Altered DNA methylation within DNMT3A, AHRR, LTA/TNF loci mediates the effect of smoking on inflammatory bowel disease

This work aims to investigate how smoking exerts effect on the development of inflammatory bowel disease (IBD). A prospective cohort study and a Mendelian randomization study are first conducted to evaluate the association between smoking behaviors, smoking-related DNA methylation and the risks of Crohn's disease (CD) and ulcerative colitis (UC). We then perform both genome-wide methylation analysis and co-localization analysis to validate the observed associations. Compared to never smoking, current and previous smoking habits are associated with increased CD (P = 7.09 × 10-10) and UC (P < 2 × 10-16) risk, respectively. DNA methylation alteration at cg17742416 [DNMT3A] is linked to both CD (P = 7.30 × 10-8) and UC (P = 1.04 × 10-4) risk, while cg03599224 [LTA/TNF] is associated with CD risk (P = 1.91 × 10-6), and cg14647125 [AHRR] and cg23916896 [AHRR] are linked to UC risk (P = 0.001 and 0.002, respectively). Our study identifies biological mechanisms and pathways involved in the effects of smoking on the pathogenesis of IBD.

Transcriptomic Context of RUNX3 Expression in Monocytes: A Cross-Sectional Analysis

The runt-related transcription factor 3 (RUNX3) regulates the differentiation of monocytes and their response to inflammation. However, the transcriptomic context of RUNX3 expression in blood monocytes remains poorly understood. We aim to learn about RUNX3 from its relationships within transcriptomes of bulk CD14+ cells in adults. This study used immunomagnetically sorted CD14+ cell gene expression microarray data from the Multi-Ethnic Study of Atherosclerosis (MESA, n = 1202, GSE56047) and the Correlated Expression and Disease Association Research (CEDAR, n = 281, E-MTAB-6667) cohorts. The data were preprocessed, subjected to RUNX3-focused correlation analyses and random forest modeling, followed by the gene ontology analysis. Immunity-focused differential ratio analysis with intermediary inference (DRAIMI) was used to integrate the data with protein-protein interaction network. Correlation analysis of RUNX3 expression revealed the strongest positive association for EVL (r_mean = 0.75, p_FDR-MESA = 5.37 × 10^-140, p_FDR-CEDAR = 5.52 × 10^-80), ARHGAP17 (r_mean = 0.74, p_FDR-MESA = 1.13 × 10^-169, p_FDR-CEDAR = 9.20 × 10^-59), DNMT1 (r_mean = 0.74, p_FDR-MESA = 1.10 × 10^-169, p_FDR-CEDAR = 1.67 × 10^-58), and CLEC16A (r_mean = 0.72, p_FDR-MESA = 3.51 × 10^-154, p_FDR-CEDAR = 2.27 × 10^-55), while the top negative correlates were C2ORF76 (r_mean = -0.57, p_FDR-MESA = 8.70 × 10^-94, p_FDR-CEDAR = 1.31 × 10^-25) and TBC1D7 (r_mean = -0.55, p_FDR-MESA = 1.36 × 10^-69, p_FDR-CEDAR = 7.81 × 10^-30). The RUNX3-associated transcriptome signature was involved in mRNA metabolism, signal transduction, and the organization of cytoskeleton, chromosomes, and chromatin, which may all accompany mitosis. Transcriptomic context of RUNX3 expression in monocytes hints at its relationship with cell growth, shape maintenance, and aspects of the immune response, including tyrosine kinases.

Birth weight for gestational age: standard growth charts for the Polish population

Introduction. Birth weight is one of the most important factors determining neonatal well-being. From an epidemiological viewpoint, a neonatal reference chart provides a picture of the health status of a population. Global customized growth charts seem to be the most practical in multicultural settings, allowing adjustment for ethnicity. However, regional charts might be a valuable contribution to reliable growth assessment. Our study aims to establish a reference tool for growth assessment and visualize the local potential, by creating standard charts based on the data from the tertiary center with the highest number of deliveries per year in Poland. Material and Methods. We retrospectively analysed  31,353 records from the electronic database of singleton births from a five-year period from a tertiary hospital in Poznań, Poland. We excluded pre-term deliveries and high-risk pregnancies basing on well-known factors influencing fetal growth, bringing the number of records to  21,379. The data were processed separately by gender (females n=10,312, 48.2% and males n=11,067, 51.8%). Percentiles were calculated for each week of gestational age. Means and standard deviations were determined. Results. Standard growth charts (including 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentiles) are presented. Descriptive data of population distribution are shown. Conclusions. In conclusion, obtaining standard growth charts for mature newborns has created the opportunity for a more actual and adequate assessment of the Polish neonatal population. It should allow for the implementation of new standards in future research on perinatal care.

Methylation of RUNX3 Promoter 2 in the Whole Blood of Children with Ulcerative Colitis

Ulcerative colitis (UC) results from a complex interplay between the environment, gut microbiota, host genetics, and immunity. Runt-related transcription factor 3 (RUNX3) regulates Th1/Th2 balance and, thus, the synthesis of cytokines and inflammation. We aimed to analyze the dependence of RUNX3 promoter 2 (P2) methylation level on: age, sex, body mass index (BMI), C-reactive protein (CRP), serum albumin, disease duration, Pediatric Ulcerative Colitis Activity Index (PUCAI), the Paris classification, and exposure to medications. This multicenter, cross-sectional study recruited hospitalized children with UC. Methylation of RUNX3 P2 was measured with methylation-sensitive restriction enzymes in the whole blood DNA. Sixty-four children were enrolled, with a mean age of 14.5 ± 2.8 years. Half of them were female (51.6%), and the average BMI Z-score was −0.44 ± 1.14. The mean methylation of RUNX3 P2 was 54.1 ± 13.3%. The methylation level of RUNX3 P2 did not correlate with age, sex, nutritional status, CRP, albumin, PUCAI, or the extent of colitis (Paris E1–E4). RUNX3 P2 methylation did not differ between patients recruited within two and a half months of diagnosis and children who had UC for at least a year. Current or past exposure to biologics, immunosuppressants, or steroids was not associated with RUNX3 P2 methylation. Methylation of RUNX3 promoter 2 in whole blood DNA does not seem to be associated with the characteristics of UC in children.

Fat-Soluble Vitamins in Standard vs. Liposomal Form Enriched with Vitamin K2 in Cystic Fibrosis: A Randomized Multi-Center Trial

Background: We aimed to assess a liposomal fat-soluble vitamin formulation containing vitamin K2 with standard treatment in cystic fibrosis (CF). Methods: A multi-center randomized controlled trial was carried out in 100 pancreatic-insufficient patients with CF. The liposomal formulation contained vitamin A as retinyl palmitate (2667 IU daily) and beta-carotene (1333 IU), D3 (4000 IU), E (150 IU), K1 (2 mg), and K2 as menaquinone-7 (400 µg). It was compared with the standard vitamin preparations in the closest possible doses (2500 IU, 1428 IU, 4000 IU, 150 IU, 2.14 mg, respectively; no vitamin K2) over 3 months. Results: Forty-two patients finished the trial in the liposomal and 49 in the control group (overall 91 pts: 22.6 ± 7.6 years, 62.6% female, BMI 19.9 ± 2.8 kg/m², FEV1% 70% ± 30%). The main outcome was the change of vitamin status in the serum during the study (liposomal vs. standard): all-trans-retinol (+1.48 ± 95.9 vs. −43.1 ± 121.4 ng/mL, p = 0.054), 25-hydroxyvitamin D3 (+9.7 ± 13.4 vs. +2.0 ± 9.8 ng/mL, p = 0.004), α-tocopherol (+1.5 ± 2.5 vs. −0.2 ± 1.6 µg/mL, p < 0.001), %undercarboxylated osteocalcin (−17.2 ± 24.8% vs. −8.3 ± 18.5%, p = 0.061). The secondary outcome was the vitamin status at the trial end: all-trans-retinol (370.0 ± 116.5 vs. 323.1 ± 100.6 ng/mL, p = 0.045), 25-hydroxyvitamin D3 (43.2 ± 16.6 vs. 32.7 ± 11.5 ng/mL, p < 0.001), α-tocopherol (9.0 ± 3.1 vs. 7.7 ± 3.0 µg/mL, p = 0.037), %undercarboxylated osteocalcin (13.0 ± 11.2% vs. 22.7 ± 22.0%, p = 0.008). Conclusion: The liposomal fat-soluble vitamin supplement containing vitamin K2 was superior to the standard form in delivering vitamin D3 and E in pancreatic-insufficient patients with CF. The supplement was also more effective in strengthening vitamin K-dependent carboxylation, and could improve vitamin A status.

The Impact of ERASMUS Exchanges on the Professional and Personal Development of Medical Students

The ERASMUS program is one of the most popular student exchange projects, particularly among the students of Central and Eastern European countries. However, limited research is available with regard to its influence on the professional and personal development of its participants. The study aimed at investigating the experiences and impact of the ERASMUS program on different domains of the personal and professional life of medical students. A questionnaire containing closed and open-ended questions was distributed among 269 former participants of the ERASMUS program from the Poznan University of Medical Sciences to collect qualitative and quantitative data regarding the topic. The response rate was 41%. Mastering professional foreign language skills was the most frequently reported benefit of ERASMUS (94%), followed by a change of approach towards learning by exposure to innovative teaching techniques, character, professionalism and cultural competency development, impact on the migration decisions of the students, as well as the opportunity to compare healthcare and educational systems across countries. Additionally, 57% of respondents stated that ERASMUS impacted their career plans, and few indicated that it had affected their specialty choice. Approximately 28% of respondents have worked abroad in healthcare or research since graduating. Participation in the ERASMUS program proved to be a unique opportunity for professional and personal development.

Subjective self-assessment of physical activity is negatively affected by monitoring awareness in subjects with mild cognitive impairment: a crossover randomised controlled trial

OBJECTIVE

Physical activity plays an important role in maintaining mental and physical health. This study assessed the effect of physical activity monitoring awareness on the physical activity level and subjective self-assessment of physical activity in middle-aged subjects with normal cognitive function (NCF) and mild cognitive impairment (MCI).

PATIENTS AND METHODS

Thirty-five subjects aged 50-65 years with NCF and MCI were randomised into two experimental groups, each taking part in two one-week intervention periods. Subjects in group A were not aware that their physical activity was monitored in the first week (phase I) and were aware of the monitoring in the second week (phase II), whereas it was the opposite order for group B. Physical activity was assessed using the ActiGraph GT9X accelerometer and International Physical Activity Questionnaire (IPAQ).

RESULTS

A total of 32 subjects (MCI: n = 12, NCF: n = 20) completed both intervention periods, with MCI subjects having significantly lower objectively assessed physical activity than NCF participants. Moreover, subjectively assessed physical activity in the MCI group was significantly higher when the participants were unaware of physical activity monitoring. A significant phase-group interaction was found in total (MET-min/d: p = 0.0072; min/d: p = 0.0194) and moderate (MET-min/d: p = 0.0015; min/d: p = 0.0020) physical activity as well as energy expenditure (p = 0.0366) assessed by the IPAQ and in the percentage of sedentary behaviour (p = 0.0330) and the average number of steps (p = 0.0342) assessed by ActiGraph.

CONCLUSIONS

The awareness of physical activity assessment might decrease the ability to subjectively assess physical activity in subjects with MCI.

HLA-DQA1*05 Associates with Extensive Ulcerative Colitis at Diagnosis: An Observational Study in Children

The human leukocyte antigen (HLA) allele group HLA-DQA1*05 predisposes to ulcerative colitis (UC) and is associated with the development of antibodies against infliximab in patients with inflammatory bowel disease (IBD). Therefore, we hypothesized that the presence of HLA-DQA1*05 correlates with characteristics of pediatric IBD. Within a multi-center cohort in Poland, the phenotype at diagnosis and worst flare was established and HLA-DQA1*05 status was assessed enabling genotype-phenotype analyses. HLA-DQA1*05 was present in 221 (55.1%) out of 401 children with IBD (UC n = 188, Crohn's disease n = 213). In UC, the presence of HLA-DQA1*05 was moderately associated with a large extent of colonic inflammation at diagnosis (E4 55% more frequent in HLA-DQA1*05-positive patients, p = 0.012). PUCAI at diagnosis (p = 0.078) and the time from UC diagnosis to the first administration of biologic treatment (p = 0.054) did not differ depending on HLA-DQA1*05 status. The number of days of hospitalization for exacerbation was analyzed in 98 patients for whom sufficient follow-up was available and did not differ depending on HLA-DQA1*05 carriership (p = 0.066). HLA-DQA1*05 carriers with CD were less likely to present with both stenosing and penetrating disease (B2B3, p = 0.048) and to have active disease proximal to the ligament of Treitz (L4a) at the worst flare (p = 0.046). Future research focusing on explaining and preventing anti-TNF immunogenicity should take into account that ADA may develop not only as an isolated reaction to anti-TNF exposure but also as a consequence of intrinsic differences in the early course of UC.

Analysis of Gastrointestinal Acoustic Activity Using Deep Neural Networks

Automated bowel sound (BS) analysis methods were already well developed by the early 2000s. Accuracy of ~90% had been achieved by several teams using various analytical approaches. Clinical research on BS had revealed their high potential in the non-invasive investigation of irritable bowel syndrome to study gastrointestinal motility and in a surgical setting. This article proposes a novel methodology for the analysis of BS using hybrid convolutional and recursive neural networks. It is one of the first methods of using deep learning to be widely explored. We have developed an experimental pipeline and evaluated our results with a new dataset collected using a device with a dedicated contact microphone. Data have been collected at night-time, which is the most interesting period from a neurogastroenterological point of view. Previous works had ignored this period and instead kept brief records only during the day. Our algorithm can detect bowel sounds with an accuracy >93%. Moreover, we have achieved a very high specificity (>97%), crucial in diagnosis. The results have been checked with a medical professional, and they successfully support clinical diagnosis. We have developed a client-server system allowing medical practitioners to upload the recordings from their patients and have them analyzed online. This system is available online. Although BS research is technologically mature, it still lacks a uniform methodology, an international forum for discussion, and an open platform for data exchange, and therefore it is not commonly used. Our server could provide a starting point for establishing a common framework in BS research.

App-assured essential physical activity for the prevention of cognitive decline: changing paradigms in public health – a study protocol for a randomised controlled trial

This study aims to assess the effect of an increase in daily physical activity to prevent cognitive decline, sustain brain volumes and maintain healthy biomarker levels in previously inactive (< 7,000 steps/day) mild cognitive impairment (MCI) subjects aged 50-65 years. In total, 198 subjects with MCI (assessed using the Montreal Cognitive Assessment test) will be recruited and randomised into two groups: active and passive. The active group will be instructed, encouraged and motivated to increase their physical activity to a moderate level (≥ 10,000 steps/day), while the passive group should maintain their normal activity levels. All subjects will undergo cognitive assessment, neuroimaging and biomarker tests before and after a one-year intervention. During the intervention, physical activity will be measured by the Fitbit Inspire HR wristband. The study was registered in the German Clinical Trials Register database (registration no. DRKS00020943, date of registration: 09.03.2020, protocol version: 1.0).

Automated Bowel Sound Analysis: An Overview

Despite technological progress, we lack a consensus on the method of conducting automated bowel sound (BS) analysis and, consequently, BS tools have not become available to doctors. We aimed to briefly review the literature on BS recording and analysis, with an emphasis on the broad range of analytical approaches. Scientific journals and conference materials were researched with a specific set of terms (Scopus, MEDLINE, IEEE) to find reports on BS. The research articles identified were analyzed in the context of main research directions at a number of centers globally. Automated BS analysis methods were already well developed by the early 2000s. Accuracy of 90% and higher had been achieved with various analytical approaches, including wavelet transformations, multi-layer perceptrons, independent component analysis and autoregressive-moving-average models. Clinical research on BS has exposed their important potential in the non-invasive diagnosis of irritable bowel syndrome, in surgery, and for the investigation of gastrointestinal motility. The most recent advances are linked to the application of artificial intelligence and the development of dedicated BS devices. BS research is technologically mature, but lacks uniform methodology, an international forum for discussion and an open platform for data exchange. A common ground is needed as a starting point. The next key development will be the release of freely available benchmark datasets with labels confirmed by human experts.

Preclinical atherosclerosis in cystic fibrosis: Two distinct presentations are related to pancreatic status

BACKGROUND

Patients with cystic fibrosis (CF) are exposed to overlapping cardiovascular risk factors. We hypothesized that CF is characterized by increased arterial stiffness and greater intima-media thickness (IMT).

METHODS

This cross-sectional study assessed the digital volume pulse arterial stiffness index (SI_DVP) using photopletysmography, measured intima-media complex thickness (IMT) at the common carotid artery, and obtained an extended set of clinical and atherosclerosis-related laboratory parameters.

RESULTS

Fifty-five patients with moderate-to-severe CF (mean age 26.3±8.6 years, BMI 20.3±3.1 kg/m2, FEV1 62±26%) and 51 healthy controls (25.1±4.4 years, BMI 21.7±3.0 kg/m2) entered the study. SI_DVP was greater in pancreatic insufficient (PI), but not pancreatic sufficient (PS) CF patients compared with control (7.3±1.8 m/s vs 6.0±1.2 m/s; p=7.1 × 10^-5). IMT was increased in PS (but not PI) participants relative to control (552±69 µm vs 456±95 µm, p=0.0011). SI_DVP was also greater in PI than in PS patients (7.3±1.8 m/s vs 6.3±1.7 m/s, p=0.0232) and IMT was higher in PS compared with PI (552±69 µm vs 453±82 µm, p=0.0002). SI_DVP independently associated with age, PI, the lack of liver cirrhosis, and with Pseudomonas aeruginosa colonization. PS was the only independent correlate of IMT in CF.

CONCLUSIONS

PI patients are at risk of developing general arterial stiffness. PS may relate to carotid IMT thickening, which underscores the need for further study that could lead to reconsideration of dietary guidance in PS CF.

Ileal Lactase Expression Associates with Lactase Persistence Genotypes

(1) Background: Lactose digestion depends on persistence genotypes (including rs4988235), the frequency of which exhibits broad geographical variability. However, little is known about the relationship between lactase (LCT) genotypes and intestinal expression of LCT. We aimed to investigate ileal expression of LCT depending on main genetic polymorphisms (rs4988235, rs3754689, rs3739022), age, sex, smoking status, body mass index (BMI), and the expression of other genes; (2) Methods: phenotype, array-based genotype, and ileal mucosal biopsy expression data were obtained from the CEDAR study; (3) Results: analyses included 196 healthy Europeans (53.6% women) aged 53.0 ± 13.6 years with a mean BMI of 25.6 ± 4.2 kg/m², of whom 17.4% were smoking. Ileal LCT expression was mostly independent of age, sex, BMI, or smoking. Rs4988235 homozygous minor allele (GG) associated with lower LCT expression (vs. AG p = 2.2 × 10⁻⁶, vs. AA p = 1.1 × 10⁻⁷). Homozygous major allele of rs3754689 (GG) was related to higher LCT expression (vs. AG p = 1.7 × 10⁻⁵, vs. AA p = 0.0074). Rs3754689 genotype did not modify LCT expression (GG vs. AG p = 0.051) in rs4988235-heterozygous subgroup. Interestingly, CD14, which is a marker of monocytes and macrophages, was the strongest negative transcriptomic correlate of LCT expression (r = −0.57, p_FDR = 1.1 × 10⁻¹⁴); (4) Conclusions: both rs4988235 and rs3754689 associated with ileal LCT expression, which did not seem related to age, sex, smoking, or BMI. The inverse correlation between LCT and CD14 expression in the ileum is striking and requires further investigation.

The Effect of Sodium Butyrate Enemas Compared with Placebo on Disease Activity, Endoscopic Scores, and Histological and Inflammatory Parameters in Inflammatory Bowel Diseases: A Systematic Review of Randomised Controlled Trials

INTRODUCTION

Administration of butyrate enemas might improve the health status of patients with inflammatory bowel disease (IBD). However, the results seem equivocal. Therefore, this systematic review aimed to assess the effect of sodium butyrate enemas on disease activity index (DAI), endoscopic scores, as well as histological and inflammatory parameters in IBD patients.

METHODS

The PubMed, Scopus, Web of Science, and Cochrane databases were searched. Randomised controlled trials published in English that assessed the effect of butyrate enemas on DAI, clinical symptoms, inflammatory markers, as well as histological and endoscopic scores in patients with Crohn's disease (CD) and ulcerative colitis (UC) were included in the analysis.

RESULTS

Eight studies involving 227 UC patients were included in this analysis. Only one study reported significant differences in DAI between groups. Besides, butyrate treatment groups did not differ significantly from controls concerning the effect on endoscopic and histological scores. Moreover, butyrate enemas exerted a significant effect on few inflammatory parameters measured in colonic mucosal biopsies.

CONCLUSION

The current evidence is limited and does not support the application of butyrate enemas in UC. There are no reliable data regarding the efficacy of butyrate enemas in CD. The systematic review protocol was registered in the PROSPERO database (CRD42020163654).

Whole Blood Profiling of T-cell-Derived microRNA Allows the Development of Prognostic models in Inflammatory Bowel Disease

BACKGROUND

MicroRNAs [miRNAs] are cell-specific small non-coding RNAs that can regulate gene expression and have been implicated in inflammatory bowel disease [IBD] pathogenesis. Here we define the cell-specific miRNA profiles and investigate its biomarker potential in IBD.

METHODS

In a two-stage prospective multi-centre case control study, next generation sequencing was performed on a discovery cohort of immunomagnetically separated leukocytes from 32 patients (nine Crohn's disease [CD], 14 ulcerative colitis [UC], eight healthy controls) and differentially expressed signals were validated in whole blood in 294 patients [97 UC, 98 CD, 98 non-IBD, 1 IBDU] using quantitative PCR. Correlations were analysed with phenotype, including need for early treatment escalation as a marker of progressive disease using Cox proportional hazards.

RESULTS

In stage 1, each leukocyte subset [CD4+ and CD8+ T-cells and CD14+ monocytes] was analysed in IBD and controls. Three specific miRNAs differentiated IBD from controls in CD4+ T-cells, including miR-1307-3p [p = 0.01], miR-3615 [p = 0.02] and miR-4792 [p = 0.01]. In the extension cohort, in stage 2, miR-1307-3p was able to predict disease progression in IBD (hazard ratio [HR] 1.98, interquartile range [IQR]: 1.20-3.27; logrank p = 1.80 × 10-3), in particular CD [HR 2.81; IQR: 1.11-3.53, p = 6.50 × 10-4]. Using blood-based multimarker miRNA models, the estimated chance of escalation in CD was 83% if two or more criteria were met and 90% for UC if three or more criteria are met.

INTERPRETATION

We have identified and validated unique CD4+ T-cell miRNAs that are differentially regulated in IBD. These miRNAs may be able to predict treatment escalation and have the potential for clinical translation; further prospective evaluation is now indicated.

Whose Tweets on COVID-19 Gain the Most Attention: Celebrities, Political, or Scientific Authorities?

Twitter has considerable capacity for health education and proves to be an efficient and accessible communication tool in the coronavirus disease-19 (COVID-19) pandemic. Although many stakeholders saturate Twitter with COVID-19-related information, it remains unknown who disseminates information most efficaciously. COVID-19-related tweets were obtained from Twitter accounts of health agencies, governmental authorities, universities, scientific journals, medical associations, and celebrities. Posts' impact was measured with the nominal and relative (%followers) number of likes and retweets. A sentiment analysis was conducted.We have identified 17,331 COVID-19-related tweets posted by 338 accounts in >4 months since the virus began to spread. The largest number of likes was received by tweets of celebrities (median nominal, relative likes; 14,918, 0.036 percent), politicians (259, 0.174 percent), and health agencies (231, 0.007 percent). Most retweeted messages were also posted by celebrities (2,366, 0.005 percent), health agencies (130, 0.004 percent), and politicians (55, 0.041 percent). Retweets and likes peaked in March 2020, and the overall sentiment of the tweets was growing steadily. Whereas celebrities and politicians posted positive messages, the scientific and health authorities often employed a negative vocabulary. The posts with positive sentiment gained more likes and relative likes than nonpositive. During the pandemic, the tweets of celebrities and politicians related to COVID-19 outperform those coming from health and scientific institutions. Active engagement of Twitter influencers may help key messages go viral.

Infant formula fatty acid profile following microwave heating

Microwave heating of foods may alter their content. Yet, parents commonly heat infant formula in the microwave oven. The study aimed at understanding whether microwave heating of formula changes its fatty acid (FA) composition. Portions of infant formula were prepared and divided in three parts: control (sampled twice: at the start and after 30 minutes), microwave (sampled twice: after reaching 37°C and 50°C), and water bath (sampled twice: after reaching 37°C and 50°C). In thus obtained samples, a total profile of 25 FA was assessed using gas chromatography-mass spectrometry. Overall, fourteen portions were prepared, which were sampled 84 times yielding 2075 individual total FA level measurements. Few differences were identified between the microwave, control, and water bath groups. Microwave warming to 37°C was associated with increases of C12 (median increased by +0.40%, p = 0.0063), C14 (+0.05%, p = 0.0091), and C4 content (+6.90%, p = 0.0131). Microwaving up to 50°C slightly decreased C16:1trans (-5.00%, p = 0.0463) and C18:2trans1 (-5.13%, p = 0.0231). A paired comparison of pooled control and microwaved samples revealed increases in C12 (+0.18%, p = 0.0490) as well as a loss of C18:2trans1 (also -5.13%, p = 0.0073) and C18:2trans3 (-5.56%, p = 0.0042) after microwave treatment. C18:2trans1 (-2.63%, p = 0.0132) and C18:3trans1 (-2.26%, p = 0.0434) were lower in microwaved samples compared with the water bath. A slightly lower C18:2 content was found in the water bath samples than in the control groups (-0.11%, p = 0.0430). None of these differences would remain significant after a correction for multiple comparisons. Microwave heating of infant formula to 37°C or 50°C might marginally alter its total FA profile. Further studies are required to determine whether it alters the rate of free radical formation.

Cystic fibrosis dyslipidaemia: A cross-sectional study

BACKGROUND

The interest in cystic fibrosis (CF) dyslipidaemia as a potential risk factor for cardiovascular disease is increasing with patients' survival. This study aimed to investigate CF dyslipidaemia, its clinical correlates and links to oxidized low-density lipoprotein (oxLDL), adiponectin, and apolipoprotein E (APOE).

METHODS

This cross-sectional study assessed clinical characteristics of CF, as well as the serum lipid profile, oxLDL, adiponectin, and APOE.

RESULTS

In total, 108 CF subjects were enrolled in this study, with a median age of 22 years, BMI of 20.5 kg/m², FEV1% of 61%, of which 81% were pancreatic insufficient (PI). Healthy subjects (HS; n = 51) were in similar age. Hypocholesterolaemia occurred in 31% of CF subjects and in no HS. Hypertriglyceridaemia concerned 21% of patients (HS: 8%, p = .04), and low HDL-C 45% (HS: 6%, p < .0001). At least one of these three CF dyslipidaemia disturbances was present in 62% of CF subjects, but there were no significant differences in oxLDL, oxLDL/LDL-C ratio, adiponectin, and APOE between CF and HS groups. PI was independently associated with low total cholesterol, LDL-C, and non-high density lipoprotein cholesterol, with age and sex also modifying lipid levels. In CF (n = 42), triglycerides did not correlate with serum tumour necrosis factor α (TNF-α).

CONCLUSIONS

CF dyslipidaemia is highly prevalent and heterogenous. The lipid profile weakly associates with the clinical characteristics of CF as well as oxLDL, adiponectin, and APOE. Further research is needed, especially regarding HDL function in CF, the causes of hypertriglyceridaemia, and the value of essential fatty acid supplementation for CF dyslipidaemia.

CYP3A drug metabolism in the developmental age: recent advances

Background. The 3A subfamily of cytochrome P450 (CYP3A) accomplishes phase I metabolism for approximately half of the available medications. We aimed to review the recent advances in our understanding of CYP3A activity, which could apply to infants and toddlers.Material and Methods. A literature review.Results. The reviewed recent data cover: CYP3A7 expression and functions, changes of CYP3A4 function in the first two years of life, CYP3A intestinal metabolism and zonation, CYP3A metabolic programming, pediatric CYP3A pharmacogenetics, the impact of critical illness on CYP3A, phenotyping, and other clinical implications of a better comprehension of CYP3A biology.Conclusions. Although the knowledge of CYP3A enzymes has already changed pediatric practice, much more is to be expected in the upcoming years. The areas to watch include: endogenous markers for phenotyping, new CYP3A7 substrates and products, pharmacogenetic interactions with transporter genes for non‑immunomodulatory drugs, as well as interactions with microbiota and specific bioactive foodstuffs.

Mulberry leaf extract decreases digestion and absorption of starch in healthy subjects-A randomized, placebo-controlled, crossover study

PURPOSE

Mulberry (Morus alba L.) leaf tea has recently received much attention as a dietary supplement due to the wide range of putative health benefits, such as antidiabetic effects. Nevertheless, data evaluating its influence on carbohydrate metabolism in humans are scarce. The present study aims to investigate the effect of mulberry leaf extract supplementation on starch digestion and absorption in humans.

MATERIALS AND METHODS

The study comprised of 25 healthy subjects, aged 19-27 years. In all subjects, a starch ¹³C breath test was performed twice in a crossover and single blind design. Subjects were initially randomized to ingest naturally ¹³C-abundant cornflakes (50g cornflakes+100ml low fat milk) either with the mulberry leaf extract (36mg of active component-1-deoxynojirimycin) or the placebo and each subject received the opposite preparation one week later.

RESULTS

The cumulative percentage dose recovery was lower for the mulberry leaf extract test than for the placebo test (median [quartile distribution]: 13.9% [9.9-17.4] vs. 17.2% [13.3-20.6]; p=0.015). A significant decrease was detectable from minute 120 after the ingestion.

CONCLUSIONS

A single dose of mulberry leaf extract taken with a test meal decreases starch digestion and absorption. These findings could possibly be translated into everyday practice for improvement of postprandial glycemic control.

Gastroesophageal reflux is not associated with short-term variability of parasympathetic activity in children

PURPOSE

A lower parasympathetic activity was described in patients with the gastroesophageal reflux disease. We aimed to determine whether gastroesophageal reflux (GER) episodes are associated with a short-term parasympathetic tone variability in children.

METHODS

In order to address this question we performed simultaneous 24-h esophageal multichannel intraluminal impedance-pH and electrocardiographic monitoring in 16 children (age range 6-18 years), including 8 with asthma and 2 with gastroesophageal reflux disease. After describing duration, height, and acidity of 483 GER episodes we also measured parasympathetic-related heart rate variability parameters in 4 time periods: preceding, containing, following GER, and in-between GERs (control). High frequency (HF) power and root-mean square differences of successive R-R intervals (r-MSSD) were assessed in 2.5-min and 1-min periods, respectively.

RESULTS

We did not identify the searched short-term parasympathetic tone changes.

CONCLUSIONS

In conclusion, GER episodes and their characteristics were not associated with short-term variability of parasympathetic activity in children.

Lower diastolic blood pressure in healthy subjects with vitamin K deficiency: a preliminary cross-sectional study

Introduction. There is a growing body of evidence for the role of vitamin K in cardiovascular health. As a cofactor of carboxylation of the matrix Gla protein it prevents arterial calcification. However, the data on the relationship between vitamin K status and the blood pressure are scarce, and particularly so in persons without the burden of cardiovascular risk factors. Material and Methods. We performed a pilot cross-sectional study, in which we hypothesized that vitamin K deficiency is associated with a higher blood pressure in young, healthy people. The concentration of protein induced by vitamin K absence-II (PIVKA-II) larger than 2 ng/mL was chosen as a proxy for vitamin K deficiency; it was assessed in serum using ELISA. Blood pressure was measured using a validated, automated oscillometric monitor in triplicate.Results. Twenty-three healthy subjects were enrolled (16 female; mean age 21.3 ± 1.6 years; body mass index 20.6 ± 2.4 kg/m2). The diastolic blood pressure (DBP) was lower in vitamin K-deficient subjects (58 ± 9 vs. 67 ± 5 mmHg, p = 0.01). The mean arterial blood pressure also differed (75 ± 9 vs. 83 ± 6, p = 0.02). PIVKA-II levels correlated with DBP only (Pearson’s R = -0.41, p < 0.05; Spearman’s ? ns.). Stepwise regression identified PIVKA-II concentrations as the only independent parameter associated with DBP (adjusted R2 = 13.1%; PIVKA-II: ß = -0.41; 95%CI -1.87-(-0.00098), t = -2.08, p < 0.05).Conclusions. The relationship between vitamin K deficiency and low DBP in young adults should be investigated further.

Genetic variants and magnetic resonance imaging measures in multiple sclerosis: a systematic review

Introduction. Although environmental factors play the major role in the etiopathogenesis of multiple sclerosis (MS), genetic factors are implicated as well. We aimed to summarize the current knowledge on the relationship between genetic variants and magnetic resonance (MR) imaging measures in MS.Material and Methods. A systematic review. In December 2016, Scopus (since the year 1980; including MEDLINE) was searched for studies meeting predefined criteria designed to identify articles regarding: multiple sclerosis, genetic variants, and MR imaging. These were then analyzed to identify publications linking polymorphisms and MR findings.Results. The search yielded 290 items; 26 were included in the final analysis. Two genome-wide association studies (GWAS) and two projects employing panels of a few dozen of genes of interest provided most of the data. The other publications concerned no more than 5 genes at a time. Twenty studies reported positive findings. The relationship between HLA-DRB1*15:01 or BDNF rs6265 (Val66Met) and the radiologic course of MS was not consistent across the studies. An intersection of the results of the two GWAS yielded: OPCML (rs11223055), PTPRD (rs1953594), and WWOX (rs11150140, rs1116525) (brain atrophy) as well as CDH13 (rs692612) and PLCB1 (rs6118257) (lesion load).Conclusions. Genetic variants were shown to correlate with MS-related brain atrophy and lesion load. Further research in the field is required.

Lower diastolic blood pressure in healthy subjects with vitamin K deficiency: a preliminary cross-sectional study

Introduction. There is a growing body of evidence for the role of vitamin K in cardiovascular health. As a cofactor of carboxylation of the matrix Gla protein it prevents arterial calcification. However, the data on the relationship between vitamin K status and the blood pressure are scarce, and particularly so in persons without the burden of cardiovascular risk factors. Material and Methods. We performed a pilot cross‑sectional study, in which we hypothesized that vitamin K deficiency is associated with a higher blood pressure in young, healthy people. The concentration of protein induced by vitamin K absence‑II (PIVKA‑II) larger than 2 ng/mL was chosen as a proxy for vitamin K deficiency; it was assessed in serum using ELISA. Blood pressure was measured using a validated, automated oscillometric monitor in triplicate.Results. Twenty‑three healthy subjects were enrolled (16 female; mean age 21.3 ± 1.6 years; body mass index 20.6 ± 2.4 kg/m2). The diastolic blood pressure (DBP) was lower in vitamin K‑deficient subjects (58 ± 9 vs. 67 ± 5 mmHg, p = 0.01). The mean arterial blood pressure also differed (75 ± 9 vs. 83 ± 6, p = 0.02). PIVKA‑II levels correlated with DBP only (Pearson’s R = -0.41, p < 0.05; Spearman’s ρ ns.). Stepwise regression identified PIVKA‑II concentrations as the only independent parameter associated with DBP (adjusted R2 = 13.1%; PIVKA‑II: β = -0.41; 95%CI -1.87-(-0.00098), t = -2.08, p < 0.05).Conclusions. The relationship between vitamin K deficiency and low DBP in young adults should be investigated further.

Genetic variants and magnetic resonance imaging measures in multiple sclerosis: a systematic review

Introduction. Although environmental factors play the major role in the etiopathogenesis of multiple sclerosis (MS), genetic factors are implicated as well. We aimed to summarize the current knowledge on the relationship between genetic variants and magnetic resonance (MR) imaging measures in MS.Material and Methods. A systematic review. In December 2016, Scopus (since the year 1980; including MEDLINE) was searched for studies meeting predefined criteria designed to identify articles regarding: multiple sclerosis, genetic variants, and MR imaging. These were then analyzed to identify publications linking polymorphisms and MR findings.Results. The search yielded 290 items; 26 were included in the final analysis. Two genome‑wide association studies (GWAS) and two projects employing panels of a few dozen of genes of interest provided most of the data. The other publications concerned no more than 5 genes at a time. Twenty studies reported positive findings. The relationship between HLA‑DRB1*15:01 or BDNF rs6265 (Val66Met) and the radiologic course of MS was not consistent across the studies. An intersection of the results of the two GWAS yielded: OPCML (rs11223055), PTPRD (rs1953594), and WWOX (rs11150140, rs1116525) (brain atrophy) as well as CDH13 (rs692612) and PLCB1 (rs6118257) (lesion load).Conclusions. Genetic variants were shown to correlate with MS‑related brain atrophy and lesion load. Further research in the field is required.

Smaller Width of the Pancreatic Duct During Secretin-Enhanced Magnetic Resonance Cholangiopancreatography in Pancreatic-Sufficient Cystic Fibrosis Patients

OBJECTIVES

New tools are needed in cystic fibrosis (CF) diagnostics in pancreatic-sufficient CF (PS-CF) patients. Secretin-enhanced magnetic resonance cholangiopancreatography (SE-MRCP) allows for improved assessment of the width of the pancreatic duct.

METHODS

Sixteen PS-CF patients and 17 healthy volunteers underwent SE-MRCP. The width of the pancreatic duct in the head, the body, and the tail of the pancreas was measured at the baseline and 1, 2, 3, 5, and 10 minutes after secretin administration.

RESULTS

The width of the pancreatic duct in the head of the pancreas did not differ between the groups at the baseline; after 10 minutes of secretin stimulation, it was smaller in PS-CF patients (median, 1.4 mm [first-third quartile, 1.3-2.0] vs 2.2 mm [1.7-2.4], P = 0.008). The area under the curve for discrimination between the 2 groups using this parameter was 0.77 (95% confidence interval, 0.60-0.93).

CONCLUSIONS

The SE-MRCP identified differences in the width of the pancreatic duct between PS-CF and healthy volunteers. Further improvements of the method are needed to augment its clinical utility.

Optical Coherence Tomography of the Labial Salivary Glands Reveals Age-Related Differences in Women

The labial minor salivary glands (LSGs) play a role in medical research and practice due to their superficial location and involvement in both systemic and localized diseases. Swept-source optical coherence tomography (OCT) is a noninvasive modality that enables in vivo, micrometer resolution, wide-field three-dimensional imaging in seconds. A purpose-built swept-source OCT instrument was employed to acquire three-dimensional datasets covering the area of 2.43 cm(2) of the mucosa of the lower lip to the depth of 3.4 mm in young (n = 14; mean age ± SD: 27 ± 3 years; body mass index [BMI] 20.4 ± 2.3 kg/m(2) ) and middle-aged women (n = 11; 54 ± 6 years; 25.5 ± 3.2 kg/m(2) ). Glandular tissue reflectivity mode (range 0-255; 86 ± 17 vs. 68 ± 12, p = 0.005), average single LSG area in tissue sample (5.26 ± 2.62 mm(2) vs. 2.87 ± 1.26 mm(2) , p = 0.011), and LSG surface filling factor (0.23 ± 0.13 vs. 0.11 ± 0.10, p = 0.027) had higher values in younger than in middle-aged women. A correlation between BMI and glandular tissue reflectivity mode (Spearman's ρ = -0.60) was found (p = 0.002). The results highlight the potential value of LSGs' OCT morphometry in research regarding ageing.

Clinical outcomes of conjugated linoleic acid supplementation in the overweight and the obese: a study protocol

This is the protocol of a study aiming to assess the impact of conjugated linoleic acid (CLA) on body mass and composition, carbohydrate and fat digestion and absorption, total energy expenditure, lipid profile, polyunsaturated fatty acids levels, markers of endothelial dysfunction and mineral status in humans. Seventy-four adult volunteers (BMI ? 25 kg/m2) will be randomized to receive 3.0 g of 80% CLA (50:50 cis-9, trans-11 and trans-10, cis-12 isomers) or 3.0 g of linoleic acid daily for 3 months. A range of parameters will be measured at baseline and after the intervention.

The role of Toll-like receptors and vitamin D in diabetes mellitus type 1--a review

It is widely accepted that type 1 diabetes mellitus (T1DM) is an autoimmune disease resulting from an interaction between immunologic, genetic and environmental factors. However, the exact mechanism leading to the development of T1DM remains incomplete. There is a large body of evidence pointing towards the important role of toll-like receptor (TLR) activation and vitamin D deficiency in T1DM pathogenesis. In this article, we review the available data on the influence of TLRs' level of activation and vitamin D status on the risk of the development of T1DM in humans and rodent models. We also summarize the current information regarding the interactions between TLRs' level of activation, vitamin D status and various environmental factors, such as enteroviral infections, the gut microbiota and breastfeeding substitution, among others. Our results stipulate that vitamin D seems to protect against T1DM by reducing the TLRs' level of activation.