Gastroenterology and Hepatology from Bed to Bench

.

.

.

.

.

Aim: Gastric cancer is the second most common cancer all over the world, approximately responsible for 3% to 10% of all cancer-related deaths. The identification of biomarkers may improve the diagnosis and treatment of gastric cancer.  Recent publications declared Aristaless-Like Homeobox 4 (ALX-4) expression levels to be up-regulated in multiple tumors.  These results were intriguing for a variety of reasons. This article explores, for the first time, examined the ALX-4 mRNA level in different grades of human Gastric adenocarcinoma comparatively,  in gastric cancer stem cell (GCSC) as well as MKN-45 cell line.

Methods: MKN-45 cell culture prepared, and gastric cancer stem cell (GCSC) isolation and identification performed by flowcytometry and then 37 fresh gastric cancer patients tissue sample were subjected for expression analysis with quantitative real-time PCR, prior to any therapeutic intervention in the comparative study for evaluation of ALX-4 gene expression.

Results: gastric cancer stem cell with cuboidal shape and positive expression for CD105, CD44, CD90 and negative for CD45, CD34 were identified. Overexpression of ALX-4 was detected in 46% (3.351±2.94, P<0.05) of gastric cancer tissue specimens and Significant high expression level of ALX-4 in GCSCs (4.31±0.04, P<0.005). The mRNA expression level of ALX-4 in MKN-45 gastric cancer cell line was 2.81±0.07 (P<0.005). ALX-4 mRNA level significantly correlation with tumor grad (P=0.004), stage (p=0.000153) and relationship with gender (P= 0.06). 

Conclusion: These sets of results documented the important role of ALX-4 in GCSCs as an indicated oncogenic role in progressive cancer and valuable target in treatment of drug resistant tumors. 

.

 Background: Cryptosporidium, an intracellular protozean parasite, is among the major causative agents of gastroenteritis disorders in humans and also causing water-borne and food-borne outbreaks of diarrheal diseases. This study investigated subtypes of Cryptosporidium in patients with gastrointestinal complaints in Tehran, Iran. Methods: A total of 1685 fecal samples were collected from patients with gastrointestinal complaints who had been referred to clinical laboratories Tehran, Iran. The primary diagnosis was established by detection of oocysts using the modified Ziehl-Neelsen acid-fast staining method and following that, the positive microscopically samples were selected for sequence analysis of partial 60 kDa glycoprotein (gp60) gene. Results: Out of 1685 collected samples, 7 (0.4 %) were positive for Cryptosporidium oocysts.  Sequences analysis of gp60 gene in seven Cryptosporidium isolates revealed that, two subtype families were identified, IIa and IId. Five (of 7) isolates belonged to the subtype family IIa and remaining 2 isolates belonged to IId. Three sub-types were recognized within the subtype family IIa including IIaA16G2R1 (3/5), IIaA17G1R1 (2/5), while IIdA17G1d was the only subtype within IId subtype family. Conclusion: The predominance of zoonotic subtype families of C. parvum species (IIa, IId) in this study highlights the importance of zoonotic transmission of cryptosporidiosis in the country.

Aim & background: Enterococci infections are public health growing concern due to the glycopeptide antibiotics resistance especially vancomycin. Genes, vanA, B, and H, are contributed to the influence of vancomycin-resistant enterococci (VRE). This investigation aims at exploring the VRE frequency and the rate of each genes in isolated enterococci from gastroenteritis patients in central region of Iran.

Materials (patients) and methods: This study was conducted from Jan-July 2014 in Shahrood university hospital. Enterococci isolation and its antibacterial susceptibility were performed by culturing in Aesculin Azide agar and Kirby-Bauer method, respectively. Vancomycin-resistant genes were screened through conventional PCR, and subsequently sequenced.

Results: Among 265 specimens, 100 isolates revealed enterococci, in which E. faecalis (91%) and E. faecium (9%). The isolated enterococci were resistant to vancomycin (6%) and chloramphenicol (21%), whereas their large proportions (94% to 100%) were multi-drug resistant. All VRE isolates belonged to E. faecalis, conversely, the E. faecium were susceptible to the same antibiotic. Both vanA and vanH genes were identified in all VRE isolates, although, no vanB gene was indicated. Homology analysis of sequenced amplicons verified the full length compatibility to the worldwide reported genes.

Conclusion: Present study revealed VR E. faecalis in gastroenteritis patients and resistance factor for vanA and vanH genes are coordinated. Since enterococci isolates were all multidrug resistance, increase in VR E. fecalis vanA / vanH in this area could be expected.

.

.

.

Chronic anemia is common in liver cirrhosis. In this setting the pathogenesis of anemia is complex and multifactorial. Spur cell anemia is a serious disorder in cirrhotic patients associated with poor prognosis. Liver transplantation constitutes the only therapeutic tool. We report a case of  a severe spur cell anemia in alcoholic liver cirrhosis. In the attempt to investigate the origin of the disorder we have evaluated the lipoprotein profile and found a significant reduction of apolipoprotein AI and HDL₃ subclass as possible cause of the disease. 

.

.

.