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Langgartner D, Amoroso M, Kempter E, Kustermann M, Scheurer J, Lowry CA, Strauß G, Reber SO. Mycobacterium vaccae protects against glucocorticoid resistance resulting from combined physical and psychosocial trauma in mice. Brain Behav Immun 2023; 109:221-234. [PMID: 36736929 DOI: 10.1016/j.bbi.2023.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/09/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
Stress-related somatic and psychiatric disorders are often associated with a decline in regulatory T cell (Treg) counts and chronic low-grade inflammation. Recent preclinical evidence suggests that the latter is at least partly mediated by stress-induced upregulation of toll-like receptor (TLR)2 in newly generated neutrophils and polymorphonuclear myeloid-derived suppressor cells (PMN-MDSCs), as well as glucocorticoid (GC) resistance in predominantly PMN-MDSCs following stress-induced upregulation of TLR4 expression. Here we show in mice exposed to the chronic subordinate colony housing (CSC) paradigm that repeated intragastric (i.g.) administrations of a heat-killed preparation of Mycobacterium vaccae NCTC 11659, a saprophytic microorganism with immunoregulatory properties, protected against the stress-induced reduction in systemic Tregs, increase in basal and LPS-induced in vitro splenocyte viability, as well as splenic in vitro GC resistance. Our findings further support the hypothesis that i.g. M. vaccae protects against CSC-associated splenic GC resistance via directly affecting the myeloid compartment, thereby preventing the CSC-induced upregulation of TLR4 in newly generated PMN-MDSCs. In contrast, the protective effects of i.g. M. vaccae on the CSC-induced upregulation of TLR2 in neutrophils and the subsequent increase in basal and LPS-induced in vitro splenocyte viability seems to be indirectly mediated via the Treg compartment. These data highlight the potential for use of oral administration of M. vaccae NCTC 11659 to prevent stress-induced exaggeration of inflammation, a risk factor for development of stress-related psychiatric disorders.
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Affiliation(s)
- Dominik Langgartner
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Mattia Amoroso
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Elena Kempter
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Monika Kustermann
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Jasmin Scheurer
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Christopher A Lowry
- Department of Integrative Physiology, Department of Psychology and Neuroscience, Center for Neuroscience and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO 80309, USA; Department of Physical Medicine and Rehabilitation and Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), The Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, CO 80045, USA; Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO 80045, USA; VIVO Planetary Health, of the Worldwide Universities Network (WUN), West NY, NJ 07093, USA
| | - Gudrun Strauß
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Stefan O Reber
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany.
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Fritz D, Inamo J, Zhang F. Single-cell computational machine learning approaches to immune-mediated inflammatory disease: New tools uncover novel fibroblast and macrophage interactions driving pathogenesis. Front Immunol 2023; 13:1076700. [PMID: 36685542 PMCID: PMC9846263 DOI: 10.3389/fimmu.2022.1076700] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/01/2022] [Indexed: 01/05/2023] Open
Abstract
Recent advances in single-cell sequencing technologies call for greater computational scalability and sensitivity to analytically decompose diseased tissues and expose meaningful biological relevance in individual cells with high resolution. And while fibroblasts, one of the most abundant cell types in tissues, were long thought to display relative homogeneity, recent analytical and technical advances in single-cell sequencing have exposed wide variation and sub-phenotypes of fibroblasts of potential and apparent clinical significance to inflammatory diseases. Alongside anticipated improvements in single cell spatial sequencing resolution, new computational biology techniques have formed the technical backbone when exploring fibroblast heterogeneity. More robust models are required, however. This review will summarize the key advancements in computational techniques that are being deployed to categorize fibroblast heterogeneity and their interaction with the myeloid compartments in specific biological and clinical contexts. First, typical machine-learning-aided methods such as dimensionality reduction, clustering, and trajectory inference, have exposed the role of fibroblast subpopulations in inflammatory disease pathologies. Second, these techniques, coupled with single-cell predicted computational methods have raised novel interactomes between fibroblasts and macrophages of potential clinical significance to many immune-mediated inflammatory diseases such as rheumatoid arthritis, ulcerative colitis, lupus, systemic sclerosis, and others. Third, recently developed scalable integrative methods have the potential to map cross-cell-type spatial interactions at the single-cell level while cross-tissue analysis with these models reveals shared biological mechanisms between disease contexts. Finally, these advanced computational omics approaches have the potential to be leveraged toward therapeutic strategies that target fibroblast-macrophage interactions in a wide variety of inflammatory diseases.
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Affiliation(s)
- Douglas Fritz
- Medical Scientist Training Program, University of Colorado School of Medicine, Aurora, CO, United States,Division of Rheumatology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States,Center for Health Artificial Intelligence, Department of Biomedical Informatics, University of Colorado School of Medicine, Aurora, CO, United States
| | - Jun Inamo
- Division of Rheumatology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States,Center for Health Artificial Intelligence, Department of Biomedical Informatics, University of Colorado School of Medicine, Aurora, CO, United States
| | - Fan Zhang
- Division of Rheumatology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States,Center for Health Artificial Intelligence, Department of Biomedical Informatics, University of Colorado School of Medicine, Aurora, CO, United States,*Correspondence: Fan Zhang,
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Dawud LM, Holbrook EM, Lowry CA. Evolutionary Aspects of Diverse Microbial Exposures and Mental Health: Focus on "Old Friends" and Stress Resilience. Curr Top Behav Neurosci 2023; 61:93-117. [PMID: 35947354 PMCID: PMC9918614 DOI: 10.1007/7854_2022_385] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The prevalence of inflammatory disease conditions, including allergies, asthma, and autoimmune disorders, increased during the latter half of the twentieth century, as societies transitioned from rural to urban lifestyles. A number of hypotheses have been put forward to explain the increasing prevalence of inflammatory disease in modern urban societies, including the hygiene hypothesis and the "Old Friends" hypothesis. In 2008, Rook and Lowry proposed, based on the evidence that increased inflammation was a risk factor for stress-related psychiatric disorders, that the hygiene hypothesis or "Old Friends" hypothesis may be relevant to psychiatric disorders. Since then, it has become more clear that chronic low-grade inflammation is a risk factor for stress-related psychiatric disorders, including anxiety disorders, mood disorders, and trauma- and stressor-related disorders, such as posttraumatic stress disorder (PTSD). Evidence now indicates that persons raised in modern urban environments without daily contact with pets, relative to persons raised in rural environments in proximity to farm animals, respond with greater systemic inflammation to psychosocial stress. Here we consider the possibility that increased inflammation in persons living in modern urban environments is due to a failure of immunoregulation, i.e., a balanced expression of regulatory and effector T cells, which is known to be dependent on microbial signals. We highlight evidence that microbial signals that can drive immunoregulation arise from phylogenetically diverse taxa but are strain specific. Finally, we highlight Mycobacterium vaccae NCTC 11659, a soil-derived bacterium with anti-inflammatory and immunoregulatory properties, as a case study of how single strains of bacteria might be used in a psychoneuroimmunologic approach for prevention and treatment of stress-related psychiatric disorders.
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Affiliation(s)
- Lamya'a M Dawud
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Evan M Holbrook
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Christopher A Lowry
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA.
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA.
- Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, USA.
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
- Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, USA.
- Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA.
- Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, USA.
- inVIVO Planetary Health, Worldwide Universities Network (WUN), West New York, NJ, USA.
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Tatar C, Lightner AL, Jia X, Liska D, Kalady M, Steele SR, Gorgun E. Long-term outcomes of sporadic rectal cancer versus ulcerative colitis-associated rectal cancer: a matched case-control study. ANZ J Surg 2022; 92:3232-3236. [PMID: 36054252 DOI: 10.1111/ans.17992] [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: 05/28/2022] [Accepted: 08/07/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Although patients with ulcerative colitis (UC) are at increased risk of rectal cancer compared to the general population, it remains unclear whether their oncologic outcomes are different than sporadic rectal cancer (S-RC).We aimed to compare survival and oncologic outcomes in S-RC versus UC-associated rectal cancer (UC-RC). METHODS We performed a retrospective case-control study of patients who underwent surgical resection for rectal cancer between 2005 and 2015. Data collected included patient demographics, intraoperative variables, postoperative outcomes, and oncological outcomes. RESULTS A total of 138 patients were included; 92 patients with S-RC and 46 with UC-RC. Both groups were comparable in terms of demographics, oncologic characteristics, oncologic treatment strategies, perioperative complications and operative factors except for preoperative radiotherapy. At a median follow-up time of 3.7 years the 3-and 5-year OS rates; the 1-and 3-year DFS rates were comparable between the groups. CONCLUSION Ulcerative colitis-associated rectal cancer patients have similar survival and oncologic outcomes as sporadic rectal cancer patients.
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Affiliation(s)
- Cihad Tatar
- Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Amy L Lightner
- Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Xue Jia
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - David Liska
- Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Matthew Kalady
- Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Scott R Steele
- Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Emre Gorgun
- Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Alhadab AA, AlMahamed SN, Hassan IE, Hammo AH. The impact of inflammatory bowel diseases on the quality of life of Saudi pediatric patients: A cross-sectional study. Saudi J Gastroenterol 2022; 28:448-455. [PMID: 35946259 PMCID: PMC9843516 DOI: 10.4103/sjg.sjg_162_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is a chronic gastrointestinal tract disorder characterized by periods of exacerbations and remissions that affect multiple aspects of a pediatric patient's quality of life. The purpose of this study is to describe the health-related quality of life of Saudi pediatric IBD patients and to determine the influencing factors which can affect it. METHODS This is a single center cross-sectional descriptive study, conducted between December 2019 and December 2021. Patients aged between 9 and 16 years diagnosed with IBD were included; IMPACT III quality of life questionnaire was used. RESULTS Thirty-eight patients participated in the study, 57.9 % being male, with a mean age of 12.48 ± 2.72 years, and 55.3 % of patients were diagnosed with Crohn's disease (CD). The most frequent medications were aminosalicylic acids derivatives, followed by immune-modulators and biologics. The IMPACT III quality of life questionnaire has shown lower scores in IBD patients in comparison to healthy control groups. Patients with active disease have lower total and sub-domain scores than patients with inactive disease. We found no correlation between health-related quality of life (HrQOL) and the number of medications used, disease duration, or gender. CONCLUSIONS Pediatric IBD patients have significantly lower HrQOL scores than healthy children. Disease activity was found to be a predictor for poor HrQOL outcome.
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Affiliation(s)
- Abdulhamid A. Alhadab
- Department of Pediatric, Section of Pediatric Gastroenterology, Hepatology, and Nutrition, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Shaden N. AlMahamed
- Department of Pediatric, Section of Pediatric Gastroenterology, Burjeel Specialty Hospital, Sharjah, United Arab Emirates
| | - Ibrahim E. Hassan
- Department of Pediatric, Section of Pediatric Gastroenterology, Hepatology, and Nutrition, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Abdelhai H. Hammo
- Department of Pediatric, Section of Pediatric Gastroenterology, Hepatology, and Nutrition, King Fahad Specialist Hospital, Dammam, Saudi Arabia,Address for correspondence: Dr. Abdelhai H. Hammo, Department of Pediatric, Section of Pediatric Gastroenterology, Hepatology, and Nutrition, King Fahad Specialist Hospital, Dammam, Saudi Arabia. E-mail:
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Zhang Z, Yu PF, Gu GL, Zhang YH, Wang YM, Dong ZW, Yang HR. Diffuse invasive signet ring cell carcinoma in total colorectum caused by ulcerative colitis: A case report and review of literature. World J Clin Cases 2022; 10:1729-1737. [PMID: 35211616 PMCID: PMC8855258 DOI: 10.12998/wjcc.v10.i5.1729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/05/2021] [Accepted: 12/28/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Diffuse invasive signet ring cell carcinoma of the colorectum is extremely rare clinically. This type of colorectal cancer has certain clinical, pathological and biological characteristics that are different from ordinary colorectal cancer.
CASE SUMMARY A 31-year-old young woman was admitted to the hospital for nearly 1 wk due to recurrent symptoms of mucopurulent bloody stools and abdominal distension. Preoperative colonoscopy showed a ring-shaped intestinal wall mass 10 cm from the rectum to the anus. Three pieces of tumor tissue were removed for examination. The pathological results showed rectal mucinous adenocarcinoma. The patient underwent laparoscopic exploration under general anesthesia, and then laparoscopic total colorectal resection, ileal pouch–anal anastomosis and ileostomy were performed. The patient was switched to a FOLFOX + cetuximab regimen. After the fifth cycle, the patient was unable to tolerate further treatment due to tumor progression and multiple organ dysfunction, and died at the end of May 2020. Overall survival was 7 mo.
CONCLUSION Carcinogenesis of ulcerative colitis is different from sporadic colon cancer, and the overall prognosis is extremely poor.
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Affiliation(s)
- Zhi Zhang
- Department of General Surgery, Air Force Medical Center, Chinese People's Liberation Army, Beijing 100142, China
| | - Peng-Fei Yu
- Department of General Surgery, Air Force Medical Center, Chinese People's Liberation Army, Beijing 100142, China
| | - Guo-Li Gu
- Department of General Surgery, Air Force Medical Center, Chinese People's Liberation Army, Beijing 100142, China
| | - Yu-Hui Zhang
- Department of General Surgery, Air Force Medical Center, Chinese People's Liberation Army, Beijing 100142, China
- Graduate School, Hebei North University, Zhangjiakou 075000, Hebei Province, China
| | - Yu-Ming Wang
- Health Team, 93656 Troop of Chinese People's Liberation Army, Beijing 101113, China
| | - Zhi-Wei Dong
- Department of General Surgery, Air Force Medical Center, Chinese People's Liberation Army, Beijing 100142, China
| | - Hai-Rui Yang
- Department of General Surgery, Air Force Medical Center, Chinese People's Liberation Army, Beijing 100142, China
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Wu Y, Liu X, Li G. Integrated bioinformatics and network pharmacology to identify the therapeutic target and molecular mechanisms of Huangqin decoction on ulcerative Colitis. Sci Rep 2022; 12:159. [PMID: 34997010 PMCID: PMC8741777 DOI: 10.1038/s41598-021-03980-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/13/2021] [Indexed: 12/14/2022] Open
Abstract
Huangqin decoction (HQD) is a Traditional Chinese Medicine formula for ulcerative colitis. However, the pharmacology and molecular mechanism of HQD on ulcerative colitis is still unclear. Combined microarray analysis, network pharmacology, and molecular docking for revealing the therapeutic targets and molecular mechanism of HQD against ulcerative colitis. TCMSP, DrugBank, Swiss Target Prediction were utilized to search the active components and effective targets of HQD. Ulcerative colitis effective targets were obtained by microarray data from the GEO database (GSE107499). Co-targets between HQD and ulcerative colitis are obtained by Draw Venn Diagram. PPI (Protein–protein interaction) network was constructed by the STRING database. To obtain the core target, topological analysis is exploited by Cytoscape 3.7.2. GO and KEGG enrichment pathway analysis was performed to Metascape platform, and molecular docking through Autodock Vina 1.1.2 finished. 161 active components with 486 effective targets of HQD were screened. 1542 ulcerative colitis effective targets were obtained with |Log2FC|> 1 and adjusted P-value < 0.05. The Venn analysis was contained 79 co-targets. Enrichment analysis showed that HQD played a role in TNF signaling pathway, IL-17 signaling pathway, Th17 cell differentiation, etc. IL6, TNF, IL1B, PTGS2, ESR1, and PPARG with the highest degree from PPI network were successfully docked with 19 core components of HQD, respectively. According to ZINC15 database, quercetin (ZINC4175638), baicalein (ZINC3871633), and wogonin (ZINC899093) recognized as key compounds of HQD on ulcerative colitis. PTGS2, ESR1, and PPARG are potential therapeutic targets of HQD. HQD can act on multiple targets through multi-pathway, to carry out its therapeutic role in ulcerative colitis.
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Affiliation(s)
- Yi Wu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300000, China. .,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300000, China.
| | - Xinqiao Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300000, China
| | - Guiwei Li
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300000, China
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Bai D, Sun T, Zhao J, Du J, Bu X, Cao W, Zhao Y, Lu N. Oroxylin A maintains the colonic mucus barrier to reduce disease susceptibility by reconstituting a dietary fiber-deprived gut microbiota. Cancer Lett 2021; 515:73-85. [PMID: 34052330 DOI: 10.1016/j.canlet.2021.05.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/17/2021] [Accepted: 05/20/2021] [Indexed: 12/16/2022]
Abstract
Dietary fiber intake helps to maintain gut homeostasis. Fiber deficiency causes commensals to utilize mucins as an energy source to destroy mucus layer, thus promoting susceptibility to inflammatory bowel disease. Here, we reported that oroxylin A, a natural flavonoid, ameliorated low-grade colonic inflammation caused by fiber deficiency, alleviated colitis, and further prevented colitis-associated colon cancer in mice. The anti-inflammatory effect of oroxylin A was due to its alteration of gut microbiota. We found that the levels of Eubacterium coprostanoligenes was significantly increased by oroxylin A and the colonized Eubacterium coprostanoligenes significantly protected against colitis and carcinogenesis in colon of mice. Together, our results in this study suggest that oroxylin A may reduce the susceptibility to intestinal diseases by increasing the level of Eubacterium coprostanoligenes which could provide a therapeutic alternation for the treatment of intestinal diseases.
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Affiliation(s)
- Dongsheng Bai
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Carcinogenesis and Intervention, Department of Physiology, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing, 210009, People's Republic of China
| | - Tifan Sun
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Carcinogenesis and Intervention, Department of Physiology, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing, 210009, People's Republic of China
| | - Jiawei Zhao
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Carcinogenesis and Intervention, Department of Physiology, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing, 210009, People's Republic of China
| | - Jiaying Du
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Carcinogenesis and Intervention, Department of Physiology, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing, 210009, People's Republic of China
| | - Xiumin Bu
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Carcinogenesis and Intervention, Department of Physiology, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing, 210009, People's Republic of China
| | - Wangjia Cao
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Carcinogenesis and Intervention, Department of Physiology, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing, 210009, People's Republic of China
| | - Yue Zhao
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Carcinogenesis and Intervention, Department of Physiology, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing, 210009, People's Republic of China.
| | - Na Lu
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Carcinogenesis and Intervention, Department of Physiology, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing, 210009, People's Republic of China.
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Differences in inflammatory bowel diseases between East and West: a Chinese perspective. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-019-01102-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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10
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Bodiwala V, Marshall T, Das KM, Brant SR, Seril DN. Comparison of Disease Phenotypes and Clinical Characteristics Among South Asian and White Patients with Inflammatory Bowel Disease at a Tertiary Referral Center. Inflamm Bowel Dis 2020; 26:1869-1877. [PMID: 32144933 DOI: 10.1093/ibd/izaa019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The prevalence and clinical features of inflammatory bowel disease (IBD) vary among different racial and ethnic groups. The aim of this study was to compare the clinical and phenotypic features of Crohn's disease (CD) and ulcerative colitis (UC) in South Asian patients living in the United States with those of a white cohort. METHODS The demographic, clinical, and phenotypic characteristics of 73 South Asian patients (31 CD and 42 UC) who presented initially to our tertiary referral center from 2012 to 2016 and had subsequent follow-up were retrospectively compared with those of 408 consecutive white patients (245 CD and 163 UC). RESULTS South Asian IBD patients were significantly more likely to have UC (58.0% vs 40.0%; P = 0.005) than white patients. South Asians with CD were less likely to have a family history of IBD (9.7% vs 26.9%; P = 0.037) and required fewer CD-related surgeries (22.5% vs 46.1; P = 0.012). South Asians were also less likely to be active or former smokers in both the CD (P = 0.004) and UC (P = 0.020) groups. South Asians with UC had a higher incidence of Clostridium difficile infection compared with white patients (19.0% vs 8.6%; P = 0.050). CONCLUSIONS A cohort of South Asian patients with IBD were more likely to have UC and had differing family and tobacco risk factors, requirements for surgery, and Clostridium difficile infection rates as compared with white patients.
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Affiliation(s)
- Vimal Bodiwala
- Department of Internal Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ
| | | | - Kiron M Das
- Department of Internal Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ.,Crohn's and Colitis Center of New Jersey, Division of Gastroenterology and Hepatology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Steven R Brant
- Department of Internal Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ.,Crohn's and Colitis Center of New Jersey, Division of Gastroenterology and Hepatology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Darren N Seril
- Department of Internal Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ.,Crohn's and Colitis Center of New Jersey, Division of Gastroenterology and Hepatology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ
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11
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Davies M, Dodd S, Coultate M, Ross A, Pears G, Gnaneswaran B, Tzivinikos C, Konidari A, Cheng J, Auth MK, Cameron F, Tamhne S, Renji E, Nair M, Baillie C, Collins P, Smith PJ, Subramanian S. From Paris to Montreal: disease regression is common during long term follow-up of paediatric Crohn's disease. Scand J Gastroenterol 2020; 55:148-153. [PMID: 31928099 DOI: 10.1080/00365521.2019.1710765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Introduction: Paediatric Crohn's disease (PCD) often presents with extensive and a frequent pan-enteric phenotype at onset. However, its long term evolution into adulthood, especially since the widespread use of biological agents, is not well characterised. We conducted a single centre cohort study of all PCD patients transitioned to adult care to assess the long term disease evolution in the era of biologic therapy.Methods: We conducted a retrospective observational, study of all PCD patients who were subsequently transferred to the care of an adult gastroenterology unit and had a minimum follow up of 2 years. We examined the case notes for evolution of disease location and behaviour. Disease location and behaviour was characterised using Paris classification at diagnosis and Montreal classification at last follow-up. In addition, we examined variables associated with complicated disease behaviour and the need for CD related intestinal resection.Results: In total, 132 patients were included with a median age at diagnosis of 13 (IQR 11-14) and a median follow up of 11 years (range 4-14). At diagnosis, 23 (17.4%), 39 (29.6%) and 70 (53%) patients had ileal, colonic and ileocolonic disease respectively. In addition, 31 (23.5%) patients had L4a or L4b disease at diagnosis (proximal or distal to the ligament of treitz respectively) and 13 patients (9.8%) had both whilst 27 (20.4%) patients had perianal disease. At diagnosis, 27 (20.4%) patients had complicated disease behaviour but 83 (62.9)% of patients had an extensive 'pan-enteric' phenotype. Of these patients only 55 (66.3%) retained the pan-enteric phenotype at last follow-up (p = .0002). Disease extension was noted in 25 (18.9%) of patients and regression was noted in 47 (35.6%) of patients, whereas upper GI disease was noted in significantly fewer patients at last follow-up (21, 15.9%) (p = .0001). More patients had complicated disease behaviour (46 patients, 34.9%, p = .0018) at last follow-up. There was a high exposure to both thiopurines 121 (91.7%) and biologics 84 (63.6%). The cumulative probability (95% CI) of surgery was 0.05 (0.02, 0.11) at 1 year, 0.17 (0.11, 0.24) at 3 years and 0.22 (0.15, 0.30) at 5 years. Neither disease location nor behaviour were associated with the need for intestinal resectional surgery.Conclusions: Over the course of an extended follow-up period, there appeared to be changes in both disease location and behaviour in PCD. Interestingly, a significant proportion of patients had disease involution which may be related to a high rate of exposure to thiopurines and biologics. We were unable to identify any variables associated with complicated disease course or the need for intestinal surgery.
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Affiliation(s)
- Mike Davies
- Department of Gastroenterology, Royal Liverpool, and Broadgreen University Hospital NHS Trust, Liverpool, UK
| | - Susanna Dodd
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Morwenna Coultate
- Department of Gastroenterology, Royal Liverpool, and Broadgreen University Hospital NHS Trust, Liverpool, UK
| | - Andrew Ross
- Department of Gastroenterology, Royal Liverpool, and Broadgreen University Hospital NHS Trust, Liverpool, UK
| | - George Pears
- Department of Gastroenterology, Royal Liverpool, and Broadgreen University Hospital NHS Trust, Liverpool, UK
| | - Bruno Gnaneswaran
- Department of Gastroenterology, Royal Liverpool, and Broadgreen University Hospital NHS Trust, Liverpool, UK
| | - Christos Tzivinikos
- Pediatric Gastroenterology, Hepatology and Nutrition, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Anastasia Konidari
- Pediatric Gastroenterology, Hepatology and Nutrition, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Jeng Cheng
- Pediatric Gastroenterology, Hepatology and Nutrition, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Marcus Kh Auth
- Pediatric Gastroenterology, Hepatology and Nutrition, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.,Department of Cellular and Molecular Physiology, University of Liverpool, Liverpool, UK
| | - Fiona Cameron
- Pediatric Gastroenterology, Hepatology and Nutrition, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Sarang Tamhne
- Pediatric Gastroenterology, Hepatology and Nutrition, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Elizabeth Renji
- Pediatric Gastroenterology, Hepatology and Nutrition, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Manjula Nair
- Pediatric Gastroenterology, Hepatology and Nutrition, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Colin Baillie
- Department of Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Paul Collins
- Department of Gastroenterology, Royal Liverpool, and Broadgreen University Hospital NHS Trust, Liverpool, UK
| | - Philip J Smith
- Department of Gastroenterology, Royal Liverpool, and Broadgreen University Hospital NHS Trust, Liverpool, UK
| | - Sreedhar Subramanian
- Department of Gastroenterology, Royal Liverpool, and Broadgreen University Hospital NHS Trust, Liverpool, UK.,Department of Cellular and Molecular Physiology, University of Liverpool, Liverpool, UK
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12
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Ranjbar R, Karampoor S, Jalilian FA. The protective effect of Helicobacter Pylori infection on the susceptibility of multiple sclerosis. J Neuroimmunol 2019; 337:577069. [DOI: 10.1016/j.jneuroim.2019.577069] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/13/2019] [Accepted: 09/13/2019] [Indexed: 12/18/2022]
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13
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Abstract
PURPOSE OF REVIEW We sought to understand the key aspects to optimize in the perioperative period when treating an elderly surgical patient with inflammatory bowel disease. RECENT FINDINGS Addressing preoperative polypharmacy, frailty, and nutrition is important in the elderly population. Understanding intraoperative principles of oncologic risk and pouch formation and the advantages of laparoscopy are key. Postoperative-enhanced recovery pathways and VTE prophylaxis are essential for high-quality care. Preoperative, perioperative, and postoperative factors can greatly impact elderly patients' surgical outcomes.
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14
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Saikosaponin A protects against dextran sulfate sodium-induced colitis in mice. Int Immunopharmacol 2019; 72:454-458. [DOI: 10.1016/j.intimp.2019.04.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 04/09/2019] [Accepted: 04/10/2019] [Indexed: 12/15/2022]
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15
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Dietary Support in Elderly Patients with Inflammatory Bowel Disease. Nutrients 2019; 11:nu11061421. [PMID: 31238597 PMCID: PMC6627086 DOI: 10.3390/nu11061421] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 02/06/2023] Open
Abstract
Ageing of the human population has become a big challenge for health care systems worldwide. On the other hand, the number of elderly patients with inflammatory bowel disease (IBD) is also increasing. Considering the unique clinical characteristics of this subpopulation, including many comorbidities and polypharmacy, the current therapeutic guidelines for the management of IBD should be individualized and applied with caution. This is why the role of non-pharmacological treatments is of special significance. Since both IBD and older age are independent risk factors of nutritional deficiencies, appropriate dietary support should be an important part of the therapeutic approach. In this review paper we discuss the interrelations between IBD, older age, and malnutrition. We also present the current knowledge on the utility of different diets in the management of IBD. Considering the limited data on how to support IBD therapy by nutritional intervention, we focus on the Mediterranean and Dietary Approaches to Stop Hypertension diets, which seem to be the most beneficial in this patient group. We also discuss some new findings on their hypothetical anti-inflammatory influence on the course of IBD.
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16
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Song C, Yang J, Ye W, Zhang Y, Tang C, Li X, Zhou X, Xie Y. Urban-rural environmental exposure during childhood and subsequent risk of inflammatory bowel disease: a meta-analysis. Expert Rev Gastroenterol Hepatol 2019; 13:591-602. [PMID: 30101634 DOI: 10.1080/17474124.2018.1511425] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The relationship between living conditions in urban and rural areas during childhood and subsequent inflammatory bowel disease (IBD) remains controversial. AIM To explore the association between environmental exposures early in life and the subsequent risk of IBD. METHODS Literature searches were conducted in the following databases: PubMed, EMBASE, and Conference Proceedings Citation Index. Studies were analyzed separately using rate ratios (RRs) or odds ratios (ORs) with 95% confidence intervals. RESULTS The search strategy identified 15 studies. Of these, 9 studies explored the association between urban exposure during childhood and ulcerative colitis (UC), and 12 and 4 studies explored this relationship with Crohn's disease (CD) and IBD, respectively. A meta-analysis showed that the pooled ORs estimated for the case-control studies of UC, CD, and IBD were 1.16 (0.83, 1.61), 1.45 (1.45, 1.85), and 1.34 (1.11, 1.62), respectively. The pooled RR estimated for the cohort studies of CD and IBD was 1.48 (1.17, 1.87). The stratified analysis and meta-regression showed significant relationships between CD and living conditions in case-control studies published during 2010-2017 and in non-European countries (P < 0.05). CONCLUSIONS Living conditions during childhood are positively associated with the subsequent development of IBD. Urban living environment is more common among those with CD than UC.
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Affiliation(s)
- Conghua Song
- a Department of Gastroenterology , the First Affiliated Hospital of Nanchang University , Nanchang , China.,b Department of Gastroenterology , Affiliated Hospital of Putian University , Putian , China
| | - Jinpu Yang
- c Queen Mary School , Medical College of Nanchang University , Nanchang , China
| | - Wen Ye
- a Department of Gastroenterology , the First Affiliated Hospital of Nanchang University , Nanchang , China
| | - Yuting Zhang
- d Group of Gastroenterology , Gastroenterology Institute of Jiangxi Province , Nanchang , China.,e Group of intestinal disease , Key Laboratory of Digestive Diseases of Jiangxi Province , Nanchang , China
| | - Chunyan Tang
- a Department of Gastroenterology , the First Affiliated Hospital of Nanchang University , Nanchang , China
| | - Xiaomei Li
- f Cancer Research Center , Xiamen University , Xiamen , China
| | - Xiaojiang Zhou
- a Department of Gastroenterology , the First Affiliated Hospital of Nanchang University , Nanchang , China
| | - Yong Xie
- a Department of Gastroenterology , the First Affiliated Hospital of Nanchang University , Nanchang , China.,d Group of Gastroenterology , Gastroenterology Institute of Jiangxi Province , Nanchang , China.,e Group of intestinal disease , Key Laboratory of Digestive Diseases of Jiangxi Province , Nanchang , China
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17
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Rabe H, Malmquist M, Barkman C, Östman S, Gjertsson I, Saalman R, Wold AE. Distinct patterns of naive, activated and memory T and B cells in blood of patients with ulcerative colitis or Crohn's disease. Clin Exp Immunol 2019; 197:111-129. [PMID: 30883691 PMCID: PMC6591150 DOI: 10.1111/cei.13294] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2019] [Indexed: 01/05/2023] Open
Abstract
Both major subcategories of inflammatory bowel disease (IBD), ulcerative colitis and Crohn’s disease are characterized by infiltration of the gut wall by inflammatory effector cells and elevated biomarkers of inflammation in blood and feces. We investigated the phenotypes of circulating lymphocytes in the two types of IBD in treatment‐naive pediatric patients by analysis of blood samples by flow cytometry. Multivariate analysis was used to compare the phenotypes of the blood lymphocytes of children with ulcerative colitis (n = 17) or Crohn’s disease (n = 8) and non‐IBD control children with gastrointestinal symptoms, but no signs of gut inflammation (n = 23). The two IBD subcategories could be distinguished based on the results from the flow cytometry panel. Ulcerative colitis was characterized by activated T cells, primarily in the CD8+ population, as judged by increased expression of human leukocyte antigen D‐related (HLA‐DR) and the β1‐integrins [very late antigen (VLA)] and a reduced proportion of naive (CD62L+) T cells, compared with the non‐IBD controls. This T cell activation correlated positively with fecal and blood biomarkers of inflammation. In contrast, the patients with Crohn’s disease were characterized by a reduced proportion of B cells of the memory CD27+ phenotype compared to the non‐IBD controls. Both the patients with ulcerative colitis and those with Crohn’s disease showed increased percentages of CD23+ B cells, which we demonstrate here as being naive B cells. The results support the notion that the two major forms of IBD may partially have different pathogenic mechanisms.
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Affiliation(s)
- H Rabe
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - M Malmquist
- Department of Pediatrics, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - C Barkman
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - S Östman
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - I Gjertsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - R Saalman
- Department of Pediatrics, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - A E Wold
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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18
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Langgartner D, Lowry CA, Reber SO. Old Friends, immunoregulation, and stress resilience. Pflugers Arch 2019; 471:237-269. [PMID: 30386921 PMCID: PMC6334733 DOI: 10.1007/s00424-018-2228-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/03/2018] [Accepted: 10/22/2018] [Indexed: 02/07/2023]
Abstract
There is a considerable body of evidence indicating that chronic adverse experience, especially chronic psychosocial stress/trauma, represents a major risk factor for the development of many somatic and affective disorders, including inflammatory bowel disease (IBD) and posttraumatic stress disorder (PTSD). However, the mechanisms underlying the development of chronic stress-associated disorders are still in large part unknown, and current treatment and prevention strategies lack efficacy and reliability. A greater understanding of mechanisms involved in the development and persistence of chronic stress-induced disorders may lead to novel approaches to prevention and treatment of these disorders. In this review, we provide evidence indicating that increases in immune (re-)activity and inflammation, potentially promoted by a reduced exposure to immunoregulatory microorganisms ("Old Friends") in today's modern society, may be causal factors in mediating the vulnerability to development and persistence of stress-related pathologies. Moreover, we discuss strategies to increase immunoregulatory processes and attenuate inflammation, as for instance contact with immunoregulatory Old Friends, which appears to be a promising strategy to promote stress resilience and to prevent/treat chronic stress-related disorders.
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Affiliation(s)
- Dominik Langgartner
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, University Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Christopher A Lowry
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, 80309, USA
- Department of Physical Medicine & Rehabilitation and Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Denver Veterans Affairs Medical Center (VAMC), Denver, CO, 80220, USA
- Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO, 80220, USA
| | - Stefan O Reber
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, University Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
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Yu HC, Chen TP, Chang YC. Inflammatory bowel disease as a risk factor for periodontitis under Taiwanese National Health Insurance Research database. J Dent Sci 2018; 13:242-247. [PMID: 30895127 PMCID: PMC6388870 DOI: 10.1016/j.jds.2018.03.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 02/05/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND/PURPOSE Inflammatory bowel disease (IBD), comprised Crohn's disease and ulcerative colitis, is a mucosal immune response that affects gastroenterological tract. The association between IBD and periodontitis was inconclusive. In this study, we aimed to investigate the association between IBD and periodontitis by using a register-based dataset. MATERIALS AND METHODS The dataset conducting in this retrospective cohort study was obtained from the National Health Insurance Research database (NHIRD) in Taiwan. For IBD group, conditionally selected control subjects were matched in 1:4 ratio from general population. The risk of periodontitis among IBD group comparing with non-IBD group was calculated by multivariable Cox proportional hazards model. RESULTS In IBD cohort, 27 IBD patients (7 Crohn's disease and 20 ulcerative colitis) with catastrophic illness registry were identified. 108 controls were selected as non-IBD cohort. The median follow-up period was 3.00 years in the IBD group and 3.15 years in the non-IBD group. The cumulative incidence of IBD was 4.32 per 100,000 persons. After adjusting for several confounding factors, IBD group had higher risk for developing periodontitis than non-IBD group (adjusted HR: 1.82; 95% CI: 1.09-3.03). To further stratification with subtype, Crohn's disease group had significantly higher risk of periodontitis (adjusted HR: 3.95; 95% CI: 1.59-9.82). CONCLUSIONS Taken together, this retrospective cohort study showed that patients with IBD increase risk of having periodontitis comparing with non-IBD group, especially in Crohn's disease subgroup.
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Affiliation(s)
- Hui-Chieh Yu
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
| | - Tsung-Po Chen
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Chao Chang
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
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20
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Tremlett H, Rodney R, Lucas R. Can falling infection rates in one country explain rising incidence of autoimmune and allergic diseases in other countries? Caution when (over) interpreting ecological data from disparate areas. Mult Scler Relat Disord 2018; 21:A3-A5. [PMID: 29724378 DOI: 10.1016/j.msard.2017.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 11/02/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Helen Tremlett
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Centre for Brain Health and Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, Canada.
| | - Rachael Rodney
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Robyn Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia; Centre for Ophthalmology and Visual Sciences, University of Western Australia, Perth, Western Australia, Australia
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21
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Neonatal Colonic Inflammation Epigenetically Aggravates Epithelial Inflammatory Responses to Injury in Adult Life. Cell Mol Gastroenterol Hepatol 2018; 6:65-78. [PMID: 29928672 PMCID: PMC6008258 DOI: 10.1016/j.jcmgh.2018.02.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 02/01/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND & AIMS Early life adversity is considered a risk factor for the development of gastrointestinal diseases, including inflammatory bowel disease. We hypothesized that early life colonic inflammation causes susceptibility to aggravated overexpression of interleukin (IL)1β. METHODS We developed a 2-hit rat model in which neonatal inflammation (NI) and adult inflammation (AI) were induced by trinitrobenzene sulfonic acid. RESULTS Aggravated immune responses were observed in NI + AI rats, including a sustained up-regulation of IL1β and other cytokines. In parallel with exacerbated loss of inhibitor of kappa B alpha expression, NI + AI rats showed hyperacetylation of histone H4K12 and increased V-Rel Avian Reticuloendotheliosis Viral Oncogene Homolog A binding on the IL1B promoter, accompanied by high levels of norepinephrine/epinephrine. Propranolol, a β-blocker, markedly ameliorated the inflammatory response and IL1β overexpression by mitigating against epigenetic modifications. Adrenalectomy abrogated NI-induced disease susceptibility whereas yohimbine sensitized the epithelium for exacerbated immune response. The macrophages of NI rats produced more IL1β than controls after exposure to lipopolysaccharide (LPS), suggesting hypersensitization; incubation with LPS plus Foradil (Sigma, St. Louis, MO), a β2-agonist, induced a greater IL1β expression than LPS alone. Epinephrine and Foradil also exacerbated LPS-induced IL1β activation in human THP-1-derived macrophages, by increasing acetylated H4K12, and these increases were abrogated by propranolol. CONCLUSIONS NI sensitizes the colon epithelium for exacerbated IL1β activation by increasing stress hormones that induce histone hyperacetylation, allowing greater access of nuclear factor-κB to the IL1B promoter and rendering the host susceptible to aggravated immune responses. Our findings suggest that β blockers have a therapeutic potential for inflammatory bowel disease susceptibility and establish a novel paradigm whereby NI induces epigenetic susceptibility to inflammatory bowel disease.
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Key Words
- AI, adult inflammation
- ChIP, chromatin immunoprecipitation
- Ctl, control
- Early Life Adversity
- Epinephrine
- H4K12ac, acetylated HRK12
- HDAC, histone deacetylase
- Histone Acetylation
- IBD, inflammatory bowel disease
- IL, interleukin
- Inflammatory Bowel Disease
- IκB, inhibitor of kappa B alpha
- LPS, lipopolysaccharide
- MPO, myeloperoxidase
- NF-κB
- NF-κB, nuclear factor-κB
- NI, neonatal inflammation
- PCR, polymerase chain reaction
- PMA, phorbol 12-myristate 13-acetate
- RNAP II, RNA polymerase II
- RelA, V-Rel Avian Reticuloendotheliosis Viral Oncogene Homolog A
- TNBS, 2,4,6-trinitrobenzene sulfonic acid
- Tnf, tumor necrosis factor
- mRNA, messenger RNA
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22
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Abstract
The gut microbiota, as the main member in gut microecology, is an essential mediator in health and disease. The gut microbiota interacts with various organs and systems in the body, including brain, lung, liver, bone, cardiovascular system, and others. Microbiota-derived metabolites such as the short chain fatty acid (SCFA) butyrate are primary signals, which link the gut microbiota and physiology. Recently, the gut microbiota has been identified as the origin of a number of diseases by influencing the related cell signaling pathways such as WNT/beta-catenin pathway in colorectal cancer and T cell receptor signaling in the central nervous system. Moreover, several microRNAs participate in signaling networks through the intervention of the gut microbiota. The interaction between the gut microbiota and miRNAs plays a crucial role in vascular dysfunction and hepatocellular carcinoma (HCC). In this review, we will report and discuss recent findings about the crosstalk between the gut microbiota and physical organs and how the gut microbiota and miRNAs regulate each other while influencing the host via genes, proteins, or metabolites.
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Affiliation(s)
- Qingqing Feng
- State Key Laboratory of Chemical Resource Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Wei-Dong Chen
- Key Laboratory of Receptors-Mediated Gene Regulation and Drug Discovery, School of Medicine, Henan University, Kaifeng, China.,Key Laboratory of Molecular Pathology, School of Basic Medical Science, Inner Mongolia Medical University, Hohhot, China
| | - Yan-Dong Wang
- State Key Laboratory of Chemical Resource Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
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23
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Martin L, Mullaney S, Peche W, Peterson K, Chan S, Morton R, Wan Y, Zhang C, Presson AP, Emery B, Aston K, Jenkins T, Carrell D, Hotaling J. Population-based Semen Analysis Results and Fertility Among Patients With Inflammatory Bowel Disease: Results From Subfertility Health Assisted Reproduction and the Environment (SHARE) Study. Urology 2017; 107:114-119. [DOI: 10.1016/j.urology.2017.06.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/01/2017] [Accepted: 06/19/2017] [Indexed: 12/18/2022]
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24
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Daïen CI, Pinget GV, Tan JK, Macia L. Detrimental Impact of Microbiota-Accessible Carbohydrate-Deprived Diet on Gut and Immune Homeostasis: An Overview. Front Immunol 2017; 8:548. [PMID: 28553291 PMCID: PMC5427073 DOI: 10.3389/fimmu.2017.00548] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 04/24/2017] [Indexed: 12/21/2022] Open
Abstract
Dietary fibers are non-digestible polysaccharides functionally known as microbiota-accessible carbohydrates (MACs), present in inadequate amounts in the Western diet. MACs are a main source of energy for gut bacteria so the abundance and variety of MACs can modulate gut microbial composition and function. This, in turn, impacts host immunity and health. In preclinical studies, MAC-deprived diet and disruption of gut homeostasis aggravate the development of inflammatory diseases, such as allergies, infections, and autoimmune diseases. The present review provides a synopsis on the impact of a low-MAC diet on gut homeostasis or, more specifically, on gut microbiota, gut epithelium, and immune cells.
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Affiliation(s)
- Claire Immediato Daïen
- Nutritional Immunometabolism Node Laboratory, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.,School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia.,Institut de génétique moléculaire de Montpellier, UMR5535, Montpellier University, Montpellier, France
| | - Gabriela Veronica Pinget
- Nutritional Immunometabolism Node Laboratory, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.,School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Jian Kai Tan
- Infection and Immunity Program, Department of Biochemistry and Molecular Biology, Monash Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia
| | - Laurence Macia
- Nutritional Immunometabolism Node Laboratory, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.,School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia.,Infection and Immunity Program, Department of Biochemistry and Molecular Biology, Monash Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia
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25
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Celiberto LS, Bedani R, Rossi EA, Cavallini DCU. Probiotics: The scientific evidence in the context of inflammatory bowel disease. Crit Rev Food Sci Nutr 2017; 57:1759-1768. [PMID: 25996176 DOI: 10.1080/10408398.2014.941457] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Inflammatory bowel disease (IBD) generally comprises Crohn's disease (CD) and ulcerative colitis (UC), and their main characteristic is the intestinal mucosa inflammation. Although its origin is not yet fully known, there is growing evidence related to genetics, intestinal microbiota composition, and the immune system factors such as precursors for the initiation and progression of intestinal conditions. The use of certain probiotic microorganisms has been touted as a possible and promising therapeutic approach in reducing the risk of inflammatory bowel disease, specifically ulcerative colitis. Several mechanisms have been proposed to explain the benefits of probiotics, indicating that some bacterial strains are able to positively modulate the intestinal microbiota and the immune system, and to produce metabolites with anti-inflammatory properties. The aim of this paper is to bring together the various results and information, based on scientific evidence, that are related to probiotics and inflammatory bowel disease, emphasizing the possible mechanisms involved in this action.
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Affiliation(s)
- Larissa Sbaglia Celiberto
- a Department of Food & Nutrition , Faculty of Pharmaceutical Sciences, São Paulo State University (UNESP) , Araraquara , SP , Brazil
| | - Raquel Bedani
- b Departament of Biochemical and Pharmaceutical Technology , Faculty of Pharmaceutical Sciences, University of São Paulo (USP) Properties , SP , Brazil
| | - Elizeu Antonio Rossi
- a Department of Food & Nutrition , Faculty of Pharmaceutical Sciences, São Paulo State University (UNESP) , Araraquara , SP , Brazil
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26
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Li X, Song P, Li J, Tao Y, Li G, Li X, Yu Z. The Disease Burden and Clinical Characteristics of Inflammatory Bowel Disease in the Chinese Population: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030238. [PMID: 28264519 PMCID: PMC5369074 DOI: 10.3390/ijerph14030238] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 02/09/2017] [Accepted: 02/23/2017] [Indexed: 12/17/2022]
Abstract
The temporal trend of inflammatory bowel disease (IBD) incidence is reported to be increasing in worldwide regions; however, reports focusing on China are sparse. The aim of this study was to provide an overview of the disease burden and clinical features of IBD in the Chinese population. We searched Medline, EMBASE, and another two Chinese databases. A parallel literature review and data extraction were conducted. Meta-analysis was performed to estimate the summary incidence rate of Crohn’s disease (CD) and ulcerative colitis (UC). The constituent ratios with 95% CI were calculated for clinical phenotypes and classifications. The literature review included 47 publications. The summary incidence rate of IBD was 1.74 (95% CI: 1.08; 2.40) per 100,000 person years, and the corresponding incidence rates of CD and UC were 0.40 (95% CI: 0.23; 0.57) and 1.18 (95% CI: 0.81; 1.56) per 100,000 person years, respectively. The sex distribution analysis indicated a male predominance in both CD (sex ratio: 1.64; 95% CI: 1.47–1.84) and UC (sex ratio: 1.29; 95% CI: 1.21–1.38). The clinical characteristics were summarized using data from 2283 CD cases and 17,958 UC cases; in which the majority of CD patients were diagnosed between 17–40 years of age, with non-stricturing and non-penetrating disease, varied disease locations, and less extra-intestinal manifestation. UC cases were featured with later disease diagnosis, a more severe disease course, more segmental lesions, and less extra-intestinal manifestations. Our study provided an estimated disease burden of IBD and demonstrated distinct clinical features in the Chinese population. Large-scale population-based studies are needed to further evaluate these findings.
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Affiliation(s)
- Xue Li
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China.
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh EH8 9AG, UK.
| | - Peige Song
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China.
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh EH8 9AG, UK.
| | - Jun Li
- The 153 Hospital of People's Liberation Army, Zhengzhou 450001, China.
| | - Yuchang Tao
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China.
| | - Guowei Li
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON L8S 4L8, Canada.
| | - Xiumin Li
- Department Gastroenterology, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453003, China.
| | - Zengli Yu
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China.
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Hammer T, Nielsen KR, Munkholm P, Burisch J, Lynge E. The Faroese IBD Study: Incidence of Inflammatory Bowel Diseases Across 54 Years of Population-based Data. J Crohns Colitis 2016; 10:934-42. [PMID: 26933031 PMCID: PMC4962362 DOI: 10.1093/ecco-jcc/jjw050] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 02/16/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Inflammatory bowel diseases [IBDs] include Crohn's disease [CD], ulcerative colitis [UC], and IBD unclassified [IBDU]. In 2010 and 2011, the ECCO-EpiCom study found the worldwide highest incidence of inflammatory bowel disease [IBD] in the Faroe Islands: 83 per 100 000 [European Standard Population, ESP]. The present study assessed the long-term time trends in IBD incidence in the Faroese population. METHODS In this population-based study, data were retrieved from the National Hospital of the Faroe Islands and included all incident cases of CD, UC, and IBDU diagnosed between July 1960 and July 2014. Patients of all ages were included and diagnoses were defined according to the Copenhagen Diagnostic Criteria. RESULTS A total of 664 incident IBD patients were diagnosed: 113 with CD, 417 with UC, and 134 with IBDU. Of these, 51 [8%] were diagnosed with paediatric-onset IBD. Between 1960 and 1979, a total of 55 persons were diagnosed; 105 in 1980-89; 166 in 1990-99; 180 in 2000-09; and 158 in 2010-14. This represented an increase in the age-standardised IBD incidence rate from 7, 25, 40, and 42 to 74 per 100 000 [ESP]. For CD, the increase was from 1 to 10, for UC from 4 to 44, and for IBDU from 2 to 21 per 100 000 [ESP]. CONCLUSIONS The high IBD incidence was found to be a relatively new phenomenon. The observed increase is unlikely to be an artefact resulting from, for instance, better registration. Our study indicated a real and increasing disease burden resulting from changing-so far unidentified-exposures.
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Affiliation(s)
- Turid Hammer
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark, Shared first authorship: Turid Hammer and Kári R. Nielsen
| | - Kári R. Nielsen
- Medical Centre, National Hospital, 100 Tórshavn,Faroe Islands,Genetic Biobank, 100 Tórshavn,Faroe Islands, Shared first authorship: Turid Hammer and Kári R. Nielsen
| | - Pia Munkholm
- North Zealand Hospital, Capital Region, University of Copenhagen, Danish Centre for eHealth and Epidemiology, Copenhagen, Denmark
| | - Johan Burisch
- North Zealand Hospital, Capital Region, University of Copenhagen, Danish Centre for eHealth and Epidemiology, Copenhagen, Denmark
| | - Elsebeth Lynge
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Mitomi H, Okayasu I, Bronner MP, Kanazawa H, Nishiyama Y, Otani Y, Sada M, Tanabe S, Igarashi M, Katsumata T, Saigenji K. Comparative Histologic Assessment of Proctocolectomy Specimens from Japanese and American Patients with Ulcerative Colitis with or Without Dysplasia. Int J Surg Pathol 2016; 13:259-65. [PMID: 16086081 DOI: 10.1177/106689690501300305] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There have been no reports of histologic differences in ulcerative colitis (UC) between Japanese and American patients. We therefore compared histology in proctocolectomy resection specimens between Japanese patients with UC (19 cases with and 21 without dysplasia) at the Kitasato University East Hospital and American patients with UC (21 cases with and 24 without dysplasia) at the University of Washington Medical Center. In cases of UC with, but not without dysplasia, cryptitis (p = 0.010) and epithelial apoptosis (p < 0.001) in the nondysplastic mucosa were more frequently observed in Japanese than in American cases, whereas lamina propria fibrosis was more prominent in American counterparts (p = 0.008). In patients with UC with dysplasia, the duration of disease was significantly longer in American than in Japanese patients (median, 17 vs 14 years, respectively; p = 0.038). This might, in part, explain the histologic variation. Another possibility for the differences is that the preoperative medications may have differed in the populations.
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Affiliation(s)
- Hiroyuki Mitomi
- Department of Clinical Research Laboratory, National Sagamihara Hospital, 18-1 Sakura-dai, Sagamihara, Kanagawa, Japan
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Nimmons D, Limdi JK. Elderly patients and inflammatory bowel disease. World J Gastrointest Pharmacol Ther 2016; 7:51-65. [PMID: 26855812 PMCID: PMC4734955 DOI: 10.4292/wjgpt.v7.i1.51] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 09/13/2015] [Accepted: 12/14/2015] [Indexed: 02/06/2023] Open
Abstract
The incidence and prevalence of inflammatory bowel disease (IBD) is increasing globally. Coupled with an ageing population, the number of older patients with IBD is set to increase. The clinical features and therapeutic options in young and elderly patients are comparable but there are some significant differences. The wide differential diagnosis of IBD in elderly patients may result in a delay in diagnosis. The relative dearth of data specific to elderly IBD patients often resulting from their exclusion from pivotal clinical trials and the lack of consensus guidelines have made clinical decisions somewhat challenging. In addition, age specific concerns such as co-morbidity; loco-motor and cognitive function, poly-pharmacy and its consequences need to be taken into account. In applying modern treatment paradigms to the elderly, the clinician must consider the potential for more pronounced adverse effects in this vulnerable group and set appropriate boundaries maximising benefit and minimising harm. Meanwhile, clinicians need to make personalised decisions but as evidence based as possible in the holistic, considered and optimal management of IBD in elderly patients. In this review we will cover the clinical features and therapeutic options of IBD in the elderly; as well as addressing common questions and challenges posed by its management.
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Surgical aspects of inflammatory bowel diseases in pediatric and adolescent age groups. Int J Colorectal Dis 2016; 31:301-5. [PMID: 26410260 DOI: 10.1007/s00384-015-2388-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/16/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is increasingly encountered in children. Early disease is associated with higher complication rate with increased incidence of surgical intervention. PATIENTS AND METHODS From January 2010 to June 2015, 25 patients in the pediatric and adolescent age groups with IBD underwent surgical intervention in our center. They were classified into two groups. Group I included 15 patients with ulcerative colitis where 5 cases had left colon disease underwent left colectomy, while 10 cases had pancolonic disease underwent total colectomy and anal mucosectomy with ileo-anal or ileal pouch-anal anastomosis with covering ileostomy. Group II included 10 cases with Crohn's disease where the indications for surgery were intestinal obstruction in seven cases, fulminant perianal infection with septic shock in one, perianal fistula and ulcers in one, and growth failure due to resistant intestinal fistula in one. RESULTS Group I included eight males and seven females; mean age at surgery was 10.6 years. There were postoperative complications in seven cases in the form of pelvic abscess and wound infection in one, wound infection in two, and recurrent pouchitis in four cases. Group II contained eight males and two females; mean age at surgery was 6.6 years. Two cases had recurrent symptoms after stricturoplasty. The mean length of time from diagnosis to surgery was 2.4 years (ranging from 6 to 36 months). CONCLUSION A multidisciplinary team is mandatory for proper management of IBD cases. The risk of the disease and the expected surgical complications determine the timing of surgical interference.
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Zhai H, Liu A, Huang W, Liu X, Feng S, Wu J, Yao Y, Wang C, Li Q, Hao Q, Hu J, Zhang S. Increasing rate of inflammatory bowel disease: a 12-year retrospective study in NingXia, China. BMC Gastroenterol 2016; 16:2. [PMID: 26754840 PMCID: PMC4710033 DOI: 10.1186/s12876-015-0405-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 12/01/2015] [Indexed: 12/12/2022] Open
Abstract
Background In China, the incidence of Inflammatory bowel disease (IBD) has shown a significant growth trend. Analysis of the epidemiology, clinical manifestations, diagnostic means, and treatment of IBD will further improve the clinician's understanding of IBD, improve knowledge and further enable early diagnosis and standardized therapeutic management. The purpose of this study was to analyze the clinical characteristics of IBD inpatients in General Hospital of NingXia Medical University over a 12-year period to identify trends in clinical and epidemiological features, clinical manifestations, and treatment programs. Methods By excluding188 patients with incomplete information or incompatible with the 2012 Guidlines cases, we retrospectively analyzed the case records of 567 inpatients with a diagnosis of IBD admitted to the General Hospital of NingXia Medical University between January 2002 and December 2014. The clinical epidemiological features, clinical manifestations, diagnostic methods, and therapeutic status were analyzed. Results Over the study period, IBD hospitalization rates in 2002 and 2014 groups was 1.96 % and 4.05 %, increased 2.07 times. Of 567 cases of IBD, 483 (85.19 %) cases were categorized as ulcerative colitis (UC) and 84 as Crohn’s disease (CD) (14.81 %). Total male cases were 321 (56.61 %). Mean age of cases was 49.06 ± 14.92 years for UC and 44.84 ± 14.67 years for CD. The majority of UC was located in the colon, with a moderate level of disease activity. A combination of clinical manifestations and colonoscopy was mostly used to make a diagnosis; relatively the rate of pathological diagnosis was low, with a small proportion of patient’s diagnosed based on radiology. Treatment with SASP/5ASA and steroids was applied to the majority of inpatients and 47.83 % were treated with antibiotics; in contrast, only 1.86 % cases were treated with immunosuppressive therapy. Conclusions An increasing trend of admissions for IBD can be observed in our study; there are some differences in clinical features and treatment compared with Western countries, and further research into this is required.
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Affiliation(s)
- Huihong Zhai
- Department of Digestive Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, China
| | - Aiqin Liu
- Deparment of Digestive Diseases, Graduate School of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Wenyu Huang
- Deparment of Digestive Diseases, Graduate School of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Xin Liu
- Deparment of Digestive Diseases, Graduate School of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Shanshan Feng
- Department of Digestive Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, China
| | - Jing Wu
- Deparment of Digestive Diseases, Graduate School of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Yuping Yao
- Deparment of Digestive Diseases, Graduate School of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Chao Wang
- Deparment of Digestive Diseases, Graduate School of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Qianqian Li
- Deparment of Digestive Diseases, Graduate School of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Qian Hao
- Deparment of Digestive Diseases, Graduate School of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Jianguo Hu
- Deparment of Digestive Diseases, Graduate School of Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Shutian Zhang
- Department of Gastroenterology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, 100050, China. .,Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, 100050, China. .,National Clinical Research Center for Digestive Diseases, Yongan Street, Xicheng Area, Beijing, 100050, PR China.
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Wang K, Huang RJ, Wu HG, Liu HR, Wang SS, Zhao JM, Huang Y, Lin XY, Wu LY. Mechanisms of action of vitamin D in inflammatory bowel disease. Shijie Huaren Xiaohua Zazhi 2015; 23:5655-5661. [DOI: 10.11569/wcjd.v23.i35.5655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a complex chronic inflammatory disorder caused by the interaction of environmental, hereditary and immune factors. The etiology and pathogenesis of IBD remain unveiled. In recent years, growing attention has been paid to the role of vitamin D in immune-related diseases like IBD from traditional bone metabolism. Vitamin D not only participates in calcium and phosphorus metabolism but also alleviates IBD via regulating the immune cell factors, inducing antimicrobial peptide expression and maintaining the integrity of intestinal mucosal barrier. In view of anti-inflammatory and immunomodulatory activities of vitamin D, this article discusses its role in IBD.
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Pedrini MJF, Seewann A, Bennett KA, Wood AJT, James I, Burton J, Marshall BJ, Carroll WM, Kermode AG. Helicobacter pylori infection as a protective factor against multiple sclerosis risk in females. J Neurol Neurosurg Psychiatry 2015; 86:603-7. [PMID: 25602009 DOI: 10.1136/jnnp-2014-309495] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 11/30/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND In recent years, a relationship between Helicobacter pylori and many disease conditions has been reported, however, studies in its relationship with multiple sclerosis (MS) have had contradictory results. OBJECTIVE To determine the association between the H. pylori infection and MS. METHODS 550 patients with MS were included in the study and were matched by gender and year of birth to 299 controls. Patients were assessed for clinical and demographic parameters. An enzyme immunoassay was used to detect the presence of specific IgG antibodies against H. pylori in the serum sample of both groups. RESULTS H. pylori seropositivity was found to be lower in the patients with MS than in controls (16% vs 21%) with the decrease pertaining to females (14% vs 22%, p=0.027) but not males (19% vs 20%, p=1.0). When adjusted for age at onset, year of birth and disease duration, H. pylori seropositive females presented with a lower disability score than seronegative females (p=0.049), while among males the reverse was true (p=0.025). There was no significant association between H. pylori seropositivity and relapse rate. CONCLUSIONS Our results could reflect a protective role of H. pylori in the disease development. However, it may be that H. pylori infection is a surrogate marker for the 'hygiene hypothesis', a theory which postulates that early life infections are essential to prime the immune system and thus prevent allergic and autoimmune conditions later in life. The fact that the association between H. pylori seropositivity and MS risk was seen almost exclusively in females requires further investigation.
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Affiliation(s)
- Marzena J Fabis Pedrini
- Centre for Neuromuscular and Neurological Disorders, Western Australian Neuroscience Research Institute, The University of Western Australia, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, Australia
| | - Alexandra Seewann
- Department of Neurology, VU University Medical Center, Amsterdam, Netherlands
| | - Kirsten A Bennett
- Centre for Neuromuscular and Neurological Disorders, Western Australian Neuroscience Research Institute, The University of Western Australia, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, Australia
| | - Alex J T Wood
- Centre for Neuromuscular and Neurological Disorders, Western Australian Neuroscience Research Institute, The University of Western Australia, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, Australia
| | - Ian James
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Australia
| | - Jason Burton
- Centre for Neuromuscular and Neurological Disorders, Western Australian Neuroscience Research Institute, The University of Western Australia, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, Australia
| | - Barry J Marshall
- The Marshall Centre for Infectious Diseases Research and Training, The University of Western Australia, QEII Medical Centre, Nedlands, Australia
| | - William M Carroll
- Centre for Neuromuscular and Neurological Disorders, Western Australian Neuroscience Research Institute, The University of Western Australia, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, Australia
| | - Allan G Kermode
- Centre for Neuromuscular and Neurological Disorders, Western Australian Neuroscience Research Institute, The University of Western Australia, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, Australia Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Australia
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Law ST, Li KK. Gender-related differences in clinical course of crohn?s disease in an Asian population: a retrospective cohort review. ARQUIVOS DE GASTROENTEROLOGIA 2015; 51:90-6. [PMID: 25003258 DOI: 10.1590/s0004-28032014000200004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Accepted: 12/04/2013] [Indexed: 12/31/2022]
Abstract
CONTEXT Data from Asian populations about gender-related differences in Crohn's disease are few. Objectives This study was to analyze the clinical characteristics between women and men affected by Crohn's disease. METHODS This was a retrospective cohort study to analyze consecutive Crohn's disease patients from Jan 2000 to Dec 2012. Clinical and phenotypic characteristics and treatment outcomes were evaluated. RESULTS 79 patients (55 male and two of them with positive family history) were diagnosed with Crohn's disease. Ileocolonic disease and inflammatory lesion was the most dominant site of involvement and disease behavior respectively in both men and women. Apart from higher frequency of nausea (45.83 vs 23.64%, P 0.024) and lower body mass index (19.44 vs 22.03 kg/m2, P 0.003) reported in women, no significant gender-related differences in clinical characteristics were observed. Women were more associated with delay use of immunosuppressive therapy (12 vs 36 months, P = 0.028), particularly for those aged less than 40 years old (85 vs 62.6%, P = 0.023). Cox proportional hazard regression analysis revealed that active smoking (HR, 4.679; 95% CI, 1.03-21.18) and delayed use of immunosuppressive therapy (HR, 4.13; 95% CI, 1.01-16.88) were only independent risk factors associated with increased risk of complications. CONCLUSIONS There were no significant gender-specific differences in clinical and phenotypic characteristics between male and female Crohn's disease patients. Smoking history and delay use of immunosuppressive therapy were associated with higher risk of complications.
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Affiliation(s)
- Siu-tong Law
- Division of Gastroenterology and Hepatology, Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong, China
| | - Kin Kong Li
- Division of Gastroenterology and Hepatology, Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong, China
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M'Koma AE. Diagnosis of inflammatory bowel disease: Potential role of molecular biometrics. World J Gastrointest Surg 2014. [PMID: 25429322 DOI: 10.4240/wjgs.v6.i11.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Accurate diagnosis of predominantly colonic inflammatory bowel disease (IBD) is not possible in 30% of patients. For decades, scientists have worked to find a solution to improve diagnostic accuracy for IBD, encompassing Crohn's colitis and ulcerative colitis. Evaluating protein patterns in surgical pathology colectomy specimens of colonic mucosal and submucosal compartments, individually, has potential for diagnostic medicine by identifying integrally independent, phenotype-specific cellular and molecular characteristics. Mass spectrometry (MS) and imaging (I) MS are analytical technologies that directly measure molecular species in clinical specimens, contributing to the in-depth understanding of biological molecules. The biometric-system complexity and functional diversity is well suited to proteomic and diagnostic studies. The direct analysis of cells and tissues by Matrix-Assisted-Laser Desorption/Ionization (MALDI) MS/IMS has relevant medical diagnostic potential. MALDI-MS/IMS detection generates molecular signatures obtained from specific cell types within tissue sections. Herein discussed is a perspective on the use of MALDI-MS/IMS and bioinformatics technologies for detection of molecular-biometric patterns and identification of differentiating proteins. I also discuss a perspective on the global challenge of transferring technologies to clinical laboratories dealing with IBD issues. The significance of serologic-immunometric advances is also discussed.
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Affiliation(s)
- Amosy E M'Koma
- Amosy E M'Koma, Department of Biochemistry and Cancer Biology, Meharry Medical College School of Medicine, Nashville, TN 37208-3599, United States
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M’Koma AE. Diagnosis of inflammatory bowel disease: Potential role of molecular biometrics. World J Gastrointest Surg 2014; 6:208-219. [PMID: 25429322 PMCID: PMC4241488 DOI: 10.4240/wjgs.v6.i11.208] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 04/03/2014] [Accepted: 10/27/2014] [Indexed: 02/06/2023] Open
Abstract
Accurate diagnosis of predominantly colonic inflammatory bowel disease (IBD) is not possible in 30% of patients. For decades, scientists have worked to find a solution to improve diagnostic accuracy for IBD, encompassing Crohn’s colitis and ulcerative colitis. Evaluating protein patterns in surgical pathology colectomy specimens of colonic mucosal and submucosal compartments, individually, has potential for diagnostic medicine by identifying integrally independent, phenotype-specific cellular and molecular characteristics. Mass spectrometry (MS) and imaging (I) MS are analytical technologies that directly measure molecular species in clinical specimens, contributing to the in-depth understanding of biological molecules. The biometric-system complexity and functional diversity is well suited to proteomic and diagnostic studies. The direct analysis of cells and tissues by Matrix-Assisted-Laser Desorption/Ionization (MALDI) MS/IMS has relevant medical diagnostic potential. MALDI-MS/IMS detection generates molecular signatures obtained from specific cell types within tissue sections. Herein discussed is a perspective on the use of MALDI-MS/IMS and bioinformatics technologies for detection of molecular-biometric patterns and identification of differentiating proteins. I also discuss a perspective on the global challenge of transferring technologies to clinical laboratories dealing with IBD issues. The significance of serologic-immunometric advances is also discussed.
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Hein R, Köster I, Bollschweiler E, Schubert I. Prevalence of inflammatory bowel disease: estimates for 2010 and trends in Germany from a large insurance-based regional cohort. Scand J Gastroenterol 2014; 49:1325-35. [PMID: 25259808 DOI: 10.3109/00365521.2014.962605] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE A worldwide increase in prevalence of inflammatory bowel disease (IBD) has been reported. For Germany, latest publications not restricted to actively treated disease present data of the 1980s. This study estimates the administrative 1-year period IBD prevalence in 2010 and investigates the trend in prevalence of actively treated disease between 2001 and 2010. MATERIAL AND METHODS Utilizing an insurance-based cohort (n = 311,001 in 2001 to 265,102 in 2010), case definition was based on ICD-10 codes. The prevalence of active treatment was based on internally validated IBD cases of the respective year. The 1-year period prevalence in 2010 accounts for cases actively treated in at least one of the years between 2001 and 2010. Estimates were directly standardized by age and sex to the population of Germany. The change in prevalence of actively treated disease over the years was evaluated by means of Poisson regression. RESULTS The IBD prevalence in 2010 was 744 (95% confidence interval [CI]: 707-775) per 100,000 (Crohn's disease: 322 [95% CI: 302-346], ulcerative colitis: 412 [95% CI: 389-436] per 100,000). The prevalence of actively treated disease increased significantly between 2001 (344 [95% CI: 324-364] per 100,000) and 2010 (493 [95% CI: 464-519] per 100,000; increase in prevalence by 42% [95% CI: 31%-53%], p trend = 6.0 × 10(-19)). CONCLUSION In line with worldwide reports, our results based on a large insurance cohort suggest a considerable increase in IBD prevalence in Germany since the 1980s. The significant increase in prevalence of actively treated disease in our cohort highlights the need to adapt healthcare services and deal with the burden associated with increasing numbers of IBD patients.
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Affiliation(s)
- Rebecca Hein
- PMV Research Group at the Department of Child and Adolescent Psychiatry and Psychotherapy, University of Cologne , Herderstraße 52, 50931 Cologne , Germany
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Werner H, Landolt MA, Buehr P, Koller R, Nydegger A, Spalinger J, Heyland K, Schibli S, Braegger CP. Validation of the IMPACT-III quality of life questionnaire in Swiss children with inflammatory bowel disease. J Crohns Colitis 2014; 8:641-8. [PMID: 24342766 DOI: 10.1016/j.crohns.2013.11.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 11/27/2013] [Accepted: 11/27/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Inflammatory bowel disease (IBD) frequently manifests during childhood and adolescence. For providing and understanding a comprehensive picture of a patients' health status, health-related quality of life (HRQoL) instruments are an essential complement to clinical symptoms and functional limitations. Currently, the IMPACT-III questionnaire is one of the most frequently used disease-specific HRQoL instrument among patients with IBD. However, there is a lack of studies examining the validation and reliability of this instrument. METHODS 146 paediatric IBD patients from the multicenter Swiss IBD paediatric cohort study database were included in the study. Medical and laboratory data were extracted from the hospital records. HRQoL data were assessed by means of standardized questionnaires filled out by the patients in a face-to-face interview. RESULTS The original six IMPACT-III domain scales could not be replicated in the current sample. A principal component analysis with the extraction of four factor scores revealed the most robust solution. The four factors indicated good internal reliability (Cronbach's alpha=.64-.86), good concurrent validity measured by correlations with the generic KIDSCREEN-27 scales and excellent discriminant validity for the dimension of physical functioning measured by HRQoL differences for active and inactive severity groups (p<.001, d=1.04). CONCLUSIONS This study with Swiss children with IBD indicates good validity and reliability for the IMPACT-III questionnaire. However, our findings suggest a slightly different factor structure than originally proposed. The IMPACT-III questionnaire can be recommended for its use in clinical practice. The factor structure should be further examined in other samples.
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Affiliation(s)
- Helene Werner
- Department of Psychosomatics and Psychiatry, University Children's Hospital, Zurich, Switzerland
| | - Markus A Landolt
- Department of Psychosomatics and Psychiatry, University Children's Hospital, Zurich, Switzerland; Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - Patrick Buehr
- Divison of Gastroenterology and Nutrition, University Children's Hospital, Zurich, Switzerland
| | - Rebekka Koller
- Divison of Gastroenterology and Nutrition, University Children's Hospital, Zurich, Switzerland
| | - Andreas Nydegger
- Division of Gastroenterology, University Children's Hospital, Lausanne, Switzerland
| | | | - Klaas Heyland
- Division of Gastroenterology, Children's Hospital, Winterthur, Switzerland
| | - Susanne Schibli
- Division of Gastroenterology, University Children's Hospital, Berne, Switzerland
| | - Christian P Braegger
- Divison of Gastroenterology and Nutrition, University Children's Hospital, Zurich, Switzerland; Children's Research Center, University Children's Hospital, Zurich, Switzerland.
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Cakmakci E, Erturk SM, Cakmakci S, Bayram A, Tokgoz S, Caliskan KC, Celebi I. Comparison of the results of computerized tomographic and diffusion-weighted magnetic resonance imaging techniques in inflammatory bowel diseases. Quant Imaging Med Surg 2014; 3:327-33. [PMID: 24404447 DOI: 10.3978/j.issn.2223-4292.2013.12.03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 12/10/2013] [Indexed: 12/15/2022]
Abstract
AIM To compare the findings obtained by computerised tomography (CT) enterography, which uses oral neutral contrast material and non-contrasted diffusion-weighted magnetic resonance imaging (DW-MRI) technique and reveal the diagnostic value of DW-MRI in patients with inflammatory bowel diseases. METHODS Patients with established or clinically suspect diagnosis of inflammatory bowel disease were included in the study. CT enterography and DW-MRI obtained from the patients were evaluated by a radiologist blinded to the endoscopic and/or histopathological results. Duodenum, jejunum, ileal loops, ascending, transverse, descending colon, sigmoid colon and rectum were evaluated in that order as for general imaging quality, luminal distension and adequate visualization of the intestinal wall. Image qualities of neutral contrast CT-enterography and DW-MRI were compared. RESULTS The study included 31 patients. Based on statistical analyses, the best correlation between the results of CT-enterography and diffusion-weighted imaging (DWI) were observed in the evaluation of transverse colon, ileum and duodenum in order of decreasing frequency and with an almost perfect compatibility. Radiological findings of sigmoid colon, jejunum and descending colon were completely compatible. However, a moderate degree of compatibility was estimated between radiological findings of rectum and cecum. CONCLUSIONS Though conventional enteroclysis is the gold standard method among radiological imaging techniques used for the evaluation of inflammatory small intestinal abnormalities, CT enterography and DW-MRI are alternative methods that can be used effectively to obtain useful information.
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Affiliation(s)
- Emin Cakmakci
- Department of Radiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Sukru Mehmet Erturk
- Department of Radiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Selma Cakmakci
- Department of Pediatrics, Kaçkar Government Hospital, Rize, Turkey
| | - Aysel Bayram
- Department of Radiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Safiye Tokgoz
- Department of Radiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Kosti Can Caliskan
- Department of Radiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Irfan Celebi
- Department of Radiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
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Liu JZ, Anderson CA. Genetic studies of Crohn's disease: past, present and future. Best Pract Res Clin Gastroenterol 2014; 28:373-86. [PMID: 24913378 PMCID: PMC4075408 DOI: 10.1016/j.bpg.2014.04.009] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 04/14/2014] [Accepted: 04/24/2014] [Indexed: 01/31/2023]
Abstract
The exact aetiology of Crohn's disease is unknown, though it is clear from early epidemiological studies that a combination of genetic and environmental risk factors contributes to an individual's disease susceptibility. Here, we review the history of gene-mapping studies of Crohn's disease, from the linkage-based studies that first implicated the NOD2 locus, through to modern-day genome-wide association studies that have discovered over 140 loci associated with Crohn's disease and yielded novel insights into the biological pathways underlying pathogenesis. We describe on-going and future gene-mapping studies that utilise next generation sequencing technology to pinpoint causal variants and identify rare genetic variation underlying Crohn's disease risk. We comment on the utility of genetic markers for predicting an individual's disease risk and discuss their potential for identifying novel drug targets and influencing disease management. Finally, we describe how these studies have shaped and continue to shape our understanding of the genetic architecture of Crohn's disease.
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Affiliation(s)
- Jimmy Z Liu
- The Wellcome Trust Sanger Institute, Hinxton CB10 1SA, UK
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Ko Y, Butcher R, Leong RW. Epidemiological studies of migration and environmental risk factors in the inflammatory bowel diseases. World J Gastroenterol 2014; 20:1238-47. [PMID: 24574798 PMCID: PMC3921506 DOI: 10.3748/wjg.v20.i5.1238] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 11/27/2013] [Accepted: 01/02/2014] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel diseases (IBD) are idiopathic chronic diseases of the gastrointestinal tract well known to be associated with both genetic and environmental risk factors. Permissive genotypes may manifest into clinical phenotypes under certain environmental influences and these may be best studied from migratory studies. Exploring differences between first and second generation migrants may further highlight the contribution of environmental factors towards the development of IBD. There are few opportunities that have been offered so far. We aim to review the available migration studies on IBD, evaluate the known environmental factors associated with IBD, and explore modern migration patterns to identify new opportunities and candidate migrant groups in IBD migration research.
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Eglinton TW, Gearry RB. Clinical factors predicting disease course in Crohn’s disease. Expert Rev Clin Immunol 2014; 6:41-5. [DOI: 10.1586/eci.09.76] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Highlights in IBD Epidemiology and Its Natural History in the Paediatric Age. Gastroenterol Res Pract 2013; 2013:829040. [PMID: 24454343 PMCID: PMC3884601 DOI: 10.1155/2013/829040] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 10/27/2013] [Accepted: 11/20/2013] [Indexed: 12/30/2022] Open
Abstract
Background. The number of patients of all age brackets diagnosed with Inflammatory Bowel Disease (IBD) has risen dramatically worldwide over the past 50 years. IBD's changing epidemiology suggests that environmental factors play a major role in modifying disease expression. Aim. To review studies carried out worldwide analyzing IBD epidemiology. Methods. A Medline search indicating as keywords “Inflammatory Bowel Disease,” “epidemiology,” “natural history,” “Crohn's Disease,” “Ulcerative Colitis,” and “IBD Unclassified” was performed. A selection of clinical cohort and systematic review studies that were carried out between 2002 and 2013 was reviewed. Studies referring to an earlier date were also considered whenever the data were relevant to our review. Results. The current mean prevalence of IBD in the total population of Western countries is estimated at 1/1,000. The highest prevalence and incidence rates of IBD worldwide are reported from Canada. Just as urbanization and socioeconomic development, the incidence of IBD is rising in China. Conclusions. Multicenter national registers and international networks can provide information on IBD epidemiology and lead to hypotheses about its causes and possible management strategies. The rising trend in the disease's incidence in developing nations suggests that its epidemiological evolution is linked to industrialization and modern Westernized lifestyles.
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44
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Review of the association between meat consumption and risk of colorectal cancer. Nutr Res 2013; 33:983-94. [DOI: 10.1016/j.nutres.2013.07.018] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 07/02/2013] [Accepted: 07/24/2013] [Indexed: 12/12/2022]
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Abstract
Crohn's disease (CD) is characterized as a chronic immune-mediated inflammatory disorder of the gastrointestinal tract. Current consensus surrounding the cause of the disease suggests a complex interplay between genetic susceptibility, the intestinal microbiome and environmental factors, leading to the aberrant Th1 and Th17 immune cell mediated response. Vitamin D deficiency is common in CD patients, and long-standing deficiency has been associated with reduced bone mineral density (BMD). Accumulating evidence now suggests that in addition to maintaining skeletal integrity, vitamin D also plays an integral role in regulating the general immune response, a function employed via its genomic actions on the vitamin D receptor (VDR). The VDR is expressed in all immune cells and both directly and indirectly targeted by the bioactive form of vitamin D, 1,25-Dihydroxyvitamin D (1,25[OH]2D). Impaired regulation or deficiency of the vitamin has been linked to the promotion of self-reactive T cell development, loss of immune tolerance to self-structures, and experimental colitis in animal models, whereas the subsequent administration of the vitamin in these models resulted in the improvement of immune-mediated symptoms. In addition, low vitamin D has been associated with disease activity in CD patients, and supplementation appears to be beneficial in improving clinical scores and reducing inflammation. Therefore, the primary aims of this article were to review the molecular evidence supporting the immunoregulatory roles of vitamin D and its supplementation in the CD patient, based on existing literature. The physiological processes, accepted serum concentration values, and its well-recognized role in bone health were also summarized.
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Affiliation(s)
- Abigail Basson
- Dietetics Department, University of the Western Cape, South Africa
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Alireza Taghavi S, Reza Safarpour A, Hosseini SV, Noroozi H, Safarpour M, Rahimikazerooni S. Epidemiology of Inflammatory Bowel Diseases (IBD) in Iran: A Review of 740 Patients in Fars Province, Southern Iran. ACTA ACUST UNITED AC 2013. [DOI: 10.17795/acr-11477] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Jaghult S, Saboonchi F, Moller J, Johansson UB, Wredling R, Kapraali M. Stress as a Trigger for Relapses in IBD: A Case-Crossover Study. Gastroenterology Res 2013; 6:10-16. [PMID: 27785220 PMCID: PMC5051114 DOI: 10.4021/gr528e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2013] [Indexed: 12/18/2022] Open
Abstract
Background It is important to identify factors that influence the risk of relapses in inflammatory bowel disease. Few studies have been conducted and with limited methodology. This prospective case-crossover study, aims to examine whether perceived stress has a short-term acute effect, namely whether it acts as a trigger, on the risk of relapse in inflammatory bowel disease. Methods Sixty patients with inflammatory bowel disease and in remission were included. The case-crossover design was employed, which is an epidemiological design developed to study triggers for acute events and diseases. To collect information regarding symptoms and potential trigger factors, such as perceived stress, a structured diary was constructed. The participants were instructed to fill in the diary daily during six months. Fifty patients completed the study. Results The analysis showed an effect for high level of perceived stress. Being exposed to “quite a lot” of stress, yield an increase in risk for relapse during the forthcoming day (OR = 4.8, 95% CI 1.09 - 21.10). No statistically increased risk for lower levels of perceived stress was found, although elevated effect estimates were found for “some” stress. Conclusion This study supports earlier findings regarding perceived stress as an important factor in triggering relapses in IBD. However, this is the first case-crossover study performed to explore the trigger risk of stress in this population. Further investigations with larger patient samples are needed to confirm the findings.
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Affiliation(s)
- Susanna Jaghult
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Sweden
| | - Fredrik Saboonchi
- Red Cross University, Sweden; Karolinska Institute, Department of Clinical Neuroscience, Division of Insurance Medicine, Sweden; University of Stockholm, Stress Research Institute, Sweden
| | - Jette Moller
- Karolinska Institute, Department of Public Health Sciences, Division of Public Health Epidemiology, Sweden
| | - Unn-Britt Johansson
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Sweden; Sophiahemmet University College, Sweden
| | - Regina Wredling
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Sweden
| | - Marjo Kapraali
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Sweden
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Abstract
OBJECTIVE The aim of the present study was to investigate the relation between consanguinity and inflammatory bowel diseases (IBD). METHODS Review of the medical records of children with a final diagnosis of IBD to determine age, sex, and type of IBD, supplemented by information on consanguinity and family history (FH) of IBD in relatives. There were 138 children, ages 1.4 to 19.3 years, and 50% were girls. RESULTS The prevalence of consanguinity was 50%, 53%, 39% and 60% in IBD, Crohn disease (CD), ulcerative colitis (UC), and controls, respectively. There was a significantly higher prevalence of consanguinity in controls than in patients with IBD and UC (P = 0.02 and 0.026, respectively), whereas the difference between CD patients and controls was not significant (P = 0.20). The prevalence of first cousin consanguinity was 71%, 73.2%, 61.5% and 70.5% in patients with IBD, CD, UC, and controls, respectively, indicating no significant difference between these conditions and controls (P = 0.95, P = 0.78, P = 0.33, respectively). There was no significant difference in the prevalence of consanguinity in the parents of children with or without a FH of either CD (P = 0.89) or UC (P = 0.32). CONCLUSIONS There is no significant relation between parental consanguinity and IBD in this population, especially when there is no FH of disease, suggesting reduced genetic susceptibility; however, further studies including larger sample size and details of FH of consanguinity and IBD in multiple generations are needed for further definitions of the role of consanguinity.
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Khan AR, Fallon PG. Helminth therapies: translating the unknown unknowns to known knowns. Int J Parasitol 2013; 43:293-9. [PMID: 23291459 DOI: 10.1016/j.ijpara.2012.12.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 12/01/2012] [Accepted: 12/03/2012] [Indexed: 12/26/2022]
Abstract
The use of live helminth infections is currently in clinical trials as a novel approach for the treatment of a range of allergic and autoimmune diseases. This rapid progression from observational studies some 20 years ago to helminth clinical trials can be attributed to huge advances in not just pre-clinical and clinical evidence, pertaining to the efficacy of these parasites in unrelated diseases, but also a greater understanding of the complex immunological mechanisms that underpin these effects. Helminths have exerted significant evolutionary selective pressures on the host immune genome or "immunome". Studies on helminths were pivotal in a paradigm shift in immunology with recent discoveries of a number of novel immune cell populations. Critically, these new discoveries highlight the need to further understand the underlying mechanism behind the desirable therapeutic effects that helminths offer. With these unknown unknowns there is the distinct possibility that a true, fundamental modus operandi for helminth therapy will arrive long after it has been established in the clinic.
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Affiliation(s)
- Adnan R Khan
- Trinity Biomedical Sciences Institute, School of Medicine, Trinity College Dublin, and National Children's Research Centre, Our Lady's Children's Hospital, Ireland
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Abstract
BACKGROUND AND OBJECTIVES Crohn disease (CD) is an increasingly recognized problem in Saudi Arabia. The aim of this study was to describe the clinical pattern in children and adolescents with CD seen at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. DESIGN AND SETTING Retrospective hospital-based study conducted on data collected for the period between January 2001 and March 2010. PATIENTS AND METHODS Data for all children and adolescents diagnosed at KAUH with CD in the period were retrieved and analyzed. RESULTS Ninety-six patients were identified. The median age at diagnosis was 11.3 years (range, 0.12-17.6 years). Fifty (52.1%) were males. Sixty-four (66.7%) were Saudis. Nine (9.4%) had a first degree relative with inflammatory bowel disease. The most common presenting symptoms were diarrhea (88.5%), weight loss (84.2%) and anorexia (80.2%). At least one extraintestinal manifestation occurred in 24% of patients. Forty-two percent were underweight and 19% had short stature. The most common distribution was ileocolonic (37.5%), followed by colonic in 31.2%. Twenty-five (26%) patients had perianal disease, 13 (13.5%) had strictures and 15 (15.6%) had penetrating disease. Laboratory investigations revealed anemia in 84.4%, thrombocytosis in 50%, hypoalbuminemia in 64.6%, elevated erythrocyte sedimentation rate (ESR) in 50% and elevated C-reactive protein in 58.3%. Induction of remission was achieved with enteral nutrition in 20% of patients and with corticosteroids in the remaining. CONCLUSIONS The clinical pattern of CD in children from the Western Province of Saudi Arabia was found to be similar to reports from the West. Pediatricians should be aware of the varying presentations of CD. Early referral to specialized centers is crucial.
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Affiliation(s)
- Omar I Saadah
- Department of Pediatrics, King Abdulaziz University, PO Box 80215 Jeddah 21589, Western Province, Saudi Arabia.
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