Digital Commons Network^™

Intrapulmonary Administration Of Purified Neil2 Abrogates Nf-Κb-Mediated Inflammation, Nisha Tapryal, Shandy Shahabi, Anirban Chakraborty, Koa Hosoki, Maki Wakamiya, Gobinda Sarkar, Gulshan Sharma, Victor J Cardenas, Istvan Boldogh, Sanjiv Sur, Gourisankar Ghosh, Tapas K Hazra

Faculty, Staff and Students Publications

Aberrant or constitutive activation of nuclear factor kappa B (NF-κB) contributes to various human inflammatory diseases and malignancies via the upregulation of genes involved in cell proliferation, survival, angiogenesis, inflammation, and metastasis. Thus, inhibition of NF-κB signaling has potential for therapeutic applications in cancer and inflammatory diseases. We reported previously that Nei-like DNA glycosylase 2 (NEIL2), a mammalian DNA glycosylase, is involved in the preferential repair of oxidized DNA bases from the transcriptionally active sequences via the transcription-coupled base excision repair pathway. We have further shown that Neil2-null mice are highly sensitive to tumor necrosis factor α (TNFα)- and lipopolysaccharide-induced …

Distribution Of Calcium Volume, Density, Number, And Type Of Coronary Vessel With Calcified Plaque In South Asians In The Us And Other Race/Ethnic Groups: The Masala And Mesa Studies, Mahmoud Al Rifai, Alka M Kanaya, Namratha R Kandula, Miguel Cainzos-Achirica, Jaideep Patel, Matthew Budoff, Michael H Criqui, Michael J Blaha, Salim S Virani

Faculty, Staff and Students Publications

BACKGROUND AND AIMS: South Asians (SA) experience disproportionately higher rates of atherosclerotic cardiovascular disease (ASCVD) events than non-Hispanic whites (NHW) and several other Asian groups. The coronary artery calcium (CAC) Agatston score may not capture the unique characteristics of coronary plaque in SA. We therefore evaluated the prevalence and patterns of advanced CAC measures (specific coronary vessel involvement, CAC volume and density) in SA versus other race/ethnicities.

METHODS: We combined data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) and Multi-Ethnic Study of Atherosclerosis (MESA) cohorts. We used multivariable-adjusted linear regression models to compare advanced CAC …

How Do Red Blood Cells Die?, Perumal Thiagarajan, Charles J Parker, Josef T Prchal

Faculty, Staff and Students Publications

Normal human red blood cells have an average life span of about 120 days in the circulation after which they are engulfed by macrophages. This is an extremely efficient process as macrophages phagocytose about 5 million erythrocytes every second without any significant release of hemoglobin in the circulation. Despite large number of investigations, the precise molecular mechanism by which macrophages recognize senescent red blood cells for clearance remains elusive. Red cells undergo several physicochemical changes as they age in the circulation. Several of these changes have been proposed as a recognition tag for macrophages. Most prevalent hypotheses for red cell …

Identification Of Deep-Intronic Splice Mutations In A Large Cohort Of Patients With Inherited Retinal Diseases, Xinye Qian, Jun Wang, Meng Wang, Austin D Igelman, Kaylie D Jones, Yumei Li, Keqing Wang, Kerry E Goetz, David G Birch, Paul Yang, Mark E Pennesi, Rui Chen

Faculty, Staff and Students Publications

High throughput sequencing technologies have revolutionized the identification of mutations responsible for a diverse set of Mendelian disorders, including inherited retinal disorders (IRDs). However, the causal mutations remain elusive for a significant proportion of patients. This may be partially due to pathogenic mutations located in non-coding regions, which are largely missed by capture sequencing targeting the coding regions. The advent of whole-genome sequencing (WGS) allows us to systematically detect non-coding variations. However, the interpretation of these variations remains a significant bottleneck. In this study, we investigated the contribution of deep-intronic splice variants to IRDs. WGS was performed for a cohort …

Meld-Na Is More Strongly Associated With Risk Of Infection And Outcomes Than Other Characteristics Of Patients With Cirrhosis, Zachary P Fricker, V V Pavan Kedar Mukthinuthalapati, Samuel Akinyeye, Naga Chalasani, Bashar M Attar, Maya Balakrishnan, Marwan Ghabril, Michelle T Long

Faculty, Staff and Students Publications

BACKGROUND AND AIMS: The nature and outcomes of infection among patients with cirrhosis in safety-net hospitals are not well described. We aimed to characterize the rate of and risk factors for infection, both present on admission and nosocomial, in this unique population. We hypothesized that infections would be associated with adverse outcomes such as short-term mortality.

METHODS: We used descriptive statistics to characterize infections within a retrospective cohort characterized previously. We used multivariable logistic regression models to assess potential risk factors for infection and associations with key outcomes such as short-term mortality and length of stay.

RESULTS: The study cohort …

Alcohol Consumption And The Risk Of Gastric Intestinal Metaplasia In A Us Veterans Population, Hudson M Holmes, Andre G Jove, Mimi C Tan, Hashem B El-Serag, Aaron P Thrift

Faculty, Staff and Students Publications

BACKGROUND: Chronic alcohol use is a risk factor for non-cardia gastric adenocarcinoma. However, it is less well understood whether alcohol use is a risk factor for premalignant mucosal changes, namely gastric intestinal metaplasia. We examined the association between various parameters of alcohol use and risk of gastric intestinal metaplasia.

METHODS: We used data from 2084 participants (including 403 with gastric intestinal metaplasia) recruited between February 2008-August 2013 into a cross-sectional study at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas. All participants underwent a study upper endoscopy with systematic gastric mapping biopsies. Cases had intestinal metaplasia on …

Thyroid Storm In A Patient With Covid-19, Angela N Rao, Ruaa Y Al-Ward, Ruchi Gaba

Faculty, Staff and Students Publications

OBJECTIVE: A thyroid storm is a severe exacerbation of thyrotoxicosis that can cause significant morbidity and mortality. The emergence of the novel coronavirus (SARS-CoV-2) that originated in Wuhan, China, has become a worldwide pandemic. We present the first documented case of thyroid storm (as defined by the Burch-Wartofsky criteria) in a patient with COVID-19.

METHODS: Laboratory and diagnostic studies, including thyroid function tests, thyroid antibody testing, SARS-CoV-2 nasopharyngeal polymerase chain reaction testing, and thyroid ultrasound were performed.

RESULTS: A 25-year-old woman presented to the hospital with dry cough, dyspnea, palpitations, weight loss, diarrhea, and anxiety. Physical examination revealed exophthalmos with …

A Gigantic Uterine Leiomyoma And Big Bilateral Adrenal Myelolipomas As A Result Of Untreated Congenital Adrenal Hyperplasia, Betty La, Celestine Tung, Eugene A Choi, Ha Nguyen

Faculty, Staff and Students Publications

INTRODUCTION: Patients with congenital adrenal hyperplasia (CAH) can present early with salt wasting, adrenal insufficiency, and hyperandrogenism. Late consequences as a result of untreated CAH are now rarely seen. We present a patient with a massive uterine leiomyoma and bilateral adrenal myelolipomas due to longstanding treatment noncompliance.

CASE REPORT: A female patient with CAH was treated with glucocorticoids until the age of 29 years when they stopped with the intention of identifying as a male. The patient then presented with abdominal pain and distension. Computed tomography images of the abdomen and pelvis revealed a 31 × 35 × 31-cm abdominal …

Identification Of Infant Feeding Practices In Eastern Kentucky And Southern West Virginia That Correlate With High Weight-For-Length, Havilah R. Adkins

DNP Projects

Background: Approximately 20% of children in the United States are obese. West Virginia and Kentucky rank in the top 10 for obesity rates in children as young as 2-4 years old. Obesity increases the risk for numerous short-term health problems and impacts long-term health, development, quality of life, and life expectancy. Research indicates that obesogenic behaviors can be addressed prior to the development of obesity or significant health problems to prevent, rather than treat. Interventions targeting caregivers of infants younger than 2-years can promote early development of healthy feeding habits that persist through the developmental stages of nutrition. Before a …

Osteocyte Activity And Skeletal Muscle Relative Gene Expression Profiling After Short-Term Muscle Paralysis, Michelle Gelbs

Dissertations and Theses

Mechanical loading is essential for maintaining bone tissue. Reduced mechanical loading has been shown to have a negative effect on bone, and can result in the development of disuse osteoporosis. Disuse models of muscle inactivity and immobilization, like the Botox model used in this study, result in changes in the bone microarchitecture, the mechanisms behind which are not fully understood. In a previous four-week Botox disuse study, skeletally mature 20- week-old rats experienced degradation of intracortical bone, increased vascular porosity, and decreased osteocyte lacunar density in the tibiae. The focus of this study was to explicate a potential source of …

Development Of Light Actuated Chemical Delivery Platform On A 2-D Array Of Micropore Structure, Hojjat Rostami Azmand, Hojjat Rostami Azmand

Dissertations and Theses

Localized chemical delivery plays an essential role in the fundamental information transfers within biological systems. Thus, the ability to mimic the natural chemical signal modulation would provide significant contributions to understand the functional signaling pathway of biological cells and develop new prosthetic devices for neurological disorders. In this paper, we demonstrate a light-controlled hydrogel platform that can be used for localized chemical delivery in a high spatial resolution. By utilizing the photothermal behavior of graphene-hydrogel composites confined within micron-sized fluidic channels, patterned light illumination creates the parallel and independent actuation of chemical release in a group of fluidic ports. The …

Role Of P53 Deficient Clonogenic Endothelial Cells In The Pathogenesis Of Pulmonary Hypertension, Aneel Roy Bhagwani

Theses and Dissertations

Pulmonary Artery Hypertension (PAH) is a progressive disorder of the small vessels of the pulmonary vasculature. It is characterized by occlusive vascular remodeling leading to right heart failure and ultimately death. PAH pathogenesis involves a multifactorial etiology leading to formation of occlusive lesions in small (preacinary) pulmonary arteries. These lesions contain hyper-proliferative, apoptosis resistant endothelial cells (ECs), smooth muscle cells and fibroblasts. ECs play a major role in the development of PAH. These ECs in vascular lesions are primitive and express progenitor cell markers, including CD117 (c-kit).

We have isolated clonally expanded, c-kit+ ECs from the lungs of Green Fluorescent …

The Application Of Machine Learning In Clustering Borderline Mild Cognitive Impairment Among Aging Thai People Living With Hiv, Akarin Hiransuthikul

Chulalongkorn University Theses and Dissertations (Chula ETD)

Many people living with HIV (PLWH) have cognitive impairment. Details of cognitive impairment subtypes are lacking. Unsupervised machine learning (ML) can reveal hidden subgroups within heterogeneous data. The study aimed to determine clusters of aging Thai PLWH with borderline cognitive impairment using unsupervised ML. HIV-NAT 207 study enrolled Thai PLWH aged ≥50 years. Cognitive performance was evaluated by the Thai-validated Montreal Cognitive Assessment (MoCA). This study included participants who scored between 23 and 27. The score of each cognitive domain served as cluster variables for the K-means algorithm. Among 340 PLWH, 177 (52.1%) scored between 23 and 27. Median age …

Development Of Novel Point-Of-Care-Testing For Oxalate Detection In Urine Based On Oxalate-Binding Ligands, Naruerat Joybumrung

Chulalongkorn University Theses and Dissertations (Chula ETD)

Kidney stone disease is the third most common urinary tract disease worldwide that is more prevalent in the tropics. In Thailand, the highest stone prevalence up to 17% is reported in the Northeast. The disease is highly recurrent with a recurrence rate of about 50% within 5-10 years. The most common type of kidney stones is calcium oxalate (CaOx), and an increased urinary oxalate excretion is an important risk factor. Most of kidney stone patients have a hyperoxaluria condition (urinary oxalate >40 mg/day or >0.46 mmol/day). Therefore, urinary oxalate measurement has been widely used for estimating the risk of CaOx …

Epigenetic Regulation Of Reactive Oxygen Species-Induced Tumor Progression In Hepatocellular Carcinoma, Suchittra Phoyen

Chulalongkorn University Theses and Dissertations (Chula ETD)

Oxidative stress is a consequence of an imbalance of antioxidants and reactive species. The most common form of reactive species is derived from oxygen, called reactive oxygen species (ROS). ROS involve in pathogenesis of several diseases including cancers. Cancer genesis and progression are contributed through both genetic and epigenetic mechanisms. Histone modification, a post-translational modification at histone tails, is one of the epigenetic mechanisms known to participate in carcinogenesis and tumor progression. Although the ROS-induced histone modification alteration has been demonstrated in some cancers, the change in histone methylation and gene expression by ROS in hepatocellular carcinoma (HCC) is scarcely …

Integrative Transcriptomic Analysis And Validation Of Non-Coding Rna In Liver Cancers, Varunya Virushkul

Chulalongkorn University Theses and Dissertations (Chula ETD)

Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA) are the most common and cause cancer-related deaths. Due to the lack of sensitivity and specificity of conventional markers, such as AFP, CA19-9 and CEA. Thus, this study aimed to identify miRNAs as a diagnostic biomarker for HCC and iCCA. First, in discovery set, RNA sequencing and small RNA sequencing data of 992 HCC and adjacent tissues and 116 iCCA and adjacent tissues were downloaded from the GEO database. After that, the lncRNA-miRNA-mRNA network was constructed and analyzed for the differential expression of lncRNA (DElncRNA), miRNA (DEmiRNA), and mRNA (DEmRNA). Then, the significant …

Development Of A Human Viable Heavy Chain Antibody Against The Alpha Folate Receptor As A Molecule For Targeted Application By Phage Display Technology, Nattihda Parakasikron

Chulalongkorn University Theses and Dissertations (Chula ETD)

Alpha folate receptor (FRα) is currently under investigation as a target for the treatment of patients with non-small-cell lung cancer (NSCLC), since it is highly expressed in tumor cells but is largely absent in normal tissue. In this study, a novel human variable domain of a heavy-chain (VH) antibody fragment specific to FRα was enriched and selected by phage bio-planning. The positive phage clone (3A102 VH) is specifically bound to FRα and also cross-reacted with FRβ, as tested by ELISA. Clone 3A102 VH was then successfully expressed as a soluble protein in an E. coli shuffle strain. The obtained soluble …

A Comparative Study Of Gut Microbiota In The Healthy Elderly And The Elderly With Colorectal Cancer, Nutta Iadsee

Chulalongkorn University Theses and Dissertations (Chula ETD)

Colorectal cancer is one of the third most common cancer worldwide. Dysbiosis of the human gut microbiota has been linked to sporadic colorectal cancer (CRC). This study aimed to compare the gut microbiota profile of a total of 80 Thai volunteers, who were above 50 years old, among 25 CRC patients, 33 adenoma patients, and 22 healthy controls (HC). The 16S rRNA sequencing was utilized to characterize the gut microbiome in both mucosal tissue and stool samples. Moreover, absolute quantitative PCR (qPCR) assay was conducted to quantify six CRC-associated bacteria including Fusobacterium nucleatum (FN), Parvimonas micra (PM), colibactin positive strains …

Comparative Response Of Dendritic Cells To Pathogenic And Non-Pathogenic Leptospira Spp., Pratomporn Krangvichian

Chulalongkorn University Theses and Dissertations (Chula ETD)

Leptospirosis is a zoonotic disease caused by pathogenic Leptospira species, which consist of three groups and contain 4 subclades: pathogenic strains (P1), intermediate strains (P2), and non-pathogenic strains (S1 and S2). Infection of pathogenic leptospires occurs through contact with contaminated environments. Then, leptospires present in the bloodstream disseminate to target organs. Nowadays, the knowledge of the immune response to pathogenic and non-pathogenic leptospires during early infection is still limited. Due to the limitation of a susceptible host, immunological reagents for hamsters and strains of mice are limited and not available. Dendritic cells are the first cells to encounter leptospires found …

Designing An Extracorporeal Plasma Filtration Column With Specific Binding To Dengue Virions, Sasiwimon Thonghong

Chulalongkorn University Theses and Dissertations (Chula ETD)

Dengue infection is one of the major public health concerns and no specific treatment is currently available. An extracorporeal system is one of the alternative treatment in severe dengue patients with impending shock. However, the commercial immunoadsorption devices were size-exclusive, non-selective designed for multipurpose thus not specific for dengue syndrome. This study focuses on establishing the flavivirus-specific (4G2) antibody entrapped into the alginate bead. Results showed that the viral titer reduced more than 90 % after 3 h running on a simulated circuit quantified by reverse transcription qPCR and plaque titration assay. The experiments were repeated with two biological replicates …

The Synergistic Activity Of Antibiotic Combinations Against Colistin-Resistant Acinetobacter Baumannii Clinical Isolates And Its Mechanisms Related To Colistin Resistance, Sukrit Srisakul

Chulalongkorn University Theses and Dissertations (Chula ETD)

The increasing development of colistin resistance in Acinetobacter baumannii clinical isolates is a global concern. Due to the limitation of effective antibiotics, the antibiotic combination therapies are the alternative choices. Here, we investigated the prevalence of colistin resistant A. baumannii (CoR-AB) clinical isolates and their resistance mechanisms, and examined the in vitro synergistic activities of the antibiotic combinations against CoR-AB. Among 341 carbapenem-resistant Acinetobacter spp., 317 (92.0%) were identified as A. baumannii by gyrB multiplex PCR. The rate of colistin resistance was 15.1% in A. baumannii isolates with MIC range of 0.125 – 64 mg/L. A total of 30 representative …

Endotoxemia From Nsaids-Induced Gut-Leakage Enhanced Lupus Characteristics In Fc Gamma Receptor Iib Deficient Lupus Mice, Thansita Bhunyakarnjanarat

Chulalongkorn University Theses and Dissertations (Chula ETD)

High dose of non-steroidal anti-inflammatory drugs (NSAIDs), the common analgesia, might induce lupus activity through NSAIDs-induced gastrointestinal permeability defect (gut leakage) that causes endotoxemia. Indomethacin (25 mg/day) was orally administered for 7 days in 24-week-old Fc gamma receptor IIb deficient (FcgRIIb-/-) mice, an asymptomatic lupus model, and age-matched wild-type (WT) mice. The severity of indomethacin-induced enteropathy in FcgRIIb-/- mice was higher than WT mice as demonstrated by intestinal injury (histology, immune-deposition and intestinal cytokines), gut leakage (FITC-dextran assay and endotoxemia) and serum cytokines. In addition, higher responses against endotoxemia in indomethacin-administered FcgRIIb-/- mice was also supported by the prominent responses …

Impact Of Bacterial Dna In Severity Of Sepsis, Warerat Kaewduangduen

Chulalongkorn University Theses and Dissertations (Chula ETD)

Bacterial sepsis can be caused by intestinal damage, leading to the passage of viable bacteria and their components into the circulatory system. Bacterial-free DNA in the blood during sepsis can be derived from bacterial death and intestinal translocation of free DNA in the gut contents. The presence of bacterial DNA in combination with lipopolysaccharide (LPS) can lead to more serious outcomes of sepsis. To explore the impact of bacterial-free DNA in sepsis, animal and macrophage experiments were performed. Firstly, the appearance of bacterial-free DNA and bacteriome in the blood was presented in mice with cecal ligation and puncture sepsis. Secondly, …

Localization Chulalongkorn University Of The Infraorbital Foramen And The Accessory Infraorbital Foramen With Reference To Facial Bony Landmarks: The Predicting Method And Its Accuracy., Jiraporn Suntiruamjairucksa

Chulalongkorn University Theses and Dissertations (Chula ETD)

The infraorbital nerve block is commonly used for mid-facial anesthesia. Therefore, the location of infraorbital foramen (IOF) and accessory infraorbital foramen (AIOF) where the nerve exits through is important. Although, many studies tried to identify the location of IOF and AIOF using bony and soft tissue landmarks, the results varied in each study. Objectives To determine the location of IOF and AIOF with reference to the line between anterior nasal spine (ANS) and the lowest point of the zygomaticomaxillary junction (Z) which is defined as line A, describe anatomical relationship between IOF and AIOF, and assess an accuracy of the …

Identification Of Snp Barcode For Classify Carbapenem-Resistant Enterobacteriaceae (Cre) And Non-Cre Using Nanopore Sequencing, Nicha Sangpiromapichai

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: The continuous increase of carbapenem-resistant Enterobacteriaceae (CRE) prevalence has been a serious problem for public health worldwide. In the previous study, 25% of 3864 Klebsiella pneumoniae isolates were carbapenem-resistant. One of the most important risks of bacterial drug resistance is the improper use of antibiotics. The routine antimicrobial-susceptibility test requires overnight and has a turnaround time of approximately 2–3 days which delays the proper antibiotics. This study aims to develop a technique to classify CRE and non-CRE by SNP barcode. Method: Forty Klebsiella pneumoniae (KP) clinical isolates were collected from 2020–2021 at King Chulalongkorn Memorial Hospital. Twenty samples were …

Ultrastructural Changes Of Endothelial Cell, Pericyte And Vascular Basement Membrane In Cisplatin-Induced Neuropathy In Rats: Correlation With Neuropathic Changes After Treatments, Phetnarin Kobutree

Chulalongkorn University Theses and Dissertations (Chula ETD)

Cisplatin is an antineoplastic agent used to treat cancers of several organs. Peripheral neuropathy is one of its major side effects leading to dose reduction or cessation. Underlying mechanisms of cisplatin-induced neuropathy are not fully understood. According to current evidence, vascular dysfunction may play a role. Curcumin is a polyphenol found in the root of Curcuma longa with the anti-oxidant property and neuroprotection. Curcumin has shown effectiveness against experimental cisplatin neuropathy. B vitamins are a class of water-soluble vitamins that play important roles in cell metabolism and maintaining nervous system functions. Increasing evidence suggests the efficacy of vitamin B1-6-12 for …

Study Of G6pd Deficiency With Clinical And Hematological Correlation In Newborn Infants, Thanaporn Pimpakan

Chulalongkorn University Theses and Dissertations (Chula ETD)

G6PD deficiency is the most common enzymatic aberration, affecting more than a million people worldwide. If severe cases at birth are not diagnosed and treated promptly, they can develop into cerebral jaundice and hyperbilirubinemia. Hyperbilirubinemia is caused by an imbalance between increased bilirubin production and ineffective excretion of bilirubin. This can result in the neurotoxicity of bilirubin, kernicterus, and fatal mental retardation. Besides, It has been speculated that the presence of a high number of reticulocytes in newborns interferes with the diagnosis of G6PD deficiency since reticulocytes contain higher amounts of G6PD enzyme than mature erythrocytes. Therefore, the purposes of …

Effects Of Strongyloides Stercoralis Antigens On Immune Responses In Dendritic Cells, Vittawin Sutaveesup

Chulalongkorn University Theses and Dissertations (Chula ETD)

Strongyloidiasis is a parasitic disease caused by Strongyloides stercoralis. Infection in the immunocompromised hosts such as organ transplants, SLE patients, or HIV and HIPV infected patients can cause severe strongyloidiasis. Infected patients have high levels of Th2, and Treg related cytokines, including IL-4, IL-5, IL-9, IL-10, IL-13, and TGF-β. These cytokines are then decreased to normal levels after the treatments. Parasites have several mechanisms to suppress or evade the host’s immune response, such as suppressing the expression of co-stimulatory molecules on antigen-presenting cells (APCs), stimulating apoptosis of APCs, or stimulating Th2 and Treg responses. Dendritic cells (DCs) play a crucial …

An Anatomical Study Of The Central Myelin Portion And Transitional Zone Of The Oculomotor And Abducens Nerves, Wiyada Quanchareonsap

Chulalongkorn University Theses and Dissertations (Chula ETD)

Neurovascular syndrome is a dysfunction of an individual cranial nerve which is compressed by vessels. Several neurovascular compression syndromes are well known such as trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia. Having neurovascular conflicts at oculomotor nerves and abducens nerve cause ocular neuromyotonia and abducens nerve palsy. Site of compression is still controversial because of unclear definition. The term root entry/ exit zone (REZ) is defined variously and used interchangeably with transitional zone making it hard to compare between studies. It is generally thought to be at transitional zone which is defined as junction between central and peripheral nervous system. …

A Pilot Study, Randomized Control Trial On Effect Of Oral Calcium Carbonate To Fecal Functional Levofloxacin Concentration In Healthy Volunteer Taking Oral Levofloxacin, Ophat Janphet

Chulalongkorn University Theses and Dissertations (Chula ETD)

Objective: We conducted a pilot randomized control trial (RCT) to study whether oral calcium carbonate (CaCO3) can lower fecal levofloxacin (LVX) concentration and preserve gut microbiota diversity in healthy volunteers. Methods: The healthy volunteers received a 5-day course of once-daily 500 mg LVX oral tablet and were randomly assigned to treatment (6-day course of 1,000 mg CaCO3 oral tablet twice daily) and control group (no CaCO3). The primary outcome was fecal LVX concentration by MIC and high-performance liquid chromatography (HPLC) on day 2 and 5. The secondary outcomes were fecal microbiota diversity Shannon index (H) by 16s rDNA analysis, plasma …