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Li H, Ye XF, Su YS, He W, Zhang JB, Zhang Q, Zhan LB, Jing XH. Mechanism of Acupuncture and Moxibustion on Promoting Mucosal Healing in Ulcerative Colitis. Chin J Integr Med 2023; 29:847-856. [PMID: 35412218 DOI: 10.1007/s11655-022-3531-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 12/11/2022]
Abstract
The latest guideline about ulcerative colitis (UC) clinical practice stresses that mucosal healing, rather than anti-inflammation, is the main target in UC clinical management. Current mucosal dysfunction mainly closely relates to the endoscopic intestinal wall (mechanical barrier) injury with the imbalance between intestinal epithelial cells (IECs) regeneration and death, as well as tight junction (TJ) dysfunction. It is suggested that biological barrier (gut microbiota), chemical barrier (mucus protein layer, MUC) and immune barrier (immune cells) all take part in the imbalance, leading to mechanical barrier injury. Lots of experimental studies reported that acupuncture and moxibustion on UC recovery by adjusting the gut microbiota, MUC and immune cells on multiple targets and pathways, which contributes to the balance of IEC regeneration and death, as well as TJ structure recovery in animals. Moreover, the validity and superiority of acupuncture and moxibustion were also demonstrated in clinic. This study aims to review the achievements of acupuncture and moxibustion on mucosal healing and analyse the underlying mechanisms.
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Affiliation(s)
- Han Li
- Department of Acupuncture and Moxibustion, Changzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Changzhou, Jiangsu Province, 213002, China
- Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Xiao-Feng Ye
- Department of Acupuncture and Moxibustion, Changzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Changzhou, Jiangsu Province, 213002, China
| | - Yang-Shuai Su
- Research Center of Meridians, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Wei He
- Research Center of Meridians, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Jian-Bin Zhang
- Nanjing University of Chinese Medicine, Nanjing, 210023, China
- Department of Acupuncture and Moxibustion, the Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 211005, China
| | - Qi Zhang
- Department of Acupuncture and Moxibustion, Changzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Changzhou, Jiangsu Province, 213002, China
| | - Li-Bin Zhan
- Nanjing University of Chinese Medicine, Nanjing, 210023, China
- Liaoning University of Chinese Medicine, Shenyang, 116600, China
| | - Xiang-Hong Jing
- Research Center of Meridians, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
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Effects of Antrodia camphorata-Supplemented Diets on the Non-Specific Immune Responses and Disease Resistance of Orange-Spotted Grouper (Epinephelus coioides) against Vibrio alginolyticus and Streptococcus iniae. JOURNAL OF MARINE SCIENCE AND ENGINEERING 2022. [DOI: 10.3390/jmse10040458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In Taiwan, the mushroom Antrodia camphorata (AC) is used for medicinal purposes, including cancer prevention and treatment. This study aimed to investigate the effect of AC-supplemented diets on the innate immunity and disease resistance of the orange-spotted grouper Epinephelus coioides against two bacterial infections—Vibrio alginolyticus and Streptococcus iniae. Orange-spotted groupers were fed AC-supplemented diets at 0 (control), 1.5, 3.0, 4.5, and 6.0 g kg−1 for 28 days and examined for innate immune responses and survival rates against V. alginolyticus and S. iniae. The results showed that the innate cellular and humoral immune parameters, including respiratory burst, phagocytic activity, and lysozyme activity of leukocytes, along with serum alternative complement activity (ACH50) and superoxide dismutase activity, as well as interleukin (IL)-4 and IL-6, were all significantly increased in groupers fed AC-supplemented diets. Groupers fed diets containing AC at doses higher than 3.0 g kg−1 had better survival rates than the control group 3–18 days after V. alginolyticus or S. iniae challenge. The enhanced disease resistance may be attributable to AC-induced innate immunity, suggesting that utilizing AC as a dietary supplement at 3.0 g kg−1 may enhance the disease resistance of orange-spotted groupers against Vibrio or Streptococcus infection.
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Rondanelli M, Lamburghini S, Faliva MA, Peroni G, Riva A, Allegrini P, Spadaccini D, Gasparri C, Iannello G, Infantino V, Alalwan TA, Perna S, Miccono A. A food pyramid, based on a review of the emerging literature, for subjects with inflammatory bowel disease. ACTA ACUST UNITED AC 2020; 68:17-46. [PMID: 32499202 DOI: 10.1016/j.endinu.2020.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 12/14/2019] [Accepted: 01/08/2020] [Indexed: 02/07/2023]
Abstract
Emerging literature suggests that diet plays an important modulatory role in inflammatory bowel disease (IBD) through the management of inflammation and oxidative stress. The aim of this narrative review is to evaluate the evidence collected up till now regarding optimum diet therapy for IBD and to design a food pyramid for these patients. The pyramid shows that carbohydrates should be consumed every day (3 portions), together with tolerated fruits and vegetables (5 portions), yogurt (125ml), and extra virgin olive oil; weekly, fish (4 portions), white meat (3 portions), eggs (3 portions), pureed legumes (2 portions), seasoned cheeses (2 portions), and red or processed meats (once a week). At the top of the pyramid, there are two pennants: the red one means that subjects with IBD need some personalized supplementation and the black one means that there are some foods that are banned. The food pyramid makes it easier for patients to decide what they should eat.
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Affiliation(s)
- Mariangela Rondanelli
- IRCCS Mondino Foundation, Pavia, Department of Public Health, Experimental and Forensic Medicine, Unit of Human and Clinical Nutrition, University of Pavia, Pavia 27100, Italy
| | - Silvia Lamburghini
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia 27100, Italy
| | - Milena A Faliva
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia 27100, Italy
| | - Gabriella Peroni
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia 27100, Italy
| | - Antonella Riva
- Research and Development Unit, Indena, Milan 20146, Italy
| | | | - Daniele Spadaccini
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia 27100, Italy
| | - Clara Gasparri
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia 27100, Italy
| | - Giancarlo Iannello
- General Management, Azienda di Servizi alla Persona "Istituto Santa Margherita", Pavia 27100, Italy
| | - Vittoria Infantino
- University of Bari Aldo Moro, Department of Biomedical Science and Human Oncology, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia 27100, Italy.
| | - Tariq A Alalwan
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, P.O. Box 32038, Bahrain
| | - Simone Perna
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, P.O. Box 32038, Bahrain
| | - Alessandra Miccono
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia 27100, Italy
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Experiences With Traditional Chinese Medicine Among Patients With Inflammatory Bowel Disease: A Qualitative Study. Gastroenterol Nurs 2020; 43:135-145. [PMID: 32251215 DOI: 10.1097/sga.0000000000000418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Despite the increasing number of inflammatory bowel disease (IBD) patients using traditional Chinese medicine (TCM), relatively few studies have examined their experiences with TCM in the Chinese healthcare context. The aim of this study was to explore these experiences from the perspective of IBD patients. Adopting a qualitative descriptive method, IBD patients from several comprehensive hospitals in Hangzhou, Zhejiang were recruited through purposive sampling. Data were collected using semistructured interviews and analyzed by a conventional content analysis method. The results are presented thematically. Fourteen IBD patients participated in the study. They often used TCM, such as Chinese herbal medicine, retention enemas of Chinese medicine, and acupuncture, as a complementary therapy instead of as an alternative to conventional therapies. Three themes emerged from the analysis: triggers for initiating TCM, the experienced efficacies of TCM, and disturbances caused by TCM use. The IBD patients initiate TCM treatment due to the unsatisfactory effects of conventional therapies and TCM culture. However, the efficacies of TCM are subjective and slow acting and vary across individuals. There are communication gaps between physicians and patients concerning TCM. Thus, healthcare professionals are encouraged to gain more knowledge on these therapies and employ a participatory decision-making style based on this understanding.
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Abstract
Gastrointestinal conditions are prevalent in the population and account for significant morbidity and health care costs. Patients with gastrointestinal conditions use integrative medicine. There is growing evidence that integrative medicine approaches can improve symptoms and affect physiology and disease course. This article reviews data on some common and well-studied approaches, including mind-body therapies, acupuncture, diet, probiotics, and dietary supplements and herbs. Although clear recommendations can be made for some conditions, in others there are challenges in translating these findings owing to small study size, lack of standardization, and trial heterogeneity.
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Affiliation(s)
- Michelle L Dossett
- Division of General Internal Medicine, Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, 151 Merrimac Street, 4th Floor, Boston, MA 02114, USA.
| | - Ezra M Cohen
- Division of Immunology, Department of Rheumatology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Jonah Cohen
- Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Dana 501, Boston, MA 02215, USA
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Portela F, Dias CC, Caldeira P, Cravo M, Deus J, Gonçalves R, Lago P, Morna H, Peixe P, Ramos J, Sousa H, Tavares L, Vasconcelos H, Magro F, Ministro P. The who-when-why triangle of CAM use among Portuguese IBD patients. Dig Liver Dis 2017; 49:388-396. [PMID: 28117198 DOI: 10.1016/j.dld.2016.12.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 12/29/2016] [Accepted: 12/30/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND The use of complementary and alternative medicines is increasing among chronic patients, particularly those afflicted with inflammatory bowel diseases. AIM This study aimed to address the prevalence of complementary and alternative medicines use among Portuguese inflammatory bowel diseases' patients. METHODS Patients were invited to fill an anonymous questionnaire concerning the use of complementary and alternative medicines. RESULTS Thirty-one per cent of the patients reported having used complementary and alternative medicines in the past, whereas 12% were using them by the time the questionnaire was administered. Fifty-nine per cent of the users did not share this information with their physician, whereas 14% and 8% discontinued their medication and periodical examination, respectively. Steroids prescription (OR=2.880) and a higher instruction level (OR=3.669) were predictors of complementary and alternative medicines use in this cohort. CONCLUSIONS Roughly a third of Portuguese IBD patients had used CAM. Steroid treatment and an academic degree are associated with CAM use. Given the potential side effects and interactions, patient information about the benefits and limitations of conventional and complementary treatments should be reinforced.
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Affiliation(s)
- Francisco Portela
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
| | - Camila C Dias
- CIDES - Department of Health Information and Decision Sciences, Faculty of Medicine, University of Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - Paulo Caldeira
- Gastroenterology Department, Centro Hospitalar do Algarve, Portugal
| | - Marilia Cravo
- Serviço de Gastrenterologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - João Deus
- Serviço de Gastrenterologia, Hospital Fernandes da Fonseca, Amadora, Portugal
| | | | - Paula Lago
- Gastroenterology Department, Centro Hospitalar Porto-Hospital Santo António, Portugal
| | - Henrique Morna
- Serviço de Gastrenterologia, Hospital do Funchal, Funchal, Portugal
| | - Paula Peixe
- Serviço de Gastrenterologia, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - Jaime Ramos
- Serviço de Gastrenterologia, Hospital dos Capuchos, Lisboa, Portugal
| | - Helena Sousa
- Gastroenterology Department, Centro Hospitalar do Algarve, Portugal; Biomedical Sciences and Medicine Department, University of Algarve, Portugal
| | - Lurdes Tavares
- Serviço de Gastrenterologia, Hospital de Santa Maria, Lisboa, Portugal
| | | | - Fernando Magro
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal; Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Portugal; MedInUP - Centre for Drug Discovery and Innovative Medicines, University of Porto, Portugal
| | - Paula Ministro
- Serviço Gastrenterologia, Centro Hospitalar de Tondela - Viseu, Viseu, Portugal
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Use of complementary and alternative medicine in Swedish patients with inflammatory bowel disease: a controlled study. Eur J Gastroenterol Hepatol 2016; 28:1320-8. [PMID: 27472271 PMCID: PMC5051534 DOI: 10.1097/meg.0000000000000710] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is an increasing interest in complementary and alternative medicine (CAM) in patients with chronic diseases, including those with inflammatory bowel disease (IBD). Patients may turn to CAM when conventional therapies are inadequate or associated with side effects for symptomatic relief or to regain control over their disease. The objectives were to explore CAM use and perceived effects in IBD patients in comparison with a control group. METHODS A cross-sectional, multicenter, controlled study was carried out. IBD patients were invited from 12 IBD clinics in Sweden. Controls were selected randomly from a residence registry. A study-specific questionnaire was used for data collection. RESULTS Overall, 48.3% of patients with IBD had used some kind of CAM during the past year compared with 53.5% in controls (P=0.025, adjusted for age, sex, geographic residence, and diet). The most frequently used CAM among IBD patients was massage (21.3%), versus controls (31.4%) (adjusted P=0.0003). The second most used CAM was natural products, 18.7% in IBD patients versus 22.3% of the controls (unadjusted P=0.018). In all, 83.1% of the patients experienced positive effects from CAM and 14.4% experienced negative effects. CONCLUSION Overall, 48.3% of Swedish IBD patients used some kind of CAM and controls used CAM significantly more. Natural products were used by one-fifth of the patients and even more by controls. This is notable from a patient safety perspective considering the possible risks of interactions with conventional medication. In all, 40% of the patients reported adverse events from conventional medicine. Patients experienced predominantly positive effects from CAM, and so did controls.
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Sreedhar R, Arumugam S, Karuppagounder V, Thandavarayan RA, Giridharan VV, Pitchaimani V, Afrin MR, Harima M, Nakamura T, Nakamura M, Suzuki K, Watanabe K. Jumihaidokuto effectively inhibits colon inflammation and apoptosis in mice with acute colitis. Int Immunopharmacol 2015; 29:957-963. [DOI: 10.1016/j.intimp.2015.10.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 10/05/2015] [Accepted: 10/06/2015] [Indexed: 02/07/2023]
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Additional effects of homeopathy on chronic periodontitis: a 1-year follow-up randomized clinical trial. Complement Ther Clin Pract 2014; 20:141-6. [PMID: 25129881 DOI: 10.1016/j.ctcp.2014.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 03/25/2014] [Accepted: 03/28/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVE The aim of this study was test the hypothesis that homeopathy (H) enhances the effects of scaling and root planing (SRP) in patients with chronic periodontitis (CP). MATERIALS AND METHODS 50 patients with CP were randomly allocated to one of two treatment groups: SRP (C-G) or SRP + H (H-G). Assessments were made at baseline and after 3 and 12 months of treatments. The local and systemic responses to the treatments were evaluated by clinical and serologic parameters, respectively. RESULTS Both groups displayed significant improvements, however, using clinical attachment gain and reductions in HDL, LDL and Total Cholesterol, Triglycerides, Glucose and Uric acid, from baseline to 1 year, as criteria for treatment success, H-G performed significantly better than C-G. CONCLUSION The findings of this 1-year follow-up randomized clinical trial suggest that homeopathic medicines, as an adjunctive to SRP, can provide significant local and systemic improvements for CP patients.
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Lauche R, Cramer H, Klose P, Kraft K, Dobos GJ, Langhorst J. Herbal medicines for the treatment of inflammatory bowel disease. Hippokratia 2014. [DOI: 10.1002/14651858.cd011223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Romy Lauche
- University of Duisburg-Essen; Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine; Am Deimelsberg 34a Essen Germany
| | - Holger Cramer
- University of Duisburg-Essen; Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine; Am Deimelsberg 34a Essen Germany
| | - Petra Klose
- University of Duisburg-Essen; Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine; Am Deimelsberg 34a Essen Germany
| | - Karin Kraft
- Universitätsmedizin Rostock; Center of Internal Medicine; Rostock Germany
| | - Gustav J Dobos
- University of Duisburg-Essen; Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine; Am Deimelsberg 34a Essen Germany
| | - Jost Langhorst
- University of Duisburg-Essen; Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine; Am Deimelsberg 34a Essen Germany
- University of Duisburg-Essen; Department for Integrative Gastroenterology, Kliniken Essen-Mitte, Faculty of Medicine; Am Deimelsberg 34a Essen Germany 45276
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Complementary and Alternative Medicine Use at a Single Pediatric Inflammatory Bowel Disease Center. Gastroenterol Nurs 2014; 37:265-71. [DOI: 10.1097/sga.0000000000000050] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Angelakis E, Merhej V, Raoult D. Related actions of probiotics and antibiotics on gut microbiota and weight modification. THE LANCET. INFECTIOUS DISEASES 2013; 13:889-99. [PMID: 24070562 DOI: 10.1016/s1473-3099(13)70179-8] [Citation(s) in RCA: 132] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Antibiotics and probiotics are widely used as growth promoters in agriculture. Most antibiotics prescribed in clinical practice are natural products that originate from Streptomyces spp, which were first used as agricultural probiotics. Antibiotics and probiotics both modify the gut microbiota. The effect of a probiotic species on the digestive flora depends on the strain and is largely determined by bacteriocin production. In human beings, as in animals, specific probiotics are associated with weight gain or loss. Improved understanding of the ability of specific probiotics to harvest energy from the host diet might lead to development of new treatments for obesity and malnutrition. In this Review, we present the effects of probiotics and antibiotics on the gut microbiota of human beings and animals and discuss their potential therapeutic use as interventions for weight gain and loss in human beings.
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Affiliation(s)
- Emmanouil Angelakis
- Unité des Rickettsies, Faculté de Médecine, Université de la Méditerranée, Marseille, France
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Additional benefits of homeopathy in the treatment of chronic periodontitis: a randomized clinical trial. Complement Ther Clin Pract 2013; 19:246-50. [PMID: 24199982 DOI: 10.1016/j.ctcp.2013.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 05/22/2013] [Accepted: 05/28/2013] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Homeopathic medicine (HM) in the treatment of Chronic Periodontitis (CP) aims to restore the vital energy balance of the patient allowing the body to heal itself. Thus, the aim of this study was to evaluate the additional benefits of HM as an adjunctive to conventional periodontal treatment (CPT). MATERIALS AND METHODS After sample size calculation, sixty individuals of both genders, and ages varying between 35 and 70 years old, 40 with chronic periodontitis (CP group - CPG) and 20 without CP (Healthy Group - HG) participated in this "Single-Blind Randomized Controlled Clinical Trial". The CP patients were divided into two groups: one was submitted only to CPT (CP Control Group - CPT-C) and the other group was submitted to CPT and HM, according to the similia principle (CP Test Group - CPTT). Assessments were made at baseline and after 90 days of treatments. The local and systemic responses to the treatments were evaluated by clinical and laboratory parameters, respectively. Data were analyzed by parametric and nonparametric tests. The level of significance was 5%. RESULTS At baseline, CP patients presented higher values of LDL cholesterol and blood glucose than HG individuals. After the treatment, all the systemic parameters evaluated decreased in CP patients, except LDL and HDL Cholesterol in CPT-C, and HDL Cholesterol in CPT-T. There was a statistical gain in clinical attachment level only in CPT-T (+0.51 mm) after 90 days; however, there was a reduction in probing depth, in the level of visible plaque and in the bleeding on probing, in both CP groups (CPT-C and CPT-T) after 90 days. CONCLUSION The findings of this 3-month follow-up study concluded that H M, as an adjunctive to CPT, can provide additional benefits in the treatment of CP.
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What gastroenterologists should know about the gray market, herbal remedies, and compounded pharmaceuticals and their regulation by the Food and Drug Administration. Am J Gastroenterol 2013; 108:642-6. [PMID: 23644956 DOI: 10.1038/ajg.2012.348] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Harrison KL, Farrell RM, Brinich MA, Highland J, Mercer M, McCormick JB, Tilburt J, Geller G, Marshall P, Sharp RR. 'Someone should oversee it': patient perspectives on the ethical issues arising with the regulation of probiotics. Health Expect 2012; 18:250-61. [PMID: 23279082 DOI: 10.1111/hex.12027] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2012] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Although many probiotic products are currently available in yogurt or pill form in the United States (US), there is uncertainty surrounding the structure of regulation of these products. As more therapeutic probiotics are developed, changes to existing regulatory process in the United States may be required to meet the needs of patients and users in the population. OBJECTIVE This study examined how patients with chronic gastrointestinal (GI) diseases view the regulation of probiotics. DESIGN We conducted a multi-site qualitative study consisting of focus groups of patients with chronic gastrointestinal diseases at three tertiary hospitals: at [institutions removed for blinded review]. RESULTS We conducted 22 focus groups with 136 patients with major gastrointestinal (GI) diseases between March and August 2009. Participants were not familiar with the existing regulation of probiotic products but wanted assurances of accurate labelling of strain as well as safety. Participants raised concerns that regulation of probiotics might be accompanied by greater costs, reduced access and increased involvement of pharmaceutical companies. Although participants voiced significant doubt of government regulators, they felt that products containing genetically modified probiotic strains should have oversight comparable to that of pharmaceutical drugs. DISCUSSION AND CONCLUSION If GI patient perspectives are indicative of public perceptions of therapeutic probiotics in the United States, consumers may expect more rigorous regulation in the future while simultaneously wanting low costs, easy access and low involvement of pharmaceutical companies. Manufacturers, translational scientists, clinicians and regulators should be sensitive to consumer attitudes when designing, testing and regulating new therapeutic probiotics.
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Affiliation(s)
- Krista L Harrison
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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