ABSTRACT
Introducción: Si bien la biopsia intestinal es la técnica-patrón para el diagnóstico de la Enfermedad Celíaca (EC), los ensayos serológicos son un importante complemento en el screening, diagnóstico y seguimiento de la misma. Estos son anticuerpos anti-Transglutaminasa IgA (aTgt), anticuerpos anti-endomisio IgA (EMA) y anticuerpos anti-péptidos de gliadina-deaminados IgG (a-DGP). Nuestros objetivos fueron evaluar la exactitud diagnóstica de a-DGP en pacientes adultos con diagnóstico de EC que concurrieron al Hospital Córdoba y comparar la concordancia de a-DGP con aTgt y EMA. Materiales y métodos: Se realizó un estudio experimental en el Hospital Córdoba. Se analizaron sueros conservados a - 20° C, de 54 pacientes (Marzo de 2015 a Diciembre 2017) sometidos a biopsia intestinal. Las muestras de tejido permitieron determinar los siguientes grupos:´ Grupo Enfermedad Celíaca (GEC): 25 pacientes con biopsia positiva para EC, de acuerdo a la clasificación de Marsh. Grupo Control (GC): 29 pacientes con biopsia negativa para EC. Se determinaron niveles de: a-DGP y aTgt por ELISA comercial, EMA por Inmunofluorescencia indirecta e Ig A sérica por inmunoturbidimetría. Análisis estadísticos de los datos: Se utilizaron los programas estadísticos "InfoStat" y "MedCalc" 10.2.0.0. La concordancia se determinó por el índice kappa (κ). Un valor de p <0,05 fue considerado estadísticamente significativo. Resultados: El valor de corte para a-DGP fue de 15,4 U/ml. La exactitud diagnostica para el título de corte fue de 94,44%. El valor de corte para aTgt fue de 9,3 U/ml. La exactitud diagnostica fue de 92,59 %. La concordancia entre a-DGP y aTgt fue sustancial (κ= 0.740) y casi perfecto entre a-DGP y EMA (κ=0,851). Conclusiones: El ELISA para a-DGP demostró una elevada exactitud diagnóstica. Se observó una mejor concordancia de a-DGP con EMA que con aTgt. Los resultados obtenidos confirman el potencial clínico de este marcador serológico como complemento diagnóstico de EC.
Introduction: Although intestinal biopsy is the standard technique for the diagnosis of Celiac Disease (CD), serological tests are an important complement in the screening, diagnosis and follow-up of the same. These are antibodies IgA to transglutaminase antibodies (aTgt), Ig A antibodies to endomysium (EMA) and antibodies to deamidated gliadin peptides (a-DGP). Our objectives were to evaluate the diagnostic accuracy of a-DGP in adult patients with a diagnosis of CD who attended the Córdoba Hospital and compare the concordance of a-DGP with aTgt and EMA. Materials and methods: An experimental study was carried out at the Hospital Córdoba. Serums conserved at -20 ° C were analyzed, from 54 patients (March 2015 to December 2017) submitted to intestinal biopsy. The tissue samples allowed to determine the following groups: Celiac Disease Group (GEC): 25 patients with a positive biopsy for CD, according to the Marsh classification. Control Group (GC): 29 patients with negative biopsy for CD. Levels of: a-DGP and aTgt were determined by commercial ELISA, EMA by indirect Immunofluorescence and serum IgA by immunoturbidimetry. Statistical analysis of the data: Statistical programs "InfoStat" and "MedCalc" 10.2.0.0 were used. The concordance was determined by the kappa index (κ). A value of p <0.05 was considered statistically significant. Results: The cut-off value for a-DGP was 15.4 U / ml. The diagnostic accuracy for the cutoff title was 94.44%. The cut-off value for aTgt was 9.3 U / ml. The diagnostic accuracy was 92.59%. The agreement between a-DGP and aTgt was substantial (κ = 0.740) and almost perfect between a-DGP and EMA (κ = 0.851). Conclusions: The ELISA for a-DGP demonstrated a high diagnostic accuracy. A better concordance of a-DGP with EMA was observed than with aTgt. The results obtained confirm the clinical potential of this serological marker as a diagnostic complement of CD.
ABSTRACT
Seventeen Philippine plants were subjected to antimicrobial screening against Staphylococcus aureus and Escherichia coli using antimicrobial disc assay. The result showed that Terminalia catappa, locally known as "talisay", exhibited the highest antimicrobial activity against S. aureus and none against E. coli. The growth of Staphylococcus aureus inoculated in nutrient broth with different concentrations of the T. catappa extract was determined by measuring cell density at 0 hours and 24 hours of inoculation. The results showed that bacterial cell density decreased significantly after 24 hours of inoculation in the plant extract. Talisay was further tested for its wound healing properties on 2 groups (group 1: standard drug vs. negative control; group 2: herbal extract vs. negative control) of guinea pigs using the abrasion method. A swab of inoculum of S. aureus was applied for infecting the wound. Differences in degrees of wound healing determined by free radical scavenging activity, colony forming units (CFU) counting and histopathologic analysis were noted. Samples from wound abscesses remaining after 48 hours of application of extract were swabbed in petriplates containing 20 ml nutrient agar and were verified using the catalase test. The CFUs were counted 24 hours after incubation. Crude extract was further subjected to High Pressure Liquid Chromatography (HPLC) yielding a polar substance suspected to be of the aromatic tannin family. ANOVA revealed significant difference in the positive control and negative control results against the T. catappa extract treatment in the in vivo antimicrobial activity model. Among these setups, the wounds treated with the extract exhibited advanced healing as supported by significantly lower absorbance levels in the antioxidant assay, lower CFU count, and significantly higher grade in wound healing parameters for histopathologic analysis. The T. catappa extract under study showed significant inhibition of growth of S. aureus and effective healing of infected wounds