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Conti P, Ronconi G, Caraffa A, Gallenga C, Ross R, Frydas I, Kritas S. Induction of pro-inflammatory cytokines (IL-1 and IL-6) and lung inflammation by Coronavirus-19 (COVI-19 or SARS-CoV-2): anti-inflammatory strategies. J BIOL REG HOMEOS AG 2020; 34:327-331. [PMID: 32171193 DOI: 10.23812/conti-e] [Citation(s) in RCA: 572] [Impact Index Per Article: 143.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Coronavirus-19 (COVI-19) involves humans as well as animals and may cause serious damage to the respiratory tract, including the lung: coronavirus disease (COVID-19). This pathogenic virus has been identified in swabs performed on the throat and nose of patients who suffer from or are suspected of the disease. When COVI-19 infect the upper and lower respiratory tract it can cause mild or highly acute respiratory syndrome with consequent release of pro-inflammatory cytokines, including interleukin (IL)-1β and IL-6.
The binding of COVI-19 to the Toll Like Receptor (TLR) causes the release of pro-IL-1β which is cleaved by caspase-1, followed by inflammasome activation and production of active mature IL-1β which is a mediator of lung inflammation, fever and fibrosis. Suppression of pro-inflammatory IL-1 family members and IL-6 have been shown to have a therapeutic effect in many inflammatory diseases, including viral infections.
Cytokine IL-37 has the ability to suppress innate and acquired immune response and also has the capacity to inhibit inflammation by acting on IL-18Rα receptor. IL-37 performs its immunosuppressive activity by acting on mTOR and increasing the adenosine monophosphate (AMP) kinase. This cytokine inhibits class II histocompatibility complex (MHC) molecules and inflammation in inflammatory diseases by suppressing MyD88 and subsequently IL-1β, IL-6, TNF and CCL2. The suppression of IL-1β by IL-37 in inflammatory state induced by coronavirus-19 can have a new therapeutic effect previously unknown. Another inhibitory cytokine is IL-38, the newest cytokine of the IL-1 family members, produced by several immune cells including B cells and macrophages.
IL-38 is also a suppressor cytokine which inhibits IL-1β and other pro-inflammatory IL-family members. IL-38 is a potential therapeutic cytokine which inhibits inflammation in viral infections including that caused by coronavirus-19, providing a new relevant strategy.
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Affiliation(s)
- P Conti
- Postgraduate Medical School, University of Chieti, Chieti, Italy
| | - G Ronconi
- Clinica dei Pazienti del Territorio, Fondazione Policlinico Gemelli, Rome, Italy
| | - A Caraffa
- School of Pharmacy, University of Camerino, Camerino, Italy
| | - C Gallenga
- Department of Biomedical Sciences and Specialist Surgery, Section of Ophthalmology, University of Ferrara, Ferrara, Italy
| | - R Ross
- University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, USA
| | - I Frydas
- Aristotelian University, Thessaloniki, Greece
| | - S Kritas
- Department of Microbiology and Infectious Diseases, School of Veterinary Medicine, Aristotle University of Thessaloniki, Macedonia, Greece
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Singendonk M, Kritas S, Omari T, Feinle-Bisset C, Page AJ, Frisby CL, Kentish SJ, Ferris L, McCall L, Kow L, Chisholm J, Khurana S. Upper Gastrointestinal Function in Morbidly Obese Adolescents Before and 6 Months After Gastric Banding. Obes Surg 2019; 28:1277-1288. [PMID: 29103072 DOI: 10.1007/s11695-017-3000-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The effects of laparoscopic adjustable gastric band (LAGB) placement on upper gastrointestinal tract function in obese adolescents are unknown. Therefore, our aim was to determine the short-term effects of LAGB on esophageal motility, gastroesophageal reflux, gastric emptying, appetite-regulatory hormones, and perceptions of post-prandial hunger and fullness. METHODS This study was part of a prospective cohort study (March 2009-December 2015) in one tertiary referral hospital. The study included obese adolescents (14-18 years) with a body mass index (BMI) > 40 (or ≥ 35 with comorbidities). Gastric emptying was assessed by 13C-octanoic acid breath test, pharyngeal, and esophageal motor function by high-resolution manometry with impedance (HRIM), and appetite and other perceptions using 100-mm visual analogue scales. Dysphagia symptoms were scored using a Dakkak questionnaire. Data were compared pre- and post-LAGB placement and at a 6-month follow-up. RESULTS Based upon analysis of 15 adolescents, at the 6-month follow-up, LAGB placement: (i) led to a significant reduction in weight and BMI; (ii) increased fullness and decreased hunger post-meal; (iii) increased symptoms of dysphagia after solid food; and, despite these effects, (iv) caused little or no changes to appetite hormones, while (v) effects on gastric emptying, esophageal motility, esophageal bolus transport, and esophageal emptying were not significant. CONCLUSION In adolescents, LAGB improved BMI and altered the sensitivity to nutrients without significant effects on upper gastrointestinal tract physiology at the 6-month follow-up.
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Affiliation(s)
- M Singendonk
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/AMC, Amsterdam, The Netherlands
| | - S Kritas
- Gastroenterology Unit, Women's & Children's Hospital, Adelaide, Australia
| | - T Omari
- Human Physiology, Medical Science and Technology, School of Medicine, Flinders University, Adelaide, South Australia, Australia.
| | - C Feinle-Bisset
- Centre for Nutrition and Gastrointestinal Diseases, Adelaide Medical School, University of Adelaide, Adelaide, Australia.,NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia
| | - A J Page
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - C L Frisby
- Centre for Nutrition and Gastrointestinal Diseases, Adelaide Medical School, University of Adelaide, Adelaide, Australia.,South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - S J Kentish
- Centre for Nutrition and Gastrointestinal Diseases, Adelaide Medical School, University of Adelaide, Adelaide, Australia.,South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - L Ferris
- Gastroenterology Unit, Women's & Children's Hospital, Adelaide, Australia.,Human Physiology, Medical Science and Technology, School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | - L McCall
- Gastroenterology Unit, Women's & Children's Hospital, Adelaide, Australia
| | - L Kow
- Department of Surgery, Flinders Medical Centre, Adelaide, Australia
| | - J Chisholm
- Department of Surgery, Flinders Medical Centre, Adelaide, Australia
| | - S Khurana
- Paediatric Surgery & Urology, Women's & Children's Hospital, Adelaide, Australia.,Department of Surgery, Flinders Medical Centre, Adelaide, Australia
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Tettamanti L, Caraffa A, Mastrangelo F, Ronconi G, Kritas S, Frydas I, Conti P. Different signals induce mast cell inflammatory activity: inhibitory effect of Vitamin E. J BIOL REG HOMEOS AG 2018; 32:13-19. [PMID: 29504360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Vitamin supplementation in disease reduces morbidity and mortality in humans by promoting the activation of different genes which influence several pathways. The purpose of this article is to clarify the role of vitamin E in mast cell inflammation. Vitamin E is a fat soluble antioxidant which protects from low-density lipoprotein (LDL) oxidation. Vitamin E promotes a barrier function and anti-inflammatory responses by binding the regulatory domain of protein kinase Cα (pkcα) (a regulator and antagonist of heart failure) and decreases the activation of NF-қb, a proinflammatory transcription factor, causing the generation of cytokines/chemokines and mast cell activation. Mast cells participate in innate and acquired immunity and inflammation. Several factors, including cytokines and chemokines, regulate the development and migration of activated mast cells. Mast cells generate and release inflammatory compounds in asthma and allergic diseases and have a detrimental effect on the vessel wall, which can be inhibited by vitamin E. Vitamin E inhibits histamine release generated in activated mast cells, increases calcium Ca2+ uptake and prevents the oxidation of unsaturated fatty acids. Vitamin E is relatively non-toxic, however, administered at very high doses may suppress normal hematological response as well as causing other adverse effects. Therefore, vitamin E may be beneficial in the prevention of diseases mediated by mast cells and can have special value in the treatment of asthma and allergic diseases; however, the exact mechanism by which vitamin E acts is still unclear, thus warranting future research.
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Affiliation(s)
- L Tettamanti
- Department of Medical and Morphological Science, University of Insubria, Varese, Italy
| | | | - F Mastrangelo
- Department of Medical Science and Biotechnology, University of Foggia, Foggia, Italy
| | - G Ronconi
- UOS Clinica dei Pazienti del Territorio, Policlinico Gemelli, Rome, Italy
| | - S Kritas
- Faculty of Parasitology, Aristotle University of Thessaloniki, Macedonia, Greece
| | - I Frydas
- Department of Microbiology, University of Thessaloniki, Thessaloniki, Greece
| | - P Conti
- Postgraduate Medical School, University of Chieti, Chieti, Italy
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Gold M, Omari T, Abu-Assi R, Moore D, Heine R, Tobin JM, McCall L, Savage K, Ferris L, Kritas S, Davidson G. P34: DIAGNOSTIC MARKERS IN RELATION TO CHALLENGE-PROVEN INFANT COW’S MILK PROTEIN ALLERGY. Intern Med J 2017. [DOI: 10.1111/imj.34_13578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M Gold
- Department of Allergy and Immunology Womens and Childrens Hospital; Adelaide Australia
| | - T Omari
- College of Medicine and Public Health; Flinders University; Adelaide Australia
| | - R Abu-Assi
- Department of Gastroenterology, Women's and Children's Hospital; Adelaide Australia
| | - D Moore
- Department of Gastroenterology, Women's and Children's Hospital; Adelaide Australia
| | - R Heine
- Murdoch Children’s Research Institute; University Melbourne; Melbourne Australia
| | - JM Tobin
- Murdoch Children’s Research Institute; University Melbourne; Melbourne Australia
| | - L McCall
- Murdoch Children’s Research Institute; University Melbourne; Melbourne Australia
| | - K Savage
- Department of Gastroenterology, Women's and Children's Hospital; Adelaide Australia
| | - L Ferris
- College of Medicine and Public Health; Flinders University; Adelaide Australia
| | - S Kritas
- Department of Gastroenterology, Women's and Children's Hospital; Adelaide Australia
| | - G Davidson
- Department of Gastroenterology, Women's and Children's Hospital; Adelaide Australia
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Cock C, Besanko L, Kritas S, Burgstad CM, Thompson A, Heddle R, Fraser RJL, Omari TI. Impaired bolus clearance in asymptomatic older adults during high-resolution impedance manometry. Neurogastroenterol Motil 2016; 28:1890-1901. [PMID: 27346335 DOI: 10.1111/nmo.12892] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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] [Received: 03/17/2016] [Accepted: 05/30/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Dysphagia becomes more common in old age. We performed high-resolution impedance manometry (HRIM) in asymptomatic healthy adults (including an older cohort >80 years) to assess HRIM findings in relation to bolus clearance. METHODS Esophageal HRIM was performed in a sitting posture in 45 healthy volunteers (n = 30 young control, mean age 37 ± 11 years and n = 15 older subjects aged 85 ± 4 years) using a 3.2-mm solid-state catheter (Solar GI system; MMS, Enschede, The Netherlands) with 25 pressure (1-cm spacing) and 12 impedance segments (2-cm intervals). Five swallows each of 5- and 10-mL liquid and viscous bolus were performed and analyzed using esophageal pressure topography metrics and Chicago classification criteria as well as pressure-flow parameters. Bolus transit was determined using standard impedance criteria. A p-value <0.05 was considered significant. KEY RESULTS Impaired bolus clearance occurred more frequently in asymptomatic older subjects compared with young controls (YC) during liquid (40 vs 18%, χ2 = 4.935; p < 0.05) and viscous (60 vs 17%; χ2 = 39.08; p < 0.001) swallowing. Longer peristaltic breaks (p < 0.05) and more rapid peristalsis (L: p < 0.004, V: p = 0.003) occurred in the older cohort, with reduced impedance-based clearance for both bolus consistencies (L: p < 0.05, V: p < 0.001). Decreased peristaltic vigor (distal contractile integral <450 mmHg/s/cm) was associated with reduced liquid clearance in both age groups (p < 0.001) and of viscous swallows in the older group (p < 0.001). Impedance ratio, a marker of bolus retention, was increased in older subjects during liquid (p = 0.002) and viscous (p < 0.001) swallowing. CONCLUSIONS & INFERENCES Impaired liquid and viscous bolus clearance, esophageal pressure topography, and pressure-flow changes were seen in asymptomatic older subjects.
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Affiliation(s)
- C Cock
- Gastroenterology & Hepatology, Southern Adelaide Local Health Network, Bedford Park, SA, Australia.,School of Medicine, Flinders University of South Australia, Adelaide, SA, Australia
| | - L Besanko
- Gastroenterology & Hepatology, Southern Adelaide Local Health Network, Bedford Park, SA, Australia
| | - S Kritas
- Gastroenterology Unit, Women's and Children's Health Network, Adelaide, SA, Australia
| | - C M Burgstad
- Gastroenterology & Hepatology, Southern Adelaide Local Health Network, Bedford Park, SA, Australia
| | - A Thompson
- Gastroenterology & Hepatology, Southern Adelaide Local Health Network, Bedford Park, SA, Australia
| | - R Heddle
- Gastroenterology & Hepatology, Southern Adelaide Local Health Network, Bedford Park, SA, Australia
| | - R J L Fraser
- Gastroenterology & Hepatology, Southern Adelaide Local Health Network, Bedford Park, SA, Australia.,School of Medicine, Flinders University of South Australia, Adelaide, SA, Australia
| | - T I Omari
- School of Medicine, Flinders University of South Australia, Adelaide, SA, Australia.,Gastroenterology Unit, Women's and Children's Health Network, Adelaide, SA, Australia.,Department of Human Physiology, Flinders University, Adelaide, Australia
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Kritas S, Dejaeger E, Tack J, Omari T, Rommel N. Objective prediction of pharyngeal swallow dysfunction in dysphagia through artificial neural network modeling. Neurogastroenterol Motil 2016; 28:336-44. [PMID: 26891061 DOI: 10.1111/nmo.12730] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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] [Received: 07/30/2015] [Accepted: 10/19/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Pharyngeal pressure-flow analysis (PFA) of high resolution impedance-manometry (HRIM) with calculation of the swallow risk index (SRI) can quantify swallow dysfunction predisposing to aspiration. We explored the potential use of artificial neural networks (ANN) to model the relationship between PFA swallow metrics and aspiration and to predict swallow dysfunction. METHODS Two hundred consecutive dysphagia patients referred for videofluoroscopy and HRIM were assessed. Presence of aspiration was scored and PFA software derived 13 metrics and the SRI. An ANN was created and optimized over training cycles to achieve optimal classification accuracy for matching inputs (PFA metrics) to output (presence of aspiration on videofluoroscopy). Application of the ANN returned a value between 0.00 and 1.00 reflecting the degree of swallow dysfunction. KEY RESULTS Twenty one patients were excluded due to insufficient number of swallows (<4). Of 179, 58 aspirated and 27 had aspiration pneumonia history. The SRI was higher in aspirators (aspiration 24 [9, 41] vs no aspiration 7 [2, 18], p < 0.001) and patients with pneumonia (pneumonia 27 [5, 42] vs no pneumonia 8 [3, 24], p < 0.05). The ANN Predicted Risk was higher in aspirators (aspiration 0.57 [0.38, 0.82] vs no aspiration 0.13 [0.4, 0.25], p < 0.001) and in patients with pneumonia (pneumonia 0.46 [0.18, 0.60] vs no pneumonia 0.18 [0.6, 0.49], p < 0.01). Prognostic value of the ANN was superior to the SRI. CONCLUSIONS & INFERENCES In a heterogeneous cohort of dysphagia patients, PFA with ANN modeling offers enhanced detection of clinically significant swallowing dysfunction, probably more accurately reflecting the complex interplay of swallow characteristics that causes aspiration.
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Affiliation(s)
- S Kritas
- Gastroenterology Unit, Women's & Children's Health Network, Adelaide, SA, Australia.,Neurosciences, ExpORL, KU Leuven, Leuven, Belgium.,Translational Research Center for Gastrointestinal Diseases (TARGID), KU Leuven, Leuven, Belgium
| | - E Dejaeger
- Gerontology and Geriatrics, University Hospitals Leuven, Leuven, Belgium.,Multidisciplinary Clinic for Swallowing Disorders, University Hospitals Leuven, Leuven, Belgium
| | - J Tack
- Translational Research Center for Gastrointestinal Diseases (TARGID), KU Leuven, Leuven, Belgium
| | - T Omari
- Gastroenterology Unit, Women's & Children's Health Network, Adelaide, SA, Australia.,Department of Human Physiology, School of Medicine, Flinders University, Adelaide, SA, Australia
| | - N Rommel
- Neurosciences, ExpORL, KU Leuven, Leuven, Belgium.,Translational Research Center for Gastrointestinal Diseases (TARGID), KU Leuven, Leuven, Belgium
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Cock C, Besanko L, Kritas S, Burgstad CM, Thompson A, Heddle R, Fraser RJL, Omari TI. Maximum upper esophageal sphincter (UES) admittance: a non-specific marker of UES dysfunction. Neurogastroenterol Motil 2016; 28:225-33. [PMID: 26547361 DOI: 10.1111/nmo.12714] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [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] [Received: 07/02/2015] [Accepted: 10/01/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND Assessment of upper esophageal sphincter (UES) motility is challenging, as functionally, UES relaxation and opening are distinct. We studied novel parameters, UES admittance (inverse of nadir impedance), and 0.2-s integrated relaxation pressure (IRP), in patients with cricopharyngeal bar (CPB) and motor neuron disease (MND), as predictors of UES dysfunction. METHODS Sixty-six healthy subjects (n = 50 controls 20-80 years; n = 16 elderly >80 years), 11 patients with CPB (51-83 years) and 16 with MND (58-91 years) were studied using pharyngeal high-resolution impedance manometry. Subjects received 5 × 5 mL liquid (L) and viscous (V) boluses. Admittance and IRP were compared by age and between groups. A p < 0.05 was considered significant. KEY RESULTS In healthy subjects, admittance was reduced (L: p = 0.005 and V: p = 0.04) and the IRP higher with liquids (p = 0.02) in older age. Admittance was reduced in MND compared to both healthy groups (Young: p < 0.0001 for both, Elderly L: p < 0.0001 and V: p = 0.009) and CPB with liquid (p = 0.001). Only liquid showed a higher IRP in MND patients compared to controls (p = 0.03), but was similar to healthy elderly and CPB patients. Only admittance differentiated younger controls from CPB (L: p = 0.0002 and V: p < 0.0001), with no differences in either parameter between CPB and elderly subjects. CONCLUSIONS & INFERENCES The effects of aging and pathology were better discriminated by UES maximum admittance, demonstrating greater statistical confidence across bolus consistencies as compared to 0.2-s IRP. Maximum admittance may be a clinically useful determinate of UES dysfunction.
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Affiliation(s)
- C Cock
- Gastroenterology & Hepatology, Southern Adelaide Local Health Network, Adelaide, SA, Australia.,School of Medicine, Flinders University of South Australia, Adelaide, SA, Australia
| | - L Besanko
- Gastroenterology & Hepatology, Southern Adelaide Local Health Network, Adelaide, SA, Australia
| | - S Kritas
- Gastroenterology Unit, Women's and Children's Health Network, Adelaide, SA, Australia
| | - C M Burgstad
- Gastroenterology & Hepatology, Southern Adelaide Local Health Network, Adelaide, SA, Australia
| | - A Thompson
- Gastroenterology & Hepatology, Southern Adelaide Local Health Network, Adelaide, SA, Australia
| | - R Heddle
- Gastroenterology & Hepatology, Southern Adelaide Local Health Network, Adelaide, SA, Australia
| | - R J L Fraser
- Gastroenterology & Hepatology, Southern Adelaide Local Health Network, Adelaide, SA, Australia.,School of Medicine, Flinders University of South Australia, Adelaide, SA, Australia
| | - T I Omari
- School of Medicine, Flinders University of South Australia, Adelaide, SA, Australia.,Gastroenterology Unit, Women's and Children's Health Network, Adelaide, SA, Australia.,School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, SA, Australia
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Evangelopoulou G, Kritas S, Christodoulopoulos G, Burriel AR. The commercial impact of pig Salmonella spp. infections in border-free markets during an economic recession. Vet World 2015; 8:257-72. [PMID: 27047083 PMCID: PMC4774829 DOI: 10.14202/vetworld.2015.257-272] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 01/15/2015] [Accepted: 01/21/2015] [Indexed: 11/16/2022] Open
Abstract
The genus Salmonella, a group of important zoonotic pathogens, is having global economic and political importance. Its main political importance results from the pathogenicity of many of its serovars for man. Serovars Salmonella Enteritidis and Salmonella Typhimurium are currently the most frequently associated to foodborne infections, but they are not the only ones. Animal food products contaminated from subclinically infected animals are a risk to consumers. In border free markets, an example is the EU, these consumers at risk are international. This is why, economic competition could use the risk of consumer infection either to restrict or promote free border trade in animals and their products. Such use of public health threats increases during economic recessions in nations economically weak to effectively enforce surveillance. In free trade conditions, those unable to pay the costs of pathogen control are unable to effectively implement agreed regulations, centrally decided, but leaving their enforcement to individual states. Free trade of animal food products depends largely on the promotion of safety, included in "quality," when traders target foreign markets. They will overtake eventually the markets of those ineffectively implementing agreed safety regulations, if their offered prices are also attractive for recession hit consumers. Nations unable to effectively enforce safety regulations become disadvantaged partners unequally competing with producers of economically robust states when it comes to public health. Thus, surveillance and control of pathogens like Salmonella are not only quantitative. They are also political issues upon which states base national trade decisions. Hence, the quantitative calculation of costs incurring from surveillance and control of animal salmonelloses, should not only include the cost for public health protection, but also the long term international economic and political costs for an individual state. These qualitative and qualitative costs of man and animal Salmonella infections should be calculated in the light of free trade and open borders. Understandably, accurate calculation of the economic and political costs requires knowledge of the many factors influencing nationally the quality and safety of pork products and internationally free trade. Thus, how Salmonella pig infections affect commerce and public health across open borders depends on a state's ability to accurately calculate costs for the surveillance and control of animal salmonelloses in general, and pig infections as a particular example.
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Affiliation(s)
- G Evangelopoulou
- Laboratory of Microbiology and Parasitology, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Karditsa, Greece
| | - S Kritas
- Department of Microbiology and Infectious Diseases, Faculty of Veterinary Medicine, Aristotle University, Thessaloniki, MKD, Greece
| | - G Christodoulopoulos
- Department of Clinical Veterinary Medicine, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Karditsa, Greece
| | - A R Burriel
- Laboratory of Microbiology and Parasitology, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Karditsa, Greece
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Singendonk MMJ, Smits MJ, Heijting IE, van Wijk MP, Nurko S, Rosen R, Weijenborg PW, Abu-Assi R, Hoekman DR, Kuizenga-Wessel S, Seiboth G, Benninga MA, Omari TI, Kritas S. Inter- and intrarater reliability of the Chicago Classification in pediatric high-resolution esophageal manometry recordings. Neurogastroenterol Motil 2015; 27:269-76. [PMID: 25521418 DOI: 10.1111/nmo.12488] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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] [Received: 07/28/2014] [Accepted: 11/18/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND The Chicago Classification (CC) facilitates interpretation of high-resolution manometry (HRM) recordings. Application of this adult based algorithm to the pediatric population is unknown. We therefore assessed intra and interrater reliability of software-based CC diagnosis in a pediatric cohort. METHODS Thirty pediatric solid state HRM recordings (13M; mean age 12.1 ± 5.1 years) assessing 10 liquid swallows per patient were analyzed twice by 11 raters (six experts, five non-experts). Software-placed anatomical landmarks required manual adjustment or removal. Integrated relaxation pressure (IRP4s), distal contractile integral (DCI), contractile front velocity (CFV), distal latency (DL) and break size (BS), and an overall CC diagnosis were software-generated. In addition, raters provided their subjective CC diagnosis. Reliability was calculated with Cohen's and Fleiss' kappa (κ) and intraclass correlation coefficient (ICC). KEY RESULTS Intra- and interrater reliability of software-generated CC diagnosis after manual adjustment of landmarks was substantial (mean κ = 0.69 and 0.77 respectively) and moderate-substantial for subjective CC diagnosis (mean κ = 0.70 and 0.58 respectively). Reliability of both software-generated and subjective diagnosis of normal motility was high (κ = 0.81 and κ = 0.79). Intra- and interrater reliability were excellent for IRP4s, DCI, and BS. Experts had higher interrater reliability than non-experts for DL (ICC = 0.65 vs ICC = 0.36 respectively) and the software-generated diagnosis diffuse esophageal spasm (DES, κ = 0.64 vs κ = 0.30). Among experts, the reliability for the subjective diagnosis of achalasia and esophageal gastric junction outflow obstruction was moderate-substantial (κ = 0.45-0.82). CONCLUSIONS & INFERENCES Inter- and intrarater reliability of software-based CC diagnosis of pediatric HRM recordings was high overall. However, experience was a factor influencing the diagnosis of some motility disorders, particularly DES and achalasia.
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Affiliation(s)
- M M J Singendonk
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital AMC, Amsterdam, The Netherlands; Gastroenterology Unit, Women's and Children's Health Network, North Adelaide, SA, Australia
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Singendonk MMJ, Kritas S, Cock C, Ferris L, McCall L, Rommel N, van Wijk MP, Benninga MA, Moore D, Omari TI. Applying the Chicago Classification criteria of esophageal motility to a pediatric cohort: effects of patient age and size. Neurogastroenterol Motil 2014; 26:1333-41. [PMID: 25053225 DOI: 10.1111/nmo.12397] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [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] [Received: 03/03/2014] [Accepted: 06/16/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Applying the 2012 Chicago Classification (CC) of esophageal motility disorders to pediatric patients is problematic as it relies upon adult-derived criteria. As shorter esophageal length and smaller esophago-gastric junction (EGJ) diameter may influence CC metrics, we explored the potential for age- and size-adjustment of diagnostic criteria. METHODS We evaluated 76 high-resolution solid state impedance-manometry recordings in children referred for manometry (32M; mean age 9 ± 1 years) and 25 recordings from healthy adult subjects (7M; mean age 36 ± 2 years). CC metrics; integrated relaxation pressure (IRP4s, mmHg), contractile front velocity (CFV, cm/s), distal contractile integral (DCI, mmHg cm/s), distal latency (DL, s), and peristaltic break size (BS, cm) were derived for 10 liquid swallows using CC analysis software. Effects of age and size were examined using regression analysis. KEY RESULTS Younger patient age and shorter size correlated significantly with greater IRP4s (p < 0.05), shorter DL (p < 0.001) and smaller BS (p < 0.05). Standard diagnostic CC criteria were adjusted using the slope of the linear regression equation to define the age/size-related trend. Sixty-six percent of the pediatric cohort showed abnormal motility when applying standard CC criteria. Adjustment for age and size reduced this to 50% and 53% respectively, with the largest reduction being in the IRP4s- and DL-dependent disorders EGJ outflow obstruction and diffuse esophageal spasm (13% to 7% and 5% and 14% to 1 and 5%, respectively). CONCLUSIONS & INFERENCES CC metrics, particularly IRP4s and DL, are age and size dependent, and therefore, require adjustment to improve accuracy of diagnosis of esophageal motility disorders in children.
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Affiliation(s)
- M M J Singendonk
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital AMC, Amsterdam, The Netherlands; Gastroenterology Unit, Women's and Children's Health Network, North Adelaide, Australia
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Omari TI, Kritas S, Cock C, Besanko L, Burgstad C, Thompson A, Rommel N, Heddle R, Fraser RJL. Swallowing dysfunction in healthy older people using pharyngeal pressure-flow analysis. Neurogastroenterol Motil 2014; 26:59-68. [PMID: 24011430 DOI: 10.1111/nmo.12224] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [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] [Received: 06/13/2013] [Accepted: 08/08/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND Age-related loss of swallowing efficiency may occur for multiple reasons. Objective assessment of individual dysfunctions is difficult and may not clearly differentiate these from normal. Pharyngeal pressure-flow analysis is a novel technique that allows quantification of swallow dysfunction predisposing to aspiration risk based on a swallow risk index (SRI). In this study, we examined the effect of ageing on swallow function. METHODS Studies were performed in 68 healthy subjects aged 20-91 years (mean 59 years; 29 male), asymptomatic for oropharyngeal disease. Swallowing of liquid and viscous boluses was recorded with a pressure-impedance catheter. Indices of swallow function including the SRI, postswallow residues, upper esophageal sphincter opening and bolus transit time were derived using purpose designed software. KEY RESULTS Swallow function worsened with increasing age with a significant decline after 80 years. Higher SRI correlated with increasing age (r = 0.257, p < 0.05 for liquids and r = 0.361, p < 0.005 viscous bolus). Subjects over 80 years were overrepresented amongst those with an SRI considered diagnostically relevant (SRI > 15). In addition, upper esophageal sphincter opening was reduced and postswallow residues increased in older subjects. CONCLUSIONS & INFERENCES Pharyngeal pressure-flow analysis reveals multiple functional abnormalities in older individuals. The higher SRI levels seen in asymptomatic elders possibly reflect a loss of functional reserve with ageing. Automated impedance manometry analysis of swallow function may allow the risk of developing disordered swallowing to be quantified numerically.
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Affiliation(s)
- T I Omari
- Gastroenterology Unit, Women's and Children's Health Network, Adelaide, SA, Australia; School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, SA, Australia; Department of Gastroenterology and Hepatology, School of Medicine, Flinders University, Adelaide, SA, Australia
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Li H, Kentish SJ, Kritas S, Young RL, Isaacs NJ, O'Donnell TA, Blackshaw LA, Wittert GA, Page AJ. Modulation of murine gastric vagal afferent mechanosensitivity by neuropeptide W. Acta Physiol (Oxf) 2013; 209:179-91. [PMID: 23927541 DOI: 10.1111/apha.12154] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 06/09/2013] [Accepted: 07/31/2013] [Indexed: 12/22/2022]
Abstract
AIM Neuropeptide W (NPW) is an endogenous ligand for the receptors GPR7 and GPR8 and is involved in central regulation of energy homeostasis. NPW in the periphery is found in gastric gastrin (G) cells. In the stomach, energy intake is influenced by vagal afferent signals, so we aimed to determine the effect of NPW on mechanosensitive gastric vagal afferents under different feeding conditions. METHODS Female C57BL/6 mice (N > 10 per group) were fed a standard laboratory diet (SLD), high-fat diet (HFD) or were food restricted. The relationship between NPW immunopositive cells and gastric vagal afferent endings was determined by anterograde tracing and NPW immunohistochemistry. An in vitro gastro-oesophageal preparation was used to determine the functional effects of NPW on gastric vagal afferents. Expression of NPW in the gastric mucosa and GPR7 in whole nodose ganglia was determined by quantitative RT-PCR (QRT-PCR). The expression of GPR7 in gastric vagal afferent neurones was determined by retrograde tracing and QRT-PCR. RESULTS Neuropeptide W immunoreactive cells were found in close proximity to traced vagal afferents. NPW selectively inhibited responses of gastric vagal tension receptors to stretch in SLD but not HFD or fasted mice. In the nodose ganglia, GPR7 mRNA was specifically expressed in gastric vagal afferent neurones. In fasted mice gastric mucosal NPW and nodose GPR7, mRNA was reduced compared with SLD. A HFD had no effect on gastric NPW mRNA, but down-regulated nodose GPR7 expression. CONCLUSION Neuropeptide W modulates gastric vagal afferent activity, but the effect is dynamic and related to feeding status.
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Affiliation(s)
- H. Li
- Nerve-Gut Research Laboratory; University of Adelaide; Adelaide; Australia
| | - S. J. Kentish
- Nerve-Gut Research Laboratory; University of Adelaide; Adelaide; Australia
| | - S. Kritas
- Women's & Children's Hospital; University of Adelaide; Adelaide; Australia
| | | | - N. J. Isaacs
- Nerve-Gut Research Laboratory; University of Adelaide; Adelaide; Australia
| | | | - L. A. Blackshaw
- Wingate Institute of Neurogastroenterology; Blizard Institute; Barts and The London School of Medicine & Dentistry; Queen Mary, University of London; London; UK
| | - G. A. Wittert
- Nerve-Gut Research Laboratory; University of Adelaide; Adelaide; Australia
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Abstract
BACKGROUND Pharyngeal propulsion, strength of peristalsis and esophago-gastric junction (EJG) resistance are determinants of esophageal bolus transport. This study used pressure-impedance methods to correlate pharyngo-esophageal function with the esophageal bolus trajectory pathway and pressures generated during bolus transport. METHODS Pharyngo-esophageal pressure-impedance measurements were performed in 20 healthy adult controls. Pharyngeal automated impedance manometry (AIM) analysis was performed to derive pharyngeal swallow function variables. The esophageal time of nadir impedance (TZn) was used to track bolus trajectory pathway. The inflection, or flow stasis point (FSP), of the trajectory curve was determined as were the pressures within the bolus (PZn) above and below the FSP. The size of 20 mmHg isocontour defect (20 mmHg IC defect) measured the integrity of the peristaltic wave. KEY RESULTS For viscous boluses, weaker pharyngeal bolus propulsion correlated with the FSP being located higher in the esophagus. Pressure within the bolus was observed to increase at the FSP and below the FSP in a manner that correlated with the magnitude of esophageal peak pressures. Larger 20 mmHg IC defects were associated with lower pressures within the bolus at the FSP and below. CONCLUSIONS & INFERENCES The FSP of the bolus trajectory pathway appears to represent a switch from bolus propulsion due to pharyngeal mechanisms to bolus propulsion due to esophageal mechanisms. 20 mmHg IC defects significantly reduce bolus driving pressure at or below the FSP.
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Affiliation(s)
- T Omari
- Gastroenterology Unit, Women's and Children's Health Network, Adelaide, SA, Australia.
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Bouzalas IG, Dovas CI, Banos G, Papanastasopoulou M, Kritas S, Oevermann A, Papakostaki D, Evangelia C, Papadopoulos O, Seuberlich T, Koptopoulos G. Caprine PRNP polymorphisms at codons 171, 211, 222 and 240 in a Greek herd and their association with classical scrapie. J Gen Virol 2010; 91:1629-34. [DOI: 10.1099/vir.0.017350-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Burriel AR, Mastoraki F, Kritas S. Antimicrobial resistance of animal and human strains of Enterobacteriaceae in Greece. New Microbiol 2003; 26:27-32. [PMID: 12578308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Two hundred sixty two strains of Enterobacteriaceae from animal and human sources where intermixing and/or spreading is possible were examined for their resistance to 15 antimicrobials frequently used in animal prophylaxis and metaphylaxis. The antimicrobials with the highest proportion of resistant strains from animal sources were amoxicillin 25 mg, colistin sulphate 25 mg, erythromycin 5 mg, penicillin G 10 mg and spectinomycin 10 mg. The same with isolates from human sources where ampicillin 10 mg, amoxicillin 25 mg, colistin sulphate 25 mg, erythromycin 5 mg, neomycin 10 mg, penicillin G 10 mg and spectinomycin 10 mg. Human isolates were resistant to more antimicrobials than animal isolates. Common a high proportion of isolates from both sources were resistant to some antimicrobials. Systematic and better distributed information is needed to address the epidemiological role of veterinary treatment, prophylaxis and metaphylaxis in antimicrobial resistance in Greece.
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Affiliation(s)
- A R Burriel
- Faculty of Veterinary Medicine, Laboratory of Microbiology and Parasitology, University of Thessaly, Greece
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Fthenakis GC, Papadopoulos E, Himonas C, Leontides L, Kritas S, Papatsas J. Efficacy of moxidectin against sarcoptic mange and effects on milk yield of ewes and growth of lambs. Vet Parasitol 2000; 87:207-16. [PMID: 10622612 DOI: 10.1016/s0304-4017(99)00182-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Forty-eight dairy ewes and 45 lambs naturally infested with sarcoptic mange, were divided into three equal groups and treated with moxidectin 1% inj. sol. at a dose rate of 0.2 mg moxidectin kg(-1) bodyweight once or twice ten days apart. During the study, the skin lesions were scored and the number of mites recovered in facial skin scrapings from the animals were recorded. Moxidectin was found to be effective against ovine sarcoptic mange, when given twice; the percentage reduction of mites was 100% (p < 0.0001) and the skin lesions disappeared completely (p = 0.0001). In sheep treated once only, the percentage reduction of mites varied from 75% to 92%. Treated ewes produced up to 22.4% more milk than the infested ones (p = 0.0001). Treated lambs had up to 15% greater final weight and up to 23.7% more growth than infested controls (p = 0.0001). It is concluded that two injections of moxidectin 1% inj. sol. at a dose rate of 0.2 mg kg(-1) bodyweight, given ten days apart, were effective against ovine sarcoptic mange. Furthermore, it is considered that sarcoptic mange adversely affects the production of the infested animals.
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Affiliation(s)
- G C Fthenakis
- Veterinary Faculty, University of Thessaly, Karditsa, Greece.
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