Norberto Sotelo-Cruz

Bovine milk caseins and transglutaminase-treated cereal prolamins are differentially recognized by IgA of celiac disease patients according to their age.

The prevalence of celiac disease (CD) has increased worldwide, which could be related to some dietary proteins in infant regimens and/or new food processes, affecting CD-predisposed infants and older children or adults differentially. IgA reactivity to human and bovine caseins, as well as yogurt caseins and prolamins from wheat or maize breads, microbial transglutaminase (mTG)-treated or not, was evaluated in three patient groups: G1, <2 years old; G2, approximately 3 years old; and G3 >8 years old. Human caseins were not recognized by IgA, whereas IgA reactivity of G2 and G3 was higher to bovine milk caseins. Immunoreactivity of G1 to yogurt caseins was lower and comparable to controls, with no effects due to mTG treatment. However, mTG treatment increased reactivity of G3 to wheat and maize prolamins. IgA immunoreactivity of CD patients to caseins and mTG-treated or not prolamins was age-dependent, which could reflect a differential manifestation of the effects of such proteins on the intestinal barrier.

Giardia lamblia Infection and Its Implications for Vitamin A Liver Stores in School Children

Background: Vitamin A deficiency (VAD) is a nutritional problem affecting the health of people in developing countries because VAD compromises innate and adaptive immunity, increasing a person’s predisposition toward infectious diseases. In addition, a high prevalence of infectious diseases continues to be a problem in developing countries, including Giardia lamblia. G. lamblia may be related to VAD because of its ability to change the intestinal architecture, thereby compromising the absorption of vitamin A. The aim of this study was to evaluate the effect of giardiasis on serum retinol levels and vitamin A liver stores in school children. Methods: Thirty Giardia-infected school children participated in this study. Vitamin A liver stores were evaluated with the modified relative dose response (MRDR) technique, and antiparasitic treatment was administered. In addition, anthropometric and dietary data were collected. Results: According to anthropometric indicators (age-appropriate Z scores for weight, height and body mass index) and daily vitamin A intake, the children had a normal nutritional status. Although the mean serum retinol levels did not change significantly after treatment for Giardia (p > 0.05), the MRDR values showed significant improvement (p < 0.002). Conclusion: Giardiasis not only compromises the vitamin A status through intestinal malabsorption, it also causes profound mobilization of liver retinol stores.

In vitro degradation of covalently cross-linked arabinoxylan hydrogels by bifidobacteria

Arabinoxylan gels with different cross-linking densities, swelling ratios, and rheological properties were obtained by increasing the concentration of arabinoxylan from 4 to 6% (w/v) during oxidative gelation by laccase. The degradation of these covalently cross-linked gels by a mixture of two Bifidobacterium strains (Bifidobacterium longum and Bifidobacterium adolescentis) was investigated. The kinetics of the evolution of structural morphology of the arabinoxylan gel, the carbohydrate utilization profiles and the bacterial production of short-acid fatty acid (SCFA) were measured. Scanning electron microscopy analysis of the degraded gels showed multiple cavity structures resulting from the bacterial action. The total SCFA decreased when the degree of cross-linking increased in the gels. A slower fermentation of arabinoxylan chains was obtained for arabinoxylan gels with more dense network structures. These results suggest that the differences in the structural features and properties studied in this work affect the degradation time of the arabinoxylan gels.

Tetany caused by chronic diarrhea in a child with celiac disease: A case report

There is no awareness about celiac disease (CD) in Mexico. A 2.9 year old mestizo boy was admitted to a Mexican hospital with muscle cramps and fine tremors. He suffered chronic diarrhea, abdominal distention, hypotrophic limbs, stunting and wasting, and presented hypocalcemia, anemia and high titers of serological markers. Diagnosis of CD was confirmed by a duodenal biopsy. After replacement of calcium and a gluten-free diet, the symptoms resolved within 6 weeks. After 2-months, serum analyses, anthropometric data as well as antibodies titers were normal after 4 years. CD screening tests are needed in chronic diarrhea for any ethnicity patients.

Syneresis in Gels of Highly Ferulated Arabinoxylans: Characterization of Covalent Cross-Linking, Rheology, and Microstructure

Arabinoxylans (AXs) with high ferulic acid (FA) content (7.18 µg/mg AXs) were cross-linked using laccase. Storage (G’) modulus of AX solutions at 1% (AX-1) and 2% (AX-2) (w/v) registered maximum values of 409 Pa and 889 Pa at 180 min and 83 min, respectively. Atomic force microscopy revealed the grained and irregular surface of the AX-1 gel and the smoother surface without significant depressions of the AX-2 gel. Cured AX gels exhibited a liquid phase surrounding the samples indicating syneresis. The syneresis ratio percentage (% Rs) of the gels was registered over time reaching stabilization at 20 h. The % Rs was not significantly different between AX-1 (60.0%) and AX-2 (62.8%) gels. After 20 h of syneresis development, the dimers of the FA in the AX-1 and AX-2 gels significantly increased by 9% and 78%, respectively; moreover, the trimers of the FA in the AX-1 and AX-2 gels, by 94% and 300%, respectively. Scanning electron microscopy showed that, after syneresis stabilization, AX gels presented a more compact microstructure. Syneresis development in the gels of highly ferulated AXs could be related to the polymer network contraction due to the additional formation of dimers and trimers of the FA (cross-linking structures), which may act like a “zipping” process, increasing the polymer chains′ connectivity.

Immunological disorders: (Type 1 Diabetes, Idiopathic Thrombocytopenic Purpura and Hashimoto Encephalopathy), Associated with Autoimmune Hepatitis

Autoimmune hepatitis (AIH) is a liver disease that runs a course of chronic and progressive inflammation. This occurs in young children and adolescents. AIH can also be manifested in an acute and aggressive form. Its etiology is unknown. Two varieties have been reported. These are autoimmune hepatitis type 1 (AIH-1) and type 2 (AIH-2). AIH-1 affects children as well as adults and it is related with the presence of antinuclear (ANA) and anti-smooth muscle (ASM) antibodies. AIH-1 is associated with immunological illnesses such as ulcerative colitis, sclerosing cholangitis, arthritis, and vasculitis. AIH-2 is more frequent in children. It presents with liver and kidney microsome (Anti-LKM-1) antibodies and anti-cytosol antibodies (Anti-LC-1). AIH-2 has also been associated with other immunopathies such as polyendocrinopathy, vitiligo, thyroiditis, alopecia and diabetes mellitus type 1 (DM1). This report describes the clinical course of two patients with AIH: a female treated since five years of age and followed during 18 years. After 11 years, the patient developed DM1 and later anorexia nervosa. This patient died due to complications of the latter. The other patient, who was diagnosed with AIH at the age of 10 years, was treated and followed during 10 years. This patient manifested idiopathic thrombocytopenia purpura (IPT) and Hashimoto encephalopathy during the course of the disease. This patient continues to remain under control. The relationship of AIH-1 with other autoimmune processes, such as Diabetes mellitus type 1 (DM1) until now, has been poorly investigated. Also, ITP followed by Hashimoto encephalopathy was a rare association in our patient. It has been considered that these are a consequence of autoimmune dysregulation.

Assessment of the Sensitizing Potential of Proteins in BALB/c Mice: Comparison of Three Protocols of Intraperitoneal Sensitization

Most food allergy cases are associated with a limited group of allergens. This could be attributed to an increased ability of some foods to sensitize and trigger allergic reactions. However, there are no validated animal models to evaluate the sensitizing or allergenic potentials of proteins. Our aim was to evaluate three protocols of adjuvant-free intraperitoneal sensitization that differ in the time points for sample collection (days 14, 28 and 35 from beginning of the sensitization) and also in the number of immunizations (2, 5 and 3, respectively). Ovalbumin (OVA; 0.05 mg), cow milk proteins (CMP; 0.025, 0.05 and 0.25 mg), and potato acid phosphatase (PAP; low allergenic protein; 250.0 mg) were administered intraperitoneally (ip) to BALB/c mice (n = 4–6) and the protein-specific IgE and IgG antibody responses were evaluated using ELISA. Additional serum protein-specific IgE antibodies evaluations were carried out after IgG depletion. Anti-OVA IgE antibodies were detected in mice from all three protocols. The responses were higher in the group of mice that underwent the 28-day protocol than in those that underwent the 14- or 35-day protocols (p < 0.01 and p < 0.05, respectively). Anti-CMP IgE antibodies were detected in both the 14- and 28-day protocols, but the response was higher in the group that underwent the 28-day protocol (p < 0.001). The anti-CMP IgE antibody response detection was improved after serum IgG depletion (p < 0.001). Anti-PAP IgE antibodies were not detected. Mice with undetectable serum levels of protein-specific IgE triggered anti-OVA, -CMP, and -PAP IgG responses. An adjuvant-free 28-day protocol with five ip immunizations seems appropriate for evaluation of the inherent sensitizing or allergenic capacity of the studied proteins. Reproducible results were obtained utilizing the BALB/c mouse strain. Inter-laboratory studies including a larger number of proteins should be carried out to validate this model.

Polysaccharides in Alternative Methods for Insulin Delivery

Abstract Diabetes is currently a global health problem manifested by a high blood glucose level commonly classified into type 1 (insulin-dependent) and type 2 (noninsulin-dependent) diabetes. Insulin is a hormone that regulates blood glucose levels by acting on target tissues such as liver, fat, and skeletal tissues, and it is usually administered by subcutaneous injection. Studies related to insulin administration by noninvasive routes are increasing in number. Ocular, vaginal, rectal, oral, pulmonary, and nasal routes are being investigated as alternative methods. However, the administration of these drugs through noninvasive routes is complicated mostly due to poor insulin absorption and/or degradation phenomena. Encapsulation into polymeric systems has been proposed to protect insulin from degradation. Among polymers, polysaccharides and grafted polysaccharides offer the advantages of being biodegradable, biocompatible, and nontoxic. In this chapter, research on alternative methods for insulin delivery is presented. We focus on insulin encapsulation efforts made through polysaccharide systems for the oral delivery of insulin, where alginate, chitosan, arabinoxylan, dextran, and some polymer conjugates have shown good performance.

Curso atípico o incompleto de la enfermedad de Kawasaki en edades pediátricas

In Mexico, as in other Latin American countries, the number of patients with Kawasaki disease (KD) that are annually registered is unknown. Furthermore, the diagnosis of KD is late.1 In 1977, Dr. Romeo S. Rodríguez reported the first case of KD in the Boletín Médico del Hospital Infantil de México.2 Since then and until April 30, 2015, 919 cases properly registered in medical publications have accumulated, including the one that appears in this issue of the Boletín Médico del Hospital Infantil de México,3 which is the second largest due to the number of cases reported, thus contributing to the better understanding of KD.3--7Although KD was described since 1967, its etiology is still unknown.8 Clinically, it manifests as an acute febrile syndrome associated with vasculitis of small and medium-sized vessels that can lead to severe cardiovascular complications, including coronary aneurysms, myocarditis, pericarditis, valve injuries and myocardial infarction, and eventually involves different organs. Late diagnosis and an inappropriate treatment strongly influence the development of these complications, as well as the possibility that children course with atypical or incomplete expressions of the disease, which increases the probability of injury in the cardiovascular system or other systems.9--12For the etiology, the activation of the immune system triggered by an infectious process in a genetically susceptible host has been considered. The reason for the previous statement is that KD presents the characteristics of a process that is self-limited. From an epidemiological point of view, cases occur in seasonal outbreaks although an etiologic agent has not been specified. The presence of parvovirus B19 and herpesvirus in giant cell arteritis, and