Probiotics for Inflammatory Bowel Disease; A Deep Dive into Their Impact on Disease Course and Associated Health Risks.

To date, the underlying pathology of inflammatory bowel disease (IBD) is undetermined. Disturbance of intestinal gut microbiota was implicated in many health diseases, including IBD. Increasing evidence suggests that probiotics play a beneficial role in restoring the balance of the gut ecosystem. This review searched multiple databases for relevant works that examined probiotics' possible benefits in adults with IBD. Probiotic mode of action in ulcerative colitis patients and Crohn's disease were examined with respect to probiotic strain, their benefits, and their advantages in adult cases. Eligible studies for inclusion were assessed and analyzed. They were effective in reducing IBD disease course, inducing and maintaining remission, particularly for ulcerative colitis patients, with good efficacy and safety profile. However, the evidence for Crohn's disease was lacking. Probiotics positively affect IBD-related risks, reducing the risk of gastrointestinal malignancy and optimizing treating them. Additionally, they improved reduced fertility odds for both genders. The osteoporosis risk among IBD patients was also reduced, although the duration of use and dose were still not established. There was an encouraging role for them in reducing IBD -cardiovascular risks among cases with acute myocardial infarction and those with chronic heart failure. Finally, they had novel use in reducing IBD-related depression and improved overall mental health. In conclusion, we recommend probiotics as an adjuvant therapeutic option for IBD therapy for ulcerative colitis; however, their role in Crohn's disease needs further research.

Diagnostic Value of Cytokeratin 34 beta E12 (Ck34ßE12) and α-Methylacyl-CoA racemase (AMACR) Immunohistochemical Expression in Prostatic Lesions.

BACKGROUND & OBJECTIVE: Some prostatic lesions contain small suspicious foci for prostatic carcinoma in which the morphological features are equivocal. Two immunohistochemical markers namely, cytokeratin 34 beta E12 (Ck34ßE12) and α-Methylacyl-CoA racemase (AMACR), were evaluated in these lesions for a definitive diagnosis and avoiding misdiagnosis or overdiagnosis of prostatic carcinoma. METHODS: A total of 90 paraffin embedded blocks of prostatic tissue were selected and categorized into three groups as follows: 50 cases of benign prostatic hyperplasia (BPH), 20 cases of prostatic carcinoma, and 20 cases of benign prostatic lesions with suspicious foci labeled as ASAP (atypical small acinar proliferation) that occupy not more than 5% of the lesion. These cases were revised for histopathological diagnosis and stained with two immunohistochemical markers: Ck34ßE12 and AMACR. RESULTS: While 92.9% of BPH were positive for Ck34ßE12, 96% of prostatic carcinoma were negative for this marker (P=0.0001). Regarding AMACR, 92.9% of BPH cases were negative, but 92% of prostatic carcinoma cases were positive for this marker (P=0.0001). Out of 20 cases of BPH, 15 cases containing suspicious foci showed Ck34ßE12+/AMACR- (diagnosis: benign), but 5 cases were Ck34ßE12-/AMACR+, for which the diagnosis changed to prostatic carcinoma (P=0.04). CONCLUSION: Immunohistochemical staining with Ck34ßE12 and AMACR improved the diagnostic performance and increased confidence level for establishing definite diagnosis in cases with suspicious foci, in which the morphological features were equivocal. This could help to avoid misdiagnosis or overdiagnosis of prostatic carcinoma that would eventually improve the management of the patient and subsequently the prognosis.

Immunohistochemical expression of interlukin10 (IL10) and heat shock protein-90 (HSP-90) in prostatic carcinoma.

BACKGROUND: Specific cytokines are related to pathologically changed prostate, propose that the balance in cytokine differs in normal and pathological prostate. Of these cytokines the interleukins 10, due to its "pleiotropic" actions in inflammation and angiogenesis, and HSP-90 due to its expression in tumor cells at high levels, suggesting that it has an important role for growth and/or survival of tumor cells. AIMS: Evaluation of HSP-90 and IL10 immunoreactivity in benign prostatic hyperplasia (BPH) and prostatic carcinoma and to correlate this expression with clinicopathological parameters. SETTINGS AND DESIGN: A retrospective study in which 83 Paraffin-embedded tissue specimens including (43) BPH, (40) prostatic carcinoma and (20) normal prostate as control were included between the period of January 2015 and January 2017. PATIENTS, MATERIAL AND METHODS: All the cases were evaluated histopathologically and stained immunohistochemically for IL10 and HSP-90. Only cytoplasmic staining was considered as positive. Immunoreactivity scoring for both markers expression was calculated based on both staining intensity and percentage. STATISTICAL ANALYSIS: Was done using SPSS Version 21 statistical analysis software. P value of <0.05 was considered statistically significant. RESULT: Statistical analysis of HSP-90 and IL10 expression revealed a highly significant correlation of expression of these two markers in advanced Gleason grading and tumor, node, and metastasis (TNM) staging cases of prostatic carcinoma. CONCLUSION: High expression of IL10 and HSP-90 is associated with high grade and stage of prostatic carcinoma. This provides a base for further studies and researches on the role of these investigated proteins as prognostic markers immunotherapy targets for carcinoma of the prostate.

Prognostic and biological significance of peroxisome proliferator-activated receptor-gamma in luminal breast cancer.

Peroxisome proliferator-activated receptor-gamma (PPARγ) is an adopted orphan receptor that belongs to the nuclear receptor superfamily of transcription factors. PPARγ is regarded as a differentiation factor and it plays an important role in regulating adipogenesis, cell growth, proliferation and tumour progression. In breast cancer (BC), PPARγ agonists were reported to inhibit proliferation and growth invasion and promote phenotypic changes associated with a less malignant and more differentiated status. This study aims to assess the prognostic and biological roles of PPARγ protein expression in a large cohort of BC patients (n = 1100) with emphasis on the luminal oestrogen receptor (ER) positive class. Immunohistochemistry was used to assess the levels of PPARγ expression in BC series prepared as tissue microarrays (TMAs). PPARγ antibody specificity was confirmed using Western blotting. PPARγ nuclear expression was detected in 79 % of the cases and its expression was positively correlated with the hormonal receptors (ER, progesterone receptor and androgen receptor). PPARγ levels were significantly higher in tumours with lobular subtype, smaller size and lower grade, while HER2-positive, ductal or medullary tumours were associated with lower PPARγ levels. Survival analysis showed that PPARγ is associated with better outcome in the whole series as well as in luminal ER-positive class. Cox regression model showed that PPARγ is an independent predictor of outcome. Higher PPARγ was associated with longer survival in patients with ER-positive tumours who did not receive hormone therapy. PPARγ is a good prognostic marker associated with hormone receptors. In patients with luminal BCs, PPARγ is a marker of better prognosis and is associated with longer survival.