Effect of the C3435T polymorphism of the multidrug resistance 1 gene on the severity of inflammatory bowel disease in Iranian Azeri Turks

Multidrug resistance 1 [MDR1] gene encodes for P-glycoprotein [P-gp], a transmembrane efflux pump transferring both exogenous and endogenous substrate from the cells. In the human gastrointestinal tract, P-gp is found in high concentrations on the epithelial cells of the colon and small intestine. It is hypothesized that the expression level of MDR1 gene is related to susceptibility of both forms of inflammatory bowel disease [IBD]. The aim of this study was to investigate the association of C3435T Single Nucleotide Polymorphism in IBD patients with/without clinical symptoms in Iranian Azeri Turks. A total of 116 patients with IBD and 92 healthy subjects were analyzed. We investigated the distribution of MDR1 C3435T polymorphism via polymerase chain reaction - Restriction Fragment Length Polymorphism technique. All statistical analyses were calculated with the SPSS for Windows 16.0. The Fisher exact test was used to test for departure from Hardy-Weinberg equilibrium of the genotype frequencies [P> 0.05]. The data showed that IBD patient with homozygous variant carrying MDR1 3435 T/T genotype has elevated risk for development of routine IBD clinical symptoms like Abdominal pain [P= 0.005] and chronic Diarrhea [P= 0.013] compared with MDR1 3435 C/C homozygotes who has reduced risk for development of IBD symptoms. Our data showed that patients with MDR1 3435 T/T are more susceptible to the development of some routine IBD clinical symptoms [P<0.05]. This study suggests a protective role for the MDR1 3435 C/C versus MDR1 3435 T/Tgenotype and C versus T allele for the progression of IBD in this cohort

Bone density and bone metabolism in patients with inflammatory bowel disease

Patients with inflammatory bowel disease [IBD] are at high risk for low bone mineral density [BMD]. This study aimed to evaluate BMD in IBD patients and its relationship with bone metabolism in a group of Iranian patients. A cross-sectional study was conducted on patients with IBD to assess BMD status and serum biochemical factors. After getting the demographic data from 200 patients, they were screened using dual-energy X-ray absorptiometry of the lumbar spine [L2-L4] and femoral neck for BMD status. Serum levels of calcium, phosphate, alkaline phosphatase [ALP], and 25-hydroxyvitamin D [25-OH vitamin D] were measured to assess the bone metabolism status. Two hundred patients with IBD were enrolled in the study. One hundred and eighty three [91.5%] patients were identified as having ulcerative colitis [UC] and 17 [8.5%] as having Crohn's disease [CD]. Based on the lumbar and femoral neck bone mass densitometry, 148 [74.4%] patients had low BMD at either lumbar spine or femoral neck. Of these, 100 patients [50.3%] were osteopenic and 48 patients [24.1%] were osteoporotic. A 58.6% and 61% of patients with UC had low BMD in the lumbar and femoral neck, respectively. These results for those with CD were 76.5% and 70.6%, respectively. The mean of femoral neck and lumbar T-scores in patients with UC were -1.14 and -1.38, and in patients with CD were -1.24 and -1.47, respectively [P > 0.05]. The mean [ +/- SD] levels for calcium [Ca] in UC and CD were in the normal range. The mean [ +/- SD] levels of ALP and 25-OH vitamin D in both the groups were in the normal range, and in comparison between groups [UC and CD], no significant differences were observed [P = 0.20 for ALP and P = 0.44 for 25-OH vitamin D]. In the assessment of correlation between biochemical markers and BMD, an inverse correlation between lumbar T-score and ALP or 25-OH vitamin D only in patients with UC was observed. The high prevalence of low BMD in the Iranian population with IBD needs attention. The subclinical vitamin D deficiency may contribute to bone loss in IBD patients, which is more pronounced in patients with UC in this study because of the small population of patients with CD

inverse relation between CagA + strains of helicobacter pylori infection and risk of erosive GERD

The aim of this study is investigating the association of Helicobacter pylori H. pylori infection and its cytotoxic-associated gene A cagA strain with reflux esophagitis. In a case-control setting May 2005-2006, patients with reflux esophagitis case group were compared with age and gender matched people suffering from symptoms of gastroesophageal reflux disease with normal upper gastrointestinal endoscopic findings control group in Imam Khomeini Hospital, Tabriz, Iran. The rates of H. pylori and its cagA positive infections were separately compared between the 2 groups and the subgroups with different severity of reflux esophagitis. Ninety-two and 93 patients were enrolled in the case and the control groups. The rate of H. pylori infection was insignificantly lower in the case group 81.5% versus 87.10%, p=0.29, odd ratio 0.654, 95% Confidence interval [CI] 0.293 to 1.495. The CagA positive infections were found significantly more frequent in the control group 59.1% versus 40.2%, p=0.01, odd ratio 0.465, 95% CI 0.258 to 0.836. There was no significant difference between the severity subgroups of the disease for H. pylori p=0.30 or cagA positive infection rates p=0.40. The CagA positive strains might have a protective effect against reflux esophagitis

Mannose binding lectin gene haplotype in Iranian patients with hepatitis C infection

Persistent infection with hepatitis C virus [HCV] leads to liver cirrhosis [LC] and often to liverm cancer. Mannose binding lectin [MBL] is a C-type serum lectin, which plays an important role in innate immunity by activating the classical complement pathway. Variants of the MBL have been shown to be associated with low serum concentrations of the protein and to predispose to bacterial, fungal and viral infections. This study was undertaken to investigate the association between polymorphisms of MBL gene and hepatitis C virus infection. We determined genotypes of two promoters and three exon 1 SNPs in mbl2 by SSP-PSR and grouped these genotypes according to related amount of functional MBL production in 100 patients infected with hepatitis C virus and 100 healthy blood donors in Iranian population. MBL gene mutations were determined by means of polymerase chain reaction and restriction fragment length polymorphism analyses. genotypes XA/O or O/O were significantly more frequent among patients infected with hepatitis C virus, where YA/YA genotype was more common among donors. Frequency of alleles X, Y, H and L did not have a significant difference between the two groups as well as alleles HYA, LYA nor LXA. MBL may be one of the factors that influence the course of HCV infection. Additional study on subjects at a high risk for infection with hepatitis C may clarify the role of carriage for the variant allele of mbl2 in a life-long risk of infection

Nutritional status and blood trace elements in cirrhotic patients

To determine the levels of zinc, copper, iron, albumin and zinc to copper ratio in sera of patients in different stages of cirrhosis and to find possible correlation between trace elements and anthropometrics measurements with liver cirrhosis presence and progression. This cross-sectional analytic study was carried out on sixty continuous patients with liver cirrhosis referred to hepatology clinic, Tabriz University of Medical Sciences. The mean of daily calorie and protein intake was determined by Nutrition III software and compared to recommended dietary allowances [RDA], body composition was determined by bioelectrical impedance analysis [BIA] and serum Zn, Cu and Fe levels were determined by atomic absorption spectrophotometery and albumin level of serum was measured by calorimetric method. Among sixty studied patients, 39 were male and 21 were female. 53.8% of male patients were in Child-Pugh class B while 23.8% of female patients were in Child-Pugh class B. The mean energy and protein intake of all patients was lower than RDA values and there was no significant correlation between the mean of protein and energy intake with severity of liver cirrhosis. The serum levels of Zn, Albumin and Zn/Cu ratio in patients with Child-Pugh class B were significantly lower than those with Child-Pugh class A. In general, these results suggested that changes in liver cell pathology compounded by functional impairment may alter the metabolism of trace metals, in particular, zinc

Association of mannose binding lectin polymorphism with hepatitis C infection in northwest of Iran

Persistent infection with hepatitis C virus leads to liver cirrhosis and often to liver cancer. Mannose binding lectin is a C-type serum lectin, which plays an important role in innate immunity by activating the classical complement pathway. Variants of the mannose binding lectin have been shown to be associated with low serum concentrations of the protein and to predispose the subjects to bacterial, fungal and viral infections. This study was undertaken to investigate the association between hepatitis C virus infection and polymorphisms of mannose binding lectin gene. We assessed the single nucleotide polymorphism of mannose binding lectin in exon 1, at codon 52, codon 54 and codon 57 in 100 patients infected with hepatitis C virus and 100 controls in Iranian population. Mannose binding lectin gene mutations were determined by means of polymerase chain reaction and restriction fragment length polymorphism analyses. The occurrence of the codon 54 mutation was significantly higher in patients [OR 3.53, CI 95%: 1.94-6.44, p<0.005]. No significant difference in the frequency of codon 52 and 57 mutations was observed between patient and control groups. Mannose binding lectin may be one of the factors that influence the course of HCV infection. Our results suggest that heterozygous carriage of the variant allele of codon 54 of mannose binding lectin is associated with hepatitis C virus infection in our cases. This may not be true about codons 52 and 57 mutations