ABSTRACT
BACKGROUND: Inflammatory bowel disease (IBD) as a chronic and debilitating disease is affected by sleep disturbance which increases the risk of malignancy. Sleep disturbance is more common in irritable bowel syndrome (IBS) and few reported studies have assessed its role in IBD. We evaluated the effect of IBS on sleep quality and quality of life (QOL) of IBD patients in clinical remission. METHODS: In a cross-sectional study, 115 IBD patients in clinical remission aged from 14 to 70 years referred to gastroenterology outpatient departments and private gastroenterology offices from 2007 to 2016. Patients considered in four groups (with/without IBS). The Revised "Rome III criteria" used for diagnosing IBS. Pittsburgh Sleep Quality Index questionnaire and the health-related QOL questionnaire used for evaluating sleep quality and QOL. RESULTS: About 85 (73.9%) cases had ulcerative colitis (UC) and 30 (26.1%) cases had Crohn's disease (CD). Forty (34.8%) cases had IBD + IBS. Poor sleep quality in UC + IBS (OR: 0.018, P = 0.003) and UC (OR: 0.016, P = 0.002) was less than CD. Diseases extent in left side colitis (OR: 0.064, P = 0.016) were less than with pancolitis. Sleep quality affected by quality of life (IBDQ) (P = 0.048). Mean quality of life (IBDQ) in patients who had poor sleep was 11% less than those with good sleep. CONCLUSIONS: The syndrome of IBS affects the sleep quality of IBD in clinical remission, especially in CD. Its additive effect with IBD may worsen symptoms that correlated with sleep disturbance, such as pain, psychological and physical condition, and QOL.
ABSTRACT
BACKGROUND: Despite the extensive information available in the literature, cell surface marker signature of human Amniotic Epithelial Cells (hAECs) remains controversial. The aim of the present study was to characterize immunophenotypic features, proliferative capacity and immunogenicity of hAECs. We also tested whether expression of some cell surface markers is influenced by the type of trypsin used for tissue digestion. METHODS: Single cell suspensions of amniotic membranes from four human placentas were isolated by enzymatic digestion and expression of CD9, CD10, CD29, CD34, CD38, CD44, CD45, CD73, CD105, CD133, HLA-I, HLA-DR, HLA-G, SSEA-4, STRO-1 and OCT-4 was then evaluated by flow cytometry. The differential impact of four trypsin types on the yield and expression of CD105 and HLA-I was also determined. The proliferative capacity of cultured hAECs was assessed and compared in the presence and absence of Epidermal Growth Factor (EGF). To test their immunogenicity, hAECs were injected into Balb/c mice and the reactivity of hyperimmunized sera was examined by immunofluorescence staining. RESULTS: Nearly all purified cells expressed mesenchymal markers, CD9, CD10, CD29, and CD73 and the embryonic marker, SSEA-4. A large proportion of the cells also expressed STRO-1 and OCT-4. The purified cells also expressed HLA-G and HLA-I. A very small proportion of hAECs expressed CD34, CD38, CD44, CD133 and HLA-DR. The type of trypsin used for enzymatic digestion affected both the percentage and expression of HLA-I and CD105. hAECs revealed substantial proliferative capacity only when cultured in the medium supplemented with EGF. These cells were shown to be capable of inducing high amounts of anti-donor antibodies. CONCLUSION: Here we provided evidence that hAECs are immunogenic cells with high level of HLA-I expression. Furthermore, this work highlighted the impact of isolation procedure on the immunophenotype of hAEC.
