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001-es BibID:	BIBFORM010925
Első szerző:	Papp Mária (belgyógyász, gasztroenterológus)
Cím:	Anti-microbial antibodies in celiac disease : trick or treat? / Maria Papp, Ildiko Foldi, Istvan Altorjay, Eszter Palyu, Miklos Udvardy, Judit Tumpek, Sandor Sipka, Ilma Rita Korponay-Szabo, Eva Nemes, Gabor Veres, Tamas Dinya, Attila Tordai, Hajnalka Andrikovics, Gary L. Norman, Peter Laszlo Lakatos
Dátum:	2009
ISSN:	1007-9327 (Print)
Megjegyzések:	To determine the prevalence of a new set of anti-glycan and anti-outer membrane protein (anti-OMP) antibodies in a Hungarian cohort of adult Celiac disease (CD) patients. METHODS: 190 consecutive CD patients [M/F: 71/119, age:39.9 (SD:14.1) years], 100 healthy, and 48 gastrointestinal controls were tested for glycan anti-Saccharomyces cerevisiae (gASCA), anti-laminaribioside (ALCA), anti-chitobioside, anti-mannobioside, anti-OMP antibodies and major NOD2/CARD15 mutations. Thirty out of 82 CD patients enrolled at the time of diagnosis were re-evaluated for the same antibodies after longstanding gluten-free diet (GFD). RESULTS: 65.9% of the CD patients were positive for at least one of the tested antibodies at the time of the diagnosis. Except anti-OMP and ALCA, anti-microbial antibodies were exclusively seen in untreated CD; however, the overall sensitivity was low. Any glycan positivity (LR+: 3.13; 95% CI: 2.08-4.73) was associated with an increased likelihood ratio for diagnosing CD. Significant correlation was found between the levels of anti-glycan and anti-endomysial or anti-transglutaminase antibodies. Anti-glycan positivity was lost after longstanding GFD. Anti-glycan antibody titers were associated with symptoms at presentation, but not the presence of NOD2/CARD15 mutations. Patients with severe malabsorption more frequently had multiple antibodies at diagnosis (P = 0.019). CONCLUSION: The presence of anti-glycan antibodies in CD seems to be secondary to the impaired small bowel mucosa which can lead to increased antigen presentation. Furthermore, anti-glycan positivity may be considered an additional marker of CD and dietary adherence.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban egyetemen (Magyarországon) készült közlemény
Megjelenés:	World Journal of Gastroenterology 15 : 31 (2009), p. 3891-3900. -
További szerzők:	Földi Ildikó (1981-) (orvos) Altorjay István (1954-) (belgyógyász, gasztroenterológus, onkológus) Pályu Eszter (1983-) Udvardy Miklós (1947-) (belgyógyász, haematológus) Tumpek Judit (1944-) (orvosi laboratóriumi szakorvos) Sipka Sándor (1945-) (laboratóriumi szakorvos) Korponay-Szabó Ilma (1959-) (gyermekgyógyász) Nemes Éva (1957-) (csecsemő- és gyermekgyógyász, gasztroenterológus) Veres Gábor (1969-2020) (csecsemő- és gyermekgyógyász, gasztroenterológus) Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Tordai Attila Andrikovics Hajnalka Norman, Gary L. Lakatos Péter (Semmelweis Egyetem)
Internet cím:	DOI Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM048562
Első szerző:	Tack, Greetje J.
Cím:	Consumption of gluten with gluten-degrading enzyme by celiac patients : a pilot-study / Greetje J. Tack, Jolanda M. W. van de Water, Maaike J. Bruins, Engelina M. C. Kooy-Winkelaar, Jeroen van Bergen, Petra Bonnet, Anita C. E. Vreugdenhil, Ilma Korponay-Szabo, Luppo Edens, B. Mary E. von Blomberg, Marco W. J. Schreurs, Chris J. Mulder, Frits Koning
Dátum:	2013
ISSN:	1007-9327
Megjegyzések:	AIM:To assesses the safety and efficacy of Aspergillus niger prolyl endoprotease (AN-PEP) to mitigate the immunogenic effects of gluten in celiac patients.METHODS:Patients with initial diagnosis of celiac disease as confirmed by positive serology with subtotal or total villous atrophy on duodenal biopsies who adhere to a strict gluten-free diet (GFD) resulting in normalised antibodies and mucosal healing classified as Marsh 0 or I were included. In a randomised double-blind placebo-controlled pilot study, patients consumed toast (approximately 7 g/d gluten) with AN-PEP for 2 wk (safety phase). After a 2-wk washout period with adherence of the usual GFD, 14 patients were randomised to gluten intake with either AN-PEP or placebo for 2 wk (efficacy phase). Measurements at baseline included complaints, quality-of-life, serum antibodies, immunophenotyping of T-cells and duodenal mucosa immunohistology. Furthermore, serum and quality of life questionnaires were collected during and after the safety, washout and efficacy phase. Duodenal biopsies were collected after the safety phase and after the efficacy phase. A change in histological evaluation according to the modified Marsh classification was the primary endpoint.RESULTS:In total, 16 adults were enrolled in the study. No serious adverse events occurred during the trial and no patients withdrew during the trial. The mean score for the gastrointestinal subcategory of the celiac disease quality (CDQ) was relatively high throughout the study, indicating that AN-PEP was well tolerated. In the efficacy phase, the CDQ scores of patients consuming gluten with placebo or gluten with AN-PEP did not significantly deteriorate and moreover no differences between the groups were observed. During the efficacy phase, neither the placebo nor the AN-PEP group developed significant antibody titers. The IgA-EM concentrations remained negative in both groups. Two patients were excluded from entering the efficacy phase as their mucosa showed an increase of two Marsh steps after the safety phase, yet with undetectable serum antibodies, while 14 patients were considered histologically stable on gluten with AN-PEP. Also after the efficacy phase, no significant deterioration was observed regarding immunohistological and flow cytometric evaluation in the group consuming placebo compared to the group receiving AN-PEP. Furthermore, IgA-tTG deposit staining increased after 2 wk of gluten compared to baseline in four out of seven patients on placebo. In the seven patients receiving AN-PEP, one patient showed increased and one showed decreased IgA-tTG deposits.CONCLUSION:AN-PEP appears to be well tolerated. However, the primary endpoint was not met due to lack of clinical deterioration upon placebo, impeding an effect of AN-PEP.
Tárgyszavak:	Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Adverse events Aspergillus niger prolyl endoprotease Celiac disease Enzyme IgA-tTG intestinal deposits Prolyl endoprotease
Megjelenés:	World Journal of Gastroenterology 19 : 35 (2013), p. 5837-5847. -
További szerzők:	Water, Jolanda M. W. van de Bruins, Maaike J. Kooy-Winkelaar, Engelina M. C. Bergen, Jeroen van Bonnet, Petra Vreugdenhil, Anita C. E. Korponay-Szabó Ilma (1959-) (gyermekgyógyász) Edens, Luppo Blomberg, B. Mary E. von Schreurs, Marco W. J. Mulder, Chris J. Koning, Frits
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