Apmis

doi: 10.1111/apm.12326pmid: N/A

Sener, Asli Gamze

doi: 10.1111/apm.12442pmid: 26359647

Autoimmune hepatitis is a chronic hepatitis of unknown etiology characterized by clinical, histological, and immunological features, generally including circulating autoantibodies and a high total serum and/or gamma globulin. Liver‐related autoantibodies are very significant for the correct diagnosis and classification of autoimmune liver diseases (AILD), namely autoimmune hepatitis types 1 and 2 (AIH‐1 and 2), primary biliary cirrhosis (PBC), and the sclerosing cholangitis types in adults and children. This article intends to review recent studies that investigate autoantibodies in autoimmune liver diseases from a microbiological perspective.

Jørgensen, Peter Hjorth; Vainer, Ben; Hermann, Gregers Gautier

doi: 10.1111/apm.12456pmid: 26358542

Inverted papilloma (IP) of the urinary tract is classified by the World Health Organisation as a non‐invasive urothelial tumour with normal to minimal cytological atypia of the neoplastic cells. During the 1980s, it came under suspicion of having a premalignant or malignant potential and of being concurrent with urothelial cell carcinoma (UCC). This quandary has been proven difficult to solve, due to the fact that IP is very rare and literature mostly consists of case reports with varying levels of information, making strong meta‐analyses problematic. New immunohistochemical techniques and genetic approaches are more frequently being used in the attempt to achieve better classifications, prognosis and treatment of lesions hereunder IP. This review will, in our awareness, be the first to combine the knowledge from retrospective studies with these new approaches for determining a possible premalignant potential and concurrency with UCC and subsequently outline a recommendation for follow‐up.

Gupta, Parikshaa; Dey, Pranab; Gupta, Nalini

doi: 10.1111/apm.12441pmid: 26358408

Micronucleus (MN) is an additional, small nucleus formed due to failure of incorporation of a fragment or the whole chromosome into the main daughter nuclei during cell division. MN scoring is a useful indicator of exposure to genotoxic agents and of malignancy. This study was conducted to know whether the MN score was significantly different in cervical cytology smears of patients with endometrial carcinoma, atypical and benign cells. Three groups of cervical smears were taken up for MN scoring: Group ‘A’ included benign endometrial cells, Group ‘B’, atypical glandular cells – endometrial and Group ‘C’, endometrial adenocarcinoma. Post hoc analysis of variance test was used to determine significant differences between the three groups. There were 30 cases in Group ‘A’, 31 cases in Group ‘B’ and 39 cases in Group ‘C’. The mean MN score was 0.67 ± 0.711 in Group A, 1.74 ± 0.930 in Group B and 4.10 ± 2.500 in Group C. MN scores were significantly different between all three groups (p < 0.05). The MN score is significantly higher in cervical smears of patients with endometrial carcinoma; as compared to smears showing atypical and benign cells and that this finding may be useful for further research.

Mitra, Suvradeep; Anand, Shashi; Das, Ashim; Thapa, Baburam; Chawla, Yogesh Kumar; Minz, Ranjana Walker

doi: 10.1111/apm.12457pmid: 26434354

Autoimmune liver diseases (AILDs) encompass a group of diseases with variable clinicopathological manifestations. Th17 and Treg cells have roles in the pathogenesis of AILDs with a balance shifted towards a relative increase in activity of the Th17 cells. In this study, the balance between the transcription factors of Treg and Th17 cells (FoXp3 and RORγt) was sought as a molecular marker of disease activity and to highlight the pathogenesis. The peripheral blood samples of 46 treatment‐naive patients were collected and RNA was extracted. Real time PCR was performed and the ratio of gene expression was calculated. Histopathology of 18 patients was obtained and the activity score of these biopsies were also corroborated with their respective molecular (FoXp3/RORγt) (FRGT=FoXp3‐ROR Gamma T) ratio. The FRGT ratio in healthy individuals was close to 1 and in disease the ratio changed significantly. This ratio (FRGT) was not significantly different in different varieties of AILD or in adult or paediatric form of the disease. However, the ratio remained consistently below 1 (mean 0.3) in acute disease and high (mean 224.7) in chronic or asymptomatic form of the disease (p < 0.001). The histopathological activity score also significantly correlated with the ratio. This signified the relative excess of Th17 (RORγt) in active disease as compared to Treg (FoXp3) and the reverse in chronic form. This ratio can be an important peripheral molecular marker to assess the disease activity without the necessity of performing a liver biopsy.

Lee, Chi‐Tsung; Hsiao, Kuang‐Ming; Chen, Jin‐Cherng; Su, Cheng‐Chuan

doi: 10.1111/apm.12437pmid: 26332098

Acute bacterial meningitis causes high morbidity and mortality; the associated clinical symptoms often are insensitive or non‐specific; and the pathogenic bacteria are geographically diverse. Clinical diagnosis requires a rapid and accurate methodology. This study aimed to develop a new multiplex polymerase chain reaction (mPCR) assay to detect simultaneously six major bacteria that cause adult bacterial meningitis in Taiwan: Klebsiella pneumoniae, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus aureus, Escherichia coli, and Acinetobacter baumannii. Species‐specific primers for the six bacteria were developed using reference strains. The specificities of the mPCRs for these bacteria were validated, and the sensitivities were evaluated via serial dilutions. The mPCR assay specifically detected all of the six pathogens, particularly with sensitivities of 12 colony forming units (CFU)/mL, 90 CFU/mL, and 390 CFU/mL for E. coli, S. pneumoniae, and K. pneumoniae, respectively. This mPCR assay is a rapid and specific tool to detect the six major bacterial pathogens that cause acute adult meningitis in Taiwan, particularly sensitive for detecting E. coli, S. pneumoniae, and K. pneumoniae. The assay may facilitate early diagnosis and guidance for antimicrobial therapy for adult patients with this deadly disease in Taiwan.

Perez, Leandro Reus Rodrigues

doi: 10.1111/apm.12438pmid: 26361367

Determination of polymyxin susceptibility profile is important to monitor resistance rates and for implementing control measures for polymyxin‐resistant carbapenem‐resistant Enterobacteriaceae. Some laboratorial methods have been used to determine the polymyxin susceptibility profile. However, the performance of MicroScan WalkAway has been poorly reported for KPC‐producing Klebsiella pneumoniae, so far. To evaluate two different methods, Etest and the MicroScan automated system, in determining minimal inhibitory concentration (MIC) of polymyxin among KPC‐producing K. pneumoniae isolated from patients in two care units (ICUs) of a tertiary hospital in Porto Alegre, Southern Brazil. A total of 101 KPC‐Kb isolates were obtained from rectal swabs and clinical specimens (urine, blood, and endotracheal aspirate). Colistin and polymyxin B MICs were determined using MicroScan WalkAway automated system and Etest, respectively. Discrepant results were resolved by broth microdilution (BMD). MicroScan showed 88.1% of sensitivity for predicting polymyxin B resistance in KPC‐producing K. pneumoniae compared to the results obtained by Etest. All discrepant results were tested by BMD and these were concordant with results obtained by Etest. The MicroScan automated system does not seem to be very efficient for the screening of polymyxin‐resistant isolates once an inappropriate sensitivity is achieved. The results presented here show the need for confirmation of the susceptibility profile by use of a dilution method (Etest or BMD).

Golparian, Daniel; Hellmark, Bengt; Unemo, Magnus

doi: 10.1111/apm.12440pmid: 26332192

Detection of Neisseria gonorrhoeae relies increasingly on nucleic acid amplification tests (NAATs). The specificity of many gonococcal NAATs has been suboptimal and supplementary testing remains recommended in Europe and several additional countries. The novel dual‐target GeneProof Neisseria gonorrhoeae PCR kit, targeting porA pseudogene and 16S rRNA gene, showed a high specificity and sensitivity when isolates of non‐gonococcal Neisseria and related species (n = 144), and gonococci (n = 104) were tested. However, rare gonococcal porA mutants were only detected in the 16S rRNA gene target and two non‐gonococcal isolates showed a low‐level cross‐reactivity in the 16S rRNA gene target. The detection limit for both targets was 1.5 copies per reaction.

Modarresi, Farzan; Azizi, Omid; Shakibaie, Mohammad Reza; Motamedifar, Mohammad; Valibeigi, Behnaz; Mansouri, Shahla

doi: 10.1111/apm.12455pmid: 26350174

Resistance‐nodulation‐division efflux system (RND) adeABC contributes to intrinsic resistance to various drug classes in Acinetobacter baumannii. Similarly, quorum sensing (QS) plays an important role in the biofilm formation and pathogenicity of this bacterium. The aims of this study were to evaluate the influence of iron limitation on the expression of efflux pump (adeABC) genes and QS (luxI, luxR) system by relative quantitative real‐time polymerase chain reaction (qRT‐PCR). In addition, DNA sequence and phylogenetic relatedness of biofilm‐associated protein (Bap) gene was also investigated. Sixty‐five multidrug‐resistant isolates of A. baumannii were recovered from ICU patients of three hospitals in Kerman, Iran. The isolates were highly resistant to at least 11 antibiotics (MIC ≥64 μg/mL); however, 87% and 89% were susceptible to colistin and tigecycline, respectively (MIC 0.05 μg/mL) (p ≤ 0.05). We detected the presence of RND efflux pump, QS, and bap genes with the frequencies of 92% (adeA), 61.5% (adeB), 84.6% (adeC), 80% (luxI), 61% (luxR), and 66% (bap), respectively. qRT‐PCR analysis showed that in some isolates, expression of both adeABC and luxI/R was increased more than fourfold in the presence of low iron (20 μm), suggesting the additional regulatory role of iron on both efflux pump and QS system. Alignment and phylogenetic analysis on the strong biofilm forming isolates confirmed that the fragments amplified were indeed part of bap gene and deduced sequence was similar to A. baumannii K9B410.

Essa, Enas S.; Elzorkany, Khaled M. A.

doi: 10.1111/apm.12459pmid: 26495896

The triggering receptor expressed on myeloid cells‐1 (TREM‐1) is a member of the immunoglobulin superfamily. TREM‐1 has been implicated as an amplifier of inflammation. Soluble TREM‐1 (sTREM‐1) was investigated in different clinical conditions, but not in hemodialysis (HD) patients. We aimed to investigate sTREM‐1 as a marker of inflammation in HD patients. We investigated 40 CKD patients undergoing chronic HD treatment and 15 controls. Routine laboratory investigations in addition to CRP measured by immunoturbidimetry, TNF‐ α, and sTREM‐1 measured by ELISA were assayed in post–hemodialysis patients’ blood samples and in controls’ blood samples. CRP, TNF‐α, and sTREM‐1 levels were significantly higher in HD patients than in controls (p < 0.001 for all). sTREM‐1 was positively correlated with CRP and TNF‐α (r = +0.50, p < 0.001 and r = +0.53, p < 0.001 respectively). It was negatively correlated with hemoglobin concentration (r = −0.69, p < 0.001). Hemoglobin concentration was the significant predictor of sTREM‐1 level (p < 0.001). In conclusion, sTREM‐1 level is significantly increased in HD patients as are other pro‐inflammatory markers.