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Li X, Li J, Cao Z, Kang N. The incidence of chronic diarrhea decreases with increasing serum calcium levels: a cross-sectional study based on NHANES 2005-2010. BMC Gastroenterol 2023; 23:394. [PMID: 37968590 PMCID: PMC10647030 DOI: 10.1186/s12876-023-03029-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/04/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Chronic diarrhea is difficult to prevent and treat due to its complex etiology and pathogenesis. It places a huge burden on patients and public healthcare. It is known that the regulation of body homeostasis relies heavily on calcium. However, in the general population, the relationship between calcium and chronic diarrhea remains uncertain. METHODS We assessed the association between serum calcium and diarrhea using data from the 2005-2010 National Health and Nutrition Examination Survey (NHANES). Serum calcium level was measured from collected blood samples. Diarrhea was assessed using the Bristol Stool Scale (BSFS) (types 1-7). The stability of the results was assessed using logistic regression and sensitivity analysis. The dose-response association between serum calcium and the risk of diarrhea was analyzed using a restricted cubic spline plot. RESULTS This study included 12,342 participants. In each of the five models, an increased calcium level was negatively associated with the incidence of diarrhea (OR[95%CI]:0.26 [0.13-0.53], 0.28 [0.14-0.58], 0.4 [0.19-0.82], 0.27 [0.11-0.64] and 0.24 [0.10-0.59], respectively). When serum calcium was analyzed as a categorical variable, a significant association between serum calcium and diarrhea prevalence was found. The restricted cubic spline plot showed a linear relationship between serum calcium and diarrhea. Sensitivity analysis confirmed that the results were stable. CONCLUSION The results of our cross-sectional study suggest that a higher level of serum calcium may reduce the incidence of diarrhea. In the future, this finding should be further validated in a randomized controlled trial.
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Affiliation(s)
- Xiaotong Li
- The First Clinical College, Shandong University of Traditional Chinese Medicine, No. 4655 University Road, University Science Park, Changqing District, Jinan, Shandong Province, 250355, China
| | - Jiali Li
- Department of Traditional Chinese Medicine, Affiliated Hospital of Jining Medical University, No. 89, Guhuai Road, Rencheng District, Jining, Shandong Province, 272029, China
| | - Zhiqun Cao
- The First Clinical College, Shandong University of Traditional Chinese Medicine, No. 4655 University Road, University Science Park, Changqing District, Jinan, Shandong Province, 250355, China
- Department of Gastroenterology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No. 42 Wenhua West Road, Jinan, Shandong Province, 250011, China
| | - Nan Kang
- Department of Traditional Chinese Medicine, Affiliated Hospital of Jining Medical University, No. 89, Guhuai Road, Rencheng District, Jining, Shandong Province, 272029, China.
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Mogwasi R, Kariuki DK, Getenga ZM. Effect of Farm Additives on the Potential Bioavailability of Some Nutritional Elements from Kenyan Wild Plants. Biol Trace Elem Res 2020; 195:658-668. [PMID: 31506912 DOI: 10.1007/s12011-019-01855-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/30/2019] [Indexed: 11/24/2022]
Abstract
In this study, the effects of farm additives on eight wild plants from Nyamira County, Kenya were evaluated for their release of iron, copper, calcium, potassium and magnesium. A hundred and sixty traditional medicinal practitioners were surveyed and found to use Solanum indicum, Carissa edulis, Urtica dioica, Clerodendrum myricoides, Aloe vera, Plectranthus barbatus, Bidens pilosa and Solanum mauense. Atomic absorption spectrophotometer was used to determine the total nutritional element contents in the plants while ultra filtration and physiologically based extraction tests were used to determine the release and solubility of the nutritional elements. The plants from areas with high use of farm additives were found to have statistically significant high total levels of copper from the area with no or little application. Elemental analysis of the molecular species fractions into < 3 kDa, 3-10 kDa, 10 kDa-0.45 μm and 0.45-5 μm mass fractions showed that the mass distribution of the elements in the plants depended on the element. The nutritional elements released by gastrointestinal digestion were more than those released aquatically. Farm additives had no significant effect on the levels of most nutritional elements determined and the plants can be used as mineral element supplements in the human body in addition to their therapeutic activity.
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Affiliation(s)
- R Mogwasi
- Department of Chemistry, Kisii University, P.O. Box 408-40200, Kisii, Kenya.
- Department of Chemistry, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya.
| | - D K Kariuki
- Department of Chemistry, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya
| | - Z M Getenga
- Department of Chemistry, Machakos University, P.O. Box 136-90100, Machakos, Kenya
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Fraebel J, Gonzalez-Peralta R, Maximos M, Beasley GL, Jolley CD, Cheng SX. Extracellular Calcium Dictates Onset, Severity, and Recovery of Diarrhea in a Child with Immune-Mediated Enteropathy. Front Pediatr 2018; 6:7. [PMID: 29435439 PMCID: PMC5796911 DOI: 10.3389/fped.2018.00007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 01/10/2018] [Indexed: 12/21/2022] Open
Abstract
Diarrhea causes monovalent and divalent ion losses that can influence clinical outcome. Unlike the losses of monovalent ions, such as Na+, K+, Cl-, and [Formula: see text], which are generally large in quantity (osmoles) and therefore determine the severity of diarrhea, the losses of divalent ions are relatively small in osmoles and are often overlooked during diarrheal treatment. Studies now suggest that despite divalent ions being small in osmoles, their effects are large due to the presence of divalent ion-sensing receptors and their amplifying effects in the gut. As a result, losses of these divalent ions without prompt replacement could also significantly affect the onset, severity, and/or recovery of diarrheal disease. Herein, we report a case of a malnourished child with an immune-mediated enteropathy who developed episodes of "breakthrough" diarrhea with concurrent hypocalcemia while on appropriate immunotherapy. Interestingly, during these periods of diarrhea, stool volume fluctuated with levels of blood Ca2+. When Ca2+ was low, diarrhea occurred; when Ca2+ levels normalized with replacement, diarrhea stopped. Based on this and other observations, a broader question arises as to whether the Ca2+ lost in diarrhea should be replaced promptly in these patients.
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Affiliation(s)
- Johnathan Fraebel
- Department of Pediatrics, Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL, United States
| | - Regino Gonzalez-Peralta
- Department of Pediatrics, Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL, United States
| | - Maryann Maximos
- Department of Pediatrics, Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL, United States
| | - Genie L Beasley
- Department of Pediatrics, Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL, United States
| | - Christopher Douglas Jolley
- Department of Pediatrics, Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL, United States
| | - Sam Xianjun Cheng
- Department of Pediatrics, Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL, United States
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4
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Yang K, Fard S, Furrer R, Archer MC, Bruce WR, Lip H, Mehta R, O'Brien PJ, Giacca A, Ward WE, Femia AP, Caderni G, Medline A, Banks K. Risk factors for colorectal cancer in man induce aberrant crypt foci in rats: Preliminary findings. Nutr Cancer 2015; 68:94-104. [PMID: 26709971 PMCID: PMC4784512 DOI: 10.1080/01635581.2016.1115098] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Epidemiological studies have demonstrated clear associations between specific dietary and environmental risk factors and incidence of colorectal cancer, but the mechanisms responsible for these associations are not known. An animal model could facilitate such an understanding. Both genotoxic and nongenotoxic carcinogens induce aberrant crypt foci (ACF) in the colons of F344 rats. F344 rats were provided with diets that contained putative risk factors for CRC: low calcium and low vitamin D, high iron, high fructose, and decreased light (UV) exposure or a control diet for 14 wk. The rats were then assessed with biochemical measures and by topological examination for evidence of colon abnormalities. Circulating ionized calcium was decreased from 2.85 to 1.69 mmol/L, and ACF were increased from 0.7 to 13.6 lesions/colon (both P < 0.001). Rats exposed to the multiple environmental conditions associated with colon cancer, developed ACF similar to the heterogeneous or ill-defined ACF in the human colon. Heterogeneous ACF are the most frequently seen in humans and are also seen in rats shortly after exposure to the non-genotoxic colon carcinogen, dextransulfate sodium. The rodent model could be used to assess the pathways from diet and environment to colon cancer and to provide guidance for clinical studies.
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Affiliation(s)
- Kai Yang
- a Faculty of Medicine, University of Toronto , Toronto , Canada
| | - Sara Fard
- b Department of Nutritional Sciences , Faculty of Medicine, University of Toronto , Toronto , Canada
| | - Rudolf Furrer
- b Department of Nutritional Sciences , Faculty of Medicine, University of Toronto , Toronto , Canada
| | - Michael C Archer
- b Department of Nutritional Sciences , Faculty of Medicine, University of Toronto , Toronto , Canada
| | - W Robert Bruce
- b Department of Nutritional Sciences , Faculty of Medicine, University of Toronto , Toronto , Canada
| | - HoYin Lip
- c Department of Pharmaceutical Science , Faculty of Pharmacy, University of Toronto , Toronto , Canada
| | - Rhea Mehta
- c Department of Pharmaceutical Science , Faculty of Pharmacy, University of Toronto , Toronto , Canada
| | - Peter J O'Brien
- c Department of Pharmaceutical Science , Faculty of Pharmacy, University of Toronto , Toronto , Canada
| | - Adria Giacca
- d Department of Physiology , Faculty of Medicine, University of Toronto , Toronto , Canada
| | - Wendy E Ward
- e Centre for Bone and Muscle Health, Brock University , St. Catharines , Canada
| | - A Pietro Femia
- f NEUROFARBA Department , Section of Pharmacology and Toxicology, University of Florence , Florence , Italy
| | - Giovanna Caderni
- f NEUROFARBA Department , Section of Pharmacology and Toxicology, University of Florence , Florence , Italy
| | - Alan Medline
- g Department of Pathology , Humber River Hospital , Toronto , Canada
| | - Kate Banks
- h Division of Comparative Medicine and Department of Physiology, Faculty of Medicine, University of Toronto , Toronto , Canada
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5
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Powell JJ, Thomas-McKay E, Thoree V, Robertson J, Hewitt RE, Skepper JN, Brown A, Hernandez-Garrido JC, Midgley PA, Gomez-Morilla I, Grime GW, Kirkby KJ, Mabbott NA, Donaldson DS, Williams IR, Rios D, Girardin SE, Haas CT, Bruggraber SFA, Laman JD, Tanriver Y, Lombardi G, Lechler R, Thompson RPH, Pele LC. An endogenous nanomineral chaperones luminal antigen and peptidoglycan to intestinal immune cells. NATURE NANOTECHNOLOGY 2015; 10:361-9. [PMID: 25751305 PMCID: PMC4404757 DOI: 10.1038/nnano.2015.19] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 01/21/2015] [Indexed: 05/06/2023]
Abstract
In humans and other mammals it is known that calcium and phosphate ions are secreted from the distal small intestine into the lumen. However, why this secretion occurs is unclear. Here, we show that the process leads to the formation of amorphous magnesium-substituted calcium phosphate nanoparticles that trap soluble macromolecules, such as bacterial peptidoglycan and orally fed protein antigens, in the lumen and transport them to immune cells of the intestinal tissue. The macromolecule-containing nanoparticles utilize epithelial M cells to enter Peyer's patches, small areas of the intestine concentrated with particle-scavenging immune cells. In wild-type mice, intestinal immune cells containing these naturally formed nanoparticles expressed the immune tolerance-associated molecule 'programmed death-ligand 1', whereas in NOD1/2 double knockout mice, which cannot recognize peptidoglycan, programmed death-ligand 1 was undetected. Our results explain a role for constitutively formed calcium phosphate nanoparticles in the gut lumen and show how this helps to shape intestinal immune homeostasis.
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Affiliation(s)
- Jonathan J Powell
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK
| | - Emma Thomas-McKay
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK
| | - Vinay Thoree
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK
| | - Jack Robertson
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK
| | - Rachel E Hewitt
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK
| | - Jeremy N Skepper
- Cambridge Advanced Imaging Centre, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge CB2 3DY, UK
| | - Andy Brown
- Institute for Materials Research, SPEME, University of Leeds, Leeds LS2 9JT, UK
| | - Juan Carlos Hernandez-Garrido
- Departamento de Ciencia de los Materiales e Ingenieria Metalúrgica y Química Inorganica, Facultad de Ciencias, Universidad de Cádiz, Campus Universitario Rio San Pedro, Puerto Real (Cádiz) 11.510, Spain
| | - Paul A Midgley
- Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS, UK
| | - Inmaculada Gomez-Morilla
- Technische Universitaet Dresden, Fakultaet Maschinenwesen, Institut fuer Stroemungsmechanik, Dresden 01062, Germany
| | - Geoffrey W Grime
- Ion Beam Centre, Advanced Technology Institute, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK
| | - Karen J Kirkby
- 1] Ion Beam Centre, Advanced Technology Institute, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK [2] Institute of Cancer Sciences, The University of Manchester, 27 Palatine Road, Withington, Manchester M20 3LJ, UK
| | - Neil A Mabbott
- The Roslin Institute and Royal (Dick) School of Veterinary Sciences, University of Edinburgh, Easter Bush, Midlothian EH25 9RG, UK
| | - David S Donaldson
- The Roslin Institute and Royal (Dick) School of Veterinary Sciences, University of Edinburgh, Easter Bush, Midlothian EH25 9RG, UK
| | - Ifor R Williams
- Department of Pathology, Emory University School of Medicine, 615 Michael Street, Atlanta, Georgia 30322, USA
| | - Daniel Rios
- Department of Pathology, Emory University School of Medicine, 615 Michael Street, Atlanta, Georgia 30322, USA
| | - Stephen E Girardin
- Department of Laboratory Medicine and Pathobiology, 1 King's College Circle, Toronto M5S 1A8, Canada
| | - Carolin T Haas
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK
| | - Sylvaine F A Bruggraber
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK
| | - Jon D Laman
- 1] Department of Immunology, Erasmus MC, University Medical Centre and MS Centre ErasMS, PO Box 2040, Rotterdam 3000 CA, The Netherlands [2] Department of Neuroscience, Section Medical Physiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Yakup Tanriver
- Department of Internal Medicine IV and Institute of Medical Microbiology and Hygiene, University Medical Center, Freiburg 79106, Germany
| | - Giovanna Lombardi
- Immunoregulation Laboratory, MRC Centre for Transplantation, King's College London, Guys' Hospital, London SE1 9RT, UK
| | - Robert Lechler
- Immunoregulation Laboratory, MRC Centre for Transplantation, King's College London, Guys' Hospital, London SE1 9RT, UK
| | - Richard P H Thompson
- 1] Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK [2] Royal College of Physicians, 11 St Andrews Place, Regent's Park, London NW1 4LE, UK
| | - Laetitia C Pele
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK
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Cheng SX, Lightfoot YL, Yang T, Zadeh M, Tang L, Sahay B, Wang GP, Owen JL, Mohamadzadeh M. Epithelial CaSR deficiency alters intestinal integrity and promotes proinflammatory immune responses. FEBS Lett 2014; 588:4158-66. [PMID: 24842610 PMCID: PMC4234694 DOI: 10.1016/j.febslet.2014.05.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 04/30/2014] [Accepted: 05/02/2014] [Indexed: 12/22/2022]
Abstract
The intestinal epithelium is equipped with sensing receptor mechanisms that interact with luminal microorganisms and nutrients to regulate barrier function and gut immune responses, thereby maintaining intestinal homeostasis. Herein, we clarify the role of the extracellular calcium-sensing receptor (CaSR) using intestinal epithelium-specific Casr(-/-) mice. Epithelial CaSR deficiency diminished intestinal barrier function, altered microbiota composition, and skewed immune responses towards proinflammatory. Consequently, Casr(-/-) mice were significantly more prone to chemically induced intestinal inflammation resulting in colitis. Accordingly, CaSR represents a potential therapeutic target for autoinflammatory disorders, including inflammatory bowel diseases.
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Affiliation(s)
- Sam X Cheng
- Division of Gastroenterology, Department of Pediatrics, University of Florida, Gainesville, FL 32607, USA
| | - Yaíma L Lightfoot
- Department of Infectious Diseases and Pathology, University of Florida, Gainesville, FL 32608, USA; Division of Gastroenterology, Hepatology & Nutrition, Department of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Tao Yang
- Department of Infectious Diseases and Pathology, University of Florida, Gainesville, FL 32608, USA; Division of Gastroenterology, Hepatology & Nutrition, Department of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Mojgan Zadeh
- Department of Infectious Diseases and Pathology, University of Florida, Gainesville, FL 32608, USA; Division of Gastroenterology, Hepatology & Nutrition, Department of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Lieqi Tang
- Division of Gastroenterology, Department of Pediatrics, University of Florida, Gainesville, FL 32607, USA
| | - Bikash Sahay
- Department of Infectious Diseases and Pathology, University of Florida, Gainesville, FL 32608, USA; Division of Gastroenterology, Hepatology & Nutrition, Department of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Gary P Wang
- Division of Infectious Diseases and Global Medicine, Department of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Jennifer L Owen
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Mansour Mohamadzadeh
- Department of Infectious Diseases and Pathology, University of Florida, Gainesville, FL 32608, USA; Division of Gastroenterology, Hepatology & Nutrition, Department of Medicine, University of Florida, Gainesville, FL 32610, USA.
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Iwaya H, Kashiwaya M, Shinoki A, Lee JS, Hayashi K, Hara H, Ishizuka S. Marginal zinc deficiency exacerbates experimental colitis induced by dextran sulfate sodium in rats. J Nutr 2011; 141:1077-82. [PMID: 21525261 DOI: 10.3945/jn.111.138180] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
We investigated the impact of Zn status on the maintenance of mucosal homeostasis. Rats were fed diets containing different amounts of Zn (30, 10, 5, <1 mg Zn/kg diet) for 21 d. Serum Zn concentrations were lower in rats fed marginally Zn-deficient (MZD; 5 mg Zn/kg diet) and severely Zn-deficient (<1 mg/kg) diets but not in those fed the marginally Zn-adequate diet (10 mg/kg) or the Zn-adequate (ZA; 30 mg/kg) group (P < 0.05). However, organ weights, colonic epithelial cell proliferation, and crypt fission did not differ between the MZD and ZA groups. We then evaluated whether MZD modulated dextran sulfate sodium (DSS)-induced colonic inflammation by administering 2% DSS to the MZD and ZA groups for 7 d. Myeloperoxidase activity and TNFα production increased in response to DSS in the MZD group (P < 0.03). Colonic permeability in the 2 groups did not differ after DSS administration. In a culture experiment using isolated mesenteric leukocytes, TNFα production was higher (P < 0.05) and TNF receptor type I (TNFR1) expression was detected in culture medium containing 20 and 30 μmol/L of Zn compared with culture medium lacking Zn supplementation. These results suggest that MZD exacerbated colitis by modulating the immune response through the impairment of TNFα production and TNFR1 expression rather than through the impairment of epithelial barrier function.
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Affiliation(s)
- Hitoshi Iwaya
- Graduate School of Agriculture, Hokkaido University, Sapporo 060-8589 Japan
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Goel GA, Kandiel A, Achkar JP, Lashner B. Molecular pathways underlying IBD-associated colorectal neoplasia: therapeutic implications. Am J Gastroenterol 2011; 106:719-30. [PMID: 21386829 DOI: 10.1038/ajg.2011.51] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Chronic inflammatory diseases, depending upon the duration and severity, are frequently associated with an increased risk of developing cancer. A classic paradigm is the enhanced risk of colorectal cancer (CRC) in patients with inflammatory bowel disease (IBD). Carcinogenesis is a multifactorial process that involves accumulation of genetic defects, protein modification, and cell-matrix interaction. In this review, we discuss aspects of chronic inflammation in IBD that influence the development of CRC and highlight the key molecular mediators involved in this process. Also, we identify potential targets that could facilitate earlier detection of dysplasia. The targeted manipulation of specific molecules or pathways could provide opportunities for the development of therapeutic and chemopreventive interventions, which may prove effective in arresting the progression of colitis-associated cancer (CAC), with clinical implications.
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Affiliation(s)
- Gati A Goel
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.
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Abstract
Ca is not only essential for bone mineralisation, but also for regulation of extracellular and intracellular processes. When the Ca2+ intake is low, the efficiency of intestinal Ca2+ absorption and renal Ca2+ reabsorption is increased. This adaptive mechanism involves calcitriol enhancement via parathyroid hormone stimulation. Bone is also highly affected. Low Ca2+ intake is considered a risk factor for osteoporosis. Patients with renal lithiasis may be at higher risk of recurrence of stone formation when they have low Ca2+ intake. The role of dietary Ca2+ on the regulation of lipid metabolism and lipogenic genes in adipocytes might explain an inverse relationship between dairy intake and BMI. Dietary Ca2+ restriction produces impairment of the adipocyte apoptosis and dysregulation of glucocorticosteroid metabolism in the adipose tissue. An inverse relationship between hypertension and a low-Ca2+ diet has been described. Ca2+ facilitates weight loss and stimulates insulin sensitivity, which contributes to the decrease in the blood pressure. There is also evidence that dietary Ca2+ is associated with colorectal cancer. Dietary Ca2+ could alter the ratio of faecal bile acids, reducing the cytotoxicity of faecal water, or it could activate Ca2+-sensing receptors, triggering intracellular signalling pathways. Also it could bind luminal antigens, transporting them into mucosal mononuclear cells as a mechanism of immunosurveillance and promotion of tolerance. Data relative to nutritional Ca2+ and incidences of other human cancers are controversial. Health professionals should be aware of these nutritional complications and reinforce the dairy intakes to ensure the recommended Ca2+ requirements and prevent diseases.
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Schrenk D. Dietary fiber, low-molecular-weight food constituents and colo-rectal inflammation in animal models - A review. Mol Nutr Food Res 2009; 53:1281-8. [DOI: 10.1002/mnfr.200800576] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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11
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Schepens MAA, Schonewille AJ, Vink C, van Schothorst EM, Kramer E, Hendriks T, Brummer RJ, Keijer J, van der Meer R, Bovee-Oudenhoven IMJ. Supplemental calcium attenuates the colitis-related increase in diarrhea, intestinal permeability, and extracellular matrix breakdown in HLA-B27 transgenic rats. J Nutr 2009; 139:1525-33. [PMID: 19535420 DOI: 10.3945/jn.109.105205] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
We have shown in several controlled rat and human infection studies that dietary calcium improves intestinal resistance and strengthens the mucosal barrier. Reinforcement of gut barrier function may alleviate inflammatory bowel disease (IBD). Therefore, we investigated the effect of supplemental calcium on spontaneous colitis development in an experimental rat model of IBD. HLA-B27 transgenic rats were fed a purified high-fat diet containing either a low or high calcium concentration (30 and 120 mmol CaHPO4/kg diet, respectively) for almost 7 wk. Inert chromium EDTA (CrEDTA) was added to the diets to quantify intestinal permeability by measuring urinary CrEDTA excretion. Relative fecal wet weight was determined to quantify diarrhea. Colonic inflammation was determined histologically and by measuring mucosal interleukin (IL)-1beta. In addition, colonic mucosal gene expression of individual rats was analyzed using whole-genome microarrays. The calcium diet significantly inhibited the increase in intestinal permeability and diarrhea with time in HLA-B27 rats developing colitis compared with the control transgenic rats. Mucosal IL-1beta levels were lower in calcium-fed rats and histological colitis scores tended to be lower (P = 0.08). Supplemental calcium prevented the colitis-induced increase in the expression of extracellular matrix remodeling genes (e.g. matrix metalloproteinases, procollagens, and fibronectin), which was confirmed by quantitative real-time PCR and gelatin zymography. In conclusion, dietary calcium ameliorates several important aspects of colitis severity in HLA-B27 transgenic rats. Reduction of mucosal irritation by luminal components might be part of the mechanism. These results show promise for supplemental calcium as effective adjunct therapy for IBD.
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