Celiac disease (CD) is a systemic autoimmune disease, which is triggered by gluten intake in genetically susceptible individuals. The most important serological markers used for CD diagnosis are test based on immunoglobulin (Ig) A isotype, being the determination of tissue anti-transglutaminase IgA (tTG) 2 the marker of choice for diagnosis. Selective IgA deficiency (SIgAD) is more prevalent in CD patients than in the general population, making the serologically diagnosis of the diseasedifficult. In the present descriptive observational study, 74 adult patients with a confirmed CD diagnosis were included and anti-tTG2 IgA was determined by using ELISA assay in order to detect those patients with undetermined or negative levels, which could present SIgAD. The total IgA level was determined in these patients and the mean concentration was 237.8 ± 100.6 mg/dL. In a female patient, total IgA was less than 7 mg/dL, with normal IgG and IgM levels, characteristic of SIgAD. Thus, the calculated frequency of SIgAD was 1.35% of the CD study population. In conclusion, this work is a first approach to describe the frequency of SIgAD in CD patients of the country and reaffirms the importance of including total IgA determination in the case of conducting IgA-based serological tests specific for CD.

Introduction: Celiac disease (CD) is an autoimmune enteropathy triggered by gluten ingestion in genetically susceptible individuals. In CD, activation of the immune response causes damage of the intestinal mucosa, and a gluten-free diet (GFD) is the only available therapy. Intestinal damage can lead to an increase in the circulation of components of bacteria from the intestinal lumen, such as lipopolysaccharide (LPS). Soluble CD14 (sCD14) and lipopolysaccharide-binding protein (LBP) participate in the recognition of LPS, and their levels are altered in different pathologies. In the present study, the circulating levels of sCD14 and LBP from untreated CD patients were evaluated and compared to CD patients on a GFD and controls.Material and methods: In total seventy-two adult patients with CD, twenty-three untreated CD patients and forty-nine on a GFD were included. In addition, fifty-five healthy individuals were included as controls. Additionally, the effect of LPS on sCD14 production by both normal and inflamed intestinal tissue culture was explored.Results: Serum levels of sCD14 were found to be significantly increased in untreated CD patients compared to patients on a GFD and controls. In addition, we found that LPS induced the production of sCD14 by biopsies of intestinal tissue from untreated CD patients. Conclusions:The data from this study show that circulating levels of sCD14 are increased in the untreated CD patients compared to patients on a GFD. Our data show that LPS induces the production of sCD14 by the intestinal tissue from untreated CD patients.

Introducción: La enfermedad granulomatosa crónica (EGC) se caracteriza por una alteración de la función oxidativa de neutrófilos, presentando herencia ligada al cromosoma X (EGC-LX) y autosómica recesiva (EGC-AR). El ensayo de dihidrorodamina (DHR) es utilizado para el diagnóstico y detección de portadoras, además proporciona información sobre patrones de herencia.Objetivo: Detectar casos de EGC en niños con infecciones recurrentes y evaluar a sus familiares femeninas mediante el ensayo de DHR, para identificar portadoras y obtener información acerca de posibles patrones de herencia.Pacientes y Método: Fueron incluidos 107 pacientes (<18 años de edad) con sospecha clínica de EGC como neumonías, linfadenopatías y abscesos, remitidos por médicos de hospitales públicos, del 2014 al 2017. Además, se incluyeron seis mujeres, familiares de los niños con EGC. A las muestras de los pacientes se aplicó el ensayo DHR, expresando los resultados como índice de estimulación de neutrófilos (IE).Resultados: La mediana de edad de los pacientes fue de 3 años y 62/107 fueron varones. El IE promedio fue 39.7±13.8 y 101/107 niños exhibieron un cambio completo de fluorescencia de DHR. En 2/107 niños no se observó dicho cambio (IE=1.0), lo cual indica posible EGC-LX, y un tercer niño mostró un leve cambio (IE=4.8), compatible con EGC-AR. En 5/6 mujeres se encontró un patrón bimodal, indicando un estado de portadora.Conclusiones: Fueron detectados tres casos de EGC y cinco portadoras mediante el ensayo de DHR, realizado por primera vez en Paraguay. También se obtuvo información sobre los posibles patrones de herencia, EGC-LX en dos familias y un caso probable de EGC-AR.

Extractos vegetales de tres especies del género Baccharis inducen la proliferación de células mononucleares humanas.