Effects of metformin on autoimmune immunoglobins and interferon-γ in patients with early diagnosed pemphigus vulgaris: a prospective clinical trial

The management of pemphigus vulgaris (PV) is challenging. This study aimed to evaluate the immunomodulating effects of metformin on PV. The study was conducted in two phases: in the first phase, patients received routine first-line treatment (prednisolone plus azathioprine) for 2 months, then in the second phase, metformin was added to this regimen for another 2 months. After addition of metformin to the first-line medications, significant reductions were seen in serum IgG1 (reduced from 534.92 ± 134.83 mg/dL to 481.58 ± 130.46 mg/dL, P < 0.001), IgG4 (51.83 ± 27.26 mg/dL to 44.50 ± 26.05 mg/dL, P < 0.001) and interferon-γ (277.99 ± 108.71 pg/mL to 45.05 ± 17.080 pg/mL, P = 0.03) concentrations. The suppressant effect of metformin was greatest on IgG4 (coefficient of variation 1.28), the dominant subclass of IgG involved in PV. Metformin could have immunomodulating effects on PV with controlling effects on steroid complications.

Characteristics of Clostridioides difficile colonization in Ilamian children

Background

The increasing colonization with Clostridioides difficile in paediatric hospitalized population is a well known event; however, its prevalence in Iranian children has not effectively been identified yet.

Objective

The objective of this study was to determine the intestinal-carriage rates of C. difficile and molecular characterization of C. difficile in the Ilamian pediatric population from May 22, 2018, until September 22, 2018.

Materials and Methods

Eighty samples were obtained from 40 children aged <5 years, at day 0 of their hospitalization (N=40 samples), to determine community-associated colonization, and then at day 5 days after hospitalization (N=40 samples), to determine healthcare associated colonization. The stool samples were examined for C. difficile, and isolated strains were evaluated for production of Clostridial toxins A/B and molecular characterizations.

Results

The colonization rates of C. difficile and toxigenic C. difficile were 10% (8/80) and 3.75% (3/80), respectively. Based on the age group, the intestinal-carriage rates of C. difficile were 37.5, 50, and 12.5% in children ≤ 1, 1-3, and 3-5 years old, respectively. Our findings have revealed eight distinct ribotypes. Our findings have revealed eight distinct ribotypes of C. difficile isolates. Three out of 8 (37.5%) of C. difficile isolates were considered as community-associated colonization and belonged to ribotypes 7, 8, and 9. Conclusion. Our findings suggest the need of confirmation by further epidemiological studies in Iranian children. Given that the 37.5% of cases observed were community-associated, estimates of the incidence of C. difficile infections, that include only hospitalized children, may largely underestimate the burden of disease in children.

Extraction of glycogen on mild condition lacks AIG fraction

OBJECTIVE

Extraction of animal tissues with cold water or perchloric acid yields less glycogen than is obtained with hot-alkaline. Extraction with acid and alkaline gives two fractions, acid soluble (ASG) and insoluble glycogen (AIG). The aim of this work is to examine the hypothesis that not all liver glycogen is extractable by Tris-buffer using current techniques.

MATERIALS AND METHODS

Rat liver was homogenized with Tris-buffer pH 8.3 and extracted for the glycogen fractions, ASG and AIG. The degree of homogenization was changed to remove all glycogen.

RESULTS

The content of glycogen was 47.7 ± 1.2 and 11.6 ± 0.8 mg/g wet liver in the supernatant and pellet of the first extraction respectively. About 24% of total glycogen is lost through the first pellet. Increasing the extent of homogenization from 30 to 180 sec and from 15000 to 20000 rpm followed with 30 sec ultrasonication did not improve the extraction. ASG and AIG constitute about 77% and 23% of the pellet glycogen respectively.

CONCLUSIONS

Extraction with cold Tris-buffer failed to extract glycogen completely.  Increasing the extent of homogenization followed with ultrasonication also did not improve the extraction. Thus it is necessary to re-examine the previous findings obtained by extraction with cold Tris-buffer.