Study of Fecalibacteria prausntzii in Egyptian patients with inflammatory bowel disease.

Introduction: Inflammatory bowel diseases (IBD) are characterised by chronic inflammation of the gastrointestinal tract. There aetiopathogenesis has not yet been fully elucidated. Faecalibacterium prausnitzii is one of the most abundant in human gut, and it is found in about 5% of the gut microbiota. Aim: To study the role of F. prausnitzii in Egyptian patients with ulcerative colitis (UC) and Crohn's disease (CD) and to assess its relationship with the disease activity. Material and methods: This study includes 80 patients divided as follows: group I: 30 patients with UC; group II: 30 patients with CD; and group III: 20 healthy patients as control. DNA execration was performed using a faecal extraction kit and quantitative SYBR green real time PCR to identify the core of F. prausnitzii. Results: In group 1 of UC patients, the level of bacteria was reduced by a mean of 1.68E-01, and in the control group by a mean of 2.72E-01 (p 2 = 0.004, significant). Regarding F. prausnitzii in UC patients according to Mayo score, in severe patients the level of bacteria was reduced significantly by a median of 4.80E-02. Regarding F. prausnitzii in group 2 of CD, the level of bacteria was significantly reduced by mean of 1.70E-01, and in the control group by a mean of 2.72E-01 (p 3 = 0.037, significant). Conclusions: There was a significant difference between CD and UC patients and the control group in F. prausnitzii. There was a significant reduction in the level of F. prausnitzii in severe UC cases.

Seattle protocol vs narrow band imaging guided biopsy in screening of Barrett's esophagus in gastroesophageal reflux disease patients.

Barrett's esophagus has 0.5% to 7% risk of progression to esophageal adenocarcinoma. The method of obtaining biopsies to diagnose Barrett's is challenging. Seattle protocol has been considered as the gold standard, however its difficulty limits its applicability in practice. Narrow band imaging guided biopsy has been proposed as an alternative.To investigate the accuracy, sensitivity, specificity and applicability of Narrow band guided biopsy as a screening tool for Barret's esophagus in gastroesophageal reflux patients.Endoscopy was done in 2 different sessions 2 weeks apart for 100 patients in Alexandria, Egypt. Patients had at least one of the following: Chronic Gastroesophageal reflux disease, frequent Gastroesophageal reflux disease, or two or more risk factors for Barrett's esophagus. All patients with known Barrett's esophagus were excluded.Seventeen patients had Barrett's esophagus either by one of the two techniques or by both, 4 patients by both methods, 7 patients by narrow band imaging alone and 6 patients by Seattle protocol alone (P < .001, κ = 0.461). Sensitivity, specificity, negative predictive value and positive predictive value for Seattle protocol were 58.8%, 100%, 92.2%, 100% vs 76.5%, 100%, 95.4%, 100% respectively for narrow band imaging. A mean of 7.73 samples/patient was taken in Seattle protocol vs 3.42 samples in narrow band imaging (P < .001). A mean of 8.63 minutes was consumed in Seattle protocol vs 2.65 minutes in narrow band imaging (P < .001).Narrow band imaging guided biopsy might have higher accuracy, sensitivity and negative predictive value as well as fewer number of biopsies and shorter time of the procedure compared to Seattle protocol which might increases its applicability as screening protocol for Barrett's esophagus. However, further larger multicentric studies are needed.

Monitoring Hepcidin Level in Chronic Hepatitis C Virus Patients during Therapy

Introduction and study aim : Egypt has the highest prevalence of hepatitis C in the world estimated about 15. There are several host and viral factors that aid in predicting response to treatment; Hepcidine hormone is being investigated as one of these host factors. The aim of the work is to assess the serum concentration of hepcidin in chronic hepatitis C patients and evaluate any possible association with the viral load during therapy.Patients and methods: This study was carried on 35 chronic HCV patients on peg IFN/ Ribavirin therapy and 15 chronic HCV patients not on therapy as a control group.Hepcidin hormone levels were measured in sera of patients before starting therapy (base line) then at 12 and 24 weeks during therapy. RT PCR was used to asses response to ongoing therapy.Results: The level of hepcidin in all cases was low before starting therapy and it showed a significant increase during the course of therapy. This rise was detected earlier in responding cases. A negative correlation was found between baseline hepcidin level and baseline viral load of the responding cases. Conclusion: Chronic HCV infection is associated with reduced level of serum hepcidin hormone. The reduced serum hepcidin in chronic HCV patients is fully reversible after IFN/RBV therapy. Initial rise in serum hepcidin concentration might have a potential for being used as one of the indicators of patient response to therapy

Effects of intestinal protozoa infection on gastrointestinal transit and contractility in experimental animals.

Three groups of animals each was orally infected with Cryptosporidia parvum oocysts, Enterocytozoon bieneusi spores or Cyclospora cayetanensis oocysts. At the time peak of colonization of infected animals, each group and its corresponding control were infused orally with radioactive isotope. Gastric emptying of isotope was significantly greater in infected compared to controls in both fasted and fed states, to determine the effect of each parasite on the contractility of longitudinal and circular muscle, isometric tension of jejunal segments was recorded. The development of active tension with stretch and the dose-response curve to muscarinic against were significantly increased in the longitudinal muscle of infected animals compared to controls. The circular smooth muscle did not show an increase in contractility. The results suggest that an altered gastrointestinal transit and smooth muscle contractility may be involved in the intestinal protozoa infections' pathophysiology.