Gold nanoparticles phytoreduced with Cornus mas extract mitigate some of gliadin effects on Caco-2 cells.

Celiac disease (CD) is an autoimmune condition that occurs in genetically predisposed people where the ingestion of gluten produces damage in the small intestine. The treatment accepted until now is a strict gluten free diet. This implies the need for novel or adjuvant treatments, in addition to the standard of care. The present study aimed to assess the effect of gold nanoparticles phytosynthesized with Cornus mas extract (AuCM) compared to Cornus mas extract (CM) and luteolin (LT) on Caco-2 cells, exposed or not to gliadin. Ultraviolet-visible spectroscopy and transmission electron microscopy were used for the characterization of AuCM. Measured cellular outcomes included oxidative stress markers (malondialdehyde level, catalase and superoxide dismutase activities), inflammatory response and cellular signaling and transcription factors involved in apoptosis (NFκB, pNFκB, NOS2, TNF-α, TRAIL, Bax, Bcl-2, p53). The internalization of gold nanoparticles in cells was evidenced by transmission electron microscopy (TEM). The gliadin administration induced oxidative stress, improved the activity of antioxidants enzymes, increased NOS2 and NFκB expressions and reduced pNFκB/NFκB ratio. In addition, gliadin enhanced TRAIL and Bcl-2 levels and reduced p53 expression in Caco-2 cells. The pretreatment with AuCM, CM extract and LT diminished oxidative stress and reduced NOS2 activity. AuCM and CM treatment amplified the expression of p53 and pNFκB/NFκB ratio and diminished Bcl-2, NFκB and pNFκB, especially AuCM. The results obtained confirmed that AuCM mitigate some of gliadin effects on Caco-2 cells through modulation of oxidative stress and inflammation.

Celiac disease: a multi-faceted medical condition.

Celiac disease (CD) is a systemic condition of autoimmune origin, affecting genetically predisposed individuals who at some point lose tolerance towards dietary gluten. Prevalence in the general population is 0.5 - 1%, with a higher frequency in women. The most important environmental factor for CD is ingestion of specific gluten peptides. It triggers a sequence of molecular events, involving the intestinal permeability and the immune system, which ends in damage of the intestinal mucosa. A number of studies have demonstrated the correlation between the intestinal microbiota and celiac disease. MicroRNAs through their regulatory role on gene expression have been implicated in the pathogenesis of CD and suggested as potential biomarkers. In the pediatric and adult population, CD displays different clusters of clinical symptoms. Persistent diarrhea, abdominal pain and involuntary weight loss are the classic symptoms of CD. In the majority of cases diagnosis relies on the combination of serum autoantibodies (anti-transglutaminase and anti-endomisium IgA) and duodenal biopsy showing villous atrophy, crypt hyperplasia and intraepithelial lymphocytes. Observance of a lifelong gluten-free diet, which interrupts the immune response to gluten peptides, is the only effective treatment of CD.

Effects of rifaximin on indomethacin-induced intestinal damage in guinea-pigs.

AIM: Enterobacterial translocation into the gut mucosa is the first step required for activation of neutrophils and inducible nitric oxide synthase (iNOS), involved in the pathogenesis of indomethacin-induced intestinal lesions. Rifaximin may limit NSAID-associated intestinal damage by decreasing the bacterial load. We aimed to study the effect of rifaximin on indomethacin-induced intestinal damage in guinea-pigs. MATERIALS AND METHODS: Twenty-four guinea pigs, equally divided in four interventional groups (A-D), received indomethacin, given orally once daily (30 mg/kg) for three consecutive days. In groups B, C, D different doses of rifaximin (50 mg/kg, 100 mg/kg and 200 mg/kg) were given orally two hours before indometachin administration. Semi-quantitative grades were measure for gross findings, degenerative lesions, neutrophils and eosinophils infiltrates and iNOS immunopositivity. Statistical comparisons used Mann Whitney Test, with a Bonferroni correction for alpha (p ≤ 0.016). RESULTS: Statistical analysis of graded gross findings, microscopic degenerative lesions, endothelium damage and iNOS immunopositivity found no difference between A and B groups. Significant fewer gross findings (U = 3, p = 0.015), microscopic degenerative lesions (U = 2, p = 0.008) and lower grades for iNOS immunopositivity (U = 0, p = 0.002) were found in group C compared with group A. In group D, significant lower grades for iNOS immunopositivity were obtained (U = 0, p = 0.002) compared with group A and fewer degenerative lesions without reaching statistical significance (U = 4, p = 0.026). CONCLUSIONS: 100 mg/kg of rifaximin proved efficient in preventing gut degenerative lesions induced by indomethacin in a guinea pig model, the iNOS activity being significantly decreased.

Surgical outcome of inflammatory bowel disease - experience of a tertiary center.

UNLABELLED: BACKGROUNDS/AIM: Despite advances in medical treatment, a large number of patients with inflammatory bowel disease(IBD) require surgery. We aim to evaluate the efficacy and outcome of surgical interventions in patients with chronic inflammatory bowel diseases. MATERIAL AND METHODS: We retrospectively analysed the medical records from 221 patients admitted to our institution between 2009-2012 with the diagnosis of IBD. Out of these patients, 55 (24.88 %) were diagnosed with Crohn's disease,while the remaining 166 patients (75.11%) had ulcerative colitis. RESULTS: Seventeen of 55 patients with Crohn's disease (30.91%)required surgical management before or during this period. Nine with disease proximal to the transverse colon underwent segmental resections (enteral or colonic) with primary anastomosis, without morbidity. The other 8 patients, with disease distal to the transverse colon, underwent segmental colonic resections (two with primary anastomosis, three with stoma formation) or major colonic resection- subtotal colectomy with ileostomy (1 case) and total proctocolectomy with ileostomy(2 cases). Sixteen of 166 patients with ulcerative colitis(9.64%) required surgery before or during this period. The surgical procedure used included total proctocolectomy with definitive ileostomy (3 cases) and total colectomy with ileostomy(13 cases). 7 of the 13 patients had restorative surgery after total colectomy, 1 remaining with definitive ileostomy due to short vascular pedicle and 5 patients refused restorative surgery. Median daily stool frequency after reconstructive surgery was 7(range 3-12). CONCLUSION: For patients with Crohn's disease proximal to the transverse colon, limited resection with primary anastomosis is safe. Major colonic resection (subtotal colectomy or proctocolectomy)is indicated if the disease is located distal to the transverse colon and primary anastomosis should be avoided. Due to unsatisfactory quality of live after reconstructive surgery(stool frequency remains high), total proctocolectomy with end-ileostomy remains a viable alternative for patients with ulcerative colitis.

The prevalence of anti-Helicobacter pylori antibodies in the patients with ischemic heart disease.

The authors proposed to assess the prevalence of anti-Hp antibodies (IgG class) in patients with ischemic heart disease. The study included 93 patients distributed into two groups: a) group A--61 patients with ischemic heart disease; b) group B--32 controls. The Hp infection diagnosis was established by determination of the Hp antibodies in the peripheral blood. Hp infection was correlated with the following factors: (a) smoking, alcohol consumption, antiinflammatory drugs intake and water source; (b) biological parameters (fibrinogen, alpha1-globulins, cholesterol, triglycerides, thrombocyte count). In the patients with ischemic heart disease the prevalence of the Hp infection was 78.3%, and in controls 56.2% (p<0.05). The patients consuming alcohol and smoking had a significantly higher prevalence than controls. Antiinflammatory drugs and water source did not influence the prevalence of the Hp infection. Among the biological parameters, fibrinogen and alpha1 globulins were significantly increased in the Hp-positive patients with ischemic heart disease. In conclusion, the serum prevalence of anti-Hp antibodies was higher in the patients with ischemic heart disease, smokers and alcohol consumers than in health individuals.

[The determination by computed scintigraphy of the evacuation time of the resected stomach under the administration of salbutamol and dopamine]. / Determinarea prin scintigrafie computerizata a timpului de evacuare a stomaculul rezecat, în conditiile administrarii de salbutamol si dopamina.

The evacuation time (T1/2) of the stomach was determined in the patients with partial gastric resection by a sequential computerized scintigraphic method. The effect of Salbutamol and Dopamine was followed on T1/2 and the scintigraphic surface of the stomach (appreciated indirectly by measuring the longitudinal and transversal diameters). Salbutamol prolongs significantly T1/2, from 6.41 +/- 2.72 minutes to 12.33 +/- 6.45 minutes. The scintigraphic surface of the resected stomach is not slightly modified by Salbutamol. Dopamine prolongs very much T1/2, from 13.00 +/- 4.01 minutes to 75.03 +/- 24.36 minutes, in parallel with the increase of the scintigraphic image of the stomach. Our investigations lead to the conclusion that Salbutamol, given per os, may become a new therapeutic mean in the dumping syndrome.

The action of glucagon on gastric acid secretion and serum pepsinogen I.

In 39 patients the following were assessed: gastric acid secretion (mmol/hour), gastric juice volume (ml/hour), glycemia (mg%), and in 10 of them also pepsinogen I serum concentration (ng/ml). All these parameters were determined in basal conditions and after administration of glucagon. Glucagon induced achlorhydria in 33.3% of the patients, hypochlorhydria in 33.3%, did not influence HCl in 12.8%, and hyperchlorhydria in 20.5%. The gastric juice volume changed in parallel with chlorhydria. The HCl secretion did not correlate with the glycemia levels. Pepsinogen I was not significantly influenced by glucagon. It may be concluded that glucagon had a two-fold action on HCl secretion: (a) in two thirds of the patients studied it induced hypo- or achlorhydria; (b) in about 20% it induced hyperchlorhydria.

Biochemical changes induced by Campylobacter pylori in the gastric juice.

The biochemical changes induced in the gastric juice by the presence of Campylobacter pylori (CP) were followed up in 151 patients with various gastric and duodenal diseases. The diagnosis of CP infection was made by the urease test. In the presence of CP urea decreased in the gastric juice and ammonia increased. The sialic acid, fucose and hexoses, glucide components of the mucus glycoproteins dissolved in the gastric juice, underwent no change in the presence of CP. The hexosamines in the gastric mucus increased significantly in CP patients. Urease activity is present in the gastric juice even in the absence of CP, probably due to other microorganisms present in the human stomach. This does not exclude the use of the urease test for the diagnosis of CP infection. However the test can only be used in the bioptically removed gastric mucosa samples, not in the gastric juice.

Helicobacter-like organisms in gastroduodenal diseases.

The incidence of the Helicobacter-like organisms (HLO) was investigated on biopsy specimens of antral gastric mucosa, stained by the Wayson technique, in 509 patients with various gastric and duodenal diseases. The incidence of HLO was: 72.8 percent in gastric ulcer, 69.6 percent in duodenal ulcer, 69.2 percent in bulbitis, 61.0. percent in chronic gastritis, 37.5 percent in the postoperative stomach, 50 percent in gastric cancer, and 34.3 percent on healthy controls. The HLO were present over the whole year, with a peak in March. Sex and age had little influence on the HLO incidence. The Wayson staining technique proved to be a good technique of detection of HLO on gastric mucosa smears.

[Campylobacter pylori infection in chronic gastritis and gastric cancer]. / Infectii cu Campylobacter pylori in gastrita cronica si cancerul gastric.

The present paper analyses, in correlation with histologic lesions, the incidence of infection with Campylobacter pylori (CP) in patients with chronic gastritis, operated stomach, gastric neoplasm and healthy subjects. In chronic gastritis, incidence of infection with CP is 71.6%, significantly increased in comparison with the controls, in whom the positive percentage is 37.5. The most of the patients in this group suffered from superficial chronic gastritis. In the group with operated stomach, the CP infection included 48% of the patients studied; all had superficial chronic gastritis. In gastric cancer, CP bacteria appeared in 50% of cases. CP may represent a pathogenetic ring that starts the gastric process.

Beta adrenergic regulation of the hydrochloric acid secretion.

Propranolol induces basal achlorhydria in 30.7% of the patients, decreases significantly the HCl secretion in 42.3%, does not change it in 25% and increases it in 1.9%. After histamine stimulation (Kay test) propranolol decreases HCl in 57% and increases it in 43% of the cases. Propranolol induces a significant decrease of carbon anhydrase in the gastric mucosa. Serum gastrin is not significantly decreased after propranolol treatment. Isoprenaline increases the HCl secretion in all the patients investigated. Propranolol suppresses the effect of isoprenaline in 28.6% of the cases, decreases it in 33%, does not change it in 19% and increases it in 19%. The action of isoprenaline is not influenced by atropine, so the mechanism of action of the beta agonist is non-cholinergic. The gastric juice volume is not changed significantly by the blockage or stimulation of beta receptors. The beta adrenergic nervous system stimulates HCl secretion.

Campylobacter pylori infection in gastric and duodenal ulcer.

The incidence of infection with Campylobacter pylori (CP) in gastric ulcer (GU) and duodenal ulcer (DU) and its correlation with the gastritis lesions associated to the two diseases, was investigated. In GU the incidence of CP infection was 76.3%, close to that in DU (71.4), but different from controls (33.3%). Chronic gastritis associated to gastric or duodenal ulcer is of variable severity, CP infection being the more often encountered the higher the severity of gastritis. Presence of CP was also observed in 75% of the cases associated also with intestinal metaplasia from UG. The diameter of CP-positive GU was significantly increased as compared with that in CP-negative GU. Type I GU was associated with CP infection in 81.8% of the cases. The results obtained allowed the conclusion that in GU and DU the incidence of CP infection is significantly higher as compared with that in controls but the pathogenetic relationship ulcer-bacterium is not yet elucidated.

Gastric sequential scintigraphy. Methodology with liquid isotonic meal.

The radioisotopic measurement of gastric emptying offers information about an aspect of gastric motility. A procedure performed in our laboratory is presented. It is based on the ingestion of 500 ml saline including 1 mCi (3.7 MBq)113m In-DTPA or 99Tc-DTPA. The subject is placed in a half-supine position. Radioactive counts of the tracer are collected with a gammacamera and processed with a microcomputer, using a special program. This offers the histograms of the whole stomach and of the regions of interest (proximal and distal stomach), and also the half-time of these curves. Normal values range between 8-25 min for each curve half-time. The method has applications in physiology, pharmacology and clinical diagnosis.

Contributions to the study of gastric carcinogenesis.

Investigations were carried out on duodeno- and jejunogastric reflux, gastric juice acidity, microbial population and the concentration of nitrites in 199 subjects. In gastric cancer patients or those with gastric ulcer, chronic atrophic gastritis, stomach resection or more seldom with removal of the gallbladder, a significant increase over normal values of the pH, duodenogastric reflux, microbial flora contamination (especially intestinal) and nitrite concentration was found. In smokers the salivary nitrite concentration was greater than in non-smokers and in direct relationship to gastric concentrations. The parallelism of these alterations suggests a causative relation between them and their presence in diseases or conditions of notorious increased incidence in gastric cancer highlights the direction to be followed in the primary prophylaxis of this disease.

The gastric 99mTc clearance--a technique for the evaluation of the gastric blood flow.

The gastric mucosa blood flow was investigated using the 99mTc clearance. Besides the clearance the "R" ratio, total radioactivity of the gastric juice and the volume of gastric juice (ml/15 min) were also investigated. The main characteristics of the method are its reproducibility and the parallelism existing between: clearance, the "R" ratio and total radioactivity. The parameters investigated reach a maximum 30-45 min after administration of 99mTc; consequently, to evaluate gastric blood flow, it is sufficient to determine the parameters at this time interval. The 99mTc clearance represents an accessible method for the evaluation blood circulation in the gastric mucosa.