A single administration of barley ß-glucan and arabinoxylan extracts reduces blood glucose levels at the second meal via intestinal fermentation.

Diet with barley may suppress the glycemic response after consuming the next meal ("second meal effect"). This study aimed to investigate the second meal effect and its mechanism. Mice were given a single dose of ß-glucan or arabinoxylan, the primary sources of soluble fiber in barley. A single dose of ß-glucan or arabinoxylan extract, followed 6 h later by a 20% glucose solution (second meal), suppressed blood glucose elevation. Arabinoxylan and ß-glucan increased the levels of short-chain fatty acids (SCFAs) in the ileum and cecum, respectively. Total GLP-1 secretion in the blood increased with ß-glucan and showed an increasing trend with arabinoxylan. These results suggest barley ß-glucan and arabinoxylan are fermented in the intestinal tract to generate SCFAs, which may induce GLP-1 secretion and control blood glucose levels during the second meal.

Arabinoxylan as well as ß-glucan in barley promotes GLP-1 secretion by increasing short-chain fatty acids production.

Barley is rich in soluble dietary fiber including ß-glucan and arabinoxylan. Barley ß-glucan is fermented by gut bacteria and, thereby contributes to an effect on intestinal bacterial composition and short-chain fatty acids (SCFAs). It also increases GLP-1 secretion via SCFAs receptor. However, few studies have focused on barley arabinoxylan. Therefore, we have investigated the effects of arabinoxylan from barley on intestinal fermentability and GLP-1 secretion. C57BL/6J mice were fed a high-fat diet containing arabinoxylan-dominant barley flour without ß-glucan (bgl) and high ß-glucan-containing barley flour (BF) for 12 weeks. We conducted oral glucose tolerance test (OGTT) to measure insulin and GLP-1 concentrations. The concentration of SCFAs in the cecum contents was also determined. Furthermore, we measured mRNA expression assay GLP-1 secretion using real-time PCR. The OGTT result showed that GLP-1 concentrations at 60 min were increased in mice fed bgl and BF. Acetic acid and total SCFAs concentrations in the cecum contents were increased in both the barley groups, and butyric acid was increased in the bgl group. Furthermore, the bgl and BF groups had increased Gpr43, a receptor for SCFAs, and NeuroD which is involved in L cell differentiation. These results show arabinoxylan as well as ß-glucan is involved in the SCFAs-mediated increase in GLP-1 secretion upon barley consumption.

Simultaneously developed polymyositis and autoimmune hepatitis.

The inflammatory myopaties such as polymyositis (PM) and dermatomyositis (DM) are autoimmune inflammatory muscle disorders characterised by the development of proximal and often symmetrical muscle weakness. Levels of serum muscle enzymes such as creatine kinase (CK), lactate dehydrogenase (LDH), asparate aminotransferase (AST) and alanine aminotransferase (ALT) are usually elevated. However, high levels of AST, ALT and LDH, without a determination of CK, are often misdiagnosed with hepatic diseases. Conversely, concomitant elevations of AST, ALT and LDH along with CK in patients with PM and DM may be considered to be due to myopathy itself even in a case of coexistence of liver injury. Oral administration of prednisolone was begun at a dose of 60 mg/day, resulting in a good outcome.

Severe autoimmune hemolytic anemia associated with IgM warm auto-antibodies in primary Sjögren's syndrome.

Primary Sjögren's syndrome is an autoimmune disorder involving mainly salivary and lachrymal glands. However, many extraglandular symptoms have also been reported. Although leucocytopenia and lymphocytopenia are frequently observed in hematological disorders, autoimmune hemolytic anemia is rarely reported. We experienced a case of primary Sjögren's syndrome developing severe autoimmune hemolytic anemia. The patient's red blood cells showed spontaneous agglutination in saline at room temperature, and immunoglobulin M (IgM) was detected on the surface of red blood cells by flow cytometry, indicating that autoimmune hemolytic anemia was caused by warm reactive IgM antibodies. Immediate corticosteroid therapy resulted in a dramatic recovery. We report a first case of severe autoimmune hemolytic anemia caused by warm reactive IgM antibodies in primary Sjögren's syndrome.

Presenting manifestations of hemophagocytic syndrome in a male patient with systemic lupus erythematosus.

Hemophagocytic syndrome (HPS) is an unusual but sometimes fatal disorder. We reported a case of 21-year-old man who developed HPS and SLE simultaneously. Febrile pancytopenia, hyperferritinemia, and abnormal liver function tests were observed. Hemophagocytic cells were observed by means of bone marrow biopsy and diagnosed as HPS. The patient was treated with high-dose prednisolone, resulting in an excellent outcome. Early diagnosis of HPS by bone marrow biopsy is important for the successful treatment.

Interstitial pneumonitis associated with infliximab therapy without methotrexate treatment.

Tumor necrosis factor (TNF)-α inhibitors are increasingly being used to treat rheumatoid arthritis. Infliximab (INF) is a TNF-α inhibitor that is usually used in combination with methotrexate (MTX). Interstitial lung disease (ILD) during combination therapy has been attributed to MTX rather than INF. However, INF-associated ILD without combination with MTX has recently been reported. We describe herein a case of severe ILD secondary to INF without MTX therapy.