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1.
Rev Esp Enferm Dig ; 112(7): 583-584, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32579012

RESUMO

Mönkemüller et al. brilliantly describe the pathogenesis of SARS-CoV-2 (COVID-19) in the gastrointestinal tract. Their findings highlight the local and systemic inflammatory response generated by the coronavirus. After having the opportunity to observe three cases of severe colonic ischemia and elevation of D-dimer levels in patients with COVID-19 and severe acute respiratory distress syndrome (SARS) due to SARS-CoV-2, we would like to highlight the thromboembolic complications in COVID-19, which are related to those reported by Mönkemüller and which have been mentioned by other authors.


Assuntos
Infecções por Coronavirus , Trato Gastrointestinal , Pandemias , Pneumonia Viral , Tromboembolia Venosa , Autopsia , Betacoronavirus , Humanos
3.
An Acad Bras Cienc ; 92 Suppl 1: e20180477, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32491140

RESUMO

Anticarsia gemmatalis Hübner, 1818 (Lepidoptera) is a major pest of soybean in the Brazil. It is known that the reduction of proteolytic activity by the ingestion of protease inhibitors reduces digestion and larval development of the insects. Control via inhibition of the digestive enzymes necessitates deeper knowledge of the enzyme kinetics and the characterization of the inhibition kinetics of these proteases, for better understanding of the active centers and action mechanisms of this enzyme. Trypsin-like proteases found in the gut of Anticarsia gemmatalis were purified in a p-aminobenzamidine agarose column. Kinetic characterization showed KM 0.503 mM for the L-BApNA substrate; Vmax= 46.650 nM s-1; Vmax/[E]= 9.256 nM s-1 mg L-1 and Vmax/[E]/KM= 18.402 nM s-1 mg L-1 mM. The Ki values for the inhibitors benzamidine, berenil, SKTI and SBBI were 11.2 µM, 32.4 µM, 0.25 nM and 1.4 nM, respectively, and all revealed linear competitive inhibition. The SKTI showed the greatest inhibition, which makes it a promising subject for future research to manufacture peptide mimetic inhibitors.


Assuntos
Trato Gastrointestinal/enzimologia , Lepidópteros/enzimologia , Inibidores de Proteases/farmacologia , Animais , Controle de Insetos/métodos , Cinética , Lepidópteros/crescimento & desenvolvimento
4.
An Acad Bras Cienc ; 92(2): e20181165, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32556047

RESUMO

This study describes the histological characteristics and distribution of gastrointestinal tract endocrine cells (ECs) of Prochilodus lineatus (detritivorous fish) using immunohistochemical procedures. The digestive tract of P. lineatus was divided into seven portions: stomach (cardial and pyloric), pyloric caeca, and intestine (anterior, glandular, middle and posterior). A pool of specific antisera against cholecystokinin (CCK-8), -neuropeptide Y (NPY), -ghrelin (Ghre) and -leu-enkephalin (Leu-ENK) to identify ECs were used. According to the morphological characteristics of ECs, two different types were identified and classified as open or closed-type. The number of ECs varied throughout the gastrointestinal tract, though a high abundance was found in the anterior intestine and pyloric caeca. A large number of ECs immunoreactive to CCK-8 and NPY were recorded in the anterior, glandular and middle intestine. ECs immunopositive to Leu-ENK were distributed in the stomach and pyloric caeca. For Ghre, immunopositive ECs were restricted to the glandular intestine. The results of the present study indicate that P. lineatus presents an ECs distribution pattern with species-specific particularities. However, CCK showed a distribution similar to that of omnivores, which is possibly related to local signaling functions in order to achieve the correct digestion of the various organisms found in the detritus.


Assuntos
Caraciformes/classificação , Encefalina Leucina/análise , Trato Gastrointestinal/química , Grelina/análise , Neuropeptídeos/análise , Sincalida/análise , Animais , Imuno-Histoquímica
5.
Indian Pediatr ; 57(6): 533-535, 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32562397

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), though primarily a respiratory pathogen, also involves the gastrointestinal tract. Similar to the respiratory mucosa, angiotensin converting enzyme-2 (ACE-2) receptor and transmembrane serine protease 2 (TMPRSS2) co-express in the gastrointestinal tract, which facilitates viral entry into the tissue. Less than 10% of children with infection develop diarrhea and vomiting. Prolonged RT PCR positivity in the stool has raised the possibility of feco-oral transmission. Elevated transaminases are common, especially in those with severe coronavirus disease (COVID-19). Children with inflammatory bowel disease and post liver transplant patients do not have an increased risk of disease, and should remain on medications they are already on. Children with chronic liver disease should continue their medications as usual. All elective procedures like endoscopy should be postponed.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Gastroenteropatias/complicações , Gastroenteropatias/virologia , Trato Gastrointestinal/virologia , Pneumonia Viral/complicações , Criança , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Infecções por Coronavirus/transmissão , Gastroenteropatias/terapia , Trato Gastrointestinal/fisiopatologia , Humanos , Hepatopatias/complicações , Hepatopatias/terapia , Hepatopatias/virologia , Pandemias , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Pneumonia Viral/transmissão
6.
World J Gastroenterol ; 26(19): 2323-2332, 2020 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-32476796

RESUMO

The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) that causes coronavirus disease-2019 (COVID-19) is a global pandemic, manifested by an infectious pneumonia. Although patients primarily present with fever, cough and dyspnea, some patients also develop gastrointestinal (GI) and hepatic manifestations. The most common GI symptoms reported are diarrhea, nausea, vomiting, and abdominal discomfort. Liver chemistry abnormalities are common and include elevation of aspartate transferase, alanine transferase, and total bilirubin. Studies have shown that SARS-CoV-2 infects the GI tract via its viral receptor angiotensin converting enzyme II, which is expressed on enterocytes of the ileum and colon. Viral RNA has also been isolated from stool specimens of COVID-19 patients, which raised the concern for fecal-oral transmission in addition to droplet transmission. Although indirect evidence has suggested possible fecal-oral transmission of SARS-CoV-2, more effort is needed to establish the role of the fecal-oral transmission route. Further research will help elucidate the association between patients with underlying GI diseases, such as chronic liver disease and inflammatory bowel disease, and severity of COVID-19. In this review, we summarize the data on GI involvement to date, as well as the impact of COVID-19 on underlying GI diseases.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Gastroenteropatias/virologia , Hepatopatias/virologia , Pneumonia Viral/complicações , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Transmissão de Doença Infecciosa , Gastroenteropatias/epidemiologia , Gastroenteropatias/etiologia , Trato Gastrointestinal/virologia , Humanos , Doenças Inflamatórias Intestinais/epidemiologia , Fígado/virologia , Hepatopatias/epidemiologia , Hepatopatias/etiologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia
9.
Ecotoxicol Environ Saf ; 200: 110745, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32460051

RESUMO

Chronic dietary bioaccumulation tests with rodents are required for new substances, including engineered nanomaterials (ENMs), in order to provide information on the potential hazards to human health. However, screening tools are needed to manage the diversity of ENMs and alternative methods are desirable with respect to animal welfare. Here, an ex vivo gut sac method was used to estimate the dietary bioaccumulation potential of silver nanomaterials. The entire gastrointestinal tract (except the caecum) was removed and filled with a gut saline containing 1 mg L-1 of Ag as either AgNO3, silver nanoparticles (Ag NPs) or silver sulphide nanoparticles (Ag2S NPs), and compared to controls with no added Ag. The gut sacs were incubated for 4 h, rinsed to remove excess media, and the total Ag determined in the mucosa and muscularis. There was no detected Ag in the control treatments. Within the Ag treatments, 1.4-22% of the exposure dose was associated with the tissues and serosal saline. Within the mucosa of the AgNO3 treatment, the highest Ag concentration was associated with the intestinal regions (3639-7087 ng g-1) compared to the stomach (639 ± 128 ng g-1). This pattern was also observed in the Ag NP and Ag2S NP treatments, but there was no significant differences between any Ag treatments for the mucosa. However, differences between treatments were observed in the muscularis concentration. For example, both the Ag NP (907 ± 284 ng g -1) and Ag2S NP (1482 ± 668 ng g-1) treatments were significantly lower compared to the AgNO3 treatment (2514 ± 267 ng g-1). The duodenum demonstrated serosal accumulation in both the AgNO3 (~10 ng mL-1) and Ag NP (~3 ng mL-1) treatments. The duodenum showed some of the highest Ag accumulation with 41, 61 and 57% of the total Ag in the mucosa compared to the muscularis for the AgNO3, Ag NP and Ag2S NP treatments, respectively. In conclusion, the ex vivo gut sac method demonstrates the uptake of Ag in all Ag treatments, with the duodenum the site of highest accumulation. Based on the serosal saline accumulation, the ranked order of accumulation is AgNO3 > Ag NPs > Ag2S NPs.


Assuntos
Trato Gastrointestinal/metabolismo , Nanopartículas Metálicas , Compostos de Prata/metabolismo , Nitrato de Prata/metabolismo , Prata/metabolismo , Animais , Bioacumulação , Dieta , Intestinos , Membrana Mucosa/metabolismo , Ratos Wistar , Estômago
10.
Lancet Gastroenterol Hepatol ; 5(6): 616-624, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32416862

RESUMO

Sleep quality and sleep disorders affect symptom manifestation and the pathogenesis of digestive diseases. Sleep is largely regulated by the light-dark cycle and associated circadian rhythms. These occurrences are closely regulated through several mechanisms with direct effects on the gastrointestinal tract. Misalignment of the circadian system is a common cause of sleep complaints, which play an important role in the presentation of many gastrointestinal disorders. This Review will focus on sleep disorders and how these alterations in sleep play an important role in many commonly encountered digestive diseases, such as gastro-oesophageal reflux disease, irritable bowel syndrome, inflammatory bowel disease, and non-alcoholic fatty liver disease. Therapeutic interventions focusing on resolving sleep disorders could optimise treatment and improve quality of life in these patients.


Assuntos
Relógios Biológicos/fisiologia , Refluxo Gastroesofágico/fisiopatologia , Doenças Inflamatórias Intestinais/fisiopatologia , Síndrome do Intestino Irritável/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Transtornos do Sono-Vigília/fisiopatologia , Ritmo Circadiano/fisiologia , Refluxo Gastroesofágico/metabolismo , Trato Gastrointestinal/fisiologia , Trato Gastrointestinal/fisiopatologia , Humanos , Doenças Inflamatórias Intestinais/metabolismo , Síndrome do Intestino Irritável/metabolismo , Hepatopatia Gordurosa não Alcoólica/metabolismo , Sono/fisiologia , Apneia Obstrutiva do Sono/metabolismo , Apneia Obstrutiva do Sono/fisiopatologia , Transtornos do Sono-Vigília/metabolismo
11.
Nat Commun ; 11(1): 2097, 2020 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-32350281

RESUMO

Astroviruses are a global cause of pediatric diarrhea, but they are largely understudied, and it is unclear how and where they replicate in the gut. Using an in vivo model, here we report that murine astrovirus preferentially infects actively secreting small intestinal goblet cells, specialized epithelial cells that maintain the mucus barrier. Consequently, virus infection alters mucus production, leading to an increase in mucus-associated bacteria and resistance to enteropathogenic E. coli colonization. These studies establish the main target cell type and region of the gut for productive murine astrovirus infection. They further define a mechanism by which an enteric virus can regulate the mucus barrier, induce functional changes to commensal microbial communities, and alter host susceptibility to pathogenic bacteria.


Assuntos
Infecções por Astroviridae/patologia , Infecções por Astroviridae/virologia , Astroviridae/fisiologia , Trato Gastrointestinal/patologia , Trato Gastrointestinal/virologia , Células Caliciformes/virologia , Muco/virologia , Animais , Células Epiteliais/patologia , Células Epiteliais/virologia , Escherichia coli/fisiologia , Feminino , Trato Gastrointestinal/microbiologia , Trato Gastrointestinal/ultraestrutura , Masculino , Camundongos Endogâmicos C57BL , Muco/microbiologia , Transcriptoma/genética , Replicação Viral/fisiologia , Eliminação de Partículas Virais/fisiologia
12.
Environ Pollut ; 264: 114633, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32388295

RESUMO

A study was conducted to quantify the abundance of plastic pollution in the gastrointestinal tracts in birds of prey. Data was collected from all birds retrieved from the Audubon Center for Birds of Prey in central Florida, USA from January to May 2018. Individuals were either dead prior to reaching the Center or died within 24 h of arrival with no food consumed during captivity. Sixty-three individuals representing eight species were dissected to extract the gastrointestinal (GI) tract from the esophagus to the large intestine. Microplastics were found in the GI tracts in all examined species and in all individual birds. The overall mean number (±S.E.) of microplastics for species of bird of prey in central Florida was 11.9 (±2.8), and the overall mean number of microplastics per gram of GI tract tissue was 0.3 (±0.1). A total of 1197 pieces of plastic were recorded. Microfibers accounted for 86% of total plastics followed by microfragments (13%), macroplastics (0.7%) and microbeads (0.3%). Most fibers were either clear or royal blue in color. Micro-Fourier-transform infrared spectroscopy (µ-FTIR) found that processed cellulose was the most common polymer identified in birds (37%), followed by polyethylene terephthalate (16%) and a polymer blend (4:1) of polyamide-6 and poly(ethylene-co-polypropylene) (11%). Two bird species, Buteo lineatus (red-shouldered hawk, n = 28) and Pandion haliaetus (osprey, n = 16), were sufficiently abundant to enable statistical analyses. Microplastics were significantly more abundant per gram in the gastrointestinal tract tissue of B. lineatus, that consumes small mammals, snakes, and amphibians, than in fish-feeding P. haliaetus (ANOVA: p = 0.013). If raptors in terrestrial food webs have higher densities of microplastics than aquatic top predators, then it potentially could be due to a combination of direct intake of plastics and indirect consumption via trophic transfer.


Assuntos
Trato Gastrointestinal/química , Poluentes Químicos da Água/análise , Animais , Aves , Monitoramento Ambiental , Florida , Microplásticos , Plásticos
13.
J Clin Virol ; 128: 104386, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32388469

RESUMO

There is an increasing number of confirmed cases and deaths caused by the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contributing to the Coronavirus disease 2019 (COVID-19) pandemic. At this point, the need for further disease characterization is critical. COVID-19 is well established as a respiratory tract pathogen; however, recent studies have shown an increasing number of patients reporting gastrointestinal manifestations such as diarrhea, nausea, vomiting, and abdominal pain. The time from onset of gastrointestinal symptoms to hospital presentation is often delayed compared to that of respiratory symptoms. It has been noted that SARS-CoV-2 RNA can be detected in fecal matter for an extended period of time, even after respiratory samples have tested negative and patients are asymptomatic. In this article, SARS-CoV-2 and its disease COVID-19 will be reviewed with consideration of the latest literature about gastrointestinal symptomatology, the mechanisms by which the virus may inflict damage, and the possibility of viral replication contributing to a fecal-oral route of transmission.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/epidemiologia , Diarreia/virologia , Doenças do Sistema Digestório/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Betacoronavirus/genética , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Doenças do Sistema Digestório/prevenção & controle , Doenças do Sistema Digestório/virologia , Fezes/virologia , Trato Gastrointestinal/virologia , Humanos , Fígado/virologia , Oxigênio/administração & dosagem , Pâncreas/virologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Respiração Artificial , Replicação Viral , Vômito/virologia
14.
Environ Sci Pollut Res Int ; 27(21): 27161-27168, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32440872

RESUMO

Microplastics in marine organisms are nowadays considered a worldwide phenomenon. An action plan needs to establish to solve this marine pollutant. It requires multidisciplinary information, including the accumulation of data on microplastics in marine biota. The research of microplastic ingestion in the marine environment and organisms of Thailand is limited. As a result, this study was conducted to evaluate the accumulation of microplastics in marine fish from Thailand and to investigate whether the different foraging mechanisms of fish impact the occurrence of microplastics in their gastrointestinal tract. A total number of 361 demersal fish and 131 pelagic fish were investigated. The collected microplastics were counted according to their shape and color. Their polymer type was identified by FT-IR for the first time in fish from Thailand. Moreover, microplastics ingestion sorted by fish size was noted. The number of ingested microplastics in this study was relatively low compared to other locations. There was no significant difference in the number of microplastics ingested between demersal and pelagic fish (p = 0.132). Microplastic fibers were the dominant shape found in both demersal (82.76%) and pelagic fish (57.14%). The most common polymer type was polyamide in both demersal (55.17%) and pelagic fish (50.00%). The dominant microplastics color in both demersal and pelagic fish was red (31.03% and 28.57%, respectively). Microplastics ingestion along different fish sizes fluctuated. This study provides evidence to fill a gap of research relating to microplastic ingestion by fish from Thailand.


Assuntos
Trato Gastrointestinal/química , Poluentes Químicos da Água/análise , Animais , Monitoramento Ambiental , Peixes , Microplásticos , Plásticos , Espectroscopia de Infravermelho com Transformada de Fourier , Tailândia
15.
Virus Res ; 285: 198018, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32430279

RESUMO

Covid-19 is a major pandemic facing the world today caused by SARS-CoV-2 which has implications on our understanding of infectious diseases. Although, SARS-Cov-2 primarily causes lung infection through binding of ACE2 receptors present on the alveolar epithelial cells, yet it was recently reported that SARS-CoV-2 RNA was found in the faeces of infected patients. Interestingly, the intestinal epithelial cells particularly the enterocytes of the small intestine also express ACE2 receptors. Role of the gut microbiota in influencing lung diseases has been well articulated. It is also known that respiratory virus infection causes perturbations in the gut microbiota. Diet, environmental factors and genetics play an important role in shaping gut microbiota which can influence immunity. Gut microbiota diversity is decreased in old age and Covid-19 has been mainly fatal in elderly patients which again points to the role the gut microbiota may play in this disease. Improving gut microbiota profile by personalized nutrition and supplementation known to improve immunity can be one of the prophylactic ways by which the impact of this disease can be minimized in old people and immune-compromised patients. More trials may be initiated to see the effect of co-supplementation of personalized functional food including prebiotics/probiotics along with current therapies.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/microbiologia , Microbioma Gastrointestinal , Trato Gastrointestinal/imunologia , Trato Gastrointestinal/microbiologia , Pneumonia Viral/imunologia , Pneumonia Viral/microbiologia , Envelhecimento , Infecções por Coronavirus/virologia , Dieta , Disbiose , Homeostase , Humanos , Imunidade , Pulmão/microbiologia , Pulmão/virologia , Pandemias , Pneumonia Viral/virologia
16.
Chemosphere ; 251: 126632, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32443225

RESUMO

Flame retardants (FRs) from electronic waste (e-waste) are a widespread environmental concern. In our study, in vitro physiologically based extraction tests (PBETs) for FRs were conducted in three different areas where dust remained after processing of e-waste to identify the bioaccessible FRs and quantify their bioaccessibilities of gastrointestinal tract for human as well as to assess the exposure via ingestion of workers in e-waste processing workshops. All 36 FRs were measured and detected in indoor dusts. Among the FRs, the mean concentrations of polybrominated diphenyl ethers (PBDEs) in the floor dust and settled dust were highest, 65,000 ng/g, and 31,000 ng/g, respectively. In contrast, phosphorus-containing flame retardants (PFRs) presented the highest mean concentration in the workplace dust samples, 64,000 ng/g. However, the highest bioaccessible concentrations in workplace dust, floor dust, and settled dust were observed for PFRs: 5900, 1600, and 680 ng/g, respectively. This study revealed that the higher bioaccessibility of PFRs versus other compounds was related to the negative correlation between FR concentrations and log KOW (hydrophobicity) values. The fact that hazard indices calculated using measured bioaccessibilities were less than 1 suggested that the non-cancer risk to human health by the FRs exposure via dust ingestion might be low.


Assuntos
Poeira/análise , Resíduo Eletrônico/análise , Retardadores de Chama/análise , Éteres Difenil Halogenados/análise , Exposição Ocupacional/análise , Poluição do Ar em Ambientes Fechados/análise , Disponibilidade Biológica , Ingestão de Alimentos , Monitoramento Ambiental , Trato Gastrointestinal/metabolismo , Humanos , Modelos Biológicos , Medição de Risco , Vietnã
17.
Nat Biomed Eng ; 4(5): 560-571, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32393891

RESUMO

The oral administration of peptide drugs is hampered by their metabolic instability and limited intestinal uptake. Here, we describe a method for the generation of small target-specific peptides (less than 1,600 Da in size) that resist gastrointestinal proteases. By using phage display to screen large libraries of genetically encoded double-bridged peptides on protease-resistant fd bacteriophages, we generated a peptide inhibitor of the coagulation Factor XIa with nanomolar affinity that resisted gastrointestinal proteases in all regions of the gastrointestinal tract of mice after oral administration, enabling more than 30% of the peptide to remain intact, and small quantities of it to reach the blood circulation. We also developed a gastrointestinal-protease-resistant peptide antagonist for the interleukin-23 receptor, which has a role in the pathogenesis of Crohn's disease and ulcerative colitis. The de novo generation of targeted peptides that resist proteolytic degradation in the gastrointestinal tract should help the development of effective peptides for oral delivery.


Assuntos
Peptídeos/administração & dosagem , Peptídeos/uso terapêutico , Proteólise , Administração Oral , Sequência de Aminoácidos , Animais , Técnicas de Visualização da Superfície Celular , Cristalografia por Raios X , Feminino , Trato Gastrointestinal/metabolismo , Humanos , Isomerismo , Camundongos Endogâmicos BALB C , Modelos Moleculares , Peptídeo Hidrolases/metabolismo , Biblioteca de Peptídeos , Peptídeos/química , Estabilidade Proteica , Estrutura Secundária de Proteína , Receptores de Interleucina/antagonistas & inibidores , Receptores de Interleucina/metabolismo
19.
Am J Trop Med Hyg ; 103(1): 18-21, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32406369

RESUMO

The ongoing pandemic COVID-19, caused by SARS-CoV-2, has already resulted in more than 3 million cases and more than 200,000 deaths globally. Significant clinical presentations of COVID-19 include respiratory symptoms and pneumonia. In a minority of patients, extrapulmonary organs (central nervous system, eyes, heart, and gut) are affected, with detection of viral RNA in bodily secretions (stool, tears, and saliva). Infection of such extrapulmonary organs may serve as a reservoir for SARS-CoV-2, representing a potential source of viral shedding after the cessation of respiratory symptoms in recovered patients or in asymptomatic individuals. It is extremely important to understand this phenomenon, as individuals with intermittent virus shedding could be falsely identified as reinfected and may benefit from ongoing antiviral treatment. The potential of SARS-CoV-2 infection to rapidly disseminate and infect extrapulmonary organs is likely mediated through the nonstructural and accessory proteins of SARS-CoV-2, which act as ligands for host cells, and through evasion of host immune responses. The focus of this perspective is the extrapulmonary tissues affected by SARS-CoV-2 and the potential implications of their involvement for disease pathogenesis and the development of medical countermeasures.


Assuntos
Infecções Assintomáticas , Infecções por Coronavirus/virologia , Pneumonia Viral/virologia , Eliminação de Partículas Virais , Betacoronavirus , Sistema Nervoso Central/virologia , Olho/virologia , Trato Gastrointestinal/virologia , Coração/virologia , Humanos , Evasão da Resposta Imune , Pandemias
20.
PLoS One ; 15(5): e0230784, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32384113

RESUMO

BACKGROUND: Lactose intolerance is a frequent gastrointestinal disease affecting 47% of the Eastern European population. Small intestinal bacterial overgrowth (SIBO) leads to carbohydrate malabsorption and therefore to false results during lactose breath and tolerance tests. OBJECTIVES: We aimed to assess the prevalence of lactose maldigestion and intolerance in Hungary and to investigate the role of combined diagnostic method and testing for SIBO in reducing false results. METHODS: We retrospectively analyzed data from 264 adult symptomatic patients who underwent 50g lactose breath and tolerance tests in parallel over a one-year period at our center. A ≥20 ppm elevation of H2 or less than 1.1 mmol/l rise of blood glucose was diagnostic for lactose maldigestion. Patients with maldigestion who had symptoms during the test were defined as lactose intolerant. Patients with an early (≤90 min) significant (≥20 ppm) rise of H2 during lactose and/or lactulose breath tests were determined to have SIBO. Patients with slow/rapid oro-cecal transit and inappropriate preparation before the test were excluded. RESULTS: 49.6% of the 264 patients had lactose maldigestion, and 29.5% had lactose intolerance. The most frequent symptom was bloating (22.7%), while 34.8% of the study population and 60% of the symptomatic patients had SIBO. In 9.1% and 9.8% of the patients, the lactose breath and tolerance test alone gave false positive result compared with the combined method. SIBO was present in 75% of the false positives diagnosed with breath test only. CONCLUSIONS: The prevalence of lactose intolerance is lower in Hungary compared to the Eastern European value (29.5% vs 47%), so it is worth performing a population-based prospective analysis in this area. A combination of lactose breath and tolerance tests and the careful monitoring of results (with early H2 rise, lactulose breath test, etc.) can decrease the false cases caused by e.g. SIBO.


Assuntos
Infecções Bacterianas/diagnóstico , Intestino Delgado/microbiologia , Síndrome do Intestino Irritável/diagnóstico , Intolerância à Lactose/diagnóstico , Adulto , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Infecções Bacterianas/patologia , Testes Respiratórios , Reações Falso-Positivas , Feminino , Trato Gastrointestinal/microbiologia , Humanos , Hungria/epidemiologia , Hidrogênio , Síndrome do Intestino Irritável/epidemiologia , Síndrome do Intestino Irritável/microbiologia , Síndrome do Intestino Irritável/patologia , Lactose/administração & dosagem , Intolerância à Lactose/epidemiologia , Intolerância à Lactose/microbiologia , Intolerância à Lactose/patologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
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