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Chimienti G, Russo F, Bianco A, Maqoud F, De Virgilio C, Galeano G, Orlando A, Riezzo G, D’Attoma B, Ignazzi A, Linsalata M, Prospero L, Franco I, Bagnato CB, Curci R, Coletta S. Effect of a 12-Week Walking Program Monitored by Global Physical Capacity Score (GPCS) on Circulating Cell-Free mtDNA and DNase Activity in Patients with Irritable Bowel Syndrome. Int J Mol Sci 2024; 25:4293. [PMID: 38673878 PMCID: PMC11050617 DOI: 10.3390/ijms25084293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
Irritable bowel syndrome (IBS) involves low-grade mucosal inflammation. Among the various approaches capable of managing the symptoms, physical activity is still under investigation. Despite its benefits, it promotes oxidative stress and inflammation. Mitochondria impacts gut disorders by releasing damage-associated molecular patterns, such as cell-free mtDNA (cf-mtDNA), which support inflammation. This study evaluated the effects of a 12-week walking program on the cf-mtDNA and DNase in 26 IBS and 17 non-IBS subjects. Pro- and anti-inflammatory cytokines were evaluated by ELISA. Digital droplet PCR was used to quantify cf-mtDNA; DNase activity was assessed using a single radial enzyme diffusion assay. PCR-RFLP was used to genotype DNASE1 rs1053874 SNP. Significantly lower IL-10 levels were found in IBS than in non-IBS individuals. Exercise reduced cf-mtDNA in non-IBS subjects but not in IBS patients. DNase activity did not correlate with the cf-mtDNA levels in IBS patients post-exercise, indicating imbalanced cf-mtDNA clearance. Different rs1053874 SNP frequencies were not found between groups. The study confirms the positive effects of regular moderate-intensity physical activity in healthy subjects and its role in cf-mtDNA release and clearance. Walking alone might not sufficiently reduce subclinical inflammation in IBS, based on imbalanced pro- and anti-inflammatory molecules. Prolonged programs are necessary to investigate their effects on inflammatory markers in IBS.
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Affiliation(s)
- Guglielmina Chimienti
- Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, 70125 Bari, Italy; (G.C.); (C.D.V.)
| | - Francesco Russo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (F.M.); (G.G.); (A.O.); (G.R.); (B.D.); (A.I.); (M.L.); (L.P.)
| | - Antonella Bianco
- Laboratory of Movement and Wellness, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (C.B.B.); (R.C.)
| | - Fatima Maqoud
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (F.M.); (G.G.); (A.O.); (G.R.); (B.D.); (A.I.); (M.L.); (L.P.)
| | - Caterina De Virgilio
- Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, 70125 Bari, Italy; (G.C.); (C.D.V.)
| | - Grazia Galeano
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (F.M.); (G.G.); (A.O.); (G.R.); (B.D.); (A.I.); (M.L.); (L.P.)
| | - Antonella Orlando
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (F.M.); (G.G.); (A.O.); (G.R.); (B.D.); (A.I.); (M.L.); (L.P.)
| | - Giuseppe Riezzo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (F.M.); (G.G.); (A.O.); (G.R.); (B.D.); (A.I.); (M.L.); (L.P.)
| | - Benedetta D’Attoma
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (F.M.); (G.G.); (A.O.); (G.R.); (B.D.); (A.I.); (M.L.); (L.P.)
| | - Antonia Ignazzi
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (F.M.); (G.G.); (A.O.); (G.R.); (B.D.); (A.I.); (M.L.); (L.P.)
| | - Michele Linsalata
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (F.M.); (G.G.); (A.O.); (G.R.); (B.D.); (A.I.); (M.L.); (L.P.)
| | - Laura Prospero
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (F.M.); (G.G.); (A.O.); (G.R.); (B.D.); (A.I.); (M.L.); (L.P.)
| | - Isabella Franco
- Laboratory of Movement and Wellness, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (C.B.B.); (R.C.)
| | - Claudia Beatrice Bagnato
- Laboratory of Movement and Wellness, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (C.B.B.); (R.C.)
| | - Ritanna Curci
- Laboratory of Movement and Wellness, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (C.B.B.); (R.C.)
| | - Sergio Coletta
- Core Facility Biobank, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy;
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Linsalata M, Riezzo G, Orlando A, D’Attoma B, Prospero L, Ignazzi A, Losurdo G, Di Leo A, Giannelli G, Russo F. The Role of Intestinal Barrier Function in Overweight Patients with IBS with Diarrhea Undergoing a Long-Term Low Fermentable Oligo-, Di-, and Monosaccharide and Polyol Diet. Nutrients 2023; 15:4683. [PMID: 37960336 PMCID: PMC10648034 DOI: 10.3390/nu15214683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/26/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
Overweight and obesity have been suggested as significant factors in irritable bowel syndrome (IBS) development. However, the relationship between overweight/obesity and IBS is unclear. It is known that a modified intestinal barrier, especially the permeability of the small intestine (s-IP), can play a significant role in the pathogenesis of both obesity and IBS. Moreover, dietary interventions are essential for treating both pathologies. We evaluated the gastrointestinal (GI) symptoms and the urinary and circulating markers of GI barrier function and integrity, the markers of intestinal dysbiosis and bacterial translocation, in 40 IBS patients with predominant diarrhea (IBS-D) (32 females and 8 males; mean age = 43.5 ± 1.4 years), categorized using their Body Mass Index levels as normal (NW) and overweight (OW). Evaluations were performed before and after 12 weeks of a Low FODMAP Diet (LFD). At the baseline, OW patients showed a significantly higher s-IP than NW. After an LFD, a significant improvement of s-IP in OW patients occurred, along with a significant decrease in markers of epithelial integrity and bacterial translocation. Our findings highlight the close relationship between overweight and the intestinal barrier and support their involvement in IBS-D pathophysiology. Furthermore, the positive role of an LFD in managing overweight IBS-D was highlighted.
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Affiliation(s)
- Michele Linsalata
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Metropolitan, Italy; (M.L.); (G.R.); (A.O.); (B.D.); (L.P.); (A.I.)
| | - Giuseppe Riezzo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Metropolitan, Italy; (M.L.); (G.R.); (A.O.); (B.D.); (L.P.); (A.I.)
| | - Antonella Orlando
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Metropolitan, Italy; (M.L.); (G.R.); (A.O.); (B.D.); (L.P.); (A.I.)
| | - Benedetta D’Attoma
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Metropolitan, Italy; (M.L.); (G.R.); (A.O.); (B.D.); (L.P.); (A.I.)
| | - Laura Prospero
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Metropolitan, Italy; (M.L.); (G.R.); (A.O.); (B.D.); (L.P.); (A.I.)
| | - Antonia Ignazzi
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Metropolitan, Italy; (M.L.); (G.R.); (A.O.); (B.D.); (L.P.); (A.I.)
| | - Giuseppe Losurdo
- Section of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, Italy; (G.L.); (A.D.L.)
| | - Alfredo Di Leo
- Section of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, Italy; (G.L.); (A.D.L.)
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Metropolitan, Italy;
| | - Francesco Russo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Metropolitan, Italy; (M.L.); (G.R.); (A.O.); (B.D.); (L.P.); (A.I.)
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Bianco A, Russo F, Franco I, Riezzo G, Donghia R, Curci R, Bonfiglio C, Prospero L, D’Attoma B, Ignazzi A, Campanella A, Osella AR. Enhanced Physical Capacity and Gastrointestinal Symptom Improvement in Southern Italian IBS Patients following Three Months of Moderate Aerobic Exercise. J Clin Med 2023; 12:6786. [PMID: 37959251 PMCID: PMC10648315 DOI: 10.3390/jcm12216786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Moderate-intensity aerobic exercise improves gastrointestinal (GI) health and alleviates irritable bowel syndrome (IBS) symptoms. This study explored its effects on physical capacity (PC) and IBS symptoms in 40 patients from Southern Italy (11 males, 29 females; 52.10 ± 7.72 years). The exercise program involved moderate-intensity aerobic exercise (60/75% of HRmax) for at least 180 min per week. Before and after the intervention, participants completed the IBS-SSS questionnaire to assess IBS symptoms, reported their physical activity levels, and underwent field tests to evaluate PC. PC was quantified as the Global Physical Capacity Score (GPCS). A total of 38 subjects (21 males, 17 females; 53.71 ± 7.27 years) without lower GI symptoms served as a No IBS group. No significant differences were found between IBS patients and No IBS subjects, except for the symptom score, as expected. After the exercise, all participants experienced significant improvements in both IBS symptoms and PC. Higher PC levels correlated with greater benefits in IBS symptomatology, especially with GPCS reaching above-average values. Engaging in moderate-intensity aerobic exercise for at least 180 min per week positively impacts IBS symptoms and PC. Monitoring GPCS in IBS patients provides insights into the connection between physical activity and symptom severity, aiding healthcare professionals in tailoring effective treatment plans.
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Affiliation(s)
- Antonella Bianco
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (C.B.); (A.C.); (A.R.O.)
| | - Francesco Russo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Isabella Franco
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (C.B.); (A.C.); (A.R.O.)
| | - Giuseppe Riezzo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Rossella Donghia
- Data Science Unit, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy;
| | - Ritanna Curci
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (C.B.); (A.C.); (A.R.O.)
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (C.B.); (A.C.); (A.R.O.)
| | - Laura Prospero
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Benedetta D’Attoma
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Antonia Ignazzi
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Angelo Campanella
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (C.B.); (A.C.); (A.R.O.)
| | - Alberto Ruben Osella
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (C.B.); (A.C.); (A.R.O.)
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Riezzo G, Prospero L, D’Attoma B, Ignazzi A, Bianco A, Franco I, Curci R, Campanella A, Bonfiglio C, Osella AR, Russo F. The Impact of a Twelve-Week Moderate Aerobic Exercise Program on Gastrointestinal Symptom Profile and Psychological Well-Being of Irritable Bowel Syndrome Patients: Preliminary Data from a Southern Italy Cohort. J Clin Med 2023; 12:5359. [PMID: 37629401 PMCID: PMC10455088 DOI: 10.3390/jcm12165359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/09/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Walking is popular moderate-intensity aerobic exercise that improves mental and gastrointestinal (GI) health. It can relieve symptoms associated with irritable bowel syndrome (IBS), e.g., intestinal gas, abdominal distension, and bowel disturbances. This study examined the impact of a moderate-intensity aerobic exercise program on the clinical and psychological parameters of IBS patients. In total, 40 IBS patients (11 males and 29 females; mean age 51.9 ± 7.8 years) participated in a 12-week aerobic exercise program. Participants completed questionnaires assessing GI symptoms, psychological profiles, and quality of life (QoL) before and after the intervention. Field tests, anthropometric measurements, and bioimpedance assessments were also conducted. The present findings confirmed a significant improvement in IBS symptoms after the aerobic exercise program. Bloating was the most common symptom and, together with abdominal pain, was significantly reduced after treatment. Psychological and QoL questionnaires indicated decreased anxiety, depression, somatization, and stress levels. Correlations were found between anxiety/depression and the severity of abdominal pain as well as between stress and the severity of abdominal distension. Moderate-intensity aerobic exercise positively impacted GI symptoms and psychological well-being, complementing dietary and psychological support as a non-pharmacological therapy for the management of IBS. These findings emphasize the importance of alternative approaches for IBS treatment.
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Affiliation(s)
- Giuseppe Riezzo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Laura Prospero
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Benedetta D’Attoma
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Antonia Ignazzi
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Antonella Bianco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (A.C.); (C.B.); (A.R.O.)
| | - Isabella Franco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (A.C.); (C.B.); (A.R.O.)
| | - Ritanna Curci
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (A.C.); (C.B.); (A.R.O.)
| | - Angelo Campanella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (A.C.); (C.B.); (A.R.O.)
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (A.C.); (C.B.); (A.R.O.)
| | - Alberto Ruben Osella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (A.C.); (C.B.); (A.R.O.)
| | - Francesco Russo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
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Linsalata M, Russo F, Riezzo G, D'Attoma B, Prospero L, Orlando A, Ignazzi A, Di Chito M, Sila A, De Nucci S, Rinaldi R, Giannelli G, De Pergola G. The Effects of a Very-Low-Calorie Ketogenic Diet on the Intestinal Barrier Integrity and Function in Patients with Obesity: A Pilot Study. Nutrients 2023; 15:nu15112561. [PMID: 37299524 DOI: 10.3390/nu15112561] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/23/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
The very-low-calorie ketogenic diet (VLCKD) is effective and safe for obese individuals, but limited information exists on its impact on the intestinal barrier. This study analyzed the effects of 8 weeks of VLCKD on 24 obese patients (11M/13F). Carbohydrate intake was fixed at 20-50 g/day, while protein and lipid intake varied from 1-1.4 g/kg of ideal body weight and 15-30 g per day, respectively. Daily calorie intake was below 800 kcal. The lactulose-mannitol absorption test assessed small intestinal permeability. Multiple markers, such as serum and fecal zonulin, fatty acid-binding protein, diamine oxidase concentrations, urinary dysbiosis markers (indican and skatole), and circulating lipopolysaccharide levels, were analyzed. Inflammation markers (serum interleukin 6, 8, 10, and tumor necrosis factor-α concentrations) were also evaluated. The results showed significant reductions in weight, BMI, and waist circumference post-diet. However, the lactulose-mannitol ratio increased by 76.5%, and a significant increase in dysbiosis markers at the end of the diet occurred. This trend was particularly evident in a subgroup of patients. Despite initial benefits, the VLCKD might negatively affect the intestinal barrier function in obese patients, potentially worsening their compromised intestinal balance.
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Affiliation(s)
- Michele Linsalata
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "S. de Bellis", 70013 Castellana Grotte, Italy
| | - Francesco Russo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "S. de Bellis", 70013 Castellana Grotte, Italy
| | - Giuseppe Riezzo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "S. de Bellis", 70013 Castellana Grotte, Italy
| | - Benedetta D'Attoma
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "S. de Bellis", 70013 Castellana Grotte, Italy
| | - Laura Prospero
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "S. de Bellis", 70013 Castellana Grotte, Italy
| | - Antonella Orlando
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "S. de Bellis", 70013 Castellana Grotte, Italy
| | - Antonia Ignazzi
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "S. de Bellis", 70013 Castellana Grotte, Italy
| | - Martina Di Chito
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Annamaria Sila
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Sara De Nucci
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Roberta Rinaldi
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology IRCCS "S. de Bellis", 70013 Castellana Grotte, Italy
| | - Giovanni De Pergola
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
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Linsalata M, Prospero L, Riezzo G, Orlando A, D'Attoma B, Ignazzi A, Russo F. Somatization is associated with altered serum levels of vitamin D, serotonin, and brain-derived neurotrophic factor in patients with predominant diarrhea irritable bowel syndrome. Neurogastroenterol Motil 2023; 35:e14512. [PMID: 36520620 DOI: 10.1111/nmo.14512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/14/2022] [Accepted: 11/15/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Patients with irritable bowel syndrome (IBS) often show psychological disorders, including somatization, usually driven by an altered gut-brain axis. These changes are also accompanied by modifications in the circulating levels of vitamin D (VD) and neurotransmitters such as serotonin (5-HT) and brain-derived neurotrophic factor (BDNF). The present study aimed to evaluate the relationship between gastrointestinal (GI) symptoms and circulating levels of VD, 5-HT, and BDNF in IBS patients with diarrhea (IBS-D) categorized according to somatization. METHODS Fifty-three IBS-D patients were recruited and profiled for GI symptoms by validated questionnaires. The fasting serum concentrations of VD, 5-HT, and BDNF were assessed. The health of the intestinal barrier, minimal inflammation, and dysbiosis was also evaluated. KEY RESULTS Thirty patients showed high somatization scores, IBS-D(S+), and 23 low somatization scores, IBS-D(S-). IBS-D(S+) patients reported higher "Abdominal pain" and the "Abdominal pain duration in days" scores, lower serum VD levels and increased 5-HT and BDNF concentrations than IBS-D(S-). Besides, in IBS-D(S+) patients, the GI symptoms correlated with 5HT, BDNF, and VD concentrations. These parameters were associated with impaired small intestinal permeability and increased inflammation markers. CONCLUSIONS AND INFERENCES These data support the multifactorial IBS pathogenesis in which organic and psychological factors interact. An active role by VD, 5-HT, and BDNF in affecting the clinical and biochemical profiles in IBS-D(S+) patients may be conceivable. Therefore, the routine VD estimation and the assay of circulating levels of 5-HT and BDNF could be considered a new approach for managing these patients.
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Affiliation(s)
- Michele Linsalata
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology "S. de Bellis" Research Hospital, Castellana Grotte, Italy
| | - Laura Prospero
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology "S. de Bellis" Research Hospital, Castellana Grotte, Italy
| | - Giuseppe Riezzo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology "S. de Bellis" Research Hospital, Castellana Grotte, Italy
| | - Antonella Orlando
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology "S. de Bellis" Research Hospital, Castellana Grotte, Italy
| | - Benedetta D'Attoma
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology "S. de Bellis" Research Hospital, Castellana Grotte, Italy
| | - Antonia Ignazzi
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology "S. de Bellis" Research Hospital, Castellana Grotte, Italy
| | - Francesco Russo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology "S. de Bellis" Research Hospital, Castellana Grotte, Italy
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Russo F, Riezzo G, Linsalata M, Orlando A, Tutino V, Prospero L, D'Attoma B, Giannelli G. Corrigendum: Managing symptom profile of IBS-D patients with Tritordeum-based foods: results from a pilot study. Front Nutr 2023; 10:1196030. [PMID: 37125042 PMCID: PMC10141649 DOI: 10.3389/fnut.2023.1196030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/04/2023] [Indexed: 05/02/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fnut.2022.797192.].
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Affiliation(s)
- Francesco Russo
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy
- *Correspondence: Francesco Russo
| | - Giuseppe Riezzo
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy
| | - Michele Linsalata
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy
| | - Antonella Orlando
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy
| | - Valeria Tutino
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy
| | - Laura Prospero
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy
| | - Benedetta D'Attoma
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy
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Graser JV, Prospero L, Liesch M, Keller U, van Hedel HJA. Test-retest reliability of upper limb robotic exoskeleton assessments in children and youths with brain lesions. Sci Rep 2022; 12:16685. [PMID: 36202825 PMCID: PMC9537308 DOI: 10.1038/s41598-022-20588-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 09/15/2022] [Indexed: 12/01/2022] Open
Abstract
In children with congenital or acquired brain lesions, impaired upper limb function can affect independence. Assessing upper limb function is important for planning and evaluating neurorehabilitative interventions. Robotic devices increase measurement-objectivity and enable measuring parameters reflecting more complex motor functions. We investigated the relative and absolute test–retest reliability of assessments to measure upper limb functions in children and adolescents with brain lesions with the exoskeleton ChARMin. Thirty children (9 females, mean age ± SD = 12.5 ± 3.3 years) with congenital brain injuries (n = 15), acquired (n = 14), both (n = 1) and impaired upper limb function participated. They performed the following ChARMin assessments and repeated them within three to seven days: active and passive Range of Motion (ROM), Strength, Resistance to Passive Movement, Quality of Movement, Circle, and Workspace. We calculated the systematic difference, Intraclass Correlation Coefficient (ICC) and Smallest Real Difference (SRD) for each parameter. Six parameters of three assessments showed systematic errors. ICCs ranged from little to very high and SRD values varied considerably. Test–retest reliability and measurement errors ranged widely between the assessments. Systematic differences indicated that random day-to-day variability in performance would be responsible for reduced reliability of those parameters. While it remains debatable whether robot-derived outcomes should replace certain routine assessments (e.g., ROM, strength), we recommend applying certain technology-based assessments also in clinical practice. Trial registration: This study was registered prospectively at ClinicalTrials.gov (identifier: NCT02443857) on May 14, 2015.
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Affiliation(s)
- Judith V Graser
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland. .,Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland. .,Neuroscience Centre Zurich, University of Zurich and Federal Institute of Technology, Zurich, Switzerland. .,Research Line Functioning, Participation and Rehabilitation CAPHRI, Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
| | - Laura Prospero
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.,Department of Health Sciences and Technology, Federal Institute of Technology, Zurich, Switzerland
| | - Monica Liesch
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.,Department of Health Sciences and Technology, Federal Institute of Technology, Zurich, Switzerland
| | - Urs Keller
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland
| | - Hubertus J A van Hedel
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.,Neuroscience Centre Zurich, University of Zurich and Federal Institute of Technology, Zurich, Switzerland
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Russo F, Riezzo G, Orlando A, Linsalata M, D’Attoma B, Prospero L, Ignazzi A, Giannelli G. A Comparison of the Low-FODMAPs Diet and a Tritordeum-Based Diet on the Gastrointestinal Symptom Profile of Patients Suffering from Irritable Bowel Syndrome-Diarrhea Variant (IBS-D): A Randomized Controlled Trial. Nutrients 2022; 14:nu14081544. [PMID: 35458106 PMCID: PMC9027989 DOI: 10.3390/nu14081544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/28/2022] [Accepted: 04/05/2022] [Indexed: 11/16/2022] Open
Abstract
The dietary approach low in oligosaccharides, disaccharides, monosaccharides, and fermentable polyols (FODMAPs-LFD) is a good strategy for treating irritable bowel syndrome (IBS). Beyond the LFD, other dietary approaches with beneficial effects may be hypothesized. Among them, consumption of Tritordeum-based foods (TBD, bread, bakery products, and pasta) in substitution of other cereals seem to achieve promising results. In a randomized controlled trial, we compared the effects of 12 weeks of LFD to TBD in improving the symptom profile of IBS-diarrhea (IBS-D) patients. The two diets equally improved gastrointestinal symptoms and QoL, measured by the IBS Severity Scoring System (IBS-SSS) questionnaire, reducing the total score after four weeks and maintaining this range until the end of treatment (IBS-SSS total score change: −132.1; 95% CI: −74.9 to −189.4 and −130.5; 95% CI: −73.2 to −187.7; p < 0.0001 after LFD and TBD, respectively). The two diets did not modify the micronutrients content when extended for 12 weeks. LFD could be regarded as a first-line dietary approach for IBS-D patients. However, TBD may represent a valid alternative, with high palatability, especially among Italian patients, for whom pasta is considered one of the main assets of dietetic culture, and would be easier to manage in their daily habits.
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Affiliation(s)
- Francesco Russo
- Functional Gastrointestinal Disorders Research Unit, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte, BA, Italy; (G.R.); (A.O.); (M.L.); (B.D.); (L.P.); (A.I.)
- Correspondence: ; Tel.: +39-080-4994-315
| | - Giuseppe Riezzo
- Functional Gastrointestinal Disorders Research Unit, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte, BA, Italy; (G.R.); (A.O.); (M.L.); (B.D.); (L.P.); (A.I.)
| | - Antonella Orlando
- Functional Gastrointestinal Disorders Research Unit, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte, BA, Italy; (G.R.); (A.O.); (M.L.); (B.D.); (L.P.); (A.I.)
| | - Michele Linsalata
- Functional Gastrointestinal Disorders Research Unit, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte, BA, Italy; (G.R.); (A.O.); (M.L.); (B.D.); (L.P.); (A.I.)
| | - Benedetta D’Attoma
- Functional Gastrointestinal Disorders Research Unit, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte, BA, Italy; (G.R.); (A.O.); (M.L.); (B.D.); (L.P.); (A.I.)
| | - Laura Prospero
- Functional Gastrointestinal Disorders Research Unit, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte, BA, Italy; (G.R.); (A.O.); (M.L.); (B.D.); (L.P.); (A.I.)
| | - Antonia Ignazzi
- Functional Gastrointestinal Disorders Research Unit, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte, BA, Italy; (G.R.); (A.O.); (M.L.); (B.D.); (L.P.); (A.I.)
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte, BA, Italy;
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Russo F, Riezzo G, Linsalata M, Orlando A, Tutino V, Prospero L, D'Attoma B, Giannelli G. Managing Symptom Profile of IBS-D Patients With Tritordeum-Based Foods: Results From a Pilot Study. Front Nutr 2022; 9:797192. [PMID: 35242794 PMCID: PMC8886127 DOI: 10.3389/fnut.2022.797192] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/06/2022] [Indexed: 12/12/2022] Open
Abstract
In the past few years, increasing attention has been given to the pathologic role of specific foods in IBS, like wheat and other cereals. Recent literature describes IBS patients who may experience gastrointestinal (GI) and extra-GI symptoms precipitated by the ingestion of cereals. Tritordeum is a cereal of Spanish origin derived from the hybridization of durum wheat and wild barley. It is different from classic wheat for its gluten protein composition, with fewer carbohydrates and fructans and a higher content of proteins, dietary fibers, and antioxidants. This pilot study aimed to investigate the effects of a 12-week diet with Tritordeum-based foods in substitution of other cereals on the profile of GI symptoms (evaluated by appropriate questionnaire) and the health of the GI barrier (assessed by sugar absorption test and different markers of integrity and functions) in 16 diarrhea-predominant IBS (IBS-D) patients. The diet with Tritordeum-based foods (bread, bakery products, and pasta) significantly reduced IBS-D patients' symptoms. This amelioration appears to occur through an overall improvement of the GI barrier, as demonstrated by the reduced intestinal permeability and the decreased levels of markers of intestinal mucosal integrity, mucosal inflammation, and fermentative dysbiosis.
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Affiliation(s)
- Francesco Russo
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy
- *Correspondence: Francesco Russo
| | - Giuseppe Riezzo
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy
| | - Michele Linsalata
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy
| | - Antonella Orlando
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy
| | - Valeria Tutino
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy
| | - Laura Prospero
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy
| | - Benedetta D'Attoma
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy
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Bianco A, Franco I, Osella AR, Giannelli G, Riezzo G, Bonfiglio C, Prospero L, Sorino P, Russo F. Physical Activity Reduction and the Worsening of Gastrointestinal Health Status during the Second COVID-19 Home Confinement in Southern Italy. Int J Environ Res Public Health 2021; 18:ijerph18189554. [PMID: 34574477 PMCID: PMC8464817 DOI: 10.3390/ijerph18189554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 11/16/2022]
Abstract
Due to the COVID-19 pandemic, in December 2020, the Italian government established a second home confinement during the Christmas holidays. These restrictions offered the opportunity to utilize a well-defined model for observing the consequences of lifestyle changes of healthy individuals. This study aimed at estimating in healthy subjects from Southern Italy the physical activity (PA), the presence and the severity of gastrointestinal (GI) symptoms, and the association between the possible worsening of GI health status and the PA levels. An adapted version of the International PA Questionnaire-short form (IPAQ-SF) and the Gastrointestinal Symptom Rating Scale (GSRS) were proposed through Google’s online survey platform in three different periods via WhatsAppTM to 499 healthy subjects (62% females) from Apulia (25%), Calabria (37%), and Campania (38%). Our results showed statistically significant changes during the home confinement: reduced energy expenditure (EE) among overweight subjects (−239.82, 95%CI −405.74; −73.89) or those who had high GSRS total score (−1079.54, 95%CI −2027.43; −131.66). An increase in GSRS total score was observed in overweight subjects, reaching statistical significance in those from Campania. Our study supports the importance of PA to reduce health risks, including those related to the possible onset of GI tract diseases.
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Affiliation(s)
- Antonella Bianco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (A.R.O.); (C.B.); (P.S.)
| | - Isabella Franco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (A.R.O.); (C.B.); (P.S.)
| | - Alberto Rubén Osella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (A.R.O.); (C.B.); (P.S.)
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy;
| | - Giuseppe Riezzo
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (G.R.); (L.P.)
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (A.R.O.); (C.B.); (P.S.)
| | - Laura Prospero
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (G.R.); (L.P.)
| | - Paolo Sorino
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (A.R.O.); (C.B.); (P.S.)
| | - Francesco Russo
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (G.R.); (L.P.)
- Correspondence: ; Tel.: +39-080-499-4315
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12
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Prospero L, Riezzo G, Linsalata M, Orlando A, D'Attoma B, Di Masi M, Martulli M, Russo F. Somatization in patients with predominant diarrhoea irritable bowel syndrome: the role of the intestinal barrier function and integrity. BMC Gastroenterol 2021; 21:235. [PMID: 34022802 PMCID: PMC8141183 DOI: 10.1186/s12876-021-01820-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/12/2021] [Indexed: 02/06/2023] Open
Abstract
Background Irritable bowel syndrome (IBS) is characterised by gastrointestinal (GI) and psychological symptoms (e.g., depression, anxiety, and somatization). Depression and anxiety, but not somatization, have already been associated with altered intestinal barrier function, increased LPS, and dysbiosis. The study aimed to investigate the possible link between somatization and intestinal barrier in IBS with diarrhoea (IBS-D) patients. Methods Forty-seven IBS-D patients were classified as having low somatization (LS = 19) or high somatization (HS = 28) according to the Symptom Checklist-90-Revised (SCL-90-R), (cut-off score = 63). The IBS Severity Scoring System (IBS-SSS) and the Gastrointestinal Symptom Rating Scale (GSRS) questionnaires were administered to evaluate GI symptoms. The intestinal barrier function was studied by the lactulose/mannitol absorption test, faecal and serum zonulin, serum intestinal fatty-acid binding protein, and diamine oxidase. Inflammation was assessed by assaying serum Interleukins (IL-6, IL-8, IL-10), and tumour necrosis factor-α. Dysbiosis was assessed by the urinary concentrations of indole and skatole and serum lipopolysaccharide (LPS). All data were analysed using a non-parametric test. Results The GI symptoms profiles were significantly more severe, both as a single symptom and as clusters of IBS-SSS and GSRS, in HS than LS patients. This finding was associated with impaired small intestinal permeability and increased faecal zonulin levels. Besides, HS patients showed significantly higher IL-8 and lowered IL-10 concentrations than LS patients. Lastly, circulating LPS levels and the urinary concentrations of indole were higher in HS than LS ones, suggesting a more pronounced imbalance of the small intestine in the former patients. Conclusions IBS is a multifactorial disorder needing complete clinical, psychological, and biochemical evaluations. Trial registration: https://clinicaltrials.gov/ct2/show/NCT03423069.
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Affiliation(s)
- Laura Prospero
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology "S. de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Giuseppe Riezzo
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology "S. de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Michele Linsalata
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology "S. de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Antonella Orlando
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology "S. de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Benedetta D'Attoma
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology "S. de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Marta Di Masi
- Scientific Direction, National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013, Castellana Grotte, BA, Italy
| | - Manuela Martulli
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology "S. de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Francesco Russo
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology "S. de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy.
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Linsalata M, Riezzo G, Orlando A, D’Attoma B, Prospero L, Tutino V, Notarnicola M, Russo F. The Relationship between Low Serum Vitamin D Levels and Altered Intestinal Barrier Function in Patients with IBS Diarrhoea Undergoing a Long-Term Low-FODMAP Diet: Novel Observations from a Clinical Trial. Nutrients 2021; 13:nu13031011. [PMID: 33801020 PMCID: PMC8004066 DOI: 10.3390/nu13031011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/08/2021] [Accepted: 03/18/2021] [Indexed: 12/12/2022] Open
Abstract
Decreased serum vitamin D (VD) levels have been associated with gastrointestinal (GI) disorders, including irritable bowel syndrome (IBS). VD can also modulate the intestinal barrier. Given the link between the GI barrier’s alterations and diet, attention has aroused the positive effects of the Low FODMAP Diet (LFD) on IBS patients’ symptom profile. We evaluated the GI symptoms and the urinary and circulating markers of GI barrier function, the markers of inflammation and intestinal dysbiosis in 36 IBS patients with predominant diarrhea (IBS-D) (5 men and 31 women, 43.1 ± 1.7 years) categorized for their circulating VD levels in low (L-VD) and normal (N-VD) (cutoff = 20 ng/mL). Evaluations were performed before and after 12 weeks of LFD. At the baseline, L-VD patients showed a significantly worse symptom profile and altered small intestinal permeability (s-IP) than N-VD. After LFD, a significant increase in the circulating VD levels in both the subgroups and a significant improvement of s-IP in L-VD patients occurred. Finally, VD levels negatively correlated with the symptom score and fecal zonulin. These data highlight the close relationship between VD and the intestinal barrier and support their involvement in IBS-D pathophysiology. Moreover, the potentially positive role of LFD in the management of IBS-D was confirmed.
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Affiliation(s)
- Michele Linsalata
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Ba, Italy; (M.L.); (G.R.); (A.O.); (B.D.); (L.P.)
| | - Giuseppe Riezzo
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Ba, Italy; (M.L.); (G.R.); (A.O.); (B.D.); (L.P.)
| | - Antonella Orlando
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Ba, Italy; (M.L.); (G.R.); (A.O.); (B.D.); (L.P.)
| | - Benedetta D’Attoma
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Ba, Italy; (M.L.); (G.R.); (A.O.); (B.D.); (L.P.)
| | - Laura Prospero
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Ba, Italy; (M.L.); (G.R.); (A.O.); (B.D.); (L.P.)
| | - Valeria Tutino
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Ba, Italy; (V.T.); (M.N.)
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Ba, Italy; (V.T.); (M.N.)
| | - Francesco Russo
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Ba, Italy; (M.L.); (G.R.); (A.O.); (B.D.); (L.P.)
- Correspondence: ; Tel.: +39-080-4994-129
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Orlando A, Tutino V, Notarnicola M, Riezzo G, Linsalata M, Clemente C, Prospero L, Martulli M, D’Attoma B, De Nunzio V, Russo F. Improved Symptom Profiles and Minimal Inflammation in IBS-D Patients Undergoing a Long-Term Low-FODMAP Diet: A Lipidomic Perspective. Nutrients 2020; 12:nu12061652. [PMID: 32498383 PMCID: PMC7353020 DOI: 10.3390/nu12061652] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/25/2020] [Accepted: 06/01/2020] [Indexed: 12/12/2022] Open
Abstract
Given the link between the minimal inflammation underlying irritable bowel syndrome (IBS) and dietary treatments, considerable attention has focused on diets low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs). In this context, inflammatory patterns and lipidomic investigations may shed light on the pathophysiological mechanisms whereby a low-FODMAP diet (LFD) improves the IBS diarrhoea (IBS-D) variant. Thus, we investigated whether a long-term LFD induced changes in symptom profiles, anthropometric characteristics, inflammatory markers (C-reactive protein, cyclooxygenase-2, and prostaglandin E2) and erythrocyte-membrane fatty acid (FA) composition in IBS-D patients. Twenty IBS-D patients underwent a 90 day personalised LFD programme, and were regularly evaluated at scheduled visits. At the diet’s end, both IBS symptoms and anthropometric parameters were significantly improved. A significant decrease in prostaglandin E2 also accompanied these reductions. As for FAs, the putative inflammatory indicators, arachidonic acid (AA) levels and the AA/eicosapentaenoic acid ratio were significantly decreased. In conclusion, IBS-D patients following a controlled long-term LFD experienced improved symptom profiles and decreased inflammatory markers linked to FAs. Lipidomic data may be insightful for unravelling the molecular mechanisms associated with IBS-D pathophysiology.
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Affiliation(s)
- Antonella Orlando
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte (Ba), Italy; (A.O.); (G.R.); (M.L.); (C.C.); (L.P.); (M.M.); (B.D.)
| | - Valeria Tutino
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte (Ba), Italy; (V.T.); (M.N.); (V.D.N.)
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte (Ba), Italy; (V.T.); (M.N.); (V.D.N.)
| | - Giuseppe Riezzo
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte (Ba), Italy; (A.O.); (G.R.); (M.L.); (C.C.); (L.P.); (M.M.); (B.D.)
| | - Michele Linsalata
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte (Ba), Italy; (A.O.); (G.R.); (M.L.); (C.C.); (L.P.); (M.M.); (B.D.)
| | - Caterina Clemente
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte (Ba), Italy; (A.O.); (G.R.); (M.L.); (C.C.); (L.P.); (M.M.); (B.D.)
| | - Laura Prospero
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte (Ba), Italy; (A.O.); (G.R.); (M.L.); (C.C.); (L.P.); (M.M.); (B.D.)
| | - Manuela Martulli
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte (Ba), Italy; (A.O.); (G.R.); (M.L.); (C.C.); (L.P.); (M.M.); (B.D.)
| | - Benedetta D’Attoma
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte (Ba), Italy; (A.O.); (G.R.); (M.L.); (C.C.); (L.P.); (M.M.); (B.D.)
| | - Valentina De Nunzio
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte (Ba), Italy; (V.T.); (M.N.); (V.D.N.)
| | - Francesco Russo
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology “S. de Bellis” Research Hospital, 70013 Castellana Grotte (Ba), Italy; (A.O.); (G.R.); (M.L.); (C.C.); (L.P.); (M.M.); (B.D.)
- Correspondence:
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Stecchini M, Maltini E, Venir E, Torre M, Prospero L. Properties of Wheat Dough at Sub-Zero Temperatures and Freeze Tolerance of a Baker's Yeast (Saccharomyces cerevisiae). J Food Sci 2002. [DOI: 10.1111/j.1365-2621.2002.tb09526.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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16
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Chiarotti F, Palombi M, Schinaia N, Ghirardini A, Prospero L. Effects of different parametric estimates of seroconversion time on analysis of progression to AIDS among Italian HIV-positive haemophiliacs. Stat Med 1992; 11:591-601. [PMID: 1594802 DOI: 10.1002/sim.4780110504] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The purpose of this study was to estimate seroconversion time using different parametric methods and to assess their influence on the estimation of the incubation time between HIV infection and onset of AIDS. Study subjects were 712 HIV-positive haemophiliacs enrolled in the Italian National Registry of patients with congenital coagulation disorders. Seroconversion time was estimated using the mid-point of each seroconversion interval (MID), the median of each interval under an estimated uniform distribution with cutpoints at December 1981 and December 1985 (MUU), the median of each interval under an estimated Weibull distribution (MUW), and the median of three random values drawn from each interval under the Weibull distribution (RUW). Kaplan-Meier survival analysis showed that the cumulative incidence of AIDS over a 7-year period was 11.6 per cent (SE 1.3 per cent) when using the MID estimate of seroconversion time, 10.8 per cent (1.2 per cent) with the MUU estimate, and 13.4 per cent (1.3 per cent) and 12.3 per cent (1.3 per cent) when using MUW and RUW estimates, respectively. This study demonstrates that the estimate of seroconversion time does not seem to be a major factor affecting estimates of AIDS incidence since the different techniques for estimating HIV seroconversion time yielded very similar results.
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Affiliation(s)
- F Chiarotti
- Istituto Superiore di Sanità, Laboratorio di Fisiopatologia di Organo e di Sistema, Roma, Italy
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