Materials and Methods: The study comprised 20 patients in Group I presenting with various symptoms of gastritis and 10 asymptomatic subjects in Group II. The intestinal endoscopy antral biopsies were collected from 20 symptomatic patients with gastroduodenal disorders. The saliva specimens were taken from all patients before endoscopy. PCR was performed using genomic DNA, isolated from the saliva and the biopsies of the patients as the template to detect the presence of the 16S ribosomal RNA gene in H. pylori.
Results: In Group I, 10 (50%) cases of clinical gastritis were positive for H. pylori by endoscopy biopsy and 10 (50%) were negative. Of the 10 endoscopy biopsy positive cases for H. pylori, eight were PCR positive in saliva and two were negative. Of the 10 endoscopy biopsy negative cases, three were PCR positive for H. pylori in saliva and seven were negative. In Groups II, four were symptomatic for gastritis and six were negative. Of the six gastritis negative cases, three were PCR positive, four were gastritis positive, and three were PCR positive. Sensitivity and specificity of PCR were found to be 80% and 70%, respectively. The positive predictive and negative predictive values of PCR in saliva were 72.7% and 77.7%, respectively.
Conclusion: PCR analysis of saliva may be handy in identification of H. pylori and serves as a noninvasive technique to diagnose and monitor the prognosis.
METHODS: The cross-sectional study enrolled 156 participants, with 114 confirmed clinical dengue cases and 42 healthy controls. Serological profiling (NS1, anti-DENV IgM, and anti-DENV IgG), estimation of serum acute-phase reactants, clinico-laboratory parameters, and viral load were performed to classify dengue patients under dengue with warning signs (DWS+, n = 35), dengue without warning signs (DWS-, n = 74), and severe dengue (n = 5) (based on varying grades of severity) in accordance with the 2009 WHO guidelines. Measurement of complement factors, i.e., C1 inhibitor (C1Inh) (n = 145), C1q (n = 152), C2 (n = 146), C3a (n = 153), C3b (n = 152), mannose-binding lectin (MBL) (n = 151), C5a (n = 150), and soluble complement receptor 1 (sCR1, also designated as sCD35) (n = 139), was performed using commercial ELISA, and their concentrations were correlated with acute-phase reactants, clinical laboratory parameters, grades of dengue severity, and platelet levels.
RESULTS: Our analysis showed a significant alteration in early classical complement proteins, C1Inh, C1q, and C2. The levels of downstream factors and sCR1 remained largely unchanged across both the grades of dengue severity and primary/secondary dengue cohorts. Univariate analysis revealed NS1 positivity, IgG positivity, age, urea, and sCR1 as factors associated with disease severity. Our multivariate analysis showed sCR1 as the only independent predictor that correlated negatively with dengue severity. Every unit increase of sCR1 was associated with 22% reduced odds of dengue severity. Platelet counts showed a negative association with red cell distribution width (RDW) and basophils and a strong positive correlation with serum uric acid levels.
CONCLUSIONS: Our findings show that aberrant complement activation and levels of sCR1 could attribute to varying grades of dengue severity. Given its inverse association, the levels of sCR1 could likely render early prediction of dengue disease severity. The role of sCR1 in complement-mediated pathogenesis in dengue remains a gray area of investigation.