ABSTRACT
A role of disturbed intestinal normal flora, such as Chronic Intestinal Candidiasis [C.I.C.] syndrome, in the genesis of intractable allergic diseases, through changing in the intestinal mucosal barrier was suggested. In this study, we have assessed the C.I.C. in the patients with intractable allergies to elucidate the potential involvement of this syndrome in the genesis of these diseases and to find out a relation between the serum level of candida IgG, IgM and IgA with the disease intractability [serum total IgE] through an intestinal functional impairment in these patients. The serum levels of candida IgG, IgM, IgA were assessed in 20 patients with C.I.C. and intractable allergic diseases as well as in 20 healthy volunteers and their levels were correlated to the laboratory parameter of disease intractability referring to an intestinal functional impairment in these patients. When compared with the control group, the patients showed a significantly higher concentration [< 0.0001] of only serum candida IgG. A statistically significant positive correlation was found between this higher concentration and disease intractability while a negative insignificant correlation was found between serum candida IgM and negative significant correlation between serum candida IgA and disease intractability in these patients. The results of intestinal biopsies showed variable lesions but there was absence of candida hyphae or intestinal invasion. The results of this study suggest that disturbed intestinal normal flora produced by C.I.C. may play important role in the genesis of intractable allergic diseases. Measurement of serum candida IgG reflects the disease intractability in these patients even without increasing frequency of acute intestinal candida infection [IgM] or invasion [IgA]. In addition, inhibition of C.I.C. either by drugs or diet adjustment may improve the clinical manifestations or decrease the progress of these diseases. However, further studies are needed to elucidate the exact role of C.I.C. in relation to other factors involved in the pathogenesis of intractable allergic diseases by affecting the intestinal mucosal barrier
ABSTRACT
Relationship between HCV and DM was documented in several studies. HCV through pro-inflammatory cytokines causes insulin resistance. Steatosis in HCV is a well known pathological feature. Interest in the last decade was turned into the possible link between insulin resistance and Steatosis and their effect on fibrosis progression was to study relationships between fibrosis, inflammation, Steatosis and insulin resistance in HCV patients. This study was conducted on 80 patients with HCV and 20 healthy controls. Participants were subjected to clinical examination, laboratory investigations [liver and kidney function tests, hepatitis markers, fasting glucose, insulin, and serum lipids], HOMA score estimation, BMI calculation and abdominal ultrasonography. Patients underwent liver biopsy and qualitative PCR for HCV RNA. showed higher HOMA score and fasting insulin levels in HCV patients than controls. A strong positive correlation was found between insulin resistance, fasting insulin levels and liver fibrosis in HCV patients. No correlation was found between insulin resistance and neither BMI nor age of patients. Prevalence of Steatosis in HCV patients biopsies was 93.75%. Significant correlation was found between fibrosis and Steatosis, and between insulin resistance and Steatosis. detection and treatment of insulin resistance in chronic hepatitis C patients are recommended to improve outcome of patients and decrease rate of progression of fibrosis