ISSN: 2008-2258

Review Article

The Capacity of Probiotics on Gluten Hydrolysis; a Review Study

Najmeh Ramedani, Anousheh Sharifan, Fahimeh Sadat Gholam-Mostafaei, Mohammad Rostami Nejad, Abbas Yadegar, Mohammad Javad Ehsani-Ardakani

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Celiac disease (CD) is an autoimmune disorder of the small intestinal mucosa in genetically susceptible subject when getting exposed to gluten on their diet. Gluten in wheat, rye and barley is harmful to some individuals and leads to various symptoms. Different research approved that, treatment with probiotics in CD patients could improve the symptoms by the gluten hydrolysis. for this purpose, different databases such as Medline, PubMed, Scopus, and Google Scholar were searched using the following keywords: Celiac disease, Wheat flour, Gluten, glutamine, Probiotic, Bifidobacterium, Lactobacillus, Enzymes, Wheat allergy, Immune system, T cells, HLA-DQ2, HLA-DQ8, Gluten-free diet, Proteolysis, α2-gliadin fragment, Gliadin, 33-mer peptide, Zonulin. The search aimed to retrieve the articles published during 2000-2019. Today, a gluten-free diet (GFD) is the only celiac disease treatment. Biotechnological strategy based on probiotic treatment could be able to degrade gluten. Research has shown that, combination of the probiotic enzyme is more effective than single on gluten hydrolysis. The result of different studies showed that probiotic mixture has the capacity to hydrolyze a considerable concentration of the 33-mer of gliadin completely. The present was study aimed to investigate the associations between the capacities of probiotics on gluten hydrolysis.

Keywords: Celiac disease, Gliadin, Gluten-free diet, Probiotics, Wheat

An algorithmic approach to gastrointestinal bleeding in patients receiving antithrombotic agents

Amir Sadeghi, Pardis Ketabi Moghadam, Mohammad Reza Zali, Hamid Mohaghegh Shalmani, Mohsen Rajabnia Chenari, Hamid Asadzadeh-Aghdaei

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Introduction: Gastrointestinal bleeding is an overwhelming complication of patients taking antithrombotic agents. These drugs pose a challenge to physicians in the management of bleeding to establish hemostasis without putting these patients at a higher risk for thromboembolism. This study aims to propose an algorithmic approach to four major groups of patients receiving antithrombotic agents (single antiplatelet agents, dual antiplatelet agents, anticoagulants and direct oral anticoagulants) to decide when and how these drugs should be held or restarted to offset between the risk of re-bleeding and thromboembolism. Case presentation: Four case-based algorithms are proposed in this article based on some relevant articles. Having designed four case-based algorithms, we are hoping to guide physicians who face a dilemma on the management of patients receiving antithrombotics when gastrointestinal bleeding occurs. Results: Patients using antithrombotics referred for gastrointestinal bleeding were stratified into four groups based on the medication which is used as an antithrombotic agent and four algorithms were designed which are presented here. We have made an attempt to have a stepwise approach to four cases relevant to the study and have an evaluation on the management of their antithrombotic agents during an episode of gastrointestinal bleeding. Conclusion: literally, It is widely accepted that antithrombotic agents be restarted as soon as possible after establishment of hemostasis in a patient taking antithrombotics referring for gastrointestinal bleeding. The time for reinitiating of these drugs would be different based on the severity of bleeding, the probability of thromboembolic events as well as the nature of the antithrombotic medication which is used by the patient.

Key words: Algorithms, Gastrointestinal bleeding; Thromboembolic events; Antithrombotic agents

Original Article

Personalized medicine approach in colorectal cancer

Padina Vaseghi Maghvan, Shabnam Jeibouei, Mohammad esmael Akbari, Vahid Niazi, Farshid Karami, Alireza Rezvani, Nafiseh Ansarinejad, Masroor Abbasinia, Gisoo Sarvari, Hakimeh Zali, Ramin Talaie

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Colorectal cancer (CRC) is a heterogeneous disease with various genetic and epigenetic factors lead to different results in response to both the therapy and drug resistance. However, even in tumors with similar histopathological characteristics, different responses and various molecular features could be observed because of the genetic basis and its interactions with the environment in which the patients’ lifestyle plays an important role. Personalized medicine suggests that classifying the patients into separate groups according to their genetic and epigenetic features and their susceptibility for a specific disease could help with choosing the best therapeutic approach. In this review, genetic and epigenetic factors that cause heterogeneity in colorectal cancer are evaluated and proper drug administration in both chemotherapy and target therapy.

Keywords: Colorectal cancer, personalized medicine, biomarker, targeted therapy, chemotherapy

The Spatial Distribution of Colorectal Cancer Relative Risk in Iran: A Nationwide Spatial Study

Mohamad Amin Pourhoseingholi, Hadis Najafimehr, Amir Kavousi, Leila Pasharavesh, Binazir Khanabadi

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Aim: The aim of this study was to estimate the standardized incidence rate (SIR) and also the relative risk (RR) of colorectal cancer (CRC) in the whole of Iran and to determine the distribution of CRC risk in a map after adjusting socioeconomic risk factors.

Background: Growing of CRC incidence rate in Iran is one of the major public health problems. Identify the high risk regions is an essential for further intervention.

Methods:  For this cross- sectional study all CRC cases that occurred in 30 Iranian provinces between 2005 and 2008 were collected according to the International Classification of Diseases (ICD-10). In addition, socioeconomic information was extracted from statistical center of Iran. Bayesian and Poison regression models were fitted to identify significant covariates. For RR estimating, the spatial analysis using GIS technique was used.

Results: The Bayesian method with increasing precision of the parameter estimates had a better fit. According to spatial model,  East Azerbaijan province had a high (11.14) and South Khorasan province had a low  (0.22) risk of CRC in the period of study. SIR for male was 1.92 ± 3.25 and for female was 1.85 ± 3.37.   

Conclusion:  There is a non- uniform spatial pattern of CRC risk in Iran. According to the results, North, Northwest and some parts of West and Central provinces of Iran are identified as high risk areas, thus it is recommended that health policymakers, especially in these areas, have more intervention measures. Further studies are needed to mapp the RR adjusted for nutrition factors.



 Keywords: Colorectal Cancer; Relative risk; Bayesian model; Poisson regression; Spatial analysis  

Lack of association between VEGF -2578C/A polymorphism and risk of colorectal cancer in an Iranian population

Sanaz Savabkar , Neda Zali , Mahrooyeh Hadizadeh, Shabnam Tavangarroosta, Chris Young, Fateme Shojaeian, Nastaran Ebrahimi, Maziar Ashrafian Bonab, Hamid Rezvani, Farzaneh Shalileh, Ehsan Nazemalhosseini Mojarad

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Aim: Vascular endothelial growth factor (VEGF) is a key regulatory factor in angiogenesis and with essential roles in the development of malignancy in colorectal cancer (CRC), which is the third most prevalent cancer worldwide. Here we evaluated the VEGF gene -2578C/A polymorphism as a potential susceptibility factor in colorectal cancer (CRC) occurrence amongst Iranian CRC patients. M&M: VEGF -2578C/A polymorphism was evaluated in 200 CRC patients and 200 healthy control subjects using restriction fragment length polymorphism analysis methods. Results: The frequencies of CC, AC and AA genotypes among CRC patients were 22.5%, 51% and 26.5%, respectively and genotype frequencies were 16%, 54% and 30% in controls cohort respectively (P=0.247). The A allele frequency among case group was 52% and for control group, 57%. C allele frequency in case and control groups was 48% and 43%, respectively (p=0.156). No significant association between this polymorphism and CRC stage was observed (p=0.990). Conclusion: Our findings provide limited support for the hypothesis that the -2578C/A VEGF are associated with increased risk for Colorectal cancer in Iranian colorectal cancer patients and suggest instead that meta data studies, which have previously relied upon populations definitions such as ‘asian’, should more specifically take into account country of origin when associating prognostic value to a given genotype.

Keywords: Colorectal cancer, Angiogenesis, VEGF, Single Nucleotide Polymorphism, Vascular Endothelial Growth Factor

Assessment of Liver Cancer Biomarkers

Vahid Mansouri, Mohhamadreza Razzaghi, Abdolrahim Nikzamir, Alireza Ahmadzadeh, Majid Iranshahi, Mehrdad Haghazali, Mostafa Hamdieh

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Background. Liver cancer is third cause of cancer related deaths in the world. Liver cancer primarily divides into two main types, which are hepatocellular carcinoma (HC) and cholangiocarcinoma (IC). Due to the increasing number of patients with liver cancer and the high mortality rate in this disease, early diagnosis of the disease can be helpful in treatment, unfortunately most patients are diagnosed with late stages of HC.

Aim. The aim of this study is to screen and provide overview on candidate biomarkers related to primary liver cancer to introduce the critical ones.

Methods. In this study, various biomarkers related to the diagnosis of primary liver cancer have been studied from different researches. According to existing researches, biomarkers divided into different groups as blood biomarkers which classified as serum and plasma biomarkers, tissue biomarkers, microRNA biomarkers, proteomic biomarkers and altered genes in this regard.

Results. Previous researches have focused on liver cells and bile ducts, the surround cellular environment, how cells differentiate, and some other research have focused on the types of genes expressed in liver cancer. The searches for the origin of tumor cells and how they differentiate and develop were also between these studies. In all of these studies, the expression of specific proteins and genes in liver cancer has been considered.

Conclusion. According to the available sources , summarizing and concluding in this direction, we introduce biomarkers can be considered as candidates to diagnose and prognosis of different types of primary liver cancer, from different sources as blood, tissue, mic-RNA, proteom, and genes. However more investigations required to introduce a biomarker for precise detection of early liver cancer.

Key words: Hepatocellular carcinoma, Biomarker, diagnosis, prognosis , proteomics

Introducing GATA3 as a prominent player in Crohn’s Disease

Sina Rezaei-Tavirani, Nastaran Asri, MohammadAli Emamhadi, Somayeh Jahani-Sherafat, Ali Seyed Salehi, Zahra Gholamrezaei, Elena Lak

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Aim: This study was aimed at gene assessment of crohn's disease (CD) through protein-protein interaction (PPI) network analysis to find crucial genes.

Background: CD is one of the main subtypes of inflammatory bowel diseases (IBD), which affects any part of the gastrointestinal tract. PPI network analysis is a suitable tool to clarify a critical gene as a drug target or diagnostic biomarker for these types of diseases.

Methods: Gene expression profile GSE126124 of 20 CD patients and 20 healthy controls was obtained from the Gene Expression Omnibus (GEO) database. RNA profile of peripheral blood mononuclear cells (PBMCs) and colon biopsy samples of the studied groups was investigated. The significant genes were selected and analyzed via the PPI network by Cytoscape software. Gene ontology enrichment for the hubs, bottlenecks, and hub-bottlenecks was done via the CluGO plugin of Cytoscape software.

Results: eighty-one differentially expressed genes (DEGs) among 250 initial DEGs were highlighted as significant by FC>2 and p-value ≤ 0.05, and 69 significant DEGs were used for PPI network construction. The network was characterized by poor connections, so 20 first neighbors were added to form a scale-free network. The main connected component was included 39 query DEGs and 20 added first neighbors. Three clusters of biological processes related to the crucial genes were identified and discussed.

Conclusion: The result of this study indicated that GATA3 has a key role in CD pathogenesis and could be a possible drug target or diagnostic biomarker for crohn’s disease.


Keywords: Crohn’s Disease, Genes, Gene Ontology, GATA3 Transcription Factor


Evaluation common genes expression in the intestine and peripheral blood monocytes (PBMC) associated with celiac disease

Ensieh Khalkhal, Fatemeh Nobakht, Mohammad Hosain Haidari, Zahra Razaghi, Mahsa Ghasemzad; Melika Sheikhan; Mohammad Rostami Nejad

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Aim: Celiac disease (CD) is a chronic systemic autoimmune disease of the small intestine in genetically-susceptible individuals. There are several genes that are related to the immune response. The aim of this study is to explore the expression of genes associated to CD in the target tissue in order to estimate the contribution of each single gene to the development of immune response. Then the same set of genes in peripheral blood monocytes (PBMC) are evaluated.

Methods: The genes related to CD were extracted from public databases (proteomics and microarray-based techniques documents) and organized in a protein-protein interaction network with the help of STRING database as a plugin of Cytoscape software version 3.6.0. The main genes were introduced and enriched via ClueGO to find the related biochemical pathways. The network was analyzed, and the most important genes were introduced based on central indices.

Results: Among 20 CD genes as hub and bottleneck nodes, the genes that have common expression in blood and intestinal tissue are seven (CXCL11, GZMB, IL15, IL17A, IL23A, TBX21, TNFAIP3).

Conclusion: The enriched biological process and related to the central nodes of celiac network indicate that most of hub-bottleneck genes are well-known ones involved in different types of autoimmune and inflammatory diseases

Keywords: Celiac disease, PBMs, intestinal tissue, autoimmune, inflammatory



Highlighted Role of “IL17 Signaling Pathway” in Gastroesophageal Reflux Disease

Mona Zamanian Azodi, Mohammadreza Razzaghi, Habib Malekpour, Majid Rezaei-Tavirani, Mostafa Rezaei –Tavirani, Mohammad Hossein Heidari

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Aim: The aim of this study is to assess molecular profile of gastroesophageal reflux disease (GERD) Via Protein-protein interaction (PPI) network analysis and gene ontology (GO) investigation.

Background: GERD which effect life style of about 30% of people; is associated with highly cost in the human papulation. Several risk factors such as smoking, eating habits, BMI, and dysfunction of lower esophageal sphincter are highlighted to onset and progression of GERD. Role of some types of interleukins and inflammatory factors as molecular features of GERD are investigated.

Methods: Genes related to GERD were analyzed by Cytoscape v.3.7.2 and the corresponding plug-ins.  ClueGO and CluePedia assessed the gene ontology and action type properties for the central nodes.

Results: The results indicate that there are 12 hub-bottlenecks that almost all of them except ALB are dispersed in the network clusters 1 and 2.  Il17 signaling pathway among 7 identified biochemical pathways was also detected as a most related annotation for these central genes.

Conclusion: Numbers of 11 critical genes and “IL17 signaling pathway” were highlighted as the deregulate genes and pathway in GERD. Common molecular features of GERD and cancer were appeared.

Keywords: Gastroesophageal reflux disease, Protein-protein interaction network analysis, Gene ontology, Biomarker

Impact of biofeedback therapy for pelvic floor related constipation to improve sexual function.

Seyedshahab Banihashem, Nasrin Chalakinia, Pegah Eslami, Mehran Mahdavi Roshan, Ali Kheradmand, Saeed Abdi, Somayeh Motazedian, Maryam Nasserinejad

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Objective: It appears that pelvic floor disorder could lead to sexual complaints. Unfortunately, there are few data on the correlation between pelvic floor-related constipation and sexual disorders. The biofeedback role as a conservative method on improving the health status in these patients is conflicting. The purpose of this study was to investigate the effect of biofeedback therapy on constipation in order to improve sexual function among the female population with pelvic floor hypertonicity.

Study design: 42 eligible women were included in the study. The exclusion criteria were not being sexually active, not having functional constipation according to Rome IV criteria, and having other psychiatric issues, according to DSM4TR criteria. All the participants were treated using biofeedback in eight sessions, during two months. Before and after the treatment, they were analyzed by Pelvic floor impact questionnaire, pelvic floor Distress Inventory and Short Scale Personal Experiences Questionnaire (SPE Q).

Results: Biofeedback significantly improved orgasm, arousal, dyspareunia (respectively P = 0.001, P = 0.001, P = 0.001). But there was no significant improvement in libido and partner satisfaction domains (respectively P = 0.132, P = 0.341). The significant negative correlations were detected between the age and sexual function. On the other hand, there was no negative relation between vaginal delivery and cesarean delivery with different components of sexual function.

Conclusion: It seems the improvement in pelvic floor muscle hypertonicity leads to sexual satisfaction. However, more data are needed to prove this correlation.

Keywords: Sexual Dysfunction, Biofeedback, Pelvic Floor Disorder, Constipation.

The synergistic impact of NSAIDs and aggressive hydration therapy on the rate of post-ERCP pancreatitis in high risk and low risk patients.

Morteza Aghajanpoor Pasha, Pegah Eslami, Arash Dooghaie Moghadam, Bobak Moazzami, Sajad Shojaee, Faezeh Almasi, Narjes Tavakolikia, Mohsen Norouzinia, Ebrahim Radinnia, Amir Sadeghi

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020


Background: The main complication of Endoscopic retrograde cholangiopancreatography (ERCP) is post-ERCP pancreatitis (PEP). Patients according to demographic characteristics and underlying issues or the reason of ERCP indication are categorized as high risk or low risk patients. Previous investigations represented the effective role of NSAIDS or hydration therapy before the ERCP in reduction PEP. Nevertheless, there is no available evidence about the evaluation the synergistic effects of NSAIDS and hydration therapy, separately sorted by the risk assessment of PEP in different groups of patients.

Method: This study included 281 eligible participants after exclusion. The patients according to demographic characteristics and co-morbidities were divided to high risk and low risk participants. High risk group was divided randomly to two subgroups. both of them received NSAIDs (100 mg rectal Diclofenac). In one group received standard hydration (1.5mg/kg/hr), another group received aggressive hydration (3mg/kh/h). Low risk group received standard hydration. One of its subgroups received NSAID, other not. The efficacy of these preventions were compared between 4 subgroups.

Result: the mean age was 59.85±17.17. The amylase and lipase 8 hours after ERCP were significantly higher in high risk group with standard hydration (P=0.00). amylase, lipase 8 hours, between two low risk subgroups, NSAIDs had no significant effect (P=0.38, P=0.95, respectively). After adjustment based on cannulation, manipulation and duration time, the results had no change (P=0.64, P=0.19, P=0.61).

Conclusion: the aggressive hydration could significantly decrease the risk of PEP. However, still, the low risk group exposed lowest risk of PEP. NSAIDS, could not alone help to decrease the rate PEP in low risk groups. Overall, it seems hydration and NSAIDs therapy had synergistic outcome in high risk patients.

Showing NAFLD, as a key connector disease between Alzheimer’s disease and Diabetes, via systems biology analysis

Elham Gholizadeh, Ali Khaleghian, Reza Karbalaei, Diba Najafgholizadeh Seyfi

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Aim: Network analysis of Alzheimer and Diabetes and find their correlation with each other and other disease/pathways.

Background: Alzheimer’s disease (AD) as a neurodegenerative disease and Diabetes as metabolic disease are two major health problems in recent years. Recent studies reported their correlation and same spreading pathways of these two disease together, but details of this relation at molecular level not well known.

Methods: In TPP technique after treatment of extracted proteins by heat and drug concentration, the resulted proteins analyzed by mass spectrometry. Enrichment analysis of these proteins lead to Alzheimer`s and Diabetes. First, the corresponding genes for each disease were extracted from DisGeNET, then, the protein-protein interaction network for each of them were constructed using STRING. After analyzing these networks, the hub-bottleneck nodes of networks were evaluated. Also, common nodes between two networks were extracted and used for further analysis.

Results: High correlation between Alzheimer disease and Diabetes by the existence of 40 genes in common. Analyzes, revealed 14 genes in AD and 12 genes in Diabetes as hub-bottleneck which seven of them were common including: CASP3, IGF1, CAT, TNF LEP, VEGFA and IL6.

Conclusion: This study, revealed a direct correlation between AD and Diabetes also the correlation between these two diseases and NAFLD, suggesting small change in each three diseases can develop any other disease in patients. Also the enrichments exhibited existence of common pathways between AD, Diabetes, NAFLD and mail fertility.

Key words: NAFLD, Alzheimer's Disease, Diabetes Mellitus, Type II, Male Infertility, Bioinformatics


Evaluation of Long Term Consumption of Omeprazole Disadvantages: A Network Analysis

Abdolrahim Nikzamir , Mostafa Rezaei –Tavirani, Mohhamadreza Razzaghi, Sina Rezaei Tavirani, Maryam Hamzeloo-Moghadam, Somayeh Esmaeili, Behzad Hatami, Alireza Ahmadzadeh

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Background: Proton pump inhibitors (PPIs) are used to inhibit gastric high rate of acid secretion in patients. Omeprazole as a PPI is a common drug in this regard. Evaluation of long term consumption of omeprazole is studied in the present study via its effects on gene expression of “human coronary artery endothelial cells”.

Methods: Net effect of presence of omeprazole on gene expression profiles of “human coronary artery endothelial cells” was evaluated by using data from gene expression omnibus (GEO). Results of protein-protein interaction (PPI) network analysis were assessed via biological process examination to find the critical deregulated genes after long term consumption of omeprazole.

Results: “Negative regulation of muscle cell apoptotic process”, “negative regulation of DNA binding”, “telencephalon cell migration”, “forebrain cell migration” “response to cadmium ion”, “cell-cell recognition”, “positive regulation of protein targeting to mitochondrion”, and “central nervous system neuron development” were the clusters of biological processes that were associated to the long term presence of omeprazole. The final critical deregulated genes were JAK2, PTK2, and NRG1.

Conclusion: It can be concluded that cell cycle, proliferation, and apoptosis and several essential biological processes are affected and nervous system is a possible target related to the long term consumption of omeprazole.

Evaluation of CXCR1 as a Possible Diagnostic Biomarker in Acute Appendicitis

Ensieh Khalkhal, Zahra Razzaghi, Alireza Akbarzadeh Baghban, Nosratollah Naderi, Mostafa Rezaei –Tavirani, Majid Rezaei-Tavirani

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Background: Diagnosis of acute appendicitis (AA) without computed tomography, subject to significant radiation, can be surprisingly difficult. Blood circulation may have conscious alterations in its RNA, protein, or metabolite composition.

AIM: The aim of this study was to obtain genes with commonly expression in blood and appendix tissue samples to introduce as possible diagnostic biomarkers.

Methods: The genes related to tissue and blood of AA patients were extracted from public databases. Fold change (FC) ? 2 in blood and FC ? 5 in appendix tissue samples were considered to screen the differential expressed genes (DEGs). a protein-protein interaction network was organized with using of STRING database as a plugin of Cytoscape software version 3.6.0. The main genes were enriched by DAVID Bioinformatics Resources to find the related biochemical pathways.

Results: Among the differential expressed genes in blood and appendix tissue samples, CXCR1, LILRA3, FCGR3, and SOD2 are common in both sources. CXCR1 is only hub gene that is up regulated in both blood and tissue of patients compared to controls and other abdominal pain.

Conclusion: CXCR1 beside FCGR3, LILRA3, and SOD2  is a suitable possible biomarker panel to diagnose AA disease.

Proteomic study of advanced cirrhosis based on HCV to reveal potential biomarkers

Akram Safai, Afsaneh Arefi Oskouie, Seyed Reza Mohebbi, Zahra Razaghi, Naser Nejadi

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Background. Cirrhosis is a condition that liver damage and loses its function that follows the high rate of mortality in the world. Proteome profiling may help to identify important proteins and find the pathogenesis.

Aim. Proteomic assessment of long term effects of hepatitis C on liver is aim of this study.

Methods. Here, by the application two-dimensional polyacrylamide gel electrophoresis (2-D PAGE), combined with (MALDI-TOF-TOF MS), proteome profile of decompensated HCV cirrhosis compared to healthy matched controls is determined. Furthermore, Cytoscape has used network analysis. The proteome comparison between two groups identified proteins with the significant expression changes (p<0.05 and fold change ≥ 1.5).

Results. Our results include of upregulation of IGHA1, C3, A1BG, IGKC and one isoform of HP. It also has been shown the decreased in the expression of APOA4 and the other spot of HP in advanced cirrhosis patients based on HCV compared to matched controls. According to network analysis, ALB has been introduced as key protein, which may play important role in pathogenesis.

Conclusion. Finally, integration of the proteomics with protein interaction data led to the identification of several novel key proteins related to the immune system that may reflect the long-term effects of hepatitis C virus on the liver and can introduce as therapeutic targets for advanced HCV- cirrhosis.   


Keyword: Proteomic, liver cirrhosis, hepatitis C, Two-dimensional gel electrophoresis (2DE), Protein –protein interaction

Prevalence of Astrovirus, Adenovirus, Sapovirus infections among Iranian children with acute gastroenteritis

Seyed Dawood Mousavi Nasab, Fatemeh Zali, Hooman Kaghazian, Mohammad Reza Aghasadeghi, Rajab Mardani, Latif Gachkar, Abbas Ahmadi Vasmehjani, Nayeb Ali Ahmadi, Ali Ghasemzadeh

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Aim: This study aimed to determine the prevalence of Human Astroviruses (HAstVs), enteric Adenoviruses (HAdVs), Sapoviruses (SaVs) in acute diarrhea patients, as well as their relation to age, sex and season.

Background: Acute gastroenteritis is one of the most common diseases affecting children <5 years old and viral agents with approximately >75% are most of the agents of acute infectious diarrhea. After Rotavirus and Norovirus, the greater viral agents of acute gastroenteritis include HAstVs, HAdVs, SaVs. To our best knowledge, there are the little study in Iran that were detected at least three enteric viruses as causative agents of diarrhea simultaneously.

Methods: The Sample was collected from children that referred to Children’s Medical Centers in Tehran, Iran and tested for Astrovirus, enteric Adenovirus, and Sapovirus by conventional PCR method. The association of incidence of viral enteric agents evaluated with age, sex and seasonal pattern in children <5 years old.

Results: The positive case number among acute gastroenteritis patients was 17/120 (14.1%). Patients ranged in age from 1–60 month but 52.9% were aged ≤ 12 months. Males comprised the majority (70.6), and the male: female ratio was 2.4. HAstV was the most frequently detected virus (6.7%), while SaVs were detected only by 2.5%. Mixed infections were not detected in these samples. The highest rate of HAstV was identified in winter (66.7%), HAdV in autumn (66.7%) and SaV in winter (33.3%)

Conclusion: These findings underscore the importance of monitoring the epidemiology of HAstV, HAdV, and SaV as agents of viral diarrhea infections.

Detection and Characterization of Rotavirus G and P Types from children with acute gastroenteritis in Qom, central Iran

Saeed Shams, Seyed Dawood Mousavi Nasab, Hosein Heydari, Javad Tafaroji, Nayeb Ali Ahmadi, Esmaeil Shams Afzali

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Objective: The aim of the study is to estimate the burden of Rotavirus gastroenteritis as well as predominant genotypes of Rotavirus among children less than 5 years of age referred to Children's University Hospital in Qom, Iran.

Method: During two years, 130 patients referred to a children's hospital were enrolled in this study. After RNA extraction, Rotaviruses were detected by the VP6 gene. Then, G-typing (G1, G2, G3, G4, G8, G9, and G12) and P-typing (P4, P6, and P8) were performed using RT-PCR and specific primers.

Results: The results of the PCR showed that from a total of 130 patients, 22 cases (16.9%) showed positive VP6 by RT-PCR.G1 was mostly the predominant serotype (27%), accounting for 22% of all VP7-positive isolates, followed by G9 (18%),G2 (9%), G3 (9%), andG4 (9%). None of the strains revealed the presence of G8 genotype (0%) and 5 specimens (23%) were non-typable.

The frequency of P typing was P8 (50%), P6 (23%), P4 (14%), and3 samples were P-non-typable (13%), respectively. The dominant of G-P combination was G1 [8] (32%).

Conclusions: Such studies base on typing methods assists in the Rotavirus vaccine introduction by policymakers and design new effective vaccines. 

Early estimation the epidemiological parameters of novel coronavirus disease (COVID-2019) outbreak in Iran: 19 Feb-15 March, 2020

Meysam Olfatifar, Walid Q. Alali, Hamidreza Houri, Mohamad Amin Pourhoseingholi, Ebrahim Babaee, Romina Seifollahi Asl, Afsaneh Sharifian, Mohammad Reza Zali

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Background: Estimating the epidemiological parameters of new public health threat (COVID-19) are essential to support and inform public health decision making in different communities including Iran.

Methods: We established a mathematical model to estimate the epidemiological parameters from 19 Feb to 15 March based on daily COVID-19 confirmed cases in Iran. Then we estimated the effect of early traffic restriction on our estimation.

Results: We estimated the R0 at 2.11 (95% CI, 1.87-2.50) while we estimate the infected number at 92,260 (95% CI: 59,263 -152,212) by 15 March. Our estimate for the ascertainment rate was about 1.2% (95% CI: 1.1-1.4). The latent period estimation was 4.24 (95% CI: 2.84-6.65). We observed a decline in our estimate after considering the traffic restriction.

Conclusion: Our results suggest that health authorities in Iran must take impactful strategies to control the COVID-19 outbreak so R0<1. Therefore, the establishment of complementary, multilateral, and cost-effectiveness measures for the treatment of symptomatic and early diagnosis and isolation of asymptomatic cases/contacts are strongly recommended owing to the low ascertainment rate and the high number of infected cases. We additionally recommend that traffic restriction should be combined with other controlling measures.  

The Role of extracellular matrix proteins in gastric cancer development via epithelial-mesenchymal transition

Shima AbedKahnamouei, Kaveh Baghaei, Parviz Pakzad, Mehrdad Hashemi, Mohammad Reza Zali

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Background: Gastric cancer (GC) is one of the most incident gastrointestinal cancers with high rate of mortality. Metastasis is one of the most challenging problems in gastric cancer treatment. Epithelial mesenchymal transition (EMT) of cancer cells is a complicated process controlled by different cells and molecular pathways which is considered as an important step in metastasis beginning.

Objectives: Due to finding better perception from environment of EMT, we evaluated the expression of some candidate extra cellular matrix (ECM) proteins including of THBS2, OSMR and CHI3L1 which were collected from RNA-seq bioinformatic analyses in our studies.

Materials and methods: AGS gastric cancer cell line was cultured and treated by TGF-β. EMT induction was verified by measuring expression of E-cadherin, Snail, β-catenin and Vimentin genes by real time PCR. Then, in following of our previous study, we evaluated expression of THBS2, OSMR and CHI3L1 genes in EMT induced cells by real time PCR

Results: Downregulation of E-cadherin and upregulation of Snail, β-catenin and Vimentin genes were verified in AGS treated cells in comparison with none-treated cells (P-value = 0.0355, P-value = 0.007, P-value = 0.0059, P-value = 0.0206 respectively). Also, Upregulation of THBS2, OSMR and CHI3L1 were validated in these cells after EMT induction (P-value = 0.0147, P-value = 0.05, P-value = 0.05 respectively).

Conclusion: Our morphological and molecular results validated EMT induction by TGF- β cytokine in AGS gastric cancer cell line. Furthermore, significant upregulation of candidate genes including of THBS2, OSMR and CHI3L1 verified the role of these proteins in gastric cancer invasiveness. However, further studies are needed for validation of prognostic value of these markers.

Case Report

An uncommon presentation of hepatic hydatid cyst leading to biliary cirrhosis and portal hypertension

Hamid Asadzadeh-Aghdaei, Mohammad Reza Moshari, Reza Zandi, Mohammad Ali Karimi, Sina Salari, Pardis Ketabi Moghadam

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Hydatid disease is still one of the major current issues in endemic areas. Hydatid cysts can be seen in any organ but, liver is one of the most common involved organs. Cystobiliary communication as an overwhelming complication of hepatic hydatid cysts can contribute to the obstructive jaundice, cholangitis, sepsis and even biliary cirrhosis if left untreated. The patient we are trying to present is a 61-year-old farmer who presented with obstructive jaundice, multiple common bile duct stones and biliary cirrhosis attributed to a long-lasting untreated hepatic hydatid cyst. Portal hypertension is introduced to be an uncommon presentation of hydatid cyst. Extrinsic compression of the porta hepatis and obstruction of inferior vena cava are amongst the most important reported reasons for hydatidosis leading up to portal hypertension in the literature. Portal hypertension in the presented case is proposed to emerge from long-lasting cystobiliary communication ending in biliary cirrhosis.

Photo Quiz

A diagnostic challenge presented in a 37-year-old man with severe weight loss and multiple liver masses

Saeed Abdi, Amin Momeni Moghadam, Mitra Rafiezadeh, Forough Mangeli, Ayub Ghafurian

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Fascioliasis is still of a great concern in Iranian population. There is a diagnostic challenge in the management of fascioliasis since the Fasciola eggs are not found in stool specimens until several months after ingestion of metacercariae. Awareness of this fact would prevent a diagnostic delay by using alternative methods of diagnosis in these patients. Serologic tracing of antibodies against antigenic products of microorganism is available and has been advised per the pervious guidelines. CT scan and MRCP are also diagnostic. Liver biopsy is not mandatory in the diagnosis of fascioliasis but it would be helpful when other modalities are not definitely diagnostic.

A 29-year-old man presented with acute upper gastrointestinal bleeding

Shabnam Shahrokh, Mohammad Pishgahi, Pardis Ketabi Moghadam, Fatemeh Naderi Noukabadi, Mohammad Reza Abdehagh, Asghar Arab Hosseini

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

  1. A traumatic diaphragmatic defect in acute phase is accompanied by respiratory signs and symptoms attributed to pneumothorax and hemothorax. Repair of defect is a necessity. Untreated defects would be overwhelmed by diaphragmatic stomach herniation leading to strangulation, gangrene and even death.


Abstract Meeting

Case Presentation

A new Endoscopic submucosal resection –ligation technique for Gastric tumors

Hamid Asadzadeh Aghdaei, Amir Sadeghi , Ahmad Ghorbanpour Nouri, Gholam Reza Nouri, Arash Dooghaie Moghadam, Mohammad Reza Azizi, Pegah Eslami

Gastroenterology and Hepatology from Bed to Bench, , 9 December 2020

Two middle-aged cases with gastric subepithelial tumors were admitted to Taleghani gastrointestinal department. The polyps were resected via our new Endoscopic Mucosal Resection (EMR) technique. In this technique, the needle knife was used for un-roofing the mucosal surface. Then, the polyps were resected with hot snares. The hemoclips were applied for ligation, too. We found no early or delayed complications. More investigations are necessary for confirming the validity of our new EMR technique.