Diagnosis of Intestinal Microsporidiosis as an Emerging Agent of Chronic Diarrhea in Patients with Immune System Deficiency = تشخيص الميكروسبوريديا المعوية كعامل مسبب للإسهال المزمن في المرضى الذين يعانون من نقص كفاءة جهاز المناعة

2015 ◽  
Vol 66 (4-6) ◽  
pp. 419-429
Author(s):  
Mohammad H. Abd-Elbaki ◽  
Magdy A. Arafa ◽  
Dina M. Abd-Elhameed ◽  
Khaled S. Habib ◽  
Abeer A. Abd-Elrahman ◽  
...  
Keyword(s):  
Immune System ◽  
Chronic Diarrhea ◽  
Intestinal Microsporidiosis

Diagnosis of intestinal microsporidiosis in pediatric oncology patients in Egypt using modified acid fast trichrome staining versus PCR

2011 ◽  
Vol 56 (4) ◽  
Author(s):  
Hadir El-Mahallawy ◽  
Mayssa Zaki ◽  
Maha El-Arousy ◽  
Lobna Shalabi ◽  
Tarek Mansour
Keyword(s):  
Clinical Laboratory ◽  
Chronic Diarrhea ◽  
Staining Technique ◽  
Negative Control ◽  
Molecular Techniques ◽  
Specific Staining ◽  
Patients With Cancer ◽  
Pediatric Cancer Patients ◽  
Stool Samples ◽  
Intestinal Microsporidiosis

AbstractMicrosporidia are intracellular opportunistic parasites that cause chronic diarrhea in AIDS patients. Little is known about the prevalence of these pathogens in pediatric cases with cancer and diarrhea. Unidentified causes of chronic diarrhea were previously encountered in pediatric cancer patients at the National Cancer Institute in Egypt. Therefore, this study tried to search for the contribution of microsporidia as a causative agent of diarrhea in this population using acid-fast trichrome stain as a specific staining and the PCR in order to evaluate the staining technique in clinical diagnosis of microsporidia. Between January 2008 and June 2009, 271 diarrheic samples from pediatric patients with cancer were studied. Microsporidia were confirmed in 13 (4.8%) cases by both PCR and staining, and additional 2 samples were positive only by staining. As a negative control, stool samples from 60 diarrheic children without malignant cancer and no microsporidia detection were examined by these two methods. So, it can be concluded that adding a diagnostic test for microsporidia to the clinical laboratory work in hospitals concerned with cancer is essential. Acid fast trichrome staining technique as being nearly efficacious as the PCR, but simpler and less expensive, can replace the molecular techniques for the diagnosis of microsporidia.

Beneficial effects of estrogen treatment in the HLA-B27 transgenic rat model of inflammatory bowel disease

2004 ◽  
Vol 286 (1) ◽  
pp. G118-G125 ◽  
Author(s):  
Douglas C. Harnish ◽  
Leo M. Albert ◽  
Yelena Leathurby ◽  
Amy M. Eckert ◽  
Agnes Ciarletta ◽  
...  
Keyword(s):  
Mast Cell ◽  
Immune System ◽  
Cell Activation ◽  
Immune Cell ◽  
Chronic Diarrhea ◽  
Cell Activity ◽  
Neutrophil Infiltration ◽  
Transgenic Rat ◽  
Hla B27 ◽  
Beneficial Effects

A well-established model of bowel inflammation is the HLA-B27 transgenic rat that exhibits a spontaneous disease phenotype resulting in chronic diarrhea caused by immune cell activation. Estrogens have previously been shown to modulate the immune system, and both estrogen receptors (ERα and ERβ) are present in the intestine and cells of the immune system. Therefore, the ability of estrogen to ameliorate disease progression in the HLA-B27 transgenic rat was determined. HLA-B27 transgenic rats with chronic diarrhea were treated with 17α-ethynyl-17β-estradiol (EE) for 5 days. EE treatment dramatically improved stool scores after only 3 days. Histological scores of the degree of ulceration, inflammatory cell infiltration, fibrosis, and lesion depth of the colon were also improved by EE treatment. Because neutrophil infiltration into the colon is involved in the development and propagation of disease, myeloperoxidase (MPO) activity was measured. MPO levels were reduced by 80% by EE treatment. Cotreatment with the pure ER antagonist ICI-182780 (ICI) blocked the effects of EE on stool character, MPO activity, and histology scores, strongly suggesting that the activity of EE is mediated through ER. Mast cell proteases can promote neutrophil infiltration, and gene expression analysis demonstrated that mast cell protease 1, 3, and 4 mRNA were all decreased in colons from estrogen-treated rats. In addition, a direct effect of estrogen on bone marrow-derived mast cell activity was demonstrated, suggesting that ER-mediated inactivation of mast cells may contribute to the improvement in the clinical sign and histological scores in this model.

scholarly journals Intestinal microsporidiosis in HIV-positive patients with chronic unexplained diarrhea in Rio de Janeiro, Brazil: diagnosis, clinical presentation and follow-up

1996 ◽  
Vol 38 (2) ◽  
pp. 97-102 ◽  
Author(s):  
Patrícia Brasil ◽  
Fernando C. Sodré ◽  
Tullia Cuzzi-Maya ◽  
Maria Clara G.F.S. Gutierrez ◽  
Haroldo Mattos ◽  
...  
Keyword(s):  
Rio De Janeiro ◽  
Clinical Presentation ◽  
Chronic Diarrhea ◽  
Hiv Positive ◽  
Intestinal Infection ◽  
Bowel Movements ◽  
Advanced Stages ◽  
Initial Improvement ◽  
Intestinal Microsporidiosis

After the diagnosis of two cases of microsporidial intestinal infection in 1992, in Rio de Janeiro, we have started looking for this parasite in HIV-infected patients with chronic unexplained diarrhea. We have studied 13 patients from Hospital Evandro Chagas, IOC-FIOCRUZ. Fecal specimens from these patients were examined for the presence of Cryptosporidia and Microsporidia, in addition to routine examination. Spores of Microsporidia were found in the stools of 6 (46.1%) of the 13 patients studied, with 2 histological jejunal confirmations. The Microsporidia-infected patients presented chronic diarrhea with about 6 loose to watery bowel movements a day. Five infected patients were treated with Metronidazole (1.5 g/day). They initially showed a good clinical response, but they never stopped eliminating spores. After about the 4th week of therapy, their diarrhea returned. Two patients utilized Albendazole (400 mg/day-4 weeks) with a similar initial improvement and recurrence of the diarrhea. Intestinal Microsporidiosis seems to be a marker of advanced stages of AIDS, since 5 of our 6 infected patients were dead after a 6 month period of follow-up. The present study indicates that intestinal microsporidiosis may be a burgeoning problem in HIV-infected patients with chronic diarrhea in Brazil, which deserves further investigation.

scholarly journals Clinical and diagnostic aspects of intestinal microsporidiosis in HIV-infected patients with chronic diarrhea in Rio de Janeiro, Brazil

2000 ◽  
Vol 42 (6) ◽  
pp. 299-304 ◽  
Author(s):  
Patrícia BRASIL ◽  
Dirce Bonfim de LIMA ◽  
Daurita Darci de PAIVA ◽  
Maria Stella de Castro LOBO ◽  
Fernando Campos SODRÉ ◽  
...  
Keyword(s):  
Rio De Janeiro ◽  
Intestinal Tract ◽  
Chronic Diarrhea ◽  
Enterocytozoon Bieneusi ◽  
Intestinal Infection ◽  
Chain Reaction ◽  
Transmission Electron ◽  
Polymerase Chain ◽  
Parasitic Pathogens ◽  
Intestinal Microsporidiosis

The objectives of this study were to determine both the prevalence of microsporidial intestinal infection and the clinical outcome of the disease in a cohort of 40 HIV-infected patients presenting with chronic diarrhea in Rio de Janeiro, Brazil. Each patient, after clinical evaluation, had stools and intestinal fragments examined for viral, bacterial and parasitic pathogens. Microsporidia were found in 11 patients (27.5%) either in stools or in duodenal or ileal biopsies. Microsporidial spores were found more frequently in stools than in biopsy fragments. Samples examined using transmission electron microscopy (n=3) or polymerase chain reaction (n=6) confirmed Enterocytozoon bieneusi as the causative agent. Microsporidia were the only potential enteric pathogens found in 5 of the 11 patients. Other pathogens were also detected in the intestinal tract of 21 patients, but diarrhea remained unexplained in 8. We concluded that microsporidial infection is frequently found in HIV infected persons in Rio de Janeiro, and it seems to be a marker of advanced stage of AIDS.

Learned Placebo Effects in the Immune System

2014 ◽  
Vol 222 (3) ◽  
pp. 148-153 ◽  
Author(s):  
Sabine Vits ◽  
Manfred Schedlowski
Keyword(s):  
Nervous System ◽  
Immune System ◽  
Associative Learning ◽  
Placebo Response ◽  
Immunosuppressive Drug ◽  
Immune Functions ◽  
Placebo Effects ◽  
New Therapeutic Approaches ◽  
Biological Variables ◽  
Experimental Approaches

Associative learning processes are one of the major neuropsychological mechanisms steering the placebo response in different physiological systems and end organ functions. Learned placebo effects on immune functions are based on the bidirectional communication between the central nervous system (CNS) and the peripheral immune system. Based on this “hardware,” experimental evidence in animals and humans showed that humoral and cellular immune functions can be affected by behavioral conditioning processes. We will first highlight and summarize data documenting the variety of experimental approaches conditioning protocols employed, affecting different immunological functions by associative learning. Taking a well-established paradigm employing a conditioned taste aversion model in rats with the immunosuppressive drug cyclosporine A (CsA) as an unconditioned stimulus (US) as an example, we will then summarize the efferent and afferent communication pathways as well as central processes activated during a learned immunosuppression. In addition, the potential clinical relevance of learned placebo effects on the outcome of immune-related diseases has been demonstrated in a number of different clinical conditions in rodents. More importantly, the learned immunosuppression is not restricted to experimental animals but can be also induced in humans. These data so far show that (i) behavioral conditioned immunosuppression is not limited to a single event but can be reproduced over time, (ii) immunosuppression cannot be induced by mere expectation, (iii) psychological and biological variables can be identified as predictors for this learned immunosuppression. Together with experimental approaches employing a placebo-controlled dose reduction these data provide a basis for new therapeutic approaches to the treatment of diseases where a suppression of immune functions is required via modulation of nervous system-immune system communication by learned placebo effects.

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