scholarly journals Influencing factors on the severity of clinical and laboratory manifestations of carbohydrate malabsorption syndrome in early-aged children with rotavirus infection

2021 ◽  
pp. 25-33
Author(s):  
N.V. Vorobiova ◽  
Keyword(s):  
Atopic Dermatitis ◽  
Food Allergy ◽  
Malabsorption Syndrome ◽  
Allelic Polymorphism ◽  
Rotavirus Infection ◽  
Carbohydrate Malabsorption ◽  
Significant Difference ◽  
Daily Frequency ◽  
Bowel Movements ◽  
Lactase Gene

Purpose — to determine the role of the lactase gene MCM6 allelic polymorphism 13910 C/T and the concomitant food allergy (FA) and atopic dermatitis (AD) on the formation of carbohydrate malabsorption syndrome manifestations in early-aged children with rotavirus infection (RVI). Materials and methods. 60 children aged 1–24 months with RVI were examined. The determination of single nucleotide polymorphism 13910 C/T of the MCM6 gene was performed by real-time polymerase chain reaction and the content of total Ig E in serum was determined by enzyme immunoassay for all children on the day of hospitalization. Total amount of carbohydrates in feces (Benedict's test) and the level of lactose in feces (Malfatti's test) were also determined in the dynamics of the disease (on the 3rd, 5th, 7th, 10th day). The analysis of the carbohydrate malabsorption syndrome clinical and laboratory signs was carried out in subgroups depending on the genotype 13910 C/T of the MCM6 gene and concomitant allergic pathology. Results. No significant differences were found in the maximum daily frequency of diarrhea, its duration and the frequency of intestinal colic and flatulence registration in children with genotypes C/C, C/T and T/T -13910 of the MCM6 gene (p>0.05). There was no statistically significant difference in the total level of carbohydrates and lactose in feces at all stages of the disease (p>0.05 on the 3rd, 5th, 7th, 10th). Children with concomitant FA and AD had 1.3 and 2 times higher daily frequency of liquid bowel movements during the height of the disease (p<0.05 on the 5th and 7th days, respectively), 1.3 times longer diarrhea (p<0.05), 1.6 and 1.8 times higher incidence of flatulence and intestinal colic (p<0.05). These children had 3 and 3.3 times higher Benedict's test values (p<0.01), as well as 3 and 2.5 times higher Malfatti's test values (p<0.01; p<0.05, respectively) on the 3rd and 5th days of RVI, respectively, than in patients without allergies, with a gradual decrease in this difference during the period of convalescence (p>0.05 on the 10th day). Conclusions. The allelic polymorphism 13910 C/T of the MCM6 gene does not affect the degree of oligosaccharide metabolism disorders in the intestines in early-aged children with RVI. Against the background of concomitant food allergy and atopic dermatitis in children with RVI, there are more pronounced laboratory signs of carbohydrate malabsorption, and, as a consequence, diarrhea more pronounced during the height of the disease with a higher incidence of flatulence and intestinal colic. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the author. Key words: rotavirus infection, early-aged children, carbohydrate malabsorption syndrome, lactase gene polymorphism, food allergy, atopic dermatitis.

scholarly journals Laboratory signs of carbohydrate malabsorption in early age children with rotavirus infection

Pathologia ◽  
2021 ◽  
Vol 18 (1) ◽  
pp. 72-79
Author(s):  
N. V. Vorobiova ◽  
O. V. Usachova
Keyword(s):  
Atopic Dermatitis ◽  
Iron Deficiency ◽  
Malabsorption Syndrome ◽  
Food Allergies ◽  
Deficiency Anemia ◽  
Early Age ◽  
Healthy Children ◽  
Lactase Deficiency ◽  
Rotavirus Infection ◽  
Carbohydrate Malabsorption

The aim – to determine the laboratory manifestations of carbohydrate malabsorption syndrome in the dynamics of rotavirus infection in early age children and to identify the factors that influence its severity. Materials and methods. The study included 60 breastfed children aged 1–24 months with rotavirus infection, who underwent pH-metry of feces, semi-quantitative determination of total carbohydrates (Benedict’s method), lactose (Malfatti method) and glucose (test systems Glucophan) in feces on the 2nd, 3rd, 5th, 7th and 10th days of the disease. Results. Carbohydrate malabsorption syndrome was observed in 98.3% of patients. The level of fecal carbohydrates increased on the second-third day to a clinically significant 0.50 [0.20; 1,50] %, reached its maximum in the midst of the disease – from the fifth to the seventh day (0.75 [0.50; 1.65] % and 0.87 [0.40; 1.65] %, respectively), decreasing during convalescence to 0.50 [0.20; 1.50] % (P < 0.05 relative to the 10th day), but remained elevated in 81.7 % of patients (P < 0.05 relative to healthy children). Lactase deficiency and glucose malabsorption (P < 0.05 relative to healthy children) were observed throughout the RVI period. At all stages of RVI there was a strong direct correlation between the total level of carbohydrates and lactose in the feces (on the second, third, fifth, seventh and tenth days r = 0.91; r = 0.86; r = 0.91; r = 0.89, respectively). The age dependence of the severity of laboratory indicators of carbohydrate malabsorption was established. Children in the first 6 months had the highest maximum levels of carbohydrates and fecal lactose – 1.75 [1.00; 2.00] % and 3.50 [2.00; 4.00] + respectively (P < 0.05 relative to 12–24 months children) and significantly higher values of these indicators in the dynamics of RVI (P < 0.05 relative to 12–24 months children) for the second-third, fifth and the tenth day). Children with concomitant food allergies, atopic dermatitis and iron deficiency anemia had 2.0 and 1.5 times higher maximum levels of carbohydrates and lactose in the stool, respectively (P < 0.05), as well as higher values of these indicators in the dynamics of the disease – on the third and fifth days (P < 0.05). Conclusions. The vast majority of young patients with rotavirus infection have carbohydrate malabsorption syndrome, which occurs from the first days of the disease and is most pronounced on the fifth to seventh day (P < 0.05 relative to the 10th day), realized mainly due to lactase deficiency. The most pronounced carbohydrate malabsorption syndrome and lactase deficiency in the dynamics of the disease are present in children of the first six months of life. Factors that increase the severity of carbohydrate malabsorption due to secondary lactase deficiency in the acute period of rotavirus infection are concomitant food allergies, atopic dermatitis and iron deficiency anemia.

scholarly journals Assessing patients’ characteristics and treatment patterns among children with atopic dermatitis

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Davide Geat ◽  
Mattia Giovannini ◽  
Gabriele Barlocco ◽  
Riccardo Pertile ◽  
Manuela Pace ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Food Allergy ◽  
Treatment Options ◽  
Thermal Spring ◽  
Treatment Patterns ◽  
Spring Water ◽  
Systemic Treatments ◽  
Thermal Spring Water ◽  
Significant Difference ◽  
Inhalant Allergy

Abstract Background Atopic dermatitis (AD) is the most common immune-mediated skin disease in childhood. Several treatment options for pediatric AD, both topical and systemic, are currently available. We carried out a single-center observational study with the aim of describing characteristics and treatment patterns in pediatric AD patients. Methods The study included 867 patients aged ≤16 years (females 50.5%, mean patient’s age 5.9 years, standard deviation ±3.6 years) with a previous doctor-confirmed diagnosis of AD who underwent balneotherapy at the Comano Thermal Spring Water Center (Comano, Trentino, Italy) from April to October 2014. Results Among the patients included in the study, 41.2% had mild (SCORing Atopic Dermatitis, SCORAD 0-15), 43.6% moderate (SCORAD 16–40) and 15.2% severe AD (SCORAD > 40). A higher occurrence of reported food allergy was observed among children with more severe AD (p < 0.0001), while no association was found between AD severity and reported inhalant allergy or passive smoking (p = 0.15 and 0.92, respectively). Emollients (55.1%) and topical corticosteroids (TCS; 45.7%) were the main treatment options used in the previous month. The use of oral steroids and topical calcineurin inhibitors (TCI) was considerably less common (6.3 and 4.5%, respectively), while no patients were on systemic agents other than steroids. Among patients with severe AD, 9.8% had not used TCS, TCI or any systemic treatments. Moreover, 20.0% of the patients in the study population had followed elimination diets, although only 27.2% of them had a reported food allergy. Conclusions A significant difference in the prevalence of reported food allergy emerged across the different AD severity categories. Furthermore, although further data are necessary to confirm our findings, undertreatment in children with AD appeared to be very common, at least among those attending the Comano Thermal Spring Water Center. Moreover, many patients followed elimination diets in the absence of reported food allergy.

scholarly journals Pathogenetic role of intestinal microflora in carbohydrate malabsorption syndrome in early-aged children with rotavirus infection

2021 ◽  
Vol 23 (5) ◽  
pp. 683-690
Author(s):  
N. V. Vorobiova ◽  
O. V. Usachova ◽  
A. H. Kaplaushenko
Keyword(s):  
Fatty Acids ◽  
Intestinal Microbiota ◽  
Metabolic Activity ◽  
Intestinal Microflora ◽  
Short Chain Fatty Acids ◽  
Short Chain ◽  
Malabsorption Syndrome ◽  
Rotavirus Infection ◽  
Carbohydrate Malabsorption ◽  
Chain Fatty Acids

The aim is to evaluate the effect of metabolic activity of intestinal microflora on laboratory manifestations of carbohydrate malabsorption syndrome in early-aged children with rotavirus infection by studying the main intestinal metabolites – short-chain fatty acids in faeces. Materials and methods. 60 breastfed children with rotavirus infection aged 1–24 months were examined. The total amount of carbohydrates in faecal samples was determined using Benedict’s test, and the detection of short-chain fatty acids in faeces was carried out using liquid chromatography in the dynamics of the disease – on the 3rd, 5th and 10th day. Results. It was established, that the amount of reducing sugars in faeces decreased with the increasing concentration of intestinal microflora metabolites during the entire period of rotavirus infection. In patients with ≤0.5 % level of carbohydrates in faeces, the total content of short-chain fatty acids was the highest and exceeded by 2.0, 1.8 and 1.7 times the indicators of children with Benedict’s test values >0.5 % on the 3rd, 5th and 10th days of the disease, respectively (p < 0.05). A decrease in the metabolic activity of the intestinal microbiota in the above category of children occurred mainly due to a deficiency in the production of acetic and propionic acids (P < 0.05). In the acute period of the disease, an imbalance in the intestinal microbiota infrastructure was noted towards a deficiency of obligate anaerobes that was expressed in a decrease in the anaerobic index (P < 0.05). The severity of these disorders influenced the severity of carbohydrate malabsorption: with an increase in the level of undigested sugars in faeces >0.5 %, the anaerobic index values were 3 and 5 times lower than at a carbohydrate level ≤0.5 % on the 3rd and 5th days of the disease, respectively (P < 0.05). Conclusions. It has been found that early-aged children with rotavirus infection have structural and functional disorders of the intestinal microflora, which influence the severity of carbohydrate malabsorption syndrome. The lower the saccharolytic activity of intestinal bacteria, the more pronounced the manifestations of this syndrome during the entire period of the disease.

scholarly journals A Combined Analysis of Gut and Skin Microbiota in Infants with Food Allergy and Atopic Dermatitis: A Pilot Study

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1682
Author(s):  
Ewa Łoś-Rycharska ◽  
Marcin Gołębiewski ◽  
Marcin Sikora ◽  
Tomasz Grzybowski ◽  
Marta Gorzkiewicz ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Food Allergy ◽  
Gut Microbiota ◽  
Bacterial Species ◽  
Rrna Gene ◽  
Healthy Children ◽  
Skin Microbiota ◽  
Fecal Samples ◽  
Healthy Infants ◽  
Α Diversity

The gut microbiota in patients with food allergy, and the skin microbiota in atopic dermatitis patients differ from those of healthy people. We hypothesize that relationships may exist between gut and skin microbiota in patients with allergies. The aim of this study was to determine the possible relationship between gut and skin microbiota in patients with allergies, hence simultaneous analysis of the two compartments of microbiota was performed in infants with and without allergic symptoms. Fifty-nine infants with food allergy and/or atopic dermatitis and 28 healthy children were enrolled in the study. The skin and gut microbiota were evaluated using 16S rRNA gene amplicon sequencing. No significant differences in the α-diversity of dermal or fecal microbiota were observed between allergic and non-allergic infants; however, a significant relationship was found between bacterial community structure and allergy phenotypes, especially in the fecal samples. Certain clinical conditions were associated with characteristic bacterial taxa in the skin and gut microbiota. Positive correlations were found between skin and fecal samples in the abundance of Gemella among allergic infants, and Lactobacillus and Bacteroides among healthy infants. Although infants with allergies and healthy infants demonstrate microbiota with similar α-diversity, some differences in β-diversity and bacterial species abundance can be seen, which may depend on the phenotype of the allergy. For some organisms, their abundance in skin and feces samples may be correlated, and these correlations might serve as indicators of the host’s allergic state.

scholarly journals Sex-Specific Associations of Trimethylamine-N-Oxide and Zonulin with Signs of Depression in Carbohydrate Malabsorbers and Nonmalabsorbers

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Sophie Meinitzer ◽  
Andreas Baranyi ◽  
Sandra Holasek ◽  
Wolfgang J. Schnedl ◽  
Sieglinde Zelzer ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Beck Depression Inventory ◽  
Intestinal Permeability ◽  
Serum Concentrations ◽  
Carbohydrate Malabsorption ◽  
Specific Relationship ◽  
Breath Testing ◽  
Lactase Gene ◽  
Study Participants ◽  
Gender Specific

Background. The microbiome-derived trimethylamine-N-oxide (TMAO) and the intestinal permeability marker zonulin are considered to be linked with depression. Moreover, carbohydrate malabsorption (CMA) was shown to be associated with signs of depression. This study is aimed at investigating possible sex-specific associations between TMAO and zonulin and the presence of depressive signs in individuals with and without CMA. Methods. Serum concentrations of TMAO and zonulin were determined in 115 and 136 individuals with the presence or absence of CMA. All 251 study participants underwent lactase gene C/T-13910 polymorphism genotyping and fructose H2/CH4 breath testing. Additionally, they filled in the Beck Depression Inventory (BDI-II) questionnaire. Results. The median TMAO and zonulin serum concentrations were 2.66 (1.93–4.14) μmol/L and 40.83 (34.73–47.48) ng/mL. Serum TMAO levels were positively correlated with depressive symptoms (P=0.011, ρ=0.160). The strongest correlations were observed in 87 females (P=0.010, ρ=0.274) and 49 males (P=0.027, ρ=0.315) without CMA, whereas 115 patients with CMA showed no significant correlations. Zonulin tended to be negatively correlated with the BDI-II score in 49 males without CMA (P=0.062, ρ=−0.269). Conclusion. This study demonstrates a positive correlationship between the serum TMAO concentrations and the severity of depressive symptoms in females and males without CMA. Serum zonulin levels were negatively correlated with signs of depression in males without CMA. These findings suggest a gender-specific relationship between the serum TMAO and zonulin concentrations, depression, and CMA.

Clinical and molecular epidemic characterization of rotavirus infection among children under five years old in Shandong province, China.

2021 ◽  
Author(s):  
Shixiao Dong ◽  
Deyu Huang ◽  
Zheng Wang ◽  
Guanyou Zhang ◽  
Fengjuan Zhang ◽  
...  
Keyword(s):  
Lower Incidence ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Shandong Province ◽  
Rotavirus Infection ◽  
National Immunization ◽  
Significant Difference ◽  
The Mean ◽  
And Control

Abstract Rotavirus was the an important causative agent of acute gastroenteritis in children. In China, rotavirus was positive in approximately 30% of the diarrhea children and become a serious public problem. This study was carried out to investigate the clinical and molecular epidemic characterization of rotavirus infection among children under 5 years old with acute diarrhea in Shandong province, China. From July 2017 to June 2018, a total of 1211 fecal specimens were detected and the prevalence of rotavirus infection was 32.12%. The mean age of positive children was 12.2 ± 10.9 months and the highest infection rate was observed in children aged 7–12 months with a rate of 41.64%. G9P[8] (76.61%) was the most prevalent combinations followed by G2P[4] (7.20%), G3P[8] (3.60%) and G9P[4] (2.06%). In addition to diarrhea, vomiting, fever and dehydration were the most common accompanied symptoms. In general, there was no significant difference in clinical manifestations among different age groups. However, the clinical manifestations between vaccinated and unvaccinated children were significantly different. Vaccinated children showed lower incidence and frequency of vomiting, lower incidence and degree of dehydration, lower incidence of severe cases than unvaccinated children. The findings suggested necessary to continue rotavirus strains surveillance in order to monitor the change of prevalent genotype. Moreover, introducing vaccine into national immunization program to prevent and control rotavirus infections is needed in China.

Sign in / Sign up

Export Citation Format

Share Document