Autoimmune liver serology:Current diagnostic and clinical challenges

Liver-related autoantibodies are crucial for the correct diagnosis and classification of autoimmune liver diseas-es(AiLD),namely autoimmune hepatitis types 1 and 2(AIH-1 and 2),primary biliary cirrhosis(PBC),and the sclerosing cholangitis variants in adults and children.AIH-1 is specified by anti-nuclear antibody(ANA) and smooth muscle antibody(SMA).AIH-2 is specified by antibody to liver kidney microsomal antigen type-1(anti-LKM1) and anti-liver cytosol type 1(anti-LC1).SMA,ANA and anti-LKM antibodies can be present in de-novo AIH following liver transplantation.PBC is specified by antimitochondrial antibodies(AMA) react-ing with enzymes of the 2-oxo-acid dehydrogenase complexes(chiefly pyruvate dehydrogenase complex E2 subunit) and disease-specific ANA mainly react-ing with nuclear pore gp210 and nuclear body sp100.Sclerosing cholangitis presents as at least two variants,first the classical primary sclerosing cholangitis(PSC) mostly affecting adult men wherein the only(and non-specific) reactivity is an atypical perinuclear antineutro-phil cytoplasmic antibody(p-ANCA),also termed peri-nuclear anti-neutrophil nuclear antibodies(p-ANNA) and second the childhood disease called autoimmune sclerosing cholangitis(ASC) with serological features resembling those of type 1 AIH.Liver diagnostic serol-ogy is a fast-expanding area of investigation as new purified and recombinant autoantigens,and automatedtechnologies such as ELISAs and bead assays,become available to complement(or even compete with) tradi-tional immunofluorescence procedures.We survey for the first time global trends in quality assurance impact-ing as it does on(1) manufacturers/purveyors of kits and reagents,(2) diagnostic service laboratories that fulfill clinicians' requirements,and(3) the end-user,the physician providing patient care,who must properly interpret test results in the overall clinical context.

Immunologic changes to autologous transfusion after operational trauma in malignant tumor patients:Neopterin and Interleukin-2

Objective:To estimate the impact of autologous transfusion on the status of perioperative immune activation inmalignant tumor patients.The Serum Neopterin and Interleukin-2(IL-2)were measured.Methods:Sixty patients undergoingelective radical resection for malignant stomach tumor were enrolled in the prospective study and assigned to the following groups:(Ⅰ)Group A received autologous transfusion;(2)Group H received allogeneic transfusion.The perioperative course(Beforeinduction of anesthesia,after operation and 5 d after operation)of Neopterin and IL-2 was compared.Results:In group A,SerumNeopterin was significantly lower than baseline alter operation and IL-2 had no significant changes.In group H,both SerumNeopterin and IL-2 were significantly lower than baseline alter operation and 5 d after operation.Compared with group A,SerumNeopterin was significantly lower than baseline alter operation and 5 d after operation and IL-2 was significantly lower thanbaseline 5 d alter operation.Conchision:Autologous transfusion decreased the perioperative immune suppression in malignantstomach tumor patients.

Is enteroscopy necessary for diagnosis of celiac disease?

Celiac disease （CD） is an autoimmune inflammatory disease of the small intestine as a result of reaction to wheat protein, gluten. Exclusion of dietary gluten is the mainstay of the treatment that necessitates a precise diagnosis of the disease. Serological screen ing may aid in identifying patients with suspected CD, which should be confirmed by intestinal biopsy. It has been shown that duodenal biopsies are good for de- tection of the disease in most patients. However, there is a group of patients with positive serology and incon- clusive pathology. As a result of the widespread use of serology, many patients with equivocal findings grow quickly. Unfortunately current endoscopic methods can only diagnose villous atrophy, which can be present in the later grades of disease （i.e., Marsh m）. To diag- nose CD correctly, going deeper in the intestine may be necessary. Enteroscopy can reveal changes in CD in the intestinal mucosa in 10%-17% of cases that have negative histology at initial workup. Invasiveness of the method limits its use. Capsule endoscopy may be a good substitute for enteroscopy. However, both tech- niques should be reserved for patients with suspected diagnosis of complications. This paper reviews the cur- rent literature in terms of the value of enteroscopy for diagnosis of CD.

Antioxidant Activity and Anti-Hyperglycemic Effect of Lagenaria Siceraria Fruit Extract

Lagenaria siceraria （Molina） Standl., known as bottle gourd is widely available throughout Vietnam as an edible vegetable. Bottle gourd is a commonly fruit but there are little reports about its biological activities. The aim of the present study was to evaluate antioxidant activity and anti-hyperglycemic potential of ethanolic extract of bottle gourd. The ethanolic extract was tested for its antioxidant activity on chelating power, the ferric reducing/antioxidant power assay （FRAP） and the 1, 1-diphenyl-2-picryl-hydrazyl （DPPH） free radical scavenging assay. The results showed that chelating activity was 80.02%, FRAP value was 92.84 μmol Fe^2＋/g and active radical scavenging which showed an IC50 was 49.50 μg/ml. The five different doses of ethanolic extract were treated by oral tolerance to mice body before oral glucose tolerance and blood glucose level was measured using glucose oxidase method. The result indicated that inhibition percentage of ethanolic extract of bottle gourd at the dose of 400 mg/kg in glucose-induced hyperglycemic mice was effectively similar to standard drug glibenclamide. The results obtained indicate that ethanolic extract from bottle gourd is the potential antioxidant and anti-hyperglycemic agent.

Mechanism and effect of Shijueming (Concha Haliotidis) on serum calcium in spontaneously hypertensive rats

OBJECTIVE： To observe the impact of Shijueming （Concha Haliotidis） on spontaneously hypertensive rats via blood pressure, serum calcium, vascular smooth muscle membrane L-type calcium channel α1 C subunit （CaL-α1C）, plasma membrane calci- um-ATPase （PMCA） mRNA expression, and the L-type calcium channel in vascular smooth muscle cells. METHODS： Twelve-week-old male rats with sponta- neous hypertension were divided into three groups： a Shijueming （Concha Haliotidis） group （group 1）, a nifedipine group （group 2）, and a dis- tilled water group （group 3）. All were given a four-week treatment. Blood pressure and dissocia- tive serum calcium were examined before treat- ment. Blood pressure was taken every week during treatment. Atomic absorption spectrometry was used to examine dissociative serum calcium. Re-verse transcription-polymerase chain reaction was used to examine the expression of CaL-α1C and PM- CA1 mRNA. The patch clamp technique was used to examine the electrophysiological characteristics of the vascular smooth muscle cell calcium chan- nels. RESULTS： After treatment, blood pressure of the Shijueming （Concha Halioticlis） group lowered but not significantly （P〉0.05）. Blood pressure of the nifedipine group lowered significantly （P〈0.05）. Blood pressure of the distilled water group re- mained high. The concentration of serum calcium in the Shijueming （Concha Haliotidis） and the dis- tilled water groups lowered （P〈0.05）. Expression of CaL-α1C mRNA in the nifedipine group decreased compared with the distilled water group （P〈0.01）. There was the decreasing trend in the Shijueming （Concha Haliotidis） group, but it was not statistically significant. Shijueming （Concha Haliotidis） also had effects on the expression of PMCA1 mRNA but with- out statistical significance. However, there was a significant decreasing effect on vascular smooth muscle cell Ica-L flow. CONCLUSION： This study indicated that Shijuem- ing （Concha Haliotidis） could increase serum calci- um and decrease blood pressure. It may work by in- fluencing calcium channels, expression of PMCA1 mRNA, and regulating ion calcium channels and calcium-ATPase.