- MeSH
- anemie z nedostatku železa * diagnóza etiologie terapie MeSH
- aplikace orální MeSH
- bezlepková dieta MeSH
- celiakie * komplikace krev patofyziologie MeSH
- intravenózní podání MeSH
- lidé MeSH
- železité sloučeniny aplikace a dávkování terapeutické užití MeSH
- železo aplikace a dávkování terapeutické užití MeSH
- Check Tag
- lidé MeSH
Funkční hyposplenizmus je stav provázející řadu chorob, vč. autoimunitních onemocnění a lymfomů. Hyposplenizmus se běžně vyskytuje také u celiakie (až ve 20 % nekomplikované a 80 % komplikované nemoci). Hyposplenizmus je spojen se zvýšeným rizikem závažných infekcí (Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae). Cílem této prospektivní pilotní studie bylo vyšetřit paměťové B lymfocyty coby nepřímý biomarker funkčního hyposplenizmu. Bylo vyšetřeno 42 pacientů s celiakií (11 mužů, 31 žen, průměrný věk 49 ± 14 let) a 10 kontrolních osob, dárců krve (2 muži, 8 žen, průměrný věk 39 ± 7 let). Pomocí panelu DuraClone IM byly průtokovou cytometrií (Navios, Beckman Coulter) vyšetřeny jednotlivé subpopulace B lymfocytů v periferní krvi. Imunoglobulin (Ig) M a IgD paměťové B lymfocyty byly u nemocných s celiakií signifikantně nižší ve srovnání s kontrolními osobami. Dysfunkce paměťových B lymfocytů může být zodpovědná za zvýšené riziko bakteriálních infekcí u celiakie. Pacienti s celiakií s prokázanou dysfunkcí paměťových B lymfocytů jsou indikováni k pneumokokové vakcinaci.
Functional hyposplenism is a condition accompanying many diseases including autoimmune disorders and lymphomas. Hyposplenism is also commonly found in adult coeliac disease (up to 20% of non-complicated and up to 80% of complicated disease). Hyposplenism is associated with an increased risk of severe infections (Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae). The aim of this prospective study was to investigate memory B lymphocytes as an indirect biomarker of functional hyposplenism. A total of 42 patients with coeliac disease (11 men, 31 women; mean age 49 ± 14 years) and 10 healthy controls, blood donors (2 men, 8 women; mean age 39 ± 7 years) were enrolled into the study. None of the patients had a history of splenectomy and none of them suffered. from immunodeficiency. The DuraClone IM panel was used to identify B lymphocytes subpopulations in peripheral blood samples by flow cytometry Navios (Beckman Coulter) with software analysis using Kaluza version 1.2. Patients with coeliac disease and controls did not differ in basic parameters of leukocyte and total lymphocyte blood count. Switched memory B lymphocytes (CD19+CD27+IgD-), non-switched memory/marginal-zone-like B lymphocytes (CD19+CD27+IgD+) and immunoglobulin (Ig) M memory B lymphocytes (CD19+CD27+IgM++) were significantly lower in patients with coeliac compared to controls. Follicular (naïve) B lymphocytes were not significantly different between coeliac disease and controls. In conclusion, dysfunction of memory B lymphocytes can be responsible for an increased risk of severe bacterial infections in coeliac disease. Patients with coeliac disease with dysfunction of memory B lymphocytes are clearly indicated for pneumococcal vaccination.
- Klíčová slova
- funkční hyposplenizmus, paměťové B lymfocyty,
- MeSH
- B-lymfocyty * MeSH
- celiakie komplikace krev MeSH
- lidé MeSH
- pilotní projekty MeSH
- pneumokokové vakcíny MeSH
- průtoková cytometrie MeSH
- slezina * imunologie patofyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
The elevated plasma cell-free DNA (cfDNA) concentrations were repeatedly reported in association with the process of inflammation. The qualitative and quantitative characteristics of plasma cfDNA in active (newly diagnosed) celiac disease patients (CD) have not yet been studied despite the fact that cfDNA of healthy individuals is able to regulate immune response. We determined the total cfDNA concentration and relative content of telomeric sequences in plasma cfDNA in CD (n = 10) and healthy age- and sex-matched controls (HC, n = 10) by quantitative PCR. To obtain the evidence that the observed biological effects are caused solely by cfDNA molecules, we applied the treatment of paired plasma samples with DNase. Using paired samples of plasma (non-treated/native and treated by DNase), we analyzed the contribution of cfDNA to the activation of TLR9 and TNF-α mRNA expression in THP1 monocytic cell line. There were no significant differences in the quantities of plasma cfDNA and relative contents of telomeric sequences in their pools. When we compared the levels of TNF-α mRNA expression in THP1 cells achieved after stimulation with native CD and HC plasma samples, we found significantly (p = .031) higher expression after stimulation with CD samples. We documented also the ability of cfDNA contained in CD plasma samples to stimulate the production of TLR9 mRNA. The TLR9 mRNA expression levels were significantly (p = .014) lowered after cfDNA removal from CD plasma samples. The design of our experiments allowed us to study the effects of cfDNA without its isolation from plasma. cfDNA contained in CD plasma samples differs significantly in its immunoregulatory capacity from cfDNA in HC plasma. The differences are caused neither by different concentrations of cfDNA in plasma samples nor by different relative abundance of telomeric sequences. Further studies are needed to elucidate the role of plasma cfDNA in celiac disease pathogenesis.
- MeSH
- celiakie krev MeSH
- dospělí MeSH
- imunologické faktory * krev imunologie farmakologie MeSH
- kvantitativní polymerázová řetězová reakce MeSH
- lidé MeSH
- pilotní projekty MeSH
- regulace genové exprese * účinky léků imunologie MeSH
- THP-1 buňky MeSH
- TNF-alfa * biosyntéza imunologie MeSH
- toll-like receptor 9 * biosyntéza imunologie MeSH
- volné cirkulující nukleové kyseliny * krev imunologie farmakologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Celiac disease (CD) is an autoimmune disorder that is expressed by chronic food sensitivity to gluten. Among the autoimmune diseases, CD is the one that has more expression, having the numbers of new cases increased steadily during the last years. In addition to the most common symptoms, such as low weight, diarrhea and abdominal pain, atypical cases, such as overweight, arise which imply the development of new approaches and diagnostic methodologies. The most obvious diagnosis involves endoscopy, an invasive and costly method that causes discomfort to the patient and overload of the health systems. The protocol methodology for CD diagnosis from WGO, NASPGHAN, ESPGHAN and BSPGHAN, the worldwide most recognized specialist ‘organizations, was analyzed in order to assess if social implications were considered on their guidelines. After a detailed review of the literature, a global chart was completed in order to summarize the most referenced protocols for the screening and CD diagnosis.
- MeSH
- autoprotilátky krev MeSH
- celiakie * diagnóza krev MeSH
- HLA-DQ antigeny MeSH
- lidé MeSH
- plošný screening MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- směrnice pro lékařskou praxi MeSH
The expanding knowledge about gluten-related autoimmunity led to a serology-based step-wised approach to diagnose celiac disease that might be misleading due to laboratory techniques. We present a rare case associating initial false-negative anti-transglutaminase IgA antibodies while CD was confirmed by IgG anti-transglutaminase and subsequent duodenal biopsy.
- MeSH
- celiakie * diagnóza krev MeSH
- dítě MeSH
- falešně negativní reakce MeSH
- imunoglobulin A krev MeSH
- lidé MeSH
- transglutaminasy * antagonisté a inhibitory MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
A concerning pathological and serological aspect that is found in both HCV and celiac disease is the hypercoagulability state which can lead to various complications.
The alcohol-soluble fraction of wheat gluten (gliadins) induces in genetically susceptible individuals immunologically mediated celiac disease (CLD). However, gliadins and related cereal proteins are not unique foodstuff targets of CLD patients´ immune system. Non-gluten wheat alpha-amylase inhibitor 0.19 (AAI 0.19) has been found to be capable of activating human monocyte-derived dendritic cells and inducing pro-inflammatory status in intestinal mucosa of patients with celiac disease (CLD). The possible contribution of this reactivity in incomplete remission of CLD patients on a gluten-free diet (GFD) is matter of contention. In an attempt to characterize the antigenicity of AAI 0.19 in patients with active CLD, patients on a GFD and healthy controls we developed ELISA employing wheat recombinant AAI 0.19. Using this test we revealed a significant (P<0.001) elevation of IgA anti-AAI 0.19 antibodies (Ab) in patients with active CLD (12 out of 30 patients were seropositive) but also in CLD patients on a GFD (15/46), in contrast to healthy controls (2/59). Anti-AAI 0.19 IgG Ab levels were increased (P<0.001) only in patients with active CLD (14/30) in contrast to the controls. Interestingly, the levels of anti-AAI 0.19 IgG Ab were decreased in CLD patients on a GFD (P<0.001, 1/46) compared to the controls (1/59). Notably, 20 out of 30 patients with active CLD were positive either for IgA or for IgG anti-AAI 0.19 Ab. Thus, the majority of CLD patients developed a robust IgA and IgG Ab response against AAI 0.19. These findings may contribute to the broadening of the knowledge about CLD pathogenesis.
- MeSH
- celiakie krev diagnóza imunologie MeSH
- dospělí MeSH
- imunoglobulin A krev imunologie MeSH
- imunoglobulin G krev imunologie MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- protilátky anti-idiotypické krev imunologie MeSH
- rostlinné proteiny * imunologie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Celiac disease has been associated with a number of immune-mediated hematologic disorders, including idiopathic or immune thrombocytopenic purpura (ITP). Review of the literature suggests that children are particularly affected, often with overt skin findings, but in this report, a 39-yr old male with biopsy-defined celiac disease was detected with a persistent immune-mediated reduction in his platelet count despite treatment and follow-up for more than a decade. Although the celiac disease resolved with a strict gluten-free diet, there was no effect on the ITP. Experience suggests that ITP may be rarely appreciated in adults (compared to children) because it may be limited in severity and occurs without clinically obvious purpura or evidence of bleeding, even with diagnostic or therapeutic biopsy procedures. A subsequent retrospective review of over 300 celiac disease patient records from a single teaching hospital clinical practice experience spanning almost 40 years confirmed no additional cases of thrombocytopenia. ITP appears to be rarely associated with celiac disease in adults and, in spite of resolution of the enteropathy, did not appear to respond to a gluten-free diet, even after more than a decade of dietary treatment.
- MeSH
- bezlepková dieta MeSH
- celiakie * diagnóza dietoterapie imunologie komplikace krev MeSH
- dospělí MeSH
- lidé MeSH
- trombocytopenie * diagnóza etiologie imunologie krev MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Iron deficiency anemia is a common presentation of adult celiac disease. In a retrospective review of over 200 adults with celiac disease complicated by iron deficiency anemia, 7 patients were selected that were treated either with oral iron supplements with a limited hematologic response or unable to tolerate oral iron. Subsequently, treatment with a strict gluten free diet alone was provided. In all, resolution of the anemia resulted without a need for concomitant oral iron supplements. Another patient with marked fatigue and exercise intolerance was treated with intravenous iron, but the iron deficiency anemia only partially improved. After a strict gluten-free diet, her iron deficiency anemia resolved completely. Clinical experience in these celiac patients indicates that the key element in the treatment of iron deficiency anemia is a positive intestinal mucosal response to a gluten-free diet. In celiac patients with iron deficiency anemia, particularly with a limited hematologic response, intolerance or side effects to iron supplements, treatment solely with a gluten-free diet may be a reasonable option. Iron deficiency anemia in celiac disease is heterogeneous and may have multiple causes. Although duodenal mucosal disease is a critical factor, other factors may alter the regulation of iron homeostasis in this setting, including altered erythropoiesis due to the underlying chronic intestinal inflammatory process.
- MeSH
- anemie z nedostatku železa etiologie MeSH
- anemie * diagnóza etiologie krev MeSH
- bezlepková dieta MeSH
- celiakie * diagnóza dietoterapie imunologie komplikace krev MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- Geografické názvy
- Evropa MeSH
