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Li S, Wu L, Zeng H, Zhang J, Qin S, Liang LX, Andersson J, Meng WJ, Chen XY, Wu QZ, Lin LZ, Chou WC, Dong GH, Zeng XW. Hepatic injury and ileitis associated with gut microbiota dysbiosis in mice upon F-53B exposure. Environ Res 2024; 248:118305. [PMID: 38307183 DOI: 10.1016/j.envres.2024.118305] [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] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/04/2024]
Abstract
Chlorinated polyfluorinated ether sulfonate (F-53B), a substitute of perfluorooctane sulfonic acid (PFOS), has attracted significant attention for its link to hepatotoxicity and enterotoxicity. Nevertheless, the underlying mechanisms of F-53B-induced enterohepatic toxicity remain incompletely understood. This study aimed to explore the role of F-53B exposure on enterohepatic injury based on the gut microbiota, pathological and molecular analysis in mice. Here, we exposed C57BL/6 mice to F-53B (0, 4, 40, and 400 μg/L) for 28 days. Our findings revealed a significant accumulation of F-53B in the liver, followed by small intestines, and feces. In addition, F-53B induced pathological collagen fiber deposition and lipoid degeneration, up-regulated the expression of fatty acid β-oxidation-related genes (PPARα and PPARγ, etc), while simultaneously down-regulating pro-inflammatory genes (Nlrp3, IL-1β, and Mcp1) in the liver. Meanwhile, F-53B induced ileal mucosal barrier damage, and an up-regulation of pro-inflammatory genes and mucosal barrier-related genes (Muc1, Muc2, Claudin1, Occludin, Mct1, and ZO-1) in the ileum. Importantly, F-53B distinctly altered gut microbiota compositions by increasing the abundance of Akkermansia and decreasing the abundance of Prevotellaceae_NK3B31_group in the feces. F-53B-altered microbiota compositions were significantly associated with genes related to fatty acid β-oxidation, inflammation, and mucosal barrier. In summary, our results demonstrate that F-53B is capable of inducing hepatic injury, ileitis, and gut microbiota dysbiosis in mice, and the gut microbiota dysbiosis may play an important role in the F-53B-induced enterohepatic toxicity.
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Affiliation(s)
- Shenpan Li
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - LuYin Wu
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - HuiXian Zeng
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Jing Zhang
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - ShuangJian Qin
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Li-Xia Liang
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - John Andersson
- Department of Psychology Umeå University, Umeå, SE-90187, Sweden.
| | - Wen-Jie Meng
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Xing-Yu Chen
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Qi-Zhen Wu
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Li-Zi Lin
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Wei-Chun Chou
- Center for Environmental and Human Toxicology, Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32611, United States.
| | - Guang-Hui Dong
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Xiao-Wen Zeng
- Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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Anto VP, Ramos AE, Mollen KP. Ouch, my pouch! a clinician's guide to pouchitis. Semin Pediatr Surg 2024; 33:151406. [PMID: 38636151 DOI: 10.1016/j.sempedsurg.2024.151406] [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] [Indexed: 04/20/2024]
Abstract
Pouchitis is defined as inflammation of the ileal pouch created during a restorative proctocolectomy with ileal pouch-anal anastomosis. Although the incidence of this inflammatory condition is high, the exact etiology often remains unclear and the management challenging. In this review, we summarize the clinical presentation, pathogenesis, diagnosis, and management of this common complication.
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Affiliation(s)
- Vincent P Anto
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Anna E Ramos
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kevin P Mollen
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Division of Pediatric Surgery, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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Zhang Y, Zhang E, Hou L, Lu H, Guo T, Wang R, Wang Y, Xing M. Assessing and mitigating foodborne acetochlor exposure induced ileum toxicity in broiler chicks: The role of omega-3 polyunsaturated fatty acids supplementation and molecular pathways analysis. Pestic Biochem Physiol 2024; 199:105761. [PMID: 38458672 DOI: 10.1016/j.pestbp.2023.105761] [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] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/20/2023] [Accepted: 12/26/2023] [Indexed: 03/10/2024]
Abstract
Excessive acetochlor residues present ecological and food safety challenges. Here, broiler chicks were exposed to varied acetochlor doses to first assess its effects on the gut. Subsequent dietary supplementation with omega-3 was used to assess its anti-contamination effects. Pathologically, acetochlor induced notable ileal lesions including inflammation, barrier disruption, tight junction loss, and cellular anomalies. Mechanistically, acetochlor stimulated the TNFα/TNFR1 and TLR4/NF-κB/NLRP3 pathways, promoting RIPK1/RIPK3 complex formation, MLKL phosphorylation, NLRP3 inflammasome activation, Caspase-1 activation, and GSDMD shearing with inflammatory factor release. These mechanisms elucidate ileal cell death patterns essential for understanding chicken enteritis. Omega-3 supplementation showed promise in mitigating inflammation, though its precise counteractive role remains unclear. Our findings suggest early omega-3 intervention offered protective benefits against acetochlor's adverse intestinal effects, emphasizing its potential poultry health management role. Harnessing dietary interventions' therapeutic potential will be pivotal in ensuring sustainable poultry production and food safety despite persistent environmental contaminants.
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Affiliation(s)
- Yue Zhang
- College of Wildlife and Protected Area, Northeast Forestry University, Harbin 150040, Heilongjiang, PR China
| | - Enyu Zhang
- College of Wildlife and Protected Area, Northeast Forestry University, Harbin 150040, Heilongjiang, PR China
| | - Lulu Hou
- College of Wildlife and Protected Area, Northeast Forestry University, Harbin 150040, Heilongjiang, PR China
| | - Hongmin Lu
- College of Wildlife and Protected Area, Northeast Forestry University, Harbin 150040, Heilongjiang, PR China
| | - Tiantian Guo
- College of Wildlife and Protected Area, Northeast Forestry University, Harbin 150040, Heilongjiang, PR China
| | - Ruoqi Wang
- College of Wildlife and Protected Area, Northeast Forestry University, Harbin 150040, Heilongjiang, PR China
| | - Yu Wang
- College of Wildlife and Protected Area, Northeast Forestry University, Harbin 150040, Heilongjiang, PR China.
| | - Mingwei Xing
- College of Wildlife and Protected Area, Northeast Forestry University, Harbin 150040, Heilongjiang, PR China.
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Mohan N, Deswal S, Bhardwaj A. Spectrum and trend of pediatric inflammatory bowel disease: A two-decade experience from northern India. Indian J Gastroenterol 2024; 43:208-214. [PMID: 37943479 DOI: 10.1007/s12664-023-01440-x] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 07/24/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Pediatric inflammatory bowel disease (IBD) has been known to be a disease predominant in the west. There is scarcity of data on pediatric IBD (P-IBD) from northern India. The objective of our study was to analyze the clinical spectrum of P-IBD in northern India. METHODS A retrospective analysis of 126 children (<18-year old) diagnosed with IBD from January 1999 to December 2019 was done on a pre-designed proforma. It was systematically entered in a MS Excel spreadsheet and analyzed using Statistical Package for the Social Sciences (SPSS) version 21.0. The descriptive phenotypes of Ulcerative colitis (UC) and Crohn's disease (CD) were revised according to the Paris classification. RESULTS Of 126 children, UC was diagnosed in 76 (60.3%), CD in 44 (34.9%) and IBD-unclassified (IBD-U) in six (4.76%) patients. The mean age at diagnosis was 11.3 years; 38.8% were < 10 years with the male: female ratio of 1.6:1. Sixteen children (12.7%) had very early onset IBD (VEOBD). Overall, the median time to diagnosis in IBD was 12 months (interquartile range [IQR]: 3.25-24), which was as high as 52.5 months (IQR: 11-98) in CD. Pancolitis with bleeding per rectum and ileocolonic involvement with pain in abdomen were the commonest presentations in UC and CD, respectively. Stricturing disease was seen in 27% of CD cases. Relapses were seen in 46% (35/76) of U.C and 23% (10/44) of CD kids. Step-up treatment protocol was employed in them with the use of biologicals in 12% of cases. There was a 2.75-fold rise in the IBD cases in the last 10 years (2010-20). There was reduction in time to diagnosis (21 months vs. 90 months; p - 0.012) and empirical anti-tubercular therapy use (90% vs. 5.8%) in CD over two decades. CONCLUSION From our experience in a tertiary care centre in northern India, P-IBD is on the rise. UC is more common than CD. Pancolitis and ileocolonic disease are the commonest disease sites in UC and CD, respectively There is a significant delay in the time to diagnosis in CD. Stricturing disease was seen in a quarter of children with CD.
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Affiliation(s)
- Neelam Mohan
- Department of Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta - The Medicity Hospital, Sector - 38, Gurugram, 122 001, India.
| | - Shivani Deswal
- Department of Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta - The Medicity Hospital, Sector - 38, Gurugram, 122 001, India
| | - Anubhuti Bhardwaj
- Department of Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta - The Medicity Hospital, Sector - 38, Gurugram, 122 001, India
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Silva TL, Lopes CS, Silva MC, Ferreira FB, Barros HLS, Silva MF, Silva NM, Oliveira F, Mineo TWP, Mineo JR. Ileal inflammation is reduced due to treatment with a metalloprotease from BmooMP-α-I snake venom in an experimental model of Toxoplasma gondii infection. Parasitol Res 2023; 123:65. [PMID: 38133827 DOI: 10.1007/s00436-023-08033-9] [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: 07/15/2023] [Accepted: 11/09/2023] [Indexed: 12/23/2023]
Abstract
The selection process for advanced therapies in patients with inflammatory bowel diseases (IBDs) must prioritize safety, especially when considering new biologic agents or oral molecule modulators. In C57BL/6 mice, oral infection with Toxoplasma gondii induces intestinal inflammation through excessive tumor necrosis factor (TNF) production, making TNF neutralization a potential therapeutic intervention. Considering this, the present study aimed to evaluate the therapeutic effects of BmooMP-α-I, a snake venom metalloprotease isolated from Bothrops moojeni, which could promote TNF hydrolysis, in treating T. gondii-induced ileitis. The results showed that C57BL/6 mice orally infected with 50 cysts of T. gondii from the Me49 strain and treated with BmooMP-α-I exhibited prolonged survival and improved morbidity scores. Additionally, the treatment ameliorated both the macroscopic and microscopic aspects of the intestine, reduced macrophage influx, and decreased the production of inflammatory mediators by mesenteric lymph node cells. These findings provide compelling experimental evidence supporting the ability of BmooMP-α-I to alleviate ileal inflammation. Considering that the currently available therapeutic protocols are not completely effective and often result in side effects, the exploration of alternative strategies involving novel therapeutic agents, as demonstrated in this study, has the potential to significantly enhance the quality of life for patients suffering from inflammatory bowel diseases.
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Affiliation(s)
- Tamires Lopes Silva
- Laboratory of Immunoparasitology "Dr. Mario Endsfeldz Camargo", Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Carolina Salomão Lopes
- Laboratory of Immunoparasitology "Dr. Mario Endsfeldz Camargo", Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Maraisa Cristina Silva
- Laboratory of Immunoparasitology "Dr. Mario Endsfeldz Camargo", Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Flávia Batista Ferreira
- Laboratory of Immunoparasitology "Dr. Mario Endsfeldz Camargo", Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Heber Leão Silva Barros
- Laboratory of Immunoparasitology "Dr. Mario Endsfeldz Camargo", Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Mariana Ferreira Silva
- Laboratory of Immunoparasitology "Dr. Mario Endsfeldz Camargo", Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Neide Maria Silva
- Laboratory of Immunopathology, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Fabio Oliveira
- Laboratory of Biophysics, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
- National Institute of Science and Technology in Nano-Biopharmaceutical (N-Biofar), Belo Horizonte, MG, Brazil
| | - Tiago Wilson Patriarca Mineo
- Laboratory of Immunoparasitology "Dr. Mario Endsfeldz Camargo", Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - José Roberto Mineo
- Laboratory of Immunoparasitology "Dr. Mario Endsfeldz Camargo", Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
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Jenvrin A, Perret A, Palmieri LJ, Soularue E, Broudin C, Rance B, Taieb J, Gallois C. Chemotherapy-induced ileitis associated or not with colitis in digestive oncology patients: An AGEO multicentre study. Dig Liver Dis 2023; 55:1426-1433. [PMID: 37045619 DOI: 10.1016/j.dld.2023.03.001] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 02/06/2023] [Accepted: 03/07/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND The characteristics and management of ileitis induced by chemotherapy in cancer patients are poorly described in the literature. METHODS This retrospective multicentre study enroled patients hospitalized in a digestive oncology unit for a symptomatic chemotherapy-induced ileitis. RESULTS Forty-three patients were included, with a regimen based on fluoropyrimidine and/or irinotecan in 95% of cases. Five patients were excluded due to the diagnosis of infectious ileitis (Clostridium difficile in 3 patients, Campylobacter jejuni in 1 patient and cytomegalovirus in 1 patient). The most frequently described symptoms were diarrhoea (77% including 54% of grade 3-4 diarrhoea), abdominal pain (58%), fever (51%) and vomiting (56%). An ileo-colonoscopy was performed in 35% of patients and did not show any specific results or severity criteria. The ileitis was complicated by bowel perforation and/or obstruction in 3 patients. Disease progression was favourable in 1-2 weeks in the vast majority of cases, on symptomatic treatment, allowing resumption of the chemotherapy regimen involved in 67% of patients. CONCLUSION Chemotherapy-induced ileitis is a rare complication that most often involves fluoropyri-midine- and/or irinotecan-based regimens. In most cases, endoscopic examinations were not contributory and do not seem useful in the event of non-severe symptomatology which most often develops favourably on symptomatic therapy, allowing resumption of the chemotherapy involved.
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Affiliation(s)
- Anaïs Jenvrin
- Assistance Publique-Hôpitaux de Paris, Department of Gastroenterology and Digestive Oncology, Hôpital Européen Georges Pompidou, Paris, France
| | - Audrey Perret
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France
| | - Lola-Jade Palmieri
- Assistance Publique-Hôpitaux de Paris, Gastroenterology and Digestive Oncology Department, Cochin Hospital, Paris, France
| | - Emilie Soularue
- Institut Mutualiste Montsoutris, Department of Medical Oncology, Paris, France
| | - Chloé Broudin
- Paris University; Assistance Publique-Hôpitaux de Paris, Department of Pathology, Hôpital Européen Georges Pompidou, Paris, France
| | - Bastien Rance
- Université Paris Cité, Inserm, Centre de Recherche des Cordeliers; Assistance Publique-Hôpitaux de Paris, Department of Medical Bioinformatics, Hôpital Européen Georges Pompidou, Paris, France
| | - Julien Taieb
- Paris Cité University; Siric CARPEM; Assistance Publique-Hôpitaux de Paris, Department of Gastroenterology and Digestive Oncology, Hôpital Européen Georges Pompidou, Paris, France
| | - Claire Gallois
- Paris Cité University; Siric CARPEM; Assistance Publique-Hôpitaux de Paris, Department of Gastroenterology and Digestive Oncology, Hôpital Européen Georges Pompidou, Paris, France.
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Barbosa JCR, Nicolino RR, Gabardo MP, Gonçalves JPM, Suarez-Duarte ME, Laub RP, Daniel AGS, Mariano GHS, Costa CM, Correia PA, Araújo MD, Guedes RMC. Subsistence swine farming: seroprevalence and risk factors associated with Lawsonia intracellularis infection in the state of Minas Gerais Brazil in 2016. Trop Anim Health Prod 2023; 55:314. [PMID: 37736780 DOI: 10.1007/s11250-023-03755-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 09/12/2023] [Indexed: 09/23/2023]
Abstract
Although it is considered an economically relevant and prevalent disease, little information is available on the epidemiology and risk factors of porcine proliferative enteropathy (PPE) in commercial pigs, and no publication is available on subsistence pig farming. The objectives of this study were to estimate the seroprevalence of L. intracellularis and identify associated risk factors in backyard pigs in the 12 mesoregions of the state of Minas Gerais, Brazil. Blood from pigs between 2 months and 6 years of age were sampled; an epidemiological questionnaire was applied to 288 properties investigated in 2016. Serum samples were tested for the presence of anti-L. intracellularis antibodies using an immunoperoxidase monolayer assay. The seroprevalence of L. intracellularis was 97.7% (CI 95%: 96.7-98.4), and there was no statistical difference among the prevalence of the sampled mesoregions. Only 3 of the 12 risk factors were significant when samples were analyzed from strongly seropositive animals (≥ 1:120) in a Poisson multivariate regression model. There was an interaction between properties in peri-urban areas and extensive production systems. This interaction demonstrated an increase in prevalence rates by 3.7 times (95%CI: 2.4-5.8). Properties close to dumps demonstrated an increase in prevalence rates by 2.2 times (95%CI: 0.99-4.8). In conclusion, anti-L. intracellularis antibodies were widely dispersed in subsistence pig farming's in Minas Gerais, indicating a wide circulation of the agent in this type of production system. The interactions of animals raised close to peri-urban areas, extensively, and close to landfills are risk factors for spread of PPE.
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Affiliation(s)
- J C R Barbosa
- Department of Veterinary Clinic and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31.270-901, Brazil
| | - R R Nicolino
- Department of Preventive Veterinary Medicine, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31.270-901, Brazil
| | - M P Gabardo
- Department of Agrarian Sciences, Instituto Federal de Minas Gerais, Bambuí Campi, Fazenda Varginha Km 05 - Estrada Bambuí, Bambuí, MG, 38.900-000, Brazil
| | - J P M Gonçalves
- Instituto Mineiro de Agropecuária, Cidade Administrativa Tancredo Neves, Edificio Gerais, 10º Andar. Belo Horizonte, Belo Horizonte, MG, 31.270-901, Brazil
| | - M E Suarez-Duarte
- Department of Veterinary Clinic and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31.270-901, Brazil
| | - R P Laub
- Department of Veterinary Clinic and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31.270-901, Brazil
| | - A G S Daniel
- Department of Veterinary Clinic and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31.270-901, Brazil
| | - G H S Mariano
- Department of Veterinary Clinic and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31.270-901, Brazil
| | - C M Costa
- Department of Veterinary Clinic and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31.270-901, Brazil
| | - P A Correia
- Department of Veterinary Clinic and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31.270-901, Brazil
| | - M D Araújo
- Department of Veterinary Clinic and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31.270-901, Brazil
| | - R M C Guedes
- Department of Veterinary Clinic and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31.270-901, Brazil.
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Bislenghi G, Vancoillie PJ, Fieuws S, Verstockt B, Sabino J, Wolthuis A, D'Hoore A. Effect of anastomotic configuration on Crohn's disease recurrence after primary ileocolic resection: a comparative monocentric study of end-to-end versus side-to-side anastomosis. Updates Surg 2023; 75:1607-1615. [PMID: 37308742 DOI: 10.1007/s13304-023-01561-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/03/2023] [Indexed: 06/14/2023]
Abstract
There is ongoing debate whether the type of anastomosis following intestinal resection for Crohn's disease (CD) can impact on complications and postoperative recurrence. The aim of the present study is to describe the outcomes of side-to-side (S-S) vs end-to-end (E-E) anastomosis after ileocecal resection for CD. A retrospective comparative study was conducted in consecutive CD patients who underwent primary ileocecal resection between 2005 and 2013. All patients underwent colonoscopy 6 months postoperatively to assess endoscopic recurrence, defined as Rutgeerts' score (RS) ≥ i2. Surgical recurrence implied reoperation due to CD activity at the anastomotic site. Modified surgical recurrence was defined as the need for reoperation or balloon-dilation. Perioperative factors related to recurrence were evaluated. Of the 127 patients included, 51 (40.2%) received an E-E anastomosis. Median follow-up was longer in the E-E group (8.62 vs 13.68 years). Apart from the microscopic resection margins, patient, disease and surgical characteristics were similar between both groups. Anastomotic complications were comparable (S-S 5.3% vs E-E 5.8%, p = 1.00)0. Postoperatively, biologicals were used in 55.3% and 62.7% (p = 0.47) in S-S and E-E patients, respectively. Endoscopic recurrence did not differ between S-S and E-E patients (78.9 vs 72.9%, p = 0.37), with no significant difference in RS values between both groups (p = 0.87). Throughout follow-up, a higher surgical (p = 0.04) and modified surgical recurrence (p = 0.002) rate was observed in the E-E anastomosis group. Type of anastomosis was an independent risk factor for modified surgical recurrence. The type of anastomosis did not influence endoscopic recurrence and immediate postoperative disease complications. However, the wide diameter and the morphologic characteristic of the stapled S-S anastomosis resulted in a significant reduced risk for surgical and endoscopic reintervention on the long term.
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Affiliation(s)
- Gabriele Bislenghi
- Department of Abdominal Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - Peter-Jan Vancoillie
- Department of Abdominal Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Steffen Fieuws
- Interuniversity Center for Biostatistics and Statistical Bioinformatics, University of Leuven and Univerisity of Hasselt, Leuven, Hasselt, Belgium
| | - Bram Verstockt
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Joao Sabino
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Albert Wolthuis
- Department of Abdominal Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - André D'Hoore
- Department of Abdominal Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
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Fantasia S, Cortegoso Valdivia P, Gaiani F. Ileal Acute Diverticulitis Mimicking Crohn's Disease. Dig Dis Sci 2023; 68:2207-2208. [PMID: 37115361 DOI: 10.1007/s10620-023-07954-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023]
Affiliation(s)
- Stefano Fantasia
- Gastroenterology and Endoscopy Unit, University Hospital of Parma, University of Parma, Viale Gramsci 14, 43126, Parma, Italy
| | - Pablo Cortegoso Valdivia
- Gastroenterology and Endoscopy Unit, University Hospital of Parma, University of Parma, Viale Gramsci 14, 43126, Parma, Italy.
| | - Federica Gaiani
- Gastroenterology and Endoscopy Unit, University Hospital of Parma, University of Parma, Viale Gramsci 14, 43126, Parma, Italy
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Baldasso DZ, Guizzo JA, Dazzi CC, Paraboni Frandoloso GC, Feronato C, von Berg S, Carvalho Guedes RM, Wilson HL, Kreutz LC, Frandoloso R. Development and validation of a flow cytometry antibody test for Lawsonia intracellularis. Front Immunol 2023; 14:1145072. [PMID: 37033985 PMCID: PMC10073966 DOI: 10.3389/fimmu.2023.1145072] [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: 01/15/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Lawsonia intracellularis is the etiologic agent of porcine proliferative enteropathy (PPE), an inflammatory bowel disease with a major economic impact on the pig industry. The serological diagnosis of PPE can be performed using Blocking or Indirect ELISA, Immunoperoxidase Monolayer Assay (IPMA) and Indirect Fluorescence Antibody Test (IFAT). Here, we designed a most sophisticated immunological method for the detection of porcine anti-L. intracellularis IgGs, named Flow Cytometry Antibody Test - FCAT. This assay uses whole, live-attenuated L. intracellularis bacteria derived from a commercial vaccine. For the assay, we set up the optimal antigen concentration (106 bacterium/assay), primary antibody dilution (1:100), time of incubation (20 min), antigen stability (15 days), precision (coefficient of variation - CV < 10%), reproducibility (CV ≤ 13%) and Receiver Operating Characteristic (ROC). When using a cut-off of >15.15% for FCAT, we determined that it showed a sensitivity of 98.8% and specificity of 100%. The rate of agreement with IPMA was 84.09% with a kappa index of 0.66. FCAT was used to screen 1,000 sera from non-vaccinated pigs housed in 22 different farms and we found that 730 pigs (73%) from 16 farms (72.7%) had L. intracellularis IgG. This high prevalence confirms that L. intracellularis is endemic on Brazilian pig farms. Finally, we determined that FCAT is an easy to perform diagnostic assay and we would highly recommend it for: i) seroepidemiological studies; ii) evaluation of infection dynamics; and iii) characterization of the humoral response profile induced by vaccines.
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Affiliation(s)
- Débora Zini Baldasso
- Laboratory of Microbiology and Advanced Immunology, Faculty of Veterinary Medicine, University of Passo Fundo, Passo Fundo, Brazil
| | | | - Cláudia Cerutti Dazzi
- Laboratory of Microbiology and Advanced Immunology, Faculty of Veterinary Medicine, University of Passo Fundo, Passo Fundo, Brazil
- Section of Immunology, AFK Imunotech, Passo Fundo, Brazil
| | | | - César Feronato
- Swine Technical Department, Merck Sharp & Dohme (MSD), São Paulo, Brazil
| | - Stephan von Berg
- Global Marketing Swine, Merck Sharp & Dohme (MSD), Animal Health, Munich, Germany
| | | | - Heather Lynne Wilson
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
| | - Luiz Carlos Kreutz
- Laboratory of Microbiology and Advanced Immunology, Faculty of Veterinary Medicine, University of Passo Fundo, Passo Fundo, Brazil
- Section of Immunology, AFK Imunotech, Passo Fundo, Brazil
| | - Rafael Frandoloso
- Laboratory of Microbiology and Advanced Immunology, Faculty of Veterinary Medicine, University of Passo Fundo, Passo Fundo, Brazil
- Section of Immunology, AFK Imunotech, Passo Fundo, Brazil
- *Correspondence: Rafael Frandoloso,
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11
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Ahmad MF, Mohamad N, Sapiai NA, Razali NA, Anuar AH. A case of concurrent gastrointestinal, peritoneal and urinary bladder tuberculosis. Indian J Tuberc 2022; 69:706-709. [PMID: 36460413 DOI: 10.1016/j.ijtb.2021.09.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 09/09/2021] [Indexed: 06/17/2023]
Abstract
Tuberculosis is a top 10 leading cause of death worldwide. Lungs are primarily involved organs in tuberculosis. The rest of cases are extrapulmonary tuberculosis (14% reported in 2017). Extrapulmonary tuberculosis always presents with non-specific symptoms, thus at risk of delay diagnosis and management. In genitourinary tuberculosis, kidney alone and kidney with urinary bladder or ureter is affected in more than 70% of cases. The ureter and urinary bladder infections are almost always secondary to tuberculous involvement of the kidney. Bacilli haematogenic spreading is a known transmission pathway to the kidney. In this case, we diagnosed isolated urinary bladder tuberculosis caused by direct gastrointestinal tuberculosis infiltration, a rare occurrence of extrapulmonary tuberculosis. We illustrate the multiorgan involvement in tuberculosis infection including pulmonary, gastrointestinal, peritoneal and urinary bladder.
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Affiliation(s)
- Mohamad Firdaus Ahmad
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia; Department of Radiology, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Nasibah Mohamad
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia; Department of Radiology, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia.
| | - Nur Asma Sapiai
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia; Department of Radiology, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
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12
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Ewy MW, Chatzopoulos K, Johnson AM. Pathology Out of Place. Gastroenterology 2022; 163:835-837. [PMID: 35643177 DOI: 10.1053/j.gastro.2022.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/10/2022] [Accepted: 05/16/2022] [Indexed: 12/02/2022]
Affiliation(s)
- Matthew W Ewy
- Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Amanda M Johnson
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
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13
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Bislenghi G, Denolf M, Fieuws S, Wolthuis A, D'Hoore A. Functional outcomes of transanal versus transabdominal restorative proctectomy with ileal pouch-anal anastomosis in ulcerative colitis-a monocentric retrospective comparative study. Langenbecks Arch Surg 2022. [PMID: 35945298 DOI: 10.1007/s00423-022-02640-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/01/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Ileal pouch-anal anastomosis (IPAA) ensures satisfactory gastro-intestinal function and quality of life (QoL) in patients with refractory ulcerative colitis (UC). The transanal approach to proctectomy and IPAA (Ta-IPAA) has been developed to address the technical shortfalls of the traditional transabdominal approach (Tabd-IPAA). Ta-IPAA has proven to be safe but there is lack of reported functional outcomes. Aim of this study is to compare functional outcomes and QoL after Ta- or Tabd-IPAA for UC. METHODS This is a retrospective study of consecutive UC patients who underwent IPAA between 2011 and 2017, operated according to a modified 2- or 3-stage approach. Close rectal dissection was performed in Ta-IPAA as opposed to total mesorectal excision in Tabd-IPAA. A propensity score weighting was performed. Functional outcomes were assessed using the pouch functional score (PFS) and the Öresland score (OS). The global quality of life scale (GQOL) was used for patients' perspective on QoL. Follow-up was scheduled at 1, 3, 6, and 12 months, postoperatively. RESULTS One hundred and eight patients were included: 38 patients had Ta-IPAA. At 12 months follow-up, mean OS and PFS were 4.6 (CI 3.2-6.0) vs 6.2 (CI 5.0-7.3), p = 0.025 and 6.1 (CI 3.5-8.8) vs 7.4 (CI 5.4-9.5), p = 0.32, for Ta and Tabd-IPAA, respectively. Mean GQOL for Ta-IPAA was 82.5 (CI 74.8-90.1) vs 75.5 (69.4-81.7) for Tabd-IPAA (p = 0.045). CONCLUSIONS At 12 months postoperatively, pouch function and QoL of Ta-IPAA are probably as good as those of Tabd-IPAA. Limitations include retrospectivity, differences in the surgical technique, and lack of validated scores for QoL.
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14
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Zou Y, Liu S, Wu J, Sun Z. Severe ileum bleeding following adjuvant capecitabine chemotherapy for locally advanced colon cancer: a case report and review of the literature. World J Surg Oncol 2021; 19:332. [PMID: 34809643 PMCID: PMC8609886 DOI: 10.1186/s12957-021-02443-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/02/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Capecitabine is a prodrug that is enzymatically converted to its active form, fluorouracil (also called 5-fluorouracil), which is commonly used as adjuvant chemotherapy in colorectal cancer patients. Severe gastrointestinal bleeding induced by capecitabine is rare. Here, we are presenting the first case report of surgery specimen assisted diagnosis of this uncommon condition. CASE PRESENTATION A 63-year-old Chinese male with a history of colon adenocarcinoma and right hemicolectomy presented with severe lower gastrointestinal bleeding 2 days after finishing capecitabine administration during the first cycle of XELOX adjuvant chemotherapy. Because of the negative findings of active bleeding points by digital subtraction angiography (DSA) or colonoscopy, emergency laparotomy and partial enterectomy were performed. The bloody diarrhea had resolved after surgery and a terminal ileitis was diagnosed after pathological examination of the surgical specimen. CONCLUSIONS Terminal ileitis induced by capecitabine is likely to be underreported. It should be considered more often as a cause of severe gastrointestinal bleeding during or after treatment with capecitabine agents. Emergency surgery may achieve satisfactory outcomes if endoscopic hemostasis is ineffective. HIGHLIGHTS OF THIS CASE 1. Gastrointestinal bleeding following capecitabine treatment in colorectal cancer patients might be life-threatening. 2. Terminal ileitis induced by capecitabine should always be considered in the differential diagnosis of severe gastrointestinal bleeding. 3. Awareness of the risk factors such as deficiency of dihydropyrimidine dehydrogenase, advanced age, or right colectomy may aid in reducing capecitabine-related morbidity. 4. When severe bleeding occurs, emergency surgery may achieve satisfactory outcomes if medical and endoscopic interventions are ineffective.
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Affiliation(s)
- You Zou
- Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College in Huazhong University of Science and Technology, Wuhan, Hubei, China.,Tongji Cancer Research Institute, Tongji Hospital, Tongji Medical College in Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shuang Liu
- Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College in Huazhong University of Science and Technology, Wuhan, Hubei, China.,Tongji Cancer Research Institute, Tongji Hospital, Tongji Medical College in Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jianhong Wu
- Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College in Huazhong University of Science and Technology, Wuhan, Hubei, China.,Tongji Cancer Research Institute, Tongji Hospital, Tongji Medical College in Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhen Sun
- Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College in Huazhong University of Science and Technology, Wuhan, Hubei, China. .,Tongji Cancer Research Institute, Tongji Hospital, Tongji Medical College in Huazhong University of Science and Technology, Wuhan, Hubei, China.
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15
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Fonnes S, Rasmussen T, Brunchmann A, Holzknecht BJ, Rosenberg J. Mesenteric Lymphadenitis and Terminal Ileitis is Associated With Yersinia Infection: A Meta-analysis. J Surg Res 2021; 270:12-21. [PMID: 34628159 DOI: 10.1016/j.jss.2021.08.027] [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: 04/15/2021] [Revised: 07/05/2021] [Accepted: 08/27/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Yersinia infection affects terminal ileum and lymph nodes and could therefore mimic the symptoms of appendicitis. We aimed to systematically characterise the suspected or confirmed abdominal diseases and/or surgeries associated with Yersinia infection. MATERIALS AND METHODS This systematic review and meta-analysis was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A protocol (CRD42016053252) was uploaded to PROSPERO. The searches were conducted in PubMed and EMBASE on October 2, 2020. Original reports on patients with abdominal surgical diseases were included. The primary outcome was to characterise suspected or confirmed abdominal surgical diseases and/or surgeries associated with Yersinia infection, while the secondary outcomes were the positive rate of Yersinia species for each disease and surgery, and to investigate the rate of Yersinia spp. in different geographic regions. We calculated the weighted mean prevalence of positive tests for Yersinia spp. for the different diseases and surgeries according to the detection method and for subgroups based on geographic region. RESULTS From the search, 33 studies were included in the systematic review and 18 in the meta-analysis. Across geographic regions, the weighted mean prevalence for Yersinia spp. was 51% (95% CI 34%-69%) in mesenteric lymphadenitis, 65% (95% CI 45%-85%) in terminal ileitis, and 8% (95% CI 2%-15%) in normal appendices. CONCLUSIONS Around half of the patients with mesenteric lymphadenitis and terminal ileitis were serologically positive for infections with Yersinia spp. Yersinia infection may cause unnecessary surgery for suspected appendicitis due to symptoms from mesenteric lymphadenitis or terminal ileitis.
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Affiliation(s)
- Siv Fonnes
- Centre for Perioperative Optimisation, Department of Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
| | - Tilde Rasmussen
- Centre for Perioperative Optimisation, Department of Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Amanda Brunchmann
- Centre for Perioperative Optimisation, Department of Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Barbara Juliane Holzknecht
- Department of Clinical Microbiology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Jacob Rosenberg
- Centre for Perioperative Optimisation, Department of Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
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16
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Bislenghi G, Fieuws S, Wolthuis A, Vanbeckevoort D, Ferrante M, Sabino J, Vermeire S, D'Hoore A. Positioning strictureplasty in the treatment of extensive Crohn's disease ileitis: a comparative study with ileocecal resection. Int J Colorectal Dis 2021; 36:791-799. [PMID: 33479821 DOI: 10.1007/s00384-021-03837-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/08/2021] [Indexed: 02/04/2023]
Abstract
PURPOSE The optimal surgical approach to extensive Crohn's disease (CD) terminal ileitis is debated. To date, no studies have directly compared the short- and long-term outcomes of modified side-to-side isoperistaltic strictureplasty over the valve (mSSIS) to traditional ileocecal resection. METHODS A retrospective, observational, comparative study was conducted in consecutive CD patients operated for extensive involvement of the terminal ileum (≥ 20 cm). Ninety-day postoperative morbidity was assessed using the comprehensive complication index (CCI). Surgical recurrence was defined as the need for any surgical intervention related to CD during the follow-up period. Endoscopic remission was defined as ≤ i2a, according to the modified Rutgeerts score. Deep remission was defined as the combination of endoscopic remission and absence of clinical symptoms. Perioperative factors related to clinical recurrence were evaluated. RESULTS Eighty-seven patients were included (47 (54%) ileocecal resection and 40 (46%) mSSIS). Median follow-up was 56 (IQR 34.7-94.4) and 72 (IQR 48.3-87.2) months for resection and mSSIS, respectively (p < 0.001). No mortality occurred. Mean CCI was 9.1 vs 8.5 for ileocecal resection and mSSIS, respectively (p = 0.48). Throughout the follow-up, 8 patients in the resection group (17%) and 5 patients in the mSSIS group (12.5%) experienced surgical recurrence (p = 0.393). Thirty-seven (92.5%) of patients kept the mSSIS. No difference in deep remission was observed (41% vs 22.5%, p = 0.34). CONCLUSIONS Modified SSIS seems to be non-inferior in terms of safety, recurrence, and durability to traditional resections with the advantage of mitigating the risk of a short bowel syndrome. Larger prospective studies are required to confirm these findings.
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Affiliation(s)
- Gabriele Bislenghi
- Department of Abdominal Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - Steffen Fieuws
- Interuniversity Center for Biostatistics and Statistical Bioinformatics, University of KU Leuven, Leuven, Belgium
- University of Hasselt, Leuven, Hasselt, Belgium
| | - Albert Wolthuis
- Department of Abdominal Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Dirk Vanbeckevoort
- Department of Radiology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Marc Ferrante
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Joao Sabino
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Severine Vermeire
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - André D'Hoore
- Department of Abdominal Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
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Ochiai Y, Hoteya S, Kono K, Takazawa Y, Matsui A, Kikuchi D. Cytomegalovirus ileitis with protein-losing enteropathy in an immunocompetent adult. Clin J Gastroenterol 2021; 14:1060-1066. [PMID: 33745065 DOI: 10.1007/s12328-021-01382-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/15/2020] [Accepted: 03/08/2021] [Indexed: 11/30/2022]
Abstract
Symptomatic cytomegalovirus (CMV) infection in immunocompetent hosts has traditionally been considered to have a benign, self-limited course, and those who need intensive therapy are rare. Moreover, there are few reports of CMV infection with protein-losing enteropathy (PLE). We present an immunocompetent 74-year-old woman with CMV ileitis with PLE, which was diagnosed due to severe hypoalbuminemia and edema of the lower extremities. The patient was not immunocompromised, because a human immunodeficiency virus (HIV) antibody test was negative and she had not been taking immunosuppressants. Imaging tests including colonoscopy revealed ileitis with shallow widespread ulcers. 99mTc-human serum albumin (HAS-D) scintigraphy suggested a possibility of protein loss in the ileum based on selective accumulation of nuclides in the right abdomen. Histological findings of the biopsy showed ulcerative mucosa with abnormal cells, which had enlarged nuclei with intranuclear inclusion bodies, including typical Cowdry A type. In immunohistochemistry, these cells were positive for anti-CMV staining. She was successfully treated with medical treatments including intravenous injection of ganciclovir (GCV) (500 mg/day). We described an extremely rare case of CMV ileitis with PLE in an immunocompetent adult who was treated successfully with medical treatments, including GCV.
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Affiliation(s)
- Yorinari Ochiai
- Department of Gastroenterology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.
| | - Shu Hoteya
- Department of Gastroenterology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Kei Kono
- Department of Pathology, Toranomon Hospital, Tokyo, Japan
| | | | - Akira Matsui
- Department of Gastroenterology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Daisuke Kikuchi
- Department of Gastroenterology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
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Jacobs AAC, Harks F, Pauwels R, Cao Q, Holtslag H, Pel S, Segers RPAM. Efficacy of a novel intradermal Lawsonia intracellularis vaccine in pigs against experimental infection and under field conditions. Porcine Health Manag 2020; 6:25. [PMID: 33014411 PMCID: PMC7528468 DOI: 10.1186/s40813-020-00164-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/07/2020] [Indexed: 11/10/2022] Open
Abstract
Background The efficacy of a novel inactivated intradermal Lawsonia intracellularis vaccine, Porcilis® Lawsonia ID, was evaluated in two experimental vaccination-challenge studies and under field conditions on a farm with a history of recurrent acute ileitis. In addition, the efficacy of the vaccine was compared to that of a commercially available live attenuated vaccine. The novel inactivated vaccine consists of a freeze-dried antigen fraction that is dissolved just prior to use in either the adjuvant or in Porcilis® PCV ID; an existing intradermal vaccine against porcine Circovirus type 2. In the two experimental vaccination-challenge studies, groups of 25 piglets were vaccinated once at 3 weeks of age or left unvaccinated as challenge control. Vaccines tested were Porcilis® Lawsonia ID as standalone (study 1) or in associated mixed use with Porcilis® PCV ID (study 2) and an orally administered commercially available live vaccine (study 1). The pigs were challenged with virulent L. intracellularis at 4 weeks (study 1) or 21 weeks (study 2) after vaccination. Post-challenge, the pigs were evaluated for clinical signs, average daily weight gain, shedding and macroscopic as well as microscopic immuno-histological ileum lesion scores. In the field study, the mortality and key performance parameters were evaluated over a period of 8 months. Results The results of the two experimental vaccination-challenge studies showed that Porcilis® Lawsonia ID as single vaccine or in associated mixed use with Porcilis® PCV ID, induced statistically significant protection against experimental L. intracellularis infection, 4 weeks or 21 weeks after vaccination. This was demonstrated by lower clinical scores, improved weight gain, reduction of L. intracellularis shedding and reduction of macroscopic as well as microscopic ileum lesion scores when compared to the controls. The protection induced was superior to that of the commercially available live vaccine. In the field study Porcilis® Lawsonia ID was highly efficacious in reducing L. intracellularis associated mortality and improving key production parameters. Conclusion The results support that this new intradermal vaccine is efficacious against L. intracellularis and may be used in associated mixed use with Porcilis® PCV ID.
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Affiliation(s)
- A A C Jacobs
- MSD Animal Health, Wim de Körverstraat 35, PO Box 31, 5830AA Boxmeer, The Netherlands
| | - F Harks
- MSD Animal Health, Wim de Körverstraat 35, PO Box 31, 5830AA Boxmeer, The Netherlands
| | - R Pauwels
- MSD Animal Health, Wim de Körverstraat 35, PO Box 31, 5830AA Boxmeer, The Netherlands
| | - Q Cao
- MSD Animal Health, Wim de Körverstraat 35, PO Box 31, 5830AA Boxmeer, The Netherlands
| | - H Holtslag
- MSD Animal Health, Wim de Körverstraat 35, PO Box 31, 5830AA Boxmeer, The Netherlands
| | - S Pel
- MSD Animal Health, Wim de Körverstraat 35, PO Box 31, 5830AA Boxmeer, The Netherlands
| | - R P A M Segers
- MSD Animal Health, Wim de Körverstraat 35, PO Box 31, 5830AA Boxmeer, The Netherlands
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19
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Rodrigues Dos Santos J, Silva R, Nejo P, Vassalo T, Coimbra A, Peixoto L. A Case of Brucellosis with Possible Ileal Involvement. GE Port J Gastroenterol 2020; 27:269-273. [PMID: 32775548 DOI: 10.1159/000503454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 09/04/2019] [Indexed: 11/19/2022]
Abstract
Introduction Brucellosis is a zoonotic disease that can involve different organs and tissues. Fever, fatigue, lymphadenopathy, hepatosplenomegaly, cytopenia, and arthritis are the usual modes of presentation. Gastrointestinal manifestations of human brucellosis are common but documented ileal involvement is extremely rare. Case Description A 68-year-old female presented with a history of 10 days of intense temporal migraine, photophobia, and phonophobia with partial response to paracetamol. The patient referred night sweats, anorexia, and colicky abdominal pain after her meals for the past 4 months followed by diarrhea. She denied nausea, vomiting, hypersensitivity of the scalp, blurry vision, melena, or rectal bleeding. She denied travelling or contact with animals. Physical examination revealed fever (38.3°C) and splenomegaly. Laboratory workup revealed Hb 7.8 g/dL, leukopenia (3.47 × 109/L), C-reactive protein 5.94 mg/dL, and erythrocyte sedimentation rate 23 mm/h. Abdominal ultrasound showed hepatic steatosis and mild homogeneous splenomegaly. Chest radiography was normal. Lumbar puncture; transcranial, carotid, and temporal arteries Doppler, and head computed tomography (CT) did not show any significant changes. Abdominal CT showed diffuse thickening of the ileum and some mildly swollen locoregional lymph nodes. Fecal calprotectin was not elevated. Blood cultures and serologies were positive for Brucella (positive Rose-Bengal test, ELISA IgM-positive, IgG-negative anti-brucella antibody serology and positive Huddleson reaction - titer 1:320). The patient was started on rifampicin 600 mg/day and doxycycline 100 mg q. 12 h for 10 weeks with good clinical and analytical response. Upper and lower gastrointestinal endoscopy were normal, although the last was done already under antibiotic treatment. Discussion Although gastrointestinal manifestations of brucellosis are quite common, ileitis is thought to be extremely rare. In countries where brucellosis is endemic, doctors must consider this diagnosis when faced with patients with systemic symptoms and diarrhea or abdominal pain. Early recognition of brucellosis and institution of appropriate therapy usually leads to a good recovery without complications.
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Affiliation(s)
- Joana Rodrigues Dos Santos
- Serviço de Medicina I, Centro Hospitalar Universitário Lisboa Norte, Hospital de Santa Maria, Lisbon, Portugal
| | - Ryan Silva
- Serviço de Medicina I, Centro Hospitalar Universitário Lisboa Norte, Hospital de Santa Maria, Lisbon, Portugal
| | - Priscila Nejo
- Serviço de Medicina I, Centro Hospitalar Universitário Lisboa Norte, Hospital de Santa Maria, Lisbon, Portugal
| | - Tânia Vassalo
- Serviço de Medicina I, Centro Hospitalar Universitário Lisboa Norte, Hospital de Santa Maria, Lisbon, Portugal
| | - Alexandra Coimbra
- Serviço de Medicina I, Centro Hospitalar Universitário Lisboa Norte, Hospital de Santa Maria, Lisbon, Portugal
| | - Lígia Peixoto
- Serviço de Medicina I, Centro Hospitalar Universitário Lisboa Norte, Hospital de Santa Maria, Lisbon, Portugal
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Durayski E, Watte G, Pacini GS, Roman DH, Machado MB, Marchiori E, Hochhegger B, Baldisserotto M. Diffusion-weighted imaging and apparent diffusion coefficient values for evaluating terminal ileitis in patients with Crohn's disease. Radiol Bras 2020; 52:361-367. [PMID: 32047329 PMCID: PMC7007048 DOI: 10.1590/0100-3984.2019.0011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objective: To determine the accuracy of diffusion-weighted imaging (DWI) in identifying terminal ileitis in patients with Crohn’s disease. Materials and Methods: This was a retrospective study of 38 consecutive patients with Crohn’s disease who underwent magnetic resonance enterography with DWI in a 3.0 T scanner. The patients were divided into two groups, on the basis of colonoscopy and biopsy findings: active inflammation; and inactive disease. Apparent diffusion coefficient (ADC) values were determined, as were the magnetic resonance index of activity (MaRIA) and the Clermont score. Results: Of the 38 patients evaluated, 18 (47%) had active inflammation. The patients with active inflammation showed greater restricted diffusion, more pronounced mucosal edema, greater wall thickening, a higher MaRIA, and a higher Clermont score than did those with inactive disease. The level of interobserver agreement (intraclass correlation coefficient) was excellent for the MaRIA and the Clermont score, whereas it was substantial for the ADC values. For identifying colonoscopy-proven inflammation, the best ADC cut-off point was 2.1 × 10−3 mm2/s, which had a sensitivity of 88.8% and a specificity of 95.0%, whereas DWI presented an overall accuracy of 89.4%, with a sensitivity of 88.9% and a specificity of 90.0%. Conclusion: Visual analysis of the DWI sequence has good accuracy in detecting terminal ileitis in patients with Crohn’s disease. In addition, low ADC values have good sensitivity for detecting colonoscopy-proven inflammation.
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Affiliation(s)
- Evandra Durayski
- School of Medicine, Graduate Program in Medicine and Health Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Guilherme Watte
- School of Medicine, Graduate Program in Medicine and Health Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.,Medical Imaging Research Lab (Labimed), Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | - Gabriel Sartori Pacini
- Medical Imaging Research Lab (Labimed), Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | - Diego Hermindo Roman
- School of Medicine, Graduate Program in Medicine and Health Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Marta Brenner Machado
- School of Medicine, Graduate Program in Medicine and Health Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Edson Marchiori
- Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Bruno Hochhegger
- School of Medicine, Graduate Program in Medicine and Health Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.,Medical Imaging Research Lab (Labimed), Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | - Matteo Baldisserotto
- School of Medicine, Graduate Program in Medicine and Health Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
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Shindo R, Katagiri T, Komazawa-Sakon S, Ohmuraya M, Takeda W, Nakagawa Y, Nakagata N, Sakuma T, Yamamoto T, Nishiyama C, Nishina T, Yamazaki S, Kameda H, Nakano H. Regenerating islet-derived protein (Reg)3β plays a crucial role in attenuation of ileitis and colitis in mice. Biochem Biophys Rep 2020; 21:100738. [PMID: 32072024 DOI: 10.1016/j.bbrep.2020.100738] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/26/2019] [Accepted: 01/25/2020] [Indexed: 12/16/2022] Open
Abstract
Regenerating islet-derived protein (Reg)3β belongs to a member of the Reg family of proteins and has pleiotropic functions, including antimicrobial activity and tissue repair. However, whether Reg3β plays a protective role in the development of colitis and ileitis has not been fully investigated. We generated transgenic mice expressing a short form of cellular FLICE-inhibitory protein (cFLIPs) that promotes necroptosis, a regulated form of cell death. cFLIPs transgenic (CFLARs Tg) mice develop severe ileitis in utero. Although Reg3β is undetectable in the small intestine of wild-type embryos, its expression is aberrantly elevated in the small intestine of CFLARs Tg embryos. To test whether elevated Reg3β attenuates or exacerbates ileitis in CFLARs Tg mice, we generated a Reg3b−/− strain. Reg3b−/− mice grew to adulthood without apparent abnormalities. Deletion of Reg3b in CFLARs Tg mice exacerbated the embryonic lethality of CFLARs Tg mice. Dextran sulfate sodium-induced colitis, characterized by body weight loss and infiltration of neutrophils, was exacerbated in Reg3b−/− compared to wild-type mice. Moreover, the expression of Interleukin 6, an inflammatory cytokine and Chitinase-like 3, a marker for tissue repair macrophages was elevated in the colon of Reg3b−/− mice compared to wild-type mice after DSS treatment. Together, these results suggest that attenuation of colitis and ileitis is a result of Reg3β′s real function. The expression of Reg3β is elevated in the embryonic small intestine of CFLARs Tg mice. Reg3b−/− mice grow to adulthood without apparent abnormalities. Dextran sulfate sodium-induced colitis is exacerbated in Reg3b−/− mice. Deletion of Reg3b exacerbates ileitis in CFLARs Tg mice.
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Key Words
- Arg1, Arginase-1
- CFLARs Tg, cFLIPs transgenic
- Cellular FLICE-Inhibitory protein
- Chitinase-like 3, Chil3
- Colitis
- DSS, dextran sulfate sodium
- Dextran sulfate sodium
- GFP, green fluorescent protein
- IECs, intestinal epithelial cells
- IL, interleukin
- ILC3, group 3 innate lymphoid cell
- Ileitis
- MLKL, mixed lineage kinase domain–like protein
- Mrc1, Mannose receptor C-type 1
- RIPK, receptor-interacting protein kinase
- RORγt, RAR-related orphan receptor gamma t
- Reg, regenerating islet-derived protein
- Regenerating islet-derived protein
- Retnla, Resistin-like alpha
- STAT, signal transducer and activator of transcription
- cFLIPs and L, cellular FLICE-inhibitory protein, short and long forms
- pSTAT3, phospho-STAT3
- qPCR, quantitative polymerase chain reaction
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22
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Günther C, Ruder B, Stolzer I, Dorner H, He GW, Chiriac MT, Aden K, Strigli A, Bittel M, Zeissig S, Rosenstiel P, Atreya R, Neurath MF, Wirtz S, Becker C. Interferon Lambda Promotes Paneth Cell Death Via STAT1 Signaling in Mice and Is Increased in Inflamed Ileal Tissues of Patients With Crohn's Disease. Gastroenterology 2019; 157:1310-1322.e13. [PMID: 31352002 DOI: 10.1053/j.gastro.2019.07.031] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [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: 07/25/2018] [Revised: 07/05/2019] [Accepted: 07/22/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS Interferon lambda (IFNL) is expressed at high levels by intestinal epithelial cells (IECs) and mucosal immune cells in response to infection and inflammation. We investigated whether IFNL might contribute to pathogenesis of Crohn's disease (CD). METHODS We obtained serum samples and terminal ileum biopsies from 47 patients with CD and 16 healthy individuals (controls). We measured levels of IFNL by enzyme-linked immunosorbent assay and immunohistochemistry and location of expression by confocal microscopy. Activation of IFNL signaling via STAT1 was measured in areas of no, mild, moderate, and severe inflammation and correlated with Paneth cell homeostasis and inflammation. IFNL expression and function were studied in wild-type mice and mice with intestinal epithelial cell-specific (ΔIEC) disruption or full-body disruption of specific genes (Mlkl-/-, Stat1ΔIEC, Casp8ΔIEC, Casp8ΔIECRipk3-/-, Casp8ΔIECTnfr-/-, Casp8ΔIECMlkl-/-, and Nod2-/- mice). Some mice were given tail vein injections of a vector encoding a secreted form of IFNL. Intestinal tissues were collected from mice and analyzed by immunohistochemistry and immunoblots. We generated 3-dimensional small intestinal organoids from mice and studied the effects of IFNL and inhibitors of STAT-signaling pathway. RESULTS Patients with CD had significant increases in serum and ileal levels of IFNL compared with controls. Levels of IFNL were highest in ileum tissues with severe inflammation. High levels of IFNL associated with a reduced number of Paneth cells and increased cell death at the crypt bottom in inflamed ileum samples. Intestinal tissues from the ileum of wild-type mice injected with a vector expressing IFNL had reduced numbers of Paneth cells. IFNL-induced death of Paneth cells in mice did not occur via apoptosis, but required Mixed Lineage Kinase Domain Like (MLKL) and activation of Signal transducer and activator of transcription 1 (STAT1). In organoids, inhibitors of Janus kinase (JAK) signaling via STAT1 (glucocorticoids, tofacitinib, or filgotinib) reduced expression of proteins that mediate cell death and prevented Paneth cell death. CONCLUSIONS Levels of IFNL are increased in serum and inflamed ileal tissues from patients with CD and associated with a loss of Paneth cells. Expression of a secreted form of IFNL in mice results in loss of Paneth cells from intestinal tissues, via STAT1 and MLKL, controlled by caspase 8. Strategies to reduce IFNL or block its effects might be developed for treatment of patients with CD affecting the terminal ileum.
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Affiliation(s)
- Claudia Günther
- Medical Clinic 1, Department of Medicine, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen, Germany.
| | - Barbara Ruder
- Medical Clinic 1, Department of Medicine, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen, Germany
| | - Iris Stolzer
- Medical Clinic 1, Department of Medicine, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen, Germany
| | - Heidrun Dorner
- Medical Clinic 1, Department of Medicine, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen, Germany
| | - Gui-Wei He
- Medical Clinic 1, Department of Medicine, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen, Germany
| | - Mircea Teodor Chiriac
- Medical Clinic 1, Department of Medicine, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen, Germany
| | - Konrad Aden
- Institute of Clinical Molecular Biology, Christian-Albrechts-University and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Anne Strigli
- Center for Regenerative Therapies Dresden (CRTD), Technische Universität (TU) Dresden, Dresden, Germany; Department of Medicine I, Universitätsklinikum Carl Gustav Carus Dresden, Technische Universität (TU) Dresden, Dresden, Germany
| | - Miriam Bittel
- Medical Clinic 1, Department of Medicine, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen, Germany
| | - Sebastian Zeissig
- Center for Regenerative Therapies Dresden (CRTD), Technische Universität (TU) Dresden, Dresden, Germany; Department of Medicine I, Universitätsklinikum Carl Gustav Carus Dresden, Technische Universität (TU) Dresden, Dresden, Germany
| | - Philip Rosenstiel
- Institute of Clinical Molecular Biology, Christian-Albrechts-University and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Raja Atreya
- Medical Clinic 1, Department of Medicine, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen, Germany
| | - Markus F Neurath
- Medical Clinic 1, Department of Medicine, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen, Germany
| | - Stefan Wirtz
- Medical Clinic 1, Department of Medicine, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen, Germany
| | - Christoph Becker
- Medical Clinic 1, Department of Medicine, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen, Germany.
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23
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Obradovic MR, Wilson HL. Immune response and protection against Lawsonia intracellularis infections in pigs. Vet Immunol Immunopathol 2019; 219:109959. [PMID: 31710909 DOI: 10.1016/j.vetimm.2019.109959] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 04/18/2019] [Revised: 09/09/2019] [Accepted: 10/15/2019] [Indexed: 10/25/2022]
Abstract
Lawsonia intracellularis are Gram-negative, obligate intracellular bacteria that cause proliferative enteropathy (PE), an economically important disease for the pig industry. Numerous reviews have been published on the characteristics and pathogenesis of this bacterium since its isolation and taxonomic characterization, with most reviews only partially covering how the host immune response develops during infection and the immune correlates of protection. With the development of increasingly more sophisticated immunological assays and tools for the pig, the immune response against L. intracellularis at distinct stages of pathogenesis has been published. In this review, we discuss current knowledge of the pig immune response against L. intracellularis and strategies to achieve immune protection. The immune response is presented in relation to chronological progression of pathological lesions and clinical symptoms, with emphasis on innate immunity and the adaptive humoral and cell-mediated immune response. The aim is to achieve a comprehensive understanding of the host immune response with respect to the stage-dependent cellular and biochemical processes important during PE development. Also, strategies for development of immune protection and new vaccination technologies are discussed in the light of new discoveries in the field.
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Affiliation(s)
- Milan R Obradovic
- Vaccine and Infectious Disease Organization (VIDO)-International Vaccine Centre (InterVac), University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5E3, Canada; School of Public Health, Vaccinology, and Immunotherapeutics, Saskatchewan, Canada
| | - Heather L Wilson
- Vaccine and Infectious Disease Organization (VIDO)-International Vaccine Centre (InterVac), University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5E3, Canada; School of Public Health, Vaccinology, and Immunotherapeutics, Saskatchewan, Canada.
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24
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Dao AE, Hsu A, Nakshabandi A, Mandaliya R, Nadella S, Sivaraman A, Mattar M, Charabaty A. Role of colonoscopy in diagnosis of capecitabine associated ileitis: Two case reports. World J Gastrointest Endosc 2019; 11:383-388. [PMID: 31205599 PMCID: PMC6556489 DOI: 10.4253/wjge.v11.i5.383] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 05/09/2019] [Accepted: 05/14/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Capecitabine is considered a first line agent in adjuvant therapy for breast and colorectal cancer. However, cases of severe diarrhea have been reported with increasing frequency in recent years. When diarrhea is severe and prolonged, capecitabine associated ileitis should be considered as a possible etiology.
CASE SUMMARY Herein, we present two cases of capecitabine ileitis, specifically involving the terminal ileum and ascending colon. We will demonstrate the disease course and treatment modalities applied to alleviate this condition, as well as discuss the merits of using colonoscopy to aid in diagnosis.
CONCLUSION Ultimately our cases demonstrate that symptomatic management with traditional anti-diarrheal medications is largely ineffective. Prompt recognition and discontinuation of capecitabine is an imperative step in proper management of this condition and colonoscopy with biopsy can be helpful when the diagnosis is unclear.
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Affiliation(s)
- Alexander E Dao
- Department of Gastroenterology, Medstar Georgetown University Hospital, Washington, DC 20007, United States
| | - Angela Hsu
- Department of Gastroenterology, Medstar Georgetown University Hospital, Washington, DC 20007, United States
| | - Ahmad Nakshabandi
- Department of Gastroenterology, Medstar Georgetown University Hospital, Washington, DC 20007, United States
| | - Rohan Mandaliya
- Department of Gastroenterology, Medstar Georgetown University Hospital, Washington, DC 20007, United States
| | - Sandeep Nadella
- Department of Gastroenterology, Medstar Georgetown University Hospital, Washington, DC 20007, United States
| | - Anita Sivaraman
- Department of Gastroenterology, Medstar Georgetown University Hospital, Washington, DC 20007, United States
| | - Mark Mattar
- Department of Gastroenterology, Medstar Georgetown University Hospital, Washington, DC 20007, United States
| | - Aline Charabaty
- Department of Gastroenterology, Johns Hopkins University at Sibley Memorial Hospital, Washington, DC 20016, United States
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25
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da Silva Moraes AC, de Freitas Moraes G, de Araújo ALE, Luiz RR, Elia C, Carneiro AJ, de Souza HSP. Abdominal ultrasonography with color Doppler analysis in the assessment of ileal Crohn's disease: comparison with magnetic resonance enterography. Intest Res 2019; 17:227-236. [PMID: 30962408 PMCID: PMC6505095 DOI: 10.5217/ir.2018.00124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 03/13/2019] [Indexed: 02/07/2023] Open
Abstract
Background/Aims Consistently defining disease activity remains a critical challenge in the follow-up of patients with Crohn’s disease (CD). We investigated the potential applicability of abdominal ultrasonography with color Doppler (USCD) analysis for the detection of morphological alterations and inflammatory activity in CD. Methods Forty-three patients with CD ileitis/ileocolitis were evaluated using USCD analysis with measurements obtained on the terminal ileum and right colon. Sonographic parameters included wall thickening, stricture, hyperemia, presence of intra-abdominal mass, and fistulas. Patients were evaluated for the clinical activity (Harvey-Bradshaw Index [HBI]), fecal calprotectin (FC) and C-reactive protein (CRP). The USCD performance was assessed using magnetic resonance enterography (MRE) as a criterion standard. Results Most measurements obtained with USCD matched the data generated with MRE; however, the agreement improved in clinically active patients where sensitivity, positive predictive value, and accuracy were >80%, considering wall thickening and hyperemia. Complications such as intestinal wall thickening, stricture formation, and hyperemia, were detected in the USCD analysis with moderate agreement with MRE. The best agreement with the USCD analysis was obtained in regard to FC, where the sensitivity, positive predictive value, and accuracy were >70%. The overall performance of USCD was superior to that of HBI, FC and CRP levels, particularly when considering thickening, stricture, and hyperemia parameters. Conclusions USCD represents a practical noninvasive and low-cost tool for evaluating patients with ileal or ileocolonic disease, particularly in clinically active CD. Therefore, USCD might become a useful asset in the follow-up of patients with CD.
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Affiliation(s)
- Antonio Carlos da Silva Moraes
- Serviço de Gastroenterologia, Departamento de Clínica Médica, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Antonio Luis Eiras de Araújo
- Serviço de Radiologia, Departamento de Radiologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ronir Raggio Luiz
- Instituto de Estudos de Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Celeste Elia
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Antonio Jose Carneiro
- Serviço de Gastroenterologia, Departamento de Clínica Médica, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Heitor Siffert Pereira de Souza
- Serviço de Gastroenterologia, Departamento de Clínica Médica, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,D'Or Institute for Research and Education, Rio de Janeiro, Brazil
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26
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Jacobs AAC, Harks F, Hazenberg L, Hoeijmakers MJH, Nell T, Pel S, Segers RPAM. Efficacy of a novel inactivated Lawsonia intracellularis vaccine in pigs against experimental infection and under field conditions. Vaccine 2019; 37:2149-2157. [PMID: 30867100 DOI: 10.1016/j.vaccine.2019.02.067] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 11/07/2018] [Revised: 02/13/2019] [Accepted: 02/15/2019] [Indexed: 10/27/2022]
Abstract
The efficacy of a novel inactivated Lawsonia intracellularis vaccine, Porcilis® Lawsonia, was compared to that of a commercially available live attenuated vaccine in three experimental vaccination-challenge studies in pigs. The efficacy of the new vaccine was further tested under field conditions on a farm with a history of acute ileitis. The novel inactivated vaccine consists of a freeze-dried antigen fraction that is dissolved just prior to use in either the adjuvant or in Porcilis® PCV M Hyo; an existing combination vaccine against porcine circovirus type 2 and Mycoplasma hyopneumoniae. The three experimental vaccination-challenge trials had a similar design and for each trial 75 piglets were used, randomly allotted to three groups of 25 piglets. The pigs were vaccinated at 4 or 5 weeks of age with either Porcilis® Lawsonia in adjuvant or in associated mixed use with Porcilis® PCV M Hyo (group 1), with the live vaccine (group 2), or left as unvaccinated controls (group 3). The pigs were challenged with virulent Lawsonia intracellularis 3, 4 or 17 weeks after vaccination. Post-challenge the pigs were evaluated for clinical signs, average daily weight gain, shedding and macroscopic as well as microscopic immuno-histological ileum lesion scores. In the field study, the mortality and key performance parameters were evaluated over a period of 8 months. The results of all three experimental vaccination-challenge trials showed that Porcilis® Lawsonia induced statistically significant protection against experimental Lawsonia intracellularis infection. This was demonstrated by lower clinical scores, improved weight gain, reduction of Lawsonia intracellularis shedding and reduction of macroscopic as well as microscopic ileum lesion scores when compared to the controls. The protection induced was superior to that of the commercially available live vaccine. In the field study, Porcilis® Lawsonia proved to be highly efficacious; reducing Lawsonia associated mortality to zero and improving key production parameters.
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Affiliation(s)
- A A C Jacobs
- MSD Animal Health, PO Box 31, 5830 AA Boxmeer, the Netherlands.
| | - F Harks
- MSD Animal Health, PO Box 31, 5830 AA Boxmeer, the Netherlands.
| | - L Hazenberg
- MSD Animal Health, PO Box 31, 5830 AA Boxmeer, the Netherlands.
| | | | - T Nell
- MSD Animal Health, PO Box 31, 5830 AA Boxmeer, the Netherlands.
| | - S Pel
- MSD Animal Health, PO Box 31, 5830 AA Boxmeer, the Netherlands.
| | - R P A M Segers
- MSD Animal Health, PO Box 31, 5830 AA Boxmeer, the Netherlands.
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27
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Wattanaphansak S, Pereira CER, Kaenson W, Assavacheep P, Tantilertcharoen R, Resende TP, Barrera-Zarate JA, de Oliveira-Lee JSV, Klein U, Gebhart CJ, Guedes RMC. Isolation and in vitro antimicrobial susceptibility of porcine Lawsonia intracellularis from Brazil and Thailand. BMC Microbiol 2019; 19:27. [PMID: 30704407 PMCID: PMC6357443 DOI: 10.1186/s12866-019-1397-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 01/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lawsonia intracellularis is an obligate intracellular bacterium which cannot be cultured by conventional bacteriological methods. Furthermore, L. intracellularis needs enriched medium and a unique atmosphere for isolation, cultivation and propagation. Because of this,there are only a few isolates of L. intracellularis available and few studies in vitro demonstrating the susceptibility of this bacterium to antimicrobial agents. The objectives of this study were to isolate South American and Southeast Asia strains of L.intracellularis and to determine the in vitro antimicrobial activity against these isolates. Tested antimicrobials included: chlortetracycline, lincomycin, tiamulin, tylosin and valnemulin(against both Brazilian and Thailand strains) and additionally, amoxicillin, zinc-bacitracin, carbadox, enrofloxacin, gentamicin, sulfamethazine, trimethoprim, spectinomycin and a combination (1:1) of spectinomycin and lincomycin were also tested against the Thai isolates. The minimum inhibitory concentration (MIC) was determined by the antimicrobial activity that inhibited 99% of L. intracellularis growth in a cell culture as compared to the control (antimicrobial-free). RESULTS Two strains from Brazil and three strains from Thailand were successfully isolated and established in cell culture. Each antimicrobial was evaluated for intracellular and extracellular activity. Pleuromutilin group (valnemulin and tiamulin) and carbadox were the most active against L. intracellularis strains tested. Tylosin showed intermediate activity, chlortetracycline had variable results between low and intermediate activity, as well as spectinomycin, spectinomycin and lincomycin, amoxicillin, sulfamethazine and enrofloxacin. L. intracellularis was resistant to lincomycin, gentamicin, trimethoprim, colistin and bacitracin in in vitro conditions. CONCLUSIONS This is the first report of isolation of L. intracellularis strains from South America and Southeast Asia and characterization of the antimicrobial susceptibility patterns of these new strains.
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Affiliation(s)
- Suphot Wattanaphansak
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
| | - Carlos Eduardo Real Pereira
- Department of Clinic and Surgery, Veterinary School, Universidade Federal de Minas Gerais, PO Box 567, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Wenika Kaenson
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
| | - Pornchalit Assavacheep
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
| | - Rachod Tantilertcharoen
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand
| | - Talita Pilar Resende
- Department of Veterinary and Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA
| | - Javier Alberto Barrera-Zarate
- Department of Clinic and Surgery, Veterinary School, Universidade Federal de Minas Gerais, PO Box 567, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Juliana Saes Vilaça de Oliveira-Lee
- Department of Clinic and Surgery, Veterinary School, Universidade Federal de Minas Gerais, PO Box 567, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Ulrich Klein
- Elanco Animal Health Inc., Mattenstrasse 24A, 4058, Basel, Switzerland
| | - Connie Jane Gebhart
- Department of Veterinary and Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA
| | - Roberto Maurício Carvalho Guedes
- Department of Clinic and Surgery, Veterinary School, Universidade Federal de Minas Gerais, PO Box 567, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
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28
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Resende TP, Pereira CER, Daniel AGDS, Vasquez E, Saqui-Salces M, Vannucci FA, Gebhart CJ. Effects of Lawsonia intracellularis infection in the proliferation of different mammalian cell lines. Vet Microbiol 2018; 228:157-164. [PMID: 30593362 DOI: 10.1016/j.vetmic.2018.11.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 09/12/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 10/27/2022]
Abstract
Lawsonia intracellularis is an obligate intracellular bacterium that causes proliferative enteropathy in various animal species. While cellular proliferation of intestinal cells is recognized as the hallmark of L. intracellularis infection in vivo, it has not been demonstrated in in vitro models. In order to assay the effect of L. intracellularis, various cell lines were infected with pathogenic and non-pathogenic passages of the bacterium. Because of the high proliferative rate of these cell lines, serum deprivation, which is known to reduce proliferation, was applied to each of the cell lines to allow the observation of proliferation induced by L. intracellularis. Using antibodies for Ki-67 and L. intracellularis in dual immunofluorescence staining, we observed that L. intracellularis was more frequently observed in proliferating cells. Based on wound closure assays and on the amount of eukaryotic DNA content measured over time, we found no indication that cell lines infected with L. intracellularis increased proliferation and migration when compared to non-infected cells (p > 0.05). Cell arrest due to decreased serum in the culture media was cell-line dependent. Taken together, our findings provide data to support and expand previous subjective observations of the absence of in vitro proliferation caused by L. intracellularis in cell cultures and confirm that cell lines infected by L. intracellularis fail to serve as adequate models for understanding the cellular changes observed in proliferative enteropathy-affected intestines.
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Affiliation(s)
- Talita Pilar Resende
- Department of Veterinary and Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA.
| | - Carlos Eduardo Real Pereira
- Department of Clinic and Surgery, Veterinary School, Universidade Federal de Minas Gerais, PO Box 567, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Amanda Gabrielle de Souza Daniel
- Department of Clinic and Surgery, Veterinary School, Universidade Federal de Minas Gerais, PO Box 567, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Erika Vasquez
- Department of Veterinary and Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA
| | - Milena Saqui-Salces
- Department of Animal Science, College of Food, Agricultural and Natural Resource Sciences (CFANS), University of Minnesota, St. Paul, MN 55108, USA
| | - Fabio A Vannucci
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA
| | - Connie Jane Gebhart
- Department of Veterinary and Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA; Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA
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Sachar DB. Small Bowel Lesions Mimicking Crohn's Disease. Curr Gastroenterol Rep 2018; 20:43. [PMID: 30079433 DOI: 10.1007/s11894-018-0651-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE OF REVIEW Not all injuries of the terminal ileum are Crohn's disease. It is the purpose of this review to consider the differential diagnosis of other acute and chronic ileal lesions. RECENT FINDINGS The recognition of a granulomatous disease of the terminal ileum, distinct from tuberculosis, dates back over 85 years and perhaps much farther, but over the past decades, many other clinical pathologic entities have been described that are neither tuberculosis nor Crohn's eponymous regional enteritis. In recent years, the catalog of lesions mimicking Crohn's disease of the small bowel and proposals for differential diagnosis and treatment have expanded to include newly reported appendiceal pathology, primary cancers and lymphomas of the intestine, unexpected metastases from distant organs, unusual infections, vasculitides and other ischemic conditions, Behçet's disease, endometriosis, and drug reactions. A diagnosis of Crohn's disease should not be a reflex action in the face of small bowel structural or inflammatory lesions without consideration of pathology in adjacent organs, primary and metastatic lesions of the small intestine, infections, vascular diseases, infiltrative diseases, drug injury, or other "idiopathic" conditions.
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Tominaga K, Kamimura K, Takahashi K, Yokoyama J, Yamagiwa S, Terai S. Diversion colitis and pouchitis: A mini-review. World J Gastroenterol 2018; 24:1734-1747. [PMID: 29713128 PMCID: PMC5922993 DOI: 10.3748/wjg.v24.i16.1734] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/01/2018] [Accepted: 04/15/2018] [Indexed: 02/06/2023] Open
Abstract
Diversion colitis is characterized by inflammation of the mucosa in the defunctioned segment of the colon after colostomy or ileostomy. Similar to diversion colitis, diversion pouchitis is an inflammatory disorder occurring in the ileal pouch, resulting from the exclusion of the fecal stream and a subsequent lack of nutrients from luminal bacteria. Although the vast majority of patients with surgically-diverted gastrointestinal tracts remain asymptomatic, it has been reported that diversion colitis and pouchitis might occur in almost all patients with diversion. Surgical closure of the stoma, with reestablishment of gut continuity, is the only curative intervention available for patients with diversion disease. Pharmacologic treatments using short-chain fatty acids, mesalamine, or corticosteroids are reportedly effective for those who are not candidates for surgical reestablishment; however, there are no established assessment criteria for determining the severity of diversion colitis, and no management strategies to date. Therefore, in this mini-review, we summarize and review various recently-reported treatments for diversion disease. We are hopeful that the information summarized here will assist physicians who treat patients with diversion colitis and pouchitis, leading to better case management.
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Affiliation(s)
- Kentaro Tominaga
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Kenya Kamimura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Kazuya Takahashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Junji Yokoyama
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Satoshi Yamagiwa
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
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Yousuf H, Aleem U, Egan R, Maheshwari P, Mohamad J, McNamara D. Elevated Faecal Calprotectin Levels are a Reliable Non-Invasive Screening Tool for Small Bowel Crohn's Disease in Patients Undergoing Capsule Endoscopy. Dig Dis 2018; 36:202-208. [PMID: 29466790 DOI: 10.1159/000485375] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 04/07/2017] [Accepted: 11/02/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Approximately 10% of Crohn's disease (CD) patients have this disease affecting the small bowel (SB) beyond the reach of Ileo-colonoscopy. Capsule endoscopy (SBCE) is the recommended investigation for SB disease. An accurate and inexpensive biomarker would help identify at-risk patients. AIM To examine the efficacy of faecal calprotectin (FC) and C-reactive protein (CRP) as predictors of SBCE findings in suspected and known CD. METHODS A prospective observational study. Consecutive patients referred for SBCE gave FC and CRP samples. The diagnostic accuracy for SB CD based on SBCE result was calculated for both FC and CRP. RESULTS Of 100 invitees, FC and SBCE results were available in 64 cases. Correlation between FC >50 µg/g and SBCE result was poor К = 0.163; sensitivity, specificity, positive predictive value (PPV) and negative predictive values for ileitis were 60, 61, 32 and 83% respectively. PPV and specificity improved at FC >100 µg/g, 76 and 40%, correlation remained fair, К = 0.259. Receiver operating characteristic analysis had a sensitivity of 47% and specificity of 90% for FC >194 µg/g. CRP alone or in combination was an inaccurate predictor of ileitis. CONCLUSION Our study suggests that FC level >194 µg/g may be a useful SBCE filter test, identifying patients at risk of SB CD.
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Affiliation(s)
- Hamid Yousuf
- Department of Gastroenterology, Tallaght Hospital, Dublin, Ireland
| | - Umair Aleem
- Department of Gastroenterology, Tallaght Hospital, Dublin, Ireland
| | - Roisin Egan
- Department of Gastroenterology, Tallaght Hospital, Dublin, Ireland
| | | | - Jafaar Mohamad
- Department of Gastroenterology, Tallaght Hospital, Dublin, Ireland
| | - Deidre McNamara
- Department of Gastroenterology, Tallaght Hospital, Dublin, Ireland.,Trinity Academic Gastroenterology Group, Department of Clinical Medicine, Trinity College, Dublin, Ireland
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Sahn B, De Matos V, Stein R, Ruchelli E, Masur S, Klink AJ, Baldassano RN, Piccoli DA, Russo P, Mamula P. Histological features of ileitis differentiating pediatric Crohn disease from ulcerative colitis with backwash ileitis. Dig Liver Dis 2018; 50:147-153. [PMID: 29089273 DOI: 10.1016/j.dld.2017.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 06/07/2017] [Revised: 10/07/2017] [Accepted: 10/07/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND/AIM Pediatric ileocolonic Crohn disease (CD) may be difficult to distinguish from ulcerative colitis (UC) with backwash ileitis (BWI). The primary aim of the study was to determine the probability of CD in children with a confluent colitis and ileitis when newly diagnosed with inflammatory bowel disease (IBD). METHODS A retrospective observational study of 100 newly diagnosed patients with IBD was performed. Two pathologists reviewed ileal biopsy specimens for 8 histological features. Biopsy and clinical features were evaluated for predictive ability of a final diagnosis of CD. RESULTS The presence of crypt distortion, lamina propria (LP) expansion, and acute LP inflammation combined with 4 clinical variables in multivariate regression analysis had adequate discriminative validity when comparing the mean probability of a final CD diagnosis between CD and not-CD groups (0.90 vs. 0.59, p value <0.001). When crypt distortion, LP expansion, and acute LP inflammation are present in any combination, the sensitivity and specificity for presence of CD ranges 38.4-57% and 92.9-100%, respectively. CONCLUSIONS Combining histological features of ileitis and clinical variables can adequately discriminate between the presence and absence of Crohn disease in children who present with confluent colitis and ileitis. Combined presence of certain histological features has high specificity for CD.
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Affiliation(s)
- Benjamin Sahn
- Steven & Alexandra Cohen Children's Medical Center of New York, Northwell Health System, Division of Gastroenterology & Nutrition, New York, United States; The Children's Hospital of Philadelphia, Division of Pediatric Gastroenterology, Hepatology, & Nutrition, Philadelphia, PA, United States.
| | - Vera De Matos
- The Children's Hospital of Philadelphia, Division of Pediatric Gastroenterology, Hepatology, & Nutrition, Philadelphia, PA, United States; The Pediatric Gastroenterology and Hepatology Unit, Department of Pediatrics, University Hospitals of Geneva, Switzerland
| | - Ronen Stein
- The Children's Hospital of Philadelphia, Division of Pediatric Gastroenterology, Hepatology, & Nutrition, Philadelphia, PA, United States
| | - Eduardo Ruchelli
- The Children's Hospital of Philadelphia, Department of Pathology and Laboratory Medicine, Philadelphia, PA, United States
| | - Samuel Masur
- The Children's Hospital of Philadelphia, Division of Pediatric Gastroenterology, Hepatology, & Nutrition, Philadelphia, PA, United States
| | - Andrew J Klink
- The Children's Hospital of Philadelphia, Division of Pediatric Gastroenterology, Hepatology, & Nutrition, Philadelphia, PA, United States; Cardinal Health, Dallas, TX, United States
| | - Robert N Baldassano
- The Children's Hospital of Philadelphia, Division of Pediatric Gastroenterology, Hepatology, & Nutrition, Philadelphia, PA, United States
| | - David A Piccoli
- The Children's Hospital of Philadelphia, Division of Pediatric Gastroenterology, Hepatology, & Nutrition, Philadelphia, PA, United States
| | - Pierre Russo
- The Children's Hospital of Philadelphia, Department of Pathology and Laboratory Medicine, Philadelphia, PA, United States
| | - Petar Mamula
- The Children's Hospital of Philadelphia, Division of Pediatric Gastroenterology, Hepatology, & Nutrition, Philadelphia, PA, United States
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Roerink F, Morgan CL, Knetter SM, Passat MH, Archibald AL, Ait-Ali T, Strait EL. A novel inactivated vaccine against Lawsonia intracellularis induces rapid induction of humoral immunity, reduction of bacterial shedding and provides robust gut barrier function. Vaccine 2018; 36:1500-1508. [PMID: 29336925 PMCID: PMC5846845 DOI: 10.1016/j.vaccine.2017.12.049] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 12/08/2017] [Accepted: 12/18/2017] [Indexed: 11/21/2022]
Abstract
Porcine proliferative ileitis is a major economic burden for the swine industry, affecting growing pigs and young adult pigs. In this study, the protective efficacy of an inactivated, injectable whole-cell bacteria vaccine against L. intracellularis – Porcilis® Ileitis was evaluated under field conditions. Eighty-five, three-week-old pigs on a commercial farrow-to-finish farm were vaccinated by the intramuscular route, either with a dose of injectable vaccine, or with saline. A subset of vaccinates and control pigs were necropsied at 21 days post-challenge. Incidence and severity of ileitis were evaluated by gross and microscopic observation of ileal tissues. Colonization of the gut after challenge was examined by L. intracellularis-specific immunohistochemistry, and qPCR of ileal scrapings. Integrity of the intestinal barrier was evaluated to quantify a range of intestinal markers including secreted mucin and intestinal alkaline phosphatase, and innate immune markers including Caspase-3 and Calprotectin. A second subset of pigs was monitored for fecal shedding of L. intracellularis, until resolution of shedding. Our investigation indicated that Porcilis Ileitis provided robust protection against ileitis, reduced bacterial shedding 15-fold (p < .05) and preserved normal gut barrier function in the face of an experimental challenge with virulent L. intracellularis.
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Affiliation(s)
- F Roerink
- Merck Animal Health, 2 Giralda Farms, Madison, NJ 07940, USA.
| | - C L Morgan
- Merck Animal Health, 2 Giralda Farms, Madison, NJ 07940, USA
| | - S M Knetter
- Merck Animal Health, 2 Giralda Farms, Madison, NJ 07940, USA
| | - M-H Passat
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Roslin, Midlothian EH25 9RG, UK
| | - A L Archibald
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Roslin, Midlothian EH25 9RG, UK
| | - T Ait-Ali
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Roslin, Midlothian EH25 9RG, UK.
| | - E L Strait
- Merck Animal Health, 2 Giralda Farms, Madison, NJ 07940, USA
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Bezzio C, Arena I, Devani M, Omazzi B, Manes G, Saibeni S. Aspecific ileitis: Crohn's disease or not Crohn's disease? A prospective study. Int J Colorectal Dis 2017; 32:1025-1028. [PMID: 28161731 DOI: 10.1007/s00384-017-2770-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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] [Accepted: 01/30/2017] [Indexed: 02/04/2023]
Abstract
PURPOSE It is not clear whether aspecific ileitis may represent an early manifestation or a milder variant of Crohn's disease or not. The aim of this study was to evaluate the clinical outcomes of aspecific ileitis. METHODS Subjects with at least one of the following signs at retrograde ileoscopy: erythema, nodularity, aftae, erosions, and ulcers were considered. They should not have had defined gastrointestinal disease, biochemical signs of inflammation, use of drugs, celiac disease, and intestinal infectious disease. RESULTS We enrolled 51 subjects (22 men), mean age (± SD) at colonoscopy of 41.1 ± 13.1 years. Indications to colonoscopy were overt or occult intestinal bleeding (18), diarrhoea (15), systemic signs (10), IBS-like symptoms (5), other (3). Ileal lesions were ulcers (9), erosions (26), aftae (10), nodularity (3), and erythema (3). At histological evaluation aspecific findings were observed. Forty-four out of 51 (86.3%) subjects underwent further investigations of small bowel. Second colonoscopy was performed in 31 (60.8%) persisting symptomatic subjects: ileitis was confirmed in 14 (46.6%). Ten out of 51 (19.6%) were eventually diagnosed as affected by Crohn's disease. CONCLUSIONS A substantial proportion of subjects with endoscopic and histological findings of aspecific ileitis is eventually diagnosed as affected by Crohn's disease. In these subjects, a strict follow-up is strongly recommended.
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Affiliation(s)
- Cristina Bezzio
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho, Milan, Italy
| | - Ilaria Arena
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho, Milan, Italy
| | - Massimo Devani
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho, Milan, Italy
| | - Barbara Omazzi
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho, Milan, Italy
| | - Gianpiero Manes
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho, Milan, Italy
| | - Simone Saibeni
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho, Milan, Italy.
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Lee HS, Lim YJ, Shim KN, Moon CM, Song HJ, Kim JO, Jeon SR, Jung DY, Kim JH, Kim KO, Lee BI. Diagnostic Value of Small Bowel Capsule Endoscopy in Isolated Ileitis: A CAPENTRY Study. Dig Dis Sci 2017; 62:180-187. [PMID: 27889847 DOI: 10.1007/s10620-016-4387-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 08/13/2016] [Accepted: 11/17/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Capsule endoscopy (CE) has proven to be highly effective at detecting small bowel lesions, but studies regarding the diagnostic impact of CE on ileitis are rare. AIMS We evaluated the diagnostic value of small bowel CE for isolated ileitis observed during ileocolonoscopy. METHODS The CE results in 137 patients initially diagnosed with ileitis without colonic mucosal abnormalities on ileocolonoscopy at one of eight tertiary referral centers between October 2002 and June 2015 were retrospectively analyzed. RESULTS Among the 137 patients with isolated ileitis observed on ileocolonoscopy, 117 (85.4%) revealed positive small bowel CE findings (85.4%). The rate of positive small bowel CE findings was 92.9% in cases of ileal aphthous ulcer or erosion, and 90.9% in cases of ileal ulcer. Among 117 positive CE cases, the most common final diagnosis by CE was Crohn's disease (CD) (n = 44, 32%). No findings were identified in 20 (14.6%) of 137 cases. Ileal erosion/ulcer, rather than findings such as nodularity and erythema or elevated erythrocyte sedimentation rate (ESR) (>10 mm/h), was significant predictive factors for positive CE findings in multivariate analysis. CONCLUSIONS Small bowel CE showed a high diagnostic yield (85.4%) in symptomatic patients with isolated ileitis on ileocolonoscopy. Erosion or ulcer of the small bowel was a common finding on CE (66.4%), and approximately one-third of patients were diagnosed with CD. In patients with isolated ileitis on ileocolonoscopy, CE should be considered to evaluate small bowel lesions when the patient shows an elevated ESR or when the ileitis manifests as ileal ulcer or erosion rather than a nodular or erythematous lesion.
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Affiliation(s)
- Hyun Seok Lee
- Department of Internal Medicine, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, 807 Hoguk-ro, Buk-gu, Daegu, Korea
| | - Yun Jeong Lim
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, 27 Dongguk-ro, Ilsandong-gu, Goyang, Korea.
| | - Ki Nam Shim
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Chang Mo Moon
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyun Joo Song
- Department of Internal Medicine, Jeju National University College of Medicine, Jeju, Korea
| | - Jin Oh Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Seong Ran Jeon
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Dae Young Jung
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Hyun Kim
- Department of Internal Medicine, Inje University College of Medicine, Busan, Korea
| | - Kyeong Ok Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Bo-In Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Tahir AH, Wan J, Shah MK, Janyaro H, Li XJ, Ding MX. A novel model for studying ileitis-induced visceral hypersensitivity in goats. Acta Vet Scand 2016; 58:72. [PMID: 27716368 PMCID: PMC5052972 DOI: 10.1186/s13028-016-0253-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 09/20/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Visceral hypersensitivity (VH) is a common condition in many gastrointestinal disorders such as inflammatory bowel diseases (IBDs) in human and animals. Most studies often induce Crohn's disease/colitis to investigate VH in small experimental animals. Although farm animals commonly suffer from IBDs, their VH has not been investigated so far. Because goats can suffer from Johne's disease, a naturally occurring Crohn's-like disease, they may be suitable to be used for studying the mechanism underlying VH in common intestinal disorders of large animals. In the present study, 60 healthy goats of either sex were equally divided into a 2, 4, 6-trinitrobenzenesulfonic acid (TNBS) group and saline group. A volume of 1.2 ml of TNBS-ethanol solution (30 mg TNBS in 40 % ethanol) or an equal volume of isotonic saline was injected into the wall of the terminal ileum through laparotomy. The severity of the developing ileitis was determined according to macro- and microscopic pathologic scores and the levels of myeloperoxidase, interleukin-1β, interleukin-6 and tumor necrosis factor-α, and VH was evaluated with visceromotor responses (VMR) to colorectal distension on days 3, 7, 14, 21 and 28. VMRs were assessed with a continuous ramp distention mode with 6 s for each pressure (20, 40, 60, 80 and 100 mmHg). RESULTS Compared to the saline group, the TNBS-treated goats showed apparent transmural pathological changes and a significant increase (P < 0.05) in macroscopic and microscopic change scores, and levels of myeloperoxidase, interleukin-1β, interleukin-6 and tumor necrosis factor-α in the ileum, and VMR to colorectal distension. The goats exhibited apparent ileitis at days 3 to 21, and VH at days 7 to 28 following TNBS treatment. CONCLUSION This experiment successfully established a reproducible ileitis and VH with administration of TNBS-ethanol solution in the ileal wall of goats. This model is useful for studying the pathogenesis of the IBD and the mechanism underlying VH, and for evaluating the efficacy of new therapeutic regimens.
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Gurzu S, Molnar C, Contac AO, Fetyko A, Jung I. Tuberculosis terminal ileitis: A forgotten entity mimicking Crohn’s disease. World J Clin Cases 2016; 4:273-280. [PMID: 27672643 PMCID: PMC5018625 DOI: 10.12998/wjcc.v4.i9.273] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 06/06/2016] [Accepted: 07/13/2016] [Indexed: 02/05/2023] Open
Abstract
Intestinal tuberculosis (TB) is an uncommon lesion for which differential diagnosis can be difficult. We present a case of a 53-year-old male and a systematic review of the literature, from clinical symptoms to differential diagnosis, unusual complications and therapy. The patient was admitted to the hospital with signs of acute abdomen as a result of a perforated terminal ileitis. Based on the skip lesions of the terminal ileum and cecum, Crohn’s disease (CD) was clinically suspected. An emergency laparotomy and right colectomy with terminal ileum resection was performed and systematic antibiotherapy was prescribed. The patient’s status deteriorated and he died 4 d after the surgical intervention. At the autopsy, TB ileotyphlitis was discovered. The clinical criteria of the differential diagnosis between intestinal TB and CD are not very well established. Despite the large amount of published articles on this subject, only 50 papers present new data regarding intestinal TB. Based on these studies and our experience, we present an update focused on the differential diagnosis and therapy of intestinal TB. We highlight the importance of considering intestinal TB as a differential diagnosis for inflammatory bowel disease. Despite the modern techniques of diagnosis and therapy, the fulminant evolution of TB can still lead to a patient’s death.
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Yvon S, Olier M, Leveque M, Jard G, Tormo H, Haimoud-Lekhal DA, Peter M, Eutamène H. Donkey milk consumption exerts anti-inflammatory properties by normalizing antimicrobial peptides levels in Paneth's cells in a model of ileitis in mice. Eur J Nutr 2018; 57:155-66. [PMID: 27581119 DOI: 10.1007/s00394-016-1304-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 08/23/2016] [Indexed: 12/18/2022]
Abstract
PURPOSE In this study, we showed the beneficial effects of donkey milk (DM) on inflammatory damages, endogenous antimicrobial peptides levels and fecal microbiota profile in a mice model of Crohn's disease. Nowadays, new strategies of microbiome manipulations are on the light involving specific diets to induce and/or to maintain clinical remission. Interest of DM is explained by its high levels of antimicrobial peptides which confer it anti-inflammatory properties. METHODS C57BL/6 mice were orally administered with or without indomethacin for 5 days and co-treated with vehicle, DM or heated DM during 7 days. Intestinal length and macroscopic damage scores (MDSs) were determined; ileal samples were taken off for microscopic damage (MD), lysozyme immunostaining and mRNA α-defensin assessments. Ileal luminal content and fecal pellets were collected for lysozyme enzymatic activity and lipocalin-2 (LCN-2) evaluations. Fecal microbiota profiles were compared using a real-time quantitative PCR-based analysis. RESULTS Administration of indomethacin caused an ileitis in mice characterized by (1) a decrease in body weight and intestinal length, (2) a significant increase in MDS, MD and LCN-2, (3) a reduction in both α-defensin mRNA expression and lysozyme levels in Paneth's cells reflected by a decrease in lysozyme activity in feces, and (4) a global change in relative abundance of targeted microbial communities. DM treatment significantly reduced almost of all these ileitis damages, whereas heated DM has no impact on ileitis. CONCLUSIONS DM consumption exerts anti-inflammatory properties in mice by restoring the endogenous levels of antimicrobial peptides which contribute in turn to reduce microbiota imbalance.
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Abstract
Intestinal anisakiasis is a disease caused by human infection by Anisakis larva that can be found in undercooked fish that is increasing worldwide. The symptoms, typically abdominal pain, develop within 5-7 days after the fish intake. The diagnosis may be suspected based on common anamnesis (unfrozen fish intake) with abdominal pain or bowel obstruction and confirmed by blood serology. Resective surgery is only used in severe cases.
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Park S, Lee JB, Kim KJ, Oh YS, Kim MO, Oh YR, Hwang MA, Lee JA, Lee SW. Efficacy of a commercial live attenuated Lawsonia intracellularis vaccine in a large scale field trial in Korea. Clin Exp Vaccine Res 2013; 2:135-9. [PMID: 23858405 PMCID: PMC3710922 DOI: 10.7774/cevr.2013.2.2.135] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 04/25/2013] [Accepted: 05/10/2013] [Indexed: 11/21/2022] Open
Abstract
Purpose Porcine proliferative enteropathy (PPE) is known as one of the most important risk factors causing economic losses in swine industry worldwide. This study was conducted to evaluate the efficacy of a commercial oral attenuated Lawsonia intracellularis vaccine (Enterisol Ileitis) against PPE under a commercial pig farm condition in Korea. Materials and Methods Thirty two-day-old 672 piglets were randomly allocated into vaccinated and control groups. All piglets in the vaccinated group were inoculated with a commercial attenuated L. intracellularis vaccine as following the manufacturer's instruction. Body weights of all pigs in both groups were measured on the vaccination day and 6, 14, and 20 weeks post vaccination and an average daily weight gain (ADWG) was calculated. Health status was observed biweekly during the whole trial. Results The vaccinated group showed significantly higher body weight (p<0.05) and ADWG (p<0.05) than those of the control group. The vaccinated group had significantly reduced impairments in activity, growth, defecation frequency, and stool hardness (p<0.05). Additional health benefits and improved weight gain by the vaccination produced a 4.2:1 return of investment, and the higher gross margin was $4.80 per pig. Conclusion Our finding suggests that the L. intracellularis vaccine program has effects on the substantial health and economic benefits in the Korean swine industry.
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Affiliation(s)
- Sangshin Park
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul, Korea. ; Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
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Pawlowski NN, Struck D, Grollich K, Kuhl AA, Zeitz M, Liesenfeld O, Hoffmann JC. CD2 deficiency partially prevents small bowel inflammation and improves parasite control in murine Toxoplasma gondii infection. World J Gastroenterol 2007; 13:4207-13. [PMID: 17696249 PMCID: PMC4250619 DOI: 10.3748/wjg.v13.i31.4207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate whether bowel inflammation and/or parasite control is altered in the absence of the T cell adhesion molecule CD2.
METHODS: Wildtype (WT) and CD2 deficient (CD2-/-) mice were infected with 100 cysts of Toxoplasma gondii (T. gondii) (ME49) by gavage. On d 7 after infection mice were killed. Necrosis and the number of parasites/cm ileum were determined. Cytokine levels of stimulated cells as well as sera were evaluated. Secondly, survival of WT vs CD2-/- mice was analysed using Kaplan-Meier analysis.
RESULTS: CD2-/- mice survived longer than WT mice (mean: 23.5 vs 7.1 d, P = 0.001). Further, CD2-/- mice showed less weight loss and less ileal inflammation than WT mice at d 7 post infection. In addition, the number of parasites in the ileum was significantly lower in CD2-/- mice than in WT mice (88 ± 12 vs 349 ± 58 cm, P < 0.01). This was paralleled by lower production of IFN-γ and IL-6 from TLA-stimulated mLN cells and increased IFN-γ production by splenocytes.
CONCLUSION: CD2 deficient mice are more resistant to T. gondii infection than WT mice. In contrast to most current immunosuppressive or biological therapies CD2 deficiency reduces intestinal inflammation and at the same time helps to control infection.
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Affiliation(s)
- Nina-N Pawlowski
- Medizinische Klinik I, St. Charité-Universitätsmedizin Berlin, Berlin, Germany
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Abstract
Cytomegalovirus enteritis is most usually associated with patients positive for human immunodeficiency virus or immunosuppressed transplant patients. The gastrointestinal tract may be affected anywhere from the esophagus to the colon, but the small bowel involvement is rare. We report a case of cytomegalovirus ileitis in an immunocompetent adult, which was confirmed by histopathologic findings through colonoscopic biopsy.
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Affiliation(s)
- Kum Hei Ryu
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.
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Zippi M, Colaiacomo MC, Marcheggiano A, Pica R, Paoluzi P, Iaiani G, Caprilli R, Maccioni F. Mesenteric adenitis caused by Yersinia pseudotubercolosis in a patient subsequently diagnosed with Crohn’s disease of the terminal ileum. World J Gastroenterol 2006; 12:3933-5. [PMID: 16804986 PMCID: PMC4087949 DOI: 10.3748/wjg.v12.i24.3933] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Although the association between inflammatory bowel disease and gastrointestinal infections has been suggested, the mechanisms involved in the pathogenesis of Crohn’s disease (CD) are still undetermined. We report the case of a man, who presented with mesenteric adenitis initially due to a Yersinia pseudotubercolosis infection, who was later diagnosed with Crohn’s disease. This case is in keeping with recent evidence in the literature which suggests that CD is a disease linked to abnormal immune responses to enteric bacteria in genetically susceptible individuals.
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Affiliation(s)
- Maddalena Zippi
- Department of Clinical Sciences, Umberto I Viale del Policlinico 155, Rome, Italy.
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