201
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Ariyoshi T, Hagihara M, Eguchi S, Fukuda A, Iwasaki K, Oka K, Takahashi M, Yamagishi Y, Mikamo H. Clostridium butyricum MIYAIRI 588-Induced Protectin D1 Has an Anti-inflammatory Effect on Antibiotic-Induced Intestinal Disorder. Front Microbiol 2020; 11:587725. [PMID: 33193245 PMCID: PMC7661741 DOI: 10.3389/fmicb.2020.587725] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/15/2020] [Indexed: 12/19/2022] Open
Abstract
Metabolites are thought as the end products in cellular regulatory processes and their levels show the strongest relationships with the phenotype. Previously, we showed that the administration of Clostridium butyricum MIYAIRI 588 (CBM 588) upregulated protectin D1, an anti-inflammatory lipid metabolite, in colon tissue under antibiotic therapy. However, how CBM 588 induces protectin D1 expression and whether the metabolite has anti-inflammatory effects on antibiotic-induced inflammation are unclear. Therefore, here, we evaluated the effect of CBM 588 on lipid metabolism and protectin D1 in gut protection from antibiotic-induced intestinal disorders. In the CBM 588 treatment group, expression levels of genes encoding lipid receptors related to the conversion of DHA to protectin D1, such as polyunsaturated fatty acid (PUFA) receptors, G-protein coupled receptor 120 (GPR120), and 15-lipoxygenase (LOX), were increased in colon tissue. CD4+ cells producing interleukin (IL)-4, the main component of T helper type 2 (Th2) cells that can activate 15-LOX, also increased in CBM 588-treated groups even after clindamycin co-administration. In addition, similar to CBM 588, exogenously administered protectin D1 reduced inflammatory cytokines, while IL-10 and TGF-β1, works as anti-inflammatory cytokines, were increased. Our data revealed that CBM 588 activated 15-LOX to enhance protectin D1 production by increasing IL-4-producing CD4+ cell population in the intestinal tract. Additionally, CBM 588-induced protectin D1 clearly upregulated IL-10-producing CD4+ cells to control antibiotic-induced gut inflammation. We provide new insights into CBM 588-mediated lipid metabolism induction for the treatment of gut inflammatory diseases.
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Affiliation(s)
- Tadashi Ariyoshi
- Department of Clinical Infectious Diseases, Aichi Medical University Graduate School of Medicine, Nagakute, Japan.,Miyarisan Pharmaceutical Co., Ltd., Saitama, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University Graduate School of Medicine, Nagakute, Japan.,Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Nagakute, Japan
| | | | - Aiki Fukuda
- Miyarisan Pharmaceutical Co., Ltd., Saitama, Japan
| | - Kenta Iwasaki
- Departments of Kidney Disease and Transplant Immunology, Aichi Medical University, Nagakute, Japan
| | - Kentaro Oka
- Department of Clinical Infectious Diseases, Aichi Medical University Graduate School of Medicine, Nagakute, Japan.,Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Nagakute, Japan
| | - Motomichi Takahashi
- Department of Clinical Infectious Diseases, Aichi Medical University Graduate School of Medicine, Nagakute, Japan.,Miyarisan Pharmaceutical Co., Ltd., Saitama, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Graduate School of Medicine, Nagakute, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Graduate School of Medicine, Nagakute, Japan
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202
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Vent-Schmidt J, Goldsmith LJ, Steiner TS. Patients' Willingness and Perspectives Toward Chimeric Antigen Receptor T-Regulatory Cell Therapy for Inflammatory Bowel Diseases. CROHN'S & COLITIS 360 2020; 2:otaa085. [PMID: 36777762 PMCID: PMC9802168 DOI: 10.1093/crocol/otaa085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Indexed: 11/14/2022] Open
Abstract
Background Inflammatory bowel disease is a life-changing disease resulting from recurrent intestinal inflammation. Current therapies (eg, steroids and biologics) are associated with mild to severe side effects, and none provide a cure. Recent research has focused on genetically engineering gut-specific anti-inflammatory T-regulatory cells (CAR-Tregs) to control intestinal inflammation, a logistically and conceptually complex approach. The purpose of our study was to understand patients' willingness to try CAR-Treg given 2 hypothetical scenarios-in a clinical trial or as a new treatment. Methods We surveyed people living with inflammatory bowel disease about their willingness to try CAR-Treg. The online survey was developed using patient focus groups and associated literature. We recruited participants through email and social media. We used descriptive and inferential statistics to analyze closed-ended questions and inductive thematic analysis to analyze open-ended follow-up questions. Results Survey participants indicated high willingness to try CAR-Treg therapy in both a clinical trial and as a new treatment. Willingness to try was not correlated with disease state or medication history. Women were less likely than men to indicate willingness to participate in a clinical trial. Participants' reasons for being willing to try CAR-Treg therapy included the wish to change their current treatment and the calling to participate in research. Participants that were not willing to try CAR-Treg mentioned the lack of long-term data and the success of their current therapy. Conclusions This is the first study to our knowledge to investigate patient willingness to try CAR-Treg therapy. Our results demonstrate the promise of moving this therapy into clinical practice as most patients indicated willingness to try.
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Affiliation(s)
- Jens Vent-Schmidt
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Laurie J Goldsmith
- GoldQual Consulting, Richmond Hill, Ontario, Canada,Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Theodore S Steiner
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada,BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada,Address correspondence to: Theodore S. Steiner, Dipl-MolMed, 950 West 28th Avenue, Vancouver, BC V5Z 4H4, Canada ()
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203
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Manceur AM, Ding Z, Muser E, Obando C, Voelker J, Pilon D, Kinkead F, Lafeuille MH, Lefebvre P. Burden of Crohn's disease in the United States: long-term healthcare and work-loss related costs. J Med Econ 2020; 23:1092-1101. [PMID: 32609019 DOI: 10.1080/13696998.2020.1789649] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIMS To quantify the long-term direct and indirect costs among patients with Crohn's disease (CD) and specific subgroups of these patients in the United States from the private payer's perspective. MATERIALS AND METHODS This retrospective study used the OptumHealth Care Solutions, Inc database (01 January 1999-31 March 2017) to match (1:5) adult patients with ≥2 claims for CD to patients without inflammatory bowel disease (IBD). Patterns observed during follow-up (i.e. biologics, opioids, or steroids; CD-related surgery; moderate-to-severe disease; and comorbidities) were used to identify CD subgroups. Comparisons of healthcare resource utilization, work loss days, and direct and indirect work loss-related costs were made between matched cohorts. Descriptive analyses of costs were conducted within each CD subgroup. RESULTS There were 6,715 and 33,575 patients in the CD and non-IBD cohorts, respectively. The direct burden was significantly higher in the CD cohort compared to the non-IBD cohort, with 0.34 inpatient admissions per patient per year (PPPY) versus 0.12 (217% increase; p < .001), and $24,500 direct healthcare costs PPPY versus $7,037 ($17,463 increase; p < .001). The trend was similar for the indirect burden, with work loss-related costs PPPY of $5,490 in the CD cohort versus $3,322 in the non-IBD cohort ($2,168 increase; p < .001). The burden was numerically higher in the CD subgroups, with direct healthcare costs reaching $101,013 PPPY in the surgery subgroup. LIMITATIONS Severity of CD was determined based on claims-based algorithms due to the lack of access to medical files. Absenteeism was imputed based on claims data, and presenteeism was not assessed. CONCLUSIONS The direct healthcare and indirect work loss-related costs of patients with CD was significantly higher compared to patients without IBD over an average follow-up of 5 years.
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Affiliation(s)
| | - Zhijie Ding
- Janssen Scientific Affairs, LLC, Horsham, PA, USA
| | - Erik Muser
- Janssen Scientific Affairs, LLC, Horsham, PA, USA
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204
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Dreja J, Ekberg O, Leander P, Månsson S, Ohlsson B. Volumetric analysis of small bowel motility in an unselected cohort of patients with Crohn's disease. Neurogastroenterol Motil 2020; 32:e13909. [PMID: 32469111 DOI: 10.1111/nmo.13909] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/26/2020] [Accepted: 05/11/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Quantified terminal ileal motility during magnetic resonance enterography (MRE) has been suggested to be used as a biomarker of Crohn's disease (CD). The aim of the present study was to evaluate this method in clinical practice. METHODS Healthy volunteers and all consecutive patients referred to MRE during a 2-year period were asked to participate and complete the Irritable Bowel Syndrome-Symptom Severity Scale (IBS-SSS) to assess gastrointestinal symptoms. Medical records were scrutinized, and motility indices (MIs) were calculated from MR images. KEY RESULTS Twenty-two healthy controls and 134 examinations with CD were included (inclusion rate: 76.3%). Patients with CD had increased mural thickness of the terminal ileum, increased fecal calprotectin, and more symptoms than controls. Patients with active CD had increased mural thickness of ileum and terminal ileum, higher MR activity indices, and signs of inflammation in laboratory analyses, but similar symptoms, compared with inactive disease. After exclusion of sole colon disease (n = 13), MI inversely correlated with mural thickness in terminal ileum, and MI was lower in active disease versus controls in ileum (P = .019) and terminal ileum (P = .005), and versus inactive disease in terminal ileum (P = .044). The area under the curve of MI in terminal ileum was 0.736 for active CD against healthy controls (P = .002) and 0.682 for active against inactive CD (P = .001). MIs were similar in controls and inactive CD. CONCLUSIONS AND INTERFERENCES MI reflects inflammatory activity in the intestine. Alterations in MI did not explain symptomatology in inactive CD, without measurable inflammatory parameters in morphology or laboratory analyses.
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Affiliation(s)
- Julia Dreja
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Olle Ekberg
- Department of Translational Medicine, Diagnostic Radiology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Peter Leander
- Department of Translational Medicine, Diagnostic Radiology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Sven Månsson
- Department of Translational Medicine, Medical Radiation Physics, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Bodil Ohlsson
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
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205
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Månsson S, Ekberg O, Ohlsson B. Motility index measured by magnetic resonance enterography is associated with sex and mural thickness. World J Gastroenterol 2020; 26:5484-5497. [PMID: 33024399 PMCID: PMC7520614 DOI: 10.3748/wjg.v26.i36.5484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/27/2020] [Accepted: 09/04/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Recently, a technique has been developed to use magnetic resonance enterography (MRE) for the evaluation of small bowel motility. The hypothesis was that assessment of the motility index (MI) should reflect differences in motility between clinical conditions.
AIM To aim of the present observational, cross-sectional study was to evaluate the use of the MI in daily clinical practice.
METHODS All consecutive patients aged 18-70 years who were referred for MRE at the Department of Radiology during a 2-year period were asked to participate. Healthy volunteers were included as controls. MRE was prepared and conducted in accordance with clinical routines. On the day of examination, all the participants had to complete the visual analog scale for irritable bowel syndrome (IBS) and IBS-symptom severity scale. Maps of MI were calculated from dynamic MR images. ANOVA was used to evaluate differences in MI between groups, classified as healthy, Crohn’s disease, ulcerative colitis, IBS, other assorted disorders and dysmotility. Logistic and linear regression were applied to the MI values. All medical records were scrutinized for medical history.
RESULTS In all, 224 examinations were included (inclusion prevalence 76.3%), with 22 controls and 202 patients. There was a significant difference in the MI of the jejunum (P = 0.021) and terminal ileum (P = 0.007) between the different groups. The MI was inversely associated with the mural thickness of the terminal ileum in men (P < 0.001) and women (P = 0.063) after adjustments, and tended to be lower in men than in women (P = 0.056). Subjectively observed reduction of motility on MRI was accomplished by reduced MI of terminal ileum in men (P < 0.001) and women (P = 0.030). In women, diarrhea was inversely associated with the MI of the jejunum (P = 0.029), and constipation was positively associated with the MI of the terminal ileum (P = 0.039).
CONCLUSION Although MIs differ across diseases, a lower MI of the terminal ileum is mainly associated with male sex and an increased mural thickness. Symptoms are weakly associated with the MI.
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Affiliation(s)
- Sven Månsson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Skåne University Hospital Malmö, Malmö 20502, Sweden
| | - Olle Ekberg
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Skåne University Hospital, Malmö 20502, Sweden
| | - Bodil Ohlsson
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö S-205 02, Sweden
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206
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Törüner M, Akpınar H, Akyüz F, Dağlı Ü, Över Hamzaoğlu H, Tezel A, Ünsal B, Yıldırım S, Çelik AF. 2019 Expert opinion on biological treatment use in inflammatory bowel disease management. TURKISH JOURNAL OF GASTROENTEROLOGY 2020; 30:S913-S946. [PMID: 32207688 DOI: 10.5152/tjg.2019.061119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Murat Törüner
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
| | - Hale Akpınar
- Department of Gastroenterology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Filiz Akyüz
- Department of Gastroenterology, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Ülkü Dağlı
- Department of Gastroenterology, Başkent University School of Medicine, İstanbul, Turkey
| | - Hülya Över Hamzaoğlu
- Department of Gastroenterology, İstanbul Acıbadem Fulya Hospital, İstanbul, Turkey
| | - Ahmet Tezel
- Department of Gastroenterology, Trakya University School of Medicine, Edirne, Turkey
| | - Belkıs Ünsal
- Department of Gastroenterology, Katip Çelebi University School of Medicine, İzmir, Turkey
| | - Süleyman Yıldırım
- Department of Gastroenterology, İstanbul University-Cerrahpaşa Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Aykut Ferhat Çelik
- Department of Gastroenterology, İstanbul University-Cerrahpaşa Cerrahpaşa School of Medicine, İstanbul, Turkey
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207
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Detz DJ, Podrat JL, Muniz Castro JC, Lee YK, Zheng F, Purnell S, Pei KY. Small bowel obstruction. Curr Probl Surg 2020; 58:100893. [PMID: 34130796 DOI: 10.1016/j.cpsurg.2020.100893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 09/04/2020] [Indexed: 02/06/2023]
Affiliation(s)
| | | | | | - Yoon K Lee
- Houston Methodist Hospital, Houston, Texas
| | - Feibi Zheng
- Weill Cornell Medicine, Houston Methodist Hospital, Houston, Texas
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208
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Raftery AL, Tsantikos E, Harris NL, Hibbs ML. Links Between Inflammatory Bowel Disease and Chronic Obstructive Pulmonary Disease. Front Immunol 2020; 11:2144. [PMID: 33042125 PMCID: PMC7517908 DOI: 10.3389/fimmu.2020.02144] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/07/2020] [Indexed: 12/14/2022] Open
Abstract
Inflammatory bowel disease (IBD) and chronic obstructive pulmonary disease (COPD) are chronic inflammatory diseases of the gastrointestinal and respiratory tracts, respectively. These mucosal tissues bear commonalities in embryology, structure and physiology. Inherent similarities in immune responses at the two sites, as well as overlapping environmental risk factors, help to explain the increase in prevalence of IBD amongst COPD patients. Over the past decade, a tremendous amount of research has been conducted to define the microbiological makeup of the intestine, known as the intestinal microbiota, and determine its contribution to health and disease. Intestinal microbial dysbiosis is now known to be associated with IBD where it impacts upon intestinal epithelial barrier integrity and leads to augmented immune responses and the perpetuation of chronic inflammation. While much less is known about the lung microbiota, like the intestine, it has its own distinct, diverse microflora, with dysbiosis being reported in respiratory disease settings such as COPD. Recent research has begun to delineate the interaction or crosstalk between the lung and the intestine and how this may influence, or be influenced by, the microbiota. It is now known that microbial products and metabolites can be transferred from the intestine to the lung via the bloodstream, providing a mechanism for communication. While recent studies indicate that intestinal microbiota can influence respiratory health, intestinal dysbiosis in COPD has not yet been described although it is anticipated since factors that lead to dysbiosis are similarly associated with COPD. This review will focus on the gut-lung axis in the context of IBD and COPD, highlighting the role of environmental and genetic factors and the impact of microbial dysbiosis on chronic inflammation in the intestinal tract and lung.
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Affiliation(s)
- April L Raftery
- Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Evelyn Tsantikos
- Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Nicola L Harris
- Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Margaret L Hibbs
- Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, VIC, Australia
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209
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Makaro A, Fichna J, Włodarczyk M. Single Nucleotide Polymorphisms in Colitis-Associated Colorectal Cancer: A Current Overview with Emphasis on the Role of the Associated Genes Products. Curr Drug Targets 2020; 21:1456-1462. [PMID: 32718287 DOI: 10.2174/1389450121666200727105218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/27/2020] [Accepted: 05/18/2020] [Indexed: 12/14/2022]
Abstract
Colitis-Associated Colorectal Cancer (CA-CRC) is one of the most severe complications of Inflammatory Bowel Disease (IBD) and constitutes the cause of death in 10-15% of patients. The risk ratio for carcinogenesis depends on numerous factors, such as the extent of intestinal inflammatory lesions and the duration of the disease. CA-CRC is a major problem of today's gastroenterology and colorectal surgery due to the fact that the incidence and prevalence of IBD are increasing. In this review, we discussed the current state of knowledge regarding genetic differences between sporadic CRC and CA-CRC, especially pertaining to the chromosomal instability mechanism (CIN). In order to explain CA-CRC molecular basis, we have analyzed the data from studies regarding the correlations between CA-CRC and the presence of Single Nucleotide Polymorphisms (SNPs). Further focus on the role of associated proteins has emphasized the role of NF-κB signaling as the main link between inflammation and carcinogenesis during the course of IBD.
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Affiliation(s)
- Adam Makaro
- Department of Biochemistry, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland
| | - Jakub Fichna
- Department of Biochemistry, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland
| | - Marcin Włodarczyk
- Department of Biochemistry, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland,Department of General and Colorectal Surgery, Medical University of Lodz, Haller Square 1, 90-624 Lodz, Poland
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210
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Primary Humoral Immune Deficiencies: Overlooked Mimickers of Chronic Immune-Mediated Gastrointestinal Diseases in Adults. Int J Mol Sci 2020; 21:ijms21155223. [PMID: 32718006 PMCID: PMC7432083 DOI: 10.3390/ijms21155223] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 12/12/2022] Open
Abstract
In recent years, the incidence of immune-mediated gastrointestinal disorders, including celiac disease (CeD) and inflammatory bowel disease (IBD), is increasingly growing worldwide. This generates a need to elucidate the conditions that may compromise the diagnosis and treatment of such gastrointestinal disorders. It is well established that primary immunodeficiencies (PIDs) exhibit gastrointestinal manifestations and mimic other diseases, including CeD and IBD. PIDs are often considered pediatric ailments, whereas between 25 and 45% of PIDs are diagnosed in adults. The most common PIDs in adults are the selective immunoglobulin A deficiency (SIgAD) and the common variable immunodeficiency (CVID). A trend to autoimmunity occurs, while gastrointestinal disorders are common in both diseases. Besides, the occurrence of CeD and IBD in SIgAD/CVID patients is significantly higher than in the general population. However, some differences concerning diagnostics and management between enteropathy/colitis in PIDs, as compared to idiopathic forms of CeD/IBD, have been described. There is an ongoing discussion whether CeD and IBD in CVID patients should be considered a true CeD and IBD or just CeD-like and IBD-like diseases. This review addresses the current state of the art of the most common primary immunodeficiencies in adults and co-occurring CeD and IBD.
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211
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Singh SK, Basu S. An invited commentary on "Preoperative hypoalbuminemia is an independent risk factor for postoperative complications in Crohn's disease patients with normal BMI: A cohort study. International Journal of Surgery 2020. doi:10.1016/j.ijsu.2020.05.064". Int J Surg 2020; 80:91-92. [PMID: 32652293 DOI: 10.1016/j.ijsu.2020.06.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 06/25/2020] [Indexed: 11/18/2022]
Affiliation(s)
| | - Somprakas Basu
- All India Institute of Medical Sciences, Rishikesh, India.
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212
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Dunne MR, Byrne G, Chirdo FG, Feighery C. Coeliac Disease Pathogenesis: The Uncertainties of a Well-Known Immune Mediated Disorder. Front Immunol 2020; 11:1374. [PMID: 32733456 PMCID: PMC7360848 DOI: 10.3389/fimmu.2020.01374] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 05/28/2020] [Indexed: 12/21/2022] Open
Abstract
Coeliac disease is a common small bowel enteropathy arising in genetically predisposed individuals and caused by ingestion of gluten in the diet. Great advances have been made in understanding the role of the adaptive immune system in response to gluten peptides. Despite detailed knowledge of these adaptive immune mechanisms, the complete series of pathogenic events responsible for development of the tissue lesion remains less certain. This review contributes to the field by discussing additional mechanisms which may also contribute to pathogenesis. These include the production of cytokines such as interleukin-15 by intestinal epithelial cells and local antigen presenting cells as a pivotal event in the disease process. A subset of unconventional T cells called gamma/delta T cells are also persistently expanded in the coeliac disease (CD) small intestinal epithelium and recent analysis has shown that these cells contribute to pathogenic inflammation. Other unconventional T cell subsets may play a local immunoregulatory role and require further study. It has also been suggested that, in addition to activation of pathogenic T helper cells by gluten peptides, other peptides may directly interact with the intestinal mucosa, further contributing to the disease process. We also discuss how myofibroblasts, a major source of tissue transglutaminase and metalloproteases, may play a key role in intestinal tissue remodeling. Contribution of each of these factors to pathogenesis is discussed to enhance our view of this complex disorder and to contribute to a wider understanding of chronic immune-mediated disease.
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Affiliation(s)
- Margaret R. Dunne
- Department of Surgery, Trinity Translational Medicine Institute, Trinity College Dublin, St. James's Hospital, Dublin, Ireland
| | - Greg Byrne
- School of Biological & Health Sciences, Technological University, Dublin, Ireland
| | - Fernando G. Chirdo
- Instituto de Estudios Inmunologicos y Fisiopatologicos - IIFP (UNLP-CONICET), National University of La Plata, La Plata, Argentina
| | - Conleth Feighery
- Department of Immunology, Trinity College Dublin and St. James's Hospital, Dublin, Ireland
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213
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Immunologic Complications and Graft Survival in Crohn's Disease and NOD2 Mutant Non-Crohn's Disease Adult Recipients Following Intestine Transplantation. Transplant Direct 2020; 6:e556. [PMID: 32607422 PMCID: PMC7266359 DOI: 10.1097/txd.0000000000001006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 11/26/2022] Open
Abstract
Despite improved outcomes in the modern era of targeted immunotherapy, intestinal failure and chronic parenteral nutrition remains a significant burden for patients with Crohn’s disease (CD) worldwide. Transplantation is a key component of management when a patient with CD suffers from life-threatening complications of parenteral nutrition. Nucleotide-binding oligomerization domain 2 (NOD2) mutation is a risk factor for both development of CD and intestinal allograft rejection.
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214
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Ju JK, Cho YN, Park KJ, Kwak HD, Jin HM, Park SY, Kim HS, Kee SJ, Park YW. Activation, Deficiency, and Reduced IFN-γ Production of Mucosal-Associated Invariant T Cells in Patients with Inflammatory Bowel Disease. J Innate Immun 2020; 12:422-434. [PMID: 32535589 DOI: 10.1159/000507931] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 03/30/2020] [Indexed: 12/19/2022] Open
Abstract
Mucosal-associated invariant T (MAIT) cells are innate-like T cells that can activate either in response to T-cell receptor (TCR) engagement or through activating cytokines and play an important role in autoimmune disorders. The study examined the level and function of MAIT cells in patients with inflammatory bowel disease (IBD). Circulating MAIT cell levels were significantly reduced in IBD patients. This MAIT cell deficiency was correlated with IBD disease activity grades, hemoglobin, and CRP. IFN-γ production of circulating MAIT cells in response to both MHC class 1b-like related protein (MR1)-dependent and -independent stimulations was decreased in IBD patients, which was partially associated with reduced activation of nuclear factor of activated T cells 1 (NFAT1) transcription factor, a main regulator of IFN-γ production. Expression levels of CD69, programmed death-1 (PD-1), and annexin V in MAIT cells were elevated in IBD patients. CCL20, CXCL10, CXCL16, and CCL25 were expressed higher in inflamed intestinal tissues than in noninflamed tissues. This study demonstrates that circulating MAIT cells are activated and numerically and functionally deficient in IBD patients. Furthermore, activated MAIT cells have the potential to migrate to inflamed tissues. These findings suggest an important role of MAIT cells in mucosal immunity in IBD.
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Affiliation(s)
- Jae Kyun Ju
- Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Young-Nan Cho
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Ki-Jeong Park
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Han Deok Kwak
- Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Hye-Mi Jin
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Seon-Young Park
- Department of Gastroenterology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Hyun Soo Kim
- Department of Gastroenterology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Seung-Jung Kee
- Department of Laboratory Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Yong-Wook Park
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea,
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Kwak MS, Cha JM, Shin HP, Jeon JW, Yoon JY. Development of a Novel Metagenomic Biomarker for Prediction of Upper Gastrointestinal Tract Involvement in Patients With Crohn's Disease. Front Microbiol 2020; 11:1162. [PMID: 32582102 PMCID: PMC7283919 DOI: 10.3389/fmicb.2020.01162] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/06/2020] [Indexed: 12/28/2022] Open
Abstract
The human gut microbiota is an important component in the pathogenesis of Crohn's disease (CD), promoting host-microbe imbalances and disturbing intestinal and immune homeostasis. We aimed to assess the potential clinical usefulness of the colonic tissue microbiome for obtaining biomarkers for upper gastrointestinal (UGI) tract involvement in CD. We analyzed colonic tissue samples from 26 CD patients (13 with and 13 without UGI involvement at diagnosis) from the Inflammatory Bowel Disease Multi-Omics Database. QIIME1, DiTaxa, linear discriminant analysis effect size (LEfSe), and PICRUSt2 methods were used to examine microbial dysbiosis. Linear support vector machine (SVM) and random forest classifier (RF) algorithms were used to identify the UGI tract involvement-associated biomarkers. There were no statistically significant differences in community richness, phylogenetic diversity, and phylogenetic distance between the two groups of CD patients. DiTaxa analysis predicted significant association of the species Ruminococcus torques with UGI involvement, which was confirmed by the LEfSe analysis (P = 0.025). For the feature ranking method in both linear SVM and RF models, the species R. torques and age at diagnosis contributed to the combined models. The L-methionine biosynthesis III (P = 0.038) and palmitate biosynthesis II (P = 0.050) were under-represented in CD with UGI involvement. These findings suggest that R. torques might serve as a novel potential biomarker for UGI involvement in CD and its correlations, in addition to a range of bacterial species. The mechanisms of interaction between hosts and R. torques should be further investigated.
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Affiliation(s)
- Min Seob Kwak
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, South Korea
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216
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Hernandez-Nieto C, Sekhon L, Lee J, Gounko D, Copperman A, Sandler B. Infertile patients with inflammatory bowel disease have comparable in vitro fertilization clinical outcomes to the general infertile population. Gynecol Endocrinol 2020; 36:554-557. [PMID: 31691606 DOI: 10.1080/09513590.2019.1684465] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
To assess clinical outcomes of females diagnosed with Inflammatory Bowel Disease (IBD) and infertility, which underwent in vitro fertilization (IVF) with preimplantation genetic testing for aneuploidy. (PGT-A). Retrospective cohort study comparing clinical outcomes of patients with Inflammatory bowel disease who underwent IVF with PGT-A with a subsequent euploid single embryo transfer (SET) against a matched control group. Thirty-eight patients with an IBD diagnosis were compared to 114 controls. There was no significant difference in cycle outcomes among IBD and Control cohorts [implantation rate (71.0% vs. 78.0% (p = .68)], clinical pregnancy rate [50.0% vs. 60.5% (p = .68)], live birth [62.9% vs. 73.0% (p = .06)] multiple pregnancy rate [0% vs. 1.1% (p = .25)] and clinical pregnancy loss rate [10.5% vs. 5.7% (p = .54)]. An IBD diagnosis was not found to significantly modify the odds of implantation [adjusted OR = 0.6 (95% CI -1.2 to 0.8)]. Additionally, the odds of implantation in patients with IBD were not altered by having ulcerative colitis or Crohn's disease diagnosis. (OR = 0.4 95% CI 0.1-1.9). Patients diagnosed with IBD who undergo a SET have clinical outcomes comparable to the general infertile population. Patients and physicians can be reassured that an IBD diagnosis does not impair IVF treatment outcomes.SYNOPSISInfertile patients with inflammatory bowel disease who utilized a single, euploid blastocyst transfer had IVF success rates comparable to the general infertile population.
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Affiliation(s)
| | - Lucky Sekhon
- Reproductive Medicine Associates of New York, New York, NY, USA
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, Klingenstein Pavilion, New York, NY, USA
| | - Joseph Lee
- Reproductive Medicine Associates of New York, New York, NY, USA
| | - Dmitry Gounko
- Reproductive Medicine Associates of New York, New York, NY, USA
| | - Alan Copperman
- Reproductive Medicine Associates of New York, New York, NY, USA
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, Klingenstein Pavilion, New York, NY, USA
| | - Benjamin Sandler
- Reproductive Medicine Associates of New York, New York, NY, USA
- Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, Klingenstein Pavilion, New York, NY, USA
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217
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Pham DT, Tetyczka C, Hartl S, Absenger-Novak M, Fröhlich E, Tiyaboonchai W, Roblegg E. Comprehensive investigations of fibroin and poly(ethylenimine) functionalized fibroin nanoparticles for ulcerative colitis treatment. J Drug Deliv Sci Technol 2020. [DOI: 10.1016/j.jddst.2019.101484] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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218
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Osikov MV, Davydova EV, Boyko MS, Bakeeva AE, Kaygorodtseva NV, Galeeva IR, Fedosov AA, Ilyinyh MA, Vorgova LV. Aspects of free radical oxidation in the large bowel in ulcerative colitis and Crohn’s disease. BULLETIN OF RUSSIAN STATE MEDICAL UNIVERSITY 2020. [DOI: 10.24075/brsmu.2020.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Research into the accumulation patterns of protein oxidative modification (POM) products and lipids in Crohn’s disease (CD) and ulcerative colitis (UC) could have important implications for understanding the pathogenesis and improving the diagnosis and therapy for these diseases. The aim of this study was to investigate the aspects of free radical oxidation (FRO) in the large bowel and their possible correlations with clinical symptoms of UC and CD. In the Wistar rat model used in the experiment, CD was induced with 2,4,6-trinitrobenzenesulfonic acid, and UC was induced with oxazolone. Clinical status was assessed using the Disease activity index (DAI). Lipid peroxidation (LPO) products were measured in the heptane and isopropanol phases of the intestinal mucosa extract. POM products were measured following spontaneous and stimulated oxidation. The DAI ( Me (Q25–Q75)) was increased in both CD and UC on days 3 and 7 of the experiment: for CD, it was equally increased on days 3 and 7 (7 (3-7)) and was 11 (11–11) and 11 (9–11) for UC on days 3 and 7, respectively. The amount of primary, secondary and end LPO products in the heptane and isopropanol phases, as well as the total amount of POM products, was increased in the homogenized mucosa of the large bowel. In the CD group, the relative content of secondary basic POM products was increased on day 7 of the experiment. The following patterns of FRO were revealed: accumulation of LPO products in the UC group and accumulation of POM products in the CD group; UC is characterized by the accumulation of mostly LPO products in the heptane phase and secondary LPO products in the isopropanol phase; CD is characterized by the accumulation of secondary basic POM products. DAI scores were correlated with the amount of LPO products in the isopropanol phase and the amount of POM products in the spontaneous oxidation mode. The highest number of strong correlations was observed in the UC group. Our findings suggest a very serious contribution of FRO changes to the pathogenesis of UC and CD, meaning that LPO and POM products could be regarded as diagnostic markers and indicators of treatment efficacy.
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Affiliation(s)
- MV Osikov
- South Ural State Medical University, Chelyabinsk, Russia
| | - EV Davydova
- South Ural State Medical University, Chelyabinsk, Russia
| | - MS Boyko
- South Ural State Medical University, Chelyabinsk, Russia
| | - AE Bakeeva
- South Ural State Medical University, Chelyabinsk, Russia
| | | | - IR Galeeva
- South Ural State Medical University, Chelyabinsk, Russia
| | - AA Fedosov
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - MA Ilyinyh
- South Ural State Medical University, Chelyabinsk, Russia
| | - LV Vorgova
- South Ural State Medical University, Chelyabinsk, Russia
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219
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Liu F, Li D, Wang X, Cui Y, Li X. Polyphenols intervention is an effective strategy to ameliorate inflammatory bowel disease: a systematic review and meta-analysis. Int J Food Sci Nutr 2020; 72:14-25. [PMID: 32369394 DOI: 10.1080/09637486.2020.1760220] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Whether polyphenols could ameliorate inflammatory bowel disease (IBD) is still conflicting. To explore the efficacy of polyphenols as an adjuvant therapy for IBD, we conducted this systematic review and meta-analysis. Literature search was performed using PubMed, Web of Science, Scopus and Cochrane databases. Finally, 12 randomized controlled trials (RCTs) were included. In contrast to control group, curcumin treatment significantly improved clinical remission in intention-to-treat (ITT) (OR = 3.36, 95% CI: 1.09-10.37) and per-protocol (PP) analysis (OR = 5.13, 95% CI: 1.84-14.27). Meanwhile, curcumin could significantly ameliorate endoscopic remission (OR = 5.69, 95% CI: 1.28-25.27) and clinical response (OR = 4.69, 95% CI: 1.03-21.47) in PP analysis. Heterogeneity was present across the studies. In conclusions, polyphenols might be an effective adjuvant treatment for ameliorating IBD. Considering the relatively few studies included in our present study, further clinical trials are required to verify the effects of polyphenols on IBD.
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Affiliation(s)
- Fang Liu
- School of Public Health, Medical College of Soochow University, Jiangsu, China
| | - Deming Li
- School of Public Health, Medical College of Soochow University, Jiangsu, China
| | - Xinjing Wang
- School of Public Health, Medical College of Soochow University, Jiangsu, China
| | - Yuan Cui
- School of Public Health, Medical College of Soochow University, Jiangsu, China
| | - Xinli Li
- School of Public Health, Medical College of Soochow University, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, PR China
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220
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Stankovic B, Dragasevic S, Klaassen K, Kotur N, Srzentic Drazilov S, Zukic B, Sokic Milutinovic A, Milovanovic T, Lukic S, Popovic D, Pavlovic S, Nikcevic G. Exploring inflammatory and apoptotic signatures in distinct Crohn's disease phenotypes: Way towards molecular stratification of patients and targeted therapy. Pathol Res Pract 2020; 216:152945. [PMID: 32279918 DOI: 10.1016/j.prp.2020.152945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Crohn's disease (CD) is chronic inflammatory bowel disease with different phenotypic characteristics influencing disease prognosis and therapeutic strategies. The aim of this pilot study was to analyze selected inflammatory and apoptotic markers in non-inflamed and inflamed samples of ileal mucosa of non-stricturing/non-penetrating (NS/NP) and stricturing (S) CD mucosal phenotypes in order to characterize their distinct profiles. METHODS From twenty CD patients (9 NS/NP, 11 S) paired non-inflamed and inflamed ileal biopsies were collected and used for analysis of cytokine (TNF and IL6) and apoptotic (Bcl2, Bax, Fas and FasL) genes' expression levels by real-time PCR, while NFκB transcriptional potency was assessed by electromobility gel shift assay. RESULTS Our results demonstrated significant upregulation of TNF and IL6 in inflamed area of both NS/NP (p = 0.03, p = 0.01) and S phenotypes (p = 0.04, p = 0.04), respectively. However, TNF increase was more prominent in NS/NP compared to S inflamed mucosa (p = 0.02). Also, level of proapoptotic Bax was significantly higher in NS/NP compared to S inflamed mucosa (p = 0.01). Opposing transcription potency of NFκB has been detected between two phenotypes: being decreased in NS/NP (p = 0.07) and increased in S (p = 0.1) inflamed compared to non-inflamed mucosa, demonstrating trend towards statistical significance. CONCLUSIONS We found that two distinct CD phenotypes have specific molecular signatures. Obtained results could direct improvement of current and development of new therapeutic strategies based on more specific molecular stratification of CD patients.
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Affiliation(s)
- Biljana Stankovic
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11042 Belgrade, Serbia.
| | - Sanja Dragasevic
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Koste Todorovica 2, 11000 Belgrade, Serbia; School of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia.
| | - Kristel Klaassen
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11042 Belgrade, Serbia.
| | - Nikola Kotur
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11042 Belgrade, Serbia.
| | - Sanja Srzentic Drazilov
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11042 Belgrade, Serbia.
| | - Branka Zukic
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11042 Belgrade, Serbia.
| | - Aleksandra Sokic Milutinovic
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Koste Todorovica 2, 11000 Belgrade, Serbia; School of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia.
| | - Tamara Milovanovic
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Koste Todorovica 2, 11000 Belgrade, Serbia; School of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia.
| | - Snezana Lukic
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Koste Todorovica 2, 11000 Belgrade, Serbia; School of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia.
| | - Dragan Popovic
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Koste Todorovica 2, 11000 Belgrade, Serbia; School of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia.
| | - Sonja Pavlovic
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11042 Belgrade, Serbia.
| | - Gordana Nikcevic
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11042 Belgrade, Serbia.
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221
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Knights AJ, Yang L, Shah M, Norton LJ, Green GS, Stout ES, Vohralik EJ, Crossley M, Quinlan KGR. Krüppel-like factor 3 (KLF3) suppresses NF-κB-driven inflammation in mice. J Biol Chem 2020; 295:6080-6091. [PMID: 32213596 DOI: 10.1074/jbc.ra120.013114] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/18/2020] [Indexed: 12/14/2022] Open
Abstract
Bacterial products such as lipopolysaccharides (or endotoxin) cause systemic inflammation, resulting in a substantial global health burden. The onset, progression, and resolution of the inflammatory response to endotoxin are usually tightly controlled to avoid chronic inflammation. Members of the NF-κB family of transcription factors are key drivers of inflammation that activate sets of genes in response to inflammatory signals. Such responses are typically short-lived and can be suppressed by proteins that act post-translationally, such as the SOCS (suppressor of cytokine signaling) family. Less is known about direct transcriptional regulation of these responses, however. Here, using a combination of in vitro approaches and in vivo animal models, we show that endotoxin treatment induced expression of the well-characterized transcriptional repressor Krüppel-like factor 3 (KLF3), which, in turn, directly repressed the expression of the NF-κB family member RELA/p65. We also observed that KLF3-deficient mice were hypersensitive to endotoxin and exhibited elevated levels of circulating Ly6C+ monocytes and macrophage-derived inflammatory cytokines. These findings reveal that KLF3 is a fundamental suppressor that operates as a feedback inhibitor of RELA/p65 and may be important in facilitating the resolution of inflammation.
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Affiliation(s)
- Alexander J Knights
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Lu Yang
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Manan Shah
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Laura J Norton
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Gamran S Green
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Elizabeth S Stout
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Emily J Vohralik
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Merlin Crossley
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Kate G R Quinlan
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales 2052, Australia.
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Zhang J, Huang Q, Zhao R, Ma Z. A network pharmacology study on the Tripteryguim wilfordii Hook for treatment of Crohn's disease. BMC Complement Med Ther 2020; 20:95. [PMID: 32293395 PMCID: PMC7092476 DOI: 10.1186/s12906-020-02885-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/06/2020] [Indexed: 01/23/2023] Open
Abstract
Background To explore the mechanism of action of Tripterygium wilfordii Hook (TWH) in the treatment of Crohn’s disease (CD) by network pharmacology. Methods Traditional Chinese Medicine Systems Pharmacology database and analysis platform (TCMSP) was used to obtain the active constituents and targets of TWH. “Crohn’s disease” was used as a search term to search for related targets of CD from GeneCards database and OMIM database, thereby obtaining the targets of TWH against CD. The Cytoscape 3.7.1 software was used to construct a Chinese medicine compound-target network and STRING database to construct a protein-protein interaction network (PPI). The DAVID 6.8 online tool was used to perform gene ontology (GO) and kyoto encyclopedia of genes and genome (KEGG) pathway enrichment analysis of overlapping targets. Results The database results showed that there were 30 active ingredients (14 key active ingredients) in TWH and 36 targets were screened out for CD treatment. Network analysis indicated that main targets of main active components of TWH were target genes such as VEGFA, MAPK8 and CASP3, which are involved in the regulation of cancer pathway, TNF signal pathway, hepatitis B pathway, apoptosis pathway, NF-kappa B signal pathway and so forth. Conclusions TWH can play a multi-target and multi-channel synergistic treatment of CD by anti-angiogenesis, anti-apoptosis, anti-inflammation and immune regulation.
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Affiliation(s)
- Jing Zhang
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou, 310016, China
| | - Qifeng Huang
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou, 310016, China
| | - Rui Zhao
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou, 310016, China
| | - Zhiyuan Ma
- Department of Clinical Pharmacology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310006, People's Republic of China.
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CRISPR/Cas9-targeting of CD40 in hematopoietic stem cells limits immune activation mediated by anti-CD40. PLoS One 2020; 15:e0228221. [PMID: 32155151 PMCID: PMC7064223 DOI: 10.1371/journal.pone.0228221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 01/09/2020] [Indexed: 01/16/2023] Open
Abstract
Inflammatory bowel diseases (IBD) are complex, multifactorial disorders characterized by chronic relapsing intestinal inflammation. IBD is diagnosed around 1 in 1000 individuals in Western countries with globally increasing incident rates. Association studies have identified hundreds of genes that are linked to IBD and potentially regulate its pathology. The further dissection of the genetic network underlining IBD pathogenesis and pathophysiology is hindered by the limited capacity to functionally characterize each genetic association, including generating knockout animal models for every associated gene. Cutting-edge CRISPR/Cas9-based technology may transform the field of IBD research by efficiently and effectively introducing genetic alterations. In the present study, we used CRISPR/Cas9-based technologies to genetically modify hematopoietic stem cells. Through cell sorting and bone marrow transplantation, we established a system to knock out target gene expression by over 90% in the immune system of reconstituted animals. Using a CD40-mediated colitis model, we further validated our CRISPR/Cas9-based platform for investigating gene function in experimental IBD. In doing so, we developed a model system that delivers genetically modified mice in a manner much faster than conventional methodology, significantly reducing the time from target identification to in vivo target validation and expediting drug development.
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224
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Takač B, Mihaljević S, Glavaš-Obrovac L, Kibel A, Suver-Stević M, Canecki-Varžić S, Samardžija M, Rajkovac I, Kovač D, Štefanić M. INTERACTIONS AMONG INTERLEUKIN-6, C-REACTIVE PROTEIN AND INTERLEUKIN-6 (-174) G/C POLYMORPHISM IN THE PATHOGENESIS OF CROHN'S DISEASE AND ULCERATIVE COLITIS. Acta Clin Croat 2020; 59:67-80. [PMID: 32724277 PMCID: PMC7382872 DOI: 10.20471/acc.2020.59.01.09] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Inflammatory bowel diseases are multifactorial disorders the clinical manifestation of which depends on the interaction among immune response, genetic and environmental factors. There is growing evidence that cytokines and gene polymorphisms have an important role in disease pathogenesis in various populations although molecular mechanism of their signaling and interactions is not fully understood yet. The present study aimed at exploring the effects of interleukin-6, C-reactive protein and interleukin-6 rs1800795 polymorphism on the development of Crohn’s disease, ulcerative colitis and inflammatory bowel diseases overall and at determining differences between inflammatory bowel disease patients and healthy controls. A total of 132 inflammatory bowel disease patients and 71 healthy blood donors were investigated. In order to assess the clinical relevance of interleukin-6 and C-reactive protein serum concentration and interleukin-6 rs1800795 single nucleotide polymorphism in patients with Crohn’s disease and ulcerative colitis, we performed a cross-sectional, case-control study. Quantitative assessment of serum interleukin-6 and C-reactive protein was performed with solid-phase, enzyme-labeled, chemiluminescent sequential immunometric and immunoturbidimetric assay, respectively. A real-time fluorescence resonance energy transfer-based method on a LightCyclerTM PCR 1.2 was used for genotyping of IL-6 rs1800795 polymorphism. Both interleukin-6 and C-reactive protein serum levels were elevated in Crohn’s disease and ulcerative colitis patients. Positive correlations were observed between C-reactive protein and interleukin-6 serum concentration and ulcerative colitis activity index as measured by modified Truelove-Witt’s severity index scale. C-reactive protein serum level was higher in Crohn’s disease patients without intestinal resection than in Crohn’s disease patients with prior intestinal resection. In ulcerative colitis patients, interleukin-6 and C-reactive protein serum levels were statistically significantly higher in CC interleukin-6 genotype in comparison to GG+GC genotype. Analysis of the promoter region of the interleukin-6 rs1800795 gene polymorphism showed no statistically significant difference in allele frequency either between inflammatory bowel disease patients and healthy controls or between the two inflammatory bowel disease phenotypes and healthy controls. Associations presented in this study give a potentially important insight into the role of interleukin-6 and C-reactive protein signaling and interleukin-6 polymorphism in the pathogenesis of Crohn’s disease and ulcerative colitis disease.
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Affiliation(s)
| | - Silvio Mihaljević
- 1Department of Nuclear Medicine and Radiation Protection, Osijek University Hospital Centre, Osijek, Croatia; 2Department of Internal Medicine, Division of Gastroenterology, Osijek University Hospital Centre, Osijek, Croatia; 3Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 4Department of Transfusion Medicine, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism Disorders, Osijek University Hospital Centre, Osijek, Croatia; 6Department of Surgery, Division of Vascular Surgery, Osijek University Hospital Centre, Osijek, Croatia; 7Department of Gastroenterology and Hepatology, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
| | - Ljubica Glavaš-Obrovac
- 1Department of Nuclear Medicine and Radiation Protection, Osijek University Hospital Centre, Osijek, Croatia; 2Department of Internal Medicine, Division of Gastroenterology, Osijek University Hospital Centre, Osijek, Croatia; 3Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 4Department of Transfusion Medicine, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism Disorders, Osijek University Hospital Centre, Osijek, Croatia; 6Department of Surgery, Division of Vascular Surgery, Osijek University Hospital Centre, Osijek, Croatia; 7Department of Gastroenterology and Hepatology, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
| | - Aleksandar Kibel
- 1Department of Nuclear Medicine and Radiation Protection, Osijek University Hospital Centre, Osijek, Croatia; 2Department of Internal Medicine, Division of Gastroenterology, Osijek University Hospital Centre, Osijek, Croatia; 3Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 4Department of Transfusion Medicine, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism Disorders, Osijek University Hospital Centre, Osijek, Croatia; 6Department of Surgery, Division of Vascular Surgery, Osijek University Hospital Centre, Osijek, Croatia; 7Department of Gastroenterology and Hepatology, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
| | - Mirjana Suver-Stević
- 1Department of Nuclear Medicine and Radiation Protection, Osijek University Hospital Centre, Osijek, Croatia; 2Department of Internal Medicine, Division of Gastroenterology, Osijek University Hospital Centre, Osijek, Croatia; 3Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 4Department of Transfusion Medicine, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism Disorders, Osijek University Hospital Centre, Osijek, Croatia; 6Department of Surgery, Division of Vascular Surgery, Osijek University Hospital Centre, Osijek, Croatia; 7Department of Gastroenterology and Hepatology, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
| | - Silvija Canecki-Varžić
- 1Department of Nuclear Medicine and Radiation Protection, Osijek University Hospital Centre, Osijek, Croatia; 2Department of Internal Medicine, Division of Gastroenterology, Osijek University Hospital Centre, Osijek, Croatia; 3Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 4Department of Transfusion Medicine, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism Disorders, Osijek University Hospital Centre, Osijek, Croatia; 6Department of Surgery, Division of Vascular Surgery, Osijek University Hospital Centre, Osijek, Croatia; 7Department of Gastroenterology and Hepatology, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
| | - Marko Samardžija
- 1Department of Nuclear Medicine and Radiation Protection, Osijek University Hospital Centre, Osijek, Croatia; 2Department of Internal Medicine, Division of Gastroenterology, Osijek University Hospital Centre, Osijek, Croatia; 3Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 4Department of Transfusion Medicine, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism Disorders, Osijek University Hospital Centre, Osijek, Croatia; 6Department of Surgery, Division of Vascular Surgery, Osijek University Hospital Centre, Osijek, Croatia; 7Department of Gastroenterology and Hepatology, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
| | - Ines Rajkovac
- 1Department of Nuclear Medicine and Radiation Protection, Osijek University Hospital Centre, Osijek, Croatia; 2Department of Internal Medicine, Division of Gastroenterology, Osijek University Hospital Centre, Osijek, Croatia; 3Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 4Department of Transfusion Medicine, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism Disorders, Osijek University Hospital Centre, Osijek, Croatia; 6Department of Surgery, Division of Vascular Surgery, Osijek University Hospital Centre, Osijek, Croatia; 7Department of Gastroenterology and Hepatology, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
| | - Damir Kovač
- 1Department of Nuclear Medicine and Radiation Protection, Osijek University Hospital Centre, Osijek, Croatia; 2Department of Internal Medicine, Division of Gastroenterology, Osijek University Hospital Centre, Osijek, Croatia; 3Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 4Department of Transfusion Medicine, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism Disorders, Osijek University Hospital Centre, Osijek, Croatia; 6Department of Surgery, Division of Vascular Surgery, Osijek University Hospital Centre, Osijek, Croatia; 7Department of Gastroenterology and Hepatology, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
| | - Mario Štefanić
- 1Department of Nuclear Medicine and Radiation Protection, Osijek University Hospital Centre, Osijek, Croatia; 2Department of Internal Medicine, Division of Gastroenterology, Osijek University Hospital Centre, Osijek, Croatia; 3Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 4Department of Transfusion Medicine, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism Disorders, Osijek University Hospital Centre, Osijek, Croatia; 6Department of Surgery, Division of Vascular Surgery, Osijek University Hospital Centre, Osijek, Croatia; 7Department of Gastroenterology and Hepatology, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
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Villanacci V, Reggiani-Bonetti L, Caprioli F, Saragoni L, Salviato T, Mescoli C, Canavese G, Manenti S, Spada E, Baron L, Leoncini G, Cadei M, Battista S, Armuzzi A. Histopathology of inflammatory bowel disease - Position statement of the Pathologists of the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) and Italian Group of Gastrointestinal Pathologists (GIPAD-SIAPEC). Dig Liver Dis 2020; 52:262-267. [PMID: 31884010 DOI: 10.1016/j.dld.2019.11.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 10/27/2019] [Accepted: 11/08/2019] [Indexed: 12/11/2022]
Abstract
Diagnosis of the inflammatory bowel diseases ulcerative colitis (UC) and Crohn's disease (CD) relies mainly on the histopathological examination of endoscopic biopsies of the gastrointestinal tract. To facilitate the accurate diagnosis of these two conditions, this paper addresses key issues on the: (A) gastrointestinal biopsy procedure, (B) histomorphological characteristics of UC and CD, and (C) diagnosis of dysplasia. The 13 statements presented here represent the consensus of two groups of Italian pathologists (IG-IBD and GIPAD).
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Affiliation(s)
| | - Luca Reggiani-Bonetti
- Department of Diagnostic, Clinic and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Flavio Caprioli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda, Ospedale Policlinico di Milano, and Department of Pathophysiology, Department of Transplantation, University of Milan, Milan, Italy
| | - Luca Saragoni
- Department of Pathological Anatomy, AUSL Romagna, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Tiziana Salviato
- Department of Diagnostic, Clinic and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudia Mescoli
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padova, Padua, Italy
| | - Gabriella Canavese
- Pathology Department, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | - Luigi Baron
- Pathology Unit, St. Leonardo Hospital, Castellammare di Stabia, Naples, Italy
| | - Giuseppe Leoncini
- Pathology Unit, ASST del Garda, Desenzano del Garda (BS), Brescia, Italy
| | - Moris Cadei
- Institute of Pathology, ASST Spedali Civili, Brescia, Italy
| | - Serena Battista
- Institute of Pathology Azienda Ospedaliera Universitaria Integrata, Udine, Italy
| | - Alessandro Armuzzi
- IBD Unit, Presidio Columbus Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
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226
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Bao L, Zhao J, Liao D, Wang G, Gregersen H. Pressure overload changes mesenteric afferent nerve responses in a stress-dependent way in a fasting rat model. Biomech Model Mechanobiol 2020; 19:1741-1753. [PMID: 32072371 DOI: 10.1007/s10237-020-01305-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 02/06/2020] [Indexed: 12/28/2022]
Abstract
It is well known that overload changes the mechanical properties of biological tissues and fasting changes the responsiveness of intestinal afferents. This study aimed to characterize the effect of overload on mechanosensitivity in mesenteric afferent nerves in normal and fasted Sprague-Dawley rats. Food was restricted for 7 days in the Fasting group. Jejunal whole afferent nerve firing was recorded during three distensions, i.e., ramp distension to 80 cmH2O luminal pressure (D1), sustained distension to 120 cmH2O for 2 min (D2), and again to 80 cmH2O (D3). Multiunit afferent recordings were separated into low-threshold (LT) and wide-dynamic-range (WDR) single-unit activity for D1 and D3. Intestinal deformation (strain), distension load (stress), and firing frequency of mesenteric afferent nerve bundles [spike rate increase ratio (SRIR)] were compared at 20 cmH2O and 40 cmH2O and maximum pressure levels among distensions and groups. SRIR and stress changes showed the same pattern in all distensions. The SRIR and stress were larger in the Fasting group compared to the Control group (P < 0.01). SRIR was lower in D3 compared to D1 in controls (P < 0.05) and fasting rats (P < 0.01). Total single units and LT were significantly lower in Fasting group than in Controls at D3. LT was significantly higher in D3 than in D1 in Controls. Furthermore, correlation was found between SRIR with stress (R = 0.653, P < 0.001). In conclusion, overload decreased afferent mechanosensitivity in a stress-dependent way and was most pronounced in fasting rats. Fasting shifts LT to WDR and high pressure shifts WDR to LT in response to mechanical stimulation.
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Affiliation(s)
- Lingxia Bao
- GIOME and the Key Laboratory for Biorheological Science and Technology of Ministry of Education; State and Local Joint Engineering Laboratory for Vascular Implants, College of Bioengineering, Chongqing University, Chongqing, 400044, China.,Department of Clinical Medicine, Giome Academia, Aarhus University, 8200, Aarhus N, Denmark
| | - Jingbo Zhao
- GIOME and the Key Laboratory for Biorheological Science and Technology of Ministry of Education; State and Local Joint Engineering Laboratory for Vascular Implants, College of Bioengineering, Chongqing University, Chongqing, 400044, China.,Department of Clinical Medicine, Giome Academia, Aarhus University, 8200, Aarhus N, Denmark
| | - Donghua Liao
- Department of Clinical Medicine, Giome Academia, Aarhus University, 8200, Aarhus N, Denmark.,Department of Gastroenterology and Hepatology, Mech-Sense, Aalborg University Hospital and Clinical Institute, Faculty of Health Sciences, Aalborg University, Aalborg, Denmark
| | - Guixue Wang
- GIOME and the Key Laboratory for Biorheological Science and Technology of Ministry of Education; State and Local Joint Engineering Laboratory for Vascular Implants, College of Bioengineering, Chongqing University, Chongqing, 400044, China
| | - Hans Gregersen
- GIOME and the Key Laboratory for Biorheological Science and Technology of Ministry of Education; State and Local Joint Engineering Laboratory for Vascular Implants, College of Bioengineering, Chongqing University, Chongqing, 400044, China. .,Department of Surgery, GIOME, the Chinese University of Hong Kong, Pok Fu Lam, Hong Kong, SAR. .,Department of Surgery, Clinical Science Building, GIOME, Prince of Wales Hospital, Ngan Street, Shatin, Hong Kong.
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227
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Lazou A, Ikonomidis I, Bartekova M, Benedek T, Makavos G, Palioura D, Cabrera Fuentes H, Andreadou I. Chronic inflammatory diseases, myocardial function and cardioprotection. Br J Pharmacol 2020; 177:5357-5374. [PMID: 31943142 DOI: 10.1111/bph.14975] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/22/2019] [Accepted: 11/26/2019] [Indexed: 12/15/2022] Open
Abstract
The association between chronic inflammatory diseases (CIDs) and increased cardiovascular (CV) risk is well documented and can be a most threatening complication in these patients. However, the pathogenetic mechanisms underlying increased CV risk remain elusive, especially in their cellular and biochemical pathways. Using animal models to understand mechanisms underlying cardiac involvement are limited. Additionally, treatments may influence cardiovascular events through different outcomes. Some drugs used to treat CIDs can negatively affect cardiac function by a direct toxicity, whereas others may protect the myocardium. In the present article, we focus on the cardiac manifestations and risk factors, the pathogenetic mechanisms, and the effect of treatments on myocardial function and cardioprotection for five common worldwide CIDs (rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, psoriasis and inflammatory bowel disease). We also give recommendations in order to evaluate common targets between CID and CV disease (CVD) and to design therapies to alleviate CID-related CVD. LINKED ARTICLES: This article is part of a themed issue on Risk factors, comorbidities, and comedications in cardioprotection. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.23/issuetoc.
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Affiliation(s)
- Antigone Lazou
- School of Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ignatios Ikonomidis
- Second Cardiology Department, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Monika Bartekova
- Institute for Heart Research, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Theodora Benedek
- Clinic of Cardiology, Cardiac Critical Care Unit, University of Medicine and Pharmacy, Târgu Mureş, Romania
| | - George Makavos
- Second Cardiology Department, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitra Palioura
- School of Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Hector Cabrera Fuentes
- SingHealth Duke-NUS Cardiovascular Sciences Academic Clinical Programme and Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore.,National Heart Research Institute Singapore, National Heart Centre, Singapore.,Institute of Physiology, Medical School, Justus-Liebig University, Giessen, Germany.,Tecnologico de Monterrey, Centro de Biotecnologia-FEMSA, Monterrey, NL, Mexico.,Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russian Federation
| | - Ioanna Andreadou
- Laboratory of Pharmacology, School of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
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228
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Proteomics and Imaging in Crohn’s Disease: TAILS of Unlikely Allies. Trends Pharmacol Sci 2020; 41:74-84. [DOI: 10.1016/j.tips.2019.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/05/2019] [Accepted: 11/27/2019] [Indexed: 12/12/2022]
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229
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Pellino G, Keller DS, Sampietro GM, Annese V, Carvello M, Celentano V, Coco C, Colombo F, Cracco N, Di Candido F, Franceschi M, Laureti S, Mattioli G, Pio L, Sciaudone G, Sica G, Villanacci V, Zinicola R, Leone S, Danese S, Spinelli A, Delaini G, Selvaggi F. Inflammatory bowel disease (IBD) position statement of the Italian Society of Colorectal Surgery (SICCR): general principles of IBD management. Tech Coloproctol 2020; 24:105-126. [PMID: 31983044 DOI: 10.1007/s10151-019-02145-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 12/23/2019] [Indexed: 02/08/2023]
Abstract
The Italian Society of Colorectal Surgery (SICCR) promoted the project reported here, which consists of a Position Statement of Italian colorectal surgeons to address the surgical aspects of inflammatory bowel disease management. Members of the society were invited to express their opinions on several items proposed by the writing committee, based on evidence available in the literature. The results are presented, focusing on relevant points. The present paper is not an alternative to available guidelines; rather, it offers a snapshot of the attitudes of SICCR surgeons about the general principles of surgical treatment of inflammatory bowel disease. The committee was able to identify some points of major disagreement and suggested strategies to improve quality of available data and acceptance of guidelines.
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Affiliation(s)
- G Pellino
- Colorectal Surgery, Department of Advanced Medical and Surgical Sciences, Università Degli Studi Della Campania "Luigi Vanvitelli", Policlinico CS, Piazza Miraglia 2, 80138, Naples, Italy.
| | - D S Keller
- Division of Colon and Rectal Surgery, Department of Surgery, NewYork-Presbyterian, Columbia University Medical Center, New York, USA
| | | | - V Annese
- Gastroenterology Unit, DEA-Medicina E Chirurgia Generale E D'Urgenza, University Hospital Careggi, Firenze, Italy
| | - M Carvello
- Colon and Rectal Surgery Division, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - V Celentano
- Portsmouth Hospitals NHS Trust, Portsmouth, UK
- University of Portsmouth, Portsmouth, UK
| | - C Coco
- UOC Chirurgia Generale 2, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - F Colombo
- L. Sacco University Hospital Milano, Milan, Italy
| | - N Cracco
- Department of General Surgery, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - F Di Candido
- Colon and Rectal Surgery Division, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - M Franceschi
- IBD Surgery, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - S Laureti
- Surgery of the Alimentary Tract, Sant'Orsola Hospital, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - G Mattioli
- Pediatric Surgery Unit, Istituto Giannina Gaslini, and Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - L Pio
- Pediatric Surgery Department, Hôpital Robert-Debré and Université de Paris, Paris, France
| | - G Sciaudone
- Colorectal Surgery, Department of Advanced Medical and Surgical Sciences, Università Degli Studi Della Campania "Luigi Vanvitelli", Policlinico CS, Piazza Miraglia 2, 80138, Naples, Italy
| | - G Sica
- Minimally Invasive and Gastro-Intestinal Unit, Department of Surgery, Policlinico Tor Vergata, Rome, Italy
| | - V Villanacci
- Institute of Pathology, Spedali Civili Brescia, Brescia, Italy
| | - R Zinicola
- Department of Emergency Surgery, University Hospital Parma, Parma, Italy
| | - S Leone
- CEO, Associazione Nazionale Per Le Malattie Infiammatorie Croniche Dell'Intestino "A.M.I.C.I. Onlus", Milan, Italy
| | - S Danese
- Division of Gastroenterology, IBD Center, Humanitas University, Rozzano, Milan, Italy
| | - A Spinelli
- Colon and Rectal Surgery Division, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - G Delaini
- Department of Surgery, "Pederzoli" Hospital, Peschiera del Garda, Verona, Italy
| | - F Selvaggi
- Colorectal Surgery, Department of Advanced Medical and Surgical Sciences, Università Degli Studi Della Campania "Luigi Vanvitelli", Policlinico CS, Piazza Miraglia 2, 80138, Naples, Italy
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230
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Cui Y, Lu SY, Xu J, Peng YS, Miao Q, Wang XQ, Chen XY, Ran ZH. Microscopic features of small bowel mucosa of patients with Crohn's disease. BMC Gastroenterol 2019; 19:232. [PMID: 31888502 PMCID: PMC6937864 DOI: 10.1186/s12876-019-1138-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 12/05/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Double-balloon enteroscopy enables performing numerous small bowel biopsies for pathologic analysis. However, most histopathological characteristics of Crohn's disease are non-specific characteristics. We aimed to explore the small bowel mucosal histopathologic characters of Crohn's disease and identify some disease-specific changes. METHODS We included 253 patients without tumors and grouped them into Crohn's disease, suspected Crohn's disease, and non-Crohn's disease groups. These patients underwent double-balloon endoscopy examination and small bowel biopsy at Renji Hospital, Shanghai. All histopathological sections were reviewed, and > 20 histopathological parameters were assessed. Immunohistochemistry was conducted when necessary. RESULTS There were different forms of granulomatous lymphangitis on the small bowel mucosa in Crohn's disease. They showed as various macrophages or epithelioid cells in the lumina of lymphatics or in the center of the villi with or without evident obstruction. These features were only observed in Crohn's disease patients. Furthermore, they were correlated with granuloma and lymphangiectasia. Additionally, 15 other features showed significant differences among the three groups, and Crohn's disease patients showed an average of almost seven histopathological characteristics. CONCLUSIONS We described the detailed morphologies of granulomatous lymphangitis on the small bowel mucosa and recommend it as a useful histopathological feature for the diagnosis of Crohn's disease. In terms of specificity and sensitivity, it was superior to non-caseating epithelioid granuloma.
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Affiliation(s)
- Yun Cui
- State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, Shanghai, 200001, China
| | - Shi-Yuan Lu
- State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, Shanghai, 200001, China
| | - Jie Xu
- State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, Shanghai, 200001, China
| | - Yan-Shen Peng
- State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, Shanghai, 200001, China
| | - Qi Miao
- State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, Shanghai, 200001, China
| | - Xiao-Qing Wang
- State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, Shanghai, 200001, China
| | - Xiao-Yu Chen
- State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, Shanghai, 200001, China.
| | - Zhi-Hua Ran
- State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, Shanghai, 200001, China.
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231
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Atherly T, Rossi G, White R, Seo YJ, Wang C, Ackermann M, Breuer M, Allenspach K, Mochel JP, Jergens AE. Glucocorticoid and dietary effects on mucosal microbiota in canine inflammatory bowel disease. PLoS One 2019; 14:e0226780. [PMID: 31887117 PMCID: PMC6936794 DOI: 10.1371/journal.pone.0226780] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 12/03/2019] [Indexed: 01/14/2023] Open
Abstract
The pathogenesis of canine inflammatory bowel disease (IBD) involves complex interactions between mucosal immunity and the intestinal microbiota. Glucocorticoids are commonly administered to reduce mucosal inflammation and gastrointestinal signs. The study objective was to evaluate the effects of diet and oral prednisone on the spatial distribution of mucosal bacteria in IBD dogs. Eight dogs diagnosed with IBD were treated with immunosuppressive doses of prednisone. The mucosal microbiota from endoscopic biopsies of IBD dogs and healthy controls (HC; n = 15 dogs) was evaluated by fluorescence in situ hybridization (FISH) targeting the 16S rRNA genes of total bacteria and bacterial species relevant in canine/human IBD. Apicaljunction protein (AJP) expression using immunohistochemistry investigated the effect of medical therapy on intestinal barrier integrity. All IBD dogs had a reduction in GI signs following diet and prednisone therapy compared with baseline CIBDAI scores (P < 0.05). The mucosal microbiota of HC and diseased dogs was most abundant in free and adherent mucus. Only Lactobacilli were increased (P < 0.05) in the adherent mucus of IBD dogs compared to HC. The spatial distribution of mucosal bacteria was significantly different (P < 0.05) in IBD dogs following prednisone therapy, with higher numbers of Bifidobacteria and Streptococci detected across all mucosal compartments and increased numbers of Bifidobacterium spp., Faecalibacterium spp., and Streptococcus spp. present within adherent mucus. Differences in intestinal AJPs were detected with expression of occludin increased (P < 0.05) in IBD dogs versus HC. The expressions of occludin and E-cadherin were increased but zonulin decreased (P < 0.05 for each) in IBD dogs following prednisone therapy. In conclusion, the spatial distribution of mucosal bacteria differs between IBD and HC dogs, and in response to diet and glucocorticoid administration. Medical therapy was associated with beneficial changes in microbial community structure and enhanced mucosal epithelial AJP expression.
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Affiliation(s)
- Todd Atherly
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States of America
| | - Giacomo Rossi
- School of Biosciences and Veterinary Medicine, University of Camerino, Macerata, Italy
| | - Robin White
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States of America
| | - Yeon-Jung Seo
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States of America
| | - Chong Wang
- Department of Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States of America
| | - Mark Ackermann
- Department of Veterinary Pathology, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States of America
| | - Mary Breuer
- Department of Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States of America
| | - Karin Allenspach
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States of America
| | - Jonathan P. Mochel
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States of America
| | - Albert E. Jergens
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States of America
- * E-mail:
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Berwick DC, Heaton GR, Azeggagh S, Harvey K. LRRK2 Biology from structure to dysfunction: research progresses, but the themes remain the same. Mol Neurodegener 2019; 14:49. [PMID: 31864390 PMCID: PMC6925518 DOI: 10.1186/s13024-019-0344-2] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 11/07/2019] [Indexed: 12/12/2022] Open
Abstract
Since the discovery of leucine-rich repeat kinase 2 (LRRK2) as a protein that is likely central to the aetiology of Parkinson’s disease, a considerable amount of work has gone into uncovering its basic cellular function. This effort has led to the implication of LRRK2 in a bewildering range of cell biological processes and pathways, and probable roles in a number of seemingly unrelated medical conditions. In this review we summarise current knowledge of the basic biochemistry and cellular function of LRRK2. Topics covered include the identification of phosphorylation substrates of LRRK2 kinase activity, in particular Rab proteins, and advances in understanding the activation of LRRK2 kinase activity via dimerisation and association with membranes, especially via interaction with Rab29. We also discuss biochemical studies that shed light on the complex LRRK2 GTPase activity, evidence of roles for LRRK2 in a range of cell signalling pathways that are likely cell type specific, and studies linking LRRK2 to the cell biology of organelles. The latter includes the involvement of LRRK2 in autophagy, endocytosis, and processes at the trans-Golgi network, the endoplasmic reticulum and also key microtubule-based cellular structures. We further propose a mechanism linking LRRK2 dimerisation, GTPase function and membrane recruitment with LRRK2 kinase activation by Rab29. Together these data paint a picture of a research field that in many ways is moving forward with great momentum, but in other ways has not changed fundamentally. Many key advances have been made, but very often they seem to lead back to the same places.
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Affiliation(s)
- Daniel C Berwick
- School of Health, Life and Chemical Sciences, The Open University, Walton Hall, Milton Keynes, MK7 6AA, UK.
| | - George R Heaton
- Department of Pharmacology, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, UK
| | - Sonia Azeggagh
- School of Health, Life and Chemical Sciences, The Open University, Walton Hall, Milton Keynes, MK7 6AA, UK
| | - Kirsten Harvey
- Department of Pharmacology, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, UK.
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233
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Chen H, Xu H, Luo L, Qiao L, Wang Y, Xu M, Li Y, Zhu P, Yang B. Thalidomide Prevented and Ameliorated Pathogenesis of Crohn's Disease in Mice via Regulation of Inflammatory Response and Fibrosis. Front Pharmacol 2019; 10:1486. [PMID: 31920668 PMCID: PMC6923734 DOI: 10.3389/fphar.2019.01486] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 11/15/2019] [Indexed: 12/11/2022] Open
Abstract
Crohn's disease (CD) is a chronic, relapsing form of inflammatory bowel disease, seriously threatening human health. Thalidomide has been used for the treatment of CD. However, the effects and the possible mechanisms of thalidomide on CD are still unclear. Herein, our study demonstrated that thalidomide protected colon mucosa against trinitro-benzene-sulfonic acid (TNBS)-induced injury, diminished inflammatory infiltration and levels of IFN-γ, IGF-1, IL-6, IL-17, TNF-α, while increased the levels of IL-10 and TGF-γ. Moreover, it reversed the intestinal fibrosis and inhibited the accumulated infiltration, down-regulated the expression of col1a2, col3a2, MMP-3, MMP-9, MMP-1, TGF-γ, α-SMA, but up-regulated the expression of TIMP-1 and Vimentin. Although it could be observed that the effect of thalidomide administration in modeling was better than after modeling, there was no statistical difference between the two groups. The present study provided evidence that the therapeutic effect of thalidomide alleviated the inflammatory response and damage of colon tissue, mainly by restoring the imbalance of TH17/Treg cells and inhibiting intestinal fibrosis in TNBS-induced mice colitis.
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Affiliation(s)
- Hongjin Chen
- Department of Colorectal Surgery, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Haixia Xu
- First Clinical Medical College, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Lijiao Luo
- First Clinical Medical College, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Lichao Qiao
- First Clinical Medical College, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yaohui Wang
- Department of Pathology, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Minmin Xu
- Department of Colorectal Surgery, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Youran Li
- Department of Colorectal Surgery, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Ping Zhu
- First Clinical Medical College, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Bolin Yang
- Department of Colorectal Surgery, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
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234
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Artym J, Kocięba M, Zaczyńska E, Zimecki M, Kałas W, Strządała L, Pawlak A, Jeleń M, Morak-Młodawska B, Pluta K, Kaleta-Kuratewicz K, Madej JP, Kuropka P, Kuryszko J. Therapeutic effects of an azaphenothiazine derivative in mouse experimental colitis. Histol Histopathol 2019; 35:691-699. [PMID: 31833559 DOI: 10.14670/hh-18-192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Phenothiazines represent a class of compounds of potential therapeutic utility. In this report we evaluated therapeutic value of an azaphenothiazine derivative, 6-acetylaminobutyl-9-chloroquino[3,2-b]benzo[1,4]thiazine (QBT), given intragastrically, in the model of dextran sodium sulfate-induced colitis in C57BL/6 mice using 5-aminosalicylic acid (5-ASA) as a reference drug. Colitis symptoms such as body weight loss, diarrhea and hematochezia (blood in stool) were observed and registered and disease activity index (DAI) was calculated. In addition, weight and cell numbers in the lymphatic organs and histological parameters of the colon wall were analyzed. The effects of QBT on viability of colon epithelial cell lines were also determined. We showed that weight and cell number of draining mesenteric lymph nodes were lower in mice treated with QBT in comparison to their control counterparts. The number of thymocytes, drastically reduced in control mice, was elevated in mice treated with the compounds with a significant effect of 5-ASA. In addition, an abnormal composition of blood cell types was partially corrected in these groups. Histological analysis of the colon revealed that the pathological changes were partially normalized by QBT and even to a higher degree by 5-ASA. In conclusion we demonstrated a therapeutic efficacy of the compound in amelioration of local and systemic pathological changes associated with chemically-induced colitis in mice. A possible mechanism of action of the compound is discussed.
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Affiliation(s)
- Jolanta Artym
- Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland
| | - Maja Kocięba
- Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland
| | - Ewa Zaczyńska
- Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland
| | - Michał Zimecki
- Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland.
| | - Wojciech Kałas
- Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland
| | - Leon Strządała
- Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland
| | - Alicja Pawlak
- Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland
| | - Małgorzata Jeleń
- Medical University of Silesia in Katowice, Faculty of Pharmaceutical Sciences in Sosnowiec, Department of Organic Chemistry, Sosnowiec, Poland
| | - Beata Morak-Młodawska
- Medical University of Silesia in Katowice, Faculty of Pharmaceutical Sciences in Sosnowiec, Department of Organic Chemistry, Sosnowiec, Poland
| | - Krystian Pluta
- Medical University of Silesia in Katowice, Faculty of Pharmaceutical Sciences in Sosnowiec, Department of Organic Chemistry, Sosnowiec, Poland
| | | | - Jan P Madej
- University of Environmental and Life Sciences, Division of Histology and Embryology, Wrocław, Poland
| | - Piotr Kuropka
- University of Environmental and Life Sciences, Division of Histology and Embryology, Wrocław, Poland
| | - Jan Kuryszko
- University of Environmental and Life Sciences, Division of Histology and Embryology, Wrocław, Poland
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235
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Balbas-Martinez V, Asin-Prieto E, Parra-Guillen ZP, Troconiz IF. A Quantitative Systems Pharmacology Model for the Key Interleukins Involved in Crohn's Disease. J Pharmacol Exp Ther 2019; 372:299-307. [DOI: 10.1124/jpet.119.260539] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 12/02/2019] [Indexed: 12/12/2022] Open
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236
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A Comprehensive Review and Update on the Pathogenesis of Inflammatory Bowel Disease. J Immunol Res 2019; 2019:7247238. [PMID: 31886308 PMCID: PMC6914932 DOI: 10.1155/2019/7247238] [Citation(s) in RCA: 435] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/15/2019] [Indexed: 12/13/2022] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic and life-threating inflammatory disease of gastroenteric tissue characterized by episodes of intestinal inflammation. The pathogenesis of IBD is complex. Recent studies have greatly improved our knowledge of the pathophysiology of IBD, leading to great advances in the treatment as well as diagnosis of IBD. In this review, we have systemically reviewed the pathogenesis of IBD and highlighted recent advances in host genetic factors, gut microbiota, and environmental factors and, especially, in abnormal innate and adaptive immune responses and their interactions, which may hold the keys to identify novel predictive or prognostic biomarkers and develop new therapies.
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237
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Bottoms L, Leighton D, Carpenter R, Anderson S, Langmead L, Ramage J, Faulkner J, Coleman E, Fairhurst C, Seed M, Tew G. Affective and enjoyment responses to 12 weeks of high intensity interval training and moderate continuous training in adults with Crohn's disease. PLoS One 2019; 14:e0222060. [PMID: 31539378 PMCID: PMC6754139 DOI: 10.1371/journal.pone.0222060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 08/20/2019] [Indexed: 01/17/2023] Open
Abstract
The aim was to undertake secondary data analysis from a three-arm randomised feasibility trial of high intensity interval training (HIIT), moderate intensity continuous training (MICT), and usual care control in adults with Crohn’s disease (CD; n = 36), with a primary focus on exploring affective and enjoyment responses. Twenty-five participants with quiescent or mildly-active CD were randomised to one of the two exercise groups: HIIT (n = 13) and MICT (n = 12). Both groups were offered thrice weekly sessions for 12 weeks. MICT consisted of cycling for 30 minutes at 35% peak power (Wpeak), whereas HIIT involved ten 1-minute bouts at 90% Wpeak, interspersed with 1-minute bouts at 15% Wpeak. Heart rate (HR), differentiated ratings of perceived exertion for legs (RPE-L) and central (RPE-C), along with feeling state (Feeling Scale; FS) were measured at 92.5% of each session. Enjoyment was measured at the end of training using the Physical Activity Enjoyment Scale (PACES). Post-hoc exploratory analysis involved a mixed-model two-way ANOVA to compare HR, RPE-L, RPE-C and FS for the exercise sessions in weeks 1, 6 and 12 between groups. Overall, HR was greater (p < 0.01) during HIIT (173 ± 8 bpm) compared with MICT (128 ± 6 bpm). Similarly, RPE-L and RPE-C responses were greater overall (p = 0.03 and p = 0.03, respectively) during HIIT (5.5 ± 1.6 and 5.1 ± 1.7, respectively) compared to MICT (3.3 ± 1.5 and 2.9 ± 1.5, respectively). Overall, FS was 2.2 ± 1.9 for HIIT and 2.1 ± 1.4 for MICT with no effect of treatment group (p = 0.25) or time (p = 0.94). There was also no significant difference in PACES scores between HIIT (99.4 ± 12.9) and MICT (101.3 ± 17.4; p = 0.78). The findings suggest HIIT and MICT protocols elicited similar enjoyment and affect in adults with quiescent or mildly-active CD.
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Affiliation(s)
- Lindsay Bottoms
- Department of Psychology and Sports Science, University of Hertfordshire, Life and Medical Sciences, Hatfield, United Kingdom
- * E-mail:
| | - Dean Leighton
- Centre for Immunobiology, Queen Mary University of London, Whitechapel, London
| | - Roger Carpenter
- School of Health, Sport and Bioscience, University of East London, Stratford Campus, London, United Kingdom
| | - Simon Anderson
- Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Louise Langmead
- Digestive Diseases Clinical Academic Unit, Barts and the London NHS Trust, London, United Kingdom
| | - John Ramage
- Hampshire Hospitals NHS Foundation Trust, Hampshire, United Kingdom
| | - James Faulkner
- Department of Sport, Exercise and Health, University of Winchester, Winchester, United Kingdom
| | | | | | - Michael Seed
- School of Health, Sport and Bioscience, University of East London, Stratford Campus, London, United Kingdom
| | - Garry Tew
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, United Kingdom
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238
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Khoshnevisan R, Nekooei-Marnany N, Klein C, Kotlarz D, Behnam M, Ostadi V, Yaran M, Rezaei A, Sherkat R. IL-12Rβ1 deficiency corresponding to concurrency of two diseases, mendelian susceptibility to mycobacterial disease and Crohn's disease. J Clin Tuberc Other Mycobact Dis 2019; 17:100123. [PMID: 31788565 PMCID: PMC6879969 DOI: 10.1016/j.jctube.2019.100123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background The interleukin-12 receptor β1 (IL-12Rβ1) deficiency is a primary immunodeficiency (PID), affecting the immunological pathway of interleukin 12/interferon- γ (IL12/IFN-γ) axis and interleukin 23 receptor (IL23R). Defect in this pathway is mainly affecting the cellular immunity-related disorders. IL-12Rβ1 is a receptor chain of both the IL-12 and the IL-23 receptors and thus, deficiency of IL-12Rβ1 abolishes both IL-12 and IL-23 signaling. Material and methods In this study, we performed whole exon sequencing and confirmatory Sanger sequencing in IL-12Rβ1. Evaluation of the IL12/IFN-γ axis was performed by assessment of patients’ whole blood cell to IL12/IFN-γ responding. Total and surface IL-12Rβ1expression was evaluated, in peripheral blood mononuclear cells (PBMCs) and T cell- derived PBMCs, and Th17 count was assessed. Results In the present study, we described a c.1791 + 2T > G mutation at a splicing site position in IL-12Rβ1, using whole exome sequencing, and confirmed with targeted Sanger sequencing in a 26- year-old patient with Mendelian susceptibility to mycobacterial disease (MSMD) and Crohn's disease (CD). Complete lack of IL-12Rβ1 protein expression was detected in patient's PBMCs, compared to the healthy control. Furthermore, no IL-12Rβ1 protein was expressed on the cell surface. Interestingly, IL-12Rβ1-mutant cells showed an impaired response to IL12, and Bacillus Calmette–Guérin stimulation, confirming that the mutation is causative in this patient. Conclusion A 3′splicing site mutation in IL12Rβ1, can be corresponding to the abolished expression of IL12Rβ1 in patients' cells, and associated with an impaired IL12-mediated signaling, which may lead not only to MSMD, but also to inflammatory bowel disease (IBD).
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Affiliation(s)
- Razieh Khoshnevisan
- Immunology Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nioosha Nekooei-Marnany
- Aquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Christoph Klein
- Dr. von Hauner Children's Hospital, Department of Pediatrics, University Hospital, LMU Munich, Munich, Germany
| | - Daniel Kotlarz
- Dr. von Hauner Children's Hospital, Department of Pediatrics, University Hospital, LMU Munich, Munich, Germany
| | - Mahdieh Behnam
- Immunology Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vajihe Ostadi
- Immunology Department, Isfahan University of Medical Sciences, Isfahan, Iran.,Aquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Yaran
- Aquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbas Rezaei
- Immunology Department, Isfahan University of Medical Sciences, Isfahan, Iran.,Aquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Sherkat
- Aquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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239
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Müller S. Non-infectious Granulomatous Lesions of the Orofacial Region. Head Neck Pathol 2019; 13:449-456. [PMID: 30627963 PMCID: PMC6684712 DOI: 10.1007/s12105-018-00997-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 12/20/2018] [Indexed: 02/06/2023]
Abstract
Granulomatous lesions of the orofacial region are a heterogeneous group of disorders characterized by a granulomatous reaction to a variety of stimuli. Infectious agents, foreign material, systemic inflammation and metabolic disorders can all be associated with granulomatous inflammation. In the orofacial region primary causes of granulomatosis include foreign body reaction, delayed hypersensitivity to topical agents and idiopathic orofacial granulomatosis. Secondary causes of granulomas include infectious agents, sarcoid, and Crohn disease. For this review, infectious causes of orofacial granulomatosis (OFG) including bacteria, parasites and fungi will not be discussed.
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Affiliation(s)
- Susan Müller
- Atlanta Oral Pathology, Emory Decatur Hospital, Emory University School of Medicine, 2701 N. Decatur Road, Decatur, GA, 30033, USA.
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240
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Vargas-Robles H, Castro-Ochoa KF, Citalán-Madrid AF, Schnoor M. Beneficial effects of nutritional supplements on intestinal epithelial barrier functions in experimental colitis models in vivo. World J Gastroenterol 2019; 25:4181-4198. [PMID: 31435172 PMCID: PMC6700707 DOI: 10.3748/wjg.v25.i30.4181] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/12/2019] [Accepted: 07/05/2019] [Indexed: 02/06/2023] Open
Abstract
Acute and chronic colitis affect a huge proportion of the population world-wide. The etiology of colitis cases can be manifold, and diet can significantly affect onset and outcome of colitis. While many forms of acute colitis are easily treatable, chronic forms of colitis such as ulcerative colitis and Crohn’s disease (summarized as inflammatory bowel diseases) are multifactorial with poorly understood pathogenesis. Inflammatory bowel diseases are characterized by exacerbated immune responses causing epithelial dysfunction and bacterial translocation. There is no cure and therapies aim at reducing inflammation and restoring intestinal barrier function. Unfortunately, most drugs can have severe side effects. Changes in diet and inclusion of nutritional supplements have been extensively studied in cell culture and animal models, and some supplements have shown promising results in clinical studies. Most of these nutritional supplements including vitamins, fatty acids and phytochemicals reduce oxidative stress and inflammation and have shown beneficial effects during experimental colitis in rodents induced by dextran sulphate sodium or 2,4,6-trinitrobenzene sulfonic acid, which remain the gold standard in pre-clinical colitis research. Here, we summarize the mechanisms through which such nutritional supplements contribute to epithelial barrier stabilization.
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Affiliation(s)
- Hilda Vargas-Robles
- Department for Molecular Biomedicine, Cinvestav-IPN, Mexico City 07360, Mexico
| | | | | | - Michael Schnoor
- Department for Molecular Biomedicine, Cinvestav-IPN, Mexico City 07360, Mexico
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241
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Schwartzberg DM, Remzi FH. The Role of Laparoscopic, Robotic, and Open Surgery in Uncomplicated and Complicated Inflammatory Bowel Disease. Gastrointest Endosc Clin N Am 2019; 29:563-576. [PMID: 31078253 DOI: 10.1016/j.giec.2019.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The incidence of inflammatory bowel disease is increasing and despite advances in medical therapy, patients continue to require operations for complications of their disease. Minimally invasive surgical options have impacted postoperative morbidity dramatically with reduction of pain, length of stay and adhesion formation, but additionally, this population of patients are not only concerned with successful operative therapy but also the ability to return to their lifestyle and cosmetics. Laparoscopic and robotic surgery for Crohn's disease has proven to benefit patients with ileocolic or colonic disease, however complicated disease with phlegmon, abscess or fistulae is best served with a hybrid approach. Ulcerative colitis treatment has seen advancements with laparoscopic and robotic platforms, however the benefits of minimally invasive surgery must be balanced with producible and durable outcomes.
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Affiliation(s)
- David M Schwartzberg
- Department of Surgery, Inflammatory Bowel Disease Center, New York University Langone Health, 240 East 38th Street, 23rd Floor, New York, NY 20016, USA
| | - Feza H Remzi
- Department of Surgery, Inflammatory Bowel Disease Center, New York University Langone Health, 240 East 38th Street, 23rd Floor, New York, NY 20016, USA.
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242
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Gompertz M, Sedano R. Manifestaciones clínicas y endoscópicas en enfermedad inflamatoria intestinal. REVISTA MÉDICA CLÍNICA LAS CONDES 2019. [DOI: 10.1016/j.rmclc.2019.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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243
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The uses of naltrexone in dermatologic conditions. J Am Acad Dermatol 2019; 80:1746-1752. [DOI: 10.1016/j.jaad.2018.12.031] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/13/2018] [Accepted: 12/17/2018] [Indexed: 12/30/2022]
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244
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Jang EJ, Ha JE, Im SG, Kim MG, Sohn HS. A Real-World Analysis of Prescribing Patterns and Non-persistence of Anti-TNFα Therapy for Inflammatory Bowel Disease. Clin Drug Investig 2019; 39:625-630. [DOI: 10.1007/s40261-019-00784-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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245
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Limanskiy V, Vyas A, Chaturvedi LS, Vyas D. Harnessing the potential of gene editing technology using CRISPR in inflammatory bowel disease. World J Gastroenterol 2019; 25:2177-2187. [PMID: 31143069 PMCID: PMC6526155 DOI: 10.3748/wjg.v25.i18.2177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/27/2019] [Accepted: 03/30/2019] [Indexed: 02/06/2023] Open
Abstract
The molecular scalpel of clustered regularly interspersed short palindromic repeats/CRISPR associated protein 9 (CRISPR/Cas9) technology may be sharp enough to begin cutting the genes implicated in inflammatory bowel disease (IBD) and consequently decrease the 6.3 billion dollar annual financial healthcare burden in the treatment of IBD. For the past few years CRISPR technology has drastically revolutionized DNA engineering and biomedical research field. We are beginning to see its application in gene manipulation of sickle cell disease, human immunodeficiency virus resistant embryologic twin gene modification and IBD genes such as Gatm (Glycine amidinotransferase, mitochondrial), nucleotide-binding oligomerization domain-containing protein 2, KRT12 and other genes implicated in adaptive immune convergence pathways have been subjected to gene editing, however there are very few publications. Furthermore, since Crohn’s disease and ulcerative colitis have shared disease susceptibility and share genetic gene profile, it is paramount and is more advantageous to use CRISPR technology to maximize impact. Although, currently CRISPR does have its limitations due to limited number of specific Cas enzymes, off-target activity, protospacer adjacent motifs and crossfire between different target sites. However, these limitations have given researchers further insight on how to augment and manipulate enzymes to enable precise gene excision and limit crossfire between target sites.
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Affiliation(s)
- Viktor Limanskiy
- Department of Surgery, San Joaquin General Hospital, French Camp, CA 95231, United States
| | - Arpita Vyas
- College of Medicine, CNSU, Elk Grove, CA 95757, United States
| | | | - Dinesh Vyas
- Department of Surgery, San Joaquin General Hospital, French Camp, CA 95231, United States
- College of Medicine and College of Pharmacy, California Northstate University, Elk Grove, CA 95757, United States
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246
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Yao Q, Li E, Shen B. Autoinflammatory disease with focus on NOD2-associated disease in the era of genomic medicine. Autoimmunity 2019; 52:48-56. [PMID: 31084224 DOI: 10.1080/08916934.2019.1613382] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Systemic autoinflammatory diseases (SAIDs) represent a spectrum of genetically heterogeneous inflammatory disorders. Some SAID-associated genes are located in chromosome 16, including familial Mediterranean fever gene (MEFV) and nucleotide-binding oligomerization domain 2 [NOD2] gene that are linked to Crohn's disease, Blau syndrome, and Yao syndrome. These disorders share overlapping clinical phenotypes, and genotyping is diagnostically helpful and distinctive. Using next generation sequencing in SAIDs, digenic variants or combinations of more genetic variants in different genes can be detected, and they may be related to the MEFV and NOD2 genes. These variants may contribute to heterogeneous phenotypes in an individual, complicating the diagnosis and therapy. An awareness of the clinical significance of the digenic or combined gene variants is important in the era of genomic medicine.
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Affiliation(s)
- Qingping Yao
- a Division of Rheumatology, Allergy and Immunology , Stony Brook University , Stony Brook , NY , USA
| | - Ellen Li
- b Division of Gastroenterology , Stony Brook University , Stony Brook , NY , USA
| | - Bo Shen
- c Center for Inflammatory Bowel Disease , Digestive Disease and Surgery Institute, the Cleveland Clinic Foundation , Cleveland , OH , USA
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247
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Sedano Muñoz R, Quera Pino R, Ibáñez Lazo P, Figueroa Corona C, Flores Pérez L. Aminosalicylates, thiopurines and methotrexate in inflammatory bowel disease: Is it possible to discontinue the treatment? GASTROENTEROLOGIA Y HEPATOLOGIA 2019; 42:339-347. [PMID: 30954317 DOI: 10.1016/j.gastrohep.2019.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 06/09/2023]
Abstract
The current goals of treatment in inflammatory bowel disease, both Crohn's disease and ulcerative colitis, are to achieve clinical, endoscopic and ideally histological remission and improve the quality of life of these patients. Current therapies are effective in achieving remission in most cases, but there is a lack of clear guidelines on their optimal duration. This review aims to evaluate the current evidence on the withdrawal of therapy with 5-aminosalicylates, thiopurines and methotrexate. We also aim to identify which specific group of patients, while in remission and in the absence of risk factors, may be able to discontinue therapy without a significant risk of relapse.
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Affiliation(s)
- Rocío Sedano Muñoz
- Servicio de Gastroenterología, Hospital Clínico de la Universidad de Chile, Santiago, Chile
| | - Rodrigo Quera Pino
- Programa Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Clínica las Condes, Santiago, Chile.
| | - Patricio Ibáñez Lazo
- Programa Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Clínica las Condes, Santiago, Chile
| | - Carolina Figueroa Corona
- Programa Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Clínica las Condes, Santiago, Chile
| | - Lilian Flores Pérez
- Programa Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Clínica las Condes, Santiago, Chile
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248
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Pimentel AM, Rocha R, Santana GO. Crohn’s disease of esophagus, stomach and duodenum. World J Gastrointest Pharmacol Ther 2019; 10:35-49. [PMID: 30891327 PMCID: PMC6422852 DOI: 10.4292/wjgpt.v10.i2.35] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/31/2019] [Accepted: 02/27/2019] [Indexed: 02/06/2023] Open
Abstract
Crohn’s disease with involvement of the esophagus, stomach and duodenum has a prevalence of 0.5% to 4% in symptomatic adult patients, but some studies have shown that these results may be underestimated, since upper gastrointestinal endoscopy is not performed routinely in the initial evaluation of the disease in adult patients, as it is in the pediatric population. In general, involvement of the upper gastrointestinal tract in Crohn’s disease occurs concomitantly with involvement of the lower gastrointestinal tract. The diagnosis depends on clinical, endoscopic, histological and radiological evaluation. The presence of aphthoid ulcers, longitudinal ulcers, bamboo-joint-like appearance, stenoses and fistulas are endoscopic findings suggestive of the disease, and it is important to exclude the presence of Helicobacter pylori infection. The primary histological findings, which facilitate the diagnosis, are the presence of a chronic inflammatory process with a predominance of lymphoplasmacytic cells and active focal gastritis. The presence of epithelioid granuloma, although less frequent, is highly suggestive of the disease in the absence of chronic granulomatous disease. Treatment should include the use of proton pump inhibitors associated with corticosteroids, immunomodulators and biological therapy according to the severity of the disease.
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Affiliation(s)
- Andréa Maia Pimentel
- Programa de Pós graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, Bahia, Brazil
| | - Raquel Rocha
- Departamento de Ciências da Nutrição, Universidade Federal da Bahia, Salvador 40110-060, Bahia, Brazil
| | - Genoile Oliveira Santana
- Programa de Pós graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, Bahia, Brazil
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Abstract
Ulcerative colitis (UC) is a chronic idiopathic inflammatory bowel disorder of the colon that causes continuous mucosal inflammation extending from the rectum to the more proximal colon, with variable extents. UC is characterized by a relapsing and remitting course. UC was first described by Samuel Wilks in 1859 and it is more common than Crohn's disease worldwide. The overall incidence and prevalence of UC is reported to be 1.2-20.3 and 7.6-245 cases per 100,000 persons/year respectively. UC has a bimodal age distribution with an incidence peak in the 2nd or 3rd decades and followed by second peak between 50 and 80 years of age. The key risk factors for UC include genetics, environmental factors, autoimmunity and gut microbiota. The classic presentation of UC include bloody diarrhea with or without mucus, rectal urgency, tenesmus, and variable degrees of abdominal pain that is often relieved by defecation. UC is diagnosed based on the combination of clinical presentation, endoscopic findings, histology, and the absence of alternative diagnoses. In addition to confirming the diagnosis of UC, it is also important to define the extent and severity of inflammation, which aids in the selection of appropriate treatment and for predicting the patient's prognosis. Ileocolonoscopy with biopsy is the only way to make a definitive diagnosis of UC. A pathognomonic finding of UC is the presence of continuous colonic inflammation characterized by erythema, loss of normal vascular pattern, granularity, erosions, friability, bleeding, and ulcerations, with distinct demarcation between inflamed and non-inflamed bowel. Histopathology is the definitive tool in diagnosing UC, assessing the disease severity and identifying intraepithelial neoplasia (dysplasia) or cancer. The classical histological changes in UC include decreased crypt density, crypt architectural distortion, irregular mucosal surface and heavy diffuse transmucosal inflammation, in the absence of genuine granulomas. Abdominal computed tomographic (CT) scanning is the preferred initial radiographic imaging study in UC patients with acute abdominal symptoms. The hallmark CT finding of UC is mural thickening with a mean wall thickness of 8 mm, as opposed to a 2-3 mm mean wall thickness of the normal colon. The Mayo scoring system is a commonly used index to assess disease severity and monitor patients during therapy. The goals of treatment in UC are three fold-improve quality of life, achieve steroid free remission and minimize the risk of cancer. The choice of treatment depends on disease extent, severity and the course of the disease. For proctitis, topical 5-aminosalicylic acid (5-ASA) drugs are used as the first line agents. UC patients with more extensive or severe disease should be treated with a combination of oral and topical 5-ASA drugs +/- corticosteroids to induce remission. Patients with severe UC need to be hospitalized for treatment. The options in these patients include intravenous steroids and if refractory, calcineurin inhibitors (cyclosporine, tacrolimus) or tumor necrosis factor-α antibodies (infliximab) are utilized. Once remission is induced, patients are then continued on appropriate medications to maintain remission. Indications for emergency surgery include refractory toxic megacolon, colonic perforation, or severe colorectal bleeding.
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Alagón Fernández Del Campo P, De Orta Pando A, Straface JI, López Vega JR, Toledo Plata D, Niezen Lugo SF, Alvarez Hernández D, Barrientos Fortes T, Gutiérrez-Kobeh L, Solano-Gálvez SG, Vázquez-López R. The Use of Probiotic Therapy to Modulate the Gut Microbiota and Dendritic Cell Responses in Inflammatory Bowel Diseases. ACTA ACUST UNITED AC 2019; 7:medsci7020033. [PMID: 30813381 PMCID: PMC6410300 DOI: 10.3390/medsci7020033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/28/2019] [Accepted: 02/13/2019] [Indexed: 12/23/2022]
Abstract
Recent investigations have shown that different conditions such as diet, the overuse of antibiotics or the colonization of pathogenic microorganisms can alter the population status of the intestinal microbiota. This modification can produce a change from homeostasis to a condition known as imbalance or dysbiosis; however, the role-played by dysbiosis and the development of inflammatory bowel diseases (IBD) has been poorly understood. It was actually not until a few years ago that studies started to develop regarding the role that dendritic cells (DC) of intestinal mucosa play in the sensing of the gut microbiota population. The latest studies have focused on describing the DC modulation, specifically on tolerance response involving T regulatory cells or on the inflammatory response involving reactive oxygen species and tissue damage. Furthermore, the latest studies have also focused on the protective and restorative effect of the population of the gut microbiota given by probiotic therapy, targeting IBD and other intestinal pathologies. In the present work, the authors propose and summarize a recently studied complex axis of interaction between the population of the gut microbiota, the sensing of the DC and its modulation towards tolerance and inflammation, the development of IBD and the protective and restorative effect of probiotics on other intestinal pathologies.
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Affiliation(s)
- Pablo Alagón Fernández Del Campo
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, 52786 Cuidad de México, Mexico.
| | - Alejandro De Orta Pando
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, 52786 Cuidad de México, Mexico.
| | - Juan Ignacio Straface
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, 52786 Cuidad de México, Mexico.
| | - José Ricardo López Vega
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, 52786 Cuidad de México, Mexico.
| | - Diego Toledo Plata
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, 52786 Cuidad de México, Mexico.
| | - Sebastian Felipe Niezen Lugo
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, 52786 Cuidad de México, Mexico.
| | - Diego Alvarez Hernández
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, 52786 Cuidad de México, Mexico.
| | - Tomás Barrientos Fortes
- Director Facultad de Ciencias de la Salud, Universidad Anáhuac México, 52786 Cuidad de México, Mexico.
| | - Laila Gutiérrez-Kobeh
- Unidad de Investigación UNAM-INC, División Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México-Instituto Nacional de Cardiología "Ignacio Chávez," Mexico City 14080, Mexico.
| | - Sandra Georgina Solano-Gálvez
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico.
| | - Rosalino Vázquez-López
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, 52786 Cuidad de México, Mexico.
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