Iranian Registry of Crohn's and Colitis: study profile of first nation-wide inflammatory bowel disease registry in Middle East

BACKGROUND/AIMS: A recent study revealed increasing incidence and prevalence of inflammatory bowel disease (IBD) in Iran. The Iranian Registry of Crohn's and Colitis (IRCC) was designed recently to answer the needs. We reported the design, methods of data collection, and aims of IRCC in this paper. METHODS: IRCC is a multicenter prospective registry, which is established with collaboration of more than 100 gastroenterologists from different provinces of Iran. Minimum data set for IRCC was defined according to an international consensus on standard set of outcomes for IBD. A pilot feasibility study was performed on 553 IBD patients with a web-based questionnaire. The reliability of questionnaire evaluated by Cronbach's α. RESULTS: All sections of questionnaire had Cronbach's α of more than 0.6. In pilot study, 312 of participants (56.4%) were male and mean age was 38 years (standard deviation=12.8) and 378 patients (68.35%) had ulcerative colitis, 303 subjects (54,7%) had college education and 358 patients (64.74%) were of Fars ethnicity. We found that 68 (12.3%), 44 (7.9%), and 13 (2.3%) of participants were smokers, hookah and opium users, respectively. History of appendectomy was reported in 58 of patients (10.48%). The most common medication was 5-aminosalicylate (94.39%). CONCLUSIONS: To the best of our knowledge, IRCC is the first national IBD registry in the Middle East and could become a reliable infrastructure for national and international research on IBD. IRCC will improve the quality of care of IBD patients and provide national information for policy makers to better plan for controlling IBD in Iran.

Tumor Suppression or Oncogenic Role of miR-100 in Cancer; Implications for Esophageal Cancer

Esophageal cancer [EC] is one of the deadliest malignancies worldwide. Esophageal squamous cell carcinoma [ESCC] constitutes the most common type of EC in Asian countries. Despite advanced surgical techniques, 5-year survival of the affected patients is very low. Therefore, identification of genetic factors and cellular regulatory pathways, including microRNAs [miRNAs], in esophageal carcinogenesis is necessary for early detection. MiRNAs are a class of small non-coding RNA about 18-24 nucleotides in length that negatively regulate gene expression. Deregulation of miRNAs was shown to have a crucial role in the pathways underlying tumorigenesis and tumor progression. Evidence indicates that aberrant expression pattern of miR-100 is associated with pathogenesis of ESCC. The function and expression pattern of miR-100 in ESCC are controversial and its effects in tumor progression has not been fully elucidated. A better understanding of molecular procedures mediated by miR-100 in carcinogenesis, may lead to the opportunity of exploring potential miR-100 based therapeutic applications. In this review, we provide an overview of miR-100, including its important regulation pathways and target genes involved in the development of cancers, emphasizing on its potential role in ESCC

Relevance of helicobacter pylori plasticity and cagPAI regions known genes to gastric and duedenal ulcers in Iran

Background: Helicobacter pylori [H. pylori] is the main cause of gastroduodenal diseases, such as chronic atrophic gastritis, gastric ulcer [GU], and duodenal ulcer [DU]. There is a close relationship between H. or/-specific factors and different gastroduodenal diseases. The aim of the present study was to clarify the roles of the plasticity region genes [jhp0940, jhp0945, and jhp0947] and the known genes of cagPAI [cagA and cage] in relation to GU and DU diseases

Materials and Methods: A total of 173 strains that were isolated from 114 patients with non-atrophic gastritis [NAG], 30 patients with DU, and 29 patients with GU were genotyped. Data were collected and analyzed using SPSS software version 19.

Results: The cagE gene had the highest frequency [69.4%] and jhp0945 had the least frequency [11.0%] among the genes. When GU was considered as a dependant factor in simple logistic regression analysis, no genotype correlation was found with risk for GU in Iran [p>0.05]. Statistical analysis showed that cagA+ and cagAV jhp0940+ genotypes were significantly associated with an increased risk of DU but not GU. The Odds ratios [95% CI] were 3.143 [1.120-8.817], and 7.250 [1.493-38.199], respectively

Conclusion: Given the high frequency of cagE, this gene could be a suitable marker for the presence of cagPAI in Iranian strains. cagA[+] and cagAV jhp0940+genotypes can be beneficial biomarkers for risk prediction of DU in Iran

Prevalence of celiac disease in patients with recurrent aphthous stomatitis

Celiac disease [CD] is an immune-mediated inflammation of the small intestine caused by sensitivity to dietary gluten and related proteins in genetically sensitive individuals. Recurrent aphthous stomatitis [RAS] is an inflammatory condition characterized by painful recurrent, single or multiple ulcerations of the oral mucosa. The association between CD and RAS has been evaluated in several studies. The purpose of this study was to determine the prevalence of CD in patients with RAS. This was a prospective cross-sectional study that enrolled 181 patients with recurrent oral ulcers [at least three attacks per year]. Patients' peripheral blood samples were studied in terms of anti-tissue transglutaminase [anti-tTG] antibodies [IgA], anti-endomysial antibody [IgA] and serum IgA levels. Each patient that had a positive celiac serology underwent a duodenal biopsy. Information from all patients was entered into checklists. After completion of the checklists, the obtained data were analyzed by SPSS v19 statistical software. Of the 181 enrolled patients with recurrent aphthous, 43 [23.75%] were male and 138 [76.25%] were female. Average age of these patients was 28.45 +/- 12.27 years. The average age of disease onset was 23.39 +/- 9.46 years. Serologic survey results showed that only 2 patients were positive for these antibodies - both were women whose average age was 29 years. The average age of their disease onset was 22.5 years and biopsy results confirmed the presence of lymphocytic enteritis with crypt hyperplasia [Marsh II]. According to the results of this study, although there is a low prevalence of CD in patients with RAS, screening RAS patients for key serological markers of CD has clinical value.

Epidemiology of peptic ulcer disease: endoscopic results of a systematic investigation in Iran

Peptic ulcer disease is a multifactorial health problem affecting almost all populations worldwide. Large scale population-based studies are crucial to understanding its scope and specifications in various nations. We aimed to explore environmental risk factors of peptic ulcer disease in the first population based study in Ardabil, Northwest Iran. This study was a part of a larger survey on upper gastrointestinal tract health conducted in Ardabil and Meshkinshahr with a total catchment area population of 600,000 persons during 2000-01. Using a random sampling proportional to place of residence, 1122 persons aged 40 or elder were selected. 1011 [90.1%] accepted participation and underwent a comprehensive medical examination and a systematic upper gastrointestinal endoscopy. Point prevalence of peptic ulcers was correlated to various life style risk factors. Gastric and duodenal ulcers were identified in 33 [3.26%] and 50 [4.94%] participants, making an overall prevalence of 8.20%. Based on multivariable logistic regression analyses, H.pylori infection [OR 3.1, 95% CI: 2.1-4.7], Smoking [OR 1.8, 95% CI: 1.1-6.8], and chronic intake of NSAIDs [OR 2.8, 95% CI: 1.3-4.4] were main risk factors of gastric ulcer. For duodenal ulcer, in addition to H.pylori infection [OR 5.6, 95% CI: 1.9-8.8] and Smoking [OR 2.3, 95% CI: 1.4-6.5], male gender [OR 3.6, 95% CI: 1.2-5.8] and living in an urban area [OR 1.9, 95% CI: 1.1-5.2] were among significant risk factors. This is the first population-based endoscopic study in North West of Iran reporting accurate point prevalence of peptic ulcer disease. The rate of 3.3% for gastric ulcer and 4.9% for duodenal ulcers are substantially lower than the estimates reported in Asian population-based endoscopic studies but higher than European reports