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Claxton BB, Sun G, Nahar R, Henry C. Myocardial Infarction With Nonobstructive Coronary Arteries in New-onset Inflammatory Bowel Disease. Inflamm Bowel Dis 2022; 28:1934-1935. [PMID: 35771665 DOI: 10.1093/ibd/izac145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Indexed: 12/09/2022]
Affiliation(s)
- Benjamin B Claxton
- Division of Gastroenterology & Hepatology, Department of Medicine, Thomas Jefferson University Hospitals, Philadelphia, PA, USA
| | - George Sun
- Division of Gastroenterology & Hepatology, Department of Medicine, Thomas Jefferson University Hospitals, Philadelphia, PA, USA
| | - Ritu Nahar
- Division of Gastroenterology & Hepatology, Department of Medicine, Thomas Jefferson University Hospitals, Philadelphia, PA, USA
| | - Christopher Henry
- Division of Gastroenterology & Hepatology, Department of Medicine, Thomas Jefferson University Hospitals, Philadelphia, PA, USA
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2
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Upadacitinib Was Efficacious and Well-tolerated Over 30 Months in Patients With Crohn's Disease in the CELEST Extension Study. Clin Gastroenterol Hepatol 2022; 20:2337-2346.e3. [PMID: 34968730 DOI: 10.1016/j.cgh.2021.12.030] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The long-term efficacy and safety of upadacitinib was evaluated in an open-label extension (OLE) of a phase II, double-blind, randomized trial of patients with Crohn's disease. METHODS Patients who completed the 52-week study (CELEST) received upadacitinib in the CELEST OLE as follows: those who had received immediate-release upadacitinib 3, 6, or 12 mg twice daily or 24 mg once daily (QD) received extended-release upadacitinib 15 mg QD and those who had received immediate-release upadacitinib 12 or 24 mg twice daily as rescue therapy received extended-release upadacitinib 30 mg QD. If any patient initiating upadacitinib 15 mg QD in CELEST OLE lost response at or after week 4, the dose was escalated to upadacitinib 30 mg QD (dose-escalated group). Clinical, endoscopic, inflammatory and quality-of-life measures were assessed. RESULTS A total of 107 CELEST study completers entered CELEST OLE. The proportion of patients with clinical remission 2.8/1.0 was maintained between week 0 and month 30 in all groups (month 30: 15 mg, 61%; 30 mg, 54%; dose-escalation, 55%). Endoscopic response was maintained in all groups (month 24: 68%, 67%, and 40%, respectively). The rates of adverse events (AEs), serious AEs, AEs leading to discontinuation, infections, serious infections, herpes zoster, and creatine phosphokinase elevation were higher with upadacitinib 30 mg vs 15 mg. CONCLUSION Sustained long-term benefit at 30 months and further endoscopic improvements to month 24 were observed in patients with Crohn's disease receiving upadacitinib. Safety over 30 months was consistent with the known safety profile of upadacitinib. CLINICALTRIALS gov ID no: NCT02782663.
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3
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Wu K, Li A, Liu L, Shu T, Xia D, Sun X. Inflammatory bowel disease and cardiovascular disease: A two-sample Mendelian randomization analysis. Front Cardiovasc Med 2022; 9:927120. [PMID: 36119744 PMCID: PMC9478388 DOI: 10.3389/fcvm.2022.927120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundAlthough epidemiological studies have shown a positive relationship between inflammatory bowel disease (IBD) and risk of cardiovascular disease (CVD) outcomes, a solid causal relationship has not been established. Thus, a two-sample Mendelian randomization (MR) study was conducted to explore the potential causal effect between IBD and CVD outcomes.MethodsWe performed a two-sample MR analysis to analyze the causal effect of the IBD on CVD outcome by using summary-level genome-wide association studies of European descent. The inverse-variance weighted (IVW) method was used as the main MR analysis, with complementary analyses of MR Egger, maximum likelihood, weighted median, penalized weighted media, simple mode, weighted mode, and MR-PRESSO methods. Multiple sensitivity analyses were used to evaluate the robustness of our results.ResultsAll P-values were greater than 0.05 in the IVW method, showing no evidence of a causal association between circulating IBD and CVD. Similar results were observed by using other MR methods. No evidence of heterogeneity, pleiotropy, or outlier single-nucleotide polymorphisms was detected. Sensitivity analyses demonstrated the robustness of the results.ConclusionThe findings of this study provided no evidence to support that IBD has a large effect on risk of CVD outcomes, which is in contrast to many previous observational reports. Further studies are needed to determine the potential mechanism of association identified in observational studies.
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Affiliation(s)
- Kaiwen Wu
- Department of Gastroenterology, The Third People’s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Aoshuang Li
- Department of Gastroenterology, The Third People’s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Lei Liu
- Medical Research Center, The Third People’s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Tao Shu
- Department of Gastroenterology, The Third People’s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Demeng Xia
- Luodian Clinical Drug Research Center, Shanghai Baoshan Luodian Hospital, Shanghai University, Shanghai, China
- *Correspondence: Demeng Xia,
| | - Xiaobin Sun
- Department of Gastroenterology, The Third People’s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, China
- Xiaobin Sun,
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Dang AK, Gonzalez DA, Kumar R, Asif S, Bali A, Anne KK, Konanur Srinivasa NK. Vinculum of Cardiovascular Disease and Inflammatory Bowel Disease: A Narrative Review. Cureus 2022; 14:e26144. [PMID: 35891823 PMCID: PMC9303831 DOI: 10.7759/cureus.26144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 11/24/2022] Open
Abstract
Inflammatory bowel disease (IBD), comprising of ulcerative colitis (UC) and Crohn's disease (CrD), is a chronic relapsing-remitting inflammation of the bowel with extraintestinal involvement. Numerous studies published in the last decade have underlined the dangerous cardiovascular disease (CVD) outcomes of IBD, such as ischemic heart disease, heart failure, and stroke, and the need for better therapeutic and prognostic strategies. This article elucidated the pathological web of mechanisms that link IBD with CVD, such as immune dysregulation, endothelial dysfunction, arterial stiffness, and dysbiosis, with a comprehensive review of clinical studies standing for and against the notion in pediatric and adult populations. The current treatment and prevention aim at disease remission and dietary strategies shown to reduce the CVD risk. Exploration of other supplemental preventive and treatment methods, especially during active flares of disease, to reduce the risk of arterial thromboembolic disease (ATED) is the need of the hour.
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5
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Alicic D, Martinovic D, Rusic D, Zivkovic PM, Tadin Hadjina I, Vilovic M, Kumric M, Tokic D, Supe-Domic D, Lupi-Ferandin S, Bozic J. Urotensin II levels in patients with inflammatory bowel disease. World J Gastroenterol 2021; 27:6142-6153. [PMID: 34629825 PMCID: PMC8476337 DOI: 10.3748/wjg.v27.i36.6142] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/21/2021] [Accepted: 08/19/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with inflammatory bowel disease (IBD) are associated with increased cardiovascular risk and have increased overall cardiovascular burden. On the other hand, urotensin II (UII) is one of the most potent vascular constrictors with immunomodulatory effect that is connected with a number of different cardiometabolic disorders as well. Furthermore, patients with ulcerative colitis have shown increased expression of urotensin II receptor in comparison to healthy controls. Since the features of IBD includes chronic inflammation and endothelial dysfunction as well, it is plausible to assume that there is connection between increased cardiac risk in IBD and UII.
AIM To determine serum UII levels in patients with IBD and to compare them to control subjects, as well as investigate possible associations with relevant clinical and biochemical parameters.
METHODS This cross sectional study consecutively enrolled 50 adult IBD patients (26 with Crohn’s disease and 24 with ulcerative colitis) and 50 age and gender matched controls. Clinical assessment was performed by the same experienced gastroenterologist according to the latest guidelines. Ulcerative Colitis Endoscopic Index of Severity and Simple Endoscopic Score for Crohn’s Disease were used for endoscopic evaluation. Serum levels of UII were determined using the enzyme immunoassay kit for human UII, according to the manufacturer’s instructions.
RESULTS IBD patients have significantly higher concentrations of UII when compared to control subjects (7.57 ± 1.41 vs 1.98 ± 0.69 ng/mL, P < 0.001), while there were no significant differences between Crohn’s disease and ulcerative colitis patients (7.49 ± 1.42 vs 7.65 ± 1.41 ng/mL, P = 0.689). There was a significant positive correlation between serum UII levels and high sensitivity C reactive peptide levels (r = 0.491, P < 0.001) and a significant negative correlation between serum UII levels and total proteins (r = -0.306, P = 0.032). Additionally, there was a significant positive correlation between serum UII levels with both systolic (r = 0.387, P = 0.005) and diastolic (r = 0.352, P = 0.012) blood pressure. Moreover, serum UII levels had a significant positive correlation with Ulcerative Colitis Endoscopic Index of Severity (r = 0.425, P = 0.048) and Simple Endoscopic Score for Crohn’s Disease (r = 0.466, P = 0.028) scores. Multiple linear regression analysis showed that serum UII levels retained significant association with high sensitivity C reactive peptide (β ± standard error, 0.262 ± 0.076, P < 0.001) and systolic blood pressure (0.040 ± 0.017, P = 0.030).
CONCLUSION It is possible that UII is involved in the complex pathophysiology of cardiovascular complications in IBD patients, and its purpose should be investigated in further studies.
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Affiliation(s)
- Damir Alicic
- Department of Gastroenterology, University Hospital of Split, Split 21000, Croatia
| | - Dinko Martinovic
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Doris Rusic
- Department of Pharmacy, University of Split School of Medicine, Split 21000, Croatia
| | - Piero Marin Zivkovic
- Department of Gastroenterology, University Hospital of Split, Split 21000, Croatia
| | - Ivana Tadin Hadjina
- Department of Gastroenterology, University Hospital of Split, Split 21000, Croatia
| | - Marino Vilovic
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Marko Kumric
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Daria Tokic
- Department of Anesthesiology and Intensive care, University Hospital of Split, Split 21000, Croatia
| | | | - Slaven Lupi-Ferandin
- Department of Maxillofacial Surgery, University Hospital of Split, Split 21000, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
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6
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Bikbavova GB, Livzan MA. Cardiovascular risks in patients with inflammatory bowel disease: what should be taken into account? EXPERIMENTAL AND CLINICAL GASTROENTEROLOGY 2021; 1:112-120. [DOI: 10.31146/1682-8658-ecg-190-6-112-120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2024]
Abstract
In recent years, there has been a steady increase in the incidence of inflammatory bowel disease (IBD) worldwide. Treatment of ulcerative colitis and Crohn’s disease has become more effective thanks to the emergence of biological therapies, increased access to specialized care and a “treat to target” approach. However, with an increase in the life expectancy of patients with IBD, there is an increase in the number of persons with comorbidity, primarily with a combination of IBD with cardiovascular pathology. Environmental factors lead to a change in the diversity and density of colonization of the intestinal microbiota, a violation of its barrier function, immune dysregulation, which in turn leads to the development of chronic inflammatory diseases and atherosclerosis. Levels of proinflammatory cytokines, C-reactive protein, and homocysteine increase in IBD, leading to endothelial dysfunction and atherosclerosis. In addition, inflammatory processes in IBD promote hypercoagulation, which occurs both in the thromboembolic complications and in the pathogenesis of the disease itself. It has been suggested that medical pathogenetic therapy for IBD is also associated with the risk of cardiovascular disease. In this review, we systematize the available data on the risks of cardiovascular diseases in patients with IBD. A literature search containing information on relevant studies was carried out in PubMed and Google Scholar systems with the keywords: inflammatory bowel disease, cardiovascular disease, inflammation, atherosclerosis.
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Affiliation(s)
- G. B. Bikbavova
- Federal State Educational Establishment of Higher Education Omsk State Medical University of the Ministry of Health of the Russian Federation
| | - M. A. Livzan
- Federal State Educational Establishment of Higher Education Omsk State Medical University of the Ministry of Health of the Russian Federation
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Sinagra E, Pellegatta G, Guarnotta V, Maida M, Rossi F, Conoscenti G, Pallio S, Alloro R, Raimondo D, Pace F, Anderloni A. Microbiota Gut-Brain Axis in Ischemic Stroke: A Narrative Review with a Focus about the Relationship with Inflammatory Bowel Disease. Life (Basel) 2021; 11:life11070715. [PMID: 34357086 PMCID: PMC8305026 DOI: 10.3390/life11070715] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/04/2021] [Accepted: 07/13/2021] [Indexed: 12/16/2022] Open
Abstract
The gut microbiota is emerging as an important player in neurodevelopment and aging as well as in brain diseases including stroke, Alzheimer’s disease, and Parkinson’s disease. The complex interplay between gut microbiota and the brain, and vice versa, has recently become not only the focus of neuroscience, but also the starting point for research regarding many diseases such as inflammatory bowel diseases (IBD). The bi-directional interaction between gut microbiota and the brain is not completely understood. The aim of this review is to sum up the evidencesconcerningthe role of the gut–brain microbiota axis in ischemic stroke and to highlight the more recent evidences about the potential role of the gut–brain microbiota axis in the interaction between inflammatory bowel disease and ischemic stroke.
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Affiliation(s)
- Emanuele Sinagra
- Endoscopy Unit, Fondazione Istituto San Raffaele—G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy; (F.R.); (G.C.); (R.A.); (D.R.)
- Euro-Mediterranean Institute of Science and Technology (IEMEST), 90100 Palermo, Italy
- Correspondence: ; Tel.: +39-921-920-712
| | - Gaia Pellegatta
- Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, 20089 Rozzano, Italy; (G.P.); (A.A.)
| | - Valentina Guarnotta
- Endocrinology Section, PROMISE Department, AOUP Paolo Giaccone, 90127 Palermo, Italy;
| | - Marcello Maida
- Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, 93100 Caltanissetta, Italy;
| | - Francesca Rossi
- Endoscopy Unit, Fondazione Istituto San Raffaele—G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy; (F.R.); (G.C.); (R.A.); (D.R.)
| | - Giuseppe Conoscenti
- Endoscopy Unit, Fondazione Istituto San Raffaele—G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy; (F.R.); (G.C.); (R.A.); (D.R.)
| | - Socrate Pallio
- Endoscopy Unit, Department of clinical and experimental medicine, University of Messina, AOUP Policlinico G. Martino, 98125 Messina, Italy;
| | - Rita Alloro
- Endoscopy Unit, Fondazione Istituto San Raffaele—G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy; (F.R.); (G.C.); (R.A.); (D.R.)
- Emergency Unit, Fondazione Istituto G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Dario Raimondo
- Endoscopy Unit, Fondazione Istituto San Raffaele—G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy; (F.R.); (G.C.); (R.A.); (D.R.)
| | - Fabio Pace
- Unit of Gastroenterology, Bolognini Hospital, 24100 Bergamo, Italy;
| | - Andrea Anderloni
- Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, 20089 Rozzano, Italy; (G.P.); (A.A.)
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8
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Kondubhatla K, Kaushal A, Daoud A, Shabbir H, Mostafa JA. Pro-Atherogenic Inflammatory Mediators in Inflammatory Bowel Disease Patients Increase the Risk of Thrombosis, Coronary Artery Disease, and Myocardial Infarction: A Scientific Dilemma. Cureus 2020; 12:e10544. [PMID: 33062549 PMCID: PMC7549854 DOI: 10.7759/cureus.10544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Inflammatory bowel disease (IBD), comprising ulcerative colitis and Crohn’s disease, is characterized by widespread inflammation of the gastrointestinal tract with systemic manifestations. Inflammation is one of the driving forces for the pathogenesis of atherosclerosis and its dreaded complications like myocardial infarction (MI). Yet, the association between IBD and myocardial infarction has not been thoroughly established. Myocardial infarction in IBD patients was predominantly seen in young women during the active disease process. At the same time, elevated levels of C-reactive protein and other pro-inflammatory markers were observed in both IBD and atherosclerosis. Increasing evidence suggests inflammation inhibits fibrinolysis, expresses procoagulants, and suppresses anticoagulants promoting thrombosis formation. Moreover, the alteration of gut microbiota impacts the pathogenesis of inflammation and predisposes one to ischemic heart disease. Accordingly, all IBD patients should be screened and counseled on lifestyle modifications for the traditional risk factors of atherosclerosis. Future researchers should consider conducting more clinical trials on anti-inflammatory medication targeting atherosclerosis and therapeutics, while targeting the gut microbiota to reverse the inflammatory atherosclerotic process.
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Affiliation(s)
- Kaushik Kondubhatla
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Ayush Kaushal
- Psychiatry and Behavioral Sciences, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Ali Daoud
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Hassan Shabbir
- Hematology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Jihan A Mostafa
- Psychiatry and Behavioral Sciences, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
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9
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Abstract
OBJECTIVE Heart failure (HF) exerts deleterious effects on the gastrointestinal tract and the gut microbiome, yet its impact on inflammatory bowel disease (IBD) is unknown. This study was performed to evaluate the impact of HF on disease course and outcomes in patients with IBD. METHODS Using a large institutional database, we identified patients aged 18-65 years diagnosed with IBD and incident HF (IBD-HF), IBD without HF (IBD), and HF without IBD (HF). Patients were followed longitudinally, and IBD-related outcomes were compared between the IBD-HF and IBD cohorts using multivariable cox regression. General clinical outcomes were compared between all three cohorts using Kaplan-Meier survival analysis. RESULTS A total of 271, 2449, and 20,444 patients were included in the IBD-HF, IBD, and HF cohorts. Compared with IBD, IBD-HF had significantly higher risk of IBD-related hospitalization [hazard ratio (HR): 1.42; (95% confidence interval, CI: 1.2-1.69)], flare [HR 1.32 (1.09-1.58)], complication [HR 1.7 (1.33-2.17)], pancolitis [HR 1.55 (1.04-2.3)], and escalation to nonbiologic therapy. No significant difference was observed in the incidence of IBD-related surgery or Clostridium difficile infection. New biologic use was less frequent in IBD-HF [HR 0.52 (0.36-0.77)]. IBD-HF, compared with the other two groups, had reduced event-free survival for all-cause hospitalization (P < 0.001), emergency department visits (P = 001), and venous thromboembolism (P < 0.05). Mortality risk in IBD-HF was elevated compared to IBD but was similar to that within HF cohort. CONCLUSION Incident HF in patients with IBD is a predictor of adverse IBD-related and overall clinical outcomes.
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10
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Cross RK, Chiorean M, Vekeman F, Xiao Y, Wu E, Chao J, Wang AW. Assessment of the real-world safety profile of vedolizumab using the United States Food and Drug Administration adverse event reporting system. PLoS One 2019; 14:e0225572. [PMID: 31800627 PMCID: PMC6892509 DOI: 10.1371/journal.pone.0225572] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 11/06/2019] [Indexed: 12/26/2022] Open
Abstract
Vedolizumab is the first gut-selective integrin blocker indicated for patients with Crohn's disease (CD) and ulcerative colitis (UC). This study aimed to examine the adverse events (AEs) profile of vedolizumab compared to anti-tumor necrosis factors (anti-TNFs) indicated for CD and UC using the FDA Adverse Event Reporting System (FAERS) database. AE reports with vedolizumab (5/20/2014-6/30/2015) and CD/UC-indicated anti-TNF drugs (adalimumab, infliximab, certolizumab pegol, and golimumab, during 8/1/1998-6/30/2015) as primary suspects were extracted from the FAERS database. AEs associated with vedolizumab were compared for signals of disproportionate reporting against anti-TNF drugs and all other drugs (1969-6/30/2015), using the proportional reporting ratio (PRR) and the empirical Bayesian geometric mean (EBGM) algorithms. The search retrieved 499 reports for vedolizumab and 119,620 reports for anti-TNFs, with 35.9% and 32.1% of these, respectively, being serious AEs. With the PRR approach, vedolizumab-associated reports had signals for 22 groups of AEs (9 were associated with serious outcomes) relative to anti-TNFs and had 34 signals relative to all other drugs. Signals detected included those reported as warnings in prescribing information and new AEs related to cardiovascular disease. Due to the voluntary nature of FAERS, this finding should be considered hypothesis generating (rather than hypothesis testing). Longer-term observational studies are required to evaluate the safety of vedolizumab.
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Affiliation(s)
- Raymond K. Cross
- University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Michael Chiorean
- Virginia Mason Medical Center, Seattle, Washington, United States of America
| | | | | | - Eric Wu
- Analysis Group, Inc., Boston, Massachusetts, United States of America
| | - Jingdong Chao
- AbbVie Inc., North Chicago, Illinois, United States of America
| | - Anthony W. Wang
- AbbVie Inc., North Chicago, Illinois, United States of America
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11
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Grossman R, Francis R. The Way to Man's Heart Is through the Stomach. Thorac Cardiovasc Surg 2019; 69:2-7. [PMID: 31756748 DOI: 10.1055/s-0039-1700886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Organ systems do not exist in a vacuum. However, in an era of increasingly specialized medicine, the focus is often on the organ system alone. Many symptoms are associated with differential diagnoses from upper gastrointestinal (GI) and cardiovascular medical and surgical specialties. Furthermore, a large number of rare but deadly conditions cross paths between the upper GI tract and cardiovascular system; a significant proportion of these are iatrogenic injuries from a parallel specialty. These include unusual fistulae, herniae, and embolisms that transcend specialties. This review highlights these conditions and the shared anatomy and embryology of the two organ systems.
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Affiliation(s)
- Rebecca Grossman
- Department of General Surgery, Buckinghamshire Healthcare NHS Trust, Amersham, United Kingdom
| | - Rohin Francis
- The Hatter Cardiovascular Institute, University College London Hospitals NHS Foundation Trust, London, United Kingdom
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12
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Xu F, Dahlhamer JM, Terlizzi EP, Wheaton AG, Croft JB. Receipt of Preventive Care Services Among US Adults with Inflammatory Bowel Disease, 2015-2016. Dig Dis Sci 2019; 64:1798-1808. [PMID: 30746631 PMCID: PMC10477928 DOI: 10.1007/s10620-019-05494-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 01/24/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Previous reports suggest that adults with inflammatory bowel disease (IBD) receive suboptimal preventive care. AIMS The population-based study compared the receipt of these services by US adults with and without IBD. METHODS Adults aged ≥ 18 years with IBD (1.2%) and without IBD were identified from the 2015 and 2016 National Health Interview Survey (n = 66,610). Age-standardized prevalence of doctor visits, receipt of medical advice, and selected preventive care was calculated for adults with and without IBD. The model-adjusted prevalence ratios were estimated for receipt of preventive care associated with IBD. RESULTS The prevalence of a doctor visit in the past 12 months was significantly higher among adults with IBD than those without. IBD was also associated with significantly higher prevalence of receiving medical advice about smoking cessation (83.9% vs. 66.4%) and diet (42.9% vs. 32.1%), having colon cancer screening in the past 12 months (44.0% vs. 26.7%), having ever had an HIV test (51.5% vs. 45.4%) or pneumococcal vaccine (75.3% vs. 64.0%), having received a tetanus vaccine in the past 10 years (72.0% vs. 61.8%), and having received a flu vaccine in the past 12 months (48.4% vs. 41.0%), but was not significantly associated with receiving cervical cancer screening and hepatitis A and B vaccines. CONCLUSIONS Adults with IBD were more likely to receive many types of preventive care than adults without IBD. The findings can inform healthcare policy makers to make strategic decisions that enhance multidisciplinary coordination from various medical specialties to ensure optimal preventive care for IBD patients.
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Affiliation(s)
- Fang Xu
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Mailstop F-78, 4770 Buford Highway NE, Atlanta, GA, 30341, USA.
| | - James M Dahlhamer
- Division of Health Interview Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Rd, Hyattsville, MD, 20782, USA
| | - Emily P Terlizzi
- Division of Health Interview Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Rd, Hyattsville, MD, 20782, USA
| | - Anne G Wheaton
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Mailstop F-78, 4770 Buford Highway NE, Atlanta, GA, 30341, USA
| | - Janet B Croft
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Mailstop F-78, 4770 Buford Highway NE, Atlanta, GA, 30341, USA
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13
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Lian L, Zhang S, Yu Z, Ge H, Qi S, Zhang X, Long L, Xiong X, Chu D, Ma X, Li X, Gao H. The dietary freeze-dried fruit powder of Actinidia arguta ameliorates dextran sulphate sodium-induced ulcerative colitis in mice by inhibiting the activation of MAPKs. Food Funct 2019; 10:5768-5778. [DOI: 10.1039/c9fo00664h] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Oral administration freeze-dried Actinidia arguta powder could ameliorate ulcerative colitis disease via inhibiting the activation of MAPKs pathway.
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Zhao L, Xiong Q, Stary CM, Mahgoub OK, Ye Y, Gu L, Xiong X, Zhu S. Bidirectional gut-brain-microbiota axis as a potential link between inflammatory bowel disease and ischemic stroke. J Neuroinflammation 2018; 15:339. [PMID: 30537997 PMCID: PMC6290529 DOI: 10.1186/s12974-018-1382-3] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 11/28/2018] [Indexed: 12/16/2022] Open
Abstract
Emerging evidence suggests that gut-brain-microbiota axis (GBMAx) may play a pivotal role linking gastrointestinal and neuronal disease. In this review, we summarize the latest advances in studies of GBMAx in inflammatory bowel disease (IBD) and ischemic stroke. A more thorough understanding of the GBMAx could advance our knowledge about the pathophysiology of IBD and ischemic stroke and help to identify novel therapeutic targets via modulation of the GBMAx.
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Affiliation(s)
- Liang Zhao
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qiutang Xiong
- Diabetes Research Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Creed M. Stary
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305 USA
| | | | - Yingze Ye
- Central Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lijuan Gu
- Central Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xiaoxing Xiong
- Central Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
- Department of Neurosurgery, Renmin Hospital of Wuhan University, 99 Zhang Zhidong Rd, Wuhan, 430060 Hubei China
| | - Shengmei Zhu
- Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310000 Zhejiang China
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15
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Correlation of Paraoxonase-1 with the Severity of Crohn's Disease. Molecules 2018; 23:molecules23102603. [PMID: 30314292 PMCID: PMC6222603 DOI: 10.3390/molecules23102603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/05/2018] [Accepted: 10/08/2018] [Indexed: 12/17/2022] Open
Abstract
Diagnostics of Crohn’s disease (CD) requires noninvasive biomarkers facilitating early detection and differentiation of the disease. Therefore, in this study, we aimed to determine the relationship between paraoxonase-1 (PON-1), the severity of CD, oxidative stress, and inflammation in CD. The CD activity index was based on the current classification. Plasma PON-1 was measured in 47 patients with CD, and in 23 control volunteers. Using quantitative variables such as receiver operating characteristics (ROC) (area under the curve (AUC)), the diagnostic utility of PON-1 in differentiating the severity of CD was assessed. Circulating PON-1 was found to be decreased in the CD group compared to the control group (269.89 vs. 402.56 U/L, respectively), and it correlated well with the disease activity. PON-1 correlated positively with hemoglobin (Hb) (r = 0.539, p < 0.001), hematocrit (Ht) (r = 0.48, p < 0.001), total cholesterol (TC) (r = 0.343, p < 0.001), high density lipoprotein (HDL) (r = 0.536, p < 0.001), low density lipoprotein (LDL) (r = 0.54, p < 0.001), and triglyceride (TG) (r = 0.561, p < 0.001) and correlated negatively with white blood cell count (WBC) (r = −0.262, p = 0.029), platelet count (PLT) (r = −0.326, p = 0.006), C-reactive protein (CRP) (r = −0.61, p < 0.001), and malondialdehyde (MDA) (r = −0.924, p < 0.001). PON-1 as a marker for CD differentiation possessed a sensitivity and specificity of 93.62% and 91.30%, respectively. CD was found to be associated with the decrease in the levels of PON-1, which correlates well with activity of the disease and reflects the intensification of inflammation, as well as intensified lipid peroxidation. High sensitivity and specificity of PON-1 determines its selection as a good screening test for CD severity.
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16
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Ghattamaneni NKR, Panchal SK, Brown L. An improved rat model for chronic inflammatory bowel disease. Pharmacol Rep 2018; 71:149-155. [PMID: 30550995 DOI: 10.1016/j.pharep.2018.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/13/2018] [Accepted: 10/10/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is an important cause of chronic disability in humans. METHODS We characterized a model of chronic IBD in young male Wistar rats by administering dextran sodium sulfate (DSS: 0%, 0.25%, 0.5%, or 1% in drinking water) for six weeks, with 0.5% DSS for twelve weeks, following DSS cessation or together with treatment with sulfasalazine for the last 6 weeks. We measured gastrointestinal characteristics including stool consistency, blood in stools, small intestine and colon length, intestinal transit and permeability, and gut microbiota, as well as extra-intestinal parameters including oral glucose tolerance, systolic blood pressure, fat and lean mass, and left ventricular stiffness. RESULTS At 6 weeks, 0.25-1% DSS produced gastrointestinal changes as diarrhea and blood in stools. At 12 weeks, 0.5% DSS produced chronic and sustained gastrointestinal changes, with marked infiltration of inflammatory cells throughout the gastrointestinal tract and crypt distortion. Firmicutes increased and Bacteroidetes and Actinobacteria decreased in DSS-treated rats. Changes were reversed by DSS cessation or sulfasalazine treatment. Gastrointestinal permeability and extra-intestinal parameters did not change, so DSS changes were limited to the gastrointestinal tract. CONCLUSION Chronic 0.5% DSS produces selective and reversible gastrointestinal changes, providing an improved chronic model in rats that mimics human IBD for testing new interventions.
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Affiliation(s)
- Naga K R Ghattamaneni
- School of Health and Wellbeing, University of Southern Queensland, Toowoomba, QLD, Australia; Functional Foods Research Group, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Sunil K Panchal
- Functional Foods Research Group, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Lindsay Brown
- School of Health and Wellbeing, University of Southern Queensland, Toowoomba, QLD, Australia; Functional Foods Research Group, University of Southern Queensland, Toowoomba, QLD, Australia.
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17
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Vereecke L, Elewaut D. Tumour necrosis factor: out of my heart! Ann Rheum Dis 2018; 77:793-794. [DOI: 10.1136/annrheumdis-2018-213118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 03/20/2018] [Indexed: 11/03/2022]
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18
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Khalid U, Egeberg A, Ahlehoff O, Lane D, Gislason GH, Lip GYH, Hansen PR. Incident Heart Failure in Patients With Rheumatoid Arthritis: A Nationwide Cohort Study. J Am Heart Assoc 2018; 7:JAHA.117.007227. [PMID: 29352092 PMCID: PMC5850154 DOI: 10.1161/jaha.117.007227] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with a wide range of comorbidities, including cardiovascular disease, but its association with heart failure (HF) is not fully clear. We investigated the risk of incident HF in a nationwide cohort of patients with RA. Methods and Results The study comprised the entire Danish population aged ≥18 years followed from January 1, 2008 until first hospitalization for HF, emigration, December 31, 2012, or death. Information on comorbidity, medication, and socioeconomic status was identified by individual‐level linkage of administrative registers. Patients with a rheumatologist diagnosis of RA between 1978 and 2008 were included. The primary study outcome was incident HF defined as first hospital admission for HF. Incidence rates of HF per 1000 person‐years were calculated and incidence rate ratios adjusted for age, sex, calendar year, comorbidity, medications, socioeconomic status, smoking, and alcohol consumption were estimated. A total of 4 305 225 subjects with no history of HF were eligible for analysis at the study start. Of these subjects, 24 343 developed RA and 50 623 were hospitalized for HF. Overall incidence rates of incident HF were 2.43 and 6.64 for the reference population (n=49 879) and patients with RA (n=744), respectively. Correspondingly, the fully adjusted incidence rate ratio for incident HF was increased in patients with RA with incidence rate ratio 1.30 (95% confidence interval, 1.17–1.45). Conclusions In this cohort study, RA was associated with an increased hospitalization for HF. These findings add significantly to the existing evidence of RA as a clinically relevant risk factor for HF.
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Affiliation(s)
- Usman Khalid
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark
| | - Alexander Egeberg
- Department of Dermatology and Allergy, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark
| | - Ole Ahlehoff
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark.,Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Deirdre Lane
- Insititute of Cardiovascular Sciences, University of Birmingham, United Kingdom
| | - Gunnar H Gislason
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark.,National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,Faculty of Health Sciences, University of Copenhagen, Denmark.,Department of Cardiovascular Epidemiology and Research, The Danish Heart Foundation, Copenhagen, Denmark
| | - Gregory Y H Lip
- Insititute of Cardiovascular Sciences, University of Birmingham, United Kingdom
| | - Peter R Hansen
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark.,Faculty of Health Sciences, University of Copenhagen, Denmark
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19
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Feng W, Chen G, Cai D, Zhao S, Cheng J, Shen H. Inflammatory Bowel Disease and Risk of Ischemic Heart Disease: An Updated Meta-Analysis of Cohort Studies. J Am Heart Assoc 2017; 6:JAHA.117.005892. [PMID: 28768646 PMCID: PMC5586435 DOI: 10.1161/jaha.117.005892] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Several immune‐mediated diseases have been shown to be associated with an increased risk of cardiovascular disease. However, studies evaluating the association between inflammatory bowel disease and risk of cardiovascular disease reported inconsistent results. We assessed the association between inflammatory bowel disease and risk of ischemic heart disease in a meta‐analysis of cohort studies. Methods and Results We conducted a literature search of PubMed and Embase up to October 2016 to identify relevant studies. The summary relative risks were calculated using the random‐effects models. To explore the source of heterogeneity, we performed subgroup and sensitivity analysis. We included 10 cohort studies that satisfied our inclusion criteria. Patients with inflammatory bowel disease were associated with an increased risk of ischemic heart disease (relative risk: 1.244; 95% CI, 1.142–1.355). Considerable heterogeneity was observed. Crohn's disease showed a significantly increased risk of ischemic heart disease (relative risk=1.243; 95% CI, 1.042–1.482) and a positive association was also observed in ulcerative colitis (relative risk=1.206; 95% CI, 1.170–1.242). Conclusions Based on meta‐analysis of cohort studies, we found an increased risk of ischemic heart disease in patients with inflammatory bowel disease. Large long‐term prospective studies are warranted to confirm our results.
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Affiliation(s)
- Wan Feng
- Department of Gastroenterology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Guangxia Chen
- Department of Gastroenterology, First People's Hospital of Xuzhou, Xuzhou, China
| | - Dawei Cai
- Department of Orthopaedics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Song Zhao
- Department of Gastroenterology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jiafei Cheng
- Department of Gastroenterology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Hong Shen
- Department of Gastroenterology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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20
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Whayne TF, Morales GX, Darrat YH. Clinical Aspects of Systemic Inflammation and Arrhythmogenesis, Especially Atrial Fibrillation. Angiology 2017; 69:281-285. [PMID: 28718300 DOI: 10.1177/0003319717721399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Thomas F Whayne
- 1 Gill Heart and Vascular Institute, University of Kentucky, Lexington, KY, USA
| | - Gustavo X Morales
- 1 Gill Heart and Vascular Institute, University of Kentucky, Lexington, KY, USA
| | - Yousef H Darrat
- 1 Gill Heart and Vascular Institute, University of Kentucky, Lexington, KY, USA
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21
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Praengam K, Sahasakul Y, Kupradinun P, Sakarin S, Sanitchua W, Rungsipipat A, Rattanapinyopituk K, Angkasekwinai P, Changsri K, Mhuantong W, Tangphatsornruang S, Tuntipopipat S. Brown rice and retrograded brown rice alleviate inflammatory response in dextran sulfate sodium (DSS)-induced colitis mice. Food Funct 2017; 8:4630-4643. [DOI: 10.1039/c7fo00305f] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We investigate the impact of brown rice and retrograded brown rice consumption on colonic health in dextran sulfate sodium induced colitis mice.
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Affiliation(s)
- Kemika Praengam
- Institute of Nutrition
- Mahidol University
- Nakhonpathom
- Thailand
| | | | | | | | | | - Anudep Rungsipipat
- Department of Pathology
- Faculty of Veterinary Science
- Chulalongkorn University
- Bangkok
- Thailand
| | | | - Pornpimon Angkasekwinai
- Department of Medical technology
- Faculty of Allied Health Sciences
- Thammasat University
- Pathum Thani
- Thailand
| | - Khaimuk Changsri
- Department of Medical technology
- Faculty of Allied Health Sciences
- Thammasat University
- Pathum Thani
- Thailand
| | - Wuttichai Mhuantong
- National Center for Genetic Engineering and Biotechnology
- Pathum Thani
- Thailand
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