymorphisms between the cases with NAFLD and the controls either before or after adjustment for the confounders. Conclusion � These findings corroborate the hypothesis that genetic polymorphisms related to insulin resistance play a role in NAFLD susceptibility. Specifically, the INSR rs1799817 �TT� genotype had a protective effect for NAFLD. However, our results remain to be validated in other studies. © 2020, IBEPEGE - Inst. Bras. Estudos Pesquisas Gastroent. All rights reserved

Description of the inflammatory bowel disease natural history in Tehran province, Iran: Mixed panel approaches

Aim: Description of the inflammatory bowel disease natural history in Tehran province. Conclusion: Panel approaches have the potential efficacy to tackle the unpredictable clinical course of IBD (UC/CD). Hence, we highly recommend that our findings be included into the Iranian routine clinical environment of IBD and/or that related studies be conducted in Iran and other regions to gain a better understanding of the natural history of IBD