Gastroenterology and Hepatology From Bed to Bench最新文献

{"title":"Small fiber neuropathy in irritable bowel syndrome.","authors":"Pouria Motaghi, Iman Adibi, Peyman Adibi, Majid Ghasemi","doi":"10.22037/ghfbb.v17i1.2827","DOIUrl":"10.22037/ghfbb.v17i1.2827","url":null,"abstract":"<p><strong>Aim: </strong>In this study, we intend to evaluate the occurrence of small fiber neuropathy in patients with irritable bowel syndrome (IBS).</p><p><strong>Background: </strong>Small fiber neuropathy (SFN) is a sensory neuropathy that results from the degeneration of small Aδ and unmyelinated C fibers. SFN manifests positive symptoms, such as tingling, burning, prickling, and aching, and negative symptoms, including numbness, tightness, and coldness. The SFN coexistence with other comorbidities (e.g., fibromyalgia, inflammatory bowel disease, celiac disease) has been reported in previous studies.</p><p><strong>Methods: </strong>We conducted a cross-sectional study to assess the coexistence of SFN and IBS. Forty-two IBS patients and forty-three healthy individuals were asked to complete the Michigan Neuropathy Screening Instrument (MNSI) questionnaire. Results greater than three (>3) were considered positive. Participants with positive MNSI questionnaire results were examined for any neuropathy signs according to the Utah Early Neuropathy Scale (UENS) examination. The participants with positive results for the questionnaire and examination were checked for the sural and the superficial peroneal nerve conduction study (NCS). Normal NCS represented intact large fibers and the diagnosis of SFN.</p><p><strong>Results: </strong>Ten participants, 7 (16.7 %) in the IBS group and 3 (6.9 %) in the healthy group, had positive results for the questionnaire. Four participants were positive for the examination, with normal NCS, and were classified as SFN-positive. All four SFN diagnoses were from the IBS group. No one in the healthy group was diagnosed with SFN. We could find a significant statistical difference (p<0.05) between the IBS and healthy groups regarding the prevalence of SFN diagnosis.</p><p><strong>Conclusion: </strong>The co-occurrence of SFN and IBS suggests the possibility of a generalized neuropathy syndrome characterized by widespread neuronal impairment. Thus, any peripheral neuropathy symptom in IBS patients (and potentially other chronic pain disorders) should be evaluated for SFN since timely diagnosis and proper treatment result in a better quality of life for the patients.</p>","PeriodicalId":12636,"journal":{"name":"Gastroenterology and Hepatology From Bed to Bench","volume":"17 1","pages":"57-63"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11080693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biguanides and glucagon like peptide 1 receptor agonists in the amelioration of post liver transplant weight gain; a scoping review of the mechanism of action, safety and efficacy.","authors":"Benjamin M Mac Curtain, Luke O'Brien, Omar El Sherif, Aidan Mc Cormack, Emer Carolan, John D Ryan, Donal O'Shea, Tom K Gallagher","doi":"10.22037/ghfbb.v17i1.2899","DOIUrl":"10.22037/ghfbb.v17i1.2899","url":null,"abstract":"<p><p>Weight gain post-liver transplant can lead to adverse patient outcomes in the post-transplant period. Pharmacotherapy and other measures can be utilised to reduce the burden and occurrence of weight gain in this population. We explored the mechanism of action, safety, and efficacy of these medications, specifically GLP-1 receptor agonists and metformin, focusing on liver transplant patients. This scoping review was conducted in line with the scoping review structure as outlined by the PRISMA guidelines. Metformin and GLP-1 receptor agonists have been observed to be safe and effective in liver transplant patients. Experimental models have found liver-centric weight loss mechanisms in this drug cohort. There is a paucity of evidence about the use of antihyperglycemics in a post-transplant population for weight loss purposes. However, some small studies have shown strong safety and efficacy data. The evidence in relation to using these medications in patients with metabolic syndrome for weight loss warrants further study in a transplant population.</p>","PeriodicalId":12636,"journal":{"name":"Gastroenterology and Hepatology From Bed to Bench","volume":"17 1","pages":"17-27"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11080689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of hydrogen-rich water on liver enzyme levels in clinical populations: a comprehensive review and meta-analysis.","authors":"Ghazaleh Khalili-Tanha, Hamid Jamialahmadi, Mostafa Rezaei-Tavirani, Elham Nazari","doi":"10.22037/ghfbb.v17i4.2990","DOIUrl":"10.22037/ghfbb.v17i4.2990","url":null,"abstract":"<p><strong>Aim: </strong>This systematic review and meta-analysis aimed to assess the effect of hydrogen-rich water (HRW) on liver enzyme levels.</p><p><strong>Background: </strong>Liver disease is a significant global health concern, greatly affecting mortality rates. Elevated levels of liver enzymes, such as ALT, AST, ALP, and GGT are early symptoms of liver disorders, and various approaches can help reduce them. Recent studies have shown the prospective therapeutic advantages of hydrogen as an antioxidant and anti-inflammatory agent in many circumstances.</p><p><strong>Methods: </strong>The search strategy was developed following PRISMA guidelines. PubMed, Google Scholar, and Embase were searched from the beginning to January 2024. Eight Randomized controlled trial (RCT) studies were included, encompassing 433 participants with various liver function disorders.</p><p><strong>Results: </strong>Our results showed a slight decrease in ALT, AST, and ALP levels in the treated group with HRW compared to the PW group.</p><p><strong>Conclusion: </strong>Our findings suggest that consuming HRW may decrease liver enzyme levels in clinical populations. Further research is needed to confirm this relationship.</p>","PeriodicalId":12636,"journal":{"name":"Gastroenterology and Hepatology From Bed to Bench","volume":"17 4","pages":"338-348"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progressive familial intrahepatic cholestasis 3 Camouflaging as Wilson disease in a 12-year-old: a diagnostic Odyssey.","authors":"Kalpana Panda, Subhasis Pradhan, Mrutunjay Dash, Girish Kumar Pati","doi":"10.22037/ghfbb.v17i3.2999","DOIUrl":"10.22037/ghfbb.v17i3.2999","url":null,"abstract":"<p><p>Primary Familial Intrahepatic Cholestasis type 3 is an exceedingly rare genetic cholestatic disorder characterized by the defective hepatocanaliculr bile acid transport leading to progressive liver disease. In this case report, we describe the course of treatment for a 12-year-old kid diagnosed with Wilson disease based on Leipzig score and copper investigations. The child did not improve with chelation therapy and was subsequently genetically classified as PFIC-3. This case highlighted the caveats in Wilson disease diagnostic scoring system. The diagnostic odyssey, therapeutic interventions, and outcome of this case underscore the intricate interplay between clinical suspicion, investigative strategies, and the pivotal role of genetic testing to elucidate rare liver disorders in children.</p>","PeriodicalId":12636,"journal":{"name":"Gastroenterology and Hepatology From Bed to Bench","volume":"17 3","pages":"320-324"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The healing effects of moderate exercise on acetic acid-induced gastric ulcer in male rats.","authors":"Mohammad Sofiabadi, Ensiyeh Bahadoran, Fatemeh SamieeRad, Abbas Talis","doi":"10.22037/ghfbb.v17i3.2948","DOIUrl":"10.22037/ghfbb.v17i3.2948","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate the effect of moderate exercise on the healing of acetic acid-induced gastric ulcers in male rats.</p><p><strong>Background: </strong>Gastric ulcers include benign mucosal and submucosal lesions of the gastric wall. Exercise regulates a wide range of physiological processes.</p><p><strong>Methods: </strong>48 male Wistar rats were randomly divided into three experimental groups (n=16 per group) as follows: control, which was left untreated after causing stomach ulcers; experimental group 1, the rats were first exercised and then received acetic acid; experimental group 2, the rats received acetic acid, and then exercised. The ulcer was caused by injecting 0.12 ml of a 60% acetic acid solution after 24 hours of not eating. The rats had a period of moderate treadmill activity either before or after the development of ulcers, lasting for a duration of 30 days. On the seventh and fourteenth days after the experiment, the rats were sacrificed, their stomach was removed, and the wound healing parameters, and wound depth were determined.</p><p><strong>Results: </strong>Exercise before and after inducing gastric ulcers significantly decreased the depth of gastric ulcers in the experimental groups. The average number of PMN in the control group decreased in comparison to the seventh and fourteenth days following the experiment. Conversely, the number of fibroblasts, epithelialization, and new vessels increased. It seems that exercise before the appearance of ulcers has a greater effect on gastric ulcers compared to exercise after inducing gastric ulcers.</p><p><strong>Conclusion: </strong>Exercise can prepare the gastric mucosa for forthcoming injuries, and heal gastric ulcers. Moderate aerobic exercise has significant restorative effects on gastric ulcers caused by acetic acid and is recommended.</p>","PeriodicalId":12636,"journal":{"name":"Gastroenterology and Hepatology From Bed to Bench","volume":"17 3","pages":"313-319"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The investigation of the death-inducing potency of a recombinant Adenovector expressing Mda-7-tlyp-1 on different cancer cell lines.","authors":"Fatemeh Vatanparast, Rozita Ghojoghi, Maryam Kadkhodazadeh, Fatemeh Nekooei, Kazem Baesi, Mahroo Rastegari, Fatemeh Jamali, Zahra Farmani, Jamal Sarvari, Seyed Younes Hosseini","doi":"10.22037/ghfbb.v17i1.2779","DOIUrl":"10.22037/ghfbb.v17i1.2779","url":null,"abstract":"<p><strong>Aim: </strong>The potency of Adenovector expressing Mda7-tLyp1 (Ad-Mda7-tLyp1) for death induction was evaluated on the breast (MCF7), liver (HepG2), and gastric (MKN45) cancer cell lines.</p><p><strong>Background: </strong>Mda-7 could be a possible complementary to traditional cancer therapy, and tethering to tumor-homing peptides (THPs) might improve its therapeutic efficacy.</p><p><strong>Methods: </strong>After the preparation of recombinant Ad-Mda7-tLyp1 and Ad-Mda7, the expression of recombinant proteins was analyzed by ELISA. Adenovectors were transduced (MOI=2-5) into Hep-G2, MCF7, MKN45, and normal skin fibroblast, then tumor-killing effect was measured by cytopathic effect (CPE) monitoring, MTT viability test, BAX gene expression analysis, and Caspase3/7 assay.</p><p><strong>Results: </strong>ELISA assay revealed a sustained level of recombinant protein secretion following Adenovector transduction. In CPE microscopy, all cancer cell lines showed a significant reduction (≥50%) in their normal phenotype after receiving Ad-Mda7-tLyp1 and Ad-Mda7. The viability was significantly lower compared to the control, indicating an anti-proliferating effect. In parallel, the viability test showed that Ad-Mda7 and Ad-Mda7-tLyp1 have a significant killing effect (≥50%) on MCF-7, Hep-G2, and MKN45 compared to normal fibroblast (P≤0.05). BAX gene expression analysis showed that both Ad-Mda7-tLyp1 and Ad-Mda7 vectors induced >2-fold increase of apoptosis (P<0.05), particularly in MCF7. Similarly, caspase3/7 activity showed a significant increase (P<0.05) following Ad-Mda7, and Ad-Mda7-tLyp1 transduction into cancer cell lines, but not in normal fibroblasts.</p><p><strong>Conclusion: </strong>The newly constructed Ad-Mda-tlyp1 showed a suitable tumor cell killing activity and enough specificity on studied cell lines.</p>","PeriodicalId":12636,"journal":{"name":"Gastroenterology and Hepatology From Bed to Bench","volume":"17 1","pages":"45-56"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11080692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior tibial nerve electrical stimulation in chronic constipation: a systematic review and meta-analysis.","authors":"Mahdieh Hamedfar, Fariba Ghaderi, Hanieh Salehi Pourmehr, Abbas Soltani, Morteza Ghojazadeh, Nafiseh Vahed","doi":"10.22037/ghfbb.v17i1.2831","DOIUrl":"10.22037/ghfbb.v17i1.2831","url":null,"abstract":"<p><strong>Aim: </strong>A systematic review and meta-analysis were performed to investigate posterior tibial nerve electrical stimulation application methods in patients with chronic constipation.</p><p><strong>Background: </strong>Posterior tibial nerve electrical stimulation is a management procedure for chronic constipation.</p><p><strong>Methods: </strong>A comprehensive search was conducted on Ovid, PubMed, Scopus, ProQuest, Web of Science, and The Cochrane Library based on the PICO formation of the study. All randomized controlled trials and quasi-experimental studies in which patients with chronic constipation were treated with transcutaneous tibial nerve stimulation (TTNS) or percutaneous tibial nerve stimulation (PTNS) were included in this study. Two independent reviewers screened all titles, abstracts, and full texts. The selected studies' quality was assessed critically using the Joanna Briggs Institute checklists. The data synthesis was conducted using Review Manager Software.</p><p><strong>Results: </strong>Out of 1016 records, 11 studies were included in this study. The results showed that TTNS was effective in improving constipation symptoms (SMD: -1.52, CI 95%: -2.81 to -0.22, p< 0.0001) and reducing defecation time of patients with chronic constipation (SMD: -0.86, CI 95%: -1.60 to -0.13, p= 0.17). Additionally, PTNS was found to improve the quality of life of these patients (SMD: -1.32, CI 95%: -2.05 to -0.59, p< 0.00001).</p><p><strong>Conclusion: </strong>Both TTNS and PTNS can be effective interventions for chronic constipation. To suggest a definitive and standard treatment plan, further research is needed to determine optimal parameters for TTNS and PTNS applications.</p>","PeriodicalId":12636,"journal":{"name":"Gastroenterology and Hepatology From Bed to Bench","volume":"17 1","pages":"6-16"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11080691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of human adipose tissue-derived mesenchymal stem cells expressing alpha-1 antitrypsin gene in liver fibrosis: a study in mice.","authors":"Sara Ali Hosseinzadeh, Abbas Sahebghadam Lotfi, Nahid Davoodian, Sareh Arjmand, Marjan Rangchi, Fatemeh Mashhadiabbas","doi":"10.22037/ghfbb.v17i2.2923","DOIUrl":"10.22037/ghfbb.v17i2.2923","url":null,"abstract":"<p><strong>Aim: </strong>The present study examined the protective potential of human adipose tissue-derived mesenchymal stem cells (hASCs) modified to overexpress alpha-1 antitrypsin (AAT), in a mouse model of the liver fibrosis.</p><p><strong>Background: </strong>For the treatment of end-stage liver diseases, cell therapy has emerged as a promising noninvasive alternative to liver transplantation. Mesenchymal stem cells (MSCs) are being evaluated due to their dual capabilities of promoting liver regeneration and modulating the pathogenic inflammation of the immune system.</p><p><strong>Methods: </strong>Liver fibrosis was induced in mice via the intraperitoneal injection of carbon tetrachloride (CCl4). MSCs were extracted from the human adipose tissue. After stemness confirmation, the cells were transduced with the lentiviruses containing the AAT gene, and then injected into the mice's tail vein. Fourteen days' post-transplantation, mice were sacrificed, and blood and tissue samples were collected for analysis. Important liver enzymes, including alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), albumin, and total bilirubin (TB), were measured. Histological studies were carried out using the hematoxylin and eosin (H&E), as well as Masson's trichrome (MT) staining.</p><p><strong>Results: </strong>Compared to hASCs, treatment with AAT-hASCs resulted in greater reductions in ALT, AST, ALP, and TB, as well as normalized albumin levels. AAT-hASCs promoted enhanced liver regeneration histologically, likely attributable to anti-inflammatory and anti-proteolytic properties of AAT.</p><p><strong>Conclusion: </strong>These findings indicate AAT-engineered hASCs as a promising cell-gene therapy candidate for further study in liver cirrhosis models.</p>","PeriodicalId":12636,"journal":{"name":"Gastroenterology and Hepatology From Bed to Bench","volume":"17 2","pages":"151-160"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11234484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence and bioinformatics: a journey from traditional techniques to smart approaches.","authors":"Hamid Jamialahmadi, Ghazaleh Khalili-Tanha, Elham Nazari, Mostafa Rezaei-Tavirani","doi":"10.22037/ghfbb.v17i3.2977","DOIUrl":"10.22037/ghfbb.v17i3.2977","url":null,"abstract":"<p><p>The incorporation of AI models into bioinformatics has brought about a revolutionary era in the analysis and interpretation of biological data. This mini-review offers a succinct overview of the indispensable role AI plays in the convergence of computational techniques and biological research. The search strategy followed PRISMA guidelines, encompassing databases such as PubMed, Embase, and Google Scholar to include studies published between 2018 and 2024, utilizing specific keywords. We explored the diverse applications of AI methodologies, including machine learning (ML), deep learning (DL), and natural language processing (NLP), across various domains of bioinformatics. These domains encompass genome sequencing, protein structure prediction, drug discovery, systems biology, personalized medicine, imaging, signal processing, and text mining. AI algorithms have exhibited remarkable efficacy in tackling intricate biological challenges, spanning from genome sequencing to protein structure prediction, and from drug discovery to personalized medicine. In conclusion, this study scrutinizes the evolving landscape of AI-driven tools and algorithms, emphasizing their pivotal role in expediting research, facilitating data interpretation, and catalyzing innovations in biomedical sciences.</p>","PeriodicalId":12636,"journal":{"name":"Gastroenterology and Hepatology From Bed to Bench","volume":"17 3","pages":"241-252"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of toxin gene expression levels and molecular typing of <i>Clostridioides difficile</i> strains isolated from patients with diarrhea.","authors":"Leili Shokoohizadeh, Mahnaz Moomivand, Abbas Yadegar, Masoumeh Azimirad, Seyyed Hamid Hashemi, Mohammad Yousef Alikhani","doi":"10.22037/ghfbb.v17i3.2982","DOIUrl":"10.22037/ghfbb.v17i3.2982","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate the expression of <i>tcd</i>A, <i>tcd</i>B, and binary toxin genes (<i>cdt</i>A and <i>cdt</i>B) by Real-Time PCR and molecular typing of <i>Clostridioides difficile</i> isolated from patient diarrhea samples from Hamadan Hospitals, west of Iran.</p><p><strong>Background: </strong>The concentration of <i>C. difficile</i> toxins (CDTs) is associated with the severity of the disease and the mortality rate. Measuring CDT levels could provide a reliable and objective means of determining the severity of <i>C. difficile</i> infection (CDI).</p><p><strong>Methods: </strong>From November 2018 to September 2019, 130 diarrhea samples were collected from hospitalized patients in three hospitals in Hamadan. <i>C. difficle</i> isolates were detected by culture and PCR. The presence of the genes encoding the toxin was identified by PCR, whereas the measurement of toxin expression was conducted using a relative Real-Time PCR technique. Genetic linkage of the isolates was also assessed by Ribotyping and Repetitive Extragenic Palindromic (rep-PCR) methods.</p><p><strong>Results: </strong>Among 130 diarrhea samples, 16 (12.3%) were positive for <i>C. difficile</i>. Genes encoding <i>cdt</i>A and <i>tcd</i>B were detected in all isolates, and 8 (50%) and 6 (37.5%) isolates were positive for the <i>cdt</i>A and <i>cdt</i>B genes. Real-time PCR results showed different expression levels of the toxin genes. A significant increase in the expression of the <i>tcd</i>A gene was observed compared with the control strain (P<0.05). Besides, more expression of <i>cdt</i>A gene was observed in the strains compared with <i>cdt</i>B gene. Ribotyping and rep-PCR results showed high genetic diversity of <i>C. difficile</i> among hospitals investigated.</p><p><strong>Conclusion: </strong>We encountered toxigenic <i>C. difficile</i> strains with various toxin expression levels, ribotypes, and rep types based on the findings of this study. This indicated that various clones from various sources circulate in the hospitals and among patients.</p>","PeriodicalId":12636,"journal":{"name":"Gastroenterology and Hepatology From Bed to Bench","volume":"17 3","pages":"304-312"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}