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Low fecal elastase-1 in type I diabetes mellitus.

BACKGROUND: Previous studies suggested impaired pancreatic exocrine function in type I diabetes patients, but have been limited by small or highly selected samples. Fecal elastase-1 has facilitated evaluation of pancreatic dysfunction in population-based studies. METHODS: 112 type I diabetic patients (age +/- SD: 37 +/- 11 years; 47 % males; diabetes duration: 12.5 +/- 10.5 years) were consecutively selected from main regional diabetes centers in Essen, West-Germany. 116 non-diabetic control subjects, similar with respect to age and sex, were recruited from the same geographical region. Elastase-1 measurement was performed centrally by ELISA (ScheboTech, Germany). RESULTS: Elastase-1 concentrations in type I diabetic patients were significantly lower than in control subjects (median; inter-quartile range: diabetic patients: 227, 98-386 microgram/g stool; non-diabetic subjects: 544, 377-702 microgram/g stool) (p < 0.01). Elastase-1 < 100 microgram/g stool (E1 < 100) was found in 25.9 % of diabetic and 5.2 % of non-diabetic subjects, yielding an age-sex-adjusted prevalence Odds ratio (POR; 95 % CI) for diabetes and E1 < 100 of 6.9 (2.8-19.6). After adjusting for potential confounders (history of gastrointestinal diseases, smoking, alcohol consumption) the strong association remained (POR: 6.7; 2.7-19.2). Among patients with diabetes, E1 < 100 was associated with quality of glycemic control (HbA1c, change per 1 %: POR 1.5; 1.1-2.0), diabetes duration (per year: POR 1.1; 1.03-1.2), and age at diabetes onset (per age year: POR 1.1; 1.02-1.1). No association was found with history of gastrointestinal diseases, smoking, or alcohol consumption (current, life-time). CONCLUSIONS: Fecal elastase-1 concentrations were lower in type I diabetes patients compared to control subjects, indicating impaired pancreatic exocrine function. Low elastase-1 was associated with poor metabolic control and longer diabetes duration.

Adult↗

Whole-grain rye and wheat foods and markers of bowel health in overweight middle-aged men.

BACKGROUND: Whole-grain cereal foods including rye have been identified as providing significant health benefits that do not occur when refined-cereal foods are ingested. OBJECTIVES: Foods (90 g) containing whole-grain rye flour and whole-grain wheat flour were compared with low-fiber refined-cereal foods for their effects on markers of bowel health and the metabolic markers insulin and glucose. DESIGN: Three 4-wk interventions were undertaken in a randomized crossover design with 28 overweight men aged 40-65 y who had no history of bowel disease. Against a background intake of 14 g dietary fiber (DF), the men were fed low-fiber cereal grain foods providing 5 g DF for a total of 19 g DF/d. High-fiber wheat foods provided 18 g DF, and high-fiber rye foods provided 18 g DF, both giving a total of 32 g DF/d. Fecal samples (48-h) and fasting and postprandial blood samples were collected at the end of each period and assayed. RESULTS: Both high-fiber rye and wheat foods increased fecal output by 33-36% (P = 0.004) and reduced fecal beta-glucuronidase activity by 29% (P = 0.027). Postprandial plasma insulin was decreased by 46-49% (P = 0.0001) and postprandial plasma glucose by 16-19% (P = 0.0005). Rye foods were associated with significantly (P = 0.0001) increased plasma enterolactone (47% and 71%) and fecal butyrate (26% and 36%), relative to wheat and low-fiber options, respectively. CONCLUSIONS: High-fiber rye and wheat food consumption improved several markers of bowel and metabolic health relative to that of low-fiber food. Fiber from rye appears more effective than that from wheat in overall improvement of biomarkers of bowel health.

4-Butyrolactone↗

Identification of bacterial DNA markers for the detection of human fecal pollution in water.

We used genome fragment enrichment and bioinformatics to identify several microbial DNA sequences with high potential for use as markers in PCR assays for detection of human fecal contamination in water. Following competitive solution-phase hybridization of total DNA from human and pig fecal samples, 351 plasmid clones were sequenced and were determined to define 289 different genomic DNA regions. These putative human-specific fecal bacterial DNA sequences were then analyzed by dot blot hybridization, which confirmed that 98% were present in the source human fecal microbial community and absent from the original pig fecal DNA extract. Comparative sequence analyses of these sequences suggested that a large number (43.5%) were predicted to encode bacterial secreted or surface-associated proteins. Deoxyoligonucleotide primers capable of annealing to a subset of 26 of the candidate sequences predicted to encode factors involved in interactions with host cells were then used in the PCR and did not amplify markers in DNA from any additional pig fecal specimens. These 26 PCR assays exhibited a range of specificity in tests with 11 other animal sources, with more than half amplifying markers only in specimens from dogs or cats. Four assays were more specific, detecting markers only in specimens from humans, including those from 18 different human populations examined. We then demonstrated the potential utility of these assays by using them to detect human fecal contamination in several impacted watersheds.

Animals↗

Sources and species of cryptosporidium oocysts in the Wachusett Reservoir watershed.

Understanding the behavior of Cryptosporidium oocysts in the environment is critical to developing improved watershed management practices for protection of the public from waterborne cryptosporidiosis. Analytical methods of improved specificity and sensitivity are essential to this task. We developed a nested PCR-restriction fragment length polymorphism assay that allows detection of a single oocyst in environmental samples and differentiates the human pathogen Cryptosporidium parvum from other Cryptosporidium species. We tested our method on surface water and animal fecal samples from the Wachusett Reservoir watershed in central Massachusetts. We also directly compared results from our method with those from the immunofluorescence microscopy assay recommended in the Information Collection Rule. Our results suggest that immunofluorescence microscopy may not be a reliable indicator of public health risk for waterborne cryptosporidiosis. Molecular and environmental data identify both wildlife and dairy farms as sources of oocysts in the watershed, implicate times of cold water temperatures as high-risk periods for oocyst contamination of surface waters, and suggest that not all oocysts in the environment pose a threat to public health.

Animals↗

Monoclonal antibody capture enzyme-linked immunosorbent assay for detection of bovine enteric coronavirus.

Monoclonal antibodies reactive with three different viral polypeptides were evaluated singly and in combination as the capture antibody(s) in an enzyme-linked immunosorbent assay system for the detection of bovine enteric coronavirus. Similar levels of sensitivity were found for all combinations tested. A sensitive, highly specific, and reproducible assay for the detection of bovine enteric coronavirus was developed, using a mixture of two of these monoclonal antibodies reactive with antigenic components either external or internal to the virion. These monoclonal antibodies were bound indirectly to 96-well plates via rabbit anti-mouse immunoglobulin. After sample application and incubation, virus was detected by using rabbit anti-coronavirus peroxidase conjugate followed by enzyme substrate and chromagen. Fecal samples from a single herd of cows were screened for the presence of coronavirus by this assay. Five percent of clinically normal cows were found to be shedding coronavirus.

Animals↗

[Occurrence of Entamoeba histolytica/Entamoeba dispar in ambulatory patients of Recife, PE].

The objective this study was to determine the occurrence of the species Entamoeba histolytica/Entamoeba díspar in clinical samples of ambulatory patients in Pernambuco. A specific assay for Entamoeba histolytica was used in this study, which identified no positive fecal samples among the 213 patients. These results confirm that E. dispar is the dominant species in Pernambuco State.

Animals↗

Mycobacterium avium subsp. paratuberculosis infection in an addax (Addax nasomaculatus).

Mycobacterium avium subsp. paratuberculosis was cultured from a single fecal sample collected from a 10-yr-old, captive-bred male addax (Addax nasomaculatus). Attempts to confirm infection with additional fecal cultures, serology, semen culture, and tissue biopsy were unsuccessful. There were no gross lesions on necropsy. On histopathology there were neither acid-fast organisms nor microscopic changes suggestive of active or clinical Johne's disease. Mycobacterium avium subsp. paratuberculosis was isolated from four organ tissues: ileum, jejunum, colon, and mesenteric lymph node.

Animals↗

[Agricultural animals as a source of yersiniosis].

The role of agricultural animals as the sources of infection was studied. 8 Yersinia strains were isolated from 83 samples taken from cattle. Yersinia were isolated from feces, udder washings and milk. In the examination of 63 samples obtained from sheep the infective agent was isolated from feces in 6 cases. 6 Yersinia strains were isolated from 92 fecal samples taken from pigs. Y. enterocolitica were isolated from sick animals. The isolated strains were classified with serovars 03, 058, 08 and 09. In the foci of animal infection thus revealed antibodies to various Yersinia strains were detected in the blood sera of the animal-tending personnel, which indicates the professional character of the spread of this infection among humans. The infection is probably transferred by the contact and alimentary routes.

Agglutination Tests↗

Quantification of inflammatory mediators in stool samples of patients with inflammatory bowel disorders and controls.

Previous studies indicated that eosinophils and mast cells accumulate and become activated in inflammatory bowel disorders. The aim of the study was to examine the presence of eosinophil and mast cell mediators in human stool samples of patients with inflammatory bowel disorders. We measured eosinophil cationic protein (ECP), eosinophil protein X (EPX), methylhistamine, and alpha 1-antitrypsin in fecal samples of 136 patients (62 Crohn's disease, 24 ulcerative colitis, 15 intestinal food allergy, 35 other gastrointestinal diseases) and 8 healthy controls. We found strongly elevated levels of ECP (median: 29, range: 0.4-1783 ng/g feces) and EPX (803, 10-33,225 ng/g) in all patients groups compared to controls (ECP: 1.5, 0.5-55 ng/g; EPX: 235, 12-746 ng/g). Similar results, albeit less pronounced, were obtained for methylhistamine and alpha 1-antitrypsin. Particularly high concentrations of ECP and EPX were found in patients with active mucosal inflammation. In conclusion, the study presents an easy and reliable method for the detection of fecal ECP, EPX, and methylhistamine and may provide a tool to gain insight into the pathogenesis of inflammatory bowel diseases and have potential as diagnostic test.

Adolescent↗

Clinical pharmacology of flavopiridol following a 72-hour continuous infusion.

BACKGROUND: Flavopiridol, a novel flavone derivative, inhibits cyclin-dependent kinase-1. We initiated a Phase I trial in patients with refractory solid tumors to determine the maximum tolerated dose and characterize the adverse effect profile. OBJECTIVE: To characterize the clinical pharmacology of flavopiridol. METHODS: Serial plasma samples were collected and analyzed by HPLC using electrochemical detection. The pharmacokinetics were analyzed by noncompartmental analysis. Enterohepatic recirculation was studied by analyzing fecal samples, with an attempt to correlate cholecystokinin and post-infusional peak concentrations. The plasma protein binding was studied using equilibrium dialysis. RESULTS: Seventy-six patients were treated with flavopiridol at 13 dose levels for a total of 504 cycles of treatment. The average steady-state concentration was 26.5 and 253 nM at 4 and 122.5 mg/m2, respectively. The clearance ranged from 49.9 to 2943 mL/min, with nonlinearity at doses >50 mg/m2/d. A post-infusional increase in plasma flavopiridol concentrations was noted in a subset of patients and generally occurred between 3 and 24 hours after the end of infusion. Flavopiridol was found in fecal matter, suggesting enterohepatic recirculation. There was nonsaturable plasma protein binding of flavopiridol (fu = 6%). CONCLUSIONS: The dose-limiting toxicity for the Phase I trial of flavopiridol was secretory diarrhea. We failed to identify a clear relationship between dose or concentration and diarrhea. At 50 and 78 mg/m2/d, the mean steady-state plasma concentrations were 278 and 390 nM. These concentrations were well above those noted for in vitro antiproliferative activity. Nonlinear elimination was observed at doses above 50 mg/m2/d, and postinfusional peaks appear to be related to enterohepatic recirculation.

Adult↗

Influence of two levels of enzyme preparation on ruminal fermentation, particulate and fluid passage and cell wall digestion in wether lambs consuming either a 10% or 25% grain diet.

Effects of a fungal enzyme preparation on ruminal fermentation, digesta kinetics and cell wall digestion were studied. Either 0, 22 or 25 g/d of enzyme preparation was offered to nine ruminally cannulated Rambouillet or Columbia wether lambs (avg wt 28.6 kg) in two randomized complete block experiments. An alfalfa hay-corn mixture at 2.1% of body weight (10% corn) was used in Exp. 1. In Exp. 2, 2.7% of body weight (25% corn; Exp. 2) was fed. Ruminal samples were collected at 0, 4, 8, 12 and 24 h postfeeding on d 17 of each 22-d period to measure fluid dilution rate and fermentation characteristics. An intraruminal dose of Yb-labeled hay followed by fecal sampling on d 19 through 22 was used to estimate particulate passage and fecal output. Ruminal pH, NH3 concentrations, total volatile fatty acid and proportion of individual acids were not influenced (P greater than .10) by the addition of either level of enzyme preparation in either Exp. 1 or 2. Dry matter digestibility also showed no effect (P greater than .10) of enzyme preparation added to either diet. In Exp. 1, wethers receiving 35 g/d of the enzyme preparation had greater cell wall digestion (49.8%; P less than .05) than wethers receiving either 22 g/d or no enzyme preparation (45.7 and 42.9%, respectively). In Exp. 2, with a 25% corn diet, no influence (P greater than .10) of enzyme preparation was noted on cell wall digestibility. Particulate and ruminal fluid passage rate parameters remained unchanged (P greater than .10) by the addition of either level of enzyme preparation, regardless of the diet fed.(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Feed↗

Use of near infrared reflectance spectroscopy in the screening for biliary atresia.

Early diagnosis is crucial for treatment and prognosis of biliary atresia (BA). We used near infrared reflectance spectroscopy (NIRS) for screening of BA. Fecal samples were collected from 200 healthy infants and 16 infants for whom either BA or neonatal hepatitis was diagnosed. Diagnoses were made retrospectively by other diagnostic methods, including laparotomy. The samples (0.5 g each) were manually homogenized. Reflected light from the surface of feces was measured by NIRS. Absorbance peak spectra for fecal fat and conjugated bilirubin were determined before the study, and proved to be 730, 1158, and 1210 nm, respectively. Two cutoff points were set in the second-derivative spectrum: the first (> -0.005) at 730 nm for conjugated bilirubin, and the second (< 1.0) at 1,158:1,210 nm for fat (to include all patients with BA). The sensitivity of NIRS in the diagnosis of BA was 100%, and the specificity was 95.2%. The authors conclude that NIRS is a simple, rapid, noninvasive, and precise technique for the early diagnosis of BA.

Biliary Atresia↗

Evaluation of probe chemistries and platforms to improve the detection limit of real-time PCR.

A validated PCR-based Salmonella method targeting a 94-bp sequence of the ttr gene was used as a model to compare six different combinations of reporter and quencher dyes of a TaqMan probe, on three different instruments, to improve the detection limit in a real-time PCR assay with the aim of a same-day analysis. The use of locked nucleic acids (LNA) and Scorpion probes were also tested. The combination FAM-BHQ1 or Cy5-BHQ3, both dark quenchers, gave the best results (Cycle threshold (Ct) of 25.42+/-0.65 and 24.47+/-0.18 at 10(3) DNA copies). When comparing different probe technologies, the LNA probe (FAM-BHQ1) was the most sensitive with the strongest fluorescence signal (dR last 48066), resulting in 0.6 to 1.1 lower Ct values than a DNA TaqMan probe, and 1.9 to 4.0 lower Ct than the Scorpion system (FAM-BHQ1). The RotorGene real-time PCR instrument gave 0.4-1.0 lower Ct values (more sensitive) than the Mx3005p, and 1.5-3.0 lower than the ABI 7700. Using the LNA in a RotorGene instrument, we detected the following Salmonella DNA copies in 1-ml pre-enriched samples: fishmeal (100 copies), chicken rinse (100 copies) and pig feces (10 copies). The detection probability of the final assay on inoculated fecal samples was 100% at 2x10(4) copies per ml. In conclusion, the LNA probe with annealing temperature of 65 degrees C could be useful for more sensitive detection limits.

Animals↗

Effect of parasite burden on the detection of Fasciola hepatica antigens in sera and feces of experimentally infected sheep.

The effect of Fasciola hepatica parasite burden on the detection of excretory/secretory (E/S) antigens in sera and feces of experimentally infected sheep was evaluated using a double antibody-based capture enzyme-linked immunosorbent assay (ELISA). Four groups of five sheep each were used. The first three groups were infected with 50, 100 and 200 metacercariae of F. hepatica, and the fourth group remained as non-infected control. On the day of infection and weekly thereafter, serum and fecal samples were taken. ELISA detected F. hepatica E/S antigen levels in serum from the first week post-infection (wpi) and in fecal supernatant from the fourth wpi, which were significantly (p<0.05) higher than controls. F. hepatica eggs were not detected until after the eighth wpi. The correlation between absorbance of E/S antigens in serum with the fluke burden was 0.77 (p<0.0001) and in feces 0.76 (p<0.0001) at 12th wpi. The sensitivity of the assay to detect E/S antigens in serum was 86.6% and in feces 93.3%. It is concluded that the ELISA technique used in this study offers a diagnostic alternative for detecting early infections of F. hepatica in sheep.

Animals↗

Parasite diversity and anthelmintic resistance in two herds of horses.

Diversity of parasite populations was compared between two herds of horses, one a regularly treated herd the other a feral herd which has bad no anthelmintic treatment for at least 25 years. Eggs obtained from fecal samples of both herds were tested for anthelmintic resistance by use of an in-vitro larval hatch/development assay (LDA), DrenchRite. A fecal egg reduction test was also performed with the domesticated herd using fenbendazole, pyrantel pamoate and ivermectin. Cyathostomes were the predominant group of worms present in both herds. Trichostrongylus axei was seen in both herds, but Strongylus equinus, Strongylus vulgaris, Gyalocephalus capitatus, Poteriostomum spp. and Strongyloides westeri were only found in the feral horses. Larvae of Strongylus edentatus were found in a single domesticated horse. Fecal egg reduction tests with the domesticated herd showed a 32% egg count reduction for fenbendazole, a 93% reduction with pyrantel, and a 99% reduction with ivermectin. From the LDA, anthelmintic resistance was evaluated by determining the resistance ratio of the domesticated herd compared with the feral herd. For benzimidazoles in the domesticated herd, 45% of the cyathostome population was 9.4 times more tolerant than the feral herd's parasite population. The parasite population in the domesticated herd was 1.5 times more tolerant to Levamisole, and 1.7 times more tolerant to the benzimidazole/levamisole combination than the parasite population within the feral herd. 9% of the parasite population in the domesticated herd was 90 times more tolerant to avermectins than the feral herd's parasite population, even though a subpopulation of worms in the feral herd were tolerant to low concentrations of avermectins despite never being previously exposed to this class of anthelmintic.

Animals↗

Epidemiologic study of Giardia sp. infection in dairy cattle in southeastern New York State.

To identify animal and management factors associated with the risk of Giardia sp. infection in dairy cattle in southeastern New York State, an observational analytical epidemiologic study was conducted. A random sample of 2943 animals in 109 dairy herds located in five counties of southeastern New York was selected from the target population. Fecal samples were collected from animals in the study population and examined for the presence of Giardia sp. using a quantitative centrifugation concentration flotation technique. Data on each animal, and on general management, maternity, preweaning, and postweaning practices were collected by personal interview with the farmer or farm manager. The significance of association of these factors, within each management practice group, with the risk of infection was evaluated using the logistic regression analysis. Weighted indices for each of these four groups were developed, and were evaluated together with the age of the animal and season of sampling for their significance of association with the risk of infection using mixed effect logistic regression analysis. Only the maternity management practices, age of the animal, and the season of sampling were significantly associated with the risk of infection with Giardia sp. Summer housing of bred heifers, on pasture or in tie stalls, was associated with increased risk of infection. Calves that were fed fresh colostrum or separated immediately after birth from the dam were at decreased risk of infection. The risk of infection decreased with the age of the animal and varied by the season of sampling. There was no significant extra binomial variation in the risk of infection in this data. If consideration is to be given to reducing the risk of infection with this parasite, management must be a top priority, especially in younger animals.

Animals↗

Short-Term Success, Long-Term Failure: Strain Turnover and Virulence Re-Emergence May Drive Relapse in Pouchitis.

BACKGROUND & AIMS: Pouchitis, de-novo small intestinal inflammation is the most common complication developing in patients with ulcerative colitis after total large bowel resection and ileal pouch-anal anastomosis (IPAA) reconstruction. While the first line treatment is antibiotics, the microbial properties underlying flare, remission, and relapse remain vague. We aimed to investigate how antibiotic treatment drives microbial shifts that underlie remission and contribute to relapse. METHODS: Patients after IPAA were prospectively recruited during clinical flare (active pouchitis defined by the pouchitis disease activity index) and received a two-week course of metronidazole with either ciprofloxacin or doxycycline. Longitudinal follow up was conducted during a year. Clinical data were recorded, and fecal samples were obtained during consequent flares, recovery, and relapses. Microbial gene repertoire, strains, and resistance to antibiotics were determined. Metagenomic sequencing was integrated with whole-genome sequencing of Escherichia coli isolates, providing strain-specific virulence and antibiotic resistance profiles. RESULTS: Patients (n=21) recruited provided 130 samples over one-year follow-up. Both antibiotic regimens induced rapid but transient clinical improvement, reflected by a decrease in fecal calprotectin (728 to 265 &#x3bc;g/g, p<.05), and a marked reduction in bacterial exotoxin genes (p<.05), yet both parameters rebounded by 6 weeks post-treatment. Antibiotic resistance gene abundance significantly increased during treatment (p<.05), without expansion of resistance gene diversity, indicating that pre-existing resistant strains increased. CONCLUSIONS: Antibiotic-induced remission in pouchitis likely results from a temporary suppression of exotoxin-producing bacteria, enabling resistant, low-virulence strains to transiently dominate; The fact that harmful strains quickly rebound after treatment cessation highlights the need for targeted approaches to achieve sustained microbial control.

Inflammatory bowel disease↗

Excretion of radioactivity from rats and rabbits following cutaneous application of two 14C-labeled azo dyes.

A benzidine-derived azo dye, C.I. direct black 38 (DB38), and a p-phenylenediamine-derived dye, C.I. direct black 19 (DB19), labeled with carbon-14 in their aromatic amine moieties, were applied to the shaved dorsal skin of male Fischer-344 rats and New Zealand rabbits. Application sites were protected with nylon gauze and elastic bandage assemblies. Following application of measured amounts of radiolabeled dye in 0.1 M pH 10.2 carbonate buffer, serial urine and fecal samples were obtained from individual animals in metabolism cages at 24, 48, 72, 96, 120, and 144 h. Aliquots of urine and fecal homogenates were assayed for radioactivity by scintillation counting. Cumulative excretion of radioactivity from rats receiving DB38 was 0.05% of total dermal dose at 144 h in urine, and 0.16% of total dermal dose in feces. Cumulative excretion of radioactivity from DB38-treated rabbits at 144 h was 3.12% of total dermal dose in urine, and 5.12% in feces. From rats and rabbits receiving topical DB19, cumulative excretion of radioactivity at 144 h was less than that from DB38-treated animals. In rat urine, 0.04% of total dermal dose appeared; in rat feces, no radioactivity was recovered. In rabbit urine, 0.04% of dermal dose was found; 0.01% appeared in rabbit feces.

Animals↗