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Intestinal Microbiota in Common Chronic Inflammatory Disorders Affecting Children.

Front Immunol 2021 7;12:642166. Epub 2021 Jun 7.

Chair and Department of Biochemistry, Medical University of Warsaw, Warsaw, Poland.

The incidence and prevalence rate of chronic inflammatory disorders is on the rise in the pediatric population. Recent research indicates the crucial role of interactions between the altered intestinal microbiome and the immune system in the pathogenesis of several chronic inflammatory disorders in children, such as inflammatory bowel disease (IBD) and autoimmune diseases, such as type 1 diabetes mellitus (T1DM) and celiac disease (CeD). Here, we review recent knowledge concerning the pathogenic mechanisms underlying these disorders, and summarize the facts suggesting that the initiation and progression of IBD, T1DM, and CeD can be partially attributed to disturbances in the patterns of composition and abundance of the gut microbiota. Read More

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Gastrointestinal involvement in paediatric COVID-19 - from pathogenesis to clinical management: A comprehensive review.

World J Gastroenterol 2021 Jun;27(23):3303-3316

Department of Paediatrics, Infermi Hospital, ASLTO3, Rivoli 10098, Italy.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), is responsible for the first pandemic of the 21 century. As found in adults, signs and symptoms related to the disease mainly involve the respiratory tract in the paediatric population. However, a considerable number of children present with gastrointestinal symptoms such as vomiting, abdominal pain, and diarrhea. Read More

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Celiac disease presenting as a jejunal adenocarcinoma with severe iron deficiency anemia.

Dig Liver Dis 2021 Jun 20. Epub 2021 Jun 20.

Pathologic Department CHVNG/E, Vila Nova de Gaia, Portugal.

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A Rare Presentation of Acute Respiratory Distress Due to Diffuse Large B-Cell Lymphoma of the Tongue Base.

Cureus 2021 May 19;13(5):e15124. Epub 2021 May 19.

Otolaryngology - Head and Neck Surgery, Henry Ford Health System, Detroit, USA.

Primary diffuse large B-cell lymphoma of the tongue base (BOT) is an extremely rare entity with only a few cases described in the English literature to date. The incidence of BOT non-Hodgkin's lymphoma (NHL) increases with age, most commonly after the sixth decade of life with no observed gender differences. Our patient presented with a six-month history of right neck swelling, one-month history of dysphagia, a change in voice, and ultimately acute airway distress, which led to a tracheostomy. Read More

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Predicting reintervention after thoracic endovascular aortic repair of Stanford type B aortic dissection using machine learning.

Eur Radiol 2021 Jun 22. Epub 2021 Jun 22.

Department of Catheterization Lab, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan Er Road, Guangzhou, 510080, People's Republic of China.

Objectives: To construct models for predicting reintervention after thoracic endovascular aortic repair (TEVAR) of Stanford type B aortic dissection (TBAD).

Methods: A total of 192 TBAD patients who underwent TEVAR were included; 68 (35.4%) had indications for reintervention. Read More

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Association of autoimmune diseases with cardiomyopathy: a nationwide follow-up study from Sweden.

Eur Heart J Qual Care Clin Outcomes 2021 Jun 21. Epub 2021 Jun 21.

Center for Primary Health Care Research, Lund University, Sweden.

Background: Certain autoimmune diseases (AD), such as Crohn's disease and celiac diseases, have been linked to acute cardiovascular disorders. We examined whether there is an association between 43 different ADs and risk of subsequent hospitalization and mortality of cardiomyopathy in a nationwide follow-up study in Sweden.

Methods: All individuals in Sweden hospitalized with a main diagnosis of an AD (n = 955,410) without previous or coexisting cardiomyopathy, between January 1, 1987 and December 31 2018, were followed for hospitalization or mortality of cardiomyopathy. Read More

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Relationship Between Villous Atrophy and tTGA Levels in Dyspeptic Patients: A Case Series.

Cureus 2021 May 15;13(5):e15043. Epub 2021 May 15.

Pharmacy, University of Balochistan, Quetta, PAK.

Aim The objective of the study was to observe the association of villous atrophy with anti-tissue transglutaminase levels in the identified subjects that met our addressed inclusion criteria. Methods A case series study was conducted among 40 patients presenting with dyspepsia along with signs and symptoms of celiac disease at the Bolan Medical Complex Hospital, Quetta over a period of five months from 25/5/17 to 25/10/17. The patients were referred to undergo tissue transglutaminase antibody serum test. Read More

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Immunological Impact of a Gluten-Free Dairy-Free Diet in Children With Kidney Disease: A Feasibility Study.

Front Immunol 2021 2;12:624821. Epub 2021 Jun 2.

Renal Division, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States.

Kidney disease affects 10% of the world population and is associated with increased mortality. Steroid-resistant nephrotic syndrome (SRNS) is a leading cause of end-stage kidney disease in children, often failing standard immunosuppression. Here, we report the results of a prospective study to investigate the immunological impact and safety of a gluten-free and dairy-free (GF/DF) diet in children with SRNS. Read More

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[Autoimmune diseases in patients with common variable immunodeficiency].

Rev Alerg Mex 2021 Jan-Mar;68(1):48-64

Instituto Nacional de Pediatría, Unidad de Investigación en Inmunodeficiencias, Ciudad de México, México.

Common variable immunodeficiency (CVID) is the most prevalent symptomatic primary immunodeficiency with an estimated prevalence of one in 10,000 to 50,000 inhabitants. This heterogeneous disease is characterized by decreased levels of serum immunoglobulins, a poor production of specific antibodies upon vaccination, and recurrent bacterial infections, particularly in the respiratory and gastrointestinal tract. A subgroup of patients is characterized by additional, and often predominant, manifestations of immune deregulation rather than pure immunodeficiency. Read More

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An International Reporting Registry of Patients with Celiac Disease and COVID-19: Initial Results from SECURE-CELIAC.

Clin Gastroenterol Hepatol 2021 Jun 16. Epub 2021 Jun 16.

Department of Medicine, Columbia University Irving Medical Center, New York, New York, United States; Celiac Disease Center, Columbia University Irving Medical Center, New York, New York, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, United States. Electronic address:

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COVID-19 and celiac disease: A pathogenetic hypothesis for a celiac outbreak.

Int J Clin Pract 2021 Jun 17:e14452. Epub 2021 Jun 17.

Pediatric Gastroenterology and Liver Unit, Maternal and Child Health Department, Sapienza University of Rome, Rome, Italy.

Background: A growing body of evidence supports the intestinal trophism of SARS-CoV-2, with ciliated cells and intestinal enterocytes being target cells because of the high expression of ACE2 and TMPRSS2. Indeed, COVID-19 promotes a "cytokine storm" in the intestinal mucosa: the resulting epithelial damage leads to increased barrier permeability, allowing the passage of gliadin in the intestinal lamina.

Methods: Based on current literature, we hypothesize the role of COVID-19 as a potential trigger factor for celiac disease in predisposed patients. Read More

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COVID-19-related personal product shortages are associated with psychological distress in people living with gastrointestinal disorders: A cross-sectional survey.

Neurogastroenterol Motil 2021 Jun 18:e14198. Epub 2021 Jun 18.

Department of Psychological Sciences, Swinburne University of Technology, Victoria, Australia.

Background: The mental health response to the coronavirus (COVID-19) pandemic-related product shortages in those living with chronic gastrointestinal (GI) disorders has received little attention. We aimed to explore the association between the pandemic-related product shortages and psychological distress in people with GI disorders.

Methods: This online cross-sectional survey was nested within an ongoing, international, prospective study of well-being in people with GI disorders. Read More

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Female Fertility and the Nutritional Approach: The Most Essential Aspects.

Adv Nutr 2021 Jun 17. Epub 2021 Jun 17.

Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, the Heliodor Swiecicki Hospital, Poznan, Poland.

Infertility is an increasing problem that affects couples attempting pregnancy. A growing body of evidence points to a link between diet and female fertility. In fact, data show that a diet high in trans fats, refined carbohydrates, and added sugars can negatively affect fertility. Read More

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Nonalcoholic fatty liver disease is associated with a higher incidence of coeliac disease.

Eur J Gastroenterol Hepatol 2021 Jun 17. Epub 2021 Jun 17.

Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Düsseldorf Epidemiology, IQVIA, Frankfurt Department of Hepatology and Gastroenterology, Charité University Medicine Berlin, Berlin, Germany.

Background: Recently the incidence of nonalcoholic fatty liver disease (NAFLD) has risen to become the most frequent liver disease worldwide. NAFLD is not a disease limited to the liver, but rather represents a systemic inflammatory disease involving multiple organ systems. Previous studies have suggested an association between NAFLD and coeliac disease, another disease related to inflammation. Read More

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Panintestinal capsule endoscopy in patients with celiac disease.

Eur J Gastroenterol Hepatol 2021 Jun 17. Epub 2021 Jun 17.

Department of Medicine I, Interdisciplinary Endoscopy Unit, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.

Introduction: Capsule endoscopy has proven its utility in diagnosing villous atrophy and lymphoma in patients with celiac disease. Recently, a novel capsule endoscopy system was introduced which enables the examination of the small and large bowel. So far, it has not been evaluated in patients with celiac disease. Read More

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Evaluation of crypt apoptotic bodies and apoptotic indices in pediatric celiac disease by routine staining and H2AX immunostaining.

Int J Immunopathol Pharmacol 2021 Jan-Dec;35:20587384211026791

Faculty of Medicine, Cairo University, Cairo, Egypt.

Celiac disease (CD) is an immune-mediated disorder with premature apoptosis occurring along the entire crypt-villous axis. H2AX is the end product of the intrinsic apoptotic pathway. This is the first study to assess apoptotic body counts (ABC) by H&E and apoptotic indices (AI) by immunohistochemistry (IHC) in pediatric CD. Read More

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Catching Takayasu Early: Diagnosing the "Pulseless" Disease in a Child with Palpable Pulses.

Case Rep Pediatr 2021 27;2021:8885944. Epub 2021 May 27.

Gandhi Medical College and Hospital, Secunderabad 500003, India.

Takayasu arteritis is a systemic vasculitis of large vessels that mainly involves the aorta and its branches. It normally presents in the third decade of life and is rarely seen in children. We report a case of childhood Takayasu arteritis, in a 12-year-old girl, who presented with abdominal pain and hypertension. Read More

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Diagnostic utility of multiple site duodenal biopsies in celiac disease.

Indian J Pathol Microbiol 2021 Jun;64(Supplement):S73-S77

Department of Gastroentrology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.

Background: Celiac Disease involves the small intestine patchily affecting more frequently the proximal small bowel but the histological changes have been observed till terminal ileum. Of late in addition to D2, the duodenal bulb (D1 region) biopsies have been found helpful in identifying a small group of patients with CD. Therefore, multiple site biopsies are recommended as histological changes are not uniform throughout small intestine. Read More

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Best practices of handling, processing, and interpretation of small intestinal biopsies for the diagnosis and management of celiac disease: A joint consensus of Indian association of pathologists and microbiologists and Indian society of gastroenterology.

Indian J Pathol Microbiol 2021 Jun;64(Supplement):S8-S31

Department of Pathology, MLN Medical College, Allahabad, Uttar Pradesh, India.

The Indian Association of Pathologists and Microbiologists (IAPM) and Indian Society of Gastroenterology (ISG) decided to make a joint consensus recommendation for handling, processing, and interpretation of SI biopsies for the diagnosis and management of celiac disease (CD) recognizing the inhomogeneous practice of biopsy sampling, orientation, processing, and interpretation. A modified Delphi process was used to develop this consensus document containing a total of 42 statements and recommendations, which were generated by sharing the document draft, incorporating expert's opinion, followed by three cycles of electronic voting as well as a full-day face-to-face virtual ZOOM meeting and review of supporting literature. Of the 42 statements, 7 statements are on small intestinal (SI) biopsy in suspected patients of CD, site and the number of biopsies; 7 on handling, fixative, orientation, processing, and sectioning in pathology laboratories; 2 on histological orientation; 13 statements on histological interpretation and histological grading; 3 on the assessment of follow-up biopsies; 2 statements on gluten-free diet (GFD)-nonresponsive CD; 4 on challenges in the diagnosis of CD; 2 statements each on pathology reporting protocol and training and infrastructure in this area. Read More

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Expression of the fructose transporter GLUT5 in patients with fructose malabsorption.

Z Gastroenterol 2021 Jun 15;59(6):531-539. Epub 2021 Jun 15.

Specialist Practice for Internal Medicine, Oldenburg, Oldenburg Germany.

Background:  Patients with abdominal symptoms are frequently diagnosed with fructose malabsorption (FM). Fructose is absorbed by monosaccharide transporters located in the brush border of the human small intestine. The aim of this study was to investigate the histoanatomical distribution of the main fructose transporter GLUT5. Read More

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Gut microbiota-CRAMP axis shapes intestinal barrier function and immune responses in dietary gluten-induced enteropathy.

EMBO Mol Med 2021 Jun 14:e14059. Epub 2021 Jun 14.

State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China.

In the gut, cathelicidin-related antimicrobial peptide (CRAMP) has been largely described for its anti-infective activities. With an increasing recognition of its immune regulatory effects in extra-intestinal diseases, the role of CRAMP in gluten-induced small intestinal enteropathy celiac disease remains unknown. This study aimed to investigate the unexplored role of CRAMP in celiac disease. Read More

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COVID-19 infection as a trigger for new-onset type 1 diabetes in a susceptible individual - or just coincidence?

GMS Hyg Infect Control 2021 22;16:Doc17. Epub 2021 Apr 22.

Department of Internal Medicine II, Thuringia Clinic Saalfeld "Georgius Agricola", Saalfeld/Saale, Germany.

The cytotoxic effects of COVID-19 raise the question of a possible relation between COVID-19 infection and new-onset type 1 diabetes. We report the case of an eight-year-old boy with new-onset type 1 diabetes and an asymptomatic COVID-19 infection. The eight-year-old boy was hospitalized on December 18, 2020 due to increased polyuria during the preceding 1 week. Read More

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Impact of Bacterial Metabolites on Gut Barrier Function and Host Immunity: A Focus on Bacterial Metabolism and Its Relevance for Intestinal Inflammation.

Front Immunol 2021 26;12:658354. Epub 2021 May 26.

Laboratory of Innate Immunity, Program of Immunology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile.

The diverse and dynamic microbial community of the human gastrointestinal tract plays a vital role in health, with gut microbiota supporting the development and function of the gut immune barrier. Crosstalk between microbiota-gut epithelium and the gut immune system determine the individual health status, and any crosstalk disturbance may lead to chronic intestinal conditions, such as inflammatory bowel diseases (IBD) and celiac disease. Microbiota-derived metabolites are crucial mediators of host-microbial interactions. Read More

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What is the impact of thyroidectomy on autoimmune features associated with Hashimoto's thyroiditis?-Institutional experience.

Niger J Clin Pract 2021 Jun;24(6):905-910

Pinnamaneni Siddartha Institute of Medical Sciences (PSIMS), Gannavaram, Vijayawada, AP, India.

Background: Hashimoto's thyroiditis (HT) is one of the commonest endocrine disorders, globally. Often, HT presents a protean range of associated autoimmune features (AAI) such as vitiligo, rheumatoid arthritis, pernicious anemia, skin allergy/atopy, thrombocytopenia, Addison's disease, type 1 diabetes, celiac disease, eosinophilia, etc., The usual treatment of HT is symptomatic with no curative option. Read More

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Distal pancreatectomy with celiac artery resection acquires satisfactory survival for locally advanced pancreatic neck-body cancer.

Asian J Surg 2021 Jun 8. Epub 2021 Jun 8.

Department of General Surgery, Jinling Hospital, Medicine School of Nanjing University, NO 305 East Zhongshan Road, Nanjing, Jiangsu Province, China. Electronic address:

Background: s As a curative surgical procedure for pancreatic neck-body cancer with invasion to celiac artery (CA), the security and efficacy of distal pancreatectomy (DP) with en bloc resection of the celiac artery (DP-CAR) remain controversial. The purpose of this study was to identify the postoperative outcomes of DP-CAR.

Methods: A retrospectively analysis between January 2010 and January2019 was performed in a single center. Read More

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Altered Immune Phenotypes and Gene Variation in Multiple Sclerosis Patients Failing Interferon Treatment.

Front Immunol 2021 25;12:628375. Epub 2021 May 25.

Cytokine Signaling Unit, Department of Immunology, Institut Pasteur, Paris, France.

Background: Interferon beta (IFN) has been prescribed as a first-line disease-modifying therapy for relapsing-remitting multiple sclerosis (RRMS) for nearly three decades. However, there is still a lack of treatment response markers that correlate with the clinical outcome of patients.

Aim: To determine a combination of cellular and molecular blood signatures associated with the efficacy of IFN treatment using an integrated approach. Read More

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Triticum monococcum amylase trypsin inhibitors possess a reduced potential to elicit innate immune response in celiac patients compared to Triticum aestivum.

Food Res Int 2021 Jul 7;145:110386. Epub 2021 May 7.

Institute of Food Sciences, CNR, Avellino, Italy; E.L.F.I.D, University "Federico II" Napoli, Italy. Electronic address:

Scope: Several studies reported a role of amylase/trypsin-inhibitors (ATIs) of common wheat species in promoting immune reactions. Here, we investigated in celiac disease (CD), the immunogenic properties of ATIs from diploid compared to common hexaploid wheats after an in vitro proteolytic hydrolysis.

Methods And Results: ATIs purified from two lines of diploid Triticum monococcum (TM), Monlis and Norberto-ID331, and from Triticum aestivum (TA), Sagittario, were digested with pepsin-chymotrypsin (PC) enzymes and analyzed using a proteomic approach, and subsequently their immune stimulatory properties were investigated on jejunal biopsies and T-cell lines from CD patients. Read More

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Combination of (interferon beta-1b, lopinavir/ritonavir and ribavirin) versus favipiravir in hospitalized patients with non-critical COVID-19: A cohort study.

PLoS One 2021 10;16(6):e0252984. Epub 2021 Jun 10.

Infectious Diseases Section, Department of Medical Specialties, King Fahad Medical City, Riyadh, Saudi Arabia.

Objectives: Our study aims at comparing the efficacy and safety of IFN-based therapy (lopinavir/ritonavir, ribavirin, and interferon β-1b) vs. favipiravir (FPV) in a cohort of hospitalized patients with non-critical COVID-19.

Methods: Single center observational study comparing IFN-based therapy (interferon β-1b, ribavirin, and lopinavir/ritonavir) vs. Read More

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Pepsin Digest of Gliadin Forms Spontaneously Amyloid-Like Nanostructures Influencing the Expression of Selected Pro-Inflammatory, Chemoattractant, and Apoptotic Genes in Caco-2 Cells: Implications for Gluten-Related Disorders.

Mol Nutr Food Res 2021 Jun 10:e2100200. Epub 2021 Jun 10.

Department of Chemistry, Organic Chemistry III, Bielefeld University, Universitätsstr. 25, Bielefeld, 33615, Germany.

Scope: Proteolysis-resistant gliadin peptides are intensely investigated in biomedical research relates to celiac disease and gluten-related disorders. Herein, the first integrated supramolecular investigation of pepsin-digested gliadin peptides (p-gliadin) is presented in combination with its functional behavior in the Caco-2 cell line.

Methods And Results: First, gliadins are degraded by pepsin at pH 3, and the physicochemical properties of p-gliadin are compared with gliadin. Read More

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