PurposeUlcerative colitis (UC) as a type of inflammatory bowel disease (IBD), presumed to occur as a consequence of increased immune responses to intestinal microbiota in genetically susceptible individuals. Enterotoxigenic Bacteroides fragilis (ETBF) strains are important intestinal bacteria that can be involved in IBD. The aim of this study was to design a quantitative assay for detection of B. fragilis and ETBF and also to find their association with UC.MethodsNinety-five biopsies were collected from patients with UC (n = 35) and with no IBD (nIBD, n = 60). All the specimens were cultured in Bacteroides bile esculin agar medium. Specific primers and probes were designed for quantitative real-time PCR (QRT-PCR) based on 16S rRNA and bft genes sequences of ETBF.ResultsThe bft genes were detected in 51.4% of UC samples and 1.6% of nIBD samples, respectively. In UC patients, 37.1% of samples with diarrhea and 11.4% of samples without diarrhea, harbored the bft gene. Mean value of the number of ETBF with bft gene in UC and nIBD samples were 4.46 ן 102 and 1.96, respectively. Likewise these result for 16S rRNA gene in UC and nIBD samples were 2.0 × 103 and 8.4 × 103, respectively.ConclusionsThere was no significant association between presence and numbers of 16S rRNA gene of B. fragilis and UC. ETBF was detected more in UC specimens and biopsies of UC patients with diarrhea than in the control group. These data demonstrated that ETBF is associated with development of UC and as a causative agent for the development of diarrhea in these patients.

Introduction: Mycobacterium avium subsp. paratuberculosis (MAP) is the causative agent of paratuberculosis or Johne's disease in ruminants. Its role in triggering autoimmunity, including type 1 diabetes mellitus (T1DM), has been reported in recent years. Due to the high contamination rate of MAP in Iran's livestock and the increasing outbreak of T1DM, we investigated this association in a small group of patients with T1DM in Iran. Methodology: Blood samples of 29 T1DM patients and 29 healthy control subjects were tested through enzyme-linked immunosorbent assay (ELISA) to detect antibodies against MAP3865c and ZnT8 homologous epitopes and the presence of MAP DNA. Blood samples were also cultured in mycobacterial growth indicator tubes and Herrold's egg yolk medium containing mycobactin J. Results: The results of ELISA showed a significant difference between T1DM patients and healthy group. IS900 was also detected in 51.72% of T1DM patients but in none of the control group. None of the samples grew in culture media. Conclusions: Due to the presence of MAP DNA and antibodies against MAP peptides in a significant number of T1DM patients compared with healthy control subjects, we may consider MAP as a possible trigger of T1DM in Iran. This indicates that exposure to MAP occurred in the positive subjects. Identifying the sources of contamination and routes of MAP transmission to humans seems necessary to prevent and reduce the burden of MAP infection in Iran.

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Table S1. Demographic, clinical and immunologic information of studied patients. Parameters CVID-A (N=11) CVID-NA (N=9) P-value Demographic data Consanguinity, N (%) 9 (81.8) 6 (66.7) 0.62 Age at onset of symptoms, median (IQR), years 1 (0.5-11) 6 (1-22) 0.27 Age at time of PID diagnosis, median (IQR), years 9 (4-21) 19 (4-35) 0.30 Delay in diagnosis, median (IQR), years 5 (1-7) 3.5 (1.5-13) 0.88 Clinical Parameters Splenomegaly, N (%) 5 (45.5) 2 (22.2) 0.37 Hepatomegaly, N (%) 3 (27.3) 2 (22.2) 1.0 Early onset, N (%) 9 (81.8) 7 (77.8) 1.0 Enteropathy, N (%) 7 (63.6) 5 (55.6) 1.0 FTT, N (%) 2 (18.2) 1 (11.1) 1.0 Pneumonia, N (%) 6 (54.5) 4 (44.4) 1.0 Otitis media, N (%) 5 (45.5) 1 (11.1) 0.16 Sinusitis, N (%) 4 (36.4) 3 (33.3) 1.0 Bronchiectasis, N (%) 4 (36.4) 2 (22.2) 0.64 Immunologic data WBC, median (IQR), cells/µl 8210 )4200-8620( 6650 )5615-8115( 0.91 Lymphocyte, median (IQR), cells/µl 2300 )1218-4233( 2580 )1986-3419( 0.27 Neutrophil, median (IQR), cells/µl 3652 )2503-5662( 3025 )2530.25-3977.5( 0.79 CD3 + T cells, median (IQR), cells/µl 1695 )1417.5-3569( 1837.5 )1233.5-2034.75( 1.0 CD4 + , T cells median (IQR), cells/µl 870 )544.25-1508( 924.5 )562-1098.25( 0.72 CD8 + , T cells median (IQR), cells/µl 9465 )40.75-2032.5( 1023 )709.5-1059( 0.29 CD19 + B cells, median (IQR), cells/µl 264 )95-492.5( 317.5 )137.5-858.25( 0.65 CD16 + CD56 + NK cells, median (IQR), cells/µl 184 )150-184( 485 )485-485( 0.25 IgG, median (IQR), mg/dl 256.5 )113.55-523.25( 470 )160.5-753( 0.80 IgA, median (IQR), mg/dl 9 )6-113( 15.5 )6-50.75( 0.23 IgM, median (IQR), mg/dl 28 )9-110( 10.5 )4.5-83.25( 0.10 IgE, median (IQR), IU/ml 0 )0-2( 1 )0.75-9.5( 0.