Nelly Espinosa - Academia.edu (original) (raw)

Papers by Nelly Espinosa

Research paper thumbnail of Fiebre Tifoidea: Complicaciones en 782 niños hospitalizados

Revista chilena de pediatría, 1981

Considering the increasing sick rate caused by Thyphoid Fever, 782 cases of typhoid in children (... more Considering the increasing sick rate caused by Thyphoid Fever, 782 cases of typhoid in children (to die age of 14) were checked at two Hospitals in Santiago, Chile. Children were divided into two groups according to positive and negative bacteriology presented on diagnosis, afterwards emphasis was given to those cases showing further complication symptoms. These were analysed according to age, sex, type oi complications, treatment received and death rate. The result showed that from all cases studied, a f2,7% presented complications; a 5,4% of these had had positive bacteriology diagnoses and a 7,3% negative ones. Most children were medically treated and only a 0,7% required surgical treatment Concerning medicines, cloramfenicol was largely prescribed being development of illness mostly satisfactory, except for one patient who died.

Research paper thumbnail of Helicobacter pylori cagA+ Is Associated with Milder Duodenal Histological Changes in Chilean Celiac Patients

Frontiers in cellular and infection microbiology, 2017

HIGHLIGHTS What is already known about this subject?Celiac disease (CD) has a high clinical and h... more HIGHLIGHTS What is already known about this subject?Celiac disease (CD) has a high clinical and histological diversity and the mechanisms underlying this phenomenon remain elusive.H. pylori is a bacterium that chronically infect gastric and duodenal mucosa activating both a Th1/Th17 and T-reg pathways.The role of H. pylori (and the effect of their virulence factors) in CD have not yet completely elucidated.What are the new findings?cagA+ H. pylori strains are associated to milder histological damage in infected CD patients.In active-CD patients the presence of cagA+ H. pylori is associated to an increase in T-reg markers, contrasting with a downregulation in cagA+ infected potential-CD individuals.How might it impact on clinical practice in the foreseeable future?The identification of microbiological factors that could modulate inflammation and clinical expression of CD may be used in the future as preventive strategies or as supplementary treatment in patients that cannot achieve c...

Research paper thumbnail of Micronutrient Deficiencies in Patients With Typical and Atypical Celiac Disease

Objective: The extent of the digestive/absorptive involvement in atypical presentation of celiac ... more Objective: The extent of the digestive/absorptive involvement in atypical presentation of celiac disease (CD) is not always clear. The aim of the study was to assess nutritional status of iron (Fe), copper (Cu), and zinc (Zn) in patients with typical CD (TCD) and atypical CD (ACD). Patients and Methods: A cross-sectional study was done in patients with TCD, ACD, and healthy controls (HC). Hemoglobin, serum ferritin, free erythrocyte protoporphyrin, Fe, Cu, ceruloplasmin, Zn, anti-endomysial antibodies, and anti-tissue transglutaminase antibodies were measured. Data were analyzed by Kruskal-Wallis, principal component analysis, and linear discriminant analysis. Results: One hundred nine individuals were studied (54 TCD, 19 ACD, 36 HC); mean age AE standard deviation was 23 AE 15.8 (range 1.6-75.4) years. Median and range of hemoglobin were 12.8 g/dL (8.1-17.6) in TCD, 12.4 g/ dL (10.5-14.5) in ACD, and 13.6 g/dL (11.1-16.7) in HC (P < 0.0001); serum ferritin was 17.7 mg/L (2.9-157), 10.8 mg/L (2.7-39.8), and 28.7 mg/L (4.5-127.2), respectively (P < 0.01). Cu was 105 mg/dL (60-185), 97.5 mg/dL (40-130), and 125 mg/dL (80-205), respectively (P < 0.05). Ceruloplasmin was 21.6 mg/dL (14.2-73.2), 22.6 mg/dL (0.9-34.3), and 32.1 mg/dL (5.8-72.6), respectively (P < 0.01). There were no differences in Fe, free erythrocyte protoporphyrin, and Zn. Principal component analysis showed that 58% of observed variability was explained by Fe and Cu indicators. Linear discriminant analysis revealed differences between CD and HC (P < 0.0001), with high values of correct classification for TCD (73%) and HC (72%), but not ACD (16%), which were mostly classified as TCD (79%). Conclusions: Deficiency of micronutrients was found both in typical as well as in atypical cases.

Research paper thumbnail of DQ2, DQ7 and DQ8 Distribution and Clinical Manifestations in Celiac Cases and Their First-Degree Relatives

Nutrients, 2015

HLA-linked genes are relevant to celiac disease (CD); the potential genetic differences present w... more HLA-linked genes are relevant to celiac disease (CD); the potential genetic differences present worldwide are not fully understood. Previous results suggest that the distribution of HLA-DQ2/DQ7/DQ8 in Chile may differ from that in Europe and North America. In celiac patients and their first-degree relatives (FDRS), we assessed their clinical, serological and histological characteristics, determined HLA-DQ2, HLA-DQ7 and HLA-DQ8 alleles and genotypes, and evaluated the relations between them. A total of 222 individuals were assessed (56 cases, 166 FDRs). 16.9% of FDRs were tTG positive; 53.6% of them showed overweight/obesity and 3% undernourishment; they spontaneously declared being asymptomatic, but detailed questioning revealed that 60.7% experienced symptoms, which had not been investigated. DQ2 was present in 53.9% and 43.9.0% of cases and FDRs (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The most frequent genotype distribution was DQ2/DQ7 (fr 0.392 (cases) and 0.248 (FDRs), respectively, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.02). The next most common genotypes were HLA-DQ2/DQ8 (fr 0.236 in FDRs and 0.176 in cases, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). 3.92% cases were not HLA-DQ2/DQ8 carriers. Among tTG positive FDRs, 57.4%, 22.3% and 20.2% carried DQ2, DQ7 and DQ8, respectively. In cases, 72.7% of the biopsies classified Marsh ≥3 carried at least one DQ2; 91.7% of DQ2/DQ2 and 88.3% of DQ2/DQ7 were Marsh ≥3. Thus, DQ2 frequency is lower than reported; the higher frequency found for DQ8 and DQ7 concur with recent publications from Argentine and Brazil. These results suggest that although CD may manifest clinically in ways similar to those described in other populations, some genetic peculiarities in this region deserve further study.

Research paper thumbnail of Micronutrient Deficiencies in Patients With Typical and Atypical Celiac Disease

Journal of Pediatric Gastroenterology and Nutrition, 2011

The extent of the digestive/absorptive involvement in atypical presentation of celiac disease (CD... more The extent of the digestive/absorptive involvement in atypical presentation of celiac disease (CD) is not always clear. The aim of the study was to assess nutritional status of iron (Fe), copper (Cu), and zinc (Zn) in patients with typical CD (TCD) and atypical CD (ACD). A cross-sectional study was done in patients with TCD, ACD, and healthy controls (HC). Hemoglobin, serum ferritin, free erythrocyte protoporphyrin, Fe, Cu, ceruloplasmin, Zn, anti-endomysial antibodies, and anti-tissue transglutaminase antibodies were measured. Data were analyzed by Kruskal-Wallis, principal component analysis, and linear discriminant analysis. : One hundred nine individuals were studied (54 TCD, 19 ACD, 36 HC); mean age ± standard deviation was 23 ± 15.8 (range 1.6-75.4) years. Median and range of hemoglobin were 12.8 g/dL (8.1-17.6) in TCD, 12.4 g/dL (10.5-14.5) in ACD, and 13.6 g/dL (11.1-16.7) in HC (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001); serum ferritin was 17.7 μg/L (2.9-157), 10.8 μg/L (2.7-39.8), and 28.7 μg/L (4.5-127.2), respectively (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). Cu was 105 μg/dL (60-185), 97.5 μg/dL (40-130), and 125 μg/dL (80-205), respectively (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Ceruloplasmin was 21.6 mg/dL (14.2-73.2), 22.6 mg/dL (0.9-34.3), and 32.1 mg/dL (5.8-72.6), respectively (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). There were no differences in Fe, free erythrocyte protoporphyrin, and Zn. Principal component analysis showed that 58% of observed variability was explained by Fe and Cu indicators. Linear discriminant analysis revealed differences between CD and HC (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001), with high values of correct classification for TCD (73%) and HC (72%), but not ACD (16%), which were mostly classified as TCD (79%). Deficiency of micronutrients was found both in typical as well as in atypical cases.

Research paper thumbnail of Proinflammatory Cytokine Expression in Gastric Tissue From Children With Helicobacter pylori–Associated Gastritis

Journal of Pediatric Gastroenterology and Nutrition, 2001

Helicobacter pyloriinfection of the gastric mucosa in humans is usually acquired early in life. T... more Helicobacter pyloriinfection of the gastric mucosa in humans is usually acquired early in life. The chronic inflammation that ensues involves the increased production of inflammatory cytokines. Published data on production of these mediators by gastric mucosa of H. pylori-infected children are few. Seventy-nine children, aged 5 to 18 years, referred for upper gastrointestinal endoscopy to four separate hospitals in Chile, were studied. The concentrations of interleukin (IL)-1beta, IL-6, IL-8, and tumor necrosis factor alpha were measured in homogenates of gastric mucosal biopsy specimens. Cytokine expression was confirmed by reverse transcription polymerase chain reaction. These data were correlated with the patients&amp;amp;amp;amp;#39; clinical, histologic and sociodemographic status. Patient rate of colonization by H. pylori was inversely correlated with socioeconomic status (P &amp;amp;amp;amp;lt; 0.005) and positively correlated with age (P &amp;amp;amp;amp;lt; 0.0025). In gastric mucosa, concentrations of IL-1beta, IL-8, and tumor necrosis factor alpha were all significantly higher in H. pylori-positive patients than in H. pylori-negative patients and in patients who had histologic gastritis than in those with normal gastric mucosa. In patients with peptic ulcer disease, only IL-1beta and IL-8 concentrations were significantly elevated when compared with those of patients without ulcers. Interleukin-6 concentrations were comparable among the different groups analyzed. This study suggests that increased gastric mucosal production of the proinflammatory cytokines IL-1beta and IL-8 is probably involved in H. pylori-associated gastric damage in children and may be crucial in determining the different clinical outcomes.

Research paper thumbnail of Amerindian Mtdna Haplogroups And Celiac Disease Risk HLA Haplotypes In Mixed Blood Latin American Patients

Journal of Pediatric Gastroenterology and Nutrition, 2011

Background: Although clinical manifestations of celiac disease may change throughout life, clinic... more Background: Although clinical manifestations of celiac disease may change throughout life, clinical, histologic, immunologic, and genetic studies show that there are incomplete forms of this condition, making it difficult to define the disease at a given moment. Because there is no information published in the Latin American-Amerindian population, this study was conducted to assess relations between these parameters in Chileans with celiac disease and their first-degree relatives. Methods: Sixty-two persons with confirmed celiac disease (mean age, 17.9 ± 5.1 years; 78.3% females) and 126 relatives (mean age, 27.9 ± 17.2 years; 65.1% females) were evaluated. Clinical manifestations, antiendomysial antibodies (EMAs), and human leukocyte antigen (HLA) haplotypes were studied in patients. Additionally, jejunal biopsy specimens were assessed (light microscopy) in EMA-positive (EMA+) relatives. Results: Of the patients, 24.1% adhered to a strict gluten-free diet; 26% were oligosymptomatic, and none were malnour-ished; 45% were EMA+; 13.8% who ingested gluten were EMA-negative (EMA−); one patient consuming a strict glutenfree diet was EMA+. The DQA1*0501 allele was present in the highest frequency (48%, P < 0.0005), whereas combinations of DQ8 were predominant. Of the relatives, 4.8% were EMA+; they had a significantly higher frequency of diarrhea, weight loss, and anorexia (P < 0.03); and all had abnormal histology in biopsy specimens. Conclusions: After childhood, celiac disease is oligosymptomatic and is often unrecognized by patients. Disease in 13.8% of patients and in 4.8% relatives appeared as incomplete forms of celiac disease. Predominance of DQ8 HLA haplotypes reflects the genetic Spanish-Mapuche heritage of this population. JPGN 31:381-386, 2000.

Research paper thumbnail of Fiebre Tifoidea: Complicaciones en 782 niños hospitalizados

Revista chilena de pediatría, 1981

Considering the increasing sick rate caused by Thyphoid Fever, 782 cases of typhoid in children (... more Considering the increasing sick rate caused by Thyphoid Fever, 782 cases of typhoid in children (to die age of 14) were checked at two Hospitals in Santiago, Chile. Children were divided into two groups according to positive and negative bacteriology presented on diagnosis, afterwards emphasis was given to those cases showing further complication symptoms. These were analysed according to age, sex, type oi complications, treatment received and death rate. The result showed that from all cases studied, a f2,7% presented complications; a 5,4% of these had had positive bacteriology diagnoses and a 7,3% negative ones. Most children were medically treated and only a 0,7% required surgical treatment Concerning medicines, cloramfenicol was largely prescribed being development of illness mostly satisfactory, except for one patient who died.

Research paper thumbnail of Helicobacter pylori cagA+ Is Associated with Milder Duodenal Histological Changes in Chilean Celiac Patients

Frontiers in cellular and infection microbiology, 2017

HIGHLIGHTS What is already known about this subject?Celiac disease (CD) has a high clinical and h... more HIGHLIGHTS What is already known about this subject?Celiac disease (CD) has a high clinical and histological diversity and the mechanisms underlying this phenomenon remain elusive.H. pylori is a bacterium that chronically infect gastric and duodenal mucosa activating both a Th1/Th17 and T-reg pathways.The role of H. pylori (and the effect of their virulence factors) in CD have not yet completely elucidated.What are the new findings?cagA+ H. pylori strains are associated to milder histological damage in infected CD patients.In active-CD patients the presence of cagA+ H. pylori is associated to an increase in T-reg markers, contrasting with a downregulation in cagA+ infected potential-CD individuals.How might it impact on clinical practice in the foreseeable future?The identification of microbiological factors that could modulate inflammation and clinical expression of CD may be used in the future as preventive strategies or as supplementary treatment in patients that cannot achieve c...

Research paper thumbnail of Micronutrient Deficiencies in Patients With Typical and Atypical Celiac Disease

Objective: The extent of the digestive/absorptive involvement in atypical presentation of celiac ... more Objective: The extent of the digestive/absorptive involvement in atypical presentation of celiac disease (CD) is not always clear. The aim of the study was to assess nutritional status of iron (Fe), copper (Cu), and zinc (Zn) in patients with typical CD (TCD) and atypical CD (ACD). Patients and Methods: A cross-sectional study was done in patients with TCD, ACD, and healthy controls (HC). Hemoglobin, serum ferritin, free erythrocyte protoporphyrin, Fe, Cu, ceruloplasmin, Zn, anti-endomysial antibodies, and anti-tissue transglutaminase antibodies were measured. Data were analyzed by Kruskal-Wallis, principal component analysis, and linear discriminant analysis. Results: One hundred nine individuals were studied (54 TCD, 19 ACD, 36 HC); mean age AE standard deviation was 23 AE 15.8 (range 1.6-75.4) years. Median and range of hemoglobin were 12.8 g/dL (8.1-17.6) in TCD, 12.4 g/ dL (10.5-14.5) in ACD, and 13.6 g/dL (11.1-16.7) in HC (P < 0.0001); serum ferritin was 17.7 mg/L (2.9-157), 10.8 mg/L (2.7-39.8), and 28.7 mg/L (4.5-127.2), respectively (P < 0.01). Cu was 105 mg/dL (60-185), 97.5 mg/dL (40-130), and 125 mg/dL (80-205), respectively (P < 0.05). Ceruloplasmin was 21.6 mg/dL (14.2-73.2), 22.6 mg/dL (0.9-34.3), and 32.1 mg/dL (5.8-72.6), respectively (P < 0.01). There were no differences in Fe, free erythrocyte protoporphyrin, and Zn. Principal component analysis showed that 58% of observed variability was explained by Fe and Cu indicators. Linear discriminant analysis revealed differences between CD and HC (P < 0.0001), with high values of correct classification for TCD (73%) and HC (72%), but not ACD (16%), which were mostly classified as TCD (79%). Conclusions: Deficiency of micronutrients was found both in typical as well as in atypical cases.

Research paper thumbnail of DQ2, DQ7 and DQ8 Distribution and Clinical Manifestations in Celiac Cases and Their First-Degree Relatives

Nutrients, 2015

HLA-linked genes are relevant to celiac disease (CD); the potential genetic differences present w... more HLA-linked genes are relevant to celiac disease (CD); the potential genetic differences present worldwide are not fully understood. Previous results suggest that the distribution of HLA-DQ2/DQ7/DQ8 in Chile may differ from that in Europe and North America. In celiac patients and their first-degree relatives (FDRS), we assessed their clinical, serological and histological characteristics, determined HLA-DQ2, HLA-DQ7 and HLA-DQ8 alleles and genotypes, and evaluated the relations between them. A total of 222 individuals were assessed (56 cases, 166 FDRs). 16.9% of FDRs were tTG positive; 53.6% of them showed overweight/obesity and 3% undernourishment; they spontaneously declared being asymptomatic, but detailed questioning revealed that 60.7% experienced symptoms, which had not been investigated. DQ2 was present in 53.9% and 43.9.0% of cases and FDRs (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The most frequent genotype distribution was DQ2/DQ7 (fr 0.392 (cases) and 0.248 (FDRs), respectively, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.02). The next most common genotypes were HLA-DQ2/DQ8 (fr 0.236 in FDRs and 0.176 in cases, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). 3.92% cases were not HLA-DQ2/DQ8 carriers. Among tTG positive FDRs, 57.4%, 22.3% and 20.2% carried DQ2, DQ7 and DQ8, respectively. In cases, 72.7% of the biopsies classified Marsh ≥3 carried at least one DQ2; 91.7% of DQ2/DQ2 and 88.3% of DQ2/DQ7 were Marsh ≥3. Thus, DQ2 frequency is lower than reported; the higher frequency found for DQ8 and DQ7 concur with recent publications from Argentine and Brazil. These results suggest that although CD may manifest clinically in ways similar to those described in other populations, some genetic peculiarities in this region deserve further study.

Research paper thumbnail of Micronutrient Deficiencies in Patients With Typical and Atypical Celiac Disease

Journal of Pediatric Gastroenterology and Nutrition, 2011

The extent of the digestive/absorptive involvement in atypical presentation of celiac disease (CD... more The extent of the digestive/absorptive involvement in atypical presentation of celiac disease (CD) is not always clear. The aim of the study was to assess nutritional status of iron (Fe), copper (Cu), and zinc (Zn) in patients with typical CD (TCD) and atypical CD (ACD). A cross-sectional study was done in patients with TCD, ACD, and healthy controls (HC). Hemoglobin, serum ferritin, free erythrocyte protoporphyrin, Fe, Cu, ceruloplasmin, Zn, anti-endomysial antibodies, and anti-tissue transglutaminase antibodies were measured. Data were analyzed by Kruskal-Wallis, principal component analysis, and linear discriminant analysis. : One hundred nine individuals were studied (54 TCD, 19 ACD, 36 HC); mean age ± standard deviation was 23 ± 15.8 (range 1.6-75.4) years. Median and range of hemoglobin were 12.8 g/dL (8.1-17.6) in TCD, 12.4 g/dL (10.5-14.5) in ACD, and 13.6 g/dL (11.1-16.7) in HC (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001); serum ferritin was 17.7 μg/L (2.9-157), 10.8 μg/L (2.7-39.8), and 28.7 μg/L (4.5-127.2), respectively (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). Cu was 105 μg/dL (60-185), 97.5 μg/dL (40-130), and 125 μg/dL (80-205), respectively (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Ceruloplasmin was 21.6 mg/dL (14.2-73.2), 22.6 mg/dL (0.9-34.3), and 32.1 mg/dL (5.8-72.6), respectively (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). There were no differences in Fe, free erythrocyte protoporphyrin, and Zn. Principal component analysis showed that 58% of observed variability was explained by Fe and Cu indicators. Linear discriminant analysis revealed differences between CD and HC (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001), with high values of correct classification for TCD (73%) and HC (72%), but not ACD (16%), which were mostly classified as TCD (79%). Deficiency of micronutrients was found both in typical as well as in atypical cases.

Research paper thumbnail of Proinflammatory Cytokine Expression in Gastric Tissue From Children With Helicobacter pylori–Associated Gastritis

Journal of Pediatric Gastroenterology and Nutrition, 2001

Helicobacter pyloriinfection of the gastric mucosa in humans is usually acquired early in life. T... more Helicobacter pyloriinfection of the gastric mucosa in humans is usually acquired early in life. The chronic inflammation that ensues involves the increased production of inflammatory cytokines. Published data on production of these mediators by gastric mucosa of H. pylori-infected children are few. Seventy-nine children, aged 5 to 18 years, referred for upper gastrointestinal endoscopy to four separate hospitals in Chile, were studied. The concentrations of interleukin (IL)-1beta, IL-6, IL-8, and tumor necrosis factor alpha were measured in homogenates of gastric mucosal biopsy specimens. Cytokine expression was confirmed by reverse transcription polymerase chain reaction. These data were correlated with the patients&amp;amp;amp;amp;#39; clinical, histologic and sociodemographic status. Patient rate of colonization by H. pylori was inversely correlated with socioeconomic status (P &amp;amp;amp;amp;lt; 0.005) and positively correlated with age (P &amp;amp;amp;amp;lt; 0.0025). In gastric mucosa, concentrations of IL-1beta, IL-8, and tumor necrosis factor alpha were all significantly higher in H. pylori-positive patients than in H. pylori-negative patients and in patients who had histologic gastritis than in those with normal gastric mucosa. In patients with peptic ulcer disease, only IL-1beta and IL-8 concentrations were significantly elevated when compared with those of patients without ulcers. Interleukin-6 concentrations were comparable among the different groups analyzed. This study suggests that increased gastric mucosal production of the proinflammatory cytokines IL-1beta and IL-8 is probably involved in H. pylori-associated gastric damage in children and may be crucial in determining the different clinical outcomes.

Research paper thumbnail of Amerindian Mtdna Haplogroups And Celiac Disease Risk HLA Haplotypes In Mixed Blood Latin American Patients

Journal of Pediatric Gastroenterology and Nutrition, 2011

Background: Although clinical manifestations of celiac disease may change throughout life, clinic... more Background: Although clinical manifestations of celiac disease may change throughout life, clinical, histologic, immunologic, and genetic studies show that there are incomplete forms of this condition, making it difficult to define the disease at a given moment. Because there is no information published in the Latin American-Amerindian population, this study was conducted to assess relations between these parameters in Chileans with celiac disease and their first-degree relatives. Methods: Sixty-two persons with confirmed celiac disease (mean age, 17.9 ± 5.1 years; 78.3% females) and 126 relatives (mean age, 27.9 ± 17.2 years; 65.1% females) were evaluated. Clinical manifestations, antiendomysial antibodies (EMAs), and human leukocyte antigen (HLA) haplotypes were studied in patients. Additionally, jejunal biopsy specimens were assessed (light microscopy) in EMA-positive (EMA+) relatives. Results: Of the patients, 24.1% adhered to a strict gluten-free diet; 26% were oligosymptomatic, and none were malnour-ished; 45% were EMA+; 13.8% who ingested gluten were EMA-negative (EMA−); one patient consuming a strict glutenfree diet was EMA+. The DQA1*0501 allele was present in the highest frequency (48%, P < 0.0005), whereas combinations of DQ8 were predominant. Of the relatives, 4.8% were EMA+; they had a significantly higher frequency of diarrhea, weight loss, and anorexia (P < 0.03); and all had abnormal histology in biopsy specimens. Conclusions: After childhood, celiac disease is oligosymptomatic and is often unrecognized by patients. Disease in 13.8% of patients and in 4.8% relatives appeared as incomplete forms of celiac disease. Predominance of DQ8 HLA haplotypes reflects the genetic Spanish-Mapuche heritage of this population. JPGN 31:381-386, 2000.