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Indicators of Coeliac Disease Activity
Douda, Ladislav ; Tachecí, Ilja (advisor) ; Hucl, Tomáš (referee) ; Falt, Přemysl (referee)
Coeliac disease is a relatively common disorder that has been associated with a worldwide increase in prevalence in recent decades, with potentially serious medical, economic, psychological, and social consequences. At the same time, the high proportion of undiagnosed cases is well known and carries significant additional health risks for the future. In view of this, the introduction of new diagnostic, monitoring and therapeutic options into clinical practice is an important prerequisite for successfully combating this potentially serious disease. The aim of this study was to analyze plasma levels of the amino acids citrulline and ornithine - as potential markers of small intestinal disease activity, marginal zone memory B cell levels - as an indicator of the severity of hyposplenism, and fecal gliadin 33-mer concentration - as an indicator of adherence to a gluten-free diet - in patients followed for celiac disease. We performed an analysis of patients dispensed in gastroenterology outpatient clinics of the 2nd Dpt of Internal Medicine - Gastroenterology (University Hospital and Faculty of Medicine in Hradec Králové, Charles University). We examined the following number of patients within individual subanalyses: for plasma citrulline and ornithine 94 patients, for hyposplenism 100 patients, for...
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Gut microbiome and its changes related to therapy of chronic diseases
Hurych, Jakub ; Cinek, Ondřej (advisor) ; Kolář, Milan (referee) ; Falt, Přemysl (referee)
This work examines the response of the gut microbiome to therapeutic interventions in three longitudinal studies of chronic gastrointestinal diseases: Crohn's disease, celiac autoimmunity and irritable bowel syndrome. Multiple methods of stool microbiome analysis (especially massively parallel 16S rDNA or 18S rDNA sequencing and metagenomic sequencing) followed by bioinformatic and statistical analysis were used. In Crohn's disease, we detected a previously undescribed secondary nature of changes in the gut bacteriome after anti-TNF treatment. In celiac disease autoimmunity, where previous works described an effect of probiotic intervention on serological markers of the disease, the gut bacteriome and metabolome, we described the absence of significant changes in beneficial gut protozoa. In irritable bowel syndrome, we observed a significant response of the bacteriome after administering four doses of mixed microbiota transplantation but no response in the reduction of clinical symptoms. The results of these studies could contribute to a better understanding of the gut microbiome's role in the pathogenesis of these serious diseases. Keywords: microbiome, Crohn's disease, celiac disease, irritable bowel syndrome
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The role of preventive colonoscopy in the detection of colorectal neoplasia.
Vojtěchová, Gabriela ; Zavoral, Miroslav (advisor) ; Rejchrt, Stanislav (referee) ; Falt, Přemysl (referee)
Colonoscopy is used in colorectal cancer (CRC) screening either as an independent screening method (screening colonoscopy) or following a positive result of a primary screening test (eg. fecal occult blood test, FOBT). Preventive colonoscopy is the collective name for screening and FOBT+ colonoscopy. Due to the considerable variability in the detection of colorectal neoplasia between individual endoscopists, colonoscopy quality indicators were introduced. Adenoma detection rate (ADR) and polyp detection rate (PDR) are defined as the proportion of colonoscopies in which at least one adenoma (for ADR) or polyp (for PDR) was detected to the total number of colonoscopies performed. ADR is considered a key indicator of the quality of colonoscopy. Adenoma per colonoscopy (APC), defined as the total number of adenomas detected relative to the total number of colonoscopies performed, is the most accurate indicator currently available. However, APC limit values have not yet been set. Both ADR and APC are validated indicators, but their evaluation is time-consuming and personnel-intensive, which limits their use in clinical practice. The main purpose of the presented work is to simplify the monitoring of colonoscopy quality by introducing a more user-friendly indicator, which does not require histological...
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