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El-Sayed A, Kapila D, Taha RSI, El-Sayed S, Mahen MRA, Taha R, Alrubaiy L. The Role of the Gut Microbiome in Inflammatory Bowel Disease: The Middle East Perspective. J Pers Med 2024; 14:652. [PMID: 38929872 PMCID: PMC11204866 DOI: 10.3390/jpm14060652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 06/08/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
The gut microbiome is of paramount importance in preserving internal balance in the gastrointestinal tract; therefore, disruptions in its regulation have been linked to the development of inflammatory bowel disease (IBD). This article explores the intricate details of the gastrointestinal microbiome as it pertains to inflammatory bowel disease (IBD), with an emphasis on the Middle East. The study reviews the typical gut microbiome, modifications in inflammatory bowel disease (IBD), determinants impacting the gut microbiome of the Middle East, and prospective therapeutic interventions.
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Affiliation(s)
- Ahmed El-Sayed
- Hillingdon Hospital NHS Trust, London UB8 3NN, UK; (A.E.-S.); (D.K.)
| | - Diya Kapila
- Hillingdon Hospital NHS Trust, London UB8 3NN, UK; (A.E.-S.); (D.K.)
| | - Rama Sami Issa Taha
- Healthpoint Hospital, Abu Dhabi P.O. Box 112308, United Arab Emirates; (R.S.I.T.); (R.T.)
| | | | - Mohd Rafiw Ahmed Mahen
- Department of Medicine, King’s College Hospital London, Dubai P.O. Box 340901, United Arab Emirates;
| | - Roa’a Taha
- Healthpoint Hospital, Abu Dhabi P.O. Box 112308, United Arab Emirates; (R.S.I.T.); (R.T.)
| | - Laith Alrubaiy
- Healthpoint Hospital, Abu Dhabi P.O. Box 112308, United Arab Emirates; (R.S.I.T.); (R.T.)
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates
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Chikhoune L, Morell Dubois S, Ledoult E, Launay D, Hachulla E, Lambert M, Yelnik C, Maillard H, Terriou L, Nicolas A, Cebrian R, Despre M, Sobanski V, Farhat MM. [HYPNOSTRESS study: Interest of medical hypnosis in the evaluation of perceived stress and the experience of hospitalization in an internal medicine department]. Rev Med Interne 2024:S0248-8663(24)00635-0. [PMID: 38849231 DOI: 10.1016/j.revmed.2024.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 05/06/2024] [Accepted: 05/29/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Patients with chronic illnesses, especially rare autoimmune and/or systemic diseases associated with significant diagnostic uncertainty, have a representation of their illness and a sometimes prolonged hospitalization experience that can be traumatic and anxiety-provoking. OBJECTIVE The aim of this study was to evaluate the impact of a non-medicinal medical hypnosis intervention in reducing the stress state and improving the experience of patients hospitalized in an internal medicine department. METHODS We conducted a prospective study of 24 patients hospitalized in the Internal Medicine Department of Lille University Hospital in 2023. Twelve patients received a non-drug medical hypnosis intervention known as the "place of safety" (case group) and were compared with 12 patients who did not (control group). Stress was assessed by the STAI questionnaire and hospitalization experience by a satisfaction questionnaire. RESULTS The 24 patients, 13 of whom were women, had a mean age of 55±17 years at inclusion. On admission to hospital, the median STAI-ETAT between the two groups was 43.5 (38.0; 56.6) in the case group versus 42.0 (37.0; 48.5) in the control group (P=0.45). In the case group, the median STAI-ETAT questionnaire taken immediately after the hypnosis session was significantly lower than at the start of hospitalization (30.0 [25.5; 36.5] vs. 43.5 [38.0; 56.5] P=0.003), indicating a significant reduction in stress. At the end of hospitalization, there was also a significant persistence of the median significant reduction between cases and controls (29.5 [26.5; 35.0] for cases vs. 41.5 [33.5; 45.5] for controls P=0.002). Experience of hospitalization was better in the case group (median 5.0 [4.5; 5.0] vs. 4.0 [4.0; 4.5], P=0.016). CONCLUSION This study suggests that medical hypnosis is a promising non-medicinal supportive intervention for reducing perceived stress and improving the experience of stress in patients hospitalized on an internal medicine ward.
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Affiliation(s)
- L Chikhoune
- Service de médecine interne et immunologie clinique, centre de référence des maladies auto-immunes et auto-inflammatoires systémiques rares de l'adulte Nord, Nord-Ouest, Méditerranée et Guadeloupe, CHU de Lille, 59000 Lille, France.
| | - S Morell Dubois
- Service de médecine interne et immunologie clinique, centre de référence des maladies auto-immunes et auto-inflammatoires systémiques rares de l'adulte Nord, Nord-Ouest, Méditerranée et Guadeloupe, CHU de Lille, 59000 Lille, France
| | - E Ledoult
- Service de médecine interne et immunologie clinique, centre de référence des maladies auto-immunes et auto-inflammatoires systémiques rares de l'adulte Nord, Nord-Ouest, Méditerranée et Guadeloupe, CHU de Lille, 59000 Lille, France; U1286-INFINITE-Institute for Translational Research in Inflammation, université de Lille, 59000 Lille, France; Inserm, 59000 Lille, France
| | - D Launay
- Service de médecine interne et immunologie clinique, centre de référence des maladies auto-immunes et auto-inflammatoires systémiques rares de l'adulte Nord, Nord-Ouest, Méditerranée et Guadeloupe, CHU de Lille, 59000 Lille, France; U1286-INFINITE-Institute for Translational Research in Inflammation, université de Lille, 59000 Lille, France; Inserm, 59000 Lille, France
| | - E Hachulla
- Service de médecine interne et immunologie clinique, centre de référence des maladies auto-immunes et auto-inflammatoires systémiques rares de l'adulte Nord, Nord-Ouest, Méditerranée et Guadeloupe, CHU de Lille, 59000 Lille, France; U1286-INFINITE-Institute for Translational Research in Inflammation, université de Lille, 59000 Lille, France; Inserm, 59000 Lille, France
| | - M Lambert
- Service de médecine interne et immunologie clinique, centre de référence des maladies auto-immunes et auto-inflammatoires systémiques rares de l'adulte Nord, Nord-Ouest, Méditerranée et Guadeloupe, CHU de Lille, 59000 Lille, France
| | - C Yelnik
- Service de médecine interne et immunologie clinique, centre de référence des maladies auto-immunes et auto-inflammatoires systémiques rares de l'adulte Nord, Nord-Ouest, Méditerranée et Guadeloupe, CHU de Lille, 59000 Lille, France
| | - H Maillard
- Service de médecine interne et immunologie clinique, centre de référence des maladies auto-immunes et auto-inflammatoires systémiques rares de l'adulte Nord, Nord-Ouest, Méditerranée et Guadeloupe, CHU de Lille, 59000 Lille, France
| | - L Terriou
- Service de médecine interne et immunologie clinique, centre de référence des maladies auto-immunes et auto-inflammatoires systémiques rares de l'adulte Nord, Nord-Ouest, Méditerranée et Guadeloupe, CHU de Lille, 59000 Lille, France
| | - A Nicolas
- Service de médecine interne et immunologie clinique, centre de référence des maladies auto-immunes et auto-inflammatoires systémiques rares de l'adulte Nord, Nord-Ouest, Méditerranée et Guadeloupe, CHU de Lille, 59000 Lille, France
| | - R Cebrian
- Service de médecine interne et immunologie clinique, centre de référence des maladies auto-immunes et auto-inflammatoires systémiques rares de l'adulte Nord, Nord-Ouest, Méditerranée et Guadeloupe, CHU de Lille, 59000 Lille, France
| | - M Despre
- Service de médecine interne, CHU d'Angers, 49100 Angers, France
| | - V Sobanski
- Service de médecine interne et immunologie clinique, centre de référence des maladies auto-immunes et auto-inflammatoires systémiques rares de l'adulte Nord, Nord-Ouest, Méditerranée et Guadeloupe, CHU de Lille, 59000 Lille, France; U1286-INFINITE-Institute for Translational Research in Inflammation, université de Lille, 59000 Lille, France; Inserm, 59000 Lille, France
| | - M-M Farhat
- Service de médecine interne et immunologie clinique, centre de référence des maladies auto-immunes et auto-inflammatoires systémiques rares de l'adulte Nord, Nord-Ouest, Méditerranée et Guadeloupe, CHU de Lille, 59000 Lille, France; U1286-INFINITE-Institute for Translational Research in Inflammation, université de Lille, 59000 Lille, France; Inserm, 59000 Lille, France
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Thavorn K, Wolfe D, Faust L, Shorr R, Akkawi M, Isaranuwatchai W, Klinger C, Chai-Adisaksopa C, Tanvejsilp P, Nochaiwong S, Straus S, Hutton B. A systematic review of the efficacy and safety of turmeric in the treatment of digestive disorders. Phytother Res 2024; 38:2687-2706. [PMID: 38503513 PMCID: PMC11168884 DOI: 10.1002/ptr.8189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 02/24/2024] [Accepted: 03/02/2024] [Indexed: 03/21/2024]
Abstract
Turmeric has been gaining popularity as a treatment option for digestive disorders, although a rigorous synthesis of efficacy has not been conducted. This study aimed to summarize the evidence for the efficacy and safety of turmeric in the treatment of digestive disorders, including inflammatory bowel diseases (IBD), irritable bowel syndrome (IBS), dyspepsia, gastroesophageal reflux disease, and peptic ulcers. Literature searches were conducted in Medline, EMBASE, AMED, the Cochrane Central Register of Control Trials, and Dissertation Abstracts from inception to November 15, 2021. Dual independent screening of citations and full texts was conducted and studies meeting inclusion criteria were retained: randomized controlled trials (RCT) and comparative observational studies evaluating turmeric use in people of any age with one of the digestive disorders of interest. Extraction of relevant data and risk of bias assessments were performed by two reviewers independently. Meta-analysis was not conducted due to high heterogeneity. From 1136 citations screened, 26 eligible studies were retained. Most studies were assessed to have a high risk of bias, and many had methodological limitations. Descriptive summaries suggest that turmeric is safe, with possible efficacy in patients with IBD or IBS, but its effects were inconsistent for other conditions. The efficacy of turmeric in digestive disorders remains unclear due to the high risk of bias and methodological limitations of the included studies. Future studies should be designed to include larger sample sizes, use rigorous statistical methods, employ core outcome sets, and adhere to reporting guidance for RCTs of herbal interventions to facilitate more meaningful comparisons and robust conclusions.
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Affiliation(s)
- Kednapa Thavorn
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa Methods Centre, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
| | - Dianna Wolfe
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa Methods Centre, Ottawa, Canada
| | - Lena Faust
- McGill International Tuberculosis Centre, McGill University, Montreal, Quebec, Canada
| | - Risa Shorr
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa Methods Centre, Ottawa, Canada
| | - Maya Akkawi
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa Methods Centre, Ottawa, Canada
| | - Wanrudee Isaranuwatchai
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Bangkok, Thailand
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Christopher Klinger
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
- Institute for Life Course and Aging, University of Toronto
- National Initiative for the Care of the Elderly (NICE), Toronto, Canada
| | | | - Pimwara Tanvejsilp
- Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkla, Thailand
| | - Surapon Nochaiwong
- Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
| | - Sharon Straus
- St. Michael’s Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Brian Hutton
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa Methods Centre, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
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Ma Y, Yang D, Huang J, Liu K, Liu H, Wu H, Bao C. Probiotics for inflammatory bowel disease: Is there sufficient evidence? Open Life Sci 2024; 19:20220821. [PMID: 38585636 PMCID: PMC10998680 DOI: 10.1515/biol-2022-0821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/26/2023] [Accepted: 12/11/2023] [Indexed: 04/09/2024] Open
Abstract
Inflammatory bowel disease (IBD) refers to chronic inflammatory disorders of the gut. Ulcerative colitis (UC) and Crohn's disease (CD) are two subtypes of IBD. Evidence suggests that the intestinal microbiota plays a role in the pathogenesis of IBD, so probiotics have garnered a lot of interest as a potential treatment or prevention for IBD. However, clinical evidence of the efficacy of probiotics is still debatable. We performed a literature review. An advanced search considered clinical studies on probiotic for IBD from inception to 2023 in PubMed, Embase, Cochrane Library, and Web of Science. In the treatment of UC with probiotics, only Escherichia coli Nissle 1917 for maintenance treatment of UC in remission, and Bifidobacterium and VSL#3 for induction of remission in patients with mild to moderately active UC have shown strong evidence. Currently, there are no definitive conclusions regarding the effectiveness of probiotics in CD. The mechanism of probiotic treatment for IBD may be related to reducing oxidative stress, repairing the intestinal barrier, regulating intestinal flora balance, and modulating intestinal immune response. Differences in the benefits of probiotics between CD and UC may be attributable to the different lesion extent and immune-mediated pathophysiology. More robust randomized clinical trials are required to validate the efficacy and safety of diverse probiotic strains in IBD.
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Affiliation(s)
- Yueying Ma
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai200437, China
- Shanghai University of Traditional Chinese Medicine, Shanghai201203, China
| | - Dandan Yang
- Hong Kong Baptist University, Hong Kong999077, China
| | - Jin Huang
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai200437, China
- Shanghai University of Traditional Chinese Medicine, Shanghai201203, China
| | - Kunli Liu
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai200437, China
- Shanghai University of Traditional Chinese Medicine, Shanghai201203, China
| | - Huirong Liu
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai200437, China
- Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai200030, China
| | - Huangan Wu
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai200437, China
- Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai200030, China
| | - Chunhui Bao
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai200437, China
- Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai200030, China
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Iablokov V, Gregor J, Chande N, Ponich T, Jairath V, Khanna R, Asfaha S. Cannabis Use in Patients With Inflammatory Bowel Disease Following Legalization of Cannabis in Canada. CROHN'S & COLITIS 360 2024; 6:otae031. [PMID: 38800569 PMCID: PMC11120235 DOI: 10.1093/crocol/otae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Indexed: 05/29/2024] Open
Abstract
Background Cannabis is used by patients with Crohn's disease (CD) and ulcerative colitis (UC) as an alternative to, or in combination with, conventional therapies to treat symptoms such as abdominal pain, poor sleep, and reduced appetite. The clinical efficacy of cannabis for these disorders is controversial, with some studies showing harmful outcomes associated with its use. Previous studies suggest that cannabis is used by ~12% of patients with UC and ~16% of patients with CD in the USA despite legal prohibition. Methods We conducted a prospective cohort study of adult patients with inflammatory bowel diseases (IBD) followed in a Canadian tertiary care center. Patients completed an online 40-question survey that included demographics, IBD disease history, cannabis use, and the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Results Completed surveys were obtained from 254 participants (148 with CD, 90 with UC, and 16 with indeterminate colitis). Recent cannabis use was reported by 41% of CD and 31% of UC participants. Interestingly, only 46% of participants who used cannabis discussed their use with their physician. Participants who recently used cannabis reported more abdominal pain, poor appetite, and flatulence, and importantly this was associated with lower SIBDQ scores (recent use 37 vs non-recent use 40). Conclusions Cannabis use among patients with IBD has more than doubled since its legalization. Cannabis use is associated with worse abdominal symptoms and quality of life. Physicians should inquire about cannabis use and optimize symptom control with evidence-based therapies.
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Affiliation(s)
- Vadim Iablokov
- Division of Gastroenterology, Department of Medicine, University of Western Ontario, Lawson Health Research Institute, London, ON, Canada
| | - Jamie Gregor
- Division of Gastroenterology, Department of Medicine, University of Western Ontario, Lawson Health Research Institute, London, ON, Canada
| | - Nilesh Chande
- Division of Gastroenterology, Department of Medicine, University of Western Ontario, Lawson Health Research Institute, London, ON, Canada
| | - Terry Ponich
- Division of Gastroenterology, Department of Medicine, University of Western Ontario, Lawson Health Research Institute, London, ON, Canada
| | - Vipul Jairath
- Division of Gastroenterology, Department of Medicine, University of Western Ontario, Lawson Health Research Institute, London, ON, Canada
| | - Reena Khanna
- Division of Gastroenterology, Department of Medicine, University of Western Ontario, Lawson Health Research Institute, London, ON, Canada
| | - Samuel Asfaha
- Division of Gastroenterology, Department of Medicine, University of Western Ontario, Lawson Health Research Institute, London, ON, Canada
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Jin J, Ye X, Huang Z, Jiang S, Lin D. Curcumin@Fe/Tannic Acid Complex Nanoparticles for Inflammatory Bowel Disease Treatment. ACS OMEGA 2024; 9:14316-14322. [PMID: 38559927 PMCID: PMC10976392 DOI: 10.1021/acsomega.3c10214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/25/2024] [Accepted: 03/05/2024] [Indexed: 04/04/2024]
Abstract
Inflammatory bowel disease (IBD) is a serious public health issue because of its chronic and incurable nature. Common IBD drugs have limited efficacy and produce adverse effects, leading to an urgent need to develop new drugs and drug delivery systems. Curcumin (Cur) is a natural and nontoxic drug that is increasingly used in the treatment of IBD owing to its anti-inflammatory and antioxidant effects. Metal-polyphenol networks constructed from metal ions and polyphenols exhibit biological functionality while acting as an adhesive nanomaterial to encapsulate nano-Cur, thereby improving its solubility and drug release behavior. In this study, we prepared a Cur@Fe&TA nanodrug delivery system by constructing an Fe3+/tannic acid (TA) metal-polyphenol network with encapsulated Cur. The Cur@Fe&TA nanodrug exhibited good stability, drug release behavior, and biocompatibility. Based on the anti-inflammatory and antioxidant effects of Cur@Fe&TA, the gastrointestinal cytopathology in an IBD mouse model was effectively improved. The proposed Cur@Fe&TA nanomedicine delivery system has promising application and research value for the treatment of IBD by regulating levels of antioxidants and inflammatory cytokines.
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Affiliation(s)
- Jiman Jin
- The Third Affiliated Hospital
of Wenzhou Medical University, Wenzhou 325200, China
| | - Xiuzhi Ye
- The Third Affiliated Hospital
of Wenzhou Medical University, Wenzhou 325200, China
| | - Zhenfeng Huang
- The Third Affiliated Hospital
of Wenzhou Medical University, Wenzhou 325200, China
| | - Shicui Jiang
- The Third Affiliated Hospital
of Wenzhou Medical University, Wenzhou 325200, China
| | - Dini Lin
- The Third Affiliated Hospital
of Wenzhou Medical University, Wenzhou 325200, China
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Seymenska D, Teneva D, Nikolova I, Benbassat N, Denev P. In Vivo Anti-Inflammatory and Antinociceptive Activities of Black Elder ( Sambucus nigra L.) Fruit and Flower Extracts. Pharmaceuticals (Basel) 2024; 17:409. [PMID: 38675372 PMCID: PMC11054073 DOI: 10.3390/ph17040409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/15/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
Sambucus nigra L. (S. nigra, SN) or black elder is a traditional medicinal plant widely used worldwide for therapeutic and dietary purposes. The aim of the current study was to investigate the anti-inflammatory and antinociceptive activities of black elder fruit and flower extracts (SNFrE and SNFlE, respectively). The primary polyphenol constituents in the flower extract were flavonoids and phenolic acids, while anthocyanins were the main components in the fruit extract. SNFrE revealed pronounced and dose-dependent in vivo anti-inflammatory activity assessed by the cotton pellet-induced granuloma test. Doses of 10, 20, and 50 mg/kg BW of SNFrE reduced the weight of induced granuloma in rats by 20.3%, 20.5%, and 28.4%, respectively. At the highest dose (50 mg/kg BW), SNFrE had significant (p < 0.01) anti-inflammatory activity comparable to that of diclofenac, the reference compound used (10 mg/kg BW). In addition, the in vivo antinociceptive activity of the extracts in mice was estimated using the acetic-acid-induced writhing test. Both extracts at doses of 50 mg/kg BW inhibited the abdominal contractions induced by the acetic acid significantly comparing to the control group (p < 0.01). Our findings indicate that black elder extracts and particularly SNFrE possess anti-inflammatory and antinociceptive activities, providing experimental evidence for the use of S. nigra in traditional medicine.
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Affiliation(s)
- Daniela Seymenska
- Department of Pharmacognosy and Pharmaceutical Chemistry, Faculty of Pharmacy, Medical University-Plovdiv, 4002 Plovdiv, Bulgaria or (D.S.); (N.B.)
| | - Desislava Teneva
- Laboratory of Biologically Active Substances, Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences, 139 Ruski Blvd., 4000 Plovdiv, Bulgaria;
| | - Irina Nikolova
- Department of Pharmacology, Pharmacotherapy and Toxicology, Faculty of Pharmacy, Medical University-Sofia, 1000 Sofia, Bulgaria;
| | - Niko Benbassat
- Department of Pharmacognosy and Pharmaceutical Chemistry, Faculty of Pharmacy, Medical University-Plovdiv, 4002 Plovdiv, Bulgaria or (D.S.); (N.B.)
| | - Petko Denev
- Laboratory of Biologically Active Substances, Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences, 139 Ruski Blvd., 4000 Plovdiv, Bulgaria;
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8
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Li Y, Zhou W, Chen W, Deng B, You J. Efficacy and safety of moxibustion for ulcerative colitis: protocol for a systematic review and meta-analysis. BMJ Open 2024; 14:e078878. [PMID: 38503422 PMCID: PMC10952919 DOI: 10.1136/bmjopen-2023-078878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 02/29/2024] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION Ulcerative colitis (UC) is a global chronic inflammatory bowel disease, and the poor efficacy of currently available pharmacological regimens makes the management of UC a great challenge. Moxibustion has shown great potential in the management of UC. However, its effectiveness and safety are still controversial. The purpose of this study is to synthesise the latest evidence regarding the clinical efficacy and safety of moxibustion for UC. METHODS AND ANALYSIS The Cochrane Library, PubMed, EMBASE, CNKI, Wanfang, VIP and SinoMed databases will be searched from inception to July 2023, to identify all randomised controlled trials with moxibustion for UC. The primary outcome will be clinical efficacy, as measured by validated scales. The serum inflammatory factor, colonoscopy results, quality of life, recurrence rate and adverse events will be the secondary outcomes. The Cochrane Risk of Bias 2.0 tool will be used to assess the methodological quality of each included trial. All data extraction will be carried out independently by two investigators. RevMan V.5.4 software will be used for data analysis and Cochran's Q statistic and I2 test will be used to assess heterogeneity between studies. In addition, we will perform subgroup analyses, sensitivity analyses and publication bias if the available data are sufficient. The strength of evidence will be graded using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. ETHICS AND DISSEMINATION Ethics approval is not required for this review. Our findings will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42023425481.
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Affiliation(s)
- Yanzhen Li
- School of Clinical Medicine, Nanchang Medical College, Nanchang, Jiangxi, China
| | - Wen Zhou
- Scientific Research Division, Nanchang Medical College, Nanchang, Jiangxi, China
| | - Wenxiao Chen
- Scientific Research Division, Nanchang Medical College, Nanchang, Jiangxi, China
| | - Bailing Deng
- Formula-pattern Research Center, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Jianyu You
- School of Acupuncture-Moxibustion and Tuina, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
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Gheonea TC, Oancea CN, Mititelu M, Lupu EC, Ioniță-Mîndrican CB, Rogoveanu I. Nutrition and Mental Well-Being: Exploring Connections and Holistic Approaches. J Clin Med 2023; 12:7180. [PMID: 38002792 PMCID: PMC10672474 DOI: 10.3390/jcm12227180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/10/2023] [Accepted: 11/18/2023] [Indexed: 11/26/2023] Open
Abstract
Quality of life, well-being, and psycho-emotional balance are closely related to the quality of the diet, the level of physical activity, the quality of rest, but also the absence of the consumption of narcotic substances and tobacco, or alcohol abuse. Based on the distribution of a questionnaire that included 30 questions, we aimed to statistically evaluate several factors that influence mental health and vices. It recorded a total of 1719 valid responses, which came from 78.3% female respondents and 21.7% male respondents. After processing the anthropometric data, it was observed that the majority of respondents are of normal weight (63.87%) and come from women in particular (36.13%). Based on the answers recorded, although over 60% of the respondents participating in the study are up to 40 years old, there is an increased tendency towards sedentarism (over 58% of the respondents declaring that they do sports very rarely or not at all), a low tendency regarding optimal consumption of vegetables and fruits, many respondents do not hydrate properly, which is why approximately 60% of respondents feel frequently tired, and over 32% are frequently nervous. The increased level of stress among the respondents and emotional eating are also generated by inadequate rest, reduced physical activity, and a diet that does not help the efficient detoxification of the body.
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Affiliation(s)
- Theodora Claudia Gheonea
- Center for IBD Patients, Faculty of Medicine, University of Medicine and Pharmacy from Craiova, 200345 Craiova, Romania; (T.C.G.); (I.R.)
| | - Carmen-Nicoleta Oancea
- Department of Biochemistry, Faculty of Medicine, University of Medicine and Pharmacy from Craiova, 200345 Craiova, Romania;
| | - Magdalena Mititelu
- Department of Clinical Laboratory and Food Safety, Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, 020956 Bucharest, Romania
| | - Elena Carmen Lupu
- Department of Mathematics and Informatics, Faculty of Pharmacy, “Ovidius” University of Constanta, 900001 Constanta, Romania
| | - Corina-Bianca Ioniță-Mîndrican
- Department of Toxicology, Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, 020945 Bucharest, Romania;
| | - Ion Rogoveanu
- Center for IBD Patients, Faculty of Medicine, University of Medicine and Pharmacy from Craiova, 200345 Craiova, Romania; (T.C.G.); (I.R.)
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Alemu BK, Azeze GG, Wu L, Lau SL, Wang CC, Wang Y. Effects of maternal probiotic supplementation on breast milk microbiome and infant gut microbiome and health: a systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol MFM 2023; 5:101148. [PMID: 37660760 DOI: 10.1016/j.ajogmf.2023.101148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/18/2023] [Accepted: 08/29/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE The early-life microbiome is formed during the perinatal period and is critical for infants' lifelong health. This is established by maternal-infant microbiome crosstalk, which is mediated by the breast milk microbiome. The milk microbiome is dependent on the maternal gut microbiome, suggesting that it could potentially be restored through oral probiotic supplements. Therefore, we conducted this systematic review and meta-analysis to summarize the effect of maternal probiotic supplements on breast milk and infant gut microbiome composition and on infant health. DATA SOURCES The PubMed, EMBASE, Web of Science, Scopus, CINAHL, and Science Direct databases were searched until December 15, 2022. STUDY ELIGIBILITY CRITERIA Randomized controlled trials following the population, intervention, comparison, and outcome (population: pregnant or lactating women; intervention: probiotics; control: placebo or follow-up; outcome: breast milk and infant gut microbiome composition and infant health) principles were included. METHODS Using a random effect model, the standard mean difference, risk difference, and risk ratio with 95% confidence interval were used to measure each outcome. All analyses were conducted using the intention-to-treat approach. Heterogeneity was evaluated using I2 statistics. RESULTS The final data set included 24 randomized controlled trials with a total of 2761 mothers and 1756 infants. The overall effect of probiotics on the beneficial bacteria detection rate in breast milk had a risk difference of 24% (95% confidence interval, 0.1-0.37; P<.001; I2=91.12%). The pooled mean beneficial and pathogenic bacteria abundance in breast milk had a standard mean difference of 1.22 log10 colony forming units/mL (95% confidence interval, 0.48-1.97; P<.001; I2=95.51%) and -1.05 log10 colony forming unites/mL (95% confidence interval, -1.99 to -0.12; P=.03; I2=96.79%), respectively. The overall abundance of beneficial bacteria in the infant gut had a standard mean difference of 0.89 log10 colony forming units/g (95% confidence interval, 0.22-1.56; P=.01; I2=95.01%). It also controlled infant weight gain (standard mean difference, -0.49 kg/equivalent age; 95% confidence interval, -0.82 to -0.17; P<.001; I2=0.00%) and decreased the occurrence of infantile colic (risk ratio, 0.30; 95% confidence interval, 0.16-0.57; P<.001; I2=0.00%). CONCLUSION Maternal probiotic supplements effectively orchestrate the breast milk and infant gut microbiome with a wide range of clinical benefits and safety. Lactobacillus, Bifidobacterium, Streptococcus thermophilus, and S. boulardii can be used as maternal supplements to promote infant health.
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Affiliation(s)
- Bekalu Kassie Alemu
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR (Messers Alemu and Azeze and Drs Wu, Lau, C Wang, and Y Wang); Department of Midwifery, College of Medicine and Health Sciences, Debre Markos University, Ethiopia (Mr Alemu)
| | - Getnet Gedefaw Azeze
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR (Messers Alemu and Azeze and Drs Wu, Lau, C Wang, and Y Wang); Department of Midwifery, College Medicine and Health Sciences, Injibara University, Ethiopia (Mr Azeze)
| | - Ling Wu
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR (Messers Alemu and Azeze and Drs Wu, Lau, C Wang, and Y Wang)
| | - So Ling Lau
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR (Messers Alemu and Azeze and Drs Wu, Lau, C Wang, and Y Wang)
| | - Chi Chiu Wang
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR (Messers Alemu and Azeze and Drs Wu, Lau, C Wang, and Y Wang); Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Chinese University of Hong Kong-Sichuan University Joint Laboratory for Reproductive Medicine, Hong Kong SAR (Dr C Wang)
| | - Yao Wang
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR (Messers Alemu and Azeze and Drs Wu, Lau, C Wang, and Y Wang).
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11
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Ng JY, Liu H, Wang MC. Complementary and alternative medicine mention and recommendations in inflammatory bowel disease guidelines: systematic review and assessment using AGREE II. BMC Complement Med Ther 2023; 23:230. [PMID: 37434218 DOI: 10.1186/s12906-023-04062-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 06/29/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Many patients with inflammatory bowel disease (IBD) use complementary and alternative medicine (CAM) for disease management. There is, however, a communication gap between patients and healthcare professionals regarding CAM use, where patients are hesitant to disclose CAM use to providers. The purpose of this study was to identify the quantity and assess the quality of CAM recommendations in IBD clinical practice guidelines (CPGs) using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. METHODS MEDLINE, EMBASE, and CINAHL were systematically searched from 2011 to 2022 to find CPGs for the treatment and/or management of IBD. The Guidelines International Network (GIN) and National Center for Complementary and Integrative Health (NCCIH) websites were also searched. Eligible CPGs were assessed using the AGREE II instrument. RESULTS Nineteen CPGs made CAM recommendations for IBD and were included in this review. Average scaled domain percentages of CPGs were as follows (overall CPG, CAM section): scope and purpose (91.5%, 91.5%), clarity of presentation (90.3%, 64.0%), editorial independence (57.0%, 57.0%), stakeholder involvement (56.7%, 27.8%), rigour of development (54.7%, 45.9%), and applicability (14.6%, 2.1%). CONCLUSIONS The majority of CPGs with CAM recommendations were of low quality and their CAM sections scored substantially lower relative to other therapies in the overall CPG. In future updates, CPGs with low scaled-domain percentages could be improved in accordance with AGREE II and other guideline development resources. Further research investigating how CAM therapies can best be incorporated into IBD CPGs is warranted.
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Affiliation(s)
- Jeremy Y Ng
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
| | - Henry Liu
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Michelle Chenghuazou Wang
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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12
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Minhas HJ, Papamichael K, Cheifetz AS, Gianotti RJ. A primer on common supplements and dietary measures used by patients with inflammatory bowel disease. Ther Adv Chronic Dis 2023; 14:20406223231182367. [PMID: 37426698 PMCID: PMC10328183 DOI: 10.1177/20406223231182367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 05/30/2023] [Indexed: 07/11/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic disease of the intestines. The pathophysiology of IBD, namely Crohn's disease and ulcerative colitis, is a complex interplay between environmental, genetic, and immune factors. Physicians and patients often seek complementary and alternative medicines (CAMs) as primary and supplementary treatment modalities. CAMs in IBD span a wide range of plants, herbs, pre/probiotics, and include formulations, such as cannabis, curcumin, fish oil, and De Simone Formulation. Dietary measures are also used to improve symptoms by attempting to target trigger foods and reducing inflammation. Examples include the specific carbohydrate diet, the Mediterranean diet, and a diet low in fermentable oligo-, di- and monosaccharides as well as polyols (FODMAP). We examine and review the most common complementary supplements and diets used by patients with IBD.
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Affiliation(s)
- Hadi J Minhas
- Department of Gastroenterology, Albany Medical Center, Albany NY, USA
| | | | - Adam S. Cheifetz
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Robert J. Gianotti
- Department of Gastroenterology, Albany Medical Center, Albany NY, USA
- Albany Gastroenterology Consultants, Albany, NY, USA
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13
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Gravina AG, Pellegrino R, Auletta S, Palladino G, Brandimarte G, D’Onofrio R, Arboretto G, Imperio G, Ventura A, Cipullo M, Romano M, Federico A. Hericium erinaceus, a medicinal fungus with a centuries-old history: Evidence in gastrointestinal diseases. World J Gastroenterol 2023; 29:3048-3065. [PMID: 37346156 PMCID: PMC10280799 DOI: 10.3748/wjg.v29.i20.3048] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/22/2023] [Accepted: 04/21/2023] [Indexed: 05/26/2023] Open
Abstract
Hericium erinaceus is an edible and medicinal mushroom commonly used in traditional Chinese medicine for centuries. Several studies have highlighted its therapeutic potential for gastrointestinal disorders such as gastritis and inflammatory bowel diseases. In addition, some components of this mushroom appear to possess strong antineoplastic capabilities against gastric and colorectal cancer. This review aims to analyse all available evidence on the digestive therapeutic potential of this fungus as well as the possible underlying molecular mechanisms.
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Affiliation(s)
| | - Raffaele Pellegrino
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Salvatore Auletta
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Giovanna Palladino
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Giovanni Brandimarte
- Division of Internal Medicine and Gastroenterology, Cristo Re Hospital, Rome 00167, Italy
| | - Rossella D’Onofrio
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Giusi Arboretto
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Giuseppe Imperio
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Andrea Ventura
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Marina Cipullo
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Marco Romano
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Alessandro Federico
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
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14
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Exploring the mechanism by which acupuncture and moxibustion reduce colonic mucosal inflammation in rats with ulcerative colitis (UC) based on the P2X7R-NLRP3 inflammasome pathway. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2023. [DOI: 10.1007/s11726-023-1364-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
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15
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Yang X, He M, Tang Q, Wang Z, Jin D, Wu X, Yang Y, Ma D, Sun M, Li T. Assessment of Anti-inflammatory Efficacy of Acupuncture in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-analysis. Complement Ther Med 2023; 74:102946. [PMID: 36997007 DOI: 10.1016/j.ctim.2023.102946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/26/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Inflammation has a significant role in the onset and progression of inflammatory bowel disease (IBD). Increasing attention has been paid to the use of acupuncture in IBD patients; however, its regulatory effects on inflammatory factors in IBD still require validation. Here, we systematically evaluated the effects of acupuncture on inflammatory factors in IBD patients. METHODS Eight electronic databases were searched for studies that met the inclusion criteria. After evaluating the quality of the studies selected by two reviewers, the meta-analysis was performed to assess the efficacy of acupuncture in IBD patients and the impact on inflammatory factors (TNF-α, IL-1, IL-8 and IL-10). RESULTS Four randomized controlled trials with a total of 228 patients satisfied the inclusion criteria. Acupuncture has a positive therapeutic impact on IBD (MD = 1.22, 95% CI [1.07, 1.39], P =0.003). Moreover, it regulates the levels of TNF-α (MD =-60.58, 95% CI [-100.30, -20.89], P =0.003), IL-8 (MD =-56.40, 95% CI [-60.02, -52.14], P<0.00001) and IL-10 (MD =35.96, 95% CI [11.02, 60.91], P =0.005) in IBD patients. However, the P value of meta-analysis in IL-1 great than 0.05.(MD =-27.90, 95% CI [-97.82, 42.02], P =0.11). CONCLUSION Acupuncture has a positive therapeutic impact on IBD and can effectively regulate inflammatory factors in IBD patients. TNF-α, IL-8 and IL-10 are more appropriate inflammatory indicators for clinically evaluating the anti-inflammatory response in the blood of IBD patients by acupuncture.
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Yu TY, Feng YM, Kong WS, Li SN, Sun XJ, Zhou G, Xie RF, Zhou X. Gallic acid ameliorates dextran sulfate sodium-induced ulcerative colitis in mice via inhibiting NLRP3 inflammasome. Front Pharmacol 2023; 14:1095721. [PMID: 36762118 PMCID: PMC9905138 DOI: 10.3389/fphar.2023.1095721] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/11/2023] [Indexed: 01/26/2023] Open
Abstract
Background: Ulcerative colitis (UC) is a chronic recurrent inflammatory bowel disease (IBD). The conventional drugs for UC may induce severe side effects. Herbal medicine is considered as a complementary and alternative choice for UC. Purpose: This study aims to estimate the effect of natural polyphenol gallic acid (GA) on the NLRP3 inflammasome with dextran sulfate sodium (DSS)-induced colitis in mice. Study design: The body weights and symptoms of BALB/c mice were recorded. Histological evaluation, ELISA, q-PCR, immunohistochemistry, and western blotting were carried out to observe the morphology, cytokine contents, mRNA expressions, and protein expressions, respectively. Lipopolysaccharide (LPS)-induced RAW264.7 macrophage was used to probe GA's effect on relative protein expression. Results: GA attenuated weight loss (p < 0.05), relieved symptoms, and ameliorated colonic morphological injury (p < 0.05) in mice with colitis induced by DSS. GA also lowered the contents of TNF-α, IL-1β, IL-18, IL-33, and IFN-γ in the serum and colon of mice, which were elevated by DSS, downregulated protein, and mRNA expressions of the NLRP3 pathway in the colon tissue. Furthermore, GA downregulated the expressions of NLRP3 (p < 0.05), iNOS (p < 0.01), COX2 (p < 0.01), and P-p65 (p < 0.05), and suppressed NO release (p < 0.001) in LPS-induced RAW264.7 cells. Conclusion: GA ameliorated DSS-induced UC in mice via inhibiting the NLRP3 inflammasome. These findings furnish evidence for the anti-inflammatory effect of herbal medicines containing GA on UC.
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Affiliation(s)
- Tian-Yuan Yu
- Department of Pharmacy, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Institute of Chinese Medical Sciences, University of Macau, Macau, China
| | - Yi-Ming Feng
- Department of Pharmacy, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei-Song Kong
- Department of Pharmacy, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Department of Pharmacy, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shan-Ni Li
- Shanghai Nanyang Model Private High School, Shanghai, China
| | - Xue-Jiao Sun
- Department of Pharmacy, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Fengdu County People’s Hospital of Chongqing, Chongqing, China
| | - Gui Zhou
- Department of Pharmacy, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Rui-Fang Xie
- Department of Pharmacy, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xin Zhou
- Department of Pharmacy, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China,*Correspondence: Xin Zhou,
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Wang Q, Wang M, Li N, Chen S, Ma H, Lu Z, Liu F, Lin C, Zhu C. A comparative study of Liandan Xiaoyan Formula metabolic profiles in control and colitis rats by UPLC-Q-TOF-MS combined with chemometrics. J Pharm Biomed Anal 2023; 223:115115. [DOI: 10.1016/j.jpba.2022.115115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/10/2022] [Accepted: 10/16/2022] [Indexed: 11/07/2022]
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18
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Shen D, Ma S, Li X, Lu Y. Effect of Lactobacillus with Feruloyl Esterase-Producing Ability on Dextran Sodium Sulfate-Induced Ulcerative Colitis in Mice. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2022; 70:14817-14830. [PMID: 36394387 DOI: 10.1021/acs.jafc.2c02066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Ulcerative colitis (UC) is becoming an increasingly serious health problem. This study aimed to investigate the effect of a newly isolated Lactobacillus species that produces feruloyl esterase (FAEb) on dextran sodium sulfate (DSS)-induced UC in mice. In this study, FAEb supplementation slowed body weight loss and mitigated colon length shortening, the severity of fecal occult blood, and increases in the disease activity index (DAI) in UC model mice. FAEb supplementation was also shown to reduce the expression of proinflammatory factors, increase the antioxidant capacity, improve the production of beneficial short-chain fatty acids (SCFAs), upregulate the expression of tight junction proteins, reduce the histopathological scores, and reduce mucous barrier damage in the gut. Furthermore, FAEb supplementation was shown to inhibit inflammatory NF-κB signaling pathway activity, increase the abundance of beneficial bacteria, and regulate the balance of microbiota in the gut. These results suggest that FAEb may serve as a potential probiotic to prevent and treat UC.
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Affiliation(s)
- Dan Shen
- College of Food Science and Engineering, Nanjing University of Finance and Economics/Collaborative Innovation Center for Modern Grain Circulation and Safety, Nanjing 210023, P. R. China
| | - Shaotong Ma
- College of Food Science and Engineering, Nanjing University of Finance and Economics/Collaborative Innovation Center for Modern Grain Circulation and Safety, Nanjing 210023, P. R. China
| | - Xiangfei Li
- College of Food Science and Engineering, Nanjing University of Finance and Economics/Collaborative Innovation Center for Modern Grain Circulation and Safety, Nanjing 210023, P. R. China
| | - Yingjian Lu
- College of Food Science and Engineering, Nanjing University of Finance and Economics/Collaborative Innovation Center for Modern Grain Circulation and Safety, Nanjing 210023, P. R. China
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Zhang P, Li B, Mu J, Liu D, Zhang G, Mao X, Huang K, Waldron KJ, Chen X. The therapeutic and preventive effects of a canine-origin VB 12 -producing Lactobacillus on DSS-induced colitis in mice. J Anim Physiol Anim Nutr (Berl) 2022; 106:1368-1382. [PMID: 36045638 DOI: 10.1111/jpn.13767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 08/01/2022] [Accepted: 08/05/2022] [Indexed: 11/28/2022]
Abstract
Vitamin B12 (VB12 ) plays vital roles as a cofactor in reactions related to biosynthesis and metabolic regulation. Animals with diarrhoea from intestinal inflammation are susceptible to VB12 deficiency due to dysfunctional absorption. No current medications for canine intestinal inflammation can simultaneously act as VB12 supplements. Here we have tested a strain of VB12 -producing Lactobacillus, to investigate its safety in healthy dogs and test for hypothesized therapeutic and preventive effects on murine colitis. Results from enzyme-linked immunosorbent assay, histopathological analysis, and quantitative polymerase chain reaction showed normal physical conditions of healthy dogs given Lactobacillus, and blood biochemical indices showed no significant differences in markers, indicating safety of Lactobacillus to healthy dogs. The microbiota in animals receiving VB12 -producing Lactobacillus probiotic exhibited decreased abundance of Escherichia coli and concomitant increase in Lactobacillus. The probiotic supplement also resulted in downregulation of proinflammatory cytokines in murine colon tissues, reduced myeloperoxidase activity and malondialdehyde level, and significantly increased serum VB12 level and decreased homocysteine in therapeutic and preventive experiments. Moreover, Lactobacillus supplement decreased colonic inflammation and injury, improved gut microbiota, and ameliorated VB12 deficiency as an adjunctive therapy. We conclude this product is potentially beneficial for efficient therapy and prevention of VB12 deficiency form intestinal inflammation in canine clinical practice.
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Affiliation(s)
- Ping Zhang
- Institute of Animal Nutritional Health, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province, China
| | - Benrui Li
- Institute of Animal Nutritional Health, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province, China
| | - Jiaxin Mu
- Institute of Animal Nutritional Health, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province, China
| | - Dandan Liu
- Institute of Animal Nutritional Health, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province, China
| | - Guoying Zhang
- Department of Clinical Laboratory, Nanjing Integrated Traditional Chinese and Western Medicine Hospital, Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Xinru Mao
- Institute of Animal Nutritional Health, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province, China
| | - Kehe Huang
- Institute of Animal Nutritional Health, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province, China
| | - Kevin J Waldron
- Biosciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Xingxiang Chen
- Institute of Animal Nutritional Health, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province, China
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Vyshnevska L, Severina HI, Prokopenko Y, Shmalko A. Molecular docking investigation of anti-inflammatory herbal compounds as potential LOX-5 and COX-2 inhibitors. PHARMACIA 2022. [DOI: 10.3897/pharmacia.69.e89400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
According to the World Journal of Gastroenterology, more than 5 million people worldwide suffer from inflammatory bowel disease. The use of phytotherapeutic remedies in treatment of chronic inflammatory processes can be an effective alternative in patient’s therapy. The advantage of herbal medicines is the ability to influence various links of pathogenesis, lack of addiction, and the absence of withdrawal syndrome with long-term use in chronic pathology. In order to develop a new combined remedy with anti-inflammatory activity for the treatment of colitis, thirteen herbs, which are used in official or traditional medicine in inflammatory processes, were selected among the Ukrainian flora members. To select the most promising drugs and optimize further pharmacological research, molecular docking of the main active substances of the selected herbs to the fundamental pro-inflammatory enzymes – lipoxygenase-5 (LOX-5) and cyclooxygenase-2 (COX-2) – was carried out. Native inhibitors AKBA and celecoxib, respectively, were used as the reference ligands. The selection of candidate structures for in silico research was carried out according to the bibliosemantic research and logical-structural analysis concerning anti-inflammatory effect of the substances, which are part of chemical composition of the selected herbs. Molecular docking results have shown a high affinity level for the active site of the LOX-5 inhibitor gallotannin, quercetin, inulin, sitosterine, and moderate for ellagic acid. High affinity level for the active site of the COX-2 inhibitor was found for inulin, quercetin, gallotannin, ellagic acid and urticin A, moderate one – for gallic acid. For the further pharmacological in vitro and in vivo studies for anti-inflammatory activity, medicinal herbs with the highest content of the mentioned compounds were selected: Inula helenium, Cichorium intybus, Capsella bursa-pastoris, Foeniculum vulgare, Equisetum arvense, Veronica officinalis. Besides, it is recommended to use aqueous extracts of the selected herbs for the further pharmacological studies.
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Renshen Baidu Powder Attenuated Intestinal Inflammation and Apoptosis in Ulcerative Colitis Rats through the Inhibition of PI3K/AKT/NF-κB Signaling Pathway. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:5234025. [PMID: 35942369 PMCID: PMC9356782 DOI: 10.1155/2022/5234025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/20/2022] [Indexed: 11/17/2022]
Abstract
Objective Renshen Baidu Powder (RBP) is a famous classic compound of traditional Chinese medicine (TCM) and is commonly used for treating ulcerative colitis (UC). However, the pharmacological mechanism of RBP in treating UC remains unclear. This study investigates the possible mechanism of RBP for UC treatment by network pharmacological analysis and rat validation. Methods First, the main chemical constituents of RBP were identified using ultrahigh-performance liquid chromatography quadrupole Orbitrap high-resolution mass spectrometry (UHPLC-Q-Orbitrap-HRMS). Then, we obtained targets of identified compounds from the SwissTargetPrediction database and targets associated with UC from GeneCards database. Furthermore, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) were used to analyze the metabolism-related signaling pathways affected by RBP. Hematoxylin-eosin (HE) staining was used to observe the pathological change of colon in UC rats after treating RBP, and terminal deoxynucleotidyl-transferase (TdT)-mediated dUTP Nick end labeling (TUNEL) staining was used to detect apoptosis after RBP treatment. The enzyme-linked immunosorbent assay (ELISA) was employed to evaluate cytokine levels of TNF-α, IL-1β, and IL-6. The protein expressions of Bax, Bcl-2, PI3K, AKT, and NF-κB in colonic tissue were detected using immunohistochemistry (IHC). Real-time quantitative polymerase chain reaction (RT-QPCR) was employed to evaluate mRNA expression of PI3K, AKT, and NF-κB. Results We found a total of 24 main compounds and 329 potential targets related to UC. According to KEGG results, 3 main pathways were identified as responsible for UC, including PI3K-AKT, HIF-1, and VEGF signaling pathway. Animal experiments showed that RBP treatment significantly attenuated colon damage in rats with UC. Mechanistically, RBP could inhibit PI3K/AKT/NF-κB pathway; decrease cell apoptosis; and downregulate the expression of TNF-α, IL-1β, and IL-6. Conclusions This study demonstrated that RBP may exert anti-inflammatory and antiapoptotic therapeutic benefits in UC by regulating the PI3K/AKT/NF-κB signaling pathways, providing a scientific basis for understanding the mechanism of RBP against UC.
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22
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Abstract
Complementary and alternative medicine (CAM) is a growing entity within inflammatory bowel disease (IBD). CAM includes mind-based therapies, body-based therapies, supplements, vitamins, and probiotics. Limitations currently exist for health care providers as it pertains to IBD and CAM that stem from knowledge gaps, conflicting reports, limited oversight, and a lack of well-organized clinical data. Even without well-described data, patients are turning to these forms of therapy at increasing rates. It is imperative that the ongoing review of CAM therapies is performed, and future trials are performed to better understand efficacy as well as adverse effects related to these therapies.
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Kim ES, Tae CH, Jung SA, Park DI, Im JP, Eun CS, Yoon H, Jang BI, Ogata H, Fukuhara K, Hirai F, Ohtsuka K, Liu J, Cao Q. Perspectives of East Asian patients and physicians on complementary and alternative medicine use for inflammatory bowel disease: results of a cross-sectional, multinational study. Intest Res 2022; 20:192-202. [PMID: 35508953 PMCID: PMC9081987 DOI: 10.5217/ir.2020.00150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/12/2021] [Indexed: 11/24/2022] Open
Abstract
Background/Aims Complementary and alternative medicine (CAM) is prevalent in East Asia. However, information on CAM in East Asian patients with inflammatory bowel disease (IBD) is scarce. We aimed to profile the prevalence and pattern of CAM use among East Asian IBD patients and to identify factors associated with CAM use. We also compared physicians’ perspectives on CAM. Methods Patients with IBD from China, Japan, and South Korea were invited to complete questionnaires on CAM use. Patient demographic and clinical data were collected. Logistic regression analysis was applied for predictors of CAM use. Physicians from each country were asked about their opinion on CAM services or products. Results Overall, 905 patients with IBD participated in this study (China 232, Japan 255, and South Korea 418). Approximately 8.6% of patients with IBD used CAM services for their disease, while 29.7% of patients sought at least 1 kind of CAM product. Current active disease and Chinese or South Korean nationality over Japanese were independent predictors of CAM use. Chinese doctors were more likely to consider CAM helpful for patients with IBD than were Japanese and South Korean doctors. Conclusions In 8.6% and 29.7% of East Asian patients with IBD used CAM services and products, respectively, which does not differ from the prevalence in their Western counterparts. There is a significant gap regarding CAM usage among different Asian countries, not only from the patients’ perspective but also from the physicians’ point of view.
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Bastaki SMA, Amir N, Adeghate E, Ojha S. Lycopodium Mitigates Oxidative Stress and Inflammation in the Colonic Mucosa of Acetic Acid-Induced Colitis in Rats. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27092774. [PMID: 35566122 PMCID: PMC9102450 DOI: 10.3390/molecules27092774] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 11/19/2022]
Abstract
Inflammatory bowel diseases (IBDs) such as ulcerative colitis (UC) and Crohn’s disease (CD) are diseases of the gastrointestinal system involving genetic and environmental factors attributed to oxidative stress and inflammation. Targeting oxidative stress and inflammation by novel dietary compounds of natural origin convincingly appears to be one of the important therapeutic strategies to keep the disease in remission. As there is no permanent cure for IBD except for chronic long-term treatment or surgery, it is therefore imperative to investigate plant-based agents that are receiving attention for their therapeutic benefits to overcome the debilitating clinical conditions of IBD. Lycopodium (LYCO), a plant of tropical and subtropical origin and known by numerous names such as ground pine, club moss, or devil’s claw, has been popularly used for centuries in traditional medicine including Chinese and Indian medicines. In the present study, the effect of LYCO has been investigated in an acetic acid (AA)-induced colitis model in Wistar rats. LYCO was orally administered at the dose of 50 mg/kg/day either 3 days before or 30 min after the induction of IBD and continued for 7 days by intrarectal administration of AA. The changes in body weight and macroscopic and microscopic analysis of the colon of rats of different experimental groups were observed on days 0, 2, 4, and 7. The levels of myeloperoxidase (MPO), reduced glutathione (GSH), and malondialdehyde (MDA) were measured. AA caused a significant reduction in body weight and increased macroscopic and microscopic ulcer scores along with a significant decline in antioxidant enzymes, superoxide dismutase (SOD), and catalase and antioxidant substrate, glutathione (GSH). There was a concomitant increased formation of malondialdehyde (MDA), a marker of lipid peroxidation, and raised myeloperoxidase (MPO) activity, a marker of neutrophil activation. Treatment with LYCO significantly improved IBD-induced reduction in body weight, improved histology, inhibited MDA formation, and restored antioxidants along with reduced MPO activity. AA also caused the release of proinflammatory cytokines such as interleukin-1β (IL-1β) and interleukin-23 (IL-23). Furthermore, AA also increased the levels of calprotectin, a protein released by neutrophils under inflammatory conditions of the gastrointestinal tract. LYCO treatment significantly reduced the release of calprotectin and proinflammatory cytokines. The results demonstrate that LYCO treatment has the potential to improve disease activity by inhibiting oxidative stress, lipid peroxidation, and inflammation along with histological preservation of colonic tissues.
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Affiliation(s)
- Salim M. A. Bastaki
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (N.A.); (S.O.)
- Correspondence:
| | - Naheed Amir
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (N.A.); (S.O.)
| | - Ernest Adeghate
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates;
| | - Shreesh Ojha
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (N.A.); (S.O.)
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Kaur S, D’Silva A, Shaheen AA, Raman M. Yoga in Patients With Inflammatory Bowel Disease: A Narrative Review. CROHN'S & COLITIS 360 2022; 4:otac014. [PMID: 36777040 PMCID: PMC9802393 DOI: 10.1093/crocol/otac014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
Despite advancements in the treatment of inflammatory bowel disease (IBD), the global prevalence of IBD is increasing. Patients with IBD often experience a high psychosocial burden, worsening their IBD symptoms and increasing relapse, hospitalization rates, and healthcare costs, which impairs their quality of life (QoL). Evidence suggests that mind-body intervention in many chronic illnesses is effective in improving symptoms and QoL. Yoga is the most frequently used mind-body practice globally. Meta-analyses of randomized clinical trials and prospective studies have highlighted that yoga improves symptoms and QoL of patients with IBD; however, recommendations about indications for yoga as well as dose and frequency of yoga are lacking. The present narrative review aims to describe the available evidence regarding the effects of yoga on common patient-reported outcome measures in IBD, including depression, anxiety, stress, and QoL. Physicians can hence promote yoga interventions in their discussions with patients to help control these IBD-related outcome measures.
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Affiliation(s)
| | | | - Abdel-Aziz Shaheen
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Maitreyi Raman
- Address correspondence to: Maitreyi Raman, 6D33 TRW Building, 3280 Hospital Drive NW, Calgary, AB T2N 4N1, Canada ()
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Bao C, Wu L, Wang D, Chen L, Jin X, Shi Y, Li G, Zhang J, Zeng X, Chen J, Liu H, Wu H. Acupuncture improves the symptoms, intestinal microbiota, and inflammation of patients with mild to moderate Crohn's disease: A randomized controlled trial. EClinicalMedicine 2022; 45:101300. [PMID: 35198926 PMCID: PMC8850329 DOI: 10.1016/j.eclinm.2022.101300] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 01/16/2022] [Accepted: 01/24/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The efficacy and mechanisms of acupuncture for Crohn's disease (CD) are not well understood. We investigated its effects on symptoms, intestinal microbiota, and circulating inflammatory markers in CD patients. METHODS This 48-week, randomized, sham controlled, parallel-group clinical trial was performed at a tertiary outpatient clinic in China. From April 2015 to November 2019, 66 patients (mean age 40·4, 62·1% were male, all were Han Chinese) with mild to moderate active CD and unresponsive to drug treatment were enrolled and randomly assigned equally to an acupuncture group or a sham group. The treatment group received 3 sessions of acupuncture plus moxibustion per week for 12 weeks and a follow-up of 36 weeks. Clinicaltrials.gov: NCT02559037. FINDINGS At week 12, the clinical remission rate (the primary outcome) and clinical response rate of acupuncture group were significantly higher than that of sham group, with a difference of 42·4% (95% CI: 20·1%-64·0%) and 45·5% (95% CI: 24·0%-66·9%), respectively, both of which maintained at week 48. The acupuncture group had significantly lower CD activity index and C-reactive protein level at week 12, which maintained at 36-week follow-up. The CD endoscopic index of severity, histopathological score, and recurrence rate at week 48 were significantly lower in acupuncture group. The number of operational taxonomic unit of intestinal microbiota and relative abundance of Faecalibacterium prausnitzii and Roseburia faecis were increased. Plasma diamine oxidase, lipopolysaccharide, and Th1/Th17 related cytokines were decreased in 12-week after acupuncture. INTERPRETATION Acupuncture was effective in inducing and maintaining remission in patients with active CD, which was associated with increased abundance of intestinal anti-inflammatory bacteria, enhanced intestinal barrier, and regulation of circulating Th1/Th17-related cytokines. FUNDING National Key Basic Research Program of China (2015CB554500 and 2009CB522900), Shanghai Rising-Star Program (19QA1408100).
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Key Words
- Acupuncture
- Alternative therapy
- CD, Crohn's disease
- CDAI, Crohn's disease activity index
- CDEIS, Crohn's disease endoscopic index of severity
- CRP, C-reactive protein
- DAO, diamine oxidase
- Gut microbes
- HCs, healthy control subjects
- HS, histopathological score
- IBD, inflammatory bowel disease
- ITT, intention to treat
- Inflammatory bowel disease
- Intestinal barrier
- LEfSe, linear discriminant analysis effect size
- LPS, lipopolysaccharides
- OTU, operational taxonomic unit
- PP, per-protocol
- SCFAs, short chain fatty acids
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Affiliation(s)
- Chunhui Bao
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
- Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai 200030, China
| | - Luyi Wu
- Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai 200030, China
| | - Di Wang
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Liming Chen
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Xiaoming Jin
- Department of Anatomy and Cell Biology, Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Yin Shi
- Outpatient Department, Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai 200030, China
| | - Guona Li
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Jingzhi Zhang
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Xiaoqing Zeng
- Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Jianhua Chen
- Shanghai Clinical Research Center for Mental Health, Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Huirong Liu
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
- Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai 200030, China
- Corresponding authors at: Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China.
| | - Huangan Wu
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
- Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai 200030, China
- Corresponding authors at: Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China.
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Appleyard CB, Cruz ML, Velazquez-Cruz J, Rivera-Mendez RM, Jimenez-Garcia JG, Rivera LA, Mendez-Casillas MDM, Flores I, Al-Nakkash L, Chompre G. Voluntary Wheel Running Reduces Vesicle Development in an Endometriosis Animal Model Through Modulation of Immune Parameters. FRONTIERS IN REPRODUCTIVE HEALTH 2022; 3. [PMID: 36284640 PMCID: PMC9580825 DOI: 10.3389/frph.2021.826541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Endometriosis is a chronic gynecological disorder characterized by the growth of endometrial glands and stroma outside the endometrial cavity producing inflammation and pain. Previously we demonstrated that modulation of the hypothalamic pituitary adrenal (HPA) axis exacerbates the development and severity of this condition. A physically active lifestyle has been shown to confer health benefits in many chronic conditions by potentially acting as a stress buffer, thus we hypothesized that voluntary physical exercise can “realign/reset” the HPA axis resulting in reduced endometriosis symptoms in an animal model. Methods Endometriosis was induced in female Sprague Dawley rats by implanting uterine tissue next to the intestinal mesentery on day 0. Sham controls received sutures only. One group of endometriosis animals had access to a running wheel for 2 weeks prior to endometriosis induction until time of sacrifice at day 60. Sham and endometriosis controls received no exercise. All animals were examined for developed vesicles which were collected and measured. Uterine tissue was analyzed for cellular infiltration. Brain, liver, spleen, adrenal glands, leg muscles, and fat were collected, along with peritoneal fluid and blood. Results Endometriosis animals developed vesicles in 86.96% of the implants with significantly increased mesenteric fat compared to sham (p < 0.05). Exposure to exercise significantly decreased the size (p < 0.01) and number (p < 0.05) of vesicles that developed, as well as the mesenteric fat (p < 0.01). Exercised animals had higher levels of lactoferrin in peritoneal fluid, and decreased serum fractalkine and leptin. Exercise significantly increased estrogen alpha receptor expression levels (p < 0.01), while significantly decreasing estrogen receptor beta expression (p < 0.01) and macrophage infiltration (p < 0.05) in vesicles compared to non- exercised animals. Conclusions Our results suggest that voluntary physical activity might protect against endometriosis and alleviate the associated inflammation via immune modulation of the HPA axis. This offers the potential for further exploration of exercise as a complementary therapy in endometriosis patients.
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Affiliation(s)
- Caroline B. Appleyard
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University-Medical School, Ponce, Puerto Rico
- *Correspondence: Caroline B. Appleyard
| | - Myrella L. Cruz
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University-Medical School, Ponce, Puerto Rico
| | | | - Raquel M. Rivera-Mendez
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University-Medical School, Ponce, Puerto Rico
| | - Juan G. Jimenez-Garcia
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University-Medical School, Ponce, Puerto Rico
| | - Luis A. Rivera
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University-Medical School, Ponce, Puerto Rico
| | | | - Idhaliz Flores
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University-Medical School, Ponce, Puerto Rico
| | - Layla Al-Nakkash
- Department of Physiology, Midwestern University, Glendale, AZ, United States
| | - Gladys Chompre
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University-Medical School, Ponce, Puerto Rico
- Biology Department, Pontifical Catholic University of Puerto Rico, Ponce, Puerto Rico
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28
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Kim KO. [Functional Gastrointestinal Disorders in Patients with Inflammatory Bowel Disease]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2022; 79:4-11. [PMID: 35086967 DOI: 10.4166/kjg.2022.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/22/2022] [Accepted: 01/24/2022] [Indexed: 11/03/2022]
Abstract
With emerging more effective drugs, the therapeutic goal of inflammatory bowel disease (IBD) has progressed from clinical remission to mucosal healing. Although the inflammation could be controlled more effectively than before, symptoms such as abdominal pain and bowel habit change is still bothersome to some IBD patients. Recently, these "refractory functional gastrointestinal symptoms" in quiescent IBD patients has been paid more attention. The pathophysiology could be multifactorial with genetics, change in gut motility associated with post inflammatory condition, increased permeability, impaired colorectal function, visceral hypersensitivity and gut microbiota. Because both IBD and functional gastrointestinal disease (FGID) could share similar symptoms and some pathophysiology, it is sometimes challenging to distinguish them exactly. However, to reduce the risk of overtreatment or insufficient control of inflammation, exact diagnosis of functional disease or symptoms in quiescent IBD patients is important. Because there is limited randomized controlled trials or prospective study currently, most of the therapeutic approach in IBD patients are empirical or referred to those of functional gastrointestinal disorders. However, approaches based on pathophysiological mechanisms could give appropriate therapies for both IBD and FGIDs.
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Affiliation(s)
- Kyeong Ok Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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29
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Wang Y, Zhang J, Xu L, Ma J, Lu M, Ma J, Liu Z, Wang F, Tang X. Modified Gegen Qinlian Decoction Regulates Treg/Th17 Balance to Ameliorate DSS-Induced Acute Experimental Colitis in Mice by Altering the Gut Microbiota. Front Pharmacol 2021; 12:756978. [PMID: 34803700 PMCID: PMC8601377 DOI: 10.3389/fphar.2021.756978] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/20/2021] [Indexed: 12/12/2022] Open
Abstract
Inflammatory bowel disease (IBD) is characterized by chronic pathology associated with extensive intestinal microbial dysregulation and intestinal inflammation. Thus, efforts are underway to manipulate the gut microbiome to improve inflammatory pathology. Gegen Qinlian decoction (GQD), a traditional Chinese medicine prescription, has been widely utilized for treating diarrhea and ulcerative colitis (UC) for thousands of years. However, the underlying mechanism of its efficacy and whether its protective effect against colitis is mediated by the gut microbiota are poorly understood. In the present study, our data demonstrated that modified GQD (MGQD) administration significantly improved the pathological phenotypes and colonic inflammation challenged by DSS in mice, which were specifically manifested as reduced loss of body weight, shortening of colon length, DAI score, histological score and suppressed inflammatory response. 16S rRNA sequencing and targeted metabonomics analysis showed that MQGD altered the diversity and community landscape of the intestinal microbiota and the metabolic profiles. In particular, MQGD significantly boosted the abundance of the intestinal microbiota producing short-chain fatty acids (SCFAs), which are causally associated with promoting the development of Treg cells and suppressing the differentiation of pro-inflammatory Th17 cells. More importantly, transferring fecal microbiota from MGQD-treated or healthy controls exhibited equivalent alleviative effects on colitis mice. However, this protective effect could not be replicated in experiments of mice with depleted intestinal microbes through broad-spectrum antibiotic cocktails (ABX), further supporting the importance of SCFA-producing gut microbiota in the beneficial role of MGQD. In general, MGQD therapy has the potential to remodel the intestinal microbiome and reestablish immune homeostasis to ameliorate DSS-induced colitis.
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Affiliation(s)
- Yifan Wang
- Department of Gastroenterology, Peking University Traditional Chinese Medicine Clinical Medical School (Xiyuan), Beijing, China.,Academy of Integration of Chinese and Western Medicine, Peking University Health Science Center, Beijing, China
| | - Jiaqi Zhang
- Department of Gastroenterology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Lin Xu
- Department of Gastroenterology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jing Ma
- Department of Gastroenterology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Mengxiong Lu
- Department of Gastroenterology, Peking University Traditional Chinese Medicine Clinical Medical School (Xiyuan), Beijing, China.,Academy of Integration of Chinese and Western Medicine, Peking University Health Science Center, Beijing, China
| | - Jinxin Ma
- Department of Gastroenterology, Peking University Traditional Chinese Medicine Clinical Medical School (Xiyuan), Beijing, China.,Academy of Integration of Chinese and Western Medicine, Peking University Health Science Center, Beijing, China
| | - Zhihong Liu
- Department of Gastroenterology, Peking University Traditional Chinese Medicine Clinical Medical School (Xiyuan), Beijing, China.,Academy of Integration of Chinese and Western Medicine, Peking University Health Science Center, Beijing, China
| | - Fengyun Wang
- Department of Gastroenterology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Xudong Tang
- Department of Gastroenterology, Peking University Traditional Chinese Medicine Clinical Medical School (Xiyuan), Beijing, China.,Academy of Integration of Chinese and Western Medicine, Peking University Health Science Center, Beijing, China.,China Academy of Chinese Medical Sciences, Beijing, China
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30
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Deng M, Wu X, Duan X, Xu J, Yang X, Sheng X, Lou P, Shao C, Lv C, Yu Z. Lactobacillus paracasei L9 improves colitis by expanding butyrate-producing bacteria that inhibit the IL-6/STAT3 signaling pathway. Food Funct 2021; 12:10700-10713. [PMID: 34605504 DOI: 10.1039/d1fo02077c] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Inflammatory bowel disease (IBD) is a chronic intestinal inflammation that is currently incurable. Increasing evidence indicates that supplementation with probiotics could improve the symptoms of IBD. It is scientifically significant to identify novel and valid strains for treating IBD. It has been reported that the probiotic Lactobacillus paracasei L9 (L9), which is identified from the gut of healthy centenarians, can modulate host immunity and plays an anti-allergic role. Here, we demonstrated that L9 alleviates the pathological phenotypes of experimental colitis by expanding the abundance of butyrate-producing bacteria. Oral administration of sodium butyrate in experimental colitis recapitulates the L9 anti-inflammatory phenotypes. Mechanistically, sodium butyrate ameliorated the inflammatory responses by inhibiting the IL-6/STAT3 signaling pathway in colitis. Overall, these findings demonstrated that L9 alleviates the DSS-induced colitis development by enhancing the abundance of butyrate-producing bacterial strains that produce butyrate to suppress the IL-6/STAT3 signaling pathway, providing new insight into a promising therapeutic target for the remission of IBD.
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Affiliation(s)
- Min Deng
- State Key Laboratories for Agrobiotechnology, Department of Nutrition and Health, College of Biological Sciences, China Agricultural University, Beijing, 100193, China.
| | - Xi Wu
- State Key Laboratories for Agrobiotechnology, Department of Nutrition and Health, College of Biological Sciences, China Agricultural University, Beijing, 100193, China.
| | - Xiaoyue Duan
- State Key Laboratories for Agrobiotechnology, Department of Nutrition and Health, College of Biological Sciences, China Agricultural University, Beijing, 100193, China.
| | - Jiuzhi Xu
- State Key Laboratories for Agrobiotechnology, Department of Nutrition and Health, College of Biological Sciences, China Agricultural University, Beijing, 100193, China.
| | - Xu Yang
- State Key Laboratories for Agrobiotechnology, Department of Nutrition and Health, College of Biological Sciences, China Agricultural University, Beijing, 100193, China.
| | - Xiaole Sheng
- State Key Laboratories for Agrobiotechnology, Department of Nutrition and Health, College of Biological Sciences, China Agricultural University, Beijing, 100193, China.
| | - Pengbo Lou
- State Key Laboratories for Agrobiotechnology, Department of Nutrition and Health, College of Biological Sciences, China Agricultural University, Beijing, 100193, China.
| | - Chunlei Shao
- State Key Laboratories for Agrobiotechnology, Department of Nutrition and Health, College of Biological Sciences, China Agricultural University, Beijing, 100193, China.
| | - Cong Lv
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, China Agricultural University, Beijing, 100193, China.
| | - Zhengquan Yu
- State Key Laboratories for Agrobiotechnology, Department of Nutrition and Health, College of Biological Sciences, China Agricultural University, Beijing, 100193, China.
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Yang L, Luo H, Tan D, Zhang S, Zhong Z, Wang S, Vong CT, Wang Y. A recent update on the use of Chinese medicine in the treatment of inflammatory bowel disease. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2021; 92:153709. [PMID: 34560518 DOI: 10.1016/j.phymed.2021.153709] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is a chronic idiopathic disease that is characterized by inflammation of the gastrointestinal tract. Proper management of IBD requires both early diagnosis and novel therapies and management programs. Many reports have suggested that Chinese medicine has unique properties favorable to the treatment of IBD. However, there are no systematic analyses on this topic. PURPOSE This review summarizes recent studies that assessed the effects and mechanisms of Chinese medicine in the treatment of IBD in order to fully understand the advantages of Chinese medicine in the management of IBD. METHODS A literature search was conducted using peer-reviewed and clinical databases, including PubMed, Web of Science, ClinicalTrials.gov, MEDLINE, EMBASE, Springer LINK, Wan-fang database, the Chinese Biomedicine Database, and the China National Knowledge Infrastructure (CNKI). Keywords used were inflammatory bowel disease (including Ulcerative colitis or Crohn's disease) and Chinese medicine. All selected articles were from 1997 to 2021, and each were assessed critically for our exclusion criteria. Studies describing the pathogenesis of IBD, the effects and mechanisms of Chinese medicine in the treatment of IBD, in particular their roles in immune regulation, intestinal flora regulation, and improvement of intestinal barrier function, were included. CONCLUSION This review highlights recent progress in the use of Chinese medicine in the treatment of IBD. It also provides a reference for further evaluation and exploration of the potential of classical multi-herbal Chinese medicine in the treatment of IBD.
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Affiliation(s)
- Lin Yang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Hua Luo
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Dechao Tan
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Siyuan Zhang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Zhangfeng Zhong
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Shengpeng Wang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Chi Teng Vong
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China.
| | - Yitao Wang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China.
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32
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Transcutaneous electrical acupoint stimulation applied in lower limbs decreases the incidence of paralytic ileus after colorectal surgery: A multicenter randomized controlled trial. Surgery 2021; 170:1618-1626. [PMID: 34497027 DOI: 10.1016/j.surg.2021.08.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Postoperative paralytic ileus prolongs hospitalization duration, increases medical expenses, and is even associated with postoperative mortality; however, effective prevention of postoperative paralytic ileus is not yet available. This trial aimed to assess the preventative effectiveness of transcutaneous electrical acupoint stimulation applied in the lower limbs on postoperative paralytic ileus incidence after colorectal surgery. METHODS After ethics approval and written informed consent, 610 patients from 10 hospitals who were scheduled for colorectal surgery between May 2018 and September 2019 were enrolled. Patients were randomly allocated into the transcutaneous electrical acupoint stimulation (stimulated on bilateral Zusanli, Shangjuxu, and Sanyinjiao acupoints in lower limbs for 30 minutes each time, total 4 times) or sham (without currents delivered) group with 1:1 ratio. The primary outcome was postoperative paralytic ileus incidence, defined as no flatus for >72 hours after surgery. RESULTS Compared to the sham treatment, transcutaneous electrical acupoint stimulation lowered the postoperative paralytic ileus incidence by 8.7% (32.3% vs 41.0%, P = .026) and decreased the risk of postoperative paralytic ileus by 32% (OR, 0.68; P = .029). Transcutaneous electrical acupoint stimulation also shortened the recovery time to flatus, defecation, normal diet, and bowel sounds. Transcutaneous electrical acupoint stimulation treatment significantly increased median serum acetylcholine by 55% (P = .007) and interleukin-10 by 88% (P < .001), but decreased interleukin-6 by 47% (P < .001) and inducible nitric oxide synthase by 42% (P = .002) at 72 hours postoperatively. CONCLUSION Transcutaneous electrical acupoint stimulation attenuated the postoperative paralytic ileus incidence and enhanced gastrointestinal functional recovery, which may be associated with increasing parasympathetic nerve tone and its anti-inflammatory actions.
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Koutouratsas T, Philippou A, Kolios G, Koutsilieris M, Gazouli M. Role of exercise in preventing and restoring gut dysbiosis in patients with inflammatory bowel diseases: A review. World J Gastroenterol 2021; 27:5037-5046. [PMID: 34497433 PMCID: PMC8384738 DOI: 10.3748/wjg.v27.i30.5037] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/19/2021] [Accepted: 07/12/2021] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel diseases (IBD) include a spectrum of chronic inflammatory disorders of the gastrointestinal tract whose pathogenesis is yet to be elucidated. The intestinal microbiome has been studied as a causal component, with certain microbiotic alterations having been observed in subtypes of IBD. Physical exercise is a modulator of the intestinal microbiome, causing shifts in its composition that are partially corrective of those observed in IBD; furthermore, physical exercise may be beneficial in patients with certain IBD subtypes. This review studies the effects of physical exercise on the human gut microbiome while investigating pathophysiologic mechanisms that could explain physical activity’s clinical effects on patients with IBD.
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Affiliation(s)
- Tilemachos Koutouratsas
- Department of Basic Medical Sciences, Laboratory of Biology, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Anastassios Philippou
- Department of Basic Medical Sciences, Laboratory of Physiology, School of Medicine, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - George Kolios
- Department of Medicine, Laboratory of Pharmacology, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Michael Koutsilieris
- Department of Basic Medical Sciences, Laboratory of Physiology, School of Medicine, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Maria Gazouli
- Department of Basic Medical Sciences, Laboratory of Biology, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
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Wilke E, Reindl W, Thomann PA, Ebert MP, Wuestenberg T, Thomann AK. Effects of yoga in inflammatory bowel diseases and on frequent IBD-associated extraintestinal symptoms like fatigue and depression. Complement Ther Clin Pract 2021; 45:101465. [PMID: 34388560 DOI: 10.1016/j.ctcp.2021.101465] [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: 03/17/2021] [Revised: 06/24/2021] [Accepted: 07/28/2021] [Indexed: 12/22/2022]
Abstract
Quality of life (QoL) of persons with inflammatory bowel diseases (IBD) is often impaired by symptoms that do not primarily relate to intestinal inflammation. Among the most challenging extraintestinal symptoms are depression and fatigue, which are also frequent in other chronic diseases like multiple sclerosis, rheumatoid arthritis and cancer. Yoga as an ancient Indian tradition containing postures, breathing exercises and meditation may positively influence those symptoms. This review evaluates the current literature with regard to the effect of yoga-based interventions in persons with IBD and with regard to QoL, depression and fatigue in other somatic disorders. A systematic literature search yielded three trials examining the effects of yoga in patients with IBD and 37 trials addressing depressive syndromes or fatigue in somatic disorders. In summary, both in-person and video-based yoga classes are feasible, acceptable and safe as complementary treatment in patients with IBD and significantly improve anxiety and impaired quality of life. Current literature does not provide information on the effect of yoga on depression and fatigue in patients with IBD, but research from other somatic disorders or patients with depressive disorders implies the potential of yoga in this regard for persons with IBD. This should be specifically addressed in interventional trials with standardized yoga modules including patients with IBD suffering from fatigue, depression and/or impaired QoL.
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Affiliation(s)
- E Wilke
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany.
| | - W Reindl
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - P A Thomann
- Center for Mental Health, Odenwald District Healthcare Center, Erbach, Germany
| | - M P Ebert
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - T Wuestenberg
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - A K Thomann
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
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Mousavi T, Nikfar S, Abdollahi M. Comprehensive study on the administrative, economic, regional, and regulatory prospects of complementary and alternative medicine (CAM) in inflammatory bowel disease (IBD). Expert Rev Clin Pharmacol 2021; 14:865-888. [PMID: 33993811 DOI: 10.1080/17512433.2021.1925108] [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: 12/07/2022]
Abstract
Introduction: Due to the high cost, low effectiveness, and adverse effects plus the life-long nature of inflammatory bowel disease (IBD), and misconception on safety, efficacy, and cost-effectiveness of complementary and alternative medicine (CAM), the market demand for CAM has risen over the past decades. A critical review of patients' and physicians' attitudes, market drivers, economic aspects, regulatory roles, and regional distribution is lacking.Areas covered: Through relevant databases, the existing English language literature concerning the association of CAM use with IBD was collected over the past two decades. Data was then analyzed, comprehensively summarized in tables/figures, and justified concerning administrative, organizational, regional, economic, and regulatory perspectives.Expert opinion: Although CAM utilization is more prevalent among younger, female, and high-educated IBD patients, issues concerning weak study designs, limited-time period/regional distribution of recent surveys, and lack of economic evaluations on CAM make it entirely unfeasible to draw a firm conclusion. Regulators are lagging in meeting the dire need of IBD patients, especially the elderly. Lack of legislation regarding registration, sales monitoring, licensing, insurance coverage, efficacy/safety assessments, post-marketing surveillance, quality assurance, and reference pricing alongside the limited support for CAM research are the main matters that should be urgently addressed.
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Affiliation(s)
- Taraneh Mousavi
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), the Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Shekoufeh Nikfar
- Personalized Medicine Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Evidence-Based Evaluation of Cost-Effectiveness and Clinical Outcomes Group, Pharmaceutical Sciences Research Center (PSRC), and the Pharmaceutical Management and Economics Research Center (PMERC), the Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Pharmacoeconomics and Pharmaceutical Administration, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), the Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Personalized Medicine Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Hao C, Wang W, Zhan B, Wang Z, Huang J, Sun X, Zhu X. Trichinella spiralis Paramyosin Induces Colonic Regulatory T Cells to Mitigate Inflammatory Bowel Disease. Front Cell Dev Biol 2021; 9:695015. [PMID: 34336843 PMCID: PMC8320175 DOI: 10.3389/fcell.2021.695015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/07/2021] [Indexed: 01/02/2023] Open
Abstract
Helminth infection modulates host regulatory immune responses to maintain immune homeostasis. Our previous study identified Trichinella spiralis paramyosin (TsPmy) as a major immunomodulatory protein with the ability to induce regulatory T cells (Tregs). However, whether TsPmy regulates gut Tregs and contributes to intestinal immune homeostasis remains unclear. Here we investigated the therapeutic effect of recombinant TsPmy protein (rTsPmy) on experimental colitis in mice, and elucidated the roles and mechanisms of colonic Tregs induced by rTsPmy in ameliorating colitis. Acute colitis was induced by dextran sodium sulfate (DSS) in C57BL/6J mice, and chronic colitis was induced by naïve T cells in Rag1 KO mice. Mice with colitis were pre-treated with rTsPmy intraperitoneally, and clinical manifestations and colonic inflammation were evaluated. Colonic lamina propria (cLP) Tregs phenotypes and functions in DSS-induced colitis were analyzed by flow cytometry. Adoptive transfer of cLP Tregs treated by rTsPmy into Rag1 KO chronic colitis was utilized to verify Tregs suppressive function. rTsPmy ameliorated the disease progress of DSS-induced colitis, reduced pro-inflammatory responses but enhanced regulatory cytokines production in DSS-induced colitis. Moreover, rTsPmy specifically stimulated the expansion of thymic-derived Tregs (tTregs) rather than the peripherally derived Tregs (pTregs) in the inflamed colon, enhanced the differentiation of effector Tregs (eTregs) with higher suppressive function and stability in colitis. This study describes the mechanisms of colonic Tregs induced by the Trichinella-derived protein rTsPmy in maintaining gut immune homeostasis during inflammation. These findings provide further insight into the immunological mechanisms involved in the therapeutic effect of helminth-derived proteins in inflammatory bowel diseases.
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Affiliation(s)
- Chunyue Hao
- Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Wei Wang
- Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Bin Zhan
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Zixia Wang
- Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Jingjing Huang
- Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Ximeng Sun
- Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Xinping Zhu
- Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
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Hansen S, Sverrisdóttir UÁ, Rudnicki M. Impact of exercise on pain perception in women with endometriosis: A systematic review. Acta Obstet Gynecol Scand 2021; 100:1595-1601. [PMID: 33999412 DOI: 10.1111/aogs.14169] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/16/2021] [Accepted: 05/07/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Endometriosis is challenging to treat. It is a painful and chronic inflammatory disorder that impacts up to 10% of women of reproductive age. Despite available surgical and medical treatment options, recurrence of symptoms is common. Available studies suggest that exercise may have a therapeutic effect on chronic inflammation and thereby on pain perception. This review evaluates whether exercise can decrease pain perception in women with symptomatic endometriosis. MATERIAL AND METHODS This systematic review was conducted according to PRISMA by searching databases Medline and Embase to locate randomized controlled trials and observational studies. Risk of bias was investigated using the Cochrane Collaboration Tool for the Evaluation of Randomized Controlled Trials and the ROBINS-I quality assessment scale. Inclusion criteria were women of reproductive age, laparoscopically confirmed diagnosis of endometriosis, and intervention of any type of exercise. All manuscripts were evaluated by two of the authors and when in doubt a third author was consulted. This review was registered in PROSPERO on November 14, 2020 (CRD42020212309). RESULTS Six articles fulfilled the inclusion criteria and were included in this systematic review. Concerning exercise, two studies showed significant decrease in pain relief but the remaining studies showed either negative or no impact on pain relief. A meta-analysis could not be conducted because of the considerable heterogeneity among the included studies. CONCLUSIONS The present review does not indicate any beneficial effect of exercise on pain in women with endometriosis. There is a need for randomized controlled trials with correct power calculation, well-defined study groups and training programs to be able to answer the question of whether exercise can improve the pain experience in patients with endometriosis.
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Affiliation(s)
- Sara Hansen
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | | | - Martin Rudnicki
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
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Cao X, Wu QJ, Chang Q, Zhang TN, Li XS, Chen YX, Zhao YH. Knowledge Mapping of Dietary Factors of Metabolic Syndrome Research: Hotspots, Knowledge Structure, and Theme Trends. Front Nutr 2021; 8:655533. [PMID: 34136515 PMCID: PMC8200392 DOI: 10.3389/fnut.2021.655533] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/11/2021] [Indexed: 01/10/2023] Open
Abstract
Background: The global incidence of metabolic syndrome (MetS) is continuously increasing, making it a potential worldwide public health concern. Research on dietary factors related to MetS has attracted considerable attention in the recent decades. However, the research hotspots, knowledge structure, and theme trends for the dietary factors associated with MetS remain unknown, and have not yet been systematically mapped. This study aimed to review the research status of diet as a risk factor for MetS through bibliometric methods. Bibliometric analysis was conducted using the Web of Science database. Research hotspots were identified using biclustering analysis with the gCLUTO software, and knowledge structure was explored via social network analysis using the Ucinet software. Theme trends were investigated using evolutionary analysis with the SciMAT software. In total, 1,305 papers were analyzed. The research output on the dietary factors associated with MetS increased steadily. The research scope was gradually expanding and diverse. Overall, eight research hot spots, four key dietary nodes, and four motor themes on the dietary factors associated with MetS were identified. Fatty acids, dietary fiber, and polyphenols have been the focus of research in this field over the years. Evolutionary analysis showed that fish oil and vitamin C were well-developed research foci recently. Prebiotics was recognized as an emerging theme with certain developmental potential. These findings provide a better understanding of the research status of the dietary factors associated with MetS and a reference for future investigations.
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Affiliation(s)
- Xia Cao
- Department of Library, Shengjing Hospital of China Medical University, Shenyang, China.,Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qing Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tie-Ning Zhang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Department of Pediatrics, Pediatric Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiang-Sen Li
- Department of Library, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yun-Xiang Chen
- Department of Library, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
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Chi H, Wang D, Chen M, Lin J, Zhang S, Yu F, Zhou J, Zheng X, Zou Y. Shaoyao Decoction Inhibits Inflammation and Improves Intestinal Barrier Function in Mice With Dextran Sulfate Sodium-Induced Colitis. Front Pharmacol 2021; 12:524287. [PMID: 33959000 PMCID: PMC8093868 DOI: 10.3389/fphar.2021.524287] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/22/2021] [Indexed: 12/12/2022] Open
Abstract
Shaoyao decoction (SYD), a classical traditional Chinese medicine formula, is effective for the treatment of inflammatory bowel disease (IBD). This study was designed to investigate the therapeutic effects of SYD on IBD and possible mechanisms. Dextran sulfate sodium (DSS, 3.5%) was used to induce colitis in C57BL/6 mice. Disease phenotypes were investigated based on disease activity index (DAI), colon length, and microscopic and macroscopic scores. Additionally, the presence of proinflammatory cytokines, immune cell infiltrates, intestinal cell proliferation, apoptosis, epithelial permeability, signal transducer and activator of transcription 3 (STAT3), and nuclear factor-κB (NF-κB) signaling, as well as the intestinal mucosal barrier function, were investigated. The administration of SYD significantly ameliorated the clinical signs, suppressed the levels of proinflammatory cytokines, and reduced immune cell infiltrates into colonic tissues of DSS-induced colitis model mice. SYD also significantly reduced the DSS-induced activation of STAT3 and NF-κB signaling. Furthermore, SYD promoted epithelial integrity by regulating epithelial cell apoptosis and epithelial permeability. Finally, we demonstrated that SYD protected the intestinal barrier function by significantly regulating the mucus layer genes Muc1, Muc2, Muc4, and Tff3, as well as the epithelial barrier genes Z O -1 and Occludin. Our results indicate that SYD has a protective effect on DSS-induced colitis, which is attributable to its anti-inflammatory activity and intestinal barrier function-enhancing effects. These results provide valuable insights into the pharmacological actions of SYD for the treatment of IBD.
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Affiliation(s)
- Honggang Chi
- Department of Traditional Chinese Medicine, The Second Clinical Medical College, Guangdong Medical University, Dongguan, China.,Department of Traditional Chinese Medicine, The First Dongguan Affiliated Hospital of Guangdong Medical University, Dongguan, China
| | - Dan Wang
- Department of Pharmacology, Guangdong Medical University, Dongguan, China
| | - Mengting Chen
- Department of Pharmacology, Guangdong Medical University, Dongguan, China
| | - Jiantao Lin
- Department of Pharmacology, Guangdong Medical University, Dongguan, China
| | - Shuhua Zhang
- Department of Traditional Chinese Medicine, The Second Clinical Medical College, Guangdong Medical University, Dongguan, China
| | - Fengyan Yu
- The Second Clinical Medical College, Guangdong Medical University, Dongguan, China
| | - Jun Zhou
- Department of Pathology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xuebao Zheng
- Mathematical Engineering Academy of Chinese Medicine, Guangzhou University of Chinese Medicine, Dongguan, China
| | - Ying Zou
- Department of Traditional Chinese Medicine, The Second Clinical Medical College, Guangdong Medical University, Dongguan, China.,Department of Traditional Chinese Medicine, Dongguan Liaobu Hospital, Dongguan, China
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A Novel Research Technology to Explore the Mystery of Traditional Chinese Medicine: Optogenetics. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021. [DOI: 10.1155/2021/6613368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Traditional Chinese medicine (TCM) is gaining increasing popularity worldwide for the function of health promotion and adjuvant therapy. However, the world's understanding of TCM is far from enough, which seriously limits the modernization and internationalization of TCM. Therefore, modern and efficient analytical methods are urgently needed to understand the mechanism of TCM. Optogenetics is one of the most prevalent technologies in the 21st century and has been used to explore life science, especially neuroscience. It already has had great influences in the study of neural circuits and animal models of mental diseases and was named “Method of the Year” by the Nature Methods journal in 2010. Increased interests occurred in the applications of optogenetics to explore a myriad of medical and mental health disorders. However, it has not so far been noticed by TCM researchers. We elaborated on an idea that introducing this technique into the field of TCM research to improve diagnosis, treatments, and evaluating the therapeutic effects. In this review, we made a systematic prospect in the theory, feasibility, and application of TCM optogenetics. We mainly focused on applying optogenetic methodologies to make a more comprehensive understanding of TCM.
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Effect of nanocurcumin and fish oil as natural anti-inflammatory compounds vs. glucocorticoids in a lipopolysaccharide inflammation model on Holstein calves' health status. Heliyon 2021; 7:e05894. [PMID: 33553719 PMCID: PMC7855347 DOI: 10.1016/j.heliyon.2020.e05894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/17/2020] [Accepted: 12/30/2020] [Indexed: 01/17/2023] Open
Abstract
Curcumin (CUR) and fish oil (FO) are among the most well-known types of natural anti-inflammatory compounds. The aim of this study was to assess the effect of nanocurcumin and fish oil vs. glucocorticoids on Holstein calves’ health status. A lipopolysaccharide (LPS) challenge (0.5 μg kg−1 BW) was used to induce an acute phase response. A total of 42 male Holstein calves were randomized into 7 groups: negative control (CON), positive control (LPS, injected once), 250 mg/kg BW per day fish oil + LPS (FO250), 350 mg/kg BW per day fish oil + LPS (FO350), 2 mg/kg BW per day nanocurcumin + LPS (NCUR2), 4 mg/kg BW per day nanocurcumin + LPS (NCUR4), and 0.3 mg/kg BW dexamethasone (injected once) + LPS (DEX). The duration of this experiment was 11 days, with application of the LPS challenge on day 8. Calves were weighed on days 0, 7, 9, 10, and 11 to record the average daily weight gain; diets offered and refused were recorded daily throughout the experiment. Blood collection and clinical scoring were conducted at successive time points until 72 h post LPS challenge. The data obtained also comprised rectal temperature (RT), respiratory rate (RR), heart rate (HR), concentrations of tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), serum amyloid A (SAA), and haptoglobin (Hp). This experiment could not uncover significant effects of LPS, FO, NCUR, and DEX on the area under the curve (AUC) of the RT, HR, and RR; in addition, there was no difference between FO and NCUR vs. LPS in sickness behavior, however, DEX group significantly recovered faster than others (P < 0.01). There was no significant difference between groups in dry matter intake (DMI) and average daily gain (ADG) during three days post LPS challenge. The concentrations of TNF-⍺, IL-6, and SAA were lower in the DEX group (P < 0.05). Finally, no effects of FO and NCUR on cytokines and acute phase proteins (APPs) could be observed in this study. In conclusion, supplementation of FO and NCUR was not able to impact the acute phase response (APR) in calves, as levels of inflammatory cytokines and APPs as well as sickness behavior remained unchanged. It seems that the anti-inflammatory effects of FO and CUR on APR, as has been observed for other animal species, do not manifest that clearly in calves.
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Ng SC, Mak JWY, Pal P, Banerjee R. Optimising management strategies of inflammatory bowel disease in resource-limited settings in Asia. Lancet Gastroenterol Hepatol 2020; 5:1089-1100. [PMID: 33181088 DOI: 10.1016/s2468-1253(20)30298-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 05/16/2020] [Accepted: 05/20/2020] [Indexed: 12/16/2022]
Abstract
Over the 21st century, inflammatory bowel disease (IBD) has become a global disease with increasing prevalence reported in the Asian subcontinent as a result of rapid urbanisation, industrialisation, and westernisation of lifestyles. Although rates of surgery have shown a temporal decrease globally because of the increasing availability of new drugs and early initiation of effective therapy, health-care costs associated with IBD have continued to rise. The increase in IBD prevalence in resource-limited countries poses a substantial health-care burden. Drugs are not universally accessible or available. An optimised and practical management strategy of IBD in resource-limited countries in Asia is urgently needed. Special consideration should be made to balance the risk of undertreatment (and suboptimal disease control) because of financial constraints with the risk of overtreatment, which is associated with side-effects and costly therapeutics. In this Series paper, we summarise the current approach in optimising conventional therapies, use of other therapies, and de-escalation of biologics in low-resource settings in Asia. The long-term objective is to strive for more effective and affordable therapies with sustained durability of benefit.
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Affiliation(s)
- Siew C Ng
- Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, LKS Institute of Health Science, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Joyce Wing Yan Mak
- Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, LKS Institute of Health Science, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Partha Pal
- IBD Centre, Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, Telangana, India
| | - Rupa Banerjee
- IBD Centre, Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, Telangana, India
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Soares IP, Oliveira BAC, Baal SCS, Donatti L, Ingberman M, Beirão BCB, Appel MH, Fernandes LC. Fish oil supplementation enhances colon recovery after experimental colitis. Prostaglandins Leukot Essent Fatty Acids 2020; 163:102212. [PMID: 33249348 DOI: 10.1016/j.plefa.2020.102212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Fish oil (FO) has an anti-inflammatory and pro-resolution activity and it has been used to restore physiological disturbances on inflammatory conditions. Here, we investigate whether FO supplementation could, acutely, prevent or restore inflammatory damages on experimental colitis. METHODS Wistar rats orally received 2 g.kg-1.day-1 of FO for 30 days before induction of experimental colitis. Specimens were collected on the 2nd and 7th days after colitis-induction and intestinal mucus, inflammatory activity and colon integrity were determined. RESULTS Experimental colitis did cause colon disruption and FO, acutely, did not prevent the loss of intestinal and fecal mucus, neither the increase of inflammatory activity and intestinal permeability. On the 7th day of colitis, FO soften the perturbations of experimental colitis, increasing histological and fecal mucus and, also decreased inflammatory activity, but this was not accompanied by intestinal permeability. CONCLUSION FO did not protect, acutely, intestinal damages from experimental colitis, but at long run promotes higher intestinal recovery.
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Affiliation(s)
| | - Bruna A C Oliveira
- Department of Molecular Biology, Federal University of Parana, Curitiba, Brazil
| | - Suelen C S Baal
- Department of Physiology, Federal University of Parana, Curitiba, Brazil
| | - Lucelia Donatti
- Department of Molecular Biology, Federal University of Parana, Curitiba, Brazil
| | | | - Breno C B Beirão
- Department of Pathology, Federal University of Parana, Curitiba, Brazil
| | - Marcia H Appel
- Department of Genetics, Structural and Molecular Biology, State University of Ponta Grossa, Ponta Grossa, Brazil
| | - Luiz C Fernandes
- Department of Physiology, Federal University of Parana, Curitiba, Brazil
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Guo J, Xing X, Wu J, Zhang H, Yun Y, Qin Z, He Q. Acupuncture for Adults with Diarrhea-Predominant Irritable Bowel Syndrome or Functional Diarrhea: A Systematic Review and Meta-Analysis. Neural Plast 2020; 2020:8892184. [PMID: 33299403 PMCID: PMC7705439 DOI: 10.1155/2020/8892184] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/27/2020] [Accepted: 10/29/2020] [Indexed: 02/07/2023] Open
Abstract
Objective. To evaluate the clinical effectiveness and safety of acupuncture therapy in the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D) or functional diarrhea (FD) in adults. Method. Five electronic databases-PubMed, EMBASE, CNKI, VIP, and Wanfang-were searched, respectively, until June 8, 2020. The literature of clinical randomized controlled trials of acupuncture for the treatment of IBS-D or FD in adults were collected. Meta-analysis was conducted by Using Stata 16.0 software, the quality of the included studies was assessed by the RevMan ROB summary and graph, and the results were graded by GRADE. Result. Thirty-one studies with 3234 patients were included. Most of the studies were evaluated as low risk of bias related to selection bias, attrition bias, and reporting bias. Nevertheless, seven studies showed the high risk of bias due to incomplete outcome data. GRADE's assessments were either moderate certainty or low certainty. Compared with loperamide, acupuncture showed more effectiveness in weekly defecation (SMD = -0.29, 95% CI [-0.49, -0.08]), but no significant improvement in the result of the Bristol stool form (SMD = -0.28, 95% CI [-0.68, 0.12]). In terms of the drop-off rate, although the acupuncture group was higher than the bacillus licheniformis plus beanxit group (RR = 2.57, 95% CI [0.24, 27.65]), loperamide group (RR = 1.11, 95% CI [0.57, 2.15]), and trimebutine maleate group (RR = 1.19, 95% CI [0.31, 4.53]), respectively, it was lower than the dicetel group (RR = 0.83, 95% CI [0.56, 1.23]) and affected the overall trend (RR = 0.93, 95% CI [0.67, 1.29]). Besides, acupuncture produced more significant effect than dicetel related to the total symptom score (SMD = -1.17, 95% CI [-1.42, -0.93]), IBS quality of life (SMD = 2.37, 95% CI [1.94, 2.80]), recurrence rate (RR = 0.43, 95% CI [0.28, 0.66]), and IBS Symptom Severity Scale (SMD = -0.75, 95% CI [-1.04, -0.47]). Compared to dicetel (RR = 1.25, 95% CI [1.18, 1.32]) and trimebutine maleate (RR = 1.35, 95% CI [1.13, 1.61]), acupuncture also showed more effective at total efficiency. The more adverse effect occurred in the acupuncture group when comparing with the dicetel group (RR = 11.86, 95% CI [1.58, 89.07]) and loperamide group (RR = 4.42, 95% CI [0.57, 33.97]), but most of the adverse reactions were mild hypodermic hemorrhage. Conclusion. Acupuncture treatment can improve the clinical effectiveness of IBS-D or FD, with great safety, but the above conclusions need to be further verified through the higher quality of evidence.
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Affiliation(s)
- Jianbo Guo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Xiaoxiao Xing
- Beijing University of Chinese Medicine, Beijing, China
| | - Jiani Wu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hui Zhang
- Henan University of Chinese Medicine, Henan, China
| | - Yongen Yun
- Beijing University of Chinese Medicine, Beijing, China
| | - Zongshi Qin
- Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Qingyong He
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Ding JH, Jin Z, Yang XX, Lou J, Shan WX, Hu YX, Du Q, Liao QS, Xie R, Xu JY. Role of gut microbiota via the gut-liver-brain axis in digestive diseases. World J Gastroenterol 2020; 26:6141-6162. [PMID: 33177790 PMCID: PMC7596643 DOI: 10.3748/wjg.v26.i40.6141] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/29/2020] [Accepted: 09/18/2020] [Indexed: 02/06/2023] Open
Abstract
The gut-brain axis is a bidirectional information interaction system between the central nervous system (CNS) and the gastrointestinal tract, in which gut microbiota plays a key role. The gut microbiota forms a complex network with the enteric nervous system, the autonomic nervous system, and the neuroendocrine and neuroimmunity of the CNS, which is called the microbiota-gut-brain axis. Due to the close anatomical and functional interaction of the gut-liver axis, the microbiota-gut-liver-brain axis has attracted increased attention in recent years. The microbiota-gut-liver-brain axis mediates the occurrence and development of many diseases, and it offers a direction for the research of disease treatment. In this review, we mainly discuss the role of the gut microbiota in the irritable bowel syndrome, inflammatory bowel disease, functional dyspepsia, non-alcoholic fatty liver disease, alcoholic liver disease, cirrhosis and hepatic encephalopathy via the gut-liver-brain axis, and the focus is to clarify the potential mechanisms and treatment of digestive diseases based on the further understanding of the microbiota-gut- liver-brain axis.
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Affiliation(s)
- Jian-Hong Ding
- Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
| | - Zhe Jin
- Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
| | - Xiao-Xu Yang
- Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
| | - Jun Lou
- Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
| | - Wei-Xi Shan
- Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
| | - Yan-Xia Hu
- Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
| | - Qian Du
- Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
| | - Qiu-Shi Liao
- Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
| | - Rui Xie
- Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
| | - Jing-Yu Xu
- Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
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Altunisi A, Mosli M, Banweer M, Qari Y, Arif FO, Saadah OI. Patterns of Complementary and Alternative Medicine Use in Saudi Arabian Patients With Inflammatory Bowel Disease: A Cross-Sectional Study. Cureus 2020; 12:e9687. [PMID: 32944426 PMCID: PMC7488625 DOI: 10.7759/cureus.9687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Inflammatory bowel disease (IBD) concerns a group of chronic autoimmune diseases that results in uncontrolled inflammation of the gastrointestinal (GI) tract, which can lead to long-term complications. Conventional treatments for IBD usually target inflammation and include biologics and immunosuppressants, which have been associated with significant adverse effects. Also, non-response to biologics has been reported in up to 50% of patients. Hence, patients sometimes turn to unconventional methods of treatment, such as complementary and alternative medicine (CAM). In this study, we examine patterns of CAM use in Saudi patients diagnosed with IBD. Materials and methods We conducted a cross-sectional study of patients with IBD who were seen at the outpatient gastroenterology clinic between January 2018 and December 2019. Adult patients diagnosed with ulcerative colitis (UC) or Crohn's disease (CD) were identified and surveyed. Clinical, laboratory, endoscopic, radiologic, and histologic data were collected. The patients completed a detailed questionnaire focusing on CAM use. Descriptive statics, quantitative variables, means, standard deviations (SDs), and minimum and maximum values or medians with interquartile ranges were used where appropriate; for qualitative variables, we reported frequencies. The prevalence of CAM use was calculated using standard prevalence formulae. Logistic regression analysis was performed to identify predictors for CAM use. A p-value of <0.05 was set as statistically significant. Results A total of 71 IBD patients were surveyed, of which 75% had CD. Severe symptoms were reported by 54% of patients, and 41% were receiving biological treatment; 90% of this cohort reported using some form of CAM, of which 78% used them within the past year, and 52% reported CAM treatment having a positive effect. Of note, 63% of patients reported using CAM therapy without the knowledge of their treating physician. The most common source of advice regarding the use of CAM medicine was relatives (66%), and the most common forms of CAM used were honey (62%), Zamzam water (54%), and physical activity (32%). Binary logistic regression analysis identified watery diarrhea (OR=5.7, 95% CI=1.0-31, P=0.04) and azathioprine (OR=18.1, 95% CI=1.3-255, P=0.03) as predictors of CAM use. Conclusions CAM use is very common in Saudi patients with IBD. The majority of patients seem to turn to CAM if their symptoms are severe. They generally appear to be influenced by culture, the Internet, local society, and family tradition in their decision to use CAM, rather than expert advice from their treating physician.
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Affiliation(s)
- Albaraa Altunisi
- Internal Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Mahmoud Mosli
- Gastroenterology, King Abdulaziz University Hospital, Jeddah, SAU
| | - Mazen Banweer
- Pediatrics, King Abdulaziz University Hospital, Jeddah, SAU
| | - Yousif Qari
- Gastroenterology, King Abdulaziz University Hospital, Jeddah, SAU
| | - Faris O Arif
- Internal Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Omar I Saadah
- Pediatric Gastroenterology, King Abdulaziz University Hospital, Jeddah, SAU
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Bilski J, Wojcik D, Danielak A, Mazur-Bialy A, Magierowski M, Tønnesen K, Brzozowski B, Surmiak M, Magierowska K, Pajdo R, Ptak-Belowska A, Brzozowski T. Alternative Therapy in the Prevention of Experimental and Clinical Inflammatory Bowel Disease. Impact of Regular Physical Activity, Intestinal Alkaline Phosphatase and Herbal Products. Curr Pharm Des 2020; 26:2936-2950. [DOI: 10.2174/1381612826666200427090127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 04/18/2020] [Indexed: 02/06/2023]
Abstract
Inflammatory bowel diseases (IBD), such as ulcerative colitis and Crohn's disease, are multifactorial, chronic, disabling, and progressive diseases characterised by cyclical nature, alternating between active and quiescent states. While the aetiology of IBD is not fully understood, this complex of diseases involve a combination of factors including the genetic predisposition and changes in microbiome as well as environmental risk factors such as high-fat and low-fibre diets, reduced physical activity, air pollution and exposure to various toxins and drugs such as antibiotics. The prevalence of both IBD and obesity is increasing in parallel, undoubtedly proving the existing interactions between these risk factors common to both disorders to unravel poorly recognized cell signaling and molecular alterations leading to human IBD. Therefore, there is still a significant and unmet need for supportive and adjunctive therapy for IBD patients directed against the negative consequences of visceral obesity and bacterial dysbiosis. Among the alternative therapies, a moderate-intensity exercise can benefit the health and well-being of IBD patients and improve both the healing of human IBD and experimental animal colitis. Intestinal alkaline phosphatase (IAP) plays an essential role in the maintenance of intestinal homeostasis intestinal and the mechanism of mucosal defence. The administration of exogenous IAP could be recommended as a therapeutic strategy for the cure of diseases resulting from the intestinal barrier dysfunction such as IBD. Curcumin, a natural anti-inflammatory agent, which is capable of stimulating the synthesis of endogenous IAP, represents another alternative approach in the treatment of IBD. This review was designed to discuss potential “nonpharmacological” alternative and supplementary therapeutic approaches taking into account epidemiological and pathophysiological links between obesity and IBD, including changes in the functional parameters of the intestinal mucosa and alterations in the intestinal microbiome.
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Affiliation(s)
- Jan Bilski
- Department of Ergonomics and Exercise Physiology, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland
| | - Dagmara Wojcik
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Aleksandra Danielak
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Agnieszka Mazur-Bialy
- Department of Ergonomics and Exercise Physiology, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland
| | - Marcin Magierowski
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Katherine Tønnesen
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Bartosz Brzozowski
- Gastroenterology and Hepatology Clinic, Jagiellonian University Medical College, Cracow, Poland
| | - Marcin Surmiak
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Katarzyna Magierowska
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Robert Pajdo
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Agata Ptak-Belowska
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Tomasz Brzozowski
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
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Weber L, Kuck K, Jürgenliemk G, Heilmann J, Lipowicz B, Vissiennon C. Anti-Inflammatory and Barrier-Stabilising Effects of Myrrh, Coffee Charcoal and Chamomile Flower Extract in a Co-Culture Cell Model of the Intestinal Mucosa. Biomolecules 2020; 10:E1033. [PMID: 32664498 PMCID: PMC7407830 DOI: 10.3390/biom10071033] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/07/2020] [Accepted: 07/07/2020] [Indexed: 12/19/2022] Open
Abstract
Recent clinical evidence suggests the efficacy of a traditional herbal medicinal product containing myrrh (Commiphora molmol Engl.), coffee charcoal (Coffea arabica L.) and chamomile flower dry extract (Matricaria chamomilla L.) in the therapy of inflammatory bowel diseases (IBD). However, the mechanisms of action in this context have not been entirely elucidated. The present study aimed to evaluate the effects of myrrh, coffee charcoal and chamomile flower extract on the inflammatory cross talk between immune and intestinal epithelial cells together with the resulting intestinal barrier disorders. A complex co-culture cell model consisting of intestinal epithelial cell (IEC) monolayers (Caco-2, HT29-MTX-E12) and macrophages (THP-1) was established for the simultaneous investigation of these two IBD characteristics. The lipopolysaccharide (LPS) activation of the macrophages led to a pro-inflammatory mediator release and thereby an inflammatory stimulation of IECs with chemokine release and reduced barrier function. The effects of the individual plant extracts and a ternary combination on inflammatory mediator release (IL-6, TNF, IL-8, MCP-1, PGE2) was quantified by ELISA. The transepithelial electrical resistance (TEER) of IEC monolayers was measured to evaluate the effects on the barrier function. Budesonide served as a positive control. All three plant extracts exhibited anti-inflammatory properties via the inhibition of the inflammatory mediator release to a varying extent. An intestinal barrier stabilising effect was observed for myrrh and coffee charcoal. Myrrh exerted the most distinct pharmacological activity. Dose reducing and synergistic interactions emerged within the threefold combination. Thus, our results provide a mechanistic basis for the use of the herbal combination of myrrh, coffee charcoal and chamomile flower extract in IBD treatment and underline the potential benefits of the phytotherapeutic multi-component/multi-target approach in this complex pathogenesis.
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Affiliation(s)
- Laura Weber
- Institute of Medical Physics and Biophysics, Medical Faculty, Leipzig University, Härtelstraße 16-18, 04107 Leipzig, Germany
- Repha GmbH Biologische Arzneimittel, Alt-Godshorn 87, 30855 Langenhagen, Germany;
| | - Katrin Kuck
- Pharmaceutical Biology, Institute of Pharmacy, University of Regensburg, Universitätsstraße 31, 93053 Regensburg, Germany; (K.K.); (G.J.); (J.H.)
| | - Guido Jürgenliemk
- Pharmaceutical Biology, Institute of Pharmacy, University of Regensburg, Universitätsstraße 31, 93053 Regensburg, Germany; (K.K.); (G.J.); (J.H.)
| | - Jörg Heilmann
- Pharmaceutical Biology, Institute of Pharmacy, University of Regensburg, Universitätsstraße 31, 93053 Regensburg, Germany; (K.K.); (G.J.); (J.H.)
| | - Bartosz Lipowicz
- Repha GmbH Biologische Arzneimittel, Alt-Godshorn 87, 30855 Langenhagen, Germany;
| | - Cica Vissiennon
- Institute of Medical Physics and Biophysics, Medical Faculty, Leipzig University, Härtelstraße 16-18, 04107 Leipzig, Germany
- Repha GmbH Biologische Arzneimittel, Alt-Godshorn 87, 30855 Langenhagen, Germany;
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Complementary, alternative, integrative and dietary therapies for children with Crohn's disease - A systematic review. Complement Ther Med 2020; 52:102493. [PMID: 32951742 DOI: 10.1016/j.ctim.2020.102493] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/16/2020] [Accepted: 06/22/2020] [Indexed: 01/14/2023] Open
Abstract
Children with diagnosed inflammatory bowel diseases such as Crohn's disease are faced with the daunting prospect of living with a chronic disease. Besides psychological stress, children are suffering from therapy side-effects; in particular, corticosteroid therapies are problematic in the growth phase. This highlights that there is a need for less aggressive alternative therapies for children as well as adolescents living with such chronic conditions. Elemental diets are widely used and accepted therapy options. Several pediatric Crohn's disease patients also use complementary, alternative and integrative therapies to reduce or avoid drug therapies. To survey such therapy options and their efficiency and safety, we performed a systematic literature search and screened databases (Cochrane Library, EMBASE, OvidSP, PubMed, CAMbase, CAM-QUEST, Anthromedics) from their inception to December 2019. In total, seven of 1439 studies fulfilled search criteria. Six RCTs and one retrospective controlled trial investigating elemental diets (Flexical, Elemental 028), semi-elemental diets (Pregomin), polymeric diets (Modulen IBD), whole protein based formulas, and ω-3 fatty acid supplementation were found. Data indicated that diet therapies were equal to or more effective than corticosteroid therapies when used to treat Crohn's disease. Regrettably, we could not identify controlled studies investigating complementary, alternative and integrative medicine approaches. Our review provides an updated overview of controlled studies investigating dietary therapies used in the treatment of pediatric Crohn's disease, and demonstrates that the current study situation does not reflect the actual use of complementary, alternative and integrative therapies. Therefore, clinical trials are necessary to estimate risks and benefits of such therapies. The review indicated that enteral diets and ω-3 fatty acid supplementation may be an effective alternative to corticosteroid treatments for children with Chron's disease.
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Desmarais A, Smiddy S, Reddy S, El-Dallal M, Erlich J, Feuerstein JD. Evidence supporting the benefits of marijuana for Crohn's disease and ulcerative colitis is extremely limited: a meta-analysis of the literature. Ann Gastroenterol 2020; 33:495-499. [PMID: 32879596 PMCID: PMC7406822 DOI: 10.20524/aog.2020.0516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/12/2020] [Indexed: 01/04/2023] Open
Abstract
Background Medical marijuana is increasingly used to control inflammation and pain in inflammatory bowel disease (IBD). We performed a meta-analysis to investigate the effect of marijuana on the clinical response, induction of clinical remission, and maintenance of clinical remission compared to placebo/standard of care. Methods We performed a systematic search of PubMed, Embase, and Web of Science in June 2019, for cannabis/marijuana and IBD, Crohn’s disease or ulcerative colitis (UC). The statistical analysis was performed using Revman (version 5.3). GRADE methodology was used to assess the quality of the evidence. Results Of the 334 studies initially reviewed, 1 trial in UC and 2 trials in Crohn’s disease met eligibility. For UC, 29 patients were treated with marijuana and 31 with placebo/standard of care. There was no difference in failure to achieve clinical remission (relative risk [RR] 1.02, 95% confidence interval [CI] 0.76-1.37) or response (RR 0.99, 95%CI 0.65-1.21). Adverse events occurred in all patients receiving marijuana (RR 1.28, 95%CI 1.05-1.56). For Crohn’s disease, 21 patients were treated with marijuana and 19 with placebo/standard of care. There was no difference in failure to achieve clinical remission (RR 0.72, 95%CI 0.47-1.12) or failure to achieve clinical response (RR 0.15, 95%CI 0.02-1.05). Adverse events were not reported per patient. The quality of evidence was low to very low using GRADE methodology. Conclusions Data supporting the use of marijuana for the management of IBD are extremely limited. Further well-designed studies are needed before any positive conclusions regarding marijuana use can be drawn.
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Affiliation(s)
- Anna Desmarais
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Stephen Smiddy
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Sneha Reddy
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Mohammed El-Dallal
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jonathan Erlich
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Joseph D Feuerstein
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, USA
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