RESUMO
INTRODUCTION: Mycobacterium avium subsp. paratuberculosis (MAP) is the causative agent of paratuberculosis or Johne's disease in ruminants. Its role in triggering autoimmunity, including type 1 diabetes mellitus (T1DM), has been reported in recent years. Due to the high contamination rate of MAP in Iran's livestock and the increasing outbreak of T1DM, we investigated this association in a small group of patients with T1DM in Iran. METHODOLOGY: Blood samples of 29 T1DM patients and 29 healthy control subjects were tested through enzyme-linked immunosorbent assay (ELISA) to detect antibodies against MAP3865c and ZnT8 homologous epitopes and the presence of MAP DNA. Blood samples were also cultured in mycobacterial growth indicator tubes and Herrold's egg yolk medium containing mycobactin J. RESULTS: The results of ELISA showed a significant difference between T1DM patients and healthy group. IS900 was also detected in 51.72% of T1DM patients but in none of the control group. None of the samples grew in culture media. CONCLUSIONS: Due to the presence of MAP DNA and antibodies against MAP peptides in a significant number of T1DM patients compared with healthy control subjects, we may consider MAP as a possible trigger of T1DM in Iran. This indicates that exposure to MAP occurred in the positive subjects. Identifying the sources of contamination and routes of MAP transmission to humans seems necessary to prevent and reduce the burden of MAP infection in Iran.
Assuntos
Diabetes Mellitus Tipo 1/complicações , Testes Diagnósticos de Rotina/métodos , Ensaio de Imunoadsorção Enzimática/métodos , Mycobacterium avium subsp. paratuberculosis/isolamento & purificação , Paratuberculose/complicações , Paratuberculose/epidemiologia , Reação em Cadeia da Polimerase/métodos , Adolescente , Adulto , Anticorpos Antibacterianos/sangue , Sangue/imunologia , Sangue/microbiologia , Criança , Pré-Escolar , DNA Bacteriano/sangue , Diabetes Mellitus Tipo 1/etiologia , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Técnicas Microbiológicas , Mycobacterium avium subsp. paratuberculosis/genética , Mycobacterium avium subsp. paratuberculosis/imunologia , Adulto JovemRESUMO
INTRODUCTION: Carotid intima-media thickness (CIMT) has been introduced as a cardiovascular disease predictor which may increase in hamodialysis patients. As there are many risk factors in the uremic state that theoretically lead to increase in CIMT, this study was aimed to determine risk factors of CIMT increase in a group of hemodialysis patients. MATERIALS AND METHODS: Seventy-two hemodialysis patients with a mean age of 61.3 ± 15.0 years and 49 individuals with no history of chronic disease (control group) underwent ultrasonography for measurement of CIMT. Correlation of demographic, clinical, and laboratory factors with CIMT was studied. Carotid intima-media thickness was measured by one radiologist in the bilateral common carotid artery, and the mean value of the two sides was reported. RESULTS: The mean duration on dialysis was 82.4 ± 78.0 months. The mean CIMT was 0.96 ± 0.25 mm (range, 0.4 to 1.7 mm) in hemodialysis patients and 0.76 ± 0.06 mm (range, 0.58 to 0.91 mm) in the control group (P < .001). The mean CIMT was significantly higher in men compared to women on dialysis and in diabetic compared to nondiabetics patients. There was a positive correlation between CIMT and age (r = 0.266, P = .02) and serum cholesterol (r = 0.375, P = .002). No correlation was found between CIMT and other studied variables. CONCLUSIONS: Carotid intima-media thickness was greater in hemodialysis patients compared to the control group. It was mainly affected by traditional cardiovascular risk factors and uremic risk factors did not specifically affect CIMT.