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Grover Z, Day AS. Novel pharmacological developments in the management of paediatric inflammatory bowel disease. J Paediatr Child Health 2024; 60:162-163. [PMID: 38923605 DOI: 10.1111/jpc.16607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 06/19/2024] [Indexed: 06/28/2024]
Affiliation(s)
- Zubin Grover
- Perth Children's Hospital, Perth, Western Australia, Australia
| | - Andrew S Day
- Cure Kids Chair of Paediatric Research, Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
- Discipline of Paediatrics and Child Health, School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Gilliland A, Chan JJ, De Wolfe TJ, Yang H, Vallance BA. Pathobionts in Inflammatory Bowel Disease: Origins, Underlying Mechanisms, and Implications for Clinical Care. Gastroenterology 2024; 166:44-58. [PMID: 37734419 DOI: 10.1053/j.gastro.2023.09.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 08/28/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023]
Abstract
The gut microbiota plays a significant role in the pathogenesis of both forms of inflammatory bowel disease (IBD), namely, Crohn's disease (CD) and ulcerative colitis (UC). Although evidence suggests dysbiosis and loss of beneficial microbial species can exacerbate IBD, many new studies have identified microbes with pathogenic qualities, termed "pathobionts," within the intestines of patients with IBD. The concept of pathobionts initiating or driving the chronicity of IBD has largely focused on the putative aggravating role that adherent invasive Escherichia coli may play in CD. However, recent studies have identified additional bacterial and fungal pathobionts in patients with CD and UC. This review will highlight the characteristics of these pathobionts and their implications for IBD treatment. Beyond exploring the origins of pathobionts, we discuss those associated with specific clinical features and the potential mechanisms involved, such as creeping fat (Clostridium innocuum) and impaired wound healing (Debaryomyces hansenii) in patients with CD as well as the increased fecal proteolytic activity (Bacteroides vulgatus) seen as a biomarker for UC severity. Finally, we examine the potential impact of pathobionts on current IBD therapies, and several new approaches to target pathobionts currently in the early stages of development. Despite recognizing that pathobionts likely contribute to the pathogenesis of IBD, more work is needed to define their modes of action. Determining whether causal relationships exist between pathobionts and specific disease characteristics could pave the way for improved care for patients, particularly for those not responding to current IBD therapies.
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Affiliation(s)
- Ashley Gilliland
- Division of Gastroenterology, Department of Pediatrics, BC Children's Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
| | - Jocelyn J Chan
- Division of Gastroenterology, Department of Pediatrics, BC Children's Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
| | - Travis J De Wolfe
- Division of Gastroenterology, Department of Pediatrics, BC Children's Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
| | - Hyungjun Yang
- Division of Gastroenterology, Department of Pediatrics, BC Children's Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
| | - Bruce A Vallance
- Division of Gastroenterology, Department of Pediatrics, BC Children's Hospital and the University of British Columbia, Vancouver, British Columbia, Canada.
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Pawłowska-Seredyńska K, Akutko K, Umławska W, Śmieszniak B, Seredyński R, Stawarski A, Pytrus T, Iwańczak B. Nutritional status of pediatric patients with inflammatory bowel diseases is related to disease duration and clinical picture at diagnosis. Sci Rep 2023; 13:21300. [PMID: 38042899 PMCID: PMC10693555 DOI: 10.1038/s41598-023-48504-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/27/2023] [Indexed: 12/04/2023] Open
Abstract
This cross-sectional study presents the nutritional status of newly diagnosed pediatric patients with Crohn's disease (CD) and ulcerative colitis (UC) and its association with the duration of the disease and selected clinical features. We analyzed the data of 41 pediatric patients with CD and 29 with UC (mean age: 13.1 y, range: 5.2-18.0 y) up to 3 mo. from diagnosis. Anthropometry included body weight, body height, body mass index (BMI), three skinfold thicknesses, mid-upper arm circumference and mid-upper arm muscle circumference adjusted for age and sex using national standards. Anthropometry was linked to the disease duration, location of the disease, symptoms, and blood test results. Both studied groups presented significantly lower BMI compared to the reference population, but only children with CD characterized with significantly worse nutritional status according to arm anthropometry. In CD, better nutritional status was associated mainly with longer disease duration and, to a lesser extent, with extraintestinal manifestations, perianal disease, and small intestinal lesions. In UC, anemia at diagnosis was associated with poor nutritional status. Our finding emphasizes the need for more attentive diagnostic care for pediatric patients who exhibit extraintestinal symptoms or perianal disease with no obvious signs of malnutrition, to avoid diagnostic delays.
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Affiliation(s)
| | - Katarzyna Akutko
- 2nd Clinical Department of Pediatrics, Gastroenterology and Nutrition, Medical University of Wroclaw, Wroclaw, Poland
| | - Wioleta Umławska
- Department of Human Biology, University of Wroclaw, Wroclaw, Poland
| | - Bartłomiej Śmieszniak
- 2nd Clinical Department of Pediatrics, Gastroenterology and Nutrition, Medical University of Wroclaw, Wroclaw, Poland
| | - Rafał Seredyński
- Department of Physiology, Medical University of Wroclaw, Wroclaw, Poland
| | - Andrzej Stawarski
- 2nd Clinical Department of Pediatrics, Gastroenterology and Nutrition, Medical University of Wroclaw, Wroclaw, Poland
| | - Tomasz Pytrus
- 2nd Clinical Department of Pediatrics, Gastroenterology and Nutrition, Medical University of Wroclaw, Wroclaw, Poland
| | - Barbara Iwańczak
- 2nd Clinical Department of Pediatrics, Gastroenterology and Nutrition, Medical University of Wroclaw, Wroclaw, Poland
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Magen-Rimon R, Day AS, Shaoul R. Nutritional aspects of inflammatory bowel disease. Expert Rev Gastroenterol Hepatol 2023; 17:731-740. [PMID: 37384423 DOI: 10.1080/17474124.2023.2231340] [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: 11/26/2022] [Revised: 02/27/2023] [Accepted: 06/26/2023] [Indexed: 07/01/2023]
Abstract
INTRODUCTION The number of people diagnosed with inflammatory bowel disease (IBD) continues to increase in most parts of the world. Although the exact etiology of this chronic intestinal disease is not fully understood, nutritional factors appear to play key roles. Furthermore, individuals with IBD are at increased risk of adverse nutritional impacts, including micronutrient deficiencies. AREAS COVERED This review aims to summarize recent reports focusing on nutritional factors relevant to the development of IBD and to also review data on nutritional deficiencies seen in individuals with IBD. EXPERT OPINION The typical western diet, characterized by high-fat/high-sugar foods, along with food additives, appears to contribute to the etiopathogenesis of IBD. In contrast, some reports indicate that some foods are likely protective. However, there are inconsistencies in the currently available data, reflecting study design and other confounding factors. Furthermore, some of the conclusions are inferred from animal or in vitro studies. The presence of IBD can compromise the nutrition of individuals with one of these disorders: ongoing monitoring is critical. Nutrition and diet in the setting of IBD remain key areas for further and ongoing study.
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Affiliation(s)
- Ramit Magen-Rimon
- Pediatric Gastroenterology & Nutrition Institute, Ruth Children's Hospital of Haifa, Rambam Health Care Campus, Faculty of Medicine, Haifa, Israel
| | - Andrew S Day
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
| | - Ron Shaoul
- Pediatric Gastroenterology & Nutrition Institute, Ruth Children's Hospital of Haifa, Rambam Health Care Campus, Faculty of Medicine, Haifa, Israel
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Day AS. Editorial: Insights in pediatric gastroenterology, hepatology and nutrition: 2022. Front Pediatr 2023; 11:1210986. [PMID: 37252039 PMCID: PMC10213724 DOI: 10.3389/fped.2023.1210986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 04/28/2023] [Indexed: 05/31/2023] Open
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Hu K, He H, Yuan X, Du X, Liu R, Yang P, Yang Q, Zhang Y, Qiao J. Carboxymethyl Chitosan Oligosaccharide Holds Promise for Treatment of Stenosis Crohn's Disease. ACS Pharmacol Transl Sci 2022; 5:562-572. [PMID: 35983273 PMCID: PMC9380206 DOI: 10.1021/acsptsci.2c00035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Indexed: 11/29/2022]
Abstract
Crohn's disease (CD) is a chronic intestinal disturbance mediated by mucosal immune hyperactivity that is often associated with the formation of stenosis. No reliable solution to stenosis CD exists so far. Therefore, we generated carboxymethyl chitosan oligosaccharide (CMCOS) as a new promising therapy and investigate its efficacy in an improved rat CD model. CMCOS was synthesized by enzymatic hydrolysis, and its biosafety was evaluated in vivo. The rat model of stenosis CD was optimized by an orthogonal experiment of 75 or 100 mg/kg trinitrobenzenesulfonic acid (TNBS) in a 50 or 75% ethanol enema. The therapeutic efficacy of CMCOS on the rat model of stenosis CD was investigated and compared with the commercial drug 5-aminosalicylic acid over a 28 day period of disease progression. The rat model of stenosis CD was well established by intracolonic administration of 75 mg/kg TNBS in 75% ethanol. CMCOS significantly alleviated CD symptoms morphologically, hematologically, and pathologically, promoting functional recovery of intestinal epithelium in a dose-dependent manner. CMCOS reduced infiltrations of inflammatory cells by regulating the IL-17A/PPAR-γ pathway and reduced fibro-proliferation and fibro-degeneration of the colon tissue by downregulating the TGF-β1/WT1 pathway. 75 mg/kg TNBS in a 75% ethanol enema induces a rat model of stenosis CD suitable for preclinical pathology and pharmacological studies. The safety, antifibrosis, and functional repair performance of CMCOS make it a promising candidate for the treatment of stenosis CD.
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Affiliation(s)
- Kai Hu
- College
of Life Sciences, Anhui Medical University, Hefei City, Anhui Province 230032, P.R. China
| | - Huan He
- College
of Life Sciences, Anhui Medical University, Hefei City, Anhui Province 230032, P.R. China
| | - Xiaozheng Yuan
- College
of Life Sciences, Anhui Medical University, Hefei City, Anhui Province 230032, P.R. China
| | - Xinyu Du
- School
of Mental Health and Psychological Sciences, Anhui Medical University, Hefei
City, Anhui Province 230032, P.R. China
| | - Ronghe Liu
- College
of Life Sciences, Anhui Medical University, Hefei City, Anhui Province 230032, P.R. China
| | - Penglin Yang
- College
of Life Sciences, Anhui Medical University, Hefei City, Anhui Province 230032, P.R. China
| | - Qian Yang
- College
of Life Sciences, Anhui Medical University, Hefei City, Anhui Province 230032, P.R. China
| | - Yunjie Zhang
- College
of Life Sciences, Anhui Medical University, Hefei City, Anhui Province 230032, P.R. China
| | - Jing Qiao
- College
of Life Sciences, Anhui Medical University, Hefei City, Anhui Province 230032, P.R. China
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Zheng B, Pan B, Xu S, Xu Z, Lu G, Wang F, Fang B, Xu C. Detection of inflammatory bowel disease (IBD)-associated microRNAs by two color DNA-templated silver nanoclusters fluorescent probes. SPECTROCHIMICA ACTA PART A-MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2022; 276:121185. [PMID: 35395459 DOI: 10.1016/j.saa.2022.121185] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/28/2022] [Accepted: 03/22/2022] [Indexed: 12/16/2022]
Abstract
Researches demonstrated that circulating miRNAs could be used as novel diagnostic and prognostic potential markers for patients with inflammatory bowel diseases (IBD). It is of great significance in clinical to develop rapid and specific detection methods for miRNAs. Herein, we established a fluorescent probe for ulcerative colitis (UC) activity-associated two serum biomarkers (miR-23a and miR-223) simultaneous detection, which used multi-color fluorescent DNA-stabilized silver nanoclusters (DNA-AgNC) illuminated by a close guanine (G)-rich sequence as a signal transducer and two split DNA probes as recognition units. In principle, the two DNA probe sequences containing AgNC nucleation sequence and G-rich sequence respectively, formed a ternary complex when in the presence of target miRNA through base pairing, so as to induce enhancement of fluorescence emission of AgNC by shortening the distance from G-rich sequence. The combined probes for miR-23a and miR-223 detection generated increased fluorescence signals at 460 nm ex/545 nm em and at 560 nm ex/630 nm em, respectively. With this technique, we successfully quantified the two target miRNAs with high selectivity. Furthermore, the potential clinic applicability of this method was verified by testing the spiked standard miRNAs in human serum. Thus, this one-step, low-cost, and homogenous method offers a great opportunity for disease-associated multiplex miRNAs simultaneous detection.
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Affiliation(s)
- Bo Zheng
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Binhui Pan
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Sheng Xu
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Zhihua Xu
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Guangrong Lu
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - FangYan Wang
- Department of Pathophysiology, School of Basic Medicine Science, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Biyun Fang
- School of Basic Medical Sciences, Xi'an Key Laboratory of Immune Related Diseases, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China.
| | - ChangLong Xu
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
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Rajasekaran V, Andrews A, Roberts AJ, Evans HM, Bishop JR. Outcomes of Exclusion Enteral Nutrition in Paediatric-Onset Crohn's Disease in New Zealand. J Paediatr Child Health 2022; 58:368. [PMID: 34982499 DOI: 10.1111/jpc.15883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Vivek Rajasekaran
- Department of Paediatric Gastroenterology, Starship Child Health, Auckland, New Zealand
| | - Amy Andrews
- Department of Paediatric Gastroenterology, Starship Child Health, Auckland, New Zealand
| | - Amin J Roberts
- Department of Paediatric Gastroenterology, Starship Child Health, Auckland, New Zealand
| | - Helen M Evans
- Department of Paediatric Gastroenterology, Starship Child Health, Auckland, New Zealand
| | - Jonathan R Bishop
- Department of Paediatric Gastroenterology, Starship Child Health, Auckland, New Zealand
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Aspects of the Pathogenesis and Management of Inflammatory Bowel Diseases. GASTROINTESTINAL DISORDERS 2021. [DOI: 10.3390/gidisord3030010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Over the last two decades, inflammatory bowel disease (IBD) has been diagnosed more often in many countries around the world, including in parts of the world where IBD was previously uncommon [...]
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Shaoul R, Day AS. An Overview of Tools to Score Severity in Pediatric Inflammatory Bowel Disease. Front Pediatr 2021; 9:615216. [PMID: 33912519 PMCID: PMC8075054 DOI: 10.3389/fped.2021.615216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/15/2021] [Indexed: 01/07/2023] Open
Abstract
Background and Aims: The management of IBD entails the use of various treatments (nutrition, medications, and surgery) in order to induce and maintain remission. The assessment of IBD disease activity is based on a combination of symptoms, clinical findings, imaging, and endoscopic procedures. As in any disease, reliable assessment of disease activity or severity is required in order to plan relevant follow-up, decide on appropriate investigations, determine the best treatment option and subsequently assess response to treatment. It is important for proper documentation, follow-up, assessment of response to treatment and communication, especially in patients with IBD, to talk the same language by using validated and widely used scores for disease activity, endoscopic and radiologic activity, and patient reported outcomes both for clinical practice and research. This review aims to highlight key tools available for the assessment of disease activity or severity in individuals (especially children) with IBD. Methods: A literature search was performed using MEDLINE, Pubmed, and the Cochrane Library with the last search date of August 2020. Tools evaluating disease severity across various aspects (clinical, endoscopic, and radiological) were identified and discussed. Those tools validated and specific for children with IBD were included were available. Results: Over time a number of scoring systems have been developed to quantify clinical, endoscopic and imaging assessments in individuals with IBD. While some are exclusively for children or adults, others appear to have relevance to all age groups. In addition, some tools developed in adult populations are utilized in children, but have not expressly been validated in this age group. Conclusions: Although some available scoring tools are appropriate for children with IBD, others require consideration. The development and use of pediatric-specific tools is relevant and appropriate to optimal care of children and adolescents with IBD.
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Affiliation(s)
- Ron Shaoul
- Pediatric Gastroenterology & Nutrition Institute, Ruth Children's Hospital of Haifa, Rambam Medical Center, Faculty of Medicine, Technion, Haifa, Israel
| | - Andrew S Day
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
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