Autoimmune thyroid diseases (ATD) are the most common organspecific autoimmune diseases with complex pathogenesis including the interaction between environmental, genetic, and immunological factors. 1 ATD comprise two main entities; Hashimoto's thyroiditis (HT) and Graves' disease (GD) which are considered the most common forms of ATD. Although, GD and HT usually have opposing clinical manifestations; hyperthyroidism and hypothyroidism, respectively, however, in line with a more flexible view of ATD, HT and GD can cause both hyperthyroidism and hypothyroidism, even alternating between one form and the other. 2 The hallmark of HT is the high rate of positivity of thyroglobulin and thyroid peroxidase antibodies (anti-TPO). 3 Moreover, high anti-TSH receptor antibody (TRAb) level is the mainstay in GD diagnosis. 4 The human microbiome consist of 100 trillion bacteria, protozoa, fungi, and viruses. It is of paramount importance in

Background and aim Diagnosing inflammatory bowel disease (IBD), determining the appropriate treatment and follow-up of patients rely mainly on endoscopy and biopsy. Finding a sensitive, specific, cost-effective and less-invasive biomarker is the focus of much of the current research in this field. The aim was to investigate the relation between serum matrix metalloproteinase-9 (MMP-9) levels and disease activity in patients with IBD, correlating with clinical and endoscopic indices of disease activity and with treatment received. Patients and methods Sixty patients (30 with ulcerative colitis, 30 with Crohn’s disease) and 20 controls were included. Serum MMP-9 levels were measured for all patients and controls by ELISA. Clinical activity was determined by partial Mayo score for patients with ulcerative colitis and Crohn’s Disease Activity Index for patients with Crohn’s disease, and endoscopic activity was assessed using Ulcerative Colitis Endoscopic Index of Severity for patients with ulcerative colitis and Simple Endoscopic Score of Crohn’s disease for patients with Crohn’s disease. Results Serum MMP-9 was higher in patients with active ulcerative colitis than in patients with inactive disease and the control group. Serum MMP-9 was also higher in patients with active Crohn’s disease than in patients with inactive disease and the control group. In both ulcerative colitis and Crohn’s disease groups, there was a significant difference between serum MMP-9 levels in patients receiving conventional treatment and those on biological treatment, with lower levels of the marker detected in the sera of patients subgroups receiving biologics. Conclusion Serum MMP-9 can be used to differentiate between active and inactive IBD (including both ulcerative colitis and Crohn’s disease).

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Introduction The role of Escherichia coli in the pathogenesis of inflammatory bowel disease (IBD) is still controversial. The study aimed to investigate the pathotypes and the phylogenetic groups of E. coli in Egyptian patients with IBD in an attempt to find an association between any type or group with the severity of the disease. Methods Thirty ulcerative colitis (UC), 30 Crohn's disease (CD), and 20 control subjects with normal colonoscopy were included in a cross-sectional study. E. coli were isolated from stool samples by culture. Eight intestinal virulence genes coding for diarrheagenic E. coli were investigated using multiplex PCR. Phylogenetic grouping was performed by a triplex PCR. Antimicrobial susceptibility of all isolates was done using disc diffusion method. Results Enteroaggregative E. coli (EAEC) were identified in 25% (15/60) of IBD cases and in none of the controls (p=0.013). Out the 60 IBD cases, 30 (50%) were from phylogenetic group B2. No statistically significant differences in the distribution of E. coli phylogenetic groups were found between study groups. However, 80% of EAEC were assigned to group B2 and D. No statistically significant differences in calprotectin level or in disease severity scores were reported between the four phylogenetic groups. E. coli from both UC and CD patients showed a high rate of resistance to most antimicrobials when compared to the control group. Conclusions The identification of EAEC belonging mainly to group B2 and D in IBD cases may indicate the importance of this pathotype in the pathogenesis of IBD in Egyptian patients. Keywords E. coli, enteroaggregative, IBD, phylogenetic group. Introduction1 Inflammatory bowel disease (IBD) constitutes a group of inflammatory gastrointestinal relapsing and remitting clinical conditions, of which Crohn's disease (CD) and ulcerative colitis (UC) are the most common forms. The pathogenesis of

Ulcerative colitis (UC) is a chronic immune-mediated inflammatory condition of the large intestine with an increasing incidence worldwide. Furthermore, long-standing UC is associated with a defined risk of dysplasia and colorectal cancer, which enforces the necessity of finding different modalities for diagnosis. 1 The course of the disease is characterised by remissions and relapses with extra-intestinal manifestations that are diagnosed clinically, endoscopically and radiologically. 2 A standardised endoscopic activity index should be used during colonoscopic examinations, including the Mayo endoscopic subscore or Ulcerative Colitis Endoscopic Index of Severity (UCEIS). 3