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Szederkényi G, Kocsis D, Vághy MA, Czárán D, Sasvári P, Lengyel M, Naszlady MB, Kreis F, Antal I, Csépányi-Kömi R, Erdő F. Mathematical modeling of transdermal delivery of topical drug formulations in a dynamic microfluidic diffusion chamber in health and disease. PLoS One 2024; 19:e0299501. [PMID: 38603673 PMCID: PMC11008853 DOI: 10.1371/journal.pone.0299501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/09/2024] [Indexed: 04/13/2024] Open
Abstract
Mathematical models of epidermal and dermal transport are essential for optimization and development of products for percutaneous delivery both for local and systemic indication and for evaluation of dermal exposure to chemicals for assessing their toxicity. These models often help directly by providing information on the rate of drug penetration through the skin and thus on the dermal or systemic concentration of drugs which is the base of their pharmacological effect. The simulations are also helpful in analyzing experimental data, reducing the number of experiments and translating the in vitro investigations to an in-vivo setting. In this study skin penetration of topically administered caffeine cream was investigated in a skin-on-a-chip microfluidic diffusion chamber at room temperature and at 32°C. Also the transdermal penetration of caffeine in healthy and diseased conditions was compared in mouse skins from intact, psoriatic and allergic animals. In the last experimental setup dexamethasone, indomethacin, piroxicam and diclofenac were examined as a cream formulation for absorption across the dermal barrier. All the measured data were used for making mathematical simulation in a three-compartmental model. The calculated and measured results showed a good match, which findings indicate that our mathematical model might be applied for prediction of drug delivery through the skin under different circumstances and for various drugs in the novel, miniaturized diffusion chamber.
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Affiliation(s)
- Gábor Szederkényi
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
- Systems and Control Laboratory, HUN-REN Institute for Computer Science and Control (SZTAKI), Budapest, Hungary
| | - Dorottya Kocsis
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | - Mihály A. Vághy
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | - Domonkos Czárán
- Department of Physiology, Semmelweis University, Budapest, Hungary
| | - Péter Sasvári
- Department of Physiology, Semmelweis University, Budapest, Hungary
| | - Miléna Lengyel
- Department of Pharmaceutics, Semmelweis University, Budapest, Hungary
| | - Márton Bese Naszlady
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | - Fabiola Kreis
- Department of Physiology, Semmelweis University, Budapest, Hungary
| | - István Antal
- Department of Pharmaceutics, Semmelweis University, Budapest, Hungary
| | | | - Franciska Erdő
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
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Ponmozhi J, Dhinakaran S, Kocsis D, Iván K, Erdő F. Models for barrier understanding in health and disease in lab-on-a-chips. Tissue Barriers 2024; 12:2221632. [PMID: 37294075 PMCID: PMC11042069 DOI: 10.1080/21688370.2023.2221632] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/31/2023] [Indexed: 06/10/2023] Open
Abstract
The maintenance of body homeostasis relies heavily on physiological barriers. Dysfunction of these barriers can lead to various pathological processes, including increased exposure to toxic materials and microorganisms. Various methods exist to investigate barrier function in vivo and in vitro. To investigate barrier function in a highly reproducible manner, ethically, and high throughput, researchers have turned to non-animal techniques and micro-scale technologies. In this comprehensive review, the authors summarize the current applications of organ-on-a-chip microfluidic devices in the study of physiological barriers. The review covers the blood-brain barrier, ocular barriers, dermal barrier, respiratory barriers, intestinal, hepatobiliary, and renal/bladder barriers under both healthy and pathological conditions. The article then briefly presents placental/vaginal, and tumour/multi-organ barriers in organ-on-a-chip devices. Finally, the review discusses Computational Fluid Dynamics in microfluidic systems that integrate biological barriers. This article provides a concise yet informative overview of the current state-of-the-art in barrier studies using microfluidic devices.
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Affiliation(s)
- J. Ponmozhi
- Microfluidics Laboratory, Department of Mechanical Engineering, IPS Academy-Institute of Engineering Science, Indore, India
| | - S. Dhinakaran
- The Centre for Fluid Dynamics, Department of Mechanical Engineering, Indian Institute of Technology Indore, Indore, India
| | - Dorottya Kocsis
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | - Kristóf Iván
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | - Franciska Erdő
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
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Asbóth D, Bánfi B, Kocsis D, Erdő F. Rodent models of dermatological disorders. Ital J Dermatol Venerol 2024:S2784-8671.23.07700-9. [PMID: 38287740 DOI: 10.23736/s2784-8671.23.07700-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
To assess the possible beneficial effects of drugs and drug candidates, different dermatological disease models are available in rodents. These models are able to mimic one or more characteristic features of the disorders, but not completely recapitulate the pathogenesis of the human skin diseases. Therefore, to improve the technology many new models have been developed both by genetic engineering and by chemical or physical induction. Currently the in vivo rodent models provide the physiologically most relevant approach to produce the pathology related to the majority of dermatological diseases. In this short review some widely used animal techniques (psoriasis, allergic contact dermatitis, atopic dermatitis, wound healing, melanoma and non-melanoma type skin cancers and UV erythema) are shown which are currently applied in pharmacological, pharmacokinetic, pharmaceutical and dermatological research. First the main points of the human pathomechanism are shown and afterwards the rodent models are briefly discussed. Finally critical evaluation is provided by the authors. However, according to the 3R rule the number of experimental animals is strongly suggested to be reduced, therefore the advanced in vitro and ex vivo techniques become more and more important contrary to in vivo preclinical methods also in dermatological research. As it is described in the outlook section, although the 2D/3D in vitro and skin on-a-chip techniques are promising and have many advantages they are not able to completely substitute the animal models in their vascular, immunological, secretory and neural complexity.
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Affiliation(s)
- Dorottya Asbóth
- Pediatric Dermatology Center, Szent János Center Hospital in North Buda, Budapest, Hungary
| | - Barnabás Bánfi
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
- Faculty of Science, Eötvös Loránd University, Budapest, Hungary
| | - Dorottya Kocsis
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | - Franciska Erdő
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary -
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Kocsis D, Varga PR, Keshwan R, Nader M, Lengyel M, Szabó P, Antal I, Kánai K, Keglevich G, Erdő F. Transdermal Delivery of α-Aminophosphonates as Semisolid Formulations-An In Vitro-Ex Vivo Study. Pharmaceutics 2023; 15:pharmaceutics15051464. [PMID: 37242706 DOI: 10.3390/pharmaceutics15051464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
α-Aminophosphonates are organophosphorus compounds with an obvious similarity with α-amino acids. Owing to their biological and pharmacological characteristics, they have attracted the attention of many medicinal chemists. α-Aminophosphonates are known to exhibit antiviral, antitumor, antimicrobial, antioxidant and antibacterial activities, which can all be important in pathological dermatological conditions. However, their ADMET properties are not well studied. The aim of the current study was to provide preliminary information about the skin penetration of three preselected α-aminophosphonates when applying them as topical cream formulations in static and dynamic diffusion chambers. The results indicate that aminophosphonate 1a, without any substituent in the para position, shows the best release from the formulation and the highest absorption through the excised skin. However, based on our previous study, the in vitro pharmacological potency was higher in the case of para-substituted molecules 1b and 1c. The particle size and rheological studies revealed that the 2% cream of aminophosphonate 1a was the most homogenous formulation. In conclusion, the most promising molecule was 1a, but further experiments are proposed to uncover the possible transporter interactions in the skin, optimize the topical formulations and improve PK/PD profiles in case of transdermal delivery.
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Affiliation(s)
- Dorottya Kocsis
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary
| | - Petra Regina Varga
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics, H-1521 Budapest, Hungary
| | - Rusul Keshwan
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary
| | - Mina Nader
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary
| | - Miléna Lengyel
- Department of Pharmaceutics, Semmelweis University, H-1092 Budapest, Hungary
| | - Pál Szabó
- Centre for Structural Study, Research Centre for Natural Sciences, H-1117 Budapest, Hungary
| | - István Antal
- Department of Pharmaceutics, Semmelweis University, H-1092 Budapest, Hungary
| | - Károly Kánai
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics, H-1521 Budapest, Hungary
| | - György Keglevich
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics, H-1521 Budapest, Hungary
| | - Franciska Erdő
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary
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Lunter D, Klang V, Kocsis D, Varga-Medveczky Z, Berkó S, Erdő F. Novel aspects of Raman spectroscopy in skin research. Exp Dermatol 2022; 31:1311-1329. [PMID: 35837832 PMCID: PMC9545633 DOI: 10.1111/exd.14645] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/07/2022] [Accepted: 07/12/2022] [Indexed: 11/27/2022]
Abstract
The analytical technology of Raman spectroscopy has an almost 100‐year history. During this period, many modifications and developments happened in the method like discovery of laser, improvements in optical elements and sensitivity of spectrometer and also more advanced light detection systems. Many types of the innovative techniques appeared (e.g. Transmittance Raman spectroscopy, Coherent Raman Scattering microscopy, Surface‐Enhanced Raman scattering and Confocal Raman spectroscopy/microscopy). This review article gives a short description about these different Raman techniques and their possible applications. Then, a short statistical part is coming about the appearance of Raman spectroscopy in the scientific literature from the beginnings to these days. The third part of the paper shows the main application options of the technique (especially confocal Raman spectroscopy) in skin research, including skin composition analysis, drug penetration monitoring and analysis, diagnostic utilizations in dermatology and cosmeto‐scientific applications. At the end, the possible role of artificial intelligence in Raman data analysis and the regulatory aspect of these techniques in dermatology are briefly summarized. For the future of Raman Spectroscopy, increasing clinical relevance and in vivo applications can be predicted with spreading of non‐destructive methods and appearance with the most advanced instruments with rapid analysis time.
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Affiliation(s)
- Dominique Lunter
- University of Tübingen, Department of Pharmaceutical Technology, Institute of Pharmacy and Biochemistry, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Victoria Klang
- University of Vienna, Department of Pharmaceutical Sciences, Division of Pharmaceutical Technology and Biopharmaceutics, Faculty of Life Sciences, Vienna, Austria
| | - Dorottya Kocsis
- Pázmány Péter Catholic University, Faculty of Information Technology and Bionics, Budapest, Hungary
| | - Zsófia Varga-Medveczky
- Pázmány Péter Catholic University, Faculty of Information Technology and Bionics, Budapest, Hungary
| | - Szilvia Berkó
- University of Szeged, Faculty of Pharmacy, Institute of Pharmaceutical Technology and Regulatory Affairs, Szeged, Hungary
| | - Franciska Erdő
- Pázmány Péter Catholic University, Faculty of Information Technology and Bionics, Budapest, Hungary.,University of Tours EA 6295 Nanomédicaments et Nanosondes, Tours, France
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Kocsis D, Klang V, Schweiger EM, Varga-Medveczky Z, Mihály A, Pongor C, Révész Z, Somogyi Z, Erdő F. Characterization and ex vivo evaluation of excised skin samples as substitutes for human dermal barrier in pharmaceutical and dermatological studies. Skin Res Technol 2022; 28:664-676. [PMID: 35726964 PMCID: PMC9907592 DOI: 10.1111/srt.13165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 05/03/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Excised animal and human skins are frequently used in permeability testing in pharmaceutical research. Several factors exist that may have influence on the results. In the current study some of the skin parameters that may affect drug permeability were analysed for human, mouse, rat and pig skin. MATERIALS AND METHODS Classic biophysical skin parameters were measured (e.g. pH, hydration, permittivity, transepidermal water loss). Physiological characteristics of the skins were also analysed by confocal Raman spectroscopy, scanning electron microscopy and two-photon microscopy. RESULTS Based on biophysical testing, skin barrier function was damaged in psoriatic mouse skin and in marketed pig skin. Hydration and pH values were similar among the species, but freezing and thawing reduced the water content of the skins and shifted the surface pH to acidic. Aging reduced hydration and permittivity, resulting in impaired barrier function. Mechanical sensitization used in permeability studies resulted in proportional thinning of dead epidermis. DISCUSSION Results indicate that depending on the scientific question it should be considered whether fresh or frozen tissue is used, and for certain purposes rodent skins are well usable. The structure of the skin tissue (ceramide, cholesterol, keratin, natural moisturizing factor or urea) is similar in rats and mice, but due to the higher skin thickness the lipid distribution is different in porcine skin. Psoriasis led to irregular chemical composition of the skin. CONCLUSION A comprehensive evaluation of skin samples of four species was performed. The biophysical and microscopic observations should be considered when selecting drug penetration models and experimental conditions.
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Affiliation(s)
- Dorottya Kocsis
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | - Victoria Klang
- Department of Pharmaceutical Sciences, Division of Pharmaceutical Technology and Biopharmaceutics, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Eva-Maria Schweiger
- Department of Pharmaceutical Sciences, Division of Pharmaceutical Technology and Biopharmaceutics, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Zsófia Varga-Medveczky
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | - Anna Mihály
- Institute of Experimental Medicine, H-1094, Budapest, Hungary
| | - Csaba Pongor
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | | | - Zoltán Somogyi
- Department of Pharmacology and Toxicology, University of Veterinary Medicine, Budapest, Hungary
| | - Franciska Erdő
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
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Varga-Medveczky Z, Kocsis D, Naszlady MB, Fónagy K, Erdő F. Skin-on-a-Chip Technology for Testing Transdermal Drug Delivery-Starting Points and Recent Developments. Pharmaceutics 2021; 13:1852. [PMID: 34834264 PMCID: PMC8619496 DOI: 10.3390/pharmaceutics13111852] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/18/2021] [Accepted: 10/27/2021] [Indexed: 01/22/2023] Open
Abstract
During the last decades, several technologies were developed for testing drug delivery through the dermal barrier. Investigation of drug penetration across the skin can be important in topical pharmaceutical formulations and also in cosmeto-science. The state-of- the-art in the field of skin diffusion measurements, different devices, and diffusion platforms used, are summarized in the introductory part of this review. Then the methodologies applied at Pázmány Péter Catholic University are shown in detail. The main testing platforms (Franz diffusion cells, skin-on-a-chip devices) and the major scientific projects (P-glycoprotein interaction in the skin; new skin equivalents for diffusion purposes) are also presented in one section. The main achievements of our research are briefly summarized: (1) new skin-on-a-chip microfluidic devices were validated as tools for drug penetration studies for the skin; (2) P-glycoprotein transport has an absorptive orientation in the skin; (3) skin samples cannot be used for transporter interaction studies after freezing and thawing; (4) penetration of hydrophilic model drugs is lower in aged than in young skin; (5) mechanical sensitization is needed for excised rodent and pig skins for drug absorption measurements. Our validated skin-on-a-chip platform is available for other research groups to use for testing and for utilizing it for different purposes.
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Affiliation(s)
| | | | | | | | - Franciska Erdő
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary; (Z.V.-M.); (D.K.); (M.B.N.); (K.F.)
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Bajza Á, Kocsis D, Berezvai O, Laki AJ, Lukács B, Imre T, Iván K, Szabó P, Erdő F. Verification of P-Glycoprotein Function at the Dermal Barrier in Diffusion Cells and Dynamic "Skin-On-A-Chip" Microfluidic Device. Pharmaceutics 2020; 12:E804. [PMID: 32854319 PMCID: PMC7559210 DOI: 10.3390/pharmaceutics12090804] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/19/2020] [Accepted: 08/21/2020] [Indexed: 01/05/2023] Open
Abstract
The efficacy of transdermal absorption of drugs and the irritation or corrosion potential of topically applied formulations are important areas of investigation in pharmaceutical, military and cosmetic research. The aim of the present experiments is to test the role of P-glycoprotein in dermal drug delivery in various ex vivo and in vitro platforms, including a novel microchip technology developed by Pázmány Péter Catholic University. A further question is whether the freezing of excised skin and age have any influence on P-glycoprotein-mediated dermal drug absorption. Two P-glycoprotein substrate model drugs (quinidine and erythromycin) were investigated via topical administration in diffusion cells, a skin-on-a-chip device and transdermal microdialysis in rat skin. The transdermal absorption of both model drugs was reduced by P-glycoprotein inhibition, and both aging and freezing increased the permeability of the tissues. Based on our findings, it is concluded that the process of freezing leads to reduced function of efflux transporters, and increases the porosity of skin. P-glycoprotein has an absorptive orientation in the skin, and topical inhibitors can modify its action. The defensive role of the skin seems to be diminished in aged individuals, partly due to reduced thickness of the dermis. The novel microfluidic microchip seems to be an appropriate tool to investigate dermal drug delivery.
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Affiliation(s)
- Ágnes Bajza
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary; (Á.B.); (D.K.); (O.B.); (A.J.L.); (K.I.)
| | - Dorottya Kocsis
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary; (Á.B.); (D.K.); (O.B.); (A.J.L.); (K.I.)
| | - Orsolya Berezvai
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary; (Á.B.); (D.K.); (O.B.); (A.J.L.); (K.I.)
- Faculty of Chemical Technology and Biotechnology, Budapest University of Technology and Economics, Műegyetem rkp. 3., H-1111 Budapest, Hungary
| | - András József Laki
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary; (Á.B.); (D.K.); (O.B.); (A.J.L.); (K.I.)
- Department of Biophysics and Radiation Biology, Semmelweis University, Tűzoltó u. 37-47, H-1094 Budapest, Hungary
| | - Bence Lukács
- MedRes Medical Research Engineering Ltd., Albert Flórián út 3/b, H-1097 Budapest, Hungary; or
| | - Tímea Imre
- Research Centre for Natural Sciences, Instrumentation Centre, Magyar tudósok körútja 2, H-1117 Budapest, Hungary; (T.I.); (P.S.)
| | - Kristóf Iván
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary; (Á.B.); (D.K.); (O.B.); (A.J.L.); (K.I.)
| | - Pál Szabó
- Research Centre for Natural Sciences, Instrumentation Centre, Magyar tudósok körútja 2, H-1117 Budapest, Hungary; (T.I.); (P.S.)
| | - Franciska Erdő
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary; (Á.B.); (D.K.); (O.B.); (A.J.L.); (K.I.)
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Lukács B, Bajza Á, Kocsis D, Csorba A, Antal I, Iván K, Laki AJ, Erdő F. Skin-on-a-Chip Device for Ex Vivo Monitoring of Transdermal Delivery of Drugs-Design, Fabrication, and Testing. Pharmaceutics 2019; 11:pharmaceutics11090445. [PMID: 31480652 PMCID: PMC6781558 DOI: 10.3390/pharmaceutics11090445] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 12/24/2022] Open
Abstract
To develop proper drug formulations and to optimize the delivery of their active ingredients through the dermal barrier, the Franz diffusion cell system is the most widely used in vitro/ex vivo technique. However, different providers and manufacturers make various types of this equipment (horizontal, vertical, static, flow-through, smaller and larger chambers, etc.) with high variability and not fully comparable and consistent data. Furthermore, a high amount of test drug formulations and large size of diffusion skin surface and membranes are important requirements for the application of these methods. The aim of our study was to develop a novel Microfluidic Diffusion Chamber device and compare it with the traditional techniques. Here the design, fabrication, and a pilot testing of a microfluidic skin-on-a chip device are described. Based on this chip, further developments can also be implemented for industrial purposes to assist the characterization and optimization of drug formulations, dermal pharmacokinetics, and pharmacodynamic studies. The advantages of our device, beside the low costs, are the small drug and skin consumption, low sample volumes, dynamic arrangement with continuous flow mimicking the dermal circulation, as well as rapid and reproducible results.
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Affiliation(s)
- Bence Lukács
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary
| | - Ágnes Bajza
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary
| | - Dorottya Kocsis
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary
| | - Attila Csorba
- Biological Research Center, Hungarian Academy of Sciences, Temesvári krt. 62, H-6726 Szeged, Hungary
| | - István Antal
- Department of Pharmaceutics, Semmelweis University, Hőgyes Endre u. 7, H-1092 Budapest, Hungary
| | - Kristóf Iván
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary
| | - András József Laki
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary
- Department of Biophysics and Radiation Biology, Semmelweis University, Tűzoltó u. 37-47. H-1094 Budapest, Hungary
| | - Franciska Erdő
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50a, H-1083 Budapest, Hungary.
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Bajor J, Szakács Z, Juhász M, Papp M, Kocsis D, Szegedi É, Földi I, Farkas N, Hegyi P, Vincze Á. HLA-DQ2 homozygosis increases tTGA levels at diagnosis but does not influence the clinical phenotype of coeliac disease: A multicentre study. Int J Immunogenet 2019; 46:74-81. [PMID: 30779476 DOI: 10.1111/iji.12415] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 01/03/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Magnitude of gluten-specific T-cell responses in coeliac disease (CD) might be dependent on HLA-DQ2 gene dose. We aimed to investigate the effects of HLA-DQB1*02 allele dose on clinical outcomes. METHODS We reviewed the charts of all coeliac patients attending to three Hungarian university clinics after 1997 and included those patients, who (a) were diagnosed with CD, (b) underwent high-resolution HLA typing and (c) were ≥18 years at the time of data collection. HLA typing was performed to determine DQB1*02 allele dose. Patients were divided into risk groups by DQB1*02 allele dose, as follows: high-, intermediate- and low-risk groups corresponded to a double, single and zero doses, respectively. We used ANOVA and Pearson's chi-squared test to explore association between HLA risk and clinical variables. RESULTS A total of 727 coeliac patients attended the clinics but only 105 (14.4%) patients were eligible for inclusion. High, intermediate and low HLA risk patients comprised 35.3%, 52.3% and 12.3% of the study population, respectively. Double dose of HLA-DQB1*02 was more frequent in patient with high tTGA level (>10 times the upper limit of normal; p = 0.045). Gene dose was not associated with younger age at diagnosis (p = 0.549), gender (p = 0.739), more severe diagnostic histology (p = 0.318), more frequent classical presentation (p = 0.846), anaemia (p = 0.611), metabolic bone disease (p = 0.374), dermatitis herpetiformis (p = 0.381) and autoimmune diseases (p = 0.837). CONCLUSIONS Our study shows a significant gene dose effect in terms of tTGA level at diagnosis, but no significant association between HLA-DQB1*02 allele dose and the clinical outcomes in CD.
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Affiliation(s)
- Judit Bajor
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Zsolt Szakács
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Márk Juhász
- Department of Internal Medicine, St. Margit Hospital, Budapest, Hungary
| | - Mária Papp
- Department of Internal Medicine, Division of Gastroenterology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Dorottya Kocsis
- Second Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Éva Szegedi
- Department of Interventional Gastroenterology, National Institute of Oncology, Budapest, Hungary
| | - Ildikó Földi
- Department of Internal Medicine, Division of Gastroenterology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Nelli Farkas
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary.,Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,Hungarian Academy of Sciences, Momentum Gastroenterology Multidisciplinary Research Group, University of Szeged, Szeged, Hungary
| | - Áron Vincze
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
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Bors L, Bajza Á, Kocsis D, Erdő F. Koffein: hagyományos és új terápiás indikációk, valamint felhasználás dermatológiai modellvegyületként. Orv Hetil 2018; 159:384-390. [DOI: 10.1556/650.2018.30993] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract: Coffee consumption had already been described in the 15th century. The spreading of coffee drinking was not only a consequence of its delicious aromatic taste, but also of its pharmacological effects, especially due to its caffeine content. In this review, the mechanisms behind its complex stimulatory effects and the latest studies on the possible new therapeutic indications of caffeine are summarized. Several papers reported the neuroprotective (in Alzheimer’s and Parkinson’s disease) and hepatoprotective profiles of caffeine, and we show the most promising new results about its preventive properties in dermal malignancies. These findings were described both in cell cultures and in vivo. The application of caffeine and coffee in cosmetology and dermatological products is based on their antioxidant property and on the above-mentioned beneficial effects. Caffeine is also presented here as a dermatological model drug due to its hydrophilic profile. It can be used for designing and comparing different novel drug formulations, although beside the transcellular route, the follicular and transappendageal pathways play also important roles in its skin penetration. Taken together, caffeine molecule has many recently discovered beneficial pharmacological effects, but one should be careful with its excessive consumption. It can result in several adverse events if overdosed and in case of regular intake of high doses, after abandonment, withdrawal symptoms may appear. Orv Hetil. 2018; 159(10): 384–390.
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Affiliation(s)
- Luca Bors
- Információs Technológiai és Bionikai Kar, Pázmány Péter Katolikus Egyetem Budapest, Práter u. 50/A, 1083
| | - Ágnes Bajza
- Információs Technológiai és Bionikai Kar, Pázmány Péter Katolikus Egyetem Budapest, Práter u. 50/A, 1083
| | - Dorottya Kocsis
- Információs Technológiai és Bionikai Kar, Pázmány Péter Katolikus Egyetem Budapest, Práter u. 50/A, 1083
| | - Franciska Erdő
- Információs Technológiai és Bionikai Kar, Pázmány Péter Katolikus Egyetem Budapest, Práter u. 50/A, 1083
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Kocsis D, Herszényi L, Tóth M, Tulassay Z, Juhász M. Celiac Disease Associated with Facioscapulohumeral Muscular Dystrophy. IJCD 2016; 3:162-164. [DOI: 10.12691/ijcd-3-4-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
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Lorinczy K, Juhász M, Csontos Á, Fekete B, Terjék O, Lakatos PL, Miheller P, Kocsis D, Kárpáti S, Tulassay Z, Zágoni T. Does dermatitis herpetiformis result in bone loss as coeliac disease does? A cross sectional study. Rev Esp Enferm Dig 2016; 105:187-93. [PMID: 23859446 DOI: 10.4321/s1130-01082013000400002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
INTRODUCTION AND OBJECTIVES coeliac disease (CD) and its cutaneous manifestation, dermatitis herpetiformis are both (DH) gluten-sensitive diseases. Metabolic bone disease is common among patients with CD, even in asymptomatic forms. Data are scarce about bone density in patients with dermatitis herpetiformis. The aim of our study was to compare bone mineral density (BMD) of celiac and dermatitis herpetiformis patients. METHODS 34 coeliac patients, 53 with dermatitis herpetiformis and 42 healthy controls were studied. The mean age was 38.0 +/- 12.1, 32.18 +/- 14.95, 35.33 +/- 10.41 years in CD, dermatitis herpetiformis, and healthy controls, respectively. Bone mineral density of the lumbar spine, the left femoral neck and radius were measured by dual-energy X-ray absorptiometry. Low bone density, osteopenia and osteoporosis were defined as a body mass density (BMD) T-score between 0 and -1, between -1 and -2.5, and under -2.5, respectively. RESULTS at lumbar region, consisting of dominantly trabecular compartment, a decreased BMD was detected in 49 % (n = 26) patients with dermatitis herpetiformis, 62 % (n = 21) of CD patients, and 29 % (n = 12) of healthy controls, respectively. Lower BMD were measured at the lumbar region in dermatitis herpetiformis and CD compared to healthy subjects (0.993 +/- 0.136 g/cm2 and 0.880 +/- 0.155 g/cm2 vs. 1.056 +/- 0.126 g/cm2; p < 0.01). Density of bones consisting of dominantly cortical compartment (femoral neck) did not differ in dermatitis herpetiformis and healthy subjects. CONCLUSIONS our results show that a low bone mass is also frequent among patients with dermatitis herpetiformis. Bone mineral content in these patients is significantly lower in those parts of the skeleton which contain more trabecular than cortical bone.
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Béres NJ, Szabó D, Kocsis D, Szűcs D, Kiss Z, Müller KE, Lendvai G, Kiss A, Arató A, Sziksz E, Vannay Á, Szabó AJ, Veres G. Role of Altered Expression of miR-146a, miR-155, and miR-122 in Pediatric Patients with Inflammatory Bowel Disease. Inflamm Bowel Dis 2016; 22:327-35. [PMID: 26752469 DOI: 10.1097/mib.0000000000000687] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Evidence suggests the central role of tumor necrosis factor (TNF)-α in the pathomechanism of inflammatory bowel disease (IBD); however, its effect on epigenetic factors, including small non-coding microRNAs (miRs), is less known. Our present aim was the comparative investigation of the expression of TNF-α and immune response-related miRs in children with Crohn's disease (CD) and ulcerative colitis (UC). METHODS Fresh-frozen (FF) and formalin-fixed, paraffin-embedded (FFPE) biopsies were used to analyze the expression of miR-146a, -155, -122, and TNF-α by real-time reverse transcription polymerase chain reaction in macroscopically inflamed (CD: 12 FFPE and 24 FF; UC: 10 FF) and intact (CD: 12 FFPE; 14 FF) colonic biopsies of children with IBD and controls (16 FFPE; 23 FF). The expression of miR-146a, -155, and -122 was also determined in TNF-α-treated HT-29 colonic epithelial cells. RESULTS Increased expression of TNF-α was observed in the colonic mucosa of children with CD and UC in comparison with controls. Expression of miR-146a and -155 was higher in the inflamed mucosa of children with CD and UC than in the intact mucosa. Expression of miR-122 elevated in the macroscopically intact colonic regions of CD compared with controls and patients with UC. In HT-29 cells, TNF-α treatment increased the expression of miR-146a and -155, but not that of miR-122. CONCLUSIONS Our results showed altered expression of miR-146a, -155, and -122 in the colonic mucosa of children with IBD and in TNF-α-treated colonic epithelial cells. Our data suggest the TNF-α-related involvement of these miRs in the pathogenesis of IBD.
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Affiliation(s)
- Nóra J Béres
- *1st Department of Pediatrics, Semmelweis University, Budapest, Hungary; †2nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary; ‡Department of Pediatrics and Pediatric Health Care Center, University of Szeged, Szeged, Hungary; §2nd Department of Pathology, Semmelweis University, Budapest, Hungary; ‖MTA-SE, Tumor Progression Research Group, Budapest, Hungary; and ¶MTA-SE, Pediatrics and Nephrology Research Group, Budapest, Hungary
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Kocsis D, Papp M, Tornai T, Tulassay Z, Herszényi L, Tóth M, Juhász M. [Intestinal fatty acid binding protein: marker of enterocyte damage in acute and chronic gastroenterological diseases]. Orv Hetil 2016; 157:59-64. [PMID: 26726140 DOI: 10.1556/650.2016.30336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Intestinal fatty acid binding protein, a small cytosolic protein abundantly present in mature enterocytes of small and large intestine, has proven to be a sensitive marker for damage to the intestinal epithelium. Upon cellular damage of the enterocyte, intestinal fatty acid binding protein is readily released into the systemic circulation, passes through the glomerular filter and can be detected in the urine. In this review, the authors review studies on the application of this protein as a biomarker in acute and chronic gastrointestinal diseases.
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Affiliation(s)
- Dorottya Kocsis
- II. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szentkirályi u. 46., 1088
| | - Mária Papp
- Belgyógyászati Intézet, Gasztroenterológiai Tanszék, Debreceni Egyetem, Általános Orvostudományi Kar Debrecen
| | - Tamás Tornai
- Belgyógyászati Intézet, Gasztroenterológiai Tanszék, Debreceni Egyetem, Általános Orvostudományi Kar Debrecen
| | - Zsolt Tulassay
- II. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szentkirályi u. 46., 1088
| | - László Herszényi
- II. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szentkirályi u. 46., 1088
| | - Miklós Tóth
- II. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szentkirályi u. 46., 1088
| | - Márk Juhász
- II. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szentkirályi u. 46., 1088
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Kocsis D, Tóth Z, Csontos ÁA, Miheller P, Pák P, Herszényi L, Tóth M, Tulassay Z, Juhász M. Prevalence of inflammatory bowel disease among coeliac disease patients in a Hungarian coeliac centre. BMC Gastroenterol 2015; 15:141. [PMID: 26481725 PMCID: PMC4612406 DOI: 10.1186/s12876-015-0370-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 10/08/2015] [Indexed: 12/13/2022] Open
Abstract
Background Celiac disease, Crohn disease and ulcerative colitis are inflammatory disorders of the gastrointestinal tract with some common genetic, immunological and environmental factors involved in their pathogenesis. Several research shown that patients with celiac disease have increased risk of developing inflammatory bowel disease when compared with that of the general population. The aim of this study is to determine the prevalence of inflammatory bowel disease in our celiac patient cohort over a 15-year-long study period. Methods To diagnose celiac disease, serological tests were used, and duodenal biopsy samples were taken to determine the degree of mucosal injury. To set up the diagnosis of inflammatory bowel disease, clinical parameters, imaging techniques, colonoscopy histology were applied. DEXA for measuring bone mineral density was performed on every patient. Results In our material, 8/245 (3,2 %) coeliac disease patients presented inflammatory bowel disease (four males, mean age 37, range 22–67), 6/8 Crohn’s disease, and 2/8 ulcerative colitis. In 7/8 patients the diagnosis of coeliac disease was made first and inflammatory bowel disease was identified during follow-up. The average time period during the set-up of the two diagnosis was 10,7 years. Coeliac disease serology was positive in all cases. The distribution of histology results according to Marsh classification: 1/8 M1, 2/8 M2, 3/8 M3a, 2/8 M3b. The distribution according to the Montreal classification: 4/6 Crohn’s disease patients are B1, 2/6 Crohn’s disease patients are B2, 2/2 ulcerative colitis patients are S2. Normal bone mineral density was detected in 2/8 case, osteopenia in 4/8 and osteoporosis in 2/8 patients. Conclusions Within our cohort of patients with coeliac disease, inflammatory bowel disease was significantly more common (3,2 %) than in the general population.
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Affiliation(s)
- Dorottya Kocsis
- 2nd Department of Medicine, Semmelweis University, Szentkirályi st. 46., 1088, Budapest, Hungary.
| | - Zsuzsanna Tóth
- Peterfy S. u. Hospital, Gastroenterology Unit, Péterfy S. st. 8-20., 1076, Budapest, Hungary.
| | - Ágnes A Csontos
- 2nd Department of Medicine, Semmelweis University, Szentkirályi st. 46., 1088, Budapest, Hungary.
| | - Pál Miheller
- 2nd Department of Medicine, Semmelweis University, Szentkirályi st. 46., 1088, Budapest, Hungary.
| | - Péter Pák
- Vaszary Kolos. Hospital, Gastroenterology Unit, Petőfi S. st. 26-28., 2500, Esztergom, Hungary.
| | - László Herszényi
- 2nd Department of Medicine, Semmelweis University, Szentkirályi st. 46., 1088, Budapest, Hungary.
| | - Miklós Tóth
- 2nd Department of Medicine, Semmelweis University, Szentkirályi st. 46., 1088, Budapest, Hungary.
| | - Zsolt Tulassay
- 2nd Department of Medicine, Semmelweis University, Szentkirályi st. 46., 1088, Budapest, Hungary.
| | - Márk Juhász
- 2nd Department of Medicine, Semmelweis University, Szentkirályi st. 46., 1088, Budapest, Hungary.
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Kocsis D, Tulassay Z, Juhász M. [Dietary and pharmacological aspects of eosinophilic esophagitis]. Orv Hetil 2015; 156:927-32. [PMID: 26027600 DOI: 10.1556/650.2015.30164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Eosinophilic esophagitis is considered to be a chronic antigen-driven disease whereby food and/or aeroallergens induce a chronic inflammatory infiltrate in the esophagus leading to pathological hyperplasia of the epithelial and muscular layers, fibrosis of the lamina propria and symptoms of dysphagia and food impaction. Eosinophilic esophagitis is often associated with other allergic diseases such as asthma or atopic dermatitis. Current first line treatments of the disease include strict dietary modification and topical anti-inflammatory steroids. In this review the authors summarize currently available treatment strategies of eosinophilic esophagitis.
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Affiliation(s)
- Dorottya Kocsis
- II. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szentkirályi u. 46., 1088
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Juhász M, Nagy VL, Székely H, Kocsis D, Tulassay Z, László JF. Influence of inhomogeneous static magnetic field-exposure on patients with erosive gastritis: a randomized, self- and placebo-controlled, double-blind, single centre, pilot study. J R Soc Interface 2015; 11:20140601. [PMID: 25008086 DOI: 10.1098/rsif.2014.0601] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
This pilot study was devoted to the effect of static magnetic field (SMF)-exposure on erosive gastritis. The randomized, self- and placebo-controlled, double-blind, pilot study included 16 patients of the 2nd Department of Internal Medicine, Semmelweis University diagnosed with erosive gastritis. The instrumental analysis followed a qualitative (pre-intervention) assessment of the symptoms by the patient: lower heartburn (in the ventricle), upper heartburn (in the oesophagus), epigastric pain, regurgitation, bloating and dry cough. Medical diagnosis included a double-line upper panendoscopy followed by 30 min local inhomogeneous SMF-exposure intervention at the lower sternal region over the stomach with peak-to-peak magnetic induction of 3 mT and 30 mT m(-1) gradient at the target site. A qualitative (post-intervention) assessment of the same symptoms closed the examination. Sham- or SMF-exposure was used in a double-blind manner. The authors succeeded in justifying the clinically and statistically significant beneficial effect of the SMF- over sham-exposure on the symptoms of erosive gastritis, the average effect of inhibition was 56% by p = 0.001, n = 42 + 96. This pilot study was aimed to encourage gastroenterologists to test local, inhomogeneous SMF-exposure on erosive gastritis patients, so this intervention may become an evidence-based alternative or complementary method in the clinical use especially in cases when conventional therapy options are contraindicated.
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Affiliation(s)
- Márk Juhász
- 2nd Department of Internal Medicine, Semmelweis University, Budapest, Szentkirályi u. 46, 1088, Hungary
| | - Viktor L Nagy
- 2nd Department of Internal Medicine, Semmelweis University, Budapest, Szentkirályi u. 46, 1088, Hungary
| | - Hajnal Székely
- 2nd Department of Internal Medicine, Semmelweis University, Budapest, Szentkirályi u. 46, 1088, Hungary
| | - Dorottya Kocsis
- 2nd Department of Internal Medicine, Semmelweis University, Budapest, Szentkirályi u. 46, 1088, Hungary
| | - Zsolt Tulassay
- 2nd Department of Internal Medicine, Semmelweis University, Budapest, Szentkirályi u. 46, 1088, Hungary
| | - János F László
- e-Comers LLC, Csejtei u. 1-3, Budapest 1025, Hungary Department of Computer Science, University of Debrecen, Kassai út 26, Debrecen 4028, Hungary
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Abstract
Genetic background of coeliac disease has been subjects to intensive research since decades. However, only results of HLA phenotyping have been taken over to routine clinical practice. Meanwhile, data on the role of epigenetical factors in the manifestation of diseases have been emerging. In coeliac disease, there are several questions both in the fields of genetics and epigenetics yet to be answered. In this review, a cross section of current knowledge on these issues is presented with special interest regarding the future clinical applications.
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Affiliation(s)
- Dorottya Kocsis
- Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest Szentkirályi u. 46. 1088
| | - Nóra Béres
- Semmelweis Egyetem, Általános Orvostudományi Kar I. Gyermekgyógyászati Klinika Budapest
| | - Gábor Veres
- Semmelweis Egyetem, Általános Orvostudományi Kar I. Gyermekgyógyászati Klinika Budapest
| | - Dolóresz Szabó
- Semmelweis Egyetem, Általános Orvostudományi Kar I. Gyermekgyógyászati Klinika Budapest
| | - Katalin Eszter Müller
- Semmelweis Egyetem, Általános Orvostudományi Kar I. Gyermekgyógyászati Klinika Budapest
| | - András Arató
- Semmelweis Egyetem, Általános Orvostudományi Kar I. Gyermekgyógyászati Klinika Budapest
| | - Márk Juhász
- Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest Szentkirályi u. 46. 1088
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Kocsis D, Miheller P, Lőrinczy K, Herszényi L, Tulassay Z, Rácz K, Juhász M. Coeliac disease in a 15-year period of observation (1997 and 2011) in a Hungarian referral centre. Eur J Intern Med 2013; 24:461-7. [PMID: 23535227 DOI: 10.1016/j.ejim.2013.02.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Revised: 02/23/2013] [Accepted: 02/25/2013] [Indexed: 01/09/2023]
Abstract
AIMS The aim of this study is to evaluate the experience of a single coeliac centre over a 15-year-long study period (between November of 1997 and September of 2011). PATIENTS AND METHODS Charts of 178 patients (139 females) with coeliac disease were retrospectively evaluated. Tests performed: multiple duodenal biopsies, anti-tissue transglutaminase and anti-endomysium antibodies, body mass index calculation, osteodensitometry, evaluation of disorders associated with coeliac disease, and implementation of family screening. RESULTS Histological samples were available in 133 cases, distribution according to Marsh-Oberhuber classification: M0 in 7%, M1-M2 in 4%, M3a in 26%, M3b in 13%, and M3c in 50% of cases, respectively. Anti-tissue transglutaminase and anti-endomysium antibody tests were available in 158 cases, 132/158 showed seropositivity. Mean body mass index values were 23.05kg/m(2) for males, and 21.07kg/m(2) for females, respectively. Osteodensitometry showed normal values in 46%, osteopenia in 36%, and osteoporosis in 18% of cases, respectively. Coeliac disease associated disorders was present in 63/178 (35%) patients. Ninety coeliacs brought 197 first degree relatives for screening, with 47/197 (23%) relatives proving to have coeliac disease. Correlations between anti-tissue transglutaminase antibody titres and Marsh-Oberhuber classification, and anti-tissue transglutaminase antibody titres and bone mineral density values were found to be statistically significant (p=0.0011, and p=0.001, respectively). CONCLUSIONS Coeliac disease can become overt at any age. Female predominance is significant. Histology usually showed advanced villous atrophy. Mean body mass index values were within normal range. The high prevalence of associated disorders is also noted. The prevalence of 24% of coeliac disease among first degree relatives underlines the necessity of family screening.
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Juhász M, Kocsis D, Zágoni T, Miheller P, Herszényi L, Tulassay Z. [Retrospective evaluation of the ten-year experience of a single coeliac centre]. Orv Hetil 2012; 153:776-785. [PMID: 22580504 DOI: 10.1556/oh.2012.29366] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
UNLABELLED Coeliac disease (gluten-sensitive enteropathy, sprue) is a chrocic disorder of the small bowel leading to malabsorption. AIMS charts of all patients with coeliac disease treated at the 2nd Department of Medicine, Semmelweis University were evaluated. PATIENTS AND METHODS The authors retrospectively analysed the results of a total of 132 patients with coeliac disease (107 females and 25 males; mean age, 37 years; median, 35 years; range, 19-78 years) attending the centre between 1999 and 2010. The authors routinely performed the following investigations in patients with suspected coeliac disease: multiple biopsies taken from the duodenum, tissue transglutaminase antibody or endomysial antibody based serology, body mass index calculation, osteodensitometry, evaluation of disorders associated with coeliac disease, family history for coeliac disease, and implementation of family-screening for coeliac disease given the agreement of the index patients. RESULTS Histological samples were available in 101 cases, and distributions of data according to the Marsh-classification were as follows: negative in 9%, M3a in 27%, M3b in 18%, and M3c in 46% of cases, respectively. Serological results were available in 117 cases. 93/117 (79%) showed seropositivity. Body mass index was calculated for 95 patients, and the mean value for males was 22.4 kg/m² (range, 17-30.3 kg/m²), whereas the mean value for females was 20.7 kg/m² (range, 15.2-30.4 kg/m²). Osteodensitometry was performed in 90 patients; 45 patients (50%) proved normal, 31 (34%) had osteopenia, and 15 (26%) had osteoporosis. Coeliac disease associated disorders were present in 45/132 patients (34%; 6 males). Associated disorders were as follows: 15 dermatitis herpetiformis Duhring, 15 thyroid diseases (5 hypo- and 10 hyperthyroidism), 6 Crohn's disease, 3 selective IgA-deficiency, 2 endometrioses, 1 systemic lupus erythematosus, 1 myasthenia gravis, and 1 type-1 diabetes mellitus. Sixty-four of the 132 index patients brought 133 first-degree relatives for family screening (serology), where 26/133 (19.5%; 17 females) first-degree relatives proved to suffer from coeliac disease. CONCLUSIONS The age distribution of this cohort demonstrates that coeliac disease can present at any age. Similarly to those of other coeliac disease centres, female predominance is significant. Histology usually showed advanced villous atrophy. Serological results were usually in conjunction with the histological results and proved to be useful for monitoring dietary compliance and for accomplishing family screening. The mean body mass index values were in the normal range confirming that adult patients with coeliac disease are usually not malnourished. The 20% prevalence of coeliac disease among first-degree relatives underlines the necessity of family screening.
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Affiliation(s)
- Márk Juhász
- Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest Szentkirályi.
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