BackgroundIn patients with suspected pulmonary tuberculosis, who have difficulty in expectorating sputum, alternative specimens by invasive procedures, gastric aspirate or sputum suction, are not always available in the feeble elderly. Several studies report the benefit of stool test for pediatric or HIV infected patients, but few in adult patients.ObjectiveTo evaluate the benefit of stool examination as non-invasive alternative test to detect Mycobacterium tuberculosis (MTB) infection.MethodsStool specimens were examined for mycobacteria in 187 cases of microbiologically-diagnosed pulmonary tuberculosis between September 2013 and August 2017. We retrospectively reviewed the medical records to determine the positive detection rate of MTB with stool specimens and investigated factors related to MTB detection.ResultsAmong 187 patients included, positive rate of MTB in stool was 12.8% (24/187) by stool acid-fast bacilli smear, 68.1% (98/144) by TRC Rapid®, and 40.6% (76/187) by culture. Multivariate logistic regression analysis revealed two contributing factors to MTB detection in stool; cavitation and male. The adjusted odds ratio with 95% confidence interval (CI) for cavitation was 2.9 (95%CI 1.48–5.69) and 2.1 (95%CI 1.08–3.93) for male.ConclusionWe recommend stool examination for those who are unable to give sputum and have risks for invasive procedures.
Natalizumab, which is an antibody against α4 integrin, has been used for the treatment of multiple sclerosis. In the present study, we investigated both the role of α4 integrin and the therapeutic effect of HCA3551, a newly synthesized orally active small molecule α4 integrin antagonist, in the development of Theiler's murine encephalomyelitis virus-induced demyelinating disease (TMEV-IDD). The mRNA levels of α4 integrins were significantly up-regulated in the central nervous system (CNS) of mice with TMEV-IDD as compared with naive mice (*P < 0.05). HCA3551 treatment in the effector phase significantly suppressed both the clinical and histological development of TMEV-IDD. The number of infiltrating mononuclear inflammatory cells in the CNS was significantly decreased in the mice treated with HCA3551 (**P < 0.01). The labeling indices for CD68 antigen and the absolute cell numbers of TNF-α-producing CD4 T cells and IFN-γ-producing CD8 T cells were significantly decreased in the CNS of mice treated with HCA3551 (*P < 0.05). HCA3551 treatment in the effector phase might inhibit the binding of α4 integrin to vascular cell adhesion molecule-1, thereby decreasing the number of mononuclear cells in the CNS.
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