ABSTRACT
Celiac disease (CD) is an autoimmune pathology caused by the ingestion of gluten in genetically susceptible people, currently considered multisystemic. The treatment of CD is a lifelong strict Gluten-Free Diet (GFD), which allows a symptomatic improvement in most patients and achieve intestinal mucosa healing confirmed with histological study. The adherence to the GFD is variable, arguing as possible factors related to failure the economic, cultural, social aspects and the consumption of gluten inadvertently. The management of celiac patients contemplates instructing in the proper follow-up of GFD and evaluating their adherence. So far, the only way to assess adherence to GFD is through surveys, self-reports of eating habits and serology, being the main disadvantage the subjectivity factor. Recently the immunogenic gluten peptides have acquired relevance for the objective evaluation of the adherence to the GFD and the measurement appears as an efficient and sensitive option to determine the gluten intake, providing relevant information for the clinical management.
Subject(s)
Male , Female , Humans , Celiac Disease/immunology , Glutens/analysis , Glutens/metabolism , Peptides/analysis , Peptides/immunologyABSTRACT
Inflammatory bowel disease includes Crohn´s disease, ulcerative colitis and unclassified colitis. Conventional therapies used for treating these diseases are often insufficient orcontraindicated and biological agents have proved to be effective and safe in these cases. Infliximab is a quimeric IgG1 monoclonal anti-tumor necrosis factor antibody that is capableof inducing and mantaining clinical remission in patients with inflammatory bowel disease. Despite its proven efficacy a considerable group of patients lose response requiring changesin therapy. Serum Infliximab trough levels are correlated with clinical response, endoscopic remission and mucosal healing in patients with inflammatory bowel disease. Monitoring and adjusting therapy guided by drug serum levels have proved to be more cost-effective and safer than empiric adjustments. Current international guidelines recommend the measurement of Infliximab trough levels in the global evaluation and management of these patients to improve treatment, avoid adverse events and unnecessary costs.
Subject(s)
Male , Female , Humans , Inflammatory Bowel Diseases/drug therapy , Infliximab/pharmacokinetics , Infliximab/therapeutic useABSTRACT
Hepatitis C virus (HCV) is a globally prevalent pathogen and a leading cause of death and morbidity. The most recent estimates of disease burden show an increase in seroprevalence over the last 15 years to 2.8 percent, equating to >185 million infections worldwide. Persistent hepatitis C infection is associated with the development of liver cirrhosis, hepatocellular cancer, liver failure and death. The magnitude of disease progression in chronic infection varies significantly among individuals. Several factors have been recognized as being associated with the progression of HCV-related liver fibrosis and with clinical outcomes. As liver fibrosis progression remains variable between individuals with similar environmental or virological risks, host genetic predispositions have been suggested as another critical determinant. The single nucleotide polymorphisms in Patatin-like phospholipase domain-containing 3 (PNPLA3) and Transmembrane 6 Superfamily Member 2 (TM6SF2) genes are genetic determinants of nonalcoholic fatty liver disease, in terms of inflammation and fibrosis. The possible action of the PNPLA3 and TM6SF2 polymorphisms on fibrosis development in chronic hepatis C is being studied, with controversial results.