Impact of autoimmune gastritis on chronic urticaria in paediatric patients - pathophysiological point of views.

We would like to provide an updated comprehensive perspective and identify the components linked to chronic spontaneous urticaria (CSU) without specific triggers in autoimmune atrophic gastritis (AAG). AAG is an organ-specific autoimmune disease that affects the corpus-fundus gastric mucosa. Although we lack a unified explanation of the underlying pathways, when considering all paediatric patients reported in the literature, alterations result in gastric neuroendocrine enterochromaffin-like (ECL) cell proliferation and paracrine release of histamine. Several mechanisms have been proposed for the pathogenesis of CSU, with much evidence pointing towards AAG and ECL cell responses, which may be implicated as potential factors contributing to CSU. The excessive production/release of histamine into the bloodstream could cause or trigger exacerbations of CSU in AAG, independent of Helicobacter pylori; thus, the release of histamine from ECL cells may be the primary modulator. CONCLUSION: Considering the understanding of these interactions, recognising the respective roles of AAG in the pathogenesis of CSU may strongly impact the diagnostic workup and management of unexplained/refractory CSU and may inform future research and interventions in the paediatric population. WHAT IS KNOWN: • Autoimmune atrophic gastritis is a chronic immune-mediated inflammatory disease characterised by the destruction of the oxyntic mucosa in the gastric body and fundus, mucosal atrophy, and metaplastic changes. • Autoimmune atrophic gastritis in paediatric patients is important because of the poor outcome and risk of malignancy and possibly underestimated entities primarily reported in single-case reports. WHAT IS NEW: • Upper gastrointestinal inflammatory disorders, independent of H. pylori, have been implicated as potential inducing factors in the development of chronic spontaneous urticaria. • If a paediatric patient presents with symptoms such as anaemia, reduced vitamin B12 levels, recurrent urticaria with no other detectable aetiology, positive anti-parietal cell antibodies, and elevated gastrin levels, autoimmune atrophic gastritis should be considered a possible cause of chronic urticaria.

[Detection of Babesia canis (Piroplasmida) DNA in the blood samples and lysates of the ticks Dermacentor reticulatus (Ixodidae) collected in the Tula and Moscow Regions].

Chimeric primers, the sensitivity and specificity of which allow them to be used in both the clinical setting and the epizootological assessment of tick infection by a real-time polymerase chain reaction (RT-PCR) assay, have been designed against Babesia canis infection. The findings suggest that a large number of Babesia DNA copies are detectable in the blood in acute babesiosis. Some animals that had experienced babesiosis developed blood B. canis carriage--a small number oftrophozoites remained alive for a long time. When babesiosis was suspected, its diagnosis could be confirmed by RT-PCR in half of dogs with subclinical signs. The tick concentration of Babesia ranged from several hundred to a few thousand parasites. There were no significant differences in the number of Babesia parasites in the infected ticks in relation to their collection site. However, the occurrence of infected ticks was significantly higher in the places of constant contact with a canine population, which is indicative of the decisive role of dogs in the intensity of an epizootic process in the foci of B. canis infection.

[Tourism, imported parasitic diseases, and their prevention].

The paper gives the results of observations of 1558 patients before and after tourist travels to tropical countries and 368 individuals visiting the north areas of the Russian Federation. Different conditions (malaria, amebiasis, leishmaniasis, intestinal and tissue helminthiasis, insect bites, venomous fish pricks, medusa burn, tick bites, etc.) were found in 402 persons. Prophylactic immunization included vaccination against hepatitis A and B viruses, meningitis, typhus, yellow fever, tick-borne encephalitis in more than 2500 patients (not including influenza vaccination in the epidemic season). The performed observations reinforce the statement that imported pathology is urgent to Russia and suggest that it is necessary to develop this section of medicine and to set up a network of health care facilities with a necessary therapeutic and diagnostic base to render skilled care to tourists. It is essential to improve medical staff training in travel medicine.

[Immunomodulating effect of an Ixodes persulcatus (Ixodidae) tick salivary gland extract on BALB/c mice lymphocytes in an in vitro system].

The immunomodulating effect of the components of an Ixodes persulcatus (Ixodidae) tick salivary gland extract (SGE) on BALB/c mice lymphocytes was evaluated. SGE of partially engorged ticks at a concentration of 50 microg/ml causes the maximum suppression ofT- and B-lymphocyte subpopulations. SGE of hungry ticks at the same concentration induces the suppression of only CD69+ T cells and TLR-2+ B cells, but produces no suppressive effect on CD69+ B lymphocytes, TLR-2+ T lymphocytes, and TLR-4+ T and B lymphocytes. SGE shows different effects on the synthesis of IFN-gamma and IL-4 by T helper cells. SGE of hungry ticks stimulated the increase of IFN-gamma and IL-4 synthesis by 4.7 and 2.6 times, respectively, as compared to the control. The findings may be of value in studying the pathogenesis of transmissible infections and in designing the vaccines based on tick gland components.

[Search for protective antigens in Ixodes persulcatus (ixodidae) salivary gland extracts].

RT-PCR evaluation of the activity of eight Ixodes persulcatus salivary gland genes shows clear distinctions in their expression depending of the stage of tick feeding. Out of them, only Salp 10 and Salp 15 proteins may be regarded as candidates for protective antigens to develop anti-tick and anti-Borrelia vaccines. Firstly they play an important role in feeding a tick and modifying a host's immune response. Secondly, the increasing expression of the salp 10 and salp 10 genes begins at early tick feeding stages. Thirdly, the activity of these genes increases with the beginning of feeding by tens and hundreds times and keeps at this level until the third tick feeding stage is over.

[Changes in the expression of salivary gland genes in Ixodes persulcatus (Ixodidae) depending on the stage of tick feeding].

By using the guanidine-isothiocyanate test, the authors isolated a summary RNA preparation from Ixodes persulcatus salivary gland extracts. Activity products of the genes responsible for the expression of some salivary proteins were first identified using the RT-PCR. It has been shown that, firstly, I. persulcatus synthesizes at least 3 transcripts homologous to the respective salivary components of the related species I. scapularis, the translation product of which is likely to be immunodominant antigens; secondly, the number of each of these transcripts, as in I. scapularis, depends on the stage of tick feeding. The changes in the expression of each transcript are specific: monotonously increasing changes in Salp 17 and cyclic ones in Salp 16, and synthesis, only when the ticks are fully ingested, in Salp 25.

[Clinical features of the blepharoconjunctivitis type of the dry eye in demodicosis].

The paper presents data on demodicosis-induced blepharoconjunctivitis complicated by the dry eye, such as predictors, etiology, and pathogenesis of this disease. It gives a concise outline of the life history of mites and their species parasitizing on the human skin cycle and an extended treatment regimen for blepharoconjunctivitis complicated by the dry eye. The time course of changes in the pathological signs of blepharitis is shown when the latter is treated using the given regimen and the treatment is discontinued. The authors provide the data of Schirmer's test and Norn's test, which have been used to support the results of the present investigation. The mechanism of action of the drugs considered in the paper on the eyelids is outlined. There is a tendency for demodicosis-induced blepharoconjunctivitis to be completely eliminated and the signs of the dry eye to be compensated when meticulously chosen therapy, including hygienic measures, is performed.

[Evaluation of the occurrence of borreliae in the ticks]. / Otsenka porazhennosti kleshchei borreliiami.

The paper shows it necessary to estimate the average number of borreliae in the infected ticks, by using the geometric mean of a sign rather than the arithmetic mean.

[A laboratory model of the parasitic system of Lyme disease]. / Laboratornaia model' parazitarnoi sistemy bolezni Laima.

A laboratory model of the parasitic system of Lyme borreliosis (LB) with Ixodes persulcatus and Borrelia burgdorferi s.s. underwent 5 epizootic cycles (Cycle I transition of Borreliae by the scheme a tick-->a mouse-->a tick corresponds to the seasonal cycle). A group of 5-6 mice was inoculated with the suspension of infected nymphs by the intracutaneously route and 35-45 days later intact tick larvae or nymphs were fed on them. In the first three cycles, 40-100% of mice in a group (a total of 33 of 59) were susceptible, but 3 of 11 groups of mice were not inoculated. 20-50% of larvae and 75-92% of nymphs were susceptible on the infected mice. The mean geometric abundance of borreliae was 2.8-6.3 cells per 100 fields of vision in the nymphs infected in the larval phase and 16.1-29.5 cells in the image phase. In cycle IV, 2 of 6 groups of mice were unsusceptible to borreliae and 5 of the 17 mice from 4 groups got infected. One mouse died from Lyme borreliosis when larvae were fed on it. The nymphs remolted from underfed larvae were infected in 62.2% of cases, the mean geometric abundance in these nymphs was 5.7% per 100 fields of vision. A total of 3.2-14.7% of the ticks fed on the remaining 4 mice were infected and the abundance of boreliae was 1-2 per 100 fields of vision. In cycle V, one of 12 mice got infected, the infection rate in nymphs was 9.1%, the abundance of borreliae was 1 per 100 fields of vision. Thus, as the number of epizootic cycles increases, the proportion of infected mice, that of ticks infected on these mice on feeding, and the abundance of borreliae in the infected ticks decrease. Moreover, there was a reduction in the length of borreliae reduced from 17-18 mm to 10-11 mm and in the duration of multiplication and preservation of borreliae in the infected ticks and there was concurrently an increase in the duration of development of an infectious process in mice. It is suggested that the population of borreliae consists of 2 morphophysiological groups or more. During cultivation of the laboratory model of the parasitic system of Lyme borreliosis, a group of borrelia that are short and slightly pathogenic for mice had got many points in its favour. A five-fold procedure of artificial election of precisely defining this group set the model on the verge of disappearance. The capacity of the populations of borreliae to alter their properties rapidly and fundamentally suggests that there might be violent annual fluctuations in human morbidity.

[Autoimmune enteropathy with onset in early infancy: clinico-morphologic and immunologic manifestations]. / Autoimunní enteropatie se zacátkem v casném kojeneckém veku: klinicko-morfologické a imunologické projevy.

This paper describes a severely affected male infant with serious protracted diarrhoea caused by a rare autoimmune enteropathy. The disease began at 6 weeks of age of the child and it was associated with small bowel villous atrophy and the presence of circulating antienterocyte antibodies. The child was treated with steroids and with parenteral and special enteral nutrition. The patient showed clinical improvement as documented by decreased stool output and possibility to terminate the parenteral nutrition. The small biopsy samples showed a return to normal. Antienterocyte antibodies were negative after the treatment. The patient has been followed up for at least 18 months and was in a clinical remission. We recommend that autoantibodies tests should be performed in all infants with unexplained protracted diarrhoea. The use of potent immunosuppressive drugs and the increasing experience with parenteral and enteral nutrition can improve the perspective of these previously fatal disorders.

[The results of a study of the acaricidal activity of the preparation Fewry-med]. / Rezul'taty izucheniia akaritsidnoi aktivnosti preparata F'iuri-med.

The acaricidal activity of Fewry-med (10% zeta-zipermethrin) against Ixodes persulcatus was studied in laboratory and field conditions. The drug's doses of 0.01-0.005 g/m2 (as calculated for active ingredient) provided 100% death of ticks when forest areas (Tyumen' Province) were treated. The efficiency of treatment preserved within 31 days (the follow-up period). When Fewry-med was used in a dose of 0.005 and 0.01 g/m2, the soil levels of zeta-zipermethrin was lower than the maximum allowable concentration at days 7 and 14 after treatment. In the treated areas, the size of crawling representatives of the entomofauna restored at day 25. The drug may be recommended for industrial trials.

[An experimental study of the capacity of the rat mite Ornithonyssus bacoti (Hirst, 1913) to ingest, maintain and transmit Borrelia]. / Eksperimental'noe izuchenie sposobnosti krysinogo kleshcha Ornithonyssus bacoti (Hirst, 1913) vosprinimat', sokhraniat' i peredavat' borrelii.

For the first time a possibility of the gamasina mites' O. bacoti participation in Lyme disease spirochetes' circulation has been demonstrated. It has been experimentally shown that Borrelia burgdorferi s.l. are received by O. bacoti, survive in them for at least 21 days and are transmitted to white mice through mites' bites. Mice's infestation has occurred in 23% of cases. It is suggested that other bloodsucking gamasina mites inhabiting the Lyme borreliosis reservoir rodents nests may be capable of participating in borrelia circulation in the Lyme disease endemic areas.

[Propagation of the pathogen of Lyme disease Borrelia burgdorferi in the ticks Ixodes persulcatus]. / Razmnozhenie vozbuditelei bolezni Laima Borrelia burgdorferi v kleshchakh Ixodes persulcatus.

An increase of the number of Borrelia burgdorferi s. l. in nymphs was observed 3-4 months later the moulting and during the following 4-5 months. The percent of infected ticks remained unchanged. The reproduction of spirochete was going not only at a room temperature, but also at a lower temperature, 3-5 degrees (imitation of hibernation conditions). An increase of the spirochete density was especially well marked, when the ticks were maintained under fluctuated daily conditions. We have found out the difference in the transphase transmission. Almost all larvae and nymphs infected by a bloodsucking retained spirochetes after moulting (the first transphase transmission). When the nymphs infected at larval stage were fed on an uninfected mouse, only 30% of imago ticks retained the spirochetes (the second transphase transmission).

[The reaction of taiga ticks to an attractant. II. The rates of removing ticks from a population]. / Reaktsiia taezhnykh kleshchei na attraktant. Soobshchenie II. Tempy iz''iatiia kleshchei iz populiatsii.

Catching ticks on the attractant-moistened napkins and on the flag (control) under field conditions during 5 days has demonstrated that a population of taiga ticks on the treated areas can be killed within 1-2 weeks when attractive-acaricidal granules are applied.

[The activity of cyfluthrin and cypermethrin-based preparations against the vector of the causative agent of tick-borne relapsing fever]. / Aktivnost' tsiflutrina i preparatov na osnove tsipermetrina po otnosheniiu k perenoschiku vozbuditelia kleshchevogo vozvratnogo tifa.

Laboratory tests have established a high activity and long-term persistence of some cipermethrin isomers (fendone, fastac) and cifluthrin (zolfac) against the tick Ornithodoros papillipes, a carrier of tick-borne relapsing fever. These indices are considerably superior to those of an isomer mixture of cipermethrin (cimbush, ripkord). This can be applied to deltamethrin and cigalothrin. The findings suggest that these agents are highly promising in controlling the carrier of tick-borne relapsing fever along with a significant reduction in the ecological pesticidal load in the focus.

[The rate of infection of the taiga tick with Borrelia in the western Sayan]. / Zarazhennost' taezhnogo kleshcha borreliiami v Zapadnom Saiane.

The paper provides microscopic findings of taiga ticks collected for the causative agent of Lyme's disease in May to July 1993 in the West Sayan . A total of 1,016 specimens were examined, among them 124 (12.2%) were found to have Borreliae. The areas were demonstrated to vary greatly with their epidemiological risk. The number of ticks and hence the epidemiological risk were the most in the low-mountain and chern taiga areas.

[The acaricidal activity of pyrethroids against Ixodes persulcatus P. Sch. nymphs]. / Akaritsidnaia aktivnost' nekotorykh piretroidov po otnosheniiu k nimfam Ixodes persulcatus P. Sch.

The efficiency of 9 drugs based on cipermethrin, deltamethrin, permethrin, lambdacigalothrin, ciphenothrin, phenothrin against hungry I. persulcatus nymphs was studied in the laboratory setting. The values LD50 and LD99 (in g of an active ingredient per m2) were found when the nymphs got into contacts with the treated filter paper for 10 sec and 1 min. The paper discusses whether the pyrethroids as part of attractant-acaricidal granules can be used to suppress the size of ticks in the tick-borne encephalitis foci.