Celiac disease (CeD) is a chronic, immune-mediated enteropathy that is precipitated by dietary gluten in genetically predisposed individuals expressing HLA-DQ2 and/or HLA-DQ8. In the current clinical practice, there are many serologic studies to aid in the diagnosis of CeD which include autoantibodies like IgA antitissue transglutaminase, antiendomysium, and antideamidated forms of gliadin peptide antibodies. Small intestinal biopsy has long been considered an essential step for the diagnosis of CeD. However, in the recent era, researchers have explored the possibility of CeD screening and diagnosis without endoscopy or biopsy. The newer emerging biomarkers of CeD appear promising in diagnostic evaluation and subsequent monitoring of disease. In this review of literature, we have explored the emerging biomarker-based diagnostic evaluation and monitoring of CeD.

Investigated for more than a century now, B chromosomes (Bs) research has come a long way from Bs being considered parasitic or neutral to becoming unselfish and bringing benefits to their hosts. B chromosomes exist as accessory chromosomes along with the standard A chromosomes (As) across eukaryotic taxa. Represented singly or in multiple copies, B chromosomes are largely heterochromatic but also contain euchromatic and organellar segments. Although B chromosomes are derived entities, they follow their species-specific evolutionary pattern. B chromosomes fail to pair with the standard chromosomes during meiosis and vary in their number, size, composition and structure across taxa and ensure their successful transmission through non-mendelian mechanisms like mitotic, pre-meiotic, meiotic or post-meiotic drives, unique non-disjunction, self-pairing or even imparting benefits to the host when they lack drive. B chromosomes have been associated with cellular processes like sex determination, pathogenicity, resistance to pathogens, phenotypic effects, and differential gene expression. With the advancements in B-omics research, novel insights have been gleaned on their functions, some of which have been associated with the regulation of gene expression of A chromosomes through increased expression of miRNAs or differential expression of transposable elements located on them. The next-generation sequencing and emerging technologies will further likely unravel the cellular, molecular and functional behaviour of these enigmatic entities. Amidst the extensive fluidity shown by B chromosomes in their structural and functional attributes, we perceive that the existence and survival of B chromosomes in the populations most likely seem to be a trade-off between the drive efficiency and adaptive significance versus their adverse effects on reproduction.

Background Early management of sepsis in the emergency department improves patient outcomes. The identification of at-risk patients for aggressive management by an easily available biomarker could go a long way in the triage of patients in the emergency department. It is postulated that during sepsis, the majority of patients undergo ischaemic reperfusion injury or inflammation, and uric acid with its oxidant and antioxidant properties may be playing some role and, hence, the measurement of uric acid could possibly predict the hospital course in patients with sepsis. We were prompted to undertake this study as serum uric acid estimation is readily available and economical compared to newly evolving biomarkers in sepsis. Estimation of serum uric acid levels on arrival to the emergency department may prove a useful predictor of hospital outcome in patients with sepsis especially in regions with limited resources. Results Of 102 patients, 55 (53.9%) were males. The mean age of the study cohort was 63.2 ± 10.48. Patients with higher qSOFA scores had higher uric acid levels on admission. While 12 (11.8%) patients had a septicaemic shock, acute kidney injury was recorded in 48 (47.1%) patients and 11 (10.8%) patients required dialysis. Thirty-four (33.3%) patients had respiratory failure, and of these, 21 (20.6%) patients required mechanical ventilation. The overall median stay in the medical intensive care (MICU) was 3days (range 2–7 days). The patients with higher uric acid levels had higher rates of respiratory failure but did not reach significant levels. In 15 (14.7%) patients, 7 males expired (mortality rate of 14.7%). There was a significant association between SOFA score and mortality. Patients who succumbed to sepsis had higher serum uric acid levels on arrival. Conclusions Patients with higher qSOFA scores had higher uric acid levels on admission. Hyperuricaemia predicted acute kidney injury, a requirement of mechanical ventilation and mean hospital stay in patients with sepsis. Further studies may be required to confirm the association.

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