SUMMARYBackground: Lactoferrin, a multifunctional glycoprotein, is known to have anti-microbial actions. Bovine lactoferrin and recombinant human lactoferrin have been shown to inhibit Helicobacter pylori, and more recently recombinant human lactoferrin was found to significantly increase the eradication rate of H. pylori when added to standard triple therapy. Aim: To determine the efficacy, safety and tolerability of recombinant human lactoferrin as a therapy in suppressing or eliminating H. pylori infection in subjects with minimal upper gastrointestinal symptoms who have not previously been treated. Subjects and methods: Nine healthy subjects with minimal upper gastrointestinal symptoms and a positive

Nitazoxanide (NTZ) is an antibiotic with microbiological characteristics similar to those of metronidazole but without an apparent problem of resistance. The aim of this study was the prospective evaluation of NTZ given as a single agent in the treatment of Helicobacter pylori infection. Twenty culture-positive patients with dyspepsia who had previously failed at least one course of H. pylori eradication therapy were enrolled. Subjects received 1 g of NTZ twice daily for 10 days. The safety and tolerability of the drug were assessed by physical examination, monitoring of adverse events, and clinical laboratory evaluation. Urea breath tests (UBTs) were performed 6 weeks posttreatment. H. pylori was isolated from UBT-positive patients by the string test or endoscopy with biopsy, and the MICs for these isolates were compared to those for isolates obtained pretherapy. The levels of tizoxanide, the active deacylated derivative of NTZ, were measured in blood, saliva, and tissue from two patients during treatment. The UBT results were positive for all 20 patients after completion of NTZ therapy. The MIC results demonstrated that the NTZ susceptibilities of none of the strains isolated from the patients posttherapy had changed significantly. No major adverse reactions were observed, but frequent minor side effects were observed. In conclusion, NTZ did not eradicate H. pylori when it was given as a single agent.Nitazoxanide (NTZ), a nitrothiazolyl-salicylamide compound first described by Rossignol and Cavier (J. F. Rossignol and R. Cavier, Chem. Abstr. 83:28216n, 1975), has a broad spectrum of activity against microaerobic and anaerobic bacteria, anaerobic protozoa, and helminths (1, 6). It is the first antiparasitic agent reported to be effective against both protozoa and helminths, particularly in the treatment of intestinal parasitic infections (8, 13). The pharmacokinetics and metabolism of NTZ have been studied after the administration of single oral doses to healthy subjects (18), as well as after administration of radiocarbon-labeled NTZ (4). The main circulating metabolites have been identified as deacetyl-NTZ or tizoxanide (TIZ) and the corresponding acyl-glucuronide.Previous studies showed that the incidence of adverse events was dose related, while vital signs, electrocardiograms, and laboratory test results remained unchanged (19). Side effects included loose stools, diarrhea, abdominal pain, flatulence, nausea, vomiting, dyspepsia, xerostomia, discolored urine (yellow-green), and headache (19,20).NTZ was the first effective treatment for cryptosporidial diarrhea in patients with AIDS, eradicating Cryptosporidium parvum from the intestinal tract (5,7,14,21), and has been successful in the treatment of microsporidiosis in a patient with AIDS (3). Diarrhea caused by Giardia intestinalis and Entamoeba histolytica or Entamoeba dispar has also been shown to respond to NTZ (12,15). Furthermore, the drug was efficacious in a hamster model of antibiotic-induced diarrhea caused by Clostridium difficile compared to the...

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Abstract. Two study designs were conceived to evaluate the rheological significance of hypertriglyceridaemia. We first investigated the course of serum-(SV) and plasma viscosity (PV) and erythrocyte aggregation in serum (SEA) and plasma (PEA) of healthy normolipidaemic individuals over 4 h after a fatty rich meal, in native material and after removal of triglyceride rich lipoproteins by centrifugation. Secondly, blood from patients with untreated hypertriglyceridaemia was investigated under fasting conditions. PEA and SEA increased in parallel with postprandial triglycerides (+ 135 mg dl-I), but the effect on PEA was more pronounced (+0.8 abs% increase; 2 h after the meal) as compared to SEA (+ 0.4 abs% increase). PV and SV increased in parallel to the same extent (+0.05 mPas). In the triglyceride poor infranatant no significant changes occurred. In fasting plasma PEA and PV were significantly lower (l.labs% and PV 0.04 mPas respectively) in infranatant than in native plasma, while only small differences in triglyceride (mostly VLDL) were observed. This phenomenon was barely detectable in serum samples.We conclude that triglyceride rich lipoproteins have a profound influence on haemorheological parameters, and that fibrinogen in particular, potentiates the effect of large fasting VLDL on plasma viscosity and erythrocyte aggregation.