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Wu N, Mah C, Koentgen S, Zhang L, Grimm MC, El-Omar E, Hold GL. Inflammatory bowel disease and the gut microbiota. Proc Nutr Soc 2021; 80:1-11. [PMID: 34165053 DOI: 10.1017/s002966512100197x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Inflammatory bowel disease (IBD) is a group of immune-mediated disorders characterised by a chronic, relapsing-remitting inflammation predominantly affecting the gastrointestinal tract. IBD is incurable, affecting people in their most productive years. IBD is historically seen as a disease of Westernised nations although in recent times other countries have seen an exponential rise in cases. Although the exact pathogenesis remains unclear, evidence suggests that microbiota changes play a critical role in IBD pathogenesis. Over the past two decades, IBD has become one of the most studied human conditions linked to the gut microbiota. However, deciphering the intricate link between the gut microbiota and therapeutic efficacy remains elusive. This review will summarise the current evidence relating to the gut microbiota and its involvement in IBD pathogenesis as well as the impact of IBD treatments including pharmaceutical-, nutraceutical- and microbial-focused regimens on the gut microbiota.
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Affiliation(s)
- Nan Wu
- Microbiome Research Centre, St George and Sutherland Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Cassandra Mah
- Microbiome Research Centre, St George and Sutherland Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Sabrina Koentgen
- Microbiome Research Centre, St George and Sutherland Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Leo Zhang
- Microbiome Research Centre, St George and Sutherland Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael C Grimm
- Microbiome Research Centre, St George and Sutherland Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Emad El-Omar
- Microbiome Research Centre, St George and Sutherland Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Georgina L Hold
- Microbiome Research Centre, St George and Sutherland Clinical School, University of New South Wales, Sydney, New South Wales, Australia
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Rohwer N, Chiu CY, Huang D, Smyl C, Rothe M, Rund KM, Helge Schebb N, Kühn H, Weylandt KH. Omega-3 fatty acids protect from colitis via an Alox15-derived eicosanoid. FASEB J 2021; 35:e21491. [PMID: 33710695 DOI: 10.1096/fj.202002340rr] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/16/2021] [Accepted: 02/16/2021] [Indexed: 12/22/2022]
Abstract
An increased omega-3 polyunsaturated fatty acid (n-3 PUFA) tissue status can lead to a significant formation of anti-inflammatory lipid mediators and effective reduction in inflammation and tissue injury in murine colitis. Arachidonic acid lipoxygenases (ALOX) have been implicated in the pathogenesis of inflammatory bowel disease as well as in the formation of pro- and anti-inflammatory lipid mediators. To explore the role of Alox15 in the protective response found in fat1 transgenic mice with endogenously increased n-3 PUFA tissue status fat1 transgenic mice were crossed with Alox15-deficient animals and challenged in the dextran sulfate sodium (DSS)- and the 2,4,6-trinitrobenzene sulphonic acid (TNBS)-induced colitis model. Transgenic fat1 mice rich in endogenous n-3 PUFAs were protected from colitis. However, additional systemic inactivation of the Alox15 gene counteracted this protective effect. To explore the molecular basis for this effect Alox15 lipid metabolites derived from n-3 PUFA were analyzed in the different mice. Alox15 deficiency suppressed the formation of n-3 PUFA-derived 15-hydroxy eicosapentaenoic acid (15-HEPE). In contrast, treating mice with intraperitoneal injections of 15S-HEPE protected wild-type mice from DSS- and TNBS-induced colitis. These data suggest that the anti-colitis effect of increased n-3 PUFA in the transgenic fat1 mouse model is mediated in part via Alox15-derived 15-HEPE formation.
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Affiliation(s)
- Nadine Rohwer
- Division of Medicine, Department of Gastroenterology, Metabolism and Oncology, Ruppin General Hospital, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany.,Faculty of Health Sciences Brandenburg, Joint Faculty of the Brandenburg University of Technology Cottbus - Senftenberg, Brandenburg Medical School Theodor Fontane and University of Potsdam, Potsdam, Germany.,Division of Medicine, Department of Hepatology, Gastroenterology and Metabolism, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Molecular Toxicology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany
| | - Cheng-Ying Chiu
- Division of Medicine, Department of Hepatology, Gastroenterology and Metabolism, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Dan Huang
- Division of Medicine, Department of Hepatology, Gastroenterology and Metabolism, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Christopher Smyl
- Division of Medicine, Department of Hepatology, Gastroenterology and Metabolism, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | | | - Katharina M Rund
- Chair of Food Chemistry, Faculty of Mathematics and Natural Sciences, University of Wuppertal, Wuppertal, Germany
| | - Nils Helge Schebb
- Chair of Food Chemistry, Faculty of Mathematics and Natural Sciences, University of Wuppertal, Wuppertal, Germany
| | - Hartmut Kühn
- Institute of Biochemistry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Karsten-Henrich Weylandt
- Division of Medicine, Department of Gastroenterology, Metabolism and Oncology, Ruppin General Hospital, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany.,Faculty of Health Sciences Brandenburg, Joint Faculty of the Brandenburg University of Technology Cottbus - Senftenberg, Brandenburg Medical School Theodor Fontane and University of Potsdam, Potsdam, Germany.,Division of Medicine, Department of Hepatology, Gastroenterology and Metabolism, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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3
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Ran Z, Wu K, Matsuoka K, Jeen YT, Wei SC, Ahuja V, Chen M, Hu PJ, Andoh A, Kim HJ, Yang SK, Watanabe M, Ng SC, Hibi T, Hilmi IN, Suzuki Y, Han DS, Leung WK, Sollano J, Ooi CJ, Qian J. Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology practice recommendations for medical management and monitoring of inflammatory bowel disease in Asia. J Gastroenterol Hepatol 2021; 36:637-645. [PMID: 32672839 DOI: 10.1111/jgh.15185] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 05/05/2020] [Accepted: 05/12/2020] [Indexed: 02/06/2023]
Abstract
Inflammatory bowel disease (IBD) has increased in incidence and prevalence in Asian countries since the end of the 20th century. Moreover, differences in the cause, phenotypes, and natural history of IBD between the East and West have been recognized. Therefore, the Asian Organization for Crohn's and Colitis and the Asia Pacific Association of Gastroenterology have established recommendations on medical management of IBD in Asia. Initially, the committee members drafted 40 recommendations, which were then assessed according to Grading of Recommendations Assessment, Development and Evaluation. Eight statements were rejected as this indicated that consensus had not been reached. The recommendations encompass pretreatment evaluation; medical management of active IBD; medical management of IBD in remission; management of IBD during the periconception period and pregnancy; surveillance strategies for colitis-associated cancer; monitoring side effects of thiopurines and methotrexate; and infections in IBD.
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Affiliation(s)
- Zhihua Ran
- Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Kaichun Wu
- Department of Gastroenterology, Fourth Military Medical University, Xi'an, China
| | - Katsuyoshi Matsuoka
- Department of Gastroenterology, Toho University Sakura Medical Center, Chiba, Japan
| | - Yoon Tae Jeen
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Shu Chen Wei
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Vineet Ahuja
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - Minhu Chen
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Pin-Jin Hu
- Department of Gastroenterology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Akira Andoh
- Department of Gastroenterology, Shiga University, Otsu, Japan
| | - Hyo Jong Kim
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Suk-Kyun Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mamoru Watanabe
- Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Siew Chien Ng
- Department of Medicine and Therapeutics, Institute of Digestive Disease, LKS Institute of Health Science, State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Toshifumi Hibi
- Center for Advanced IBD Research and Treatment, Kitasato University, Tokyo, Japan
| | - Ida Normiha Hilmi
- Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yasuo Suzuki
- Department of Internal Medicine, Toho University, Sakura, Japan
| | - Dong Soo Han
- Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea
| | - Wai Keung Leung
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Hong Kong, Hong Kong
| | - Jose Sollano
- Department of Medicine, University of Santo Tomas, Manila, Philippines
| | - Choon Jin Ooi
- Gleneagles Medical Centre and Duke-NUS Medical School, Singapore
| | - Jiaming Qian
- Department of Gastroenterology, Peking Union Medical College, Beijing, China
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Chen Y, Wang Y, Shen J. Role of environmental factors in the pathogenesis of Crohn's disease: a critical review. Int J Colorectal Dis 2019; 34:2023-2034. [PMID: 31732875 DOI: 10.1007/s00384-019-03441-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/21/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To review role of environmental factors in the pathogenesis of Crohn's disease. METHODS We systematically reviewed trials and systematic reviews using PubMed and Web of science databases. Here, we review the current information on the causative factors and mechanisms of CD, including smoking, exercise, diet, animal protein, breastfeeding, history of childhood infection and vaccination, oral contraceptives, and antibiotics of CD. We also highlight important knowledge gaps that need to be filled in order to advance the field of CD research. RESULTS Epidemiological studies have indicated the significance of environmental factors in the disease behavior and outcome of Crohn's disease (CD). There are a few recognized environmental factors, such as cigarette smoking, exercise, dietary habits, and breastfeeding, which are associated with the pathogenesis of CD. These factors are hypothesized to change the epithelial barrier function, which disturbs both the innate and adaptive immune systems and the intestinal flora. However, the effect of several risk factors, such as appendectomy and pharmaceutical use, differs across several studies, indicating the need for more rigorous research. Furthermore, few studies have examined effective interventions based on environmental factors that can improve disease outcomes. Recent studies have indicated that the pathogenesis of CD is related to environmental and genetic factors. CONCLUSION We review the current information on the causative factors and mechanisms of CD, including smoking, exercise, diet, animal protein, breastfeeding, history of childhood infection and vaccination, oral contraceptives, and antibiotics of CD. However, further studies are needed to understand knowledge gaps in the field of CD.
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Affiliation(s)
- Yueying Chen
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Inflammatory Bowel Disease Research Center, Renji Hospital, School of Medicine Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, 160# Pu Jian Ave, Shanghai, 200127, China
| | - Yining Wang
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Inflammatory Bowel Disease Research Center, Renji Hospital, School of Medicine Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, 160# Pu Jian Ave, Shanghai, 200127, China
| | - Jun Shen
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Inflammatory Bowel Disease Research Center, Renji Hospital, School of Medicine Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, 160# Pu Jian Ave, Shanghai, 200127, China.
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Głąbska D, Guzek D, Kanarek B, Lech G. Analysis of Association Between Dietary Intake and Red Blood Cell Count Results in Remission Ulcerative Colitis Individuals. ACTA ACUST UNITED AC 2019; 55:medicina55040096. [PMID: 30965640 PMCID: PMC6524049 DOI: 10.3390/medicina55040096] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/30/2019] [Accepted: 04/03/2019] [Indexed: 12/17/2022]
Abstract
Background and objectives: The anemia is the most common extra-intestinal manifestation of the ulcerative colitis. Taking into account, that meat products are perceived as factor, that may promote relapses, the crucial is to indicate the dietary recommendations to prevent anemia development but without high animal products intake. Aim of the study was to analyze the influence of animal products intake on the red blood cell count results in remission ulcerative colitis individuals and pair-matched control group, during 6 weeks of observation. Materials and Methods: The intake of nutrients associated with anemia development (iron, vitamin B12, protein, animal protein, calcium) and the products being their sources (meat, meat products, dairy beverages, cottage cheese, rennet cheese) were analyzed. Results: In spite of the higher meat products intake in the group of ulcerative colitis individuals, the iron intake did not differ between groups. The positive correlations between intakes of meat, meat products, total protein, animal protein, iron, vitamin B12 and red blood cell count results were stated for ulcerative colitis individuals, while in control group were not observed, that may have resulted from higher susceptibility for the diet-influenced changes. Conclusions: The positive correlation between red blood cell count results and energy value of diet, and daily iron intake observed in ulcerative colitis individuals, accompanied by negative correlation for iron intake per 1000 kcal of diet, may indicate, that higher iron intake may be beneficial, but only while accompanied by high energy value of diet.
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Affiliation(s)
- Dominika Głąbska
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 02-776 Warsaw, Poland.
| | - Dominika Guzek
- Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 02-776 Warsaw, Poland.
| | - Barbara Kanarek
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 02-776 Warsaw, Poland.
| | - Gustaw Lech
- Department of General, Gastroenterological and Oncological Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland.
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Alrefai D, Jones J, El-Matary W, Whiting SJ, Aljebreen A, Mirhosseini N, Vatanparast H. The Association of Vitamin D Status with Disease Activity in a Cohort of Crohn's Disease Patients in Canada. Nutrients 2017; 9:nu9101112. [PMID: 29023388 PMCID: PMC5691728 DOI: 10.3390/nu9101112] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 09/28/2017] [Accepted: 10/06/2017] [Indexed: 02/07/2023] Open
Abstract
We determined the association between vitamin D status as 25hydroxyvitamin D [25(OH)D] and disease activity in a cohort of 201 Crohn’s Disease (CD) patients in Saskatoon, Canada over three years. The association between high-sensitivity C-reactive protein (hs-CRP) and 25(OH)D and several disease predictors were evaluated by the generalized estimating equation (GEE) over three time-point measurements. A GEE binary logistic regression test was used to evaluate the association between vitamin D status and the Harvey-Bradshaw Index (HBI). The deficient vitamin D group (≤29 nmol/L) had significantly higher mean hs-CRP levels compared with the three other categories of vitamin D status (p < 0.05). CRP was significantly lower in all of the other groups compared with the vitamin D-deficient group, which had Coef. = 12.8 units lower (95% CI −19.8, −5.8), Coef. 7.85 units (95% CI −14.9, −0.7), Coef. 9.87 units (95% CI −17.6, −2.0) for the vitamin D insufficient, adequate, and optimal groups, respectively. The vitamin D status was associated with the HBI active disease category. However, the difference in the odds ratio compared with the reference category of deficient vitamin D category was only significant in the insufficient category (odds ratio = 3.45, p = 0.03, 95% CI 1.0, 10.8). Vitamin D status was inversely associated with indicators of disease activity in Crohn’s disease, particularly with the objective measures of inflammation.
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Affiliation(s)
- Dania Alrefai
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5C9, Canada.
| | - Jennifer Jones
- Division of Digestive Care & Endoscopy, Department of Community Health and Epidemiology, Dalhousie University, Truro, NS B2N 5E3, Canada.
| | - Wael El-Matary
- College of Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
| | - Susan J Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5C9, Canada.
| | | | | | - Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5C9, Canada.
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Zhang W, Xu L, Cho SY, Min KJ, Oda T, Zhang L, Yu Q, Jin JO. Ginseng Berry Extract Attenuates Dextran Sodium Sulfate-Induced Acute and Chronic Colitis. Nutrients 2016; 8:199. [PMID: 27058552 PMCID: PMC4848668 DOI: 10.3390/nu8040199] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/25/2016] [Accepted: 03/29/2016] [Indexed: 12/25/2022] Open
Abstract
This study investigates the in vivo functions of ginseng berry extract (GB) as a therapy for dextran sodium sulfate (DSS)-induced colitis. C57BL/6 mice were given drinking water containing DSS (3%) for eight days to induce acute colitis. At the same time, the mice received an oral dose of GB (50 mg/kg) once daily. The GB-treated mice were less susceptible to the development of acute colitis than were control mice treated with saline, as determined by weight loss, disease activity, and colon histology. The administration of GB to DSS-treated mice also reduced the numbers and inhibited the activation of colon-infiltrating T cells, neutrophils, intestinal CD103(-)CD11c⁺ dendritic cells (cDCs), and macrophages. In addition, GB treatment promoted the migration of CD103⁺CD11c⁺ cDCs and expansion of Foxp3⁺ regulatory T cells in the colons of DSS-treated mice. Similarly, in the DSS-induced chronic colitis model, GB treatment improved the macroscopic and histological appearance of the colon wall when compared to untreated control mice, as indicated by longer colon length and lower histological scores. This is the first report to show that oral administration of GB suppresses immune activation and protects against experimentally induced colitis.
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Affiliation(s)
- Wei Zhang
- Shanghai Public Health Clinical Center, Shanghai Medical College, Fudan University, Shanghai 201508, China.
| | - Li Xu
- Shanghai Public Health Clinical Center, Shanghai Medical College, Fudan University, Shanghai 201508, China.
| | - Si-Young Cho
- R & D Unit, AmorePacific Corporation, 1920 Yonggudae-ro, Giheung-gu, Yongin-si, Gyeonggi-do 17074, Korea.
| | - Kyung-Jin Min
- Department of Biological Sciences, Inha University, Incheon 22212, Korea.
| | - Tatsuya Oda
- Division of Biochemistry, Faculty of Fisheries, Nagasaki University, Nagasaki 55001, Japan.
| | - LiJun Zhang
- Shanghai Public Health Clinical Center, Shanghai Medical College, Fudan University, Shanghai 201508, China.
| | - Qing Yu
- Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA.
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA.
| | - Jun-O Jin
- Shanghai Public Health Clinical Center, Shanghai Medical College, Fudan University, Shanghai 201508, China.
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Abstract
Scandinavian researchers have contributed to the present understanding of inflammatory bowel disease (IBD). Important epidemiological data and family risk factors have been reported from all the Nordic countries, original twin studies mainly from Denmark and Sweden, and relationships to cancer and surgery mostly from Sweden. In collaboration with the industry, development of medical compounds was for a long time in the front line of international research, and the Scandinavian countries participated in the clinical breakthrough of biologic treatment. At present, many Nordic centers are working in the forefront of IBD research. An increasing number of young investigators have entered the scene along with the extended distribution of University clinics and research laboratories in these countries. This presentation of IBD gives a brief overview in the fields of clinical epidemiology and molecular biology. Many areas are covered by International collaborations with partners from Nordic centers. IBD was a topic focused by the founders of Scandinavian Journal of Gastroenterology. After 50 years one may state that the journal's history reflects important pieces of scientific knowledge within these diseases. The early scope of Johannes Myren for IBD was shown through his work in the original World Association of Gastroenterology (OMG), and after 50 years we can clearly support the view that global perspectives in IBD are increasingly important.
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Affiliation(s)
- Morten H Vatn
- Institute of Clinical Medicine, Campus Ahus, University of Oslo , Oslo , Norway
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9
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Albenberg LG, Wu GD. Diet and the intestinal microbiome: associations, functions, and implications for health and disease. Gastroenterology 2014; 146:1564-72. [PMID: 24503132 PMCID: PMC4216184 DOI: 10.1053/j.gastro.2014.01.058] [Citation(s) in RCA: 406] [Impact Index Per Article: 40.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 01/24/2014] [Accepted: 01/31/2014] [Indexed: 12/13/2022]
Abstract
The mutual relationship between the intestinal microbiota and its mammalian host is influenced by diet. Consumption of various nutrients affects the structure of the microbial community and provides substrates for microbial metabolism. The microbiota can produce small molecules that are absorbed by the host and affect many important physiological processes. Age-dependent and societal differences in the intestinal microbiota could result from differences in diet. Examples include differences in the intestinal microbiota of breastfed vs formula-fed infants or differences in microbial richness in people who consume an agrarian plant-based vs a Western diet, which is high in meat and fat. We review how diet affects the structure and metabolome of the human intestinal microbiome and may contribute to health or the pathogenesis of disorders such as coronary vascular disease and inflammatory bowel disease.
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Affiliation(s)
| | - Gary D. Wu
- Corresponding Author: Gary D. Wu, M.D. Division of Gastroenterology Perelman School of Medicine University of Pennsylvania 915 BRB II/III 421 Curie Blvd Philadelphia, PA 19104 Phone: 215-898-0158 Fax: 215-573-2024
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10
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Gorospe EC, Oxentenko AS. Nutritional consequences of chronic diarrhoea. Best Pract Res Clin Gastroenterol 2012; 26:663-75. [PMID: 23384810 DOI: 10.1016/j.bpg.2012.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 10/24/2012] [Accepted: 11/02/2012] [Indexed: 01/31/2023]
Abstract
There is an undeniable link between gastrointestinal disorders and malnutrition. Chronic diarrhoea is one of the most common gastrointestinal conditions that can impact a patient's nutritional status. The nutritional consequences will depend on the cause of the diarrhoea as well as the location and extent of gastrointestinal involvement. In general, malabsorption plays a central role in the interaction between malnutrition and chronic diarrhoea. Malabsorption can result in both nutritional deficits and diarrhoea. With severe malnutrition, chronic diarrhoea can persist due to impaired immune function and poor mucosal recovery. Food intolerance and an inappropriate diet in the setting of malabsorption may also contribute to chronic diarrhoea. Patients may attribute their gastrointestinal symptoms to specific dietary intake, which can lead to self-imposed indiscriminate dietary restrictions. Therefore, disease-specific treatment in conjunction with appropriate nutritional counselling and intervention is recommended in the prevention and treatment of malnutrition in patients with chronic diarrhoea. Specialized nutritional support through enteral or parenteral administration may be required to treat severe caloric and micronutrient deficiencies. In this review, we aim to summarize the mechanism, diagnosis, and treatment of the nutritional consequences of chronic diarrhoea.
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Affiliation(s)
- Emmanuel C Gorospe
- Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, Rochester, MN, USA
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11
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Abstract
PURPOSE OF REVIEW The inflammatory bowel diseases (IBD) are chronic inflammatory diseases of the gastrointestinal tract apparently due to an abnormal immune response to environmental factors in genetically susceptible hosts. The composition of the gut microbiota is thought to be a critical environmental factor in IBD, and recent evidence suggests a connection between diet and the intestinal bacteria. In this review, we describe the current evidence regarding the impact of diet on the gut microbiome and how this may be relevant to the pathogenesis of IBD. RECENT FINDINGS Novel culture-independent DNA sequencing technology has revolutionized the approach to the characterization of intestinal bacterial communities. Recent studies have demonstrated an association between the diet and the human microbiome. Because the development of a 'dysbiotic' microbiota is thought to be involved in the pathogenesis of IBD, diet is being investigated as an important etiologic factor. SUMMARY The recent studies highlighting the impact of diet on the gut microbiome provide a strong rationale for further investigation of the link between diet, the gut microbiome, and the development of IBD. Such studies may provide novel information about disease pathogenesis as well as identify new therapeutic alternatives for patients suffering from IBD.
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12
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Guidelines for the management of inflammatory bowel disease in children in the United Kingdom. J Pediatr Gastroenterol Nutr 2010; 50 Suppl 1:S1-13. [PMID: 20081543 DOI: 10.1097/mpg.0b013e3181c92c53] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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13
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Elia PP, Fogaça HS, Barros RGGR, Zaltman C, Elia CSC. [Descriptive analysis of the social, clinical, laboratorial and anthropometric profiles of inflammatory bowel disease inwards patients from the "Clementino Fraga Filho" University Hospital, Rio de Janeiro, RJ, Brazil]. ARQUIVOS DE GASTROENTEROLOGIA 2008; 44:332-9. [PMID: 18317653 DOI: 10.1590/s0004-28032007000400010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2005] [Accepted: 04/03/2007] [Indexed: 12/22/2022]
Abstract
BACKGROUND The epidemiologic survey in Brazil is limited probably due to a diagnosis deficiency and a small number of population-based studies performed. The majority of the prevalence studies available have evaluated inflammatory bowel diseases outpatients, but the knowledge of the profile of inflammatory bowel diseases inpatients is important in order to detect predictive markers of disease severity that will allow earlier medical intervention decreasing the rate of hospitalization and reducing the Health System costs. AIM To determine social, clinical, laboratorial and anthropometric profiles of hospitalized adults inflammatory bowel diseases patients of a tertiary university hospital. METHODS Prospective study was performed with 43 inflammatory bowel diseases inpatients from clinical and surgical wards and emergency section of university hospital. We characterized demographic data, presence of comorbidities, disease location and behavior, surgical past-history, extra intestinal manifestations using standardized definitions. Laboratory results were abstracted from medical records and anthropometric measures were performed during our visit. RESULTS The vast majority of the inflammatory bowel diseases patients had Crohn's disease (72.1%), with ileocolic involvement (60%), with a penetrating disease behavior (77.4%) while ulcerative colitis group presented mostly pancolitis (50%). Articular pain was the most common (44.2%) extra intestinal manifestation of inflammatory bowel diseases patients and 97.7% of them had at least one type of complication related to disease. Although, the previous use of specific medical therapies to inflammatory bowel diseases before the hospitalization (more frequently corticosteroids) was done (79%), the majority of the patients were hospitalized because of inflammatory bowel diseases activity. Disease activity was present in 80.7% of Crohn's disease and 50% ulcerative colitis patients. Inflammatory bowel diseases mortality rate was 5.5% (2/36). Comorbidities presence occurred only in 30.2% of inflammatory bowel diseases patients. The predominant surgery performed was intestinal resection. The interval between the symptoms appearance and the definitive diagnosis was less than 1 year in more than 70% of inflammatory bowel diseases patients. Laboratory findings detected were a decreased serum albumin (85.7%) and anemia (69.8%). The majority of the patients had at least one anthropometric alteration. The social stratification of the inflammatory bowel diseases group was similar to the Brazilian population. CONCLUSION The inflammatory bowel diseases inpatients from the university hospital wards had more severe evolution of these illnesses with an active and extensive disease with complications and frequent extra intestinal manifestations, despite the prolonged use of corticosteroids. The higher prevalence of Crohn's disease inpatients than ulcerative colitis could reflect a higher aggressive behavior of this disease. The reduced serum albumin, anemia and anthropometric alterations are common inflammatory bowel diseases inpatients and could be related to a major severity of inflammatory bowel diseases evolution.
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Affiliation(s)
- Paula Peruzzi Elia
- Serviço de Endoscopia Digestiva Pediátrica, Departamento de Cirurgia Pediátrica, Instituto Fernandes Figueira, Fiocruz, Brazil.
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De Schepper HU, De Man JG, Moreels TG, Pelckmans PA, De Winter BY. Review article: gastrointestinal sensory and motor disturbances in inflammatory bowel disease - clinical relevance and pathophysiological mechanisms. Aliment Pharmacol Ther 2008; 27:621-37. [PMID: 18221407 DOI: 10.1111/j.1365-2036.2008.03624.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND It is well known that inflammation has a profound impact on the neuromuscular apparatus of the gastrointestinal tract during the inflammatory insult and in periods of remission, at the site of inflammation and at distance from this site. The importance of this interaction is illustrated by the higher prevalence of functional gut disorders in patients with inflammatory bowel disease. AIMS To document the epidemiological and clinical significance of functional alterations of gut motility and sensitivity in patients with inflammatory bowel disease and to formulate potential pathophysiological mechanisms. RESULTS AND CONCLUSIONS Functional gut disorders occur frequently in patients with inflammatory bowel disease, both during inflammatory episodes and in periods of remission, and have a major impact on their quality of life. The clinical manifestations of these motility and sensitivity disorders vary and are often difficult to treat, mainly because therapeutic guidelines and specific diagnostic tests to distinguish inflammatory bowel disease from functional gut disorders are lacking. Chronic bowel inflammation results in a complicated interaction between neuroendocrine serotonin-predominant cells of the mucosa, inflammatory cells (particularly mast cells) in the submucosa, the intrinsic and extrinsic innervation and the muscular apparatus including the interstitial cells of Cajal. The outcome of this interaction is a perturbation of gastrointestinal motor function, both locally and at distance from the site of inflammation and during both acute inflammation and remission.
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Affiliation(s)
- H U De Schepper
- Laboratory of Experimental Medicine and Pediatrics, Division of Gastroenterology, University of Antwerp, Antwerp, Belgium
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Kawakami Y, Murakami Y, Kawakami T, Muroyama N, Takiue T, Moritani Y, Okita M. Abnormal Fatty Acid Profile of Blood Cell Phospholipids and Dietary Fatty Acid Intake in Patients with Ulcerative Colitis. J Clin Biochem Nutr 2005. [DOI: 10.3164/jcbn.37.95] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Oz HS, Ray M, Chen TS, McClain CJ. Efficacy of a Transforming Growth Factor β2 Containing Nutritional Support Formula in a Murine Model of Inflammatory Bowel Disease. J Am Coll Nutr 2004; 23:220-6. [PMID: 15190046 DOI: 10.1080/07315724.2004.10719364] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Dietary, environmental and genetic events may influence host susceptibility to inflammatory bowel diseases (IBD). Transforming growth factor beta 2 (TGF-beta 2), a multifunctional polypeptide (cytokine) present in human and bovine milk, plays a critical role in the development of tolerance, the prevention of autoimmunity, and in anti-inflammatory responses. TGF-beta 2 is a potent inhibitor of intestinal epithelial cell (IEC) growth and stimulates IEC differentiation. The objective of this study was to determine whether a diet containing TGF-beta 2 modulates intestinal injury and immune responses in an Interleukin-10 knockout (IL-10-/-) mouse model of IBD. METHODS Five-week-old IL-10-/- mice (in BALB/c background) reared in our transgenic facility were fed either an enteral diet (Diet-A) containing TGF-beta 2 or a control enteral diet (Diet-B) not rich in TGF-beta 2. Mice were weighed weekly, monitored for illness and euthanized after eight weeks on the diet. RESULTS Final weights were 28 +/- 1.2 g (58.2% gain) for Diet-A mice and 23 +/- 1.6 g (32.9% gain) for Diet-B mice (p = 0.0194). The hematocrits were 48.3% for Diet-A compared to 42% for Diet-B mice (p = 0.0021). Mice on Diet-A had significantly lower serum TNF-alpha concentrations. Forty-four percent of mice on Diet-B developed severe diarrhea and rectal prolapse compared with none on Diet-A. Evaluation of intestinal pathology (score 0-4) revealed that animals fed Diet-A had a score of 2.1 +/- 0.4 compared to 3.2 +/- 0.36 in the Diet-B group (p = 0.040). The acute phase protein, serum amyloid A (SAA), was 3.8 times higher in the Diet-B group (p = 0.0038). CONCLUSIONS IL-10-/- mice fed a TGF-beta 2 containing diet gained more weight, did not develop diarrhea or prolapse, had lower pathological scores, and lower SAAs. These data further support the use of TGF-beta 2 containing enteral diets as one mode of therapy for Crohn's disease.
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Affiliation(s)
- Helieh S Oz
- Department of Medicine, Section of Gastroenterology/Nutrition, Rush University Medical Center, Chicago, Illinois 60612, USA.
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