Long and Short-terms Effects of Ablative Fractional Laser Therapy on Human Skin: A Network Analysis

Introduction: Time-dependent effects of laser radiation have been investigated by researchers. An understanding of the molecular mechanism of the time course effect of the laser needs molecular assessment and function evaluation of the related genes. In the present study, the importance of repetition of treatment after 4 weeks and gene expression alteration after 7 days of laser radiation versus one day on the human skin was evaluated via protein-protein interaction (PPI) network analysis and gene ontology enrichment. Methods: The differentially expressed genes (DEGs) were extracted from Gene Expression Omnibus (GEO) and assessed via PPI network analysis. The critical DEGs were enriched via gene ontology. The related biological processes and biochemical pathways were retrieved from "GO-Biological process" and "Kyoto Encyclopedia of Genes and Genomes" (KEGG) respectively. Results: The repetition of laser therapy after 4 weeks of the first treatment did not have a significant effect on treatment efficacy. Sixty-three significant DEGs and six classes of biological terms discriminated the samples seven days after the treatment from individuals one day after the treatment. The studied DEGs were organized into two clusters with certain functions. Conclusion: Based on the findings after laser therapy, several days are required to complete the critical processes such as DNA biosynthesis and skin cornification.

Introducing Critical Genes in Response to Photodynamic Therapy: A Network Analysis

Introduction: Photodynamic therapy (PDT) is applied as an efficient method for preventing the progress of cancers. Light and a photosensitive compound which is known as photosensitizer (PS) are the main parts of PDT. In the present study, molecular events after using PDT in the presence of a super lethal dose of a PS were assessed via protein-protein interaction (PPI) analysis. Methods: Data were extracted from Gene Expression Omnibus (GEO). The gene expression profiles of the treated human Sk-Cha1 cells via PDT were compared with the control cells. Expressed change analysis and PPI network analysis were administrated via Cytoscape software v 3.7.2 to find the critical differentially expressed genes (DEGs). Regulatory relationships between the central DEGs were evaluated and the highlighted genes were identified. Results: The significant amounts of gene expression values were grouped and a few DEGs characterized by tremendously expressed values were identified. EGFR, CANX, HSPA5, MYC, JUN, ITGB1, APP, and CDH1 were highlighted as hub-bottleneck DEGs. EGFR, CDH1, and JUN appeared as a set of SEGs, which play a crucial role in response to PDT in the treated Sk-Cha1 cells. Conclusion: In conclusion, regulatory relationships between EGFR, CDH1, and JUN, which have an effect on the regulation of cellular survival, differentiation, and proliferation, were highlighted in the present investigation.

Evaluating Serum Proteome in Women with Obsessive-Compulsive Disorder/Bipolar Disorder Compared to Pure Obsessive- Compulsive Disorder Subjects and Healthy Controls

Objectives

The present study aimed to evaluate the serum proteome of women with obsessive-compulsive disorder (OCD)/bipolar disorder (BP) compared to pure OCD subjects and healthy controls.

Materials & Methods

Serum proteome of women with OCD/BP, pure OCD individuals, and healthy controls were subjected to 2DE-based proteomics accompanied with MALDI-TOF-TOF mass spectrometry. Further evaluation of the identified protein spots with the significance of p<0.05 and fold≥1.5 was done by applying protein interaction mapping via Cytoscape v. 5.3.1 and its plugins.

Results

The results indicate that vitamin D binding protein (GC) and haptoglobin spots (HP) significantly changed expression in OCD and OCD/BP with different expression patterns. These identified spots may contribute to OCD/BP and act as differentially recognized biomarkers comparing pure OCD and OCD/BP.

Conclusion

The Findings imply that these proteins in the serum of the patients could be potential distinguishable biomarkers in clinical usage after related validation experiments. Therefore, this study provides a preliminary evaluation to understand OCD/BP proteome behavior better.

Network Analysis of Effect of Light-Dark Time Ratio on the Gene Expression Profile of Mouse Skin

Introduction: Circadian rhythms refer to daily cyclic events such as activity and rest in biology. A protein-based core related to the mechanism of circadian is identified. In the present study, the gene expression profiles of mouse skin in different conditions of light-dark times were investigated via protein-protein interaction (PPI) analysis to explore the main affected genes. Methods: GSE174155 was derived from Gene Expression Omnibus (GEO) and was analyzed via GEO2R to find the significant differentially expressed genes (DEGs). The gene expression profiles of Cry-null (genotype: cryptochrome-1(-/-): crytochrome-2 (-/-)) mouse skin versus the wild-type samples in the various circadian times (CTs) were assessed. The queried DEGs plus 50 first neighbors were included in a PPI network via the STRING database by Cytoscape software. The networks were analyzed and the central nodes were evaluated. Results: Three groups of mice based on CTs were identified. 15, 15, and 14 central nodes were determined as central nodes for the analyze networks. There was not a common central node for the analyzed networks. Conclusion: It was pointed out that the light/dark time ratio had a gross effect on the gene expression profile of the skin in the mice. Results imply more investigations to suggest a standard protocol related to CT, considering human lifestyle and exploring suitable protective methods for the jobs which are fixed in the abnormal CT sets.

Introducing Protein Homeostasis and Glycogen Synthesis as Two Targets of Blue Light Radiation in Lentinula edodes

Introduction: There are documents about the biological effects of blue light radiation on different organisms. An understanding of the molecular mechanism of radiation effects on biological samples is an important event which has attracted researchers' attention. Determining the critical dysregulated proteins of Lentinula edodes following blue light radiation is the aim of this study. Methods: 22 differentially expressed proteins of L. edodes in response to 300 lux of blue light were extracted from the related literature. Experimental, text mining and co-expression connections between the queried proteins were assessed via the STRING database. The maps were compared and the critical proteins were identified. Results: Among the 21 queried proteins, six individuals including heat shock HSP70 protein, 20S proteasome subunit, 26S proteasome subunit P45, Aspartate aminotransferase, phosphopyruvate hydratase, and phosphoglucomutase were highlighted as the critical proteins in response to blue light radiation. Conclusion: The finding indicates that protein homeostasis and glycogen synthesis are affected by blue light radiation. Due to the critical roles of proteins as enzymes and structural elements in life maintenance and involvement of glycogen synthesis in energy consumption, blue light radiation can be considered as a life promotional agent in future investigations.

Assessment of Immunological Effects of Low-Level Er: YAG Laser Radiation

Introduction: Low-level laser radiation has a significant effect on cell proliferation. Various investigations into the effect of Er: YAG laser on the treated cell lines have been published. Determining core targeted proteins is an attractive subject. This research aimed at identifying the critical targeted protein by a low-level Er: YAG laser in primary osteoblast-like cells. Methods: Data were extracted from the literature about proteomic assessment of 3.3 J/cm² of low-level Er: YAG laser radiation on osteoblast-like cells of rat calvaria. The significant differentially expressed proteins plus 100 first neighbors were analyzed via network analysis and gene ontology enrichment. Results: Nine differentially expressed proteins among the 12 queried proteins were included in the main connected component. Analysis revealed that Cxcl1 was a key targeted protein in response to laser radiation. The presence of Cxcl1 in the significant cellular pathways indicated that cell growth and proliferation were affected. Conclusion: It can be concluded that the immune system is affected by the laser to activate cellular defense against stress.

Assessment of Post-Radiation Time Effect on Gene Expression Profiles of Saccharomyces cerevisiae Samples After Appling a UV Laser

Introduction: Widespread application of lasers in different fields of medicine implies more investigations into the molecular mechanism of laser effects on the human body. Network analysis of the dysregulated genes of Saccharomyces cerevisiae samples are irradiated by a UV laser and harvested 30 minutes after radiation compared with a 15-minute group is the aim of this research. Methods: The significant dysregulated genes interacted via the STRING database, and the central nodes were determined by "Networkanalyzer" application of Cytoscape software. The critical genes and the related biological terms were identified via action map analysis and gene ontology assessment. Results: The gene expression profiles of the samples with 30-minute post-radiation time were different from the samples with 15 minutes of post-radiation time. 9 potent central genes, 50% of which were similar to the nodes of the 15-minute group, were identified. The terms "positive regulation of telomere maintenance" were targeted in the two sample groups. Conclusion: In spite of large alteration in the gene expression profiles of the samples, the results indicated that the main affected biological term for the 15-minute and 30-minute groups was similar.

Exploring the Reversible Effects of UV Laser Radiation on the Gene Expression Profiles of Saccharomyces cerevisiae Via Network Analysis

Introduction: The reversibility of biological processes is an important challenge in the study of environmental pollutants and also natural and artificial radiation. There are many pieces of evidence about the reversible and irreversible effects of UV radiation on the human body. Assessment of the reversibility of UV laser effects on Saccharomyces cerevisiae was the aim of this study. Methods: Gene expression alteration in S. cerevisiae samples radiated by a 30s UV laser for 15, 30, and 60 minutes post-radiation times were investigated via network analysis to explore time-dependent reversible alteration in the gene expression profiles of the samples. Results: 19 differentially expressed genes (DEGs) were identified as targeted genes for the samples which were harvested 60 minutes after radiation; network analysis revealed no significant alteration in biological processes. Conclusion: It can be concluded that the gross effects of the UV laser on S. cerevisiae samples disappear after 60 minutes of radiation.

Effect of UV Laser Radiation on "Positive Regulation of Telomere Maintenance" in Saccharomyces cerevisiae

Introduction: Excessive exposure to ultraviolet (UV) radiation may cause a variety of skin cancers and damage to the eye lens. The assessment of different aspects of UV damage has attracted researchers’ interest. UV radiation to simple biological models such as Saccharomyces cerevisiae of yeast family could help to find out different molecular changes resulting from radiation. The assessment and network analysis of gene expression data about yeast cells radiated by the UV laser was the aim of this study. Methods: The gene expression profiles of S. cerevisiae samples in the presence of the UV laser at 30 seconds radiation and 15 minutes’ post-radiation time are compared with the control profiles. The significant expressed genes interacted and the central nodes and related biological terms were identified. Results: The main connected component of the network including 427 nodes was analyzed and 11 central differentially expressed genes (DEGs) were determined. RPN11, UBI4, HSP82, and HSC82 as critical DEGs and "positive regulation of telomere maintenance" as a related biological term were introduced. Conclusion: The finding has provided a new perspective on laser application in the rejuvenation process. It seems that the laser can be used as a suitable agent against the aging process which is a limiting factor in human life.

EGR1 Is a Critical Gene in Response of Human Keratinocyte to Blue Light Radiation

Introduction: Investigating the molecular mechanism of cellular response to light radiation has attracted many researchers’ attention. In the present study, the critically affected gene by 7.5 min blue light radiation in human keratinocytes was investigated via network analysis. Methods: Gene expression profiles of human keratinocytes exposed to 7.5 min blue light radiation plus controls were extracted from Gene Expression Omnibus (GEO). The significant dysregulated genes plus 100 first neighbors were investigated by Cytoscape software and its applications. The central nodes of the network based on four centrality parameters were determined and discussed. Results: Among 6 significant dysregulated genes, 4 individuals were recognized by the STRING database. The network was constructed by using the 4 queried genes and 100 first neighbors. EGR1, STAT1, and ISG15 were identified as central nodes; however, the prominent role of EGR1 was highlighted. Conclusion: EGR1 appeared as a critically affected gene after blue light irradiation. It seems that this upregulated gene is responsible for protecting human keratinocytes against stress and cancer. Therefore, the application of blue light may be accompanied by antistress effects in the human body.

Predicting Radioresistant Biomarkers in Nasopharyngeal Carcinoma Patients Via Protein-Protein Interaction Network Analysis

Introduction: Radiotherapy as the first-line nasopharyngeal carcinoma (NPC) treatment provides different responses including radioresistant and radiosensitive states. In order to investigate the molecular basis of radioresistancy, protein-protein interaction network analysis of proteome data prior to therapy was performed. Methods: 20 dysregulated proteins of the patients who were radioresistant were extracted from the literature. Cytoscape and its plug-ins were used for the resistant network construction and its centrality analysis. Furthermore, ClueGO+ CluePedia application determined the most statistically significant biological processes (BP) related to the hubs. Results: Fourteen hubs were concluded and no differentially expressed protein (DEP) was among these agents. Among the hubs, albumin (ALB) and fibronectin (FN1) were the hub-bottlenecks, and the Serpin family was present. What is more, SERPIND1 was the highest degree-valued DEP in the network. Conclusion: It can be concluded that the central elements of the NPC network could be noteworthy for improving the radiotherapy outcome and overcoming its limitations. However, complementary studies are required for a better understanding of their major role.

The role of dimensionality and geometry in quench-induced nonequilibrium forces

We present an analytical formalism, supported by numerical simulations, for studying forces that act on curved walls following temperature quenches of the surrounding ideal Brownian fluid. We show that, for curved surfaces, the post-quench forces initially evolve rapidly to an extremal value, whereafter they approach their steady state value algebraically in time. In contrast to the previously-studied case of flat boundaries (lines or planes), the algebraic decay for curved geometries depends on the dimension of the system. Specifically, steady-state values of the force are approached in time ast^-d/2ind-dimensional spherical (curved) geometries. For systems consisting of concentric circles or spheres, the exponent does not change for the force on the outer circle or sphere. However, the force exerted on the inner circles or sphere experiences an overshoot and, as a result, does not evolve to the steady state in a simple algebraic manner. The extremal value of the force also depends on the dimension of the system, and originates from curved boundaries and the fact that particles inside a sphere or circle are locally more confined, and diffuse less freely than particles outside the circle or sphere.

Fibrinogen Dysregulation is a Prominent Process in Fatal Conditions of COVID-19 Infection; a Proteomic Analysis

INTRODUCTION

Molecular pathophysiology of COVID-19 is not completely known. Expression changes in patients' plasma proteins have revealed new information about the disease. Introducing the key targeted plasma protein in fatal conditions of COVID-19 infection is the aim of this study.

METHODS

Significant differentially expressed proteins (DEPs) in the plasma of cases with a fatal condition of COVID-19 were extracted from an original article. These proteins were included in a network via STRING database along with 100 first neighbor proteins to determine central nodes of the network for analyzing.

RESULTS

Queried and added proteins were included in a scale free network. Three hub nodes were identified as critical target proteins. The top queried hub proteins were chains of fibrinogen; Fibrinogen Alpha chain (FGA), Fibrinogen gamma chain (FGG), and Fibrinogen beta chain (FGB), which are related to the coagulation process.

CONCLUSIONS

It seems that fibrinogen dysregulation has a deep impact on the fatality of COVID-19 infection.

Bioinformatics Investigation and Contribution of Other Chromosomes Besides Chromosome 21 in the Risk of Down Syndrome Development

INTRODUCTION

Down syndrome as a genetic disorder is a popular research topic in molecular studies. One way to study Down syndrome is via bioinformatics.

METHODS

In this study, a gene expression profile from a microarray study was selected for more investigation.

RESULTS

The study of Down syndrome patients shows specific genes with differential expression and network centrality properties. These genes are introduced as RHOA, FGF2, FYN, and CD44, and their level of expression is high in these patients.

CONCLUSION

This study suggests that besides chromosomes 21, there are additional contributing chromosomes to the risk of Down syndrome development. Besides, these genes could be used for clinical studies after more analysis.

Evaluation of expression of common genes in the intestine and peripheral blood mononuclear cells (PBMC) associated with celiac disease

AIM

this study was conducted to investigate expression of the genes associated with CD in the target tissue in order to estimate contribution of each single gene to development of immune response. Then, the same set of genes was evaluated in peripheral blood mononuclear cells (PBMCs).

BACKGROUND

Celiac disease (CD) is a chronic systemic autoimmune disease of the small intestine occurring in genetically-susceptible individuals. There are several genes related to immune response.

METHODS

For this purpose, the genes related to CD were extracted from public databases (documents of proteomics and microarray-based techniques) and were organized in a protein-protein interaction network using the search tool for retrieval of interacting genes/proteins (STRING) database as a plugin of Cytoscape software version 3.6.0. The main genes were introduced and enriched via ClueGO to find the related biochemical pathways. The network was analyzed, and the most important genes were introduced based on central indices.

RESULTS

Among 20 CD genes as hub and bottleneck nodes, there were 7 genes with common expression in blood and intestinal tissue (C-X-C motif chemokine 11(CXCL11), granzyme B (GZMB), interleukin 15(IL-15), interleukin 17(IL-17A), interleukin 23(IL-23A), t-box transcription factor 21(TBX21), and tumor necrosis factor alpha-induced protein 3(TNFAIP3)).

CONCLUSION

The enriched biological process related to the central nodes of celiac network indicated that most of hub-bottleneck genes are the well-known ones involved in different types of autoimmune and inflammatory diseases.

Synergistic antitumor effect of anti-PD-L1 combined with oxaliplatin on a mouse tumor model

Oxaliplatin (OXP) can change tumor microenvironment from immune-suppressive toward the immune-favorable condition. Almost all of the antitumor agents cannot totally cure cancer as monotherapy. So the current focus of cancer research became combining therapy using different treatment regimen, especially chemotherapy with checkpoint blockers. In this study, we assessed the activity of combining regimen using anti-PD-L1 with OXP in CT26 tumor-bearing BALB/c mice. We further analyzed the immune cell phenotypes in tumor site, lymph nodes, and spleen by flow cytometry analysis. Our study showed that combination therapy with OXP and anti-PD-L1 significantly increased survival in vivo and inhibited tumor growth of tumor-bearing mice. Inconsistent with better antitumor activity, our combination therapy led to an increase in tumor-infiltrating activated CD8+ T cells. In draining lymph nodes and spleen, regulatory T cells decreased significantly. Mice receiving either anti-PD-L1 or OXP alone had a larger tumor and lower survival rate in comparison with combination therapy receiving group. The time and order of administration of each component of the combination therapy affected antitumor response.

Human Prolactinoma: A View of Protein-Protein Interaction Pattern

The aim of this study was to identify the highly expressed genes in terms of interaction concept in Prolactinoma. The study was conducted by additional analysis of the available data from the GEO database. The online tool, GEO2R, was used to analyze the gene expression profile of GSE36314 dataset using the GPL8300 platform. Consequently, a PPI network of up-regulated and down-regulated genes was constructed and examined to introduce the possible targets with possible therapeutic values. A number of 46 genes were dysregulated in Prolactinoma and their network indicated 15 essential genes via topological analysis. Moreover, the present study found that the highlighted genes of prolactinoma are involved in two major biological processes including growth regulation and metabolic function. Thus, the determined genes may be valuable for diagnosis, treatment, and patient follow-up. However, further studies are essential to validate this conclusion.

The benefits of analysing complete mitochondrial genomes: Deep insights into the phylogeny and population structure of Echinococcus granulosus sensu lato genotypes G6 and G7

Cystic echinococcosis (CE) is a zoonotic disease caused by the larval stage of the species complex Echinococcus granulosus sensu lato. Within this complex, genotypes G6 and G7 have been frequently associated with human CE worldwide. Previous studies exploring the genetic variability and phylogeography of genotypes G6 and G7 have been based on relatively short mtDNA sequences, and the resolution of these studies has often been low. Moreover, using short sequences, the distinction between G6 and G7 has in some cases remained challenging. The aim here was to sequence complete mitochondrial genomes (mitogenomes) to obtain deeper insight into the genetic diversity, phylogeny and population structure of genotypes G6 and G7. We sequenced complete mitogenomes of 94 samples collected from 15 different countries worldwide. The results demonstrated that (i) genotypes G6 and G7 can be clearly distinguished when mitogenome sequences are used; (ii) G7 is represented by two major haplogroups, G7a and G7b, the latter being specific to islands of Corsica and Sardinia; (iii) intensive animal trade, but also geographical isolation, have likely had the largest impact on shaping the genetic structure and distribution of genotypes G6 and G7. In addition, we found phylogenetically highly divergent haplotype from Mongolia (Gmon), which had a higher affinity to G6.

Diabetic Retinopathy and Laser Therapy in Rats: A Protein-Protein Interaction Network Analysis

Introduction: Diabetic retinopathy (DR) is a serious microvascular complication of diabetes which can cause vision loss or blindness ultimately. Non enzymatic glycation of proteins leads to advanced glycation end products (AGEs) in DR. Since laser therapy is a well-established method, in this study, protein-protein interaction (PPI) network is applied for protein targets in DR disease in rats treated by laser. Methods: In this study, we focused on articles that investigated and compared the proteome profiles of DR rats with healthy control and also DR rats before and after laser therapy. The networks of related differentially expressed proteins were explored using Cytoscape version 3.3.0, the PPI analysis methods and ClueGO. Results: Analysis of PPI network of 37 related proteins to DR rats including 108 nodes, introduced 10 hub-bottleneck proteins and 5 concerned biochemical pathways. On the other hand, PPI analysis of related proteins to DR rats before and after laser therapy corresponded to 33 proteins and 2 biological pathways. Discussion: Centrality and cluster screening identified hub-bottelneck genes, including Aldoa, HSPD1, Pgam2, Mapk3, SLC2A4, Ctnnb1, Ywhab, HSPA8, GAPDH and Actb for DR rats versus healthy control and ENO1, Aldoa, GAPDH for DR samples after laser therapy.

CONCLUSION

Gene expression analysis of the DR samples treated via laser therapy provides a molecular evidence in support of the therapeutic effect of laser.

The role of infectious mediators and gut microbiome in the pathogenesis of celiac disease

Celiac disease (CD) is an immune disorder that is associated with gluten sensitivity in people who are genetically predisposed. In celiac disease, food containing gluten mounts inflammatory response that results in villous atrophy in small bowel and increased permeability. This disorder is not only related to complications in the small bowel, but also has association with manifestations outside the GI tract. Small bowel mucosal immunity, exposed to infectious agents, is affected by CD; therefore, it is likely that patients with untreated celiac disease are more susceptible to infectious diseases. It is possible that sensitivity to gluten increases in patients infected with infectious diseases, and consequently infection may trigger CD in susceptible individuals. It is likely that, due to reduced immunity following the loss of intestinal villi, viral, bacterial, and parasitic infections develop faster in celiac disease patients and systemic complication occur more frequently. In addition, increased permeability, changing the microbiota following the chronic inflammation of the small intestine and abnormal immunological reactions are associated with celiac disease. PubMed, Medline, Google scholar, SID, and Magiran were searched for full text articles published between 1999 and 2014 in Persian and English. The associated keywords were used, and papers, which described particularly the impact of infectious agents on celiac disease, were selected. In this review, we have focused on the role of infectious agents and gut microbiota in the pathogenesis of celiac disease.

Characterization of Leptospira interrogans Serovars by Polymorphism Variable Number Tandem Repeat Analysis

Background:

Leptospirosis is recognized as a re-emerging infectious disease; therefore, understanding the epidemiology of the disease is vital for designing intervention programs and diminishing its transmission. Recently, Multilocus variable number tandem repeat analysis (MLVA) is used for segregating and identifying Leptospira serovars. The method has potential application in investigating the molecular epidemiology of Leptospira.

Objectives:

The propose of this study was genomic identification of pathogenic Leptospires in Iran by MLVA.

Materials and Methods:

Leptospira serovars were obtained from National Reference Laboratory of Leptospira at Razi Vaccine and Serum Research Institute, Karaj, Iran. Serovars were cultured into the liquid EMJH medium and incubated at 28˚C for 7 days. DNA of serovars was extracted using the phenol-chloroform method. PCR was performed with 5 selected variable number tandem repeat analysis (VNTR) loci. The amplified products were analyzed by agarose gel electrophoresis. The size of the amplified products was estimated by 100 bp ladder and sequencing analysis.

Results:

The saprophytic serovar showed no amplified fragments. PCR products in all pathogenic serovars were observed. The 12 reference serovars used for the development of technique displayed distinct patterns.

Conclusions:

Results showed that MLVA technique with its range of polymorphism is a good marker for identification of pathogenic serovars. Some VNTR loci are more powerful than the other ones with regard to differentiation. Serovars from the same geographical area have more genetic similarity than same serovars from different places. MLVA is a suitable technique for epidemiological survey.

Celiac disease hidden by cryptogenic hypertransaminasemia mistaken for fatty liver

A variety of signs and symptoms have been reported in regards to the typical and atypical presentations of CD. It is now well recognised that its onset may occur at any age and that atypical forms of CD are much more prevalent than its classic form (1).In this case, where the patient presented with high BMI and evidence of grade I of fatty liver disease, CD was suspected due to mildly abnormal bloating, cryptogenic hypertransaminasemia, abnormal LFT and poor response to fatty liver treatment. This presentation type is not uncommon; diagnosis was confirmed by the presence of subtotal villous atrophy in the biopsy specimen, positive specific antibody screening (AGA, tTG and EMA antibodies), negative antibody screening and normalization of liver enzymes on a gluten-free diet (Tab. 2, Ref. 13).

Gastrointestinal and non-gastrointestinal presentation in patients with celiac disease

BACKGROUND

Celiac disease (CD) may have a variety of different presentations. This study has aimed to explore the prevalence of gastrointestinal (GI) and non-GI symptoms in patients with CD according to data collected in Italy and Romania (Europe) and Iran (Middle East).

METHODS

This is a retrospective cross-sectional study conducted in Iran, Romania and Italy with data collection during the period from May 2009 - May 2011. For each center we included only patients with CD that was confirmed by endoscopy, small bowel biopsies and positive serology. GI symptoms such as abdominal pain, diarrhea, constipation, nausea and vomiting, weight loss and flatulence, as well as additional signs and symptoms of iron deficiency anemia (IDA), osteoporosis, hypertransaminasemia, and other related abnormalities were collected.

RESULTS

Overall, 323 women and 127 men, whose mean age at diagnosis was 34.2 ± 16.47 years were included in this study. Of these, 157 subjects (34.9%) reported at least one GI symptom. The majority of cases had the following primary presenting GI symptoms: diarrhea (13.6%), dyspepsia and constipation (4.0%). Other disease symptoms were reported by 168 (37.3%) patients. The most presenting non-GI symptoms in the majority of cases were anemia (20.7%) and osteopenia (6%). There were statistically significant differences between the majority of symptoms when we compared the reported clinical symptoms from different countries.

CONCLUSION

This study indicated that upper abdominal disorders such as abdominal pain and dyspepsia were the most common primary complaints among European patients, whereas Iranian patients had complaints of diarrhea and bloating as the classic presentations of CD. For non-GI symptoms, anemia was the most frequent complaint for both Iranian and Italian patients; however it was significantly higher in Iranians.

The effects of gluten-free diet on hypertransaminasemia in patients with celiac disease

BACKGROUND

Celiac disease (CD) is an immune mediated condition that leads to small bowel atrophy and improve with a gluten free diet (GFD). Extra-intestinal manifestations of CD include hypertransaminasemia. In this study, the effects of a GFD on hypertransaminasemia in patients with newly diagnosed CD were studied.

METHODS

Ninety eight new diagnosed consecutive patients with CD 40 males and 58 females) with mean age of 32 ± 17.1 were studied. All patients with CD were treated with a GFD. Patients with hypertransaminasemia, at diagnosis, had a cirrhosis screen performed. Patients with a negative cirrhosis screen were reviewed, 6 months after the introduction of a GFD, and serum levels of liver transaminases were measured again.

RESULTS

Nine patients had hypertransaminasemia. One patient was Hepatitis B surface antigen positive and was excluded from this study. The 8 remaining patients had no obvious cause for the hypertransaminasemia. Mean (± SD) of baseline aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were 42.6 ± 16.5 IU/L (range: 16-66 IU/L) and 69.3 ± 9.3 IU/L (range: 52-81 IU/L). Six months after treatment with a GFD, mean AST and ALT levels decreased to 24.5 ± 5.1 IU/L (range: 18-31 IU/L) (P: 0.04) and 24.6 ± 6 IU/L (range: 17-32 IU/L) (P: 0.01), respectively. In 7 patients the hypertransaminasemia, at diagnosis had resolved.

CONCLUSIONS

This study provides further evidence that some patients with CD have a reversible hypertransaminasemia that resolves with a GFD.

Geographic trends and risk of gastrointestinal cancer among patients with celiac disease in Europe and Asian-Pacific region

Celiac disease is an autoimmune disorder that affects genetically predisposed individuals upon the ingestion of gluten. It is now considered one of the most common genetic disorders in Europe and Asian Pacific region with a prevalence of up to 2.67% of the population. The true prevalence of celiac disease may still be underestimated. Studies remain limited by sample size and selection bias. Celiac disease predisposes to the development of gastrointestinal malignancies, especially lymphomas and small bowel adenocarcinoma. The risk of developing a celiac disease associated malignancies remains uncertain, despite numerous studies. In Middle Eastern countries, the literature regarding celiac disease has expanded significantly in recent years. These studies reported have largely concentrated on the epidemiology of Celiac disease and there is an absolute and relative paucity of published research regarding celiac disease associated malignancy. The aim of this article is to review the current literature and evaluate the risk of gastrointestinal malignancies among patients with celiac disease and then review studies from the Asian Pacific region of the world.

The concentration of serum zinc in celiac patients compared to healthy subjects in Tehran

AIM

This study evaluated serum levels of zinc in patient with CD compare to healthy subjects.

BACKGROUND

Celiac disease (CD) is characterized by small intestinal malabsorption of nutrients as a consequence of ingestion of wheat gluten. Zinc is an essential trace element that it has vital biological functions.

PATIENTS AND METHODS

Sera of 30 celiac cases and 30 healthy normal cohorts as control group were obtained. Atomic absorption spectrophotometer was employed for estimating serum zinc level.

RESULTS

Zinc concentrations in patients diagnosed with CD were significantly lower than healthy subjects (75.97±12 compared with 92.83±18, P-value < 0.0001).

CONCLUSION

The result of this study shows that serum zinc concentration is decreased in celiac patients compare to healthy controls. Serum zinc may thus be a marker of CD in adults presenting with gastrointestinal symptoms.

Metabonomics based NMR in Crohn's disease applying PLS-DA

AIM

The aim of this study was to search for metabolic biomarkers of Crohn's disease (CD).

BACKGROUND

Crohn's disease (CD) is a type of inflammatory bowel disease that causing a wide variety of symptoms. CD can influence any part of the gastrointestinal tract from mouth to anus. CD is not easily diagnosed because monitoring tools are currently insufficient. Thus, the discovery of proper methods is needed for early diagnosis of CD.

PATIENTS AND METHODS

We utilized metabolic profiling using proton nuclear magnetic resonance spectroscopy ((1)HNMR) to find the metabolites in serum. Classification of CD and healthy subject was done using partial least squares discriminant analysis (PLS-DA).

RESULTS

According to PLS-DA model, we concluded that just using one descriptor CD and control groups could be classified separately. The level of lipid in blood serum of CD compared to healthy cohorts was decreased. For the external test set, the classification model showed a 94% correct classification of CD and healthy subject.

CONCLUSION

The result of classification model presents that NMR based metabonomics is key tool as well as insight into potential targets for disease therapy and prevention.

The role of Helicobacter pylori and CagA in response to treatment in Iranian Gastroesophageal Reflux Diseases patients

AIM

This study was conducted to evaluate the influence H. pylori infection and anti-CagA status on the efficacy of Omeperazole 20 m.g. b.d. for patients with endoscopic oesophagitis.

BACKGROUND

The influence of Helicobacter pylori (H. pylori) infection and its virulent strain (cytotoxin-associated gene A: CagA) has not been evaluated on efficacy of treatment for patients with erosive oesophagitis in Iran.

PATIENTS AND METHODS

One hundred and ten patients (55 H. Pylori positive and 55 H. Pylori negative) with endoscopic evidence of oeosphagitis were enrolled in this interventional study and treated with Omeprazole 20 m.g. b.d. Healing was assessed at repeat endoscopy after 8 weeks of treatment. H. Pylori infection and anti-CagA-IgG (immunoglobulin G) antibodies were determined for each subject by the rapid urease test, pathological assessment and ELISA.

RESULTS

At repeat endoscopy, following 8 weeks of Omeprazole 20 m.g. b.d. therapy, endoscopic healing of oesophagitis had occurred in 32 % of the HP +ve patients and 23 % of the HP -ve patients (chi square p < 0.01). Among the HP +ve endoscopic healing occurred resolved in 11 (32.4 %) of the CagA +ve patients and 19 (90.5 %) of the CagA -ve patients. This difference was significant (chi-square p <0.001).

CONCLUSION

H. pylori infection and the CagA virulence factor are associated with an increased rate of healing amongst patients with endoscopic oesophagitis treated with Omperazole 20 m.g. b.d. compared to patients without H. pylori infection.

Papillary thyroid cancer and ulcerative colitis

Ulcerative colitis is associated with several malignancies. Here we report one such association, a rare one, with papillary thyroid carcinoma, and discuss the possible risk factors of such an association.

NMR based metabonomics study on celiac disease in the blood serum

AIM

The aim of this study is to look for the proper methods that would be a major step towards untreated CD diagnosis and seek the metabolic biomarkers causes of CD and compare them to control group.

BACKGROUND

Celiac disease (CD) is a common autoimmune disorder that is not easily diagnosed using the clinical tests.

PATIENTS AND METHODS

Thirty cases and 30 controls were entered into this study. Metabolic profiling was obtained using proton nuclear magnetic resonance spectroscopy ((1)HNMR) to seek metabolites that are helpful for the detection of CD. Classification of CD and healthy subject was done using random forest (RF).

RESULTS

The obtained classification model showed an 89% correct classification of CD and healthy subject for the external test set. The metabolites that caused changes in people with CD were identified using RF; these metabolites include lactate, valine and lipid.

CONCLUSION

The findings of the present study reveal serum lactate, valin and lipid levels in CD patient are lower than healthy cohorts. This metabolite may provide diagnostic tools as well as insight into potential targets for disease therapy.

Seroepidemiology of hepatitis A and E virus infections in Tehran, Iran: a population based study

Hepatitis A virus (HAV) and hepatitis E virus (HEV) are enteric hepatotropic viruses and their prevalence is related to the sanitary conditions of the region under investigation. There are only a few studies on the seroepidemiology of these two viruses in the general Iranian population. The purpose of this investigation was to measure the prevalence of hepatitis A and E infections in the general population. Between 2006 and 2007, a cross sectional study was performed in Tehran, Iran. Blood specimens were collected and questionnaires were filled in for 551 persons. Patient sera were tested by ELISA for anti-HEV and anti-HAV IgGs. The χ(2) test and independent t-test were used for statistical analysis and p<0.05 was considered significant. The overall seroprevalence rates of anti-HEV IgG and anti-HAV IgG were 9.3% and 90%, respectively. The prevalence of antibodies to HAV and HEV was greater among men than women and increased with age. However, there was no significant relationship between age and gender with the existence of anti- HAV and HEV IgG antibodies. Our results show the seroprevalence of HAV and HEV antibodies are high and both viruses are endemic in this region. These findings are in accordance with results obtained from previous studies. We recommend that foreign travelers to Iran are vaccinated against HAV.

Gluten associated dyspepsia; serology and histological characteristics

AIM

The aim of this study was to assess the prevalence of celiac disease (CD) in dyspeptic patients.

BACKGROUND

Although severe mucosal abnormality with villous atrophy (lesions Marsh III) is the histology gold standard for the diagnosis of CD, non-specific microenteropathy (Marsh I-II) with positive serology is also common Patients with dyspepsia, specific CD antibodies and microenteropathy, could have CD.

PATIENTS AND METHODS

From November 2007 to October 2008, 407 randomly chosen patients who underwent diagnostic upper gastrointestinal endoscopy for dyspeptic symptoms (193 male, 214 women; mean age 36.1 years) were studied. Small bowel biopsies were performed in all of them. Histologic characteristics in duodenal biopsy specimens for CD were evaluated according to the modified Marsh Classification. All the patients were also tested for serum total immunoglobulin A and anti-transglutaminase (tTG) antibodies. Those with IgA deficiency were tested for IgG tTG.

RESULTS

Duodenal histology showed Marsh I-IIIc lesions in 6.4% cases. 4 patients (0.98%) were IgA deficient and none of them were positive for IgG tTG. Serology showed positive results for tTGA in 8% of the patients and 2.5% of them had abnormal histology (Marsh I-IIIc) compatible with CD.

CONCLUSION

The results of this study showed that milder enteropathy (Marsh 0-II) have a low specificity for CD. The prevalence of CD among dyspeptic individuals is significantly (2.5%) higher than in the general population (1%) and CD should be investigated in these patients.

The association between clinical symptoms, laboratory findings and serum endothelin 1 concentrations, in cirrhotic patients with and without hepatopulmonary syndrome

AIM

This study evaluated the association between serum endothelin- 1 level and symptoms, clinical examination, laboratory and cardio-respiratory parameters, in patients with cirrhosis compared to controls.

BACKGROUND

Cirrhosis is associated with significant portal, pulmonary and systemic vascular abnormities. Recent studies have suggested that endothelin -1 may have a significant role in the regulation of vascular tone.

PATIENTS AND METHODS

In this case - control study, subjects that had been evaluated and diagnosed with biopsy-proven cirrhosis and age-matched controls with no evidence of cardio-vascular or liver disease were recruited. Review of medical records, routine laboratory investigations and cardio-respiratory investigations including echocardiography to look for evidence of hepato-pulmonary syndrome were performed.

RESULTS

50 patients were subjects were recruited. The most common aetiology of the cirrhosis was chronic hepatitis B viral infection. 7/50 cases had evidence of the hepatopulmonary syndrome. Among the patients with evidence of the hepatopulmonary syndrome, dyspnoea (100%) and cyanosis (90%) were the most common of the symptoms and signs recorded. Pao2 and arterial - alveolar oxygen gradients were the most sensitive tests in the diagnosis of hepatopulmonary syndrome. Orthodoxy specificity was 100%. The median concentration of serum endothelin-1 in cases with hepatopulmonary syndrome was 1.06+/- 0.015 pg/ml (range 0.92 - 1.21), in cases of sub-clinical hepatopulmonary syndrome, 2.49+/- 0.08 (4.05- 0.93) in patients with cirrhosis but no evidence of hepatopulmonary syndrome criteria 0.85+/-0.74(1.06-0.64) in controls.

CONCLUSION

There was a significant difference in serum endothelin- 1 levels between patients with cirrhosis and controls, but not between patients with cirrhosis complicated by hepatopulmonary syndrome and controls.

Duodenal adenocarcinoma might be the cause of intractable nausea and vomiting in patient with coeliac disease

Coeliac disease (CD) is an autoimmune disorder which leads to chronic inflammation of the gut. Untreated CD is associated with upper gastrointestinal malignancies, Small-bowel lymphoma and adenocarcinoma are recognized complications of untreated coeliac disease (CD). We report the case of a 43-year-old male suffering from CD who was treated with a gluten-free diet one year, presenting with complaints of intractable nausea and vomiting. After several studies, He underwent push enteroscopy, which identified one large mass lesion in the third part of duodenum. However, histopathological examination showed adenocarcinoma. Subsequently, a duodenal segment resection was performed. After surgery, the patient recovered well and left our hospital in good condition. Clinicians should take into small bowel adenocarcinoma is rare but associated with CD particularly in CD patients with worrying symptoms such as nausea and vomiting unresponsiveness to treatment and these patients should be screened for long term complications like malignancy.

Celiac disease in patients with chronic psychiatric disorders

AIM

The aim of this study was to determine the prevalence of celiac disease in Iranian patients suffering from chronic depression or schizophrenia.

BACKGROUND

Psychiatric disorders are common in untreated celiac disease.

PATIENTS AND METHODS

Two hundred Iranian inpatient men with in chronic phase of depressive disorders or schizophrenia, and 200 age-matched healthy male subjects were screened for celiac disease by anti-tissue transglutaminase IgA antibodies. The mean age of the study patients was 37 years.

RESULTS

One (1%) schizophrenic and two (2%) depressive patients were positive for anti-tissue transglutaminase IgA antibodies; duodenal biopsy was not possible in these subjects. In the control group one (0.5%) individual was positive for anti-tissue transglutaminase IgA antibodies, but had normal duodenal histology. The difference between patients and controls was not statistically significant.

CONCLUSION

The frequency of celiac disease serology in schizophrenic and depressive inpatients was not significantly higher than that in the general population. We would therefore not advocate systematic serologic screening in these patients, but alertness to celiac disease should be kept in mind.

Cholangiocarcinoma in magnetic resonance cholangiopancreatography and fascioliasis in endoscopic ultrasonography

Fascioliasis is a worldwide zoonotic infection with Fasciola hepatica and Fasciola gigantica. The zoonoses are particularly endemic in sheep-raising countries and are also endemic in Iran. Typical symptoms that may be associated with fascioliasis can be divided by phases of the disease, including the acute or liver phase, the chronic or biliary phase, and ectopic or pharyngeal fascioliasis. Cholestatic symptoms may be absent, and in some cases diagnosis and treatment may be preceded by a long period of abdominal pain, eosinophilia and vague gastrointestinal symptoms. We report a case with epigastric and upper quadrant abdominal pain for the last 4 years, with imaging suggesting cholangiocarcinoma. Considering a new concept of endoscopic ultrasonography, at last F. hepatica was extracted with endoscopic retrograde cholangiography.

Hepatitis C and hepatitis B virus infection: epidemiology and risk factors in a large cohort of pregnant women in Lorestan, West of Iran

BACKGROUND

There are little data on the prevalence of serological markers of hepatitis B and hepatitis C viruses in pregnant women in Iran.

OBJECTIVES

This study was designed to determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection among pregnant women in Lorestan, west of Iran.

PATIENTS AND METHODS

Serum samples of 827 pregnant women who lived in rural (36.8%) and urban areas (63.2%) of Lorestan were collected during 2007-2008. Data were obtained through questionnaires. Samples were first screened for anti-HCV and anti-HBc by ELISA. Those who were positive for anti-HBc were tested for HBsAg.

RESULTS

Anti-HBc was found in 28 of 827 pregnant women (overall prevalence, 3.4%; 14 of 523 in urban areas, 2.7%; 14 of 304 in rural areas, 4.6%). Of the 28 positive samples, 6(0.7%) were positive for HBs-Ag. Only 2 samples (0.2%) were anti-HCV-positive.

CONCLUSIONS

These results underscore the need for prenatal screening for HBV infection in pregnant women and treatment of newborns from HBsAg-positive mothers.More studies are needed to identify risk factors of HCV infection and highlight the importance of HCV screening and treatment programs.

Clinical and histological presentation of Helicobacter pylori and gluten related gastroenteropathy

BACKGROUND

Celiac disease has been reported to be associated with gastric abnormalities. The aim of this study was to assess the relationship between the prevalence of celiac disease and Helicobacter pylori infection in an Iranian population of 250 patients.

METHODS

Biopsies were taken from the gastric antrum and duodenum. Morphology and histology were evaluated using the updated Sydney system and modified Marsh criteria, respectively. To simplify the interpretation of gastric lesions we classified gastritis in macroscopic and microscopic stages. Serology for anti-tissue transglutaminase antibody was performed to determine the presence of celiac disease.

RESULTS

Among 250 patients, 232 (93%) had histological evidence of Helicobacter pylori infection. Histological abnormalities (Marsh I to IIIc) were present in 24 (10%). Of 24 patients, 20 (83%) with histological abnormalities were infected with Helicobacter pylori. Of 250 patients, 25 (10%) had a positive anti-tissue transglutaminase antibody. Of 25 anti-tissue transglutaminase antibody positive patients, 9 (3.6%) had microscopic and macroscopic enteritis (Marsh I to IIIc).

CONCLUSIONS

Clinical presentation of celiac disease was not distinguishable from cases infected with Helicobacter pylori. Histology, even in patients with positive serology, was non-specific and unhelpful. We found a high prevalence of Helicobacter pylori infection and chronic gastritis, but neither was associated with celiac disease, in agreement with studies in Western populations.

Liver complications in celiac disease

Celiac disease (CD) is characterized by sensitivity to gluten, which is found in dietary wheat, barley, and rye. Many extra-intestinal manifestations have been described in association with CD. Liver disease and CD share widespread risk factors. Liver disorders such as autoimmune hepatitis, elevation of liver enzyme levels, primary biliary cirrhosis, nonspecific hepatitis, primary sclerosing cholangitis, and nonalcoholic fatty liver disease have been reported in patients with CD. In this review, we provide information regarding liver disorders that may be found in association with celiac disease and the effect of the treatment of CD on these disorders.

Evaluation of four DNA extraction methods for the detection of Echinococcus granulosus genotype 1

AIM

The aim of this survey was to compare four DNA extraction methods from Iranian sheep strain E.granulosus isolates.

BACKGROUND

Cystic echinococcosis (CE) caused by the metacestode of the dog tapeworm Echinococcus spp., is a global zoonotic infection which is economically important and constitutes a major threat to public health in many countries. Strains characterization is essential for the establishment of a preventive and control strategy in every endemic area.

PATIENTS AND METHODS

Forty five infected organs from cattle, sheep and goat were collected from different abattoirs of Iran. All cysts were examined by microscopic observation of protoscoleces. For each cyst, protoscoleces were aspirated and DNA of each cyst was extracted with 4 different methods including tissue Kit extraction, modified Cinnagen extraction kit, Phenol-chloroform (Sambrook1999) and modified Phenol chloroform methods. Efficiency of the DNA was determined by degree of success in PCR amplification.

RESULTS

Cinnagen modified extraction and modified Phenol chloroform methods were equally effective and superior to other methods after DNA electrophoresis and PCR reaction. Inhibition was observed in PCR with DNA isolated from protoscoleces, and a 1/100 dilution was able to alleviate this problem with DNA extracted.

CONCLUSION

The result of this study show that the quality of extracted DNA using modified Cinnagen extraction kit and modified phenol-chloroform are very high and gave identical results after RCR reaction using 12S rRNA gene. Further evaluation is required for its utilization in other clinical specimens.

Successful twin pregnancy in a patient with ulcerative colitis using azathoprine during conception

Inflammatory bowel disease (IBD) frequently affects young patients of childbearing age. Treatments for inflammatory bowel disease include immunosuppressive, cytotoxic and surgical therapies. Azathioprine is frequently used to treat patients with steroid dependent IBD. We report the case of a patient with ulcerative colitis, treated with azathioprine prior to conception and during the subsequent pregnancy with the subsequent successful delivery of healthy twins. Although some potential risks indeed exist, the use of AZA may not be harmful to the mother or the fetus in many instances.

The evaluation of interleukin-8 chemokine in chronic and acute Toxoplasma gondii infection

AIM

We investigated whether the level of IL8 was different in patients with chronic and acute Toxoplasma gondii infection during the pregnancy compared with control group.

BACKGROUND

It is well established that T.gondii infection induces a strong cell-mediated immune response.

PATIENTS AND METHODS

ELISA was used to determine the level of IL8 in sera of 568 pregnant women. Patients were divided into three groups according to a T.gondii serology. The first group included 202 women with positive IgG titres, the second group was 66 women with IgM and negative IgG T.gondii serology; and the third group comprised the sera of 300 healthy pregnant women with negative T.gondii serology and served as controls.

RESULTS

The level of IL8 in group I was within normal range similar to control group. However, the level of IL8 was increased in those pregnant patients with positive IgM T.gondii serology.

CONCLUSION

The serum levels of pro-inflammatory cytokines such as IL8 seem to be increased in patients with serological evidence of acute T.gondii infection.

Subclinical celiac disease and gluten sensitivity

Atypical presentation is the most common form of celiac disease (CD). Although the terminologies like latent, silent and potential have expressed different aspects of clinical and pathological behaviour of CD, they also have contributed in some extent to confusion between clinicians and patients due to the multiple definitions and uncertainty around them. In the light of new advances and the discovery of entities such as non-celiac gluten sensitivity, using subclinical instead of silent and atypical instead of potential/latent may simplify the understanding behind the clinical behaviour of atypical CD. The evidence behind a lower threshold for starting a gluten free diet (GFD) in non-celiac gluten sensitive patients would strongly support applying a GFD treatment strategy in any forms of CD.