1
|
El Mouzan MI, Assiri AA, Al Sarkhy AA, Alasmi MM. Gut virome profile in healthy Saudi children. Saudi J Gastroenterol 2023:370179. [PMID: 36814173 DOI: 10.4103/sjg.sjg_444_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
Background The role of viruses is well known in health and disease. The aim of this report was to describe the profile of viruses in the gut of healthy Saudi children. Methods In 20 randomly selected school age children from Riyadh, stool samples were collected in cryovials and stored at -80° C. At the time of analysis, the samples were sent by express mail in a temperature-controlled container to the laboratory in the USA, Viral DNA was isolated and shotgun metagenomic sequencing was performed. The abundance of each organism was expressed as an average relative percentage across the viral phylogenetic tree from phyla to species. Results The median age of the children was 11.3 (range 6.8-15.4) years, and 35% were males. Caudovirales were the most abundant bacteriophage order (77%) and Siphoviridae, Myoviridae, and Podoviridae families predominated, accounting for 41%, 25%, and 11%, respectively. Among the viral bacteriophage species, the most abundant were the Enterobacteria phages. Conclusion The profile and abundance of the gut virome in healthy Saudi children reveal important differences from the literature. Further studies from different populations with larger sample sizes are needed to understand the role of gut viruses in the pathogenesis of disease in general and in the response to fecal microbiota therapy in particular.
Collapse
Affiliation(s)
- Mohammad I El Mouzan
- Department of Pediatrics, Gastroenterology Unit, College of Medicine and King Saud University Medical City, King Khaled University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Asaad A Assiri
- Department of Pediatrics, Gastroenterology Unit, College of Medicine and King Khaled University Hospital, Prince Abdullah Bin Khalid Celiac Disease Research Chair, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Ahmed A Al Sarkhy
- Department of Pediatrics, Gastroenterology Unit, College of Medicine, King Khaled University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Mona M Alasmi
- Department of Pediatrics, Gastroenterology Unit, King Saud University Medical City, King Khaled University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia
| |
Collapse
|
2
|
El Mouzan MI, Winter HS, Al Sarkhy AA, Korolev K, Menon R, Assiri AA. Bacterial dysbiosis predicts the diagnosis of Crohn's disease in Saudi children. Saudi J Gastroenterol 2021; 27:144-148. [PMID: 33642351 PMCID: PMC8265402 DOI: 10.4103/sjg.sjg_409_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Studies have reached different conclusions regarding the accuracy of dysbiosis in predicting the diagnosis of Crohn's disease (CD). The aim of this report is to assess the utility of mucosal and fecal microbial dysbiosis as predictors in the diagnosis of this condition in Saudi children. METHODS Tissue and fecal samples were collected prospectively from children with final diagnosis of CD and from controls. Bacterial DNA was extracted and sequenced using Illumina MiSeq chemistry. The abundance and diversity of bacteria in tissue and fecal samples were determined in relation to controls. Sparse logistic regression was calculated to predict the diagnosis of CD based on subject's microbiota profile. RESULTS There were 17 children with CD and 18 controls. All children were Saudis. The median age was 13.9 and 16.3 years for children with CD and controls respectively. Sex distribution showed that 11/17 (65%) of the CD and 12/18 (67%) of the control subjects were boys. The mean area under the curve (AUC) was significantly higher in stool (AUC = 0.97 ± 0.029) than in tissue samples (AUC = 0.83 ±0.055) (P < 0.001). CONCLUSIONS We found high AUC in mucosal and fecal samples. The higher AUC for fecal samples suggests higher accuracy in predicting the diagnosis of CD.
Collapse
Affiliation(s)
- Mohammad I. El Mouzan
- Department of Pediatrics, Gastroenterology Division, King Saud University, Riyadh, Kingdom of Saudi Arabia,Address for correspondence: Prof. Mohammad I. El Mouzan, Department of Pediatrics, King Saud University, P O Box 2925, Riyadh 11461, Kingdom of Saudi Arabia. E-mail:
| | | | - Ahmed A. Al Sarkhy
- Department of Pediatrics, Gastroenterology Division, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Kirill Korolev
- Department of Physics, Bioinformatics Program, Boston University, MA, USA
| | - Rajita Menon
- Department of Physics, Boston University, Boston, MA, Boston, USA
| | - Asaad A. Assiri
- Department of Pediatrics, Gastroenterology Division, Supervisor, Prince Abdullah Bin Khalid Celiac Disease Research Chair, King Saud University, Riyadh, Kingdom of Saudi Arabia
| |
Collapse
|
3
|
El Mouzan MI, AlEdreesi MH, Hasosah MY, Al-Hussaini AA, Al Sarkhy AA, Assiri AA. Regional variation of pediatric inflammatory bowel disease in Saudi Arabia: Results from a multicenter study. World J Gastroenterol 2020; 26:416-423. [PMID: 32063690 PMCID: PMC7002901 DOI: 10.3748/wjg.v26.i4.416] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 12/31/2019] [Accepted: 01/09/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Incidence and severity variations of inflammatory bowel disease (IBD) have been reported from Western populations between continents and regions of the same countries. However, no data were available from other countries.
AIM To investigate the regional differences in the IBD profiles of pediatric patients from the Kingdom of Saudi Arabia.
METHODS Data from a national multicenter IBD study were used. The incidence, time trend, and clinical presentation of Crohn’s disease (CD) and ulcerative colitis (UC) in the Central region (CR), Western region (WR), and Eastern region (ER) were analyzed and compared. Statistical analysis included Poisson regression analysis for incidence variation and Chi-square test for demographic and clinical parameters. A P < 0.05 was considered significant.
RESULTS The prevalence of positive family history was lower in children with CD from the ER than the CR or the WR. Consanguinity rate was higher in children with CD and UC from the CR and the ER, respectively. The incidences and time trends of CD and UC were not significantly different between regions. In the ER, a significantly higher percentage of children with CD presented with abdominal pain (P < 0.001), blood in stools (P = 0.048), stricturing or penetrating disease (P = 0.029), higher erythrocyte sedimentation rate (P < 0.001), higher C-reactive protein (P < 0.001), higher anemia (P = 0.017), and lower albumin level (P = 0.014). For children with UC from the ER, a significantly higher percentage presented with anemia (P = 0.006) and a lower percentage with pancolitis (P < 0.001).
CONCLUSION The most important finding is the identification of significantly more severe presentation of CD in the ER of the Kingdom of Saudi Arabia. Prospective studies are needed to explain such variations.
Collapse
Affiliation(s)
- Mohammad I El Mouzan
- Department of Pediatrics, Gastroenterology Unit, King Saud University, Riyadh11461, Saudi Arabia
| | - Mohammed H AlEdreesi
- Specialty Pediatrics Division, Pediatric Gastroenterology, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
| | - Mohammed Y Hasosah
- Department of Pediatrics, Gastroenterology Unit, King Saud bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia
| | | | - Ahmad A Al Sarkhy
- Department of Pediatrics, Gastroenterology Unit, King Saud University, Riyadh11461, Saudi Arabia
| | - Asaad A Assiri
- Department of Pediatrics, Gastroenterology Unit, King Saud University, Riyadh11461, Saudi Arabia
- Supervisor of Prince Abdullah Bin Khalid Celiac Disease Research Chair, Gastroenterology Unit, King Saud University, Riyadh 11461, Saudi Arabia
| |
Collapse
|
4
|
El Mouzan MI, AlSaleem BI, Hasosah MY, Al-Hussaini AA, Al Anazi AH, Saadah OI, Al Sarkhy AA, Al Mofarreh MA, Assiri AA. Diagnostic delay of pediatric inflammatory bowel disease in Saudi Arabia. Saudi J Gastroenterol 2019; 25:257-261. [PMID: 30971589 PMCID: PMC6714469 DOI: 10.4103/sjg.sjg_457_18] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/AIM Delay in the diagnosis of inflammatory bowel disease (IBD) is associated with complications. Our aim was to describe the pattern and risk factors associated with delay in the diagnosis of IBD in Saudi children. PATIENTS AND METHODS This was a multicenter study with a retrospective/prospective design. Data on diagnostic delay in children with Crohn's disease (CD) and ulcerative colitis (UC) were retrieved from physician's notes. Multivariate regression analysis was used to assess the risk factors associated with long delay in diagnosis. RESULTS There were 240 and 183 Saudi children with CD and UC, respectively. The median delays in diagnosis were 8 and 5 months in CD and UC, respectively, significantly longer in children with CD than UC (P < 0.001). Long diagnostic delays (>75th percentile) were 24 and 8.8 months for CD and UC, respectively. Ileal location was a significant risk factor in CD and the age of onset above 10 years was protective in UC. CONCLUSIONS Long diagnostic delay in IBD was mainly due to the longer delay in gastroenterologist consultation. Review of the referral system is needed to focus on measures to reduce long delays in diagnosis. The ileal location as a risk factor in CD and age older than 10 years as protective in UC should help recognition and early referral.
Collapse
Affiliation(s)
- Mohammad I. El Mouzan
- Department of Pediatrics, Division of Gastroenterology and Head, Pediatric IBD Research Group, King Saud University, Riyadh, Kingdom of Saudi Arabia,Address for correspondence: Prof. Mohammad I. El Mouzan, Department of Pediatrics, College of Medicine, King Saud University, Riyadh - 11461, Kingdom of Saudi Arabia. E-mail:
| | - Badr I. AlSaleem
- Division of Gastroenterology, The Children Hospital, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed Y. Hasosah
- Department of Pediatrics, Division of Gastroenterology, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Kingdom of Saudi Arabia
| | - Abdulrahman A. Al-Hussaini
- Division of Gastroenterology, The Children Hospital, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Aziz H. Al Anazi
- Department of Pediatrics, Division of Gastroenterology, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Kingdom of Saudi Arabia
| | - Omar I. Saadah
- Department of Pediatrics, Faculty of Medicine and Inflammatory Bowel Disease Research Group, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Ahmed A. Al Sarkhy
- Department of Pediatrics, Division of Gastroenterology, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | | | - Asaad A. Assiri
- Department of Pediatrics, Division of Gastroenterology and Prince Abdullah Bin Khalid Celiac Disease Research Chair, King Saud University, Riyadh, Kingdom of Saudi Arabia
| |
Collapse
|
5
|
El Mouzan MI, Korolev KS, Al Mofarreh MA, Menon R, Winter HS, Al Sarkhy AA, Dowd SE, Al Barrag AM, Assiri AA. Fungal dysbiosis predicts the diagnosis of pediatric Crohn’s disease. World J Gastroenterol 2018; 24:4510-4516. [PMID: 30356965 PMCID: PMC6196340 DOI: 10.3748/wjg.v24.i39.4510] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/03/2018] [Accepted: 10/05/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the accuracy of fungal dysbiosis in mucosa and stool for predicting the diagnosis of Crohn’s disease (CD).
METHODS Children were prospectively enrolled in two medical centers: one university hospital and one private gastroenterology clinic in the city of Riyadh, Kingdom of Saudi Arabia. The children with confirmed diagnosis of CD by standard guidelines were considered cases, and the others were considered non-inflammatory bowel disease controls. Mucosal and stool samples were sequenced utilizing Illumina MiSeq chemistry following the manufacturer’s protocols, and abundance and diversity of fungal taxa in mucosa and stool were analyzed. Sparse logistic regression was used to predict the diagnosis of CD. The accuracy of the classifier was tested by computing the receiver operating characteristic curves with 5-fold stratified cross-validation under 100 permutations of the training data partition and the mean area under the curve (AUC) was calculated.
RESULTS All the children were Saudi nationals. There were 15 children with CD and 20 controls. The mean age was 13.9 (range: 6.7-17.8) years for CD children and 13.9 (3.25-18.6) years for controls, and 10/15 (67%) of the CD and 13/20 (65%) of the control subjects were boys. CD locations at diagnosis were ileal (L1) in 4 and colonic (L3) in 11 children, while CD behavior was non-stricturing and non-penetrating (B1) in 12 and stricturing (B2) in 3 children. The mean AUC for the fungal dysbiosis classifier was significantly higher in stools (AUC = 0.85 ± 0.057) than in mucosa (AUC = 0.71 ± 0.067) (P < 0.001). Most fungal species were significantly more depleted in stools than mucosal samples, except for Saccharomyces cerevisiae and S. bayanus, which were significantly more abundant. Diversity was significantly more reduced in stools than in mucosa.
CONCLUSION We found high AUC of fungal dysbiosis in fecal samples of children with CD, suggesting high accuracy in predicting diagnosis of CD.
Collapse
Affiliation(s)
| | - Kirill S Korolev
- Bioinformatics Program, Boston University, Boston, MA 02215, United States
| | | | - Rajita Menon
- Bioinformatics Program, Boston University, Boston, MA 02215, United States
| | - Harland S Winter
- MassGeneral Hospital for Children, Boston, MA 02114, United States
| | - Ahmad A Al Sarkhy
- Department of Pediatrics, King Saud University, Riyadh 11461, Saudi Arabia
| | | | - Ahmad M Al Barrag
- Department of Microbiology, King Saud University, Riyadh 11461, Saudi Arabia
| | - Asaad A Assiri
- Department of Pediatrics, Supervisor of Prince Abdullah Bin Khalid Celiac Disease Research Chair, King Saud University, Riyadh 11461, Saudi Arabia
| |
Collapse
|
6
|
Abstract
AIM To assess the incidence and associated signs and symptoms of patients with keratoconus in Asir Province, Saudi Arabia. METHODS 125 new keratoconus patients (51 male, 74 female; mean age 18.5 (SD 3.8) years; range 8--28 years) were recruited from referrals to the department of ophthalmology, Asir Central Hospital, over a 1 year period. Age, visual acuity, and keratometry were recorded along with clinical signs and symptoms. RESULTS The incidence of keratoconus in Asir Province is 20 cases per 100,000 population. Also, the disease severity is high, as indicated by an early mean age (17.7 (3.6) years) with advanced stage keratoconus. Visual acuity, with either spectacles or rigid contact lenses, was 6/12 or better in 98% of eyes measured. Just over half (56%) of patients had atopic ocular disease. 16% of patients had a positive family history of the disease and 16% had atopic dermatitis (eczema and/or vitiligo). CONCLUSION The incidence and severity of keratoconus in Asir Province, Saudi Arabia, is high with an early onset and more rapid progress to the severe disease stage at a young age. This might reflect the influence of genetic and/or environmental factor(s) in the aetiology of keratoconus.
Collapse
Affiliation(s)
- A A Assiri
- Cardiff University, School of Optometry and Vision Sciences, Cathays Park, Cardiff CF10 3NB, UK.
| | | | | | | |
Collapse
|
7
|
Hicks BA, Etter SJ, Carnahan KG, Joyce MM, Assiri AA, Carling SJ, Kodali K, Johnson GA, Hansen TR, Mirando MA, Woods GL, Vanderwall DK, Ott TL. Expression of the uterine Mx protein in cyclic and pregnant cows, gilts, and mares. J Anim Sci 2003; 81:1552-61. [PMID: 12817504 DOI: 10.2527/2003.8161552x] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Pregnancy and interferon-tau (IFN tau) upregulate uterine Mx gene expression in ewes; however, the only known role for Mx is in the immune response to viral infection. We hypothesize that Mx functions as a conceptus-induced component of the anti-luteolytic mechanism and/or regulator of endometrial secretion or uterine remodeling during early pregnancy. This study was conducted to determine the effects of early pregnancy on uterine Mx expression in domestic farm species with varied mechanisms of pregnancy recognition. Endometrium from cows, gilts, and mares was collected during the first 20 d of the estrous cycle or pregnancy, and total messenger RNA (mRNA) and protein were analyzed for steady-state levels of Mx mRNA and protein. Northern blot analysis of Mx mRNA detected an approximately 2.5 Kb of mRNA in endometrium from each species. In pregnant cows, steady-state levels of Mx mRNA increased 10-fold (P < 0.05) above levels observed in cyclic cows by d 15 to 18. In cyclic gilts, slot blot analysis indicated that endometrial Mx mRNA levels did not change between d 5 and 18 of the cycle. However, in pregnant gilts, Mx levels tended (P = 0.06) to be elevated two-fold on d 16 only, and in situ hybridization indicated that this increase occurred in the stroma. In mares, Mx mRNA was low, but detectable, and did not change between ovulation (d 0) and d 20, regardless of reproductive status. Western blot analysis revealed multiple immunoreactive Mx protein bands in each species. One band was specific to pregnancy in cows. As in ewes, in situ hybridization analysis indicated that Mx mRNA was strongly expressed in the luminal epithelium, stroma, and myometrium by d 18 in cows. However, on d 14 in gilts, Mx was expressed primarily in the stroma, and on d 14 in mares, low levels of Mx expression were confined largely to the luminal epithelium. The uteruses of cows, gilts, and mares express Mx, and expression is upregulated during pregnancy in cows and gilts--animals whose conceptuses secrete interferons during early pregnancy, but that possess different mechanisms for pregnancy recognition.
Collapse
Affiliation(s)
- B A Hicks
- Department of Animal and Veterinary Science, Center for Reproductive Biology, University of Idaho, Moscow 83844, USA
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|