Gastrointestinal Infectious Diseases Research Articles

Prevention of Campylobacter

Since 2005, Campylobacteriosis become the most important gastrointestinal infectious disease in Europe. The disease affects especially infants under 4 years of age, causing primarily gastroenteric symptoms but also responsible of different extra intestinal pathologies. The most frequent way of infection is considered to be related to contaminated poultry meat consumption. Prevention relies on general hygienic measures. Of outmost importance is the reduction of bacterial burden in raw meat. The achievement of such objective should ensure a radical decrease of clinical forms, thus representing a sustainable prevention strategy.

Escherichia coli and Salmonella spp. in meat in Jeddah, Saudi Arabia

Food-borne pathogens are the leading cause of illness and death in developing countries, killing approximately 1.8 million people annually. In developed countries, food-borne pathogens are responsible for millions of cases of infectious gastrointestinal diseases each year, costing billions of dollars. The objective of this study was to screen for two major food-borne pathogens, Escherichia coli and Salmonella spp., from meat samples obtained from different strata of the consumer market in Jeddah. A total of 60 meat samples, 20 each from large hypermarkets, groceries and small butcher shops were used in the study. Samples were transported to the laboratory in a cooler. They were macerated in peptone water and then seeded on selective media appropriate for each organism. Colonies were identified using conventional microbiological methods and suspected colonies were confirmed as E. coli and Salmonella spp. by polymerase chain reaction (PCR) using specific primers. The results indicated a high degree of contamination in samples from butcher shops as compared to those from groceries or hypermarkets (high scale supermarkets). Both pathogens E. coli and Salmonella spp. were found in higher rates in the samples from butcher shops. In small butcher shops, E. coli was found at an incidence of 65%, and Salmonella at 45%. The results indicate an urgent need for applying proper food hygienic practices in food outlets, especially in small ones, to reduce the incidence of food-borne diseases. Vigilance by the right agencies must be implemented in order to prevent future food-borne outbreaks.

AB0232 Somatic comorbidity and comorbid depression are associated with mortality among patients with established rheumatoid arthritis: an eleven years follow-up cohort study

BackgroundRheumatoid Arthritis (RA) is associated with premature mortality (1). Somatic comorbidity has been found to be one of the most important predictors for premature mortality (2). Comorbid conditions that are...

Lipopolysaccharide Modifications of a Cholera Vaccine Candidate Based on Outer Membrane Vesicles Reduce Endotoxicity and Reveal the Major Protective Antigen

The causative agent of the life-threatening gastrointestinal infectious disease cholera is the Gram-negative, facultative human pathogen Vibrio cholerae. We recently started to investigate the potential of outer membrane vesicles (OMVs) derived from V. cholerae as an alternative approach for a vaccine candidate against cholera and successfully demonstrated the induction of a long-lasting, high-titer, protective immune response upon immunization with OMVs using the mouse model. In this study, we present immunization data using lipopolysaccharide (LPS)-modified OMVs derived from V. cholerae, which allowed us to improve and identify the major protective antigen of the vaccine candidate. Our results indicate that reduction of endotoxicity can be achieved without diminishing the immunogenic potential of the vaccine candidate by genetic modification of lipid A. Although the protective potential of anti-LPS antibodies has been suggested many times, this is the first comprehensive study that uses defined LPS mutants to characterize the LPS-directed immune response of a cholera vaccine candidate in more detail. Our results pinpoint the O antigen to be the essential immunogenic structure and provide a protective mechanism based on inhibition of motility, which prevents a successful colonization. In a detailed analysis using defined antisera, we can demonstrate that only anti-O antigen antibodies, but not antibodies directed against the major flagellar subunit FlaA or the most abundant outer membrane protein, OmpU, are capable of effectively blocking the motility by binding to the sheathed flagellum and provide protection in a passive immunization assay.

Pattern of S100-release in benign and malignant diseases beside malignant melanoma/Freisetzung von S100 bei benignen und malignen Erkrankungen jenseits des malignen Melanoms

Abstract Background: The usefulness of S100 as a prognostic marker and aid in follow-up care in patients with malignant melanoma as well as in individuals with various neurological pathologies is well known. The aim of this study was to investigate its release and clinical relevance in benign and malignant disorders beyond these indications to elucidate tumor and organ specificity of S100. Methods: S100 levels were studied in serum samples of 1856 untreated patients, among them 59 healthy individuals, 358 patients with benign disorders, and 1439 patients with malignant tumors. Results: Healthy individuals had low S100 levels reaching a median of 0.041 ng/mL and 95th and 100th percentiles of 0.096 ng/mL and 0.144 ng/mL, respectively. The medians of patient groups with benign diseases ranged from 0.030 to 0.057 ng/mL, patients with malignant diseases from 0.020 to 0.059 ng/mL, and thus were comparable to healthy individuals. Only 2% of patients with benign diseases, mainly suffering from infectious, autoimmune, or benign gastrointestinal diseases and 1% of patients with malignant diseases showed slightly higher values than healthy individuals, in most cases up to 0.5 ng/mL. Conclusions: In contrast to many other oncological biomarkers, S100 is only rarely released in elevated levels from most benign and malignant diseases apart from malignant melanoma and neurological diseases, resulting in superior organ and tumor specificity. As potentially influencing factors, severe infectious diseases have to be considered.

Influence of in Vitro Simulated Gastroduodenal Digestion on Methylglyoxal Concentration of Manuka (Lectospermum scoparium) Honey

Manuka honey (MH) is a functional food that shows in vitro antimicrobial activity and to which wound healing properties, positive effects on oral health, and beneficial properties during the treatment of gastrointestinal infection diseases and upper gastrointestinal dyspepsia are assigned. The antibacterial activity of MH is mainly due to its high concentration of methylglyoxal (MGO), a highly bifunctional alkylating agent that can induce rapid nonenzymatic modifications of proteins. The aim of the present study was to investigate the influence of in vitro simulated gastric and gastroduodenal digestion on MGO content of MH. To this aim commercial MH samples, with different MGO concentrations, were submitted to digestion, and MGO was determined before and after digestion by a validated RP-HPLC-DAD method. Moreover, the role of MGO in causing carbonylation of the digestive proteins and influencing their enzymatic activities was investigated. The results showed that after digestion MGO concentration decreases because it reacts with digestive enzymes by carbonylating their free amino groups. Nevertheless, carbonylation of pepsin and pancreatin does not influence their physiological activity and therefore does not seem to interfere with the digestion process.

Acute HIV-related gastrointestinal disorders and complications in the antiretroviral era: spectrum of cross-sectional imaging findings

Emergency physicians and radiologists are increasingly confronted with aging HIV-positive or acquired immunodeficiency syndrome (AIDS) patients with acute abdominal symptoms, who often require immediate medical or surgical treatment. A wide spectrum of infectious and neoplastic HIV-related gastrointestinal diseases may be encountered, along with atypical presentations of common disorders. Since symptoms and physical findings are commonly nonspecific or masked by concurrent illnesses, medications, and weak immune response, prompt cross-sectional diagnostic imaging studies are needed to triage patients and choose treatment. Multidetector CT currently represents the mainstay modality to promptly investigate intra-abdominal opportunistic disorders in HIV/AIDS patients, and MRI is increasingly used to assess abnormalities involving the rectum. The spectrum of cross-sectional imaging appearances of HIV-related acute gastrointestinal disorders and complications observed in the antiretroviral era is reviewed, including acute intestinal infections, causes of right lower quadrant pain, bleeding, bowel obstruction, and perforation. State-of-the-art technology, knowledge of pertinent clinical information, and familiarity with the spectrum of opportunistic diseases are necessary to improve diagnostic confidence in the detection and characterization of gastrointestinal abnormalities on urgent cross-sectional abdominal studies performed in HIV-infected patients.

An etiological survey on a foodborne disease epidemic outbreak caused by Salmonella enteritidis

To conduct an etiological molecular epidemiological survey and laboratory test on a foodborne disease epidemic outbreak to make clear of the cause and implement effective prevention and control on it. On May 12th 2012, 135 kindergarten children were sent to Xuzhou City People's Hospital and Children's Hospital with gastrointestinal infection disease. A total of 34 anus swab samples and 4 vomit samples were collected from the patients. Real-time PCR rapid detection, strains separation and cultivation, phage lysis experiments, ATB automated identification system were used to make etiological detection and identification. The genomic DNA of salmonella enteritidis were typed with the pulsed-field gel electrophoresis (PFGE), cluster analysis were carried out together with the patterns of local Salmonella infections. Children in 20 classes were suffered from the gastrointestinal infection among the 21 classes. There were no significant aggregation of class distribution. Among the 135 patients, 76 were boys (56.3%) and 59 were girls (43.7%). The main symptoms were fever (above 38°C), diarrhea and bellyache. Through real-time PCR detection and strains separation, 19 salmonella enteritidis were isolated from 34 anus swab samples of suspected cases and the detection rate was 56%. There were no strains detected from vomit samples. All of the 19 salmonella enteritidis showed the same serological subtype, biochemical reaction, drug sensitivity and phage lysis pattern. The salmonella enteritidis had the identical PFGE pattern (100% similarity), and were different from the pattern of local sporadic infection cases. It was confirmed that this was an epidemic outbreak of foodborne disease caused by homologous salmonella enteritidis by epidemiological survey, clinical information, lab etiological test and molecular typing.

English

Enterotoxigenic Escherichia coli (ETEC) infection is common in calves. Egg yolk antibodies (IgY) have been used to treat gastrointestinal infectious diseases. This study aimed to characterize IgY against bovine ETEC and to evaluate its effects on bovine intestinal cell culture challenged with a bovine ETEC strain. IgY was isolated from the egg yolks of hens immunized with ETEC. The characteristics of IgY were determined by Bradford, ELISA, gel electrophoresis and immunoblotting. Significant differences in anti-ETEC activity between anti-ETEC IgY and non-specific IgY were found in lyophilized fractions. In the bacterial growth assay, anti-ETEC IgY (40 mg/mL) showed growth inhibition of ETEC after 2 h of incubation (p<0.05). The difference in bacterial growth between anti-ETEC IgY and non-specific IgY groups was 0.51 log CFU/ml after an 8 h incubation (p<0.05). The bacterial adhesion assay indicated that anti-ETEC IgY (40 mg/ml) significantly decreased the adhesion of ETEC to bovine intestinal epithelial cells within 4 h (about 1.36 log units compared with the control group; p<0.05). This study demonstrates that anti-ETEC IgY inhibits the growth and adherence of ETEC to bovine intestinal cells and is a potential alternative to traditional treatments of E. coli infections.   Key words: Immunoglobulin Y (IgY), neonatal calf diarrhea, enterotoxigenic Escherichia coli, bacterial adherence, bacterial growth

T Regulatory Cells and Helicobacter pylori-Associated Diseases

In recent years, a crucial role for T regulatory cells (Tregs) in the pathophysiology of infectious, neoplastic and immune-mediated gastrointestinal diseases has been described. These cells represent a continuously dynamic and diverse population, mainly comprised naturally occurring and inducible Tregs. Multiple mechanisms of immune suppression are utilized by Tregs in order to regulate virtually all immune cells. These peculiar characteristics are being increasingly recognized as important determinants in gut-associated homeostasis and autoimmunity and, in particular, in Helicobacter pylori (H. pylori)-associated diseases. In this regard, Tregs have been implicated not only in the pathogenesis of the immune sequelae of this chronic infection, but also in H. pylori-related malignancies. This review attempts to present a comprehensive approach to Tregs biology and function for preserving homeostasis. In addition, current evidence for their contribution mainly to inflammatory and immune-mediated H. pylori-associated diseases is critically reviewed.

Phytotherapy and Prevention of Campylobacter

Since 2005, campylobacteriosis become the most important gastrointestinal infectious disease in Europe. The disease affects especially infants under 4 years of age, causing primarily gastroenteric symptoms but also responsible of different extra intestinal pathologies. The most frequent way of infection is considered to be related to contaminated poultry meat consumption. Prevention relies on general hygienic measures. Of outmost importance is the reduction of bacterial burden in raw meat, to ensure a radical decrease of clinical forms. Phytotherapy might represent a sustainable prevention strategy for the achievement of such objective.

Essential oils in aerial parts of Myrcia tomentosa: composition and variability

Species in the Myrtaceae family are used in folk medicine to treat gastrointestinal disorders, infectious diseases and hemorrhagic conditions and are known for their essential oil contents. Gas chromatography coupled with mass spectrometry (GC-MS) was used to characterize the chemical composition of essential oils of the leaves, stem bark and flowers of Myrcia tomentosa (Aubl.) DC., as well as to assess the chemical variability in the constituents of the essential oils of the leaf. Soil and foliar analyses were also performed to determine the mineral compositions. Principal component analysis (PCA) was used to examine the interrelationships between the obtained data. The most abundant component in the essential oils of the flowers was (2E,6E)-methyl farnesoate, whereas hexadecanoic acid was the most abundant essential oil component in the stem bark. The leaf essential oils showed seasonal variation in their chemical composition, with bicyclogermacrene and (2E,6E)-methyl farnesoate as the major chemical components. Forty-four constituents were identified, and only nine compounds were found in all of the samples. Sesquiterpenes were mainly produced in the flowers and leaves. The PCA showed a positive correlation between the oxygenated sesquiterpenes and the foliar nutrients Cu and P. Significant statistical correlations were verified between the climatic data, foliar nutrients and essential oil compositions.

Developing innovative targeted therapies for China

Background MedImmune is the biologics business unit of AstraZeneca with a mission of helping patients with significant unmet medical need by developing innovative medicines. MedImmune has a rich pipeline across five therapeutic areas including oncology, respiratory, inflammatory and autoimmunity, infectious diseases, neurosciences, cardiovascular and gastrointestinal diseases. To realize our vision of personalized healthcare—treating the right patient with the right drug at the right dose, we are applying cutting edge tools such as next-gen sequencing, circulating tumor cells and advanced PK/PD modelling across the pipeline.

Recent Twin Earthquakes in Northwest Iran: Infectious Concerns

TO THE EDITOR—Recently, on 11 August 2012, in East Azerbaijan Province, Iran, twin earthquakes, both measuring higher than 6 on the Richter scale, led to the death of 300 individuals and thousands more injured. Immediate rescue measures were taken, and all the survivors were placed in temporary shelters (tents) provided by the rescue teams. The primary shock has abated; however, both the survivors and unaffected persons living in the neighboring areas are exposed to incalculable health threats, among which public hygiene concerns are of utmost importance and require prompt measures to be implemented. Great emphasis should be placed on the risk of an outbreak of vector-borne diseases: (1) gastrointestinal infectious diseases caused by unhealthy drinking water or food consumption [1]; (2) respiratory tract infections in the cold climate [2]; (3) zoonotic diseases stemming from carcasses of dead animals [3]; (4) tetanus, measles, diphtheria, etc, where immunization coverage is often low or nonexistent [4]; and (5) hospital-acquired infections due to increased circulation between and inside the hospitals [5]. In addition to the aforementioned probable outbreaks, one should bear in mind the sporadic cases with animal(eg,snake,scorpion,spider)bites[6]. At the moment, abundant amounts of bottled water, canned and dry food, and special potable water tanks have been provided in the rescue camps. Safe disposal of dead animals was performed and a special hotline was devoted to the report of any suspicious cases. Furthermore, the surviving livestock were vaccinated. Injured people with no or incomplete history of previous tetanus immunization were given supplementary vaccines and antitoxins according to World Health Organization guidelines [7]. The Center for Disease Control at the Iranian Ministry of Health has not hitherto reported any case of infectious diseases outbreak or animal bite in the affected areas. However, precautionary measures must be adopted, especially considering the forthcoming cold season and subsequently the probable increased risk of respiratory tract infections. Therefore, appropriate emergency housing should be guaranteed for the homeless. And last, but not least, the underestimated risk of hospital-acquired infections should be borne in mind and lessened by the establishment of applicable protocols, formation of ideal intensive care units, and implementation of enhanced surveillance.

The antimicrobial, antioxidative, anti-inflammatory activity and cytotoxicity of different fractions of four South African Bauhinia species used traditionally to treat diarrhoea

Ethnopharmacological importanceMany Bauhinia species, including those indigenous to South Africa, are used in traditional medicine across the world for treating ailments such as gastrointestinal tract (GIT) disorders, diabetes, infectious diseases and inflammation. AimsSeveral relevant aspects of different fractions of leaf extracts of Bauhinia bowkeri (BAB), Bauhinia galpinii (BAG), Bauhinia petersiana (BAP), and Bauhinia variegata (BAV) used in South African traditional medicine to alleviate diarrhoea related symptoms were evaluated. Materials and MethodsThe antioxidative activities of the extracts were determined using the 2, 2-diphenyl-1-picrylhydrazyl (DPPH), 2, 2'-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid (ABTS+) radical scavenging and ferric reducing antioxidant power (FRAP) methods. In vitro antimicrobial activities of the extracts were determined against bacterial strains (Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli and Enterococcus faecalis) and clinical isolates of the opportunistic fungal strains (Aspergillus fumigatus, Candida albicans, and Cryptococcus neoformans) using a serial dilution microplate method. The polyphenolic contents were quantified using standard methods, and anti-inflammatory activities of the crude extracts were determined using the cyclooxygenase and soybean 15-lipoxygenase enzyme inhibitory assays. The safety of the extracts was evaluated by determining the cytotoxicity against Vero cell lines. ResultsThe acidified 70% acetone crude extract and their fractions had good antiradical potency against the DPPH and ABTS radicals. The methanol soluble portions of the butanol fractions were more potent (EC50 ranges from 0.64±0.05 to 1.51±0.07 and 0.88±0.18 to 1.49±0.09μg/ml against DPPH and ABTS radical respectively) compared to the standard, trolox and ascorbic acid (EC50 ranges from 1.47±0.24 to 1.70±0.27μg/ml) for both DPPH and ABTS. The crude extracts contained variable quantities of phenolic content. The crude extracts and their fractions had weak to good antimicrobial activities, inhibiting the growth of the organisms at concentrations ranging from 39 to 2500μg/ml. The BAG crude extract and its fractions were the most active against the fungi (MICs ranging from 39 to 625μg/ml) while the BAB extract and its fractions were the least active with the MICs ranging between 39 and 2500μg/ml. Aspergillus fumigatus was the least susceptible fungus while Cryptococcus neoformans was the most susceptible.The phenolic-rich crude extracts of BAB, BAG, and BAP had moderate to good dose-dependent cyclooxygenase-1 enzyme inhibitory activity with inhibitions between 22.8% and 71.4%. The extracts were however, inactive against cyclooxygenase-2. The extracts had some level of cytotoxicity towards Vero cell lines, reducing cell viability to less than 10% at concentrations more than 50μg/ml. ConclusionThe biological activities observed in Bauhinia species provide a scientific basis for the use of the plants in traditional medicines to treat diseases with multi-factorial pathogenesis such as diarrhoea, with each aspect of activity contributing to the ultimate therapeutic benefit of the plants. However, the use of the phenolic-rich extracts of these plants to treat diarrhoea or any other ailments in traditional medicine needs to be monitored closely because of potential toxic effects and selective inhibition of COX-1 with the associated GIT injury.

CURRENCY OF THE MICROFLORA CORRECTION WHEN BEGINNING FEEDING WITH ADDITIONAL FOOD AND ARTIFICIAL MILK FORMULAS

Children feeding with breast milk have significantly lower risk of gastrointestinal infectious diseases development, than children feeding with artificial milk formulas. At the beginning of feeding with additional food influence of allogenic antigens on child’s organism is increasing, which can lead to disturbances in microbiocoenosis of the gastro-intestinal tract. This causes stool disorders, intestinal colic, dyspepsia, dermatitis, allergic reactions, immunodeficiency with recurrent relapses of infections and development of non-infectious disease and their transition into chronic condition. Forming of the malabsorption syndrome at the background of such conditions leads to growth and mental development retardation of children. Numerous clinical trials proved the beneficial effects of the probiotic Hylak Forte on intestinal microflora in disbiosis.

Microbiological and Pharmacological Evaluation of the MicropropagatedRubus liebmanniiMedicinal Plant

Rubus liebmannii is an endemic species from Mexico used in traditional medicine primarily to treat dysentery and cough. The in vitro activity against Giardia lamblia and Entamoeba histolytica that produces the ethanolic extract of the aerial parts of the plant led us to expand the pharmacological and phytochemical research of this species. Gastrointestinal disorders including amebiasis remain one of the health problems that need to be addressed and it is of interest to find alternatives that improve their treatment. Also, it is important to emphasize that R. liebmannii grows wild in the country and is not found in abundance; therefore, alternatives that avoid overexploitation of the natural resource are mandatory. Ongoing with the evaluation of the potentialities that R. liebmannii possesses for treating infectious gastrointestinal diseases, the aim of the present study was to evaluate the biological effects and the chemical composition of the micropropagated plant.

Re-emergence of Cholera in the Americas: Risks, Susceptibility, and Ecology.

Background:The re-emergence of cholera in Haiti has established a new reservoir for the seventh cholera pandemic which threatens to spread to other countries in the Americas.Materials and Methods:Statistics from this new epidemic are compared to the 1991 Peru epidemic, which demonstrated the speed and complexity with which this disease can spread from country to country. Environmental factors implicated in the spread of Vibrio cholerae such as ocean currents and temperatures, as well as biotic factors from zooplankton to waterfowl pose a risk for many countries in the Americas.Results:The movement of people and goods from Hispaniola are mostly destined for North America, but occur to some degree throughout the Americas. These modes of transmission, and the probability of uncontrolled community spread beyond Hispaniola, however, are completely dependent upon risk factors within these countries such as water quality and availability of sanitation. Although North America has excellent coverage of these deterrents to the spread of infectious gastrointestinal diseases, many countries throughout Latin America and the Caribbean lack these basic services and infrastructures.Conclusions:In order to curb the immediate spread of cholera in Hispaniola, treatment availability should be expanded to all parts of the island and phase II epidemic management initiatives must be developed.

Role of faecal gas analysis for the diagnosis of IBD

The diagnosis of IBD (inflammatory bowel disease) is based on the clinical evaluation of symptoms and signs leading to a series of investigations. The investigations used are often unpleasant for patients; they are invasive, costly and potentially dangerous. Patients often report that the odour of flatus, or the gas emitted from faeces, is abnormal during a flare of their IBD. Our group has characterized the VOCs (volatile organic compounds) in the headspace gas emitted from faecal samples from healthy subjects, from patients with infectious diarrhoea and from those with Crohn's disease or ulcerative colitis, both in relapse and remission. Painstaking analysis of gas chromatography-MS data (VOC profiling) has revealed patterns of compounds that are strongly associated with specific infectious diseases and with IBD. These compounds represent a change in the microflora and/or the metabolism of bacteria and/or the epithelium in disease states. These profiles offer a potential for rapid non-invasive assessment of a range of infectious and non-infectious gastrointestinal diseases. The study of VOCs may lead to a better understanding of the pathogenesis of IBD.

CHEMICAL COMPOSITION AND ANTIBACTERIAL ACTIVITIES OF ESSENTIAL OIL AND ORGANIC EXTRACTS OF CURCUMA AROMATICA SALISB.

This study was undertaken to examine the chemical composition of essential oil, and tested the efficacy of oil and organic extracts from leaves of Curcuma aromatica Salisb. to control foodborne and spoilage pathogens. Twenty-three compounds representing 94.29% of the total oil were identified. The oil and organic extracts (hexane, chloroform, ethyl acetate and methanol) of C. aromatica displayed a remarkable antibacterial activity against Staphylococcus aureus (American Type Culture Collection [ATCC] 6538 and Korean Collection for Type Culture [KCTC] 1916), Listeria monocytogenes ATCC 19166, Bacillus subtilis ATCC 6633, Pseudomonas aeruginosa KCTC 2004, Salmonella typhimurium KCTC 2515 and Escherichia coli ATCC 8739. Also, the oil had strong detrimental effect on the viable count of the tested bacteria. The results obtained from this study may contribute to the development of new antimicrobial agents with potential applications in food industries as natural preservatives. PRACTICAL APPLICATIONS Foodborne and spoilage pathogens are the leading causes of illness and death in developed countries. These pathogens are responsible for millions of cases of infectious gastrointestinal diseases each year, costing billions of dollars in medical care and lost productivity. Fuelled by these concerns, research on plant-based natural and biological active secondary metabolites to control the foodborne and spoilage pathogens has escalated to unprecedented levels in recent years. The findings of our study clearly indicate that the essential oil and organic extracts from leaves of Curcuma aromatica Salisb. could be used as an effective candidate to control the growth of certain important foodborne and spoilage pathogens.