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Toll-like receptors play an important role in innate and adaptive immune responses and can induce acute graft rejection, especially in the early phase after transplant. The aim of this study was to evaluate the possible association between TLR2, TLR4, and CD14 polymorphisms and acute renal rejection.Our study included 239 patients seen between 2013 and 2015. Patients were classified into 3 groups: acute rejection group (71 patients), stable graft function group (71 patients), and healthy control group (97 patients). Polymorphisms in TLR2 (Arg753Gln, rs5743708), TLR4 (Asp299Gly, rs4986790; Thr399Ile, rs4986791), and CD14 (-159C/T, rs2569190) were determined by the TaqMan allelic discrimination assay for detection of single-nucleotide polymorphisms.The genotype distribution of CD14 rs2569190C/T was found to be significantly different among the acute rejection, stable graft function, and healthy control groups (P.05). Interestingly, based on logistic regression, CD14 genotype (rs2569190) in patients with acute rejection was still significant after including risk factors. The adjusted odds ratio for CD14 CT+TT over CC genotype was calculated as 3.172 (95% confidence interval, 1.397-7.200; P = .006). Moreover, incidence of acute rejection and graft loss were significantly more frequent in recipients carrying CD14 TT (95% confidence interval, 2.81-27.16; P ≤ .001). In contrast to CD14, no significant differences were observed in the single-nucleotide polymorphisms of TLR2 and TLR4 genes in the acute rejection group versus the stable graft function and healthy control groups. The presence of CD14 T allele was associated with a significantly lower rejection-free survival compared with the CD14 CT and CC genotypes (P ≤ .001).Renal transplant recipients carrying the CD14-159 TT genotype have significantly higher risk of acute rejection and reduced transplant survival rate than patients with heterozygous or wild-type genotypes.

Background The available data regarding Clostridium difficile infections (CDIs) in developing countries are scarce. This may be related in part to the complexity of anaerobic bacterial culture and/or cytotoxicity assays of C. difficile. Here, we evaluated the diagnostic efficacy of PCR in comparison with toxigenic culture for direct detection of conserved genes as well as toxin genes of C. difficile in fecal specimens of patients with clinical symptoms of CDI. Methods Loose or soft feces from 171 patients suspected of having C. difficile associated diarrhea (CDAD) were subjected to DNA extraction, PCR of cdu-2, cdd-3, gdh, tpi, tcdA/B, and toxigenic culture (TC). Limit of detection (LoD) was defined as the lowest concentration of DNA at which the target gene was amplified via PCR. The Kappa agreement between two diagnostic tests was calculated. Results The in-house extraction method extracted DNA successfully as confirmed by amplification of conserved genes of C. difficile. LoD of PCR for total DNA was 0.064 ng/μL. Only 10 specimens were positive for C. difficile via both PCR and TC. Among 10 identified C. difficile strains, 8 were tcdA+B+, but 2 were tcdA-B+. A very good agreement was observed between TC as reference method and PCR (κ = 1). Conclusions Despite the high concordance between PCR and TC, this in-house nucleic acid amplification test can be used to identify symptomatic patients who harbor high amounts of bacteria. This procedure allows primary and same day diagnosis of C. difficile, and clinical laboratories in low-income countries may adopt the method for sample extraction and PCR assay at least for symptomatic patients.

Human gastric epithelium and immunocytes have been recognized as the sole specialized eukaryotic cells that host Helicobacter pylori (H. pylori). The aim of this study was to provide further evidence for our previous proposal regarding the occurrence of H.pylori inside the yeast vacuole, verifying the viability of the intravacuolar H.pylori by western blotting.Light microscopy and polymerase chain reaction (PCR) were used for primary detection of nonculturable H.pylori in 11 Candida yeasts (six oral and five gastric). Boiling was used for extraction of proteins from yeasts and the control H.pylori. Western blot analysis was recruited to assess the occurrence of H.pylori-specific proteins in protein pool of yeasts, using IgY-Hp raised in hens and IgG1-Hp raised in mice.The fast-moving bacterium-like bodies (BLBs) were identified as H.pylori by amplification of H.pylori 16S rRNA, ureAB, vacA s1, and ahpC genes from the whole DNA of yeasts. Analysis of the sequenced products of 16S rRNA gene amplified from the yeast and H.pylori isolates of patient #2 showed 100 % homology with the corresponding sequences of the reference H. pylori strains in GenBank. According to published data, it was plausible to assign the H.pylori-specific proteins, detected by western blot analysis, as thiol peroxidase (21 kDa), peroxiredoxin (AhpC) (26 kDa), urease-A subunit (UreA) (32 kDa), vacuolating cytotoxin A (VacA) small subunit (36 kDa), and VacA large subunit (56 kDa).Results of this study show that inside yeast, H.pylori expresses proteins and is viable. These proteins appear to serve as powerful tools to help H.pylori to establish in the vacuole of yeast where it can reach nutrients and multiply. The intimate relationship between H.pylori and Candida yeast which began long time ago, could have led to the establishment of H.pylori inside the yeast vacuole before invading human cells.

Oral cavity has been proposed as an important reservoir of H.pylori, being implicated in bacterial transmission through oral-oral route. However, some investigators believe that the newborn acquires H.pylori from mother through vaginal delivery. In this study, oral and vaginal yeasts were examined for the intracellular occurrence of H.pylori and their possible role in bacterial transmission. Sixty nine oral and vaginal yeasts from expecting mothers (39 oral and 30 vaginal) and seven oral yeasts from neonates(6/46 vaginal delivery, 1/43 cesarean) were identified and studied by light and fluorescent microscopy for observing the intracellular bacterium-like bodies(BLBs). Whole DNAs of yeasts were recruited for detection of H.pylori-specific genes. Urea breath test (UBT) was performed for detection of H.pylori infection in mothers. Stool antigen test (SAT) was used for detection of H.pylori antigens in infants' stool at birth and six months of age. Oral yeasts were isolated more frequently from normally-delivered neonates. The frequency of H.pylori genes in mothers' vaginal yeasts was significantly higher than in mothers' oral yeasts. A significant correlation was found between the occurrence of H.pylori genes in vaginal yeasts and that in neonates' oral yeasts, occurrence of H.pylori genes in mothers' vaginal yeasts or neonates' oral yeasts, and UBT+ results in mothers.C.albicans which colonizes the oral cavity of neonates through vaginal delivery or contact with environment or healthcare workers could be an important reservoir of H.pylori. Vaginal yeasts are more potent in accommodating H.pylori than oral yeasts. Accordingly, vaginal yeast is proposed as the primary reservoir of H.pylori which facilitates H.pylori transmission to neonates.

Naheed Aryaeian1, Farhad Shahram2, Mahmoud Djalali1, Mohammad R Eshragian3, Abolghasem Djazayeri1, Abdolfatah Sarrafnejad4, Nasim Naderi2, Maryam Chamari1, Fariha Fatehi1, Mahnaz Zarei11Department of Nutrition and Biochemistry, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Iran; 2Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Iran; 3Department of Epidemiology and Biostatistics, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Iran; 4Department of Immunology, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, IranAbstract: The aim of this study was to assess the impact of conjugated linoleic acids (CLAs), vitamin E, and combination of these nutrients on serum lipid profiles and blood pressure (BP) in patients with active rheumatoid arthritis (RA). In a randomized, double-blind, placebo-controlled trial, 87 patients with active RA were divided into four groups receiving one of the following daily supplements for three months: Group C: CLAs 2.5 g equivalent to 2 g mixture of cis 9-trans 11 and trans 10-cis12 CLAs in a rate of 50/50; Group E: vitamin E: 400 mg; Group CE: CLAs and vitamin E at above doses: Group P: placebo. After supplementation, SBP levels decreased significantly in the group C in comparison with groups E and P and mean arterial pressure reduced signifi cantly in groups C and CE. There weren’t significant differences in the levels of prostaglandin E2 (PGE2), triglycerides, cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), LDL/HDL, cholesterol/HDL, fasting blood sugar, C-reactive protein (CRP), arylestrase activity, platelet count and body mass index between groups. CRP dropped nonsignificantly in groups P, C, E and CE (19%, 24%, 55%, and 39%, respectively). Erythrocytes sedimentation rate levels decreased in groups C, E and CE (P ≤0.05, P ≤0.05, P ≤0.001, respectively). It is concluded that supplementation of CLAs decreased BP and vitamin E decreased CRP. Therefore cosupplementation of CLAs and vitamin E might be profitable for heart disease prevention in RA patients.Keywords: rheumatoid arthritis, lipid profiles, blood pressure, conjugated linoleic acids, vitamin E