Serum Syndecan-1 Levels and Its Relationship to Disease Activity in Patients with Crohn's Disease.

Background. Syndecan-1 (SDC-1), a member of the family of heparan sulfate proteoglycans, plays an important role in the resolution of inflammation. This study aimed to investigate the relationship between SDC-1 and disease activity in Crohn's disease (CD). Methods. Serum samples of 54 patients with CD and 30 healthy controls were obtained. First, SDC-1 levels of the CD patients were compared to the control group. Subsequently, SDC-1 levels were analyzed in patients with CD in active and remission periods. Finally, SDC-1 efficacy in predicting disease activity was evaluated by performing correlation analysis between SDC-1 and C-reactive protein (CRP) and Crohn's disease activity index (CDAI). Results. SDC-1 level was higher in the CD group (61.9 ± 42.6 ng/mL) compared with the control group (34.1 ± 8.0 ng/mL) (p = 0.03). SDC-1 levels were higher in active CD patients (97.1 ± 40.3 ng/mL) compared with those in remission (33.7 ± 13.5 ng/mL) (p < 0.001). A significant positive correlation was found between SDC-1 and CRP (r = 0.687, p < 0.001) and between SDC-1 and CDAI (r = 0.747, p < 0.001). Conclusion. Serum levels of SDC-1 are higher in CD compared to the normal population and can be an effective marker of disease severity.

Evaluation of factors associated with response to hepatitis B vaccination in patients with inflammatory bowel disease.

It is recommended to investigate the serology of hepatitis B virus (HBV) and vaccinate seronegative patients at the time of diagnosis in inflammatory bowel diseases (IBD). This study aimed to investigate the efficacy of HBV vaccine and factors affecting the response.In this retrospective, observational study, HBV-seronegative IBD patients were administered 3 doses (at months 0, 1, and 6) recombinant 20  µg HbsAg. Patients' demographics, IBD attributes, and treatment methods were investigated as the factors with potential impacts on vaccination outcomes.One hundred twenty-five patients with IBD were evaluated. The number of patients with Anti-HBs >10  IU/L was 71 (56.8%), and the number of patients with anti-HBs >100  IU/L was 50 (40%). Age, disease activity, Crohn disease subtype, and immunosuppressive treatment (IST) were found to have significant effects on immune response (P = 0.011, P < 0.001, P = 0.003, and P < 0.001, respectively). With multivariate analysis, age < 45 years (OR 3.1, 95% CI 1.2-8.3, P = 0.020), vaccination during remission (OR 5.6, 95% CI 2.3-14, P < 0.001), and non-IST (OR 11.1, 95% CI 2.9-43.2, P = 0.001) had favorable effects on the occurrence of adequate vaccine response.The likelihood of achieving adequate immune response with standard HBV vaccination protocol in IBD is low. Selecting vaccination protocols with more potent immunogenicity is a better approach to achieve effective vaccine response in patients with multiple unfavorable factors.

The relationship between chronic HCV infection and the level of plasma adiponectin.

BACKGROUND/AIMS: Metabolic products (TNFalpha, adiponectin, resistin, etc.), which are effective in insulin sensitivity and in the regulation of inflammation, play an important role in the development of metabolic disorders and fatty liver disease. The aim of this study was to evaluate the effect of HCV infection alone on plasma adiponectin levels and insulin sensitivity when metabolic factors are minimized and to determine whether chronic HCV infection causes hepatosteatosis through its effect on these factors. METHODS: This study was carried out between 2006-2007, at the Gastroenterology Clinic of Izmir Atatürk Training and Research Hospital, in 30 non-diabetic patients with chronic HCV infection and 30 healthy subjects as controls. BMI (<26 kg/m2), fasting plasma glucose level, and ultrasonography were normal in both groups. In the patient group, HCV RNA was > or =1.90 x 10(3) IU/ml, ALT and AST were two times normal, and histological fibrosis scores were 1-2 in liver biopsy. Serum adiponectin levels and HOMA-IR were compared. RESULTS: Fasting blood glucose levels, body mass index and HOMA-IR of the two groups were similar and normal. The mean ALT value was significantly higher in the patient group [61.8 U/L vs 28.17 U/L (p<0.05)]. The mean viral load was determined as 5.6 x 10(5) IU/ml in the chronic HCV patient group. The mean plasma adiponectin concentrations were 71.07 microg/ml in chronic HCV patients and 82.07 microg/ml in the control group, and the difference was statistically insignificant (p>0.05). CONCLUSIONS: In the absence of metabolic disorders such as obesity, diabetes mellitus and hepatosteatosis, chronic HCV infection does not affect insulin sensitivity or adiponectin concentration.

Etiological role of brucellosis in autoimmune hepatitis.

To show that brucellosis may trigger autoimmune hepatitis (AIH), in addition to nonspecific liver involvement and toxic hepatitis, due to a class effect of tetracycline family used for treatment. We present a female patient admitted to our hospital due to partially improved fatigue and elevated liver enzymes following doxycycline and streptomycin usage for brucellosis. Brucellosis is endemic in our country, Turkey. It may involve any organ in the body. Liver is frequently involved. Doxycycline used for treatment occasionally may lead to hepatotoxicity. AIH is a necroinflammatory disease of the liver. Certain drugs (e.g. minocycline), toxins, and viruses (hepatitis B, hepatitis C, EBV, etc.) can trigger AIH. Only one case of AIH probably caused by doxycycline and brucellosis was reported. We discuss the relationship between brucellosis, AIH, and hepatotoxicity of doxycycline. Brucellosis may trigger AIH.