1
|
Ramakrishna BS, Venugopal G, Singh A, Pugazhendhi S, Dutta S, Ahuja V, Makharia GK. Human Leukocyte Antigen DQ (HLA-DQ) genotypes and haplotypes and their association with phenotype in patients with celiac disease in India. JGH Open 2021; 5:1190-1196. [PMID: 34622007 PMCID: PMC8485407 DOI: 10.1002/jgh3.12651] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 05/27/2021] [Revised: 07/28/2021] [Accepted: 08/21/2021] [Indexed: 11/10/2022]
Abstract
Background and Aim Human Leukocyte Antigen DQ (HLA‐DQ) genotypes play a permissive role in the genesis of celiac disease (CeD). In this case–control study, we used next‐generation sequencing to determine HLA‐DQA1 and ~DQB1 genotypes and haplotypes associated with CeD in Indian patients. Methods HLA‐DQA1 and ~DQB1 loci were amplified, using long‐range polymerase chain reaction (PCR), from DNA of 259 patients with symptomatic CeD (160 typical and 99 atypical), 45 asymptomatic CeD, 96 potential CeD, and 300 healthy adults. Amplicons were fragmented and sequenced on the Illumina platform, and alleles and haplotypes were assigned by matching against the HLA‐international ImMunoGeneTics (IMGT) database. Results HLA‐DQA1*05:01 (odds ratio [OR] 8.39, 95% confidence interval [CI] 5.64–12.47) and HLA‐DQB1*02:01 (OR 8.59, 95% CI 5.75–12.83) were the genotypes that showed a risk association with symptomatic CeD. Among the haplotypes, HLA‐DQA1*05:01 ~ HLA‐DQB1*02:01 (OR 8.56, 95% CI 5.67–13.19) showed a strong risk association with symptomatic CeD. When comparing symptomatic CeD with subclinical forms (asymptomatic and potential) CeD, HLA‐DQA1*05:01 ~ HLA‐DQB1*02:01 (OR 2.34, 95% CI 1.61–3.43) was significantly associated with risk of symptomatic disease. The strength of association between the HLA‐DQA1*05:01 ~ HLA‐DQB1*02:01 haplotype and the CeD phenotype showed a gradient in the order typical > atypical > asymptomatic > potential CeD. Genotypes consistent with expression of HLA DQ2 and/or 8 were noted in 128 (80%) typical, 73 atypical (74%), 27 (60%) asymptomatic, and 52 (54%) potential CeD participants. Conclusion HLA‐DQA1*05:01 ~ HLA‐DQB1*02:01 (haplotype DQ2.5) showed a very strong risk association with symptomatic CeD in Indian patients. The strength of association showed a gradient of increase from potential to typical CeD, coinciding with a phenotypic change in the celiac iceberg.
Collapse
Affiliation(s)
| | | | - Alka Singh
- Department of Gastroenterology and Human Nutrition All India Institute for Medical Sciences New Delhi India
| | | | | | - Vineet Ahuja
- Institute of Gastroenterology SRM Institutes for Medical Science Chennai India.,Department of Gastroenterology and Human Nutrition All India Institute for Medical Sciences New Delhi India.,Department of Cancer Biology Kansas University Medical Center Kansas Kankas USA.,Department of Medicine Guwahati Medical College Guwahati India
| | - Govind K Makharia
- Institute of Gastroenterology SRM Institutes for Medical Science Chennai India.,Department of Gastroenterology and Human Nutrition All India Institute for Medical Sciences New Delhi India.,Department of Cancer Biology Kansas University Medical Center Kansas Kankas USA.,Department of Medicine Guwahati Medical College Guwahati India
| |
Collapse
|
2
|
Sasidharan BK, Ramadass B, Viswanathan PN, Samuel P, Gowri M, Pugazhendhi S, Ramakrishna BS. A phase 2 randomized controlled trial of oral resistant starch supplements in the prevention of acute radiation proctitis in patients treated for cervical cancer. J Cancer Res Ther 2020; 15:1383-1391. [PMID: 31898677 DOI: 10.4103/jcrt.jcrt_152_19] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Radiation induced proctitis is frequently encountered during the radiation therapy of cervical and prostate cancers that causes pain and occasionally with bleeding and may affect the continuity of radiation therapy. Aims and Objectives The purpose of the study is to look at the benefit of administration of an oral prebiotic amylase resistant starch in reducing the incidence of acute radiation proctitis, a distressing symptom in patients receiving radiation therapy for cancer of the cervix. Material and Methods The study was conducted between 2011 and 2014 in 104 patients receiving radical chemo-radiotherapy for carcinoma cervix. Patients were randomized in to two arms, one receiving 30 gm of resistant starch and the other digestible starch on a daily basis throughout the course of the external radiotherapy. All patients received standard 4-field box radiation portals, 50 Gy in 25 fractions with 4 cycles of weekly concurrent Cisplatin. At completion of external beam radiotherapy, all patients underwent LDR/HDR brachytherapy. The study was double blinded and allocation was concealed from the investigators. The investigator recorded the radiotherapy related toxicity of the patients according to CTC V 3.0. The incidence and severity of grade 2-4 diarrhoea and proctitis were documented on a weekly basis and compared across the two groups and analyzed. Stool short chain fatty acid concentrations were measured at baseline at 2nd and 4th week and after 6 weeks of completion of radiotherapy in both study placebo arms and reported. The pattern of microbiota in the stool were also estimated in all patients at 4 time points. Two patients who progressed during therapy were not included in the analyses and two patients discontinued the intervention. A per protocol analyses was done. Results At analysis there were 50 patients in each arm. The severity of clinical proctitis was found to be similar in both groups of patients with 12.2 % of patients experiencing toxicity of grade 2 and above in digestible starch group versus 14.6% in the resistant starch group. Functional proctitis was similarly graded and it was found that 16.3 % patients in digestible starch group experienced toxicity against 10.2 % patients in the resistant starch group. This difference was seen at 4th week and continued in the subsequent weeks till the end of radiation. Both groups had similar reported toxicity at 6 weeks post intervention and similar incidence of grade 2 and above diarrhea. The resistant starch group was found to have 8% incidence as compared to 2% in the other group at the 5th and 6th week. The short chain fatty acid concentrations were not significantly different in the groups at any point. Conclusion The study did not demonstrate a significant benefit in administering resistant starch over and above normal diet to patients receiving pelvic radiotherapy. The reasons may be attributed to concurrent use of chemotherapy and decrease in intestinal probiotics. The use of digestible starch in the control arm may have contributed to lower incidence of the toxicity endpoints as well.
Collapse
Affiliation(s)
- Balu Krishna Sasidharan
- Department of Radiation Oncology, Wellcome Research Unit, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Balamurugan Ramadass
- Department of Biochemistry, Wellcome Research Unit, Christian Medical College Hospital, Vellore, Tamil Nadu; Department of Biochemisry, All India Institute of Medical Sciences, Bhubhaneswar, Orrisa, India
| | - P N Viswanathan
- Department of Radiation Oncology, Wellcome Research Unit, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Prasanna Samuel
- Department of Biostatistics, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Mahasampath Gowri
- Department of Biostatistics, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Srinivasan Pugazhendhi
- Department of Biochemistry, Wellcome Research Unit, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Balakrishnan S Ramakrishna
- Department of Gastroenterology, Christian Medical College Hospital, Vellore; Department of Medical Gastroentrology, Institute of Gastroenterology, Hepatobiliary Science and Transplantation SRM Institutes for Medical Science, Chennai, Tamil Nadu, India
| |
Collapse
|
3
|
Balamurugan R, Pugazhendhi S, Balachander GM, Dharmalingam T, Mortimer EK, Gopalsamy GL, Woodman RJ, Meng R, Alpers DH, Manary M, Binder HJ, Brown IL, Young GP, Ramakrishna BS. Effect of Native and Acetylated Dietary Resistant Starches on Intestinal Fermentative Capacity of Normal and Stunted Children in Southern India. Int J Environ Res Public Health 2019; 16:E3922. [PMID: 31618992 PMCID: PMC6843365 DOI: 10.3390/ijerph16203922] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/10/2019] [Accepted: 10/12/2019] [Indexed: 12/29/2022]
Abstract
The health benefits of dietary amylase resistant starch (RS) arise from intestinal microbial fermentation and generation of short chain fatty acids (SCFA). We compared the intestinal fermentative capability of stunted and nonstunted ('healthy') children in southern India using two types of RS: high amylose maize starch (HAMS) and acetylated HAMS (HAMSA). Twenty children (10 stunted and 10 healthy) aged 2 to 5 years were fed biscuits containing HAMS (10 g/day) for two weeks followed by a 2-week washout and then HAMSA biscuits (10 g/day) for 2 weeks. Fecal samples were collected at 3-4 day intervals and pH and SCFA analyzed. At entry, stunted children had lower SCFA concentrations compared to healthy children. Both types of RS led to a significant decrease in fecal pH and increase in fecal acetate and propionate in both healthy and stunted children. However, while HAMS increased fecal butyrate in both groups of children, HAMSA increased butyrate in healthy but not stunted children. Furthermore, healthy children showed a significantly greater increase than stunted children in both acetate and butyrate when fed either RS. No adverse effects were reported with either RS. Stunted children have impaired capacity to ferment certain types of RS which has implications for choice of RS in formulations aimed at improving microbial function in stunted children.
Collapse
Affiliation(s)
- Ramadass Balamurugan
- Wellcome Research Unit (Biochemistry), Christian Medical College, Vellore, Tamil Nadu 632004, India.
| | - Srinivasan Pugazhendhi
- Wellcome Research Unit (Biochemistry), Christian Medical College, Vellore, Tamil Nadu 632004, India.
| | - Gowri M Balachander
- Wellcome Research Unit (Biochemistry), Christian Medical College, Vellore, Tamil Nadu 632004, India.
| | - Tamilselvan Dharmalingam
- Wellcome Research Unit (Biochemistry), Christian Medical College, Vellore, Tamil Nadu 632004, India.
| | - Elissa K Mortimer
- College of Medicine and Public Health, Flinders University of South Australia, Bedford Park 5045, South Australia, Australia.
| | - Geetha L Gopalsamy
- College of Medicine and Public Health, Flinders University of South Australia, Bedford Park 5045, South Australia, Australia.
| | - Richard J Woodman
- College of Medicine and Public Health, Flinders University of South Australia, Bedford Park 5045, South Australia, Australia.
| | - Rosie Meng
- College of Medicine and Public Health, Flinders University of South Australia, Bedford Park 5045, South Australia, Australia.
| | - David H Alpers
- Washington University School of Medicine, Saint Louis, MO 63110, USA.
| | - Mark Manary
- Washington University School of Medicine, Saint Louis, MO 63110, USA.
| | - Henry J Binder
- Yale University School of Medicine, New Haven, CT 06510, USA.
| | - Ian L Brown
- Australian Cancer Research Foundation, Sydney 2000, Australia.
| | - Graeme P Young
- College of Medicine and Public Health, Flinders University of South Australia, Bedford Park 5045, South Australia, Australia.
| | | |
Collapse
|
4
|
Christudoss P, Chacko G, Selvakumar R, Fleming JJ, Pugazhendhi S, Mathew G. Expression of Metallothionein after Administration of Aspirin, Vitamin C or Zinc Supplement in the DMH Induced Colon Carcinoma in Rat. Asian Pac J Cancer Prev 2018; 19:3237-3244. [PMID: 30486626 PMCID: PMC6318414 DOI: 10.31557/apjcp.2018.19.11.3237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Indexed: 12/14/2022] Open
Abstract
Background: Chemoprevention refers to the use of specificnatural or synthetic chemical agents to suppress the development and progression to carcinoma. The purpose of this study was to assess the effect of aspirin, vitamin C or zinc on the metallothionein (MT) mRNA gene expression as well as MT protein content byimmunohistochemistry andradioimmunoassay (RIA) in 1, 2-dimethyl hydrazine (DMH) induced cancerous colonic tissuein rats. Methods: Rats were randomly divided into three groups, group 1 (aspirin), group 2 (vitamin C) group 3 (zinc), each of which was further sub divided into two groups and given subcutaneous injections of DMH (30 mg/kg body weight) twice a week for 3 months and sacrificed at either 4 months (A-precancer model) or at 6 months (B-cancer model). The control groups were administered 0.5 ml saline subcutaneously. All the 3 groups were simultaneouslyadministered aspirin, vitamin Cor zinc supplement respectively from the beginning till the end of the study. Results: It was observed that rats co-treated with aspirin, vitamin C or zinc resulted in a significant increase in the colonic MT mRNA expression in the precancer and cancer model as compared to the saline only controls. MT protein expression showed a 60%, 64% and 78% immunopositivity in the co-treated groups respectively. The mean MT content in the precancer and the cancer model was restored to near normal levels in all the three co-treated groups. Conclusion: These results suggest that co-administration of aspirin, vitamin C or zinc resulted in a significant increase in MT mRNA gene expression, MT protein expression and MT protein content which could possibly be one of the reasons for a chemo protective effect against progression to colonic cancer in a chemically induced DMH model in rat. Zinc supplement had a greater effect on metallothionein expression than aspirin or vitamin C.
Collapse
Affiliation(s)
- Pamela Christudoss
- Department of Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India.
| | | | | | | | | | | |
Collapse
|
5
|
Venugopal G, Mechenro J, Makharia G, Singh A, Pugazhendhi S, Balamurugan R, Ramakrishna BS. Sequential testing with different tissue transglutaminase antibodies, a new approach for diagnosis of celiac disease. Indian J Gastroenterol 2017; 36:481-486. [PMID: 29270909 DOI: 10.1007/s12664-017-0803-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 11/19/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND The diagnosis of celiac disease (CeD) in clinical practice relies on serological testing for IgA antibodies to human tissue transglutaminase (anti-tTG) which diagnose CeD autoimmunity. We compared three kits for their performance in diagnosis of the disease and evaluated the point prevalence of CeD autoimmunity in a South Indian urban population. METHODS In the first part of the study, sera from 90 patients with documented CeD and 92 healthy controls were tested for anti-tTG using three different kits. One thousand nine hundred and seventeen healthy adults residing in urban areas of Vellore and Kancheepuram districts were tested for CeD autoimmunity using a sequential two-test strategy. RESULTS The sensitivity, specificity, false positivity, false negativity, positive predictive value, and negative predictive value for the three assays respectively were as follows: 95.5%, 82.6%, 17.3%, 4.4%, 84.3%, and 95% for the Aeskulisa New Generation Assay; 85.5%, 100%, 0%, 14.4%, 100%, and 87.6% for Quanta Lite; and 71.1%, 100%, 0%, 28.8%, 100%, and 71% for Celiac Microlisa. The ROC curves showed good discrimination for all three ELISAs with an AUC of 0.947, 0.950, and 0.886 for the Aeskulisa, Quanta Lite, and Celiac Microlisa, respectively. Of 1917 (males 908, females 1009) healthy adults, 113 (5.89%) were seropositive for IgA anti-htTG in the Aeskulisa test. Two of the latter tested positive in the Quanta Lite assay and/or the Celiac Microlisa assay. The CeD autoimmunity prevalence in this urban population was 1.0 per thousand (95% confidence interval 0.3 to 3.7 per thousand). CONCLUSION Sequential testing for anti-tTG using first a highly sensitive assay followed by a very specific assay is a new strategy for screening for CeD in clinical practice.
Collapse
Affiliation(s)
- Giriprasad Venugopal
- SRM Institutes for Medical Science, 1, Jawaharlal Nehru Salai, Vadapalani, Chennai, 600 026, India.,SRM Medical College Hospital and Research Centre, Kattankulathur, India
| | - John Mechenro
- SRM Institutes for Medical Science, 1, Jawaharlal Nehru Salai, Vadapalani, Chennai, 600 026, India.,SRM Medical College Hospital and Research Centre, Kattankulathur, India
| | - Govind Makharia
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India
| | - Alka Singh
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India
| | | | | | - Balakrishnan S Ramakrishna
- SRM Institutes for Medical Science, 1, Jawaharlal Nehru Salai, Vadapalani, Chennai, 600 026, India. .,SRM Medical College Hospital and Research Centre, Kattankulathur, India.
| |
Collapse
|
6
|
Christudoss P, Chacko G, Selvakumar R, Fleming JJ, Pugazhendhi S, Mathew G. Expression of metallothionein in dimethylhydrazine-induced colonic precancerous and cancerous model in rat. J Cancer Res Ther 2017; 12:1307-1312. [PMID: 28169244 DOI: 10.4103/0973-1482.179107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM Metallothionein (MT) is a small protein with a high affinity for divalent heavy metals and has a function in zinc homeostasis. The purpose of this study was to assess the MT mRNA gene expression as well as the MT protein content by immunohistochemistry and radioimmunoassay (RIA) in 1,2-dimethylhydrazine (DMH)-induced precancerous and cancerous colonic tissue in rats. MATERIALS AND METHODS Six-week-old rats were given subcutaneous injections of DMH twice a week for 3 months and sacrificed at 4 months (precancerous model) and 6 months (cancerous model). We determined MT mRNA expression by reverse transcription polymerase chain reaction and MT protein content by both immunohistochemical expression and cadmium-109 RIA. RESULTS MT mRNA expression in the large intestine showed statistically significant decrease in the precancerous (P < 0.01) and the cancerous (P < 0.001) model as compared with controls. Immunohistochemical expression of MT showed statistically significant decrease (P < 0.05) in the colonic cancerous tissue. MT content in the large intestine showed statistically significant decrease in precancerous (P < 0.005) and cancerous (P < 0.001) model as compared with controls. CONCLUSION This study suggests that a decrease in the colonic MT mRNA expression, MT protein expression, and content in DMH-induced colonic cancer model is associated with the development of preneoplastic lesions and further progression to carcinoma in the colon results in a greater reduction in the levels of each of these parameters.
Collapse
Affiliation(s)
- Pamela Christudoss
- Department of Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Geeta Chacko
- Department of Neuropathology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ratnasamy Selvakumar
- Department of Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Jude Joseph Fleming
- Department of Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Srinivasan Pugazhendhi
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - George Mathew
- Department of General Surgery, Christian Medical College, Vellore, Tamil Nadu, India
| |
Collapse
|
7
|
Ramadass B, Rani BS, Pugazhendhi S, John K, Ramakrishna BS. Faecal microbiota of healthy adults in south India: Comparison of a tribal & a rural population. Indian J Med Res 2017; 145:237-246. [PMID: 28639601 PMCID: PMC5501057 DOI: 10.4103/ijmr.ijmr_639_14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND & OBJECTIVES The relevance of the gut microbiota to human health is increasingly appreciated. The objective of this study was to compare the gut microbiota of a group of adult tribals with that of healthy adult villagers in Tamil Nadu, India. METHODS Faeces were collected from 10 healthy tribal adults (TAs) in the Jawadhi hills and from 10 healthy villagers [rural adults (RAs)] in Vellore district, Tamil Nadu. DNA was extracted, and 456 bp segments comprising hypervariable regions 3 and 4 of the 16S rRNA gene were amplified, barcoded and 454 sequenced. RESULTS Totally 227,710 good-quality reads were analyzed. TAs consumed a millets-based diet, ate pork every day, and did not consume milk or milk products. RAs consumed a rice-based diet with meat intake once a week. In both groups, Firmicutes was the most abundant phylum, followed by Proteobacteria, Bacteroidetes and Actinobacteria. The median Firmicutes-to-Bacteroidetes ratio was 34.0 in TA and 92.9 in RA groups. Actinobacteria were significantly low in TA, possibly due to non-consumption of milk. Clostridium constituted the most abundant genus in both groups, but was significantly more abundant in TAs than RAs, while Streptococcus was significantly more abundant in RA (P<0.05). Analyses of genetic distance revealed that the microbiota were distinctly different between TA and RA, and principal component analysis using 550 distinct taxonomically identifiable sequences revealed a clear separation of microbiota composition in the two groups. Phylogenetic analysis of major microbiota indicated clustering of microbial groups at different major branch points for TAs and RAs. INTERPRETATION & CONCLUSIONS Phylum Firmicutes and genus Clostridium constituted the bulk of the faecal microbiota, while significant differences in composition between the groups were probably due to differences in diet and lifestyle.
Collapse
Affiliation(s)
- Balamurugan Ramadass
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - B. Sandya Rani
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | - K.R. John
- Department of Community Health, Christian Medical College, Vellore, Chennai, India
- Institute of Gastroenterology, SRM Institutes for Medical Science, Chennai, India
| | - Balakrishnan S. Ramakrishna
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
- Institute of Gastroenterology, SRM Institutes for Medical Science, Chennai, India
| |
Collapse
|
8
|
Pugazhendhi S, Sathya P, Palanisamy P, Gopalakrishnan R. Synthesis of silver nanoparticles through green approach using Dioscorea alata and their characterization on antibacterial activities and optical limiting behavior. Journal of Photochemistry and Photobiology B: Biology 2016; 159:155-60. [DOI: 10.1016/j.jphotobiol.2016.03.043] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 02/25/2016] [Accepted: 03/29/2016] [Indexed: 11/28/2022]
|
9
|
Kabeerdoss J, Jayakanthan P, Pugazhendhi S, Ramakrishna BS. Alterations of mucosal microbiota in the colon of patients with inflammatory bowel disease revealed by real time polymerase chain reaction amplification of 16S ribosomal ribonucleic acid. Indian J Med Res 2016; 142:23-32. [PMID: 26261163 PMCID: PMC4557246 DOI: 10.4103/0971-5916.162091] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background & objectives: Alterations in microbial communities closely associated with the intestinal mucosa are likely to be important in the pathogenesis of inflammatory bowel disease (IBD). We examined the abundance of specific microbial populations in colonic mucosa of patients with ulcerative colitis (UC), Crohn's disease (CD) and controls using reverse transcription quantitative polymerase chain reaction (RT-qPCR) amplification of 16S ribosomal ribonucleic acid (16S rRNA). Methods: RNA was extracted from colonic mucosal biopsies of patients with UC (32), CD (28) and patients undergoing screening colonoscopy (controls), and subjected to RT-qPCR using primers targeted at 16S rRNA sequences specific to selected microbial populations. Results: Bacteroides-Prevotella-Porphyromonas group and Enterobacteriaceae were the most abundant mucosal microbiota. Bacteroides and Lactobacillus abundance was greater in UC patients compared with controls or CD. Escherichia coli abundance was increased in UC compared with controls. Clostridium coccoides group and C. leptum group abundances were reduced in CD compared with controls. Microbial population did not differ between diseased and adjacent normal mucosa, or between untreated patients and those already on medical treatment. The Firmicutes to Bacteroidetes ratio was significantly decreased in both UC and CD compared with controls, indicative of a dysbiosis in both conditions. Interpretation & conclusions: Dysbiosis appears to be a primary feature in both CD and UC. Microbiome-directed interventions are likely to be appropriate in therapy of IBD.
Collapse
|
10
|
Sathya P, Pugazhendhi S, Gopalakrishnan R. Self-assembled supramolecular structure of 4-dimethylaminopyridinium p-hydroxy benzoate pentahydrate: synthesis, growth, optical and biological properties. RSC Adv 2016. [DOI: 10.1039/c6ra00283h] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A single crystal of 4-dimethylaminopyridinium p-hydroxybenzoate pentahydrate (DMAPHB) was obtained via a slow evaporation solution growth technique.
Collapse
Affiliation(s)
- P. Sathya
- Crystal Research Laboratory
- Department of Physics
- Anna University
- Chennai-600025
- India
| | - S. Pugazhendhi
- Crystal Research Laboratory
- Department of Physics
- Anna University
- Chennai-600025
- India
| | - R. Gopalakrishnan
- Crystal Research Laboratory
- Department of Physics
- Anna University
- Chennai-600025
- India
| |
Collapse
|
11
|
Ramakrishna BS, Makharia GK, Chetri K, Dutta S, Mathur P, Ahuja V, Amarchand R, Balamurugan R, Chowdhury SD, Daniel D, Das A, George G, Gupta SD, Krishnan A, Prasad JH, Kaur G, Pugazhendhi S, Pulimood A, Ramakrishna K, Verma AK. Prevalence of Adult Celiac Disease in India: Regional Variations and Associations. Am J Gastroenterol 2016; 111:115-23. [PMID: 26729543 DOI: 10.1038/ajg.2015.398] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [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] [Received: 06/09/2015] [Revised: 10/06/2015] [Accepted: 11/01/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Although celiac disease (CeD) affects 1% of people in the northern part of India, it is believed to be uncommon in the southern and northeastern parts because of significant differences in dietary pattern and ethnicity. We estimated the prevalence of CeD in these three populations. In a subset, we also investigated differences in the prevalence of HLA-DQ 2/8 allelotype and dietary grain consumption. METHODS A total of 23,331 healthy adults were sampled from three regions of India-northern (n=6207), northeastern (n=8149), and southern (n=8973)-and screened for CeD using IgA anti-tissue transglutaminase antibody. Positive tests were reconfirmed using a second ELISA. CeD was diagnosed if the second test was positive and these participants were further investigated. A subsample of participants was tested for HLA-DQ2/-DQ8 and underwent detailed dietary evaluation. RESULTS Age-adjusted prevalence of celiac autoantibodies was 1.23% in northern, 0.87% in northeastern, and 0.10% in southern India (P<0.0001). Prevalence of CeD and latent CeD, respectively, was 8.53/1,000 and 3.70/1,000 in northern, 4.66/1,000 and 3.92/1,000 in northeastern, and 0.11/1,000 and 1.22/1,000 in the southern part. The population prevalence of genes determining HLA-DQ2 and/or -DQ8 expression was 38.1% in northern, 31.4% in northeastern, and 36.4% in southern India. Mean daily wheat intake was highest in northern (455 g) compared with northeastern (37 g) or southern part (25 g), whereas daily rice intake showed an inverse pattern. CONCLUSIONS CeD and latent CeD were most prevalent in northern India and were the least in southern India. The prevalence correlated with wheat intake and did not reflect differences in the genetic background.
Collapse
Affiliation(s)
- B S Ramakrishna
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Govind K Makharia
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - Kamal Chetri
- Department of Gastroenterology, International Hospital, Guwahati, India
| | | | | | - Vineet Ahuja
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - Ritvik Amarchand
- Department of Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ramadass Balamurugan
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Sudipta D Chowdhury
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Dolly Daniel
- Department of Transfusion Medicine, Christian Medical College, Vellore, India
| | - Anup Das
- Department of Medicine, Guwahati Medical College, Guwahati, India
| | - Gemlyn George
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | - Anand Krishnan
- Department of Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Jasmin H Prasad
- Department of Community Health, Christian Medical College, Vellore, India
| | - Gurvinder Kaur
- Department of Transfusion Medicine and Immunohematology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Anna Pulimood
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Kartik Ramakrishna
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Anil K Verma
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| |
Collapse
|
12
|
Baskaran K, Pugazhendhi S, Ramakrishna BS. Protective association of tumor necrosis factor superfamily 15 (TNFSF15) polymorphic haplotype with Ulcerative Colitis and Crohn's disease in an Indian population. PLoS One 2014; 9:e114665. [PMID: 25501099 PMCID: PMC4264777 DOI: 10.1371/journal.pone.0114665] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 11/12/2014] [Indexed: 02/08/2023] Open
Abstract
Background Tumor necrosis factor superfamily (TNFSF) proteins are involved in the genesis of inflammatory bowel disease (IBD). We examined the association of seven single nucleotide polymorphisms (SNP) in the TNFSF15 gene with Crohn's disease (CD) and ulcerative colitis (UC) in the Indian population. Methods Seven SNPs in the TNFSF15 gene (rs10114470, rs3810936, rs6478108, rs4263839, rs6478109, rs7848647 and rs7869487) were genotyped in 309 CD patients, 330 UC patients and 437 healthy controls using the Sequenom iPLEX MassArray platform. Disease associations were evaluated for allelotypes and for genotypes. Results The minor T alleles and the TT genotypes of rs10114470 and rs3810936 were significantly protectively associated with both CD and UC. The CC genotype of rs6478108, AA genotype of rs4263839, the AA genotype of rs6478109, the TT genotype of rs7848647 and the CC genotype of rs7869487 were all protectively associated with CD but not with UC. Two haplotype blocks could be discerned, one where SNPs rs10114470 and rs3810936 were in tight LD (D′ = 0.8) and the other where rs6478108, rs4263839, rs6478109, rs7848647 and rs7869487 were in tight LD (D′ 0.92–1.00). The second block of haplotypes were not associated with CD or with UC. The first block of haplotypes was very significantly associated with both CD and UC. Conclusions Strong associations exist between TNFSF15 gene polymorphisms and IBD (both CD and UC) in the Indian population.
Collapse
Affiliation(s)
- Kirankumar Baskaran
- Wellcome Trust Research Laboratory, Christian Medical College, Vellore 632 004, India
| | | | - Balakrishnan S. Ramakrishna
- Wellcome Trust Research Laboratory, Christian Medical College, Vellore 632 004, India
- SRM Institutes for Medical Science, 1 Jawaharlal Nehru Road, Vadapalani, Chennai 600 026, India
- * E-mail:
| |
Collapse
|
13
|
Baskaran K, Pugazhendhi S, Ramakrishna BS. Association of IRGM gene mutations with inflammatory bowel disease in the Indian population. PLoS One 2014; 9:e106863. [PMID: 25191865 PMCID: PMC4156415 DOI: 10.1371/journal.pone.0106863] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 08/01/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Mutations in the IRGM gene have been associated with Crohn's disease in several populations but have not been explored in Indian patients with this disease. This study examined the association of IRGM mutations with ulcerative colitis and Crohn's disease in Indian patients with inflammatory bowel disease. METHODS The IRGM gene was amplified in four segments and Sanger-sequenced in 101 participants (42 Crohn's disease, 39 ulcerative colitis, and 20 healthy controls). Ten single nucleotide polymorphisms (SNP) were genotyped in 1200 participants (352 Crohn's disease, 400 ulcerative colitis, and 448 healthy controls) using Sequenom MassARRAY iPLEX. Disease associations were evaluated for each of the ten SNPs. RESULTS Thirty one mutations were identified in the IRGM gene, of which two had not hitherto been reported (150226250- ss947429272 & 150227858- ss947429273). Ten SNPs (6 from the above and 4 from the literature) were evaluated. Significant associations with Crohn's disease were noted with the T allele of rs1000113 (OR 1.46, 95% CI 1.12-1.90), T allele of rs9637876 (OR 1.25, 95% CI 1.005-1.561) and C allele of rs 13361189 (OR 1.33, 95% CI 1.07-1.669). Two SNPs--rs11747270 and rs180802994--did not exhibit Hardy-Weinberg equilibrium but were associated with both Crohn's disease and ulcerative colitis in this population. The remaining SNPs did not show significant associations with either Crohn's disease or ulcerative colitis. CONCLUSIONS Association of IRGM gene SNPs with Crohn's disease is reported for the first time in Indian patients. We also report, for the first time, an association of rs 9637876 in the IRGM gene with Crohn's disease.
Collapse
Affiliation(s)
- Kirankumar Baskaran
- Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India
| | | | - Balakrishnan S Ramakrishna
- Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India; SRM Institutes for Medical Science, Vadapalani, Chennai, India
| |
Collapse
|
14
|
Ramakrishna K, Pugazhendhi S, Kabeerdoss J, Peter JV. Association between heat shock protein 70 gene polymorphisms and clinical outcomes in intensive care unit patients with sepsis. Indian J Crit Care Med 2014; 18:205-11. [PMID: 24872649 PMCID: PMC4033853 DOI: 10.4103/0972-5229.130571] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: The objective of the following study is to evaluate the associations between single nucleotide polymorphisms (SNPs) in the Heat Shock Protein 70 (HSP70) gene, gene expression of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) and medical intensive care unit (MICU) stay and organ failure in sepsis. Materials and Methods: MICU patients with sepsis were genotyped for rs1061581, rs2227956, rs1008438 and rs1043618 polymorphisms in HSP70 gene using polymerase chain reaction (PCR)-restriction fragment length polymorphism analysis or allele-specific PCR. Messenger ribonucleic acid (mRNA) expression of IL-6 and TNF-α were quantitated in peripheral blood lymphocytes. Outcomes were recorded. Results: 108 patients (48 male) aged 40.7 ± 16.0 (mean ± standard deviation) years included H1N1 infection (36), scrub typhus (29) and urosepsis (12). Seventy-one (65.7%) had dysfunction of three or more organ systems, 66 patients (61.1%) were treated by mechanical ventilation, 21 (19.4%) needed dialysis. ICU stay was 9.3 ± 7.3 days. Mortality was 38.9%. One or more SNPs were noted in 101/108 (93.5%) and organ failure was noted in only 1/7 patients without a single SNP. The A allelotypes of rs1061581 and rs1008438 were associated with hematological dysfunction (P = 0.03 and 0.07) and longer ICU stay (P = 0.05 and 0.04), whereas IL-6 and TNF-α mRNA levels were associated with central nervous system dysfunction. Conclusions: HSP70 genotypes may determine some adverse outcomes in patients with sepsis.
Collapse
Affiliation(s)
- Kartik Ramakrishna
- Department of Intensive Care, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India ; Department of Internal Medicine, Unity Health System, Rochester, NY 14626, USA ; Department of Gastrointestinal Sciences, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
| | - Srinivasan Pugazhendhi
- Department of Gastrointestinal Sciences, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
| | - Jayakanthan Kabeerdoss
- Department of Gastrointestinal Sciences, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
| | - John Victor Peter
- Department of Intensive Care, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
| |
Collapse
|
15
|
Pugazhendhi S, Jayakanthan K, Pulimood AB, Ramakrishna BS. Cytokine gene expression in intestinal tuberculosis and Crohn's disease. Int J Tuberc Lung Dis 2013; 17:662-8. [PMID: 23575333 DOI: 10.5588/ijtld.12.0600] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Intestinal tuberculosis (TB) and Crohn's disease closely resemble each other clinically and morphologically. Little is known of cytokine regulation in intestinal TB. OBJECTIVE To compare cytokine gene expression in colonic mucosa and peripheral blood mononuclear cells (PBMC) in TB with that in Crohn's disease. METHODS Biopsies were obtained from normal and ulcerated colonic mucosa of 12 intestinal TB and 11 Crohn's disease patients, and PBMC from 15 intestinal TB and 12 Crohn's disease patients and 11 healthy volunteers. RNA was extracted, and the expression of selected cytokines, chemokines and pattern recognition receptors quantified by reverse transcriptase real-time polymerase chain reaction using SYBR green. RESULTS The mRNA expression of interleukin-8 (IL-8), induced protein-10, tumour necrosis factor-alpha, IL-23 p19 and IL-12 p40, and Toll-like receptors (TLR) 1 and 2 in the ulcerated mucosa was increased in both intestinal TB and Crohn's disease. Expression of growth-related oncogene-alpha was increased in intestinal TB, while expression of interferon-gamma (IFN-) and TLR 4, 5 and 9 was increased in Crohn's disease. Expression of RANTES (regulated upon activation, normal T-cell expressed and secreted) was decreased in Crohn's disease. Secretion of IFN- or IL-10 from PBMC was not significantly altered in either disease. PBMC mRNA expression of IL-1, IL-6 and IL-8 mRNA was upregulated in Crohn's disease, while that of IL-17 was upregulated in intestinal TB. CONCLUSIONS Cytokine gene expression patterns in intestinal mucosa and PBMC of intestinal TB were remarkably similar to Crohn's disease, and demonstrated innate immune activation and T-helper 1 polarisation.
Collapse
Affiliation(s)
- S Pugazhendhi
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | | | | |
Collapse
|
16
|
Kabeerdoss J, Sankaran V, Pugazhendhi S, Ramakrishna BS. Clostridium leptum group bacteria abundance and diversity in the fecal microbiota of patients with inflammatory bowel disease: a case-control study in India. BMC Gastroenterol 2013; 13:20. [PMID: 23351032 PMCID: PMC3565871 DOI: 10.1186/1471-230x-13-20] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 01/23/2013] [Indexed: 12/27/2022] Open
Abstract
Background Alterations in the fecal bacterial flora occur in inflammatory bowel disease (IBD). We examined the abundance and diversity of Clostridium leptum group, an important group of carbohydrate-fermenting bacteria, in the feces of patients with IBD and compared them with healthy controls. Methods Seventeen healthy controls (HC), 20 patients with Crohn’s disease (CD) and 22 patients with ulcerative colitis (UC) participated in the study. DNA extracted from fecal samples was amplified by PCR targeting 16S rRNA gene sequences specific to C. leptum group. The PCR product was subjected to temporal temperature gradient electrophoresis (TTGE) and the number and position of individual bands were noted and diversity was estimated. The identity of bands at different positions was confirmed by cloning and sequencing. Real time quantitative PCR with Mesa Green, targeted at specific 16S rRNA gene sequences, was used to quantitate C. leptum group and its most prominent constituent, Faecalibacterium prausnitzii. Results Twenty five different operational taxonomic units (OTUs, equivalent to species) were identified constituting the C. leptum group in these participants. Their sequences were deposited in GenBank [accession numbers GQ465348 to GQ465370]. OTU number was significantly reduced in CD (7.7±3.7, mean±SD) and UC (9.0±3.0) compared to HC (11.9±2.2) (P=0.0005). The Simpson D index of alpha diversity was not significantly different between the three groups. Total numbers of C. leptum group bacteria and F. prausnitzii were reduced in both CD and UC compared to HC (P=0.0036 and P<0.0001 respectively). Disease activity did not influence numbers of C. leptum or F. prausnitzii in patients with CD or UC. Conclusion C. leptum numbers and diversity were significantly reduced in both CD and UC suggesting that alterations noted were not specific to one disease. This could contribute to reduced short chain fatty acid production in IBD.
Collapse
Affiliation(s)
- Jayakanthan Kabeerdoss
- Wellcome Trust Research Laboratory, Department of Gastrointestinal Sciences, Christian Medical College, Vellore, 632004, India
| | | | | | | |
Collapse
|
17
|
|
18
|
|
19
|
Kabeerdoss J, Devi RS, Mary RR, Prabhavathi D, Vidya R, Mechenro J, Mahendri NV, Pugazhendhi S, Ramakrishna BS. Effect of yoghurt containing Bifidobacterium lactis Bb12® on faecal excretion of secretory immunoglobulin A and human beta-defensin 2 in healthy adult volunteers. Nutr J 2011; 10:138. [PMID: 22196482 PMCID: PMC3265429 DOI: 10.1186/1475-2891-10-138] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 12/23/2011] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Probiotics are used to provide health benefits. The present study tested the effect of a probiotic yoghurt on faecal output of beta-defensin and immunoglobulin A in a group of young healthy women eating a defined diet. FINDINGS 26 women aged 18-21 (median 19) years residing in a hostel were given 200 ml normal yoghurt every day for a week, followed by probiotic yoghurt containing Bifidobacterium lactis Bb12® (10⁹ in 200 ml) for three weeks, followed again by normal yoghurt for four weeks. Stool samples were collected at 0, 4 and 8 weeks and assayed for immunoglobulin A and human beta-defensin-2 by ELISA. All participants tolerated both normal and probiotic yoghurt well. Human beta-defensin-2 levels in faeces were not altered during the course of the study. On the other hand, compared to the basal sample, faecal IgA increased during probiotic feeding (P = 0.0184) and returned to normal after cessation of probiotic yoghurt intake. CONCLUSIONS Bifidobacterium lactis Bb12® increased secretory IgA output in faeces. This property may explain the ability of probiotics to prevent gastrointestinal and lower respiratory tract infections.
Collapse
Affiliation(s)
- Jayakanthan Kabeerdoss
- Department of Gastrointestinal Sciences & Dietary Services, Christian Medical College, Vellore, India
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Pugazhendhi S, Sahu MK, Subramanian V, Pulimood A, Ramakrishna BS. Environmental factors associated with Crohn's disease in India. Indian J Gastroenterol 2011; 30:264-9. [PMID: 22161539 DOI: 10.1007/s12664-011-0145-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [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] [Received: 11/07/2010] [Accepted: 11/01/2011] [Indexed: 02/04/2023]
Abstract
BACKGROUND The frequency of diagnosis of Crohn's disease (CD) in India is increasing. This case-control study was designed to detect associations of environmental and dietary factors with the diagnosis of CD. METHODS In 200 consecutive patients with CD and 200 control subjects without gastrointestinal disease, environmental hygiene exposures in childhood and in the past one year, and dietary preferences were recorded using a questionnaire. Univariate and multivariate analyses were done. RESULTS In univariate analysis, CD showed positive association with urban residence (at birth and current), availability of protected drinking water (childhood and current), availability of piped water in the house (childhood and current), and strict vegetarian dietary habit, and negative association with regular fish consumption and presence of cattle in the house compound. Multivariate analysis showed that regular fish consumption (OR 0.52, 95% CI 0.33-0.80, p = 0.003), and presence of cattle in the house compound currently (OR 0.57, 95% CI 0.35-0.92, p = 0.023) were significant protective associations, whereas use of safe drinking water was positively associated (OR 1.59, 95% CI 1.02-2.47, p = 0.042) with the disease. CONCLUSION Occurrence of CD was associated with dietary and environmental exposures, which indicate that diet and hygiene may influence the development of this disease.
Collapse
|
21
|
Rajesh R, Pugazhendhi S, Ganesh K, Yves D, Lenny Koh SC, Muralidharan C. Perceptions of service providers and customers of key success factors of third-party logistics relationships – an empirical study. International Journal of Logistics Research and Applications 2011. [DOI: 10.1080/13675567.2011.635640] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- R. Rajesh
- a Department of Mechanical Engineering , Noorul Islam University , Kumarakoil, India
| | - S. Pugazhendhi
- b Department of Manufacturing Engineering , Annamalai University , Chidambaram, India
| | - K. Ganesh
- c Supply Chain Management - Center of Competence , McKinsey Knowledge Center, McKinsey & Company , Gurgaon, Haryana, India
| | - Ducq Yves
- d University of Bordeaux , IMS-LAPS-GRAI – UMR 5218 CNRS, 351 cours de la Libération, 33405, Talence cedex, France
| | - S. C. Lenny Koh
- e Management School, Logistics and Supply Chain Management (LSCM) Research Centre , The University of Sheffield , 9 Mappin Street, Sheffield, S1 4DT, UK
| | - C. Muralidharan
- b Department of Manufacturing Engineering , Annamalai University , Chidambaram, India
| |
Collapse
|
22
|
Ramakrishna BS, Binder HJ, Subramanian V, Pugazhendhi S, Kabeerdoss J. Exposure to hookworms in patients with Crohn's disease: authors' reply. Aliment Pharmacol Ther 2011; 34:1250. [PMID: 22004257 DOI: 10.1111/j.1365-2036.2011.04868.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Affiliation(s)
- B S Ramakrishna
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
| | | | | | | | | |
Collapse
|
23
|
Abstract
BACKGROUND Helminths have been used to inhibit intestinal inflammation in patients with Crohn's disease. AIM This study was undertaken to determine if there is a protective association of prior hookworm infection with Crohn's disease, in a region where there is epidemiological transition from parasitic and infectious diseases to increased auto-inflammatory diseases. METHODS Hookworm exposure was assessed by peripheral blood mononuclear cell (PBMC) activation by hookworm antigens in 78 patients with Crohn's disease and 75 healthy control participants. The change in proportion of T cells exhibiting CD69 after exposure to crude hookworm antigens was measured. Interferon-γ ELISPOT response to a panel of six recombinant hookworm antigens was analysed. RESULTS Patients with Crohn's disease were more often from an urban background (P=0.005) compared to controls, while their socioeconomic status was not significantly different. T cell activation (increase in CD3(+) CD69(+) population) by hookworm antigen was significantly higher in controls compared to Crohn's disease patients (P=0.017), while activation by the nonspecific mitogen phytohemagglutinin was similar in both groups. Circulating T memory cells (CD3(+) CD45RO(+)) after exposure to hookworm antigens were not significantly different between the two groups. Mirroring these changes, interferon-γ ELISPOT responses to hookworm antigens were seen in 36 of 75 controls compared to 20 of 78 Crohn's disease patients (Fisher's exact P=0.005). Multivariate analysis indicated that CD3CD69 shifts (P=0.019), ELISPOT reactivity (P=0.039) and place of residence (P=0.024) were all independently associated with Crohn's disease. CONCLUSION The inverse association between Crohn's disease and hookworm antigen reactivity is consistent with the hygiene hypothesis, but requires further exploration.
Collapse
Affiliation(s)
- J Kabeerdoss
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | | | | | | |
Collapse
|
24
|
Rajesh R, Pugazhendhi S, Ganesh K. Towards taxonomy architecture of knowledge management for third‐party logistics service provider. Benchmarking 2011. [DOI: 10.1108/14635771111109814] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
25
|
Rajesh R, Pugazhendhi S, Ganesh K, Muralidharan C. AQUA: Analytical model for evaluation and selection of Third-Party Logistics service provider in supply chain. ACTA ACUST UNITED AC 2011. [DOI: 10.1504/ijsom.2011.037439] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
26
|
Rajesh R, Pugazhendhi S, Ganesh K. Genetic Algorithm and Particle Swarm Optimization for Solving Balanced Allocation Problem of Third Party Logistics Providers. International Journal of Information Systems and Supply Chain Management 2011. [DOI: 10.4018/jisscm.2011010102] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Third party logistics (3PL) service providers play a growing responsibility in the management of supply chain. The global and competitive business environment of 3PLs has recognized the significance of a speedy and proficient service towards the customers in the past few decades. Particularly in warehousing, distribution, and transportation services, a number of customers anticipate 3PLs to improve lead times, fill rates, inventory levels, etc. Therefore, the 3PLs are under demands to convene a range of service necessities of customers in an active and uncertain business environment. As a consequence of the dynamic environment in which supply chain must operate, 3PLs should sustain an effective distribution system of high performance and must make a sequence of inter-related decisions over time for their distribution networks. Warehouses play an important role in sustaining the continual flow of goods and materials between the manufacturer and customers. The performance of the 3PL supply chain network can be effortlessly enhanced by a balanced allocation of customers to warehouses. In this paper, the authors develop a genetic algorithm and a particle-swarm-optimisation algorithm for solving the balanced allocation problem and the results are encouraging.
Collapse
|
27
|
Mir KA, Pugazhendhi S, Paul MJ, Nair A, Ramakrishna BS. Heat-shock protein 70 gene polymorphism is associated with the severity of diabetic foot ulcer and the outcome of surgical treatment. Br J Surg 2009; 96:1205-9. [DOI: 10.1002/bjs.6689] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abstract
Background
Foot ulcer is a significant cause of morbidity in diabetics. Genetic make-up can determine inflammatory and healing responses. This study examined the hypothesis that specific polymorphisms of the heat-shock protein 70 gene could predispose to the severity of diabetic foot ulceration.
Methods
Some 106 consecutive diabetic patients (101 evaluable) with foot ulceration admitted to a tertiary care hospital were managed according to a standard protocol. DNA was extracted from venous blood and examined by polymerase chain reaction–restriction fragment length analysis for two specific polymorphisms: G1538A in the HSPA1B and C2437T in the HSPA1L gene.
Results
HSPA1B genotyping showed that 70 patients were AG and 30 GG (one not amplified). The AG genotype was significantly associated with the severity of foot ulceration (Wagner grade) (P = 0·008, χ2 test), need for amputation (relative risk 2·02, 95 per cent confidence interval 1·02 to 4·01; P = 0·025) and median length of hospital stay (8 versus 5 days for GG; P = 0·043). HSPA1L genotypes (78 TT, 22 CT, one CC) did not show any significant association with these parameters.
Conclusion
The HSPA1B genotype, was associated with the severity of diabetic foot ulceration, need for amputation and duration of hospitalization in these patients.
Collapse
Affiliation(s)
- K A Mir
- Department of Surgical Endocrinology, Christian Medical College, Vellore, India
| | - S Pugazhendhi
- Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India
| | - M J Paul
- Department of Surgical Endocrinology, Christian Medical College, Vellore, India
| | - A Nair
- Department of Surgical Endocrinology, Christian Medical College, Vellore, India
| | - B S Ramakrishna
- Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India
| |
Collapse
|
28
|
Nandakumar NS, Pugazhendhi S, Ramakrishna BS. Effects of enteropathogenic bacteria & lactobacilli on chemokine secretion & Toll like receptor gene expression in two human colonic epithelial cell lines. Indian J Med Res 2009; 130:170-178. [PMID: 19797815] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND & OBJECTIVE The intestinal epithelium is part of the innate immune system responding to contact with pathogenic or commensal bacteria. The objective of this study was to compare innate responses of intestinal epithelial cell lines to pathogenic bacteria and to lactobacilli. METHODS Two human intestinal epithelial cell lines, HT29 (enterocyte-like) and T84 (crypt-like), were exposed to pathogenic bacteria representative of non invasive (Vibrio cholerae O1 and O139), adherent (enterohaemorrhagic Escherichia coli, EHEC) or invasive (Salmonella Typhimurium and Shigella flexneri) phenotypes and to non pathogenic Lactobacillus rhamnosus GG or Lactobacillus plantarum. Interleukin-8 (IL-8) was measured in culture supernatant by ELISA, while mRNA from cells was subjected to quantitative reverse transcriptase PCR for several other chemokines (CXCL1, CCL5 and CXCL5) and for Toll-like receptors (TLR) 2, 4, 5 and 9. RESULTS V. cholerae, S. Typhimurium, S. flexneri and EHEC induced IL-8 secretion from epithelial cells into the medium. Salmonella, Shigella and EHEC, but not V. cholerae, significantly increased mRNA expression of CXCL1. None of the pathogens induced CCL5 or CXCL5. Salmonella and Vibrio significantly increased TLR4 expression, while Vibrio and EHEC decreased TLR5 expression. EHEC also decreased TLR9 expression. Lactobacilli attenuated the IL-8 response of the cell lines to V. cholerae, Salmonella, and EHEC but did not significantly change the IL-8 response to Shigella. INTERPRETATION & CONCLUSION Distinct patterns of epithelial cell chemokine responses were induced by the bacterial pathogens studied and these were modulated by commensal lactobacilli. Alterations in TLR expression by these pathogens are likely to be important in pathogenesis.
Collapse
Affiliation(s)
- N S Nandakumar
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | | |
Collapse
|
29
|
Nandakumar NS, Pugazhendhi S, Madhu Mohan K, Jayakanthan K, Ramakrishna BS. Effect of Vibrio cholerae on chemokine gene expression in HT29 cells and its modulation by Lactobacillus GG. Scand J Immunol 2009; 69:181-7. [PMID: 19281529 DOI: 10.1111/j.1365-3083.2008.02214.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Epithelial cells participate in the innate immune response to pathogenic bacteria by elaborating chemokines. This study examined the effect of Vibrio cholerae and Lactobacillus rhamnosus GG on inflammatory chemokine gene expression in the HT29 human intestinal epithelial cell line. HT29 cells were exposed to V. cholerae 0139, Lactobacillus or both for 2 h and cultured further thereafter for 4 h. RNA was extracted from the cells and expression of genes for chemokines and related molecules was quantitated by real time PCR using a pathway-focused PCR array. TLR4 was silenced using shRNA and output of interleukin-8 (IL-8) into the media quantitated with and without V. cholerae exposure. NFkappaB and p38 MAP kinase activation were determined by immunoblotting for IkappaBalpha and phosphorylated p38. Vibrio cholerae significantly upregulated gene expression for the neutrophil chemoattractant CXCL chemokines, IL-8, CXCL and CXCL in HT29 cells, while downregulating the expression of macrophage-attracting C-C chemokines. TLR4 silencing did not reduce IL-8 output from HT29 cells in response to V. cholerae. IkappaBalpha degradation was noted in the HT29 cells soon after exposure to V. cholerae and this recovered over time after removal of bacteria. p38 MAP kinase activation was not noted. Vibrio cholerae upregulated the expression of neutrophil attractant chemokines, most prominently IL-8, in HT29 cells, but downregulated macrophage-attracting chemokines. Probiotic lactobacilli modulated the IL-8, but not the other chemokine gene changes, in response to V. cholerae.
Collapse
Affiliation(s)
- N S Nandakumar
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | | | | | | |
Collapse
|
30
|
Nanda Kumar NS, Balamurugan R, Jayakanthan K, Pulimood A, Pugazhendhi S, Ramakrishna BS. Probiotic administration alters the gut flora and attenuates colitis in mice administered dextran sodium sulfate. J Gastroenterol Hepatol 2008; 23:1834-9. [PMID: 19120873 DOI: 10.1111/j.1440-1746.2008.05723.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [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 Probiotics are used in the therapy of inflammatory bowel disease. This study aimed to determine whether prior administration of probiotic lactobacilli and bifidobacteria would prevent disease and change gut flora in an animal model of colitis. METHODS Swiss albino mice received a probiotic mixture (four Lactobacillus and four Bifidobacterium species) or medium (control) for a week prior to induction of colitis by oral 4% dextran sodium sulfate (DSS) for seven days. Appropriate non-colitis controls were used. Histological damage was assessed (n = 5 per group), as was expression of mRNA for tumor necrosis factor (TNF)-alpha, interferon (IFN)-gamma, transforming growth factor (TGF)-beta1 and SOCS-1 in the colonic mucosa (n = 6 per group). Secretion of TNF-alpha was measured in distal colon organ culture (n = 5-6 per group). Levels of Bacteroides, Bifidobacterium, and Lactobacillus acidophilus in feces were quantified by real time polymerase chain reaction (PCR) targeting 16S rDNA. RESULTS Compared to untreated DSS colitis, probiotic treatment significantly reduced weight loss (P < 0.05), shifted histological damage to lesser grades of severity (P < 0.001), reduced mRNA expression of TNF-alpha and TGF-beta1 (P < 0.05), and down-regulated production of TNF-alpha from distal colon explants (P < 0.05). Colitis induced a significant reduction in the relative proportions of Bifidobacterium, Bacteroides and Lactobacillus acidophilus group bacteria in feces, and these levels were significantly increased in probiotic-treated mice compared to DSS mice (P < 0.001). CONCLUSION Prior administration of probiotic bacteria reduced mucosal inflammation and damage in DSS-induced colitis. DSS colitis was associated with significant changes in the fecal anaerobic bacterial flora and these changes were modulated by administration of probiotic bacteria.
Collapse
Affiliation(s)
- Navalpur S Nanda Kumar
- Department of Gastrointestinal Sciences, The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India
| | | | | | | | | | | |
Collapse
|
31
|
Hussain Z, Logamuthukrishnan K, Dharmarajan S, Thiagarajan G, Subbaiah SD, Narayana G, Anbuselvam M, Murugan L, Pugazhendhi S. Oral facial digital syndrome. Neurol India 1997; 45:34-37. [PMID: 29509158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We report a female infant with features suggestive of Oral Facial Digital Syndrome (OFDS) Type I and associated cerebellar anomalies with Dandy-Walker malformation which suggest OFDS Type VI. The phenotypic overlap in this child OFDS type I and TypeVI raises the question as to whether they represent separate genetic entities. This pattern of abnormalities appears to be unique.
Collapse
Affiliation(s)
- Z Hussain
- Department of Neurology, Government General Hospital, Madras - 600 003, India
| | - K Logamuthukrishnan
- Department of Neurology, Government General Hospital, Madras - 600 003, India
| | - S Dharmarajan
- Department of Neurology, Government General Hospital, Madras - 600 003, India
| | - G Thiagarajan
- Department of Neurology, Government General Hospital, Madras - 600 003, India
| | - S D Subbaiah
- Department of Neurology, Government General Hospital, Madras - 600 003, India
| | - Gsj Narayana
- Department of Neurology, Government General Hospital, Madras - 600 003, India
| | - M Anbuselvam
- Department of Neurology, Government General Hospital, Madras - 600 003, India
| | - L Murugan
- Department of Neurology, Government General Hospital, Madras - 600 003, India
| | - S Pugazhendhi
- Department of Neurology, Government General Hospital, Madras - 600 003, India
| |
Collapse
|