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Korean J Intern Med ; 35(1): 249, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30099863
Pol Arch Intern Med ; 129(9): 620-626, 2019 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-31111828


Herpes virus infection leads to severe and fatal disease in individuals with suppressed immunity. In patients with inflammatory bowel disease (IBD), particularly those with ulcerative colitis (UC), those undergoing immunosuppressive therapy, or those unresponsive to medical therapy, cytomegalovirus (CMV) has been found to be associated with significant clinical morbidity. In addition, other herpes viruses, particularly human herpes virus 6 (HHV­6) and Epstein-Barr virus (EBV), have been identified recently in the colonic mucosa of individuals with IBD, although the relationship between herpes virus infection other than CMV and exacerbation of IBD remains unknown. In this review, we discuss herpes virus infection in patients with UC, focusing on the prevalence and diagnosis of CMV infection as well as the prevalence of single or mixed infection with herpes virus (HHV­6 and EBV) in addition to CMV. Moreover, significance of genotyping of CMV in UC is discussed.

Pol Arch Intern Med ; 129(2): 130, 2019 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-30543202
World J Gastroenterol ; 24(7): 876, 2018 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-29467558


[This corrects the article on p. 12667 in vol. 21, PMID: 26640344.].

Intest Res ; 16(1): 90-98, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29422803


Background/Aims: To determine the prevalence of glycoprotein B (gB), glycoprotein N (gN), and glycoprotein H (gH) genotypes of human cytomegalovirus (HCMV) superimposed on ulcerative colitis (UC) patients in Japan. Methods: Four archived stool samples and 7-archived extracted DNA from stool samples of 11 UC patients with positive multiplex polymerase chain reaction (PCR) results for HCMV were used UL55 gene encoding gB, UL73 gene encoding gN, and UL75 gene encoding gH were identified by PCR. Genotypes of gB and glycoprotein N were determined by sequencing. Results: Among 11 samples, 8 samples were amplified through PCR. gB, gN, and gH genotypes were successfully detected in 3 of 8 (37.5%), 4 of 8 (50%), and 8 of 8 (100%), respectively. The distribution of gB and gN genotypes analyzed through phylogenetic analysis were as follows: gB1 (2/3, 66.7%), gB3 (1/3, 33.3%), gN3a (2/4, 50%), and gN3b (2/4, 50%). Other gB genotypes (gB2 and gB4) and gN genotypes (gN1, gN2, and gN4) were not detected in this study. Out of successfully amplified 8 samples of gH genotype, gH1 and gH2 were distributed in 12.5% and 75% samples, respectively. Only 1 sample revealed mixed infection of gH genotype. The distribution of gH1 and gH2 differed significantly (1:6, P<0.05) in UC patients. The distribution of single gH genotype also revealed significant difference in UC patients who were treated with immunosuppressive drug (P<0.05). Conclusions: In this study, gB1, gN3, and gH2 gene were determined as the most frequently observed genotypes in UC patients, which suggest that there might be an association between these genotypes of HCMV and UC.

BMC Infect Dis ; 17(1): 320, 2017 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-28464844


BACKGROUND: Strongyloidiasis is a chronic parasitic infection caused by Strongyloides stercoralis. Severe cases such as, hyperinfection syndrome (HS) and disseminated strongyloidiasis (DS), can involve pulmonary manifestations. These manifestations frequently aid the diagnosis of strongyloidiasis. Here, we present the pulmonary manifestations and radiological findings of severe strongyloidiasis. METHODS: From January 2004 to December 2014, all patients diagnosed with severe strongyloidiasis at the University of the Ryukyus Hospital or affiliated hospitals in Okinawa, Japan, were included in this retrospective study. All diagnoses were confirmed by the microscopic or histopathological identification of larvae. Severe strongyloidiasis was defined by the presence of any of the following: 1) the identification of S. stercoralis from extra gastrointestinal specimens, 2) sepsis, 3) meningitis, 4) acute respiratory failure, or 5) respiratory tract hemorrhage. Patients were assigned to either HS or DS. Medical records were further reviewed to extract related clinical features and radiological findings. RESULTS: Sixteen severe strongyloidiasis cases were included. Of those, fifteen cases had pulmonary manifestations, eight had acute respiratory distress syndrome (ARDS) (53%), seven had enteric bacterial pneumonia (46%) and five had pulmonary hemorrhage (33%). Acute respiratory failure was a common indicator for pulmonary manifestation (87%). Chest X-ray findings frequently showed diffuse shadows (71%). Additionally, ileum gas was detected for ten of the sixteen cases in the upper abdomen during assessment with chest X-ray. While, chest CT findings frequently showed ground-glass opacity (GGO) in 89% of patients. Interlobular septal thickening was also frequently shown (67%), always accompanying GGO in upper lobes. CONCLUSIONS: In summary, our study described HS/DS cases with pulmonary manifestations including, ARDS, bacterial pneumonia and pulmonary hemorrhage. Chest X-ray findings in HS/DS cases frequently showed diffuse shadows, and the combination of GGO and interlobular septal thickening in chest CT was common in HS/DS, regardless of accompanying pulmonary manifestations. This CT finding suggests alveolar hemorrhage could be used as a potential marker indicating the transition from latent to symptomatic state. Respiratory specimens are especially useful for detecting larvae in cases of HS/DS.

Pneumopatias/parasitologia , Estrongiloidíase/diagnóstico por imagem , Estrongiloidíase/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Feminino , Hemorragia/parasitologia , Humanos , Larva , Pneumopatias/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Síndrome do Desconforto Respiratório do Adulto/parasitologia , Estudos Retrospectivos , Strongyloides stercoralis/patogenicidade
Hum Genet ; 136(4): 387-397, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28197769


Crohn's disease (CD) involves chronic inflammation in the gastrointestinal tract due to dysregulation of the host immune response to the gut microbiome. Even though the host-microbiome interactions are likely contributors to the development of CD, a few studies have detected genetic variants that change bacterial compositions and increase CD risk. We focus on one of the well-replicated susceptible genes, tumor necrosis factor superfamily member 15 (TNFSF15), and apply statistical analyses for personal profiles of genotypes and salivary microbiota collected from CD cases and controls in the Ryukyu Islands, southernmost islands of the Japanese archipelago. Our association test confirmed the susceptibility of TNFSF15 in the Ryukyu Islands. We found that the recessive model was supported to fit the observed genotype frequency of risk alleles slightly better than the additive model, defining the genetic effect on CD if a pair of the chromosomes in an individual consists of all risk alleles. The combined analysis of haplotypes and salivary microbiome from a small set of samples showed a significant association of the genetic effect with the increase of Prevotella, which led to a significant increase of CD risk. However, the genetic effect on CD disappeared if the abundance of Prevotella was low, suggesting the genetic contribution to CD is conditionally independent given a fixed amount of Prevotella. Although our statistical power is limited due to the small sample size, these results support an idea that the genetic susceptibility of TNFSF15 to CD may be confounded, in part, by the increase of Prevotella.

Doença de Crohn/genética , Predisposição Genética para Doença , Microbiota , Ligante Indutor de Apoptose Relacionado a TNF/genética , Estudos de Casos e Controles , Humanos , Japão , Modelos Logísticos , Polimorfismo de Nucleotídeo Único , Saliva/microbiologia
Parasitol Int ; 66(1): 807-812, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27744050


Infections with parasites, such as Strongyloides stercoralis, typically cause elevated levels of serum immunoglobulin E (IgE) and eosinophils; however, co-infection with human T cell lymphotropic virus type 1 (HTLV-1) can cause lower levels of serum IgE during S. stercoralis infection. We conducted this study to determine whether serum IgE levels and eosinophil counts could also be related to other patient characteristics or symptoms. Between 1991 and 2014, we measured and compared the symptoms of 237 patients and evaluated serum IgE levels and eosinophil counts of 199 patients who were infected with S. stercoralis at the Ryukyu University Hospital and the Nishizaki Hospital. Medical records were reviewed and blood samples were taken before treatment with the anthelminthic, ivermectin, 2weeks following the first dosage, and 2weeks following the second dosage. Commonly reported symptoms included abdominal pain, diarrhea, and general fatigue. Serum IgE levels were found to be normal in patients co-infected with HTLV-1. Additionally, females and patients younger than 70years old exhibited normal serum IgE levels when infected with S. stercoralis. No factor included in our analysis was found to affect eosinophil counts. Serum IgE levels can remain within the normal range for some patients infected with S. stercoralis. Therefore, physicians should not eliminate S. stercoralis infection from the differential diagnosis solely according to findings of normal or low IgE levels.

Anticorpos Anti-Helmínticos/sangue , Coinfecção/imunologia , Eosinófilos/imunologia , Imunoglobulina E/sangue , Strongyloides stercoralis/imunologia , Estrongiloidíase/imunologia , Fatores Etários , Idoso , Animais , Antinematódeos/uso terapêutico , Infecções Assintomáticas , Coinfecção/diagnóstico , Coinfecção/parasitologia , Coinfecção/virologia , Diagnóstico Diferencial , Feminino , Infecções por HTLV-I/complicações , Infecções por HTLV-I/imunologia , Vírus Linfotrópico T Tipo 1 Humano/imunologia , Humanos , Ivermectina/uso terapêutico , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Estrongiloidíase/complicações , Estrongiloidíase/diagnóstico , Estrongiloidíase/tratamento farmacológico