Background Weaning stress-induced diarrhea is widely recognized as being associated with gut microbiota dysbio-sis.However,it has been challenging to clarify which specific intestinal microbiota and their metabolites ...Background Weaning stress-induced diarrhea is widely recognized as being associated with gut microbiota dysbio-sis.However,it has been challenging to clarify which specific intestinal microbiota and their metabolites play a crucial role in the antidiarrhea process of weaned piglets.Results In this study,we first observed that piglets with diarrhea exhibited a lower average daily gain and higher diarrhea score,and elevated levels of lipopolysaccharide(LPS)and D-lactate(D-LA)compared to healthy piglets.Subsequently,we analyzed the differences in intestinal microbial composition and metabolite levels between healthy and diarrheal weaned piglets.Diarrheal piglets demonstrated intestinal microbiota dysbiosis,characterized pri-marily by a higher Firmicutes to Bacteroidota ratio,a deficiency of Lactobacillus amylovorus and Lactobacillus reuteri,and an increased abundance of Bacteroides sp.HF-5287 and Bacteroides thetaiotaomicron.Functional pro-filing of the gut microbiota based on Kyoto Encyclopedia of Genes and Genomes(KEGG)data was performed,and the results showed that tryptophan metabolism was the most significantly inhibited pathway in piglets with diar-rhea.Most tryptophan metabolites were detected at lower concentrations in diarrheal piglets than in healthy piglets.Furthermore,we explored the effects of dietary indole-3-aldehyde(IAld),a key tryptophan metabolite,on intestinal development and gut barrier function in weaned piglets.Supplementation with 100 mg/kg IAld in the diet increased the small intestine index and improved intestinal barrier function by promoting intestinal stem cell(ISC)expansion in piglets.The promotion of ISC expansion by IAld was also confirmed in porcine intestinal organoids.Conclusions These findings revealed that intestinal microbial tryptophan metabolite IAld alleviates impaired intesti-nal development by promoting ISC expansion in weaned piglets.展开更多
The role of small bowel capsule endoscopy (CE) in suspected small bowel bleedingis well established and current European and other international guidelinesposition it as the first line test after negative bidirectiona...The role of small bowel capsule endoscopy (CE) in suspected small bowel bleedingis well established and current European and other international guidelinesposition it as the first line test after negative bidirectional endoscopies. Insuspected mid-lower gastrointestinal bleeding (MLGIB) the diagnostic yield ofcolonoscopy is poor and may cause a delay in detecting small bowel disease. Acrucial aspect of small bowel capsule endoscope performance is the timing of theprocedure, the interval between the bleeding episode and capsule ingestion isinversely related to the diagnostic yield as confirmed by a recent meta-analysis.Currently the ongoing advances achieved by video CE in particular to evaluateboth small bowel and colon in a single test using double headed capsules, raisesquestions regarding the position of pan intestinal capsule in the current algorithmto investigate patients presenting with suspected MLGIB ahead of colonoscopy.Early evidence suggests pan intestinal capsule could fit well as a diagnostic“filter” test in this cohort of patients, thereby reserving invasive conventionalcolonoscopy or device assisted enteroscopy as therapeutics options only. The recentdevelopment of magnetically controlled CE and a blood sensing capsule pushthe boundaries of CE even further in patients presenting with suspected gastrointestinalbleeding. This review will discuss the current available evidence andfuture directions of CE in suspected MLGIB.展开更多
2'-Fucosyllactose(2'-FL)shows the potential to support intestinal health as a natural prebiotic that bridges the gap between infant formula feeding and breastfeeding.However,the effect and mechanism of 2'-...2'-Fucosyllactose(2'-FL)shows the potential to support intestinal health as a natural prebiotic that bridges the gap between infant formula feeding and breastfeeding.However,the effect and mechanism of 2'-FL in improving intestinal permeability are not clear.In this study,we constructed human microbiota-associated(HMA)mouse models by colonizing healthy infant feces in mice with antibiotic-depleted intestinal microbiota.The protective effect of 2'-FL on the intestinal permeability was explored using the HMA mouse models,and the combination of metagenomics was used to analyze the possible mechanisms by which the microorganisms reduced the intestinal permeability.The results showed that 2'-FL decreased the concentration of markers of intestinal permeability(enterotoxin and diamine oxidase(DAO))and increased the expression levels of tight junctions(occludin and claudin).Metagenomics revealed the enrichment of Bifidobacterium and increased the expression of glycoside hydrolases(GHs),including GH31,GH28,and GH5.In conclusion,2'-FL strengthened intestinal permeability function by improving microbiota composition to control the translocation of harmful substance.展开更多
BACKGROUND Post-pancreaticoduodenectomy(PD)intestinal failure(IF)is rare and associated with poor outcomes.To our knowledge,the role of intestinal transplantation(ITx)as a rescue treatment for this complication has ne...BACKGROUND Post-pancreaticoduodenectomy(PD)intestinal failure(IF)is rare and associated with poor outcomes.To our knowledge,the role of intestinal transplantation(ITx)as a rescue treatment for this complication has never been reported.CASE SUMMARY A 42-year-old female with a benign neurilemmoma of the duodenum underwent PD.Her superior mesenteric vein(SMV)was injured during surgery and required reconstruction.She experienced SMV thrombosis and bowel gangrene requiring massive bowel resection.Consequently,she developed short gut syndrome and an enterocutaneous fistula,leading to prolonged hospitalization for wound care and total parenteral nutrition(TPN)support.She was referred to our hospital for ITx evaluation.Upon arrival,she had cholestasis due to IF-associated liver disease.After gastrointestinal(GI)reconstruction to restore GI continuity,she was eligible for multi-visceral transplantation(MVTx).The anticipated allograft included the stomach,small intestine,liver,pancreas,and duodenum.She found a suitable donor after two years of waiting.The MVTx procedure was straightforward with signs of immediate function.Enteral feeding was initiated on postoperative day(POD)7.TPN weaning was achieved on POD 28,and the patient was discharged on POD 69.Two years post-MVTx,she is healthy with excellent graft function.To our knowledge,this is the first case report on MVTx as the treatment for fatal post-PD complications and also the first reported case of ITx in Southeast Asia.CONCLUSION Post-PD IF is rare and lethal.Intestinal and MVTx might be a rescue treatment for IF after GI surgery in eligible patients.展开更多
BACKGROUND Intestinal injury is the most common complication of sepsis,and the mitigation of intestinal damage is crucial for treating sepsis.AIM To examine the use of ozone-rich water and its action in preventing int...BACKGROUND Intestinal injury is the most common complication of sepsis,and the mitigation of intestinal damage is crucial for treating sepsis.AIM To examine the use of ozone-rich water and its action in preventing intestinal damage caused by sepsis.METHODS Through histological analysis,immunohistochemistry,immunofluorescence assays,and Western blot detection,we evaluated the therapeutic efficacy of ozone in mitigating intestinal injury during sepsis.Additionally,by conducting 16S rRNA sequencing and untargeted metabolomics analysis on fecal samples,we identified alterations in the gut microbiota and specific metabolites in septic mice following ozone treatment.This comprehensive approach aims to further elucidate the mechanistic underpinnings of ozone therapy in alleviating sepsis-induced intestinal damage.RESULTS Our results demonstrate that ozonated water significantly ameliorates pathological damage in intestinal tissues,enhances the expression of tight junction proteins,and inhibits the polarization of intestinal macrophages,thereby reducing the expression of inflammatory cytokines in intestinal tissues of cecal ligation and puncture-induced septic mice.16S rRNA sequencing analysis revealed that ozonated water increased the abundance of beneficial bacteria and alleviated gut microbiota dysbiosis.Studies using broad-spectrum antibiotic-treated mice indicated that the protective effects of ozonated water on intestinal injury are dependent on the gut microbiota.Furthermore,metabolomic analysis identified an increase in the tryptophan metabolite DL-tryptophan in the ozonated water treatment group.This suggests that ozonated water protects against intestinal injury by activating the aryl hydrocarbon receptor and suppressing necroptosis in intestinal epithelial cells.CONCLUSION Ozone protected against sepsis-induced intestinal injury through regulation of the gut microbiota and tryptophan metabolism,inhibiting necrotic apoptosis of intestinal epithelial cells through activation of the aryl hydrocarbon receptor.展开更多
Utilizing transporter-mediated drug delivery to achieve effective oral absorption emerges as a promising strategy.Researchers have been concentrated on discovering solutions to the issues of low solubility and poor pe...Utilizing transporter-mediated drug delivery to achieve effective oral absorption emerges as a promising strategy.Researchers have been concentrated on discovering solutions to the issues of low solubility and poor permeability of insoluble drugs,whereas,current reports have revealed that drug transporter proteins are abundantly expressed in the mucosa of intestinal epithelial cells,and that their mediated drug absorption effectively improved the bioavailability of orally administered drugs.There are two main categories based on the transporter mechanism,which include the family of ATP-binding cassette(ABC)transporters with efflux effects that reduce drug bioavailability and the family of solute carriers(SLC)transporters with uptake effects that promote drug absorption,respectively.Thus,we review studies of intestinal transporter-mediated delivery of drugs to enhance oral absorption,including the types of intestinal transporters,distribution characteristics,and strategies for enhancing oral absorption using transporter-mediated drug delivery systems are summarized,with the aim of providing important theoretical references for the development of intestinal-targeted delivery system.展开更多
BACKGROUND Recently,intestinal stenting combined with laparoscopic surgery has received increasing attention as a treatment option for acute intestinal obstruction.However,its safety and efficacy have not yet been est...BACKGROUND Recently,intestinal stenting combined with laparoscopic surgery has received increasing attention as a treatment option for acute intestinal obstruction.However,its safety and efficacy have not yet been established.AIM To assess the efficacy and safety of combining intestinal stenting with laparoscopic surgery for the management of acute intestinal obstruction.METHODS Clinical data from 74 patients with colorectal cancer and acute intestinal obstruction,who were admitted to the emergency department of the authors’hospital between October 2023 and November 2024,were collected and analyzed.Patients were divided into two groups based on the surgical intervention:A control group(emergency open surgery,n=37)and a study group(intestinal stent implantation combined with laparoscopic surgery,n=37).Observation indicators included stent placement rate,obstruction relief rate,and stent-related complications.RESULTS Intestinal stent placement was 100%successful in the study group,all of whom experienced relief from obstruction while exhibiting a significantly lower rate of ostomy creation and a higher rate of primary anastomosis than in the control group,as well as less intraoperative blood loss,shorter time to flatus,and shorter hospital stay.The complication rate was 5.41%(2/37;bleeding and re-obstruction),with no statistically significant difference between the two groups in terms of operative duration or perioperative mortality.The overall complication rates were 5.41%(2/37)and 21.62%(8/37)in the intervention and control groups,respectively.Tumor recurrence and overall survival rates were 2.70%and 97.30%in the study group and 13.51%and 91.89%in the control group,respectively.CONCLUSION Intestinal stenting relieved acute obstructions,reduced the number of emergency surgeries,and supported laparoscopic procedures while improving primary anastomosis rates,minimizing ostomy occurrence,surgical trauma,and complications,and accelerating recovery.展开更多
Inflammatory bowel disease(IBD)comprises a heterogeneous group of chronic inflammatory conditions of the intestine.Current therapeutic strategies primarily focus on maintaining remission and mitigating the secondary e...Inflammatory bowel disease(IBD)comprises a heterogeneous group of chronic inflammatory conditions of the intestine.Current therapeutic strategies primarily focus on maintaining remission and mitigating the secondary effects rather than reversing its pathogenic mechanisms(Jeong et al.,2019).The pathogenesis of IBD involves intestinal barrier dysfunction,tissue damage,and dysregulated innate and adaptive immune responses(de Souza et al.,2017).Elevated neutrophil activity has been reported in IBD(Danne et al.,2024),yet the precise roles and mechanisms of neutrophils in disease progression remain to be elucidated.展开更多
Inflammatory bowel disease(IBD),a chronic disorder characterized by intestinal inflammation and mucosal damage,includes mainly Crohn’s disease and ulcerative colitis.However,the cause of its onset remains unclear.The...Inflammatory bowel disease(IBD),a chronic disorder characterized by intestinal inflammation and mucosal damage,includes mainly Crohn’s disease and ulcerative colitis.However,the cause of its onset remains unclear.The pathogenesis of IBD is closely related to host genetic susceptibility,disorders of the intestinal flora,damage to the intestinal mucosal barrier,and abnormal intestinal mucosal immunity.On the basis of the progress in research on the structure of the intestinal microbiota involved in IBD,the influence of genetics on the intestinal barrier and intestinal microbiota;the metagenomics,metatranscriptomics,and metabolomics of the intestinal microbiota involved in IBD;and treatments such as probiotics and fecal microbiota transplantation are important for the future treatment of IBD and the development of drugs for effective treatment.展开更多
BACKGROUND Ferroptosis is a newly recognized form of regulated cell death characterized by iron-dependent accumulation of lipid reactive oxygen species.It has been extensively studied in various diseases,including can...BACKGROUND Ferroptosis is a newly recognized form of regulated cell death characterized by iron-dependent accumulation of lipid reactive oxygen species.It has been extensively studied in various diseases,including cancer,Parkinson’s disease,and stroke.However,its precise role and underlying mechanisms in ischemia/reperfusion injury,particularly in the intestinal ischemia-reperfusion(IIR),remain unclear.In current work,we aimed to investigate the participation of histone lactylation during IIR progression.AIM To investigate the role of mitochondrial alanyl-tRNA synthetase 2(AARS2)in ferroptosis and its epigenetic regulation of acyl-CoA synthetase long-chain family member 4(ACSL4)through histone lactylation during IIR injury.METHODS We established a mouse model to mimic IIR and conducted AARS2 knockdown as treatment.The expression of AARS2 in intestinal tissues was measured by western blot.The integrity of intestinal tissues was detected by hematoxylin and eosin staining,serum fatty acid-binding protein,protein levels of ZO-1 and occluding.An in vitro hypoxia-reperfusion(H/R)cell model was established,and cell viability was measured by CCK-8.The in vitro and in vivo ferroptosis was determined by the accumulation of Fe2+and malondialdehyde(MDA).The epigenetic regulation of ACSL4 by AARS2 was detected by chromatin immunoprecipitation(ChIP)assay and luciferase reporter assay.RESULTS We observed a notable elevated AARS2 level in intestinal tissue of mice in IIR model group,which was reversed by shAARS2 treatment.Knockdown of AARS2 repressed alleviated intestinal barrier disruption and repressed the accumulation of ferroptosis biomarker Fe2+and MDA during IIR.The in vitro results showed that shAARS2 alleviated impaired cell viability caused by H/R,as well as repressed ferroptosis.Knockdown of AARS2 notably downregulated the RNA and protein expression of ACSL4.Mechanistically,knockdown of AARS2 downregulated the enrichment of H3K18 La modification on AARS2,as well as suppressed its promoter activity.Overexpression of AARS2 could abolish the protective effects of shACSL4 in vitro.CONCLUSION The elevation of AARS2 during IIR led to cell ferroptosis via epigenetically upregulating the expression of ACSL4.Our findings presented AARS2 as a promising therapeutic target for IIR.展开更多
Diet and nutrition significantly influence health, largely by regulating intestinalnutrient absorption. The intestinal epithelium, as the primary site for nutrientuptake, undergoes continuous renewal driven by precise...Diet and nutrition significantly influence health, largely by regulating intestinalnutrient absorption. The intestinal epithelium, as the primary site for nutrientuptake, undergoes continuous renewal driven by precise regulation of intestinalstem cells (ISCs). Nutrient sensing and metabolism are key determinants of ISCfate, making ISCs a central link between nutrient metabolism and the regulationof intestinal tissue renewal and homeostasis. Understanding how ISCs respond ormake adaptations to nutritional signals is therefore vital for maintaining intestinalhomeostasis. Recent studies have spotlighted the origin and identity of ISCs andbroadened our insight into the plasticity and function of ISCs under differentconditions. Mitochondria, the central hubs of energy production and metabolicsignals provided by dietary components and metabolic substrates, such as glucose,amino acids, and lipids, govern the intricate balance between self-renewal anddifferentiation of ISCs. This review highlights the importance of nutrient sensing,metabolic regulation, and mitochondrial function in the specification of ISC fate.A thorough understanding of these mechanisms paves the way for the developmentof stem cell-based therapy for the mucosal healing of gastrointestinaldiseases and diet intervention to foster body health.展开更多
BACKGROUND Rotavirus(RV),a primary cause of diarrhea-related mortality in 2021,has been shown to damage intestinal epithelial cells while upregulating intestinal stem cells(ISCs)activities.ISCs within the crypt niche ...BACKGROUND Rotavirus(RV),a primary cause of diarrhea-related mortality in 2021,has been shown to damage intestinal epithelial cells while upregulating intestinal stem cells(ISCs)activities.ISCs within the crypt niche drive the continuous self-renewal of intestinal epithelium,preserving its barrier functions.Paneth cells secrete antimicrobial peptide and signaling molecules within the intestine crypt,thereby playing a crucial role in intestinal immune defense and providing ISCs functional support.However,the regulatory function of Paneth cells under pathological conditions,such as RV infection,remains unclear.AIM To determine the impact of RV infection on Paneth cells and how Paneth cells regulate ISCs during intestinal injury repair.METHODS We constructed a reference genome for the RV enteric cytopathogenic human orphan virus strain and reanalyzed published single-cell RNA sequencing data to investigate Paneth cell responses to RV-induced intestinal injury.We derived Paneth-ISC communication networks using CellChat,tracked ISC differentiation with pseudotime analysis,and validated our findings in leucine-rich repeat-containing G protein-coupled receptor 5-enhanced green fluorescent protein-internal ribosomal entry site-Cre recombinase estrogen receptor variant 2 mice and organoids via immunofluorescence,flow cytometry,and reverse transcription quantitative polymerase chain reaction.RESULTS We found that RV directly infects Paneth cells,leading to a reduction in mature Paneth cells and an increase in kallikrein 1-high immature Paneth cells.Paneth-ISC communication was significantly enhanced.In particular,the bone morphogenic protein 7(BMP7)-activin A receptor type 2B/BMP receptor type 1A-Smad pathway was upregulated post-infection,suggesting that Paneth cells suppress excessive ISC proliferation.Functional validation confirmed activation of this pathway.CONCLUSION Paneth cells regulate ISC proliferation during RV infection by activating BMP7 signaling,limiting excessive stem cell expansion and preserving crypt homeostasis for effective epithelial repair.展开更多
In this editorial,we discuss the findings reported by Wang et al in the latest issue of the World Journal of Gastrointestinal Oncology.Various research methodologies,including microbiome analysis,assert that the Tzu-C...In this editorial,we discuss the findings reported by Wang et al in the latest issue of the World Journal of Gastrointestinal Oncology.Various research methodologies,including microbiome analysis,assert that the Tzu-Chi Cancer-Antagonizing and Life-Protecting II Decoction of Chinese herbal compounds mitigates inflammatory responses by inhibiting the NF-κB signaling pathway.This action helps maintain the dynamic equilibrium of the intestinal microecology and lessens chemotherapy-induced gastrointestinal damage.The efficacy of these compounds is intimately linked to the composition of intestinal microbes.These compounds regulate intestinal microecology by virtue of their specific compatibility and effectiveness,thereby enhancing the overall therapeutic outcomes of cancer chemotherapy.Nonetheless,the exact mechanisms underlying these effects warrant further investigation.Multi-omics technologies offer a systematic approach to elucidate the mechanisms and effectiveness of Chinese herbal compounds in vivo.This manuscript reviews the application of multi-omics technologies to Chinese herbal compounds and explores their potential role in modulating the gastrointestinal microenvironment following cancer chemotherapy,thus providing a theoretical foundation for their continued use in adjunct cancer treatment.展开更多
BACKGROUND Lung cancer is the most prevalent malignant tumor in human body,and is characterized by a high level of malignancy.The most common metastatic sites include the liver,bone,brain,and adrenal gland,while lung ...BACKGROUND Lung cancer is the most prevalent malignant tumor in human body,and is characterized by a high level of malignancy.The most common metastatic sites include the liver,bone,brain,and adrenal gland,while lung cancer resulting in gastrointestinal tract metastasis is uncommon.CASE SUMMARY A 74-years-old man with lung cancer was hospitalized owing to blood in the stool,The cause was identified as metastasis to the small intestine,and the patient subsequently underwent radical resection of the small intestine tumor.Currently,the overall condition of the patient is good,and undergoing combined chemotherapy.CONCLUSION Early intervention in patients with metastatic tumors can significantly improve prognosis.展开更多
It is increasingly recognized that young,chow-fed inbred mice poorly model the com-plexity of human carcinogenesis.In humans,age and adiposity are major risk factors for malignancies,but most genetically engineered mo...It is increasingly recognized that young,chow-fed inbred mice poorly model the com-plexity of human carcinogenesis.In humans,age and adiposity are major risk factors for malignancies,but most genetically engineered mouse models(GEMM)induce car-cinogenesis too rapidly to study these influences.Standard strains,such as C57BL/6,commonly used in GEMMs,further limit the exploration of aging and metabolic health effects.A similar challenge arises in modeling periodontitis,a disease influenced by aging,diabesity,and genetic architecture.We propose using diverse mouse popula-tions with hybrid vigor,such as the Collaborative Cross(CC)×Apc ^(Min) hybrid,to slow disease progression and better model human colorectal cancer(CRC)and comorbidi-ties.This perspective highlights the advantages of this model,where delayed car-cinogenesis reveals interactions with aging and adiposity.Unlike Apc ^(Min) mice,which develop cancer rapidly,CC×Apc ^(Min) hybrids recapitulate human-like progression.This facilitates the identification of modifier loci affecting inflammation,diet susceptibility,organ size,and polyposis distribution.The CC×Apc ^(Min) model offers a transformative platform for studying CRC as a disease of adulthood,reflecting its complex inter-play with aging and comorbidities.The insights gained from this approach will en-hance early detection,management,and treatment strategies for CRC and related conditions.展开更多
BACKGROUND Chronic intestinal pseudo-obstruction(CIPO)is a rare and debilitating disorder,characterized by severe impairments in gastrointestinal motility.The affected sites include the enteric/intrinsic autonomic ner...BACKGROUND Chronic intestinal pseudo-obstruction(CIPO)is a rare and debilitating disorder,characterized by severe impairments in gastrointestinal motility.The affected sites include the enteric/intrinsic autonomic nerves(neuropathy),intestinal smooth muscle cells(myopathy),and interstitial cells of Cajal(mesenchymopathy).The etiology can be genetic,idiopathic,or acquired.Owing to its nonspecific clinical presentation and lack of definitive diagnostic methods,misdiagnosis of CIPO is common.CASE SUMMARY This case involved an older male with insidious onset in adolescence who presented with postprandial bloating,intermittent diarrhea,and weight loss.During the disease course,the patient experienced two episodes of intestinal obstruction.Imaging revealed multisegmental digestive tract abnormalities(gastric emptying disorder,significant duodenal dilatation,and segmental jejunal dilatation).Whole-exome sequencing revealed a rare MYH11 mutation[NM_0010-40113.2:C.5819del(p.Pro1940HisfsTer91)],confirming hereditary myopathic CIPO.CONCLUSION This report adds to our current understanding of CIPO etiology by reinforcing the role of MYH11 variants in the pathogenesis of the CIPO phenotype.展开更多
BACKGROUND Small intestinal bacterial overgrowth(SIBO)is suspected and excluded frequently in functional gastrointestinal(GI)disorders.Children presenting with various esophago-gastro-duodenal(upper GI)symptoms are ra...BACKGROUND Small intestinal bacterial overgrowth(SIBO)is suspected and excluded frequently in functional gastrointestinal(GI)disorders.Children presenting with various esophago-gastro-duodenal(upper GI)symptoms are rarely subjected to investig-ations for SIBO.AIM To estimate the frequency of SIBO in children having functional upper GI sym-ptoms(as cases)and to compare the result of the SIBO status to that of the con-trols.METHODS Children aged 6 to 18 who presented with upper GI symptoms were selected for the study.All children were subjected to upper GI endoscopy before being advised of any proton pump inhibitors(PPIs).Children with normal endoscopy were assigned as cases,and children having any endoscopic lesion were design-ated as controls.Both groups were subjected to a glucose-hydrogen breath test by Bedfont Gastrolyser.RESULTS A total of 129 consecutive children who were naive to PPIs and had normal ba-seline investigations were included in the study.Among them,67 patients had endoscopic lesions and served as the control group,with six cases being excluded due to the presence of Helicobacter pylori in gastric biopsies.Sixty-two children with normal endoscopy results formed the case group.In the case group,35 children(59%)tested positive for hydrogen breath tests,compared to 13 children(21%)in the control group.The calculated odds ratio was 5.38(95%confidence interval:2.41-12.0),which was statistically significant.Further analysis of symptoms revealed that nausea,halitosis,foul-smelling eructation,and epigastric fullness were positive predictors of SIBO.CONCLUSION It is worthwhile to investigate and treat SIBO in all children presenting with upper GI symptoms that are not explained by endoscopy findings.展开更多
BACKGROUND Congenital intestinal atresia(CIA)is a common intestinal malformation in the neonatal period,and surgery is currently the main treatment method.The choice of postoperative feeding is crucial for the recover...BACKGROUND Congenital intestinal atresia(CIA)is a common intestinal malformation in the neonatal period,and surgery is currently the main treatment method.The choice of postoperative feeding is crucial for the recovery of gastrointestinal function in children.AIM To compare and analyze the effects of different postoperative feeding methods on gastrointestinal function reconstruction in newborns with CIA.METHODS Twenty-six children diagnosed with neonatal CIA,treated with minimally invasive surgery at Shijiazhuang Maternal and Child Health Hospital between January 2021 and May 2024,were selected for this single-center prospective randomized controlled study.They were divided into two groups using envelope randomization:Enteral nutrition(EN)group(n=13)and parenteral nutrition(PN)group(n=13).Baseline and clinical characteristics were collected,and recovery time of bowel sounds and time to first defecation were used as evaluation indices for gastrointestinal functional reconstruction.Differences between the groups were analyzed using t-test,χ2 test,and Fisher’s exact test.Spearman’s correlation tests and linear regression models were employed to analyze factors influencing time to first defecation.RESULTS The time to bowel sound recovery(51.54 vs 65.85,P=0.013)and first defecation(58.15 vs 76.62,P<0.001)was shorter in the EN group compared to the PN group.Clinical improvements in the EN group,including discharge weight(P=0.044),hospital stay(P=0.027),white blood cell count(P=0.023),albumin content(P=0.013),and direct bilirubin content(P=0.018),were also better than those in the PN group.No substantial differences in postoperative complications were found between the groups.Correlation analysis indicated that abdominal infection and operation time may relate to time to first defecation.Linear regression analysis demonstrated a considerable association between EN feeding and shorter time to first defecation.Abdominal infection and an operation time>2 hours may be risk factors for prolonged time to first defecation.CONCLUSION EN substantially promotes the recovery of gastrointestinal function after CIA in neonates and can improve clinical outcomes in children.Future research should explore optimal EN practices to enhance clinical application and child health.展开更多
BACKGROUND Gastrointestinal diseases in young children are often anatomic or inflammatory in nature and can present with symptoms similar to those of Cow’s milk protein allergy(CMPA),complicating diagnosis.This case ...BACKGROUND Gastrointestinal diseases in young children are often anatomic or inflammatory in nature and can present with symptoms similar to those of Cow’s milk protein allergy(CMPA),complicating diagnosis.This case series highlights 3 pediatric patients initially misdiagnosed with CMPA,emphasizing the need for a thorough evaluation.CASE SUMMARY Case 1:A 3-year-old child with chronic abdominal distension and constipation was initially treated for CMPA and was later diagnosed with Hirschsprung disease through rectal biopsy.Surgical intervention involved a laparoscopic colostomy followed by a pull-through procedure,leading to a successful recovery.Case 2:A 2-month-old infant presented with greenish-yellow vomiting and abdominal distension.Initially misdiagnosed with CMPA,further investigation using barium studies revealed partial intestinal malrotation.The patient underwent a laparoscopic Ladd’s procedure and recovered well.Case 3:A 6-month-old infant with persistent vomiting and failure to thrive had been treated for CMPA.Detailed imaging studies indicated achalasia.The child underwent a Heller myotomy,which resulted in significant symptom improvement and weight gain CONCLUSION Thorough evaluation of gastrointestinal symptoms is necessary in children.A high suspicion for alternative diagnoses will prevent delays in accurate diagnosis and proper treatment,leading to improved outcomes.展开更多
Background Necrotic enteritis(NE)in broiler chickens leads to significant economic losses in poultry production.This study examined the inhibitory effects of usnic acid and tannic acid on coccidia,sporozoite,and Clost...Background Necrotic enteritis(NE)in broiler chickens leads to significant economic losses in poultry production.This study examined the inhibitory effects of usnic acid and tannic acid on coccidia,sporozoite,and Clostridium perfringens and assessed their influence on growth performance and intestinal health in NE-challenged broilers through in vitro and in vivo experiments.Methods The in vitro experiment included 5 treatment groups:the negative control(NC),2μmol/L diclazuril(DZ),30μmol/L usnic acid(UA),90μmol/L tannic acid(TA),and 15μmol/L usnic acid^(+)45μmol/L tannic acid(UTA)groups.The in vivo experiment involved 320 broilers divided into four groups:PC(NE-challenged),SA(500 mg/kg salinomycin premix^(+)NE-challenged),UA(300 mg/kg usnic acid^(+)NE-challenged),and UTA(300 mg/kg usnic acid^(+)500 mg/kg tannic acid^(+)NE-challenged)groups.Results In the in vitro study,the UA,TA,and UTA treatments significantly increased apoptosis in coccidian oocysts and sporozoites,lowered the mitochondrial membrane potential(P<0.05),and disrupted the oocyst structure compared with those in the NC group.UA and TA had inhibitory effects on C.perfringens,with the strongest inhibition observed in the UTA group.The in vivo results demonstrated that the SA group presented significantly improved growth performance on d 13,21,and 28(P<0.05),whereas the UA and UTA groups presented improvements on d 13 and 21(P<0.05).The SA,UA,and UTA treatments reduced the intestinal lesion scores by d 28 and the fecal coccidian oocyst counts from d 19 to 21(P<0.05).Compared with the PC group,the UA and UTA groups presented lower intestinal sIgA levels and CD8^(+)cell percentages(P<0.05),with a trend toward a reduced CD3^(+)cell percentage(P=0.069).The SA,UA,and UTA treatments significantly reduced the serum diamine oxidase activity,crypt depth,and plateletderived growth factor levels in the intestinal mucosa while increasing the villus height to crypt depth ratio and number of goblet cells(P<0.05).The UTA treatment also significantly increased the acetate and butyrate concentrations in the cecum(P<0.05).With respect to the gut microbiota,significant changes inβdiversity in the ileum and cecum were observed in the SA,UA,and UTA groups,indicating that the microbial community compositions differed among the groups.Romboutsia dominated the SA group,Bacillales dominated the UA group,and Lactobacillales and Lachnospirales dominated the UTA group in the ileal microbiota.In the cecal microbiota,Lactobacillus,Butyricicoccus,and Blautia abundances were significantly elevated in the UTA group(P<0.05).Conclusion Usnic acid and tannic acid induce apoptosis in coccidia and sporozoites by lowering the mitochondrial membrane potential.Both usnic acid alone and in combination with tannic acid alleviate NE-induced adverse effects in broilers by modulating intestinal immunity,altering the microbial composition,and improving intestinal barrier function.Compared with usnic acid alone,the combination of usnic acid and tannic acid had superior effects,providing a promising basis for the development of effective feed additive combinations.展开更多
基金National Natural Science Foundation of China(32372830 and 31972528).
文摘Background Weaning stress-induced diarrhea is widely recognized as being associated with gut microbiota dysbio-sis.However,it has been challenging to clarify which specific intestinal microbiota and their metabolites play a crucial role in the antidiarrhea process of weaned piglets.Results In this study,we first observed that piglets with diarrhea exhibited a lower average daily gain and higher diarrhea score,and elevated levels of lipopolysaccharide(LPS)and D-lactate(D-LA)compared to healthy piglets.Subsequently,we analyzed the differences in intestinal microbial composition and metabolite levels between healthy and diarrheal weaned piglets.Diarrheal piglets demonstrated intestinal microbiota dysbiosis,characterized pri-marily by a higher Firmicutes to Bacteroidota ratio,a deficiency of Lactobacillus amylovorus and Lactobacillus reuteri,and an increased abundance of Bacteroides sp.HF-5287 and Bacteroides thetaiotaomicron.Functional pro-filing of the gut microbiota based on Kyoto Encyclopedia of Genes and Genomes(KEGG)data was performed,and the results showed that tryptophan metabolism was the most significantly inhibited pathway in piglets with diar-rhea.Most tryptophan metabolites were detected at lower concentrations in diarrheal piglets than in healthy piglets.Furthermore,we explored the effects of dietary indole-3-aldehyde(IAld),a key tryptophan metabolite,on intestinal development and gut barrier function in weaned piglets.Supplementation with 100 mg/kg IAld in the diet increased the small intestine index and improved intestinal barrier function by promoting intestinal stem cell(ISC)expansion in piglets.The promotion of ISC expansion by IAld was also confirmed in porcine intestinal organoids.Conclusions These findings revealed that intestinal microbial tryptophan metabolite IAld alleviates impaired intesti-nal development by promoting ISC expansion in weaned piglets.
文摘The role of small bowel capsule endoscopy (CE) in suspected small bowel bleedingis well established and current European and other international guidelinesposition it as the first line test after negative bidirectional endoscopies. Insuspected mid-lower gastrointestinal bleeding (MLGIB) the diagnostic yield ofcolonoscopy is poor and may cause a delay in detecting small bowel disease. Acrucial aspect of small bowel capsule endoscope performance is the timing of theprocedure, the interval between the bleeding episode and capsule ingestion isinversely related to the diagnostic yield as confirmed by a recent meta-analysis.Currently the ongoing advances achieved by video CE in particular to evaluateboth small bowel and colon in a single test using double headed capsules, raisesquestions regarding the position of pan intestinal capsule in the current algorithmto investigate patients presenting with suspected MLGIB ahead of colonoscopy.Early evidence suggests pan intestinal capsule could fit well as a diagnostic“filter” test in this cohort of patients, thereby reserving invasive conventionalcolonoscopy or device assisted enteroscopy as therapeutics options only. The recentdevelopment of magnetically controlled CE and a blood sensing capsule pushthe boundaries of CE even further in patients presenting with suspected gastrointestinalbleeding. This review will discuss the current available evidence andfuture directions of CE in suspected MLGIB.
基金financially supported by the National Key Research and Development Program of China(2022YFF1100402)National Center of Technology Innovation for Dairy(2022-Open subject-11)+1 种基金Young Elite Scientist Sponsorship Program by CAST(YESS20200271)the National Natural Science Foundation of China(32101919)。
文摘2'-Fucosyllactose(2'-FL)shows the potential to support intestinal health as a natural prebiotic that bridges the gap between infant formula feeding and breastfeeding.However,the effect and mechanism of 2'-FL in improving intestinal permeability are not clear.In this study,we constructed human microbiota-associated(HMA)mouse models by colonizing healthy infant feces in mice with antibiotic-depleted intestinal microbiota.The protective effect of 2'-FL on the intestinal permeability was explored using the HMA mouse models,and the combination of metagenomics was used to analyze the possible mechanisms by which the microorganisms reduced the intestinal permeability.The results showed that 2'-FL decreased the concentration of markers of intestinal permeability(enterotoxin and diamine oxidase(DAO))and increased the expression levels of tight junctions(occludin and claudin).Metagenomics revealed the enrichment of Bifidobacterium and increased the expression of glycoside hydrolases(GHs),including GH31,GH28,and GH5.In conclusion,2'-FL strengthened intestinal permeability function by improving microbiota composition to control the translocation of harmful substance.
文摘BACKGROUND Post-pancreaticoduodenectomy(PD)intestinal failure(IF)is rare and associated with poor outcomes.To our knowledge,the role of intestinal transplantation(ITx)as a rescue treatment for this complication has never been reported.CASE SUMMARY A 42-year-old female with a benign neurilemmoma of the duodenum underwent PD.Her superior mesenteric vein(SMV)was injured during surgery and required reconstruction.She experienced SMV thrombosis and bowel gangrene requiring massive bowel resection.Consequently,she developed short gut syndrome and an enterocutaneous fistula,leading to prolonged hospitalization for wound care and total parenteral nutrition(TPN)support.She was referred to our hospital for ITx evaluation.Upon arrival,she had cholestasis due to IF-associated liver disease.After gastrointestinal(GI)reconstruction to restore GI continuity,she was eligible for multi-visceral transplantation(MVTx).The anticipated allograft included the stomach,small intestine,liver,pancreas,and duodenum.She found a suitable donor after two years of waiting.The MVTx procedure was straightforward with signs of immediate function.Enteral feeding was initiated on postoperative day(POD)7.TPN weaning was achieved on POD 28,and the patient was discharged on POD 69.Two years post-MVTx,she is healthy with excellent graft function.To our knowledge,this is the first case report on MVTx as the treatment for fatal post-PD complications and also the first reported case of ITx in Southeast Asia.CONCLUSION Post-PD IF is rare and lethal.Intestinal and MVTx might be a rescue treatment for IF after GI surgery in eligible patients.
基金Supported by the National Natural Science Foundation of China,No.81971814Pudong New Area Health Talent Training Program,No.2025PDWSYCBJ-04Shanghai’s 2023“Technology Innovation Action Plan”Medical Innovation Research Project,No.23Y11908300。
文摘BACKGROUND Intestinal injury is the most common complication of sepsis,and the mitigation of intestinal damage is crucial for treating sepsis.AIM To examine the use of ozone-rich water and its action in preventing intestinal damage caused by sepsis.METHODS Through histological analysis,immunohistochemistry,immunofluorescence assays,and Western blot detection,we evaluated the therapeutic efficacy of ozone in mitigating intestinal injury during sepsis.Additionally,by conducting 16S rRNA sequencing and untargeted metabolomics analysis on fecal samples,we identified alterations in the gut microbiota and specific metabolites in septic mice following ozone treatment.This comprehensive approach aims to further elucidate the mechanistic underpinnings of ozone therapy in alleviating sepsis-induced intestinal damage.RESULTS Our results demonstrate that ozonated water significantly ameliorates pathological damage in intestinal tissues,enhances the expression of tight junction proteins,and inhibits the polarization of intestinal macrophages,thereby reducing the expression of inflammatory cytokines in intestinal tissues of cecal ligation and puncture-induced septic mice.16S rRNA sequencing analysis revealed that ozonated water increased the abundance of beneficial bacteria and alleviated gut microbiota dysbiosis.Studies using broad-spectrum antibiotic-treated mice indicated that the protective effects of ozonated water on intestinal injury are dependent on the gut microbiota.Furthermore,metabolomic analysis identified an increase in the tryptophan metabolite DL-tryptophan in the ozonated water treatment group.This suggests that ozonated water protects against intestinal injury by activating the aryl hydrocarbon receptor and suppressing necroptosis in intestinal epithelial cells.CONCLUSION Ozone protected against sepsis-induced intestinal injury through regulation of the gut microbiota and tryptophan metabolism,inhibiting necrotic apoptosis of intestinal epithelial cells through activation of the aryl hydrocarbon receptor.
基金funded by the National Natural Science Foundation of China(No.82304730)the Project of Academic and Technical Leaders in Major Disciplines in Jiangxi Province(No.20212BCJL23060)+3 种基金the Natural Science Foundation of Jiangxi Province(No.20232BAB216128)the Project of Jiangxi Provincial Department of Education(No.GJJ2200977)the Jiangxi University of Chinese Medicine Science and Technology Innovation Team Development Program(Nos.CXTD-22004,CXTD-22008)the PhD Startup Foundation of Affiliated Hospital of Jiangxi University of Chinese Medicine(No.23KYQDZJ02).
文摘Utilizing transporter-mediated drug delivery to achieve effective oral absorption emerges as a promising strategy.Researchers have been concentrated on discovering solutions to the issues of low solubility and poor permeability of insoluble drugs,whereas,current reports have revealed that drug transporter proteins are abundantly expressed in the mucosa of intestinal epithelial cells,and that their mediated drug absorption effectively improved the bioavailability of orally administered drugs.There are two main categories based on the transporter mechanism,which include the family of ATP-binding cassette(ABC)transporters with efflux effects that reduce drug bioavailability and the family of solute carriers(SLC)transporters with uptake effects that promote drug absorption,respectively.Thus,we review studies of intestinal transporter-mediated delivery of drugs to enhance oral absorption,including the types of intestinal transporters,distribution characteristics,and strategies for enhancing oral absorption using transporter-mediated drug delivery systems are summarized,with the aim of providing important theoretical references for the development of intestinal-targeted delivery system.
文摘BACKGROUND Recently,intestinal stenting combined with laparoscopic surgery has received increasing attention as a treatment option for acute intestinal obstruction.However,its safety and efficacy have not yet been established.AIM To assess the efficacy and safety of combining intestinal stenting with laparoscopic surgery for the management of acute intestinal obstruction.METHODS Clinical data from 74 patients with colorectal cancer and acute intestinal obstruction,who were admitted to the emergency department of the authors’hospital between October 2023 and November 2024,were collected and analyzed.Patients were divided into two groups based on the surgical intervention:A control group(emergency open surgery,n=37)and a study group(intestinal stent implantation combined with laparoscopic surgery,n=37).Observation indicators included stent placement rate,obstruction relief rate,and stent-related complications.RESULTS Intestinal stent placement was 100%successful in the study group,all of whom experienced relief from obstruction while exhibiting a significantly lower rate of ostomy creation and a higher rate of primary anastomosis than in the control group,as well as less intraoperative blood loss,shorter time to flatus,and shorter hospital stay.The complication rate was 5.41%(2/37;bleeding and re-obstruction),with no statistically significant difference between the two groups in terms of operative duration or perioperative mortality.The overall complication rates were 5.41%(2/37)and 21.62%(8/37)in the intervention and control groups,respectively.Tumor recurrence and overall survival rates were 2.70%and 97.30%in the study group and 13.51%and 91.89%in the control group,respectively.CONCLUSION Intestinal stenting relieved acute obstructions,reduced the number of emergency surgeries,and supported laparoscopic procedures while improving primary anastomosis rates,minimizing ostomy occurrence,surgical trauma,and complications,and accelerating recovery.
基金supported by the National Key R&D Program of China(2023YFA1800100and 2024YFF1206600)the National Natural Science Foundation of China(32100664)the Basic and Applied Basic Research Foundation of Guangdong Province(2024B1515040019 and 2022A1515012042).
文摘Inflammatory bowel disease(IBD)comprises a heterogeneous group of chronic inflammatory conditions of the intestine.Current therapeutic strategies primarily focus on maintaining remission and mitigating the secondary effects rather than reversing its pathogenic mechanisms(Jeong et al.,2019).The pathogenesis of IBD involves intestinal barrier dysfunction,tissue damage,and dysregulated innate and adaptive immune responses(de Souza et al.,2017).Elevated neutrophil activity has been reported in IBD(Danne et al.,2024),yet the precise roles and mechanisms of neutrophils in disease progression remain to be elucidated.
基金Supported by the National Natural Science Foundation of China,No.82574996Shaanxi Province Traditional Chinese Medicine Research and Innovation Talent Plan Project,No.TZKN-CXRC-16+3 种基金Project of Shaanxi Administration of Traditional Chinese Medicine,No.SZYKJCYC-2025-JC-010Shaanxi Province Key Research and Development Plan Project-Social Development Field,No.2025SF-YBXM-498the“Nursery Cultivation Plan”Project of Shaanxi Provincial Academy of Chinese Medicine and Shaanxi Provincial Hospital of Traditional Chinese Medicine,No.2025-04the Fifth Batch of Outstanding Clinical Talents in Traditional Chinese Medicine Project of Shaanxi Province.
文摘Inflammatory bowel disease(IBD),a chronic disorder characterized by intestinal inflammation and mucosal damage,includes mainly Crohn’s disease and ulcerative colitis.However,the cause of its onset remains unclear.The pathogenesis of IBD is closely related to host genetic susceptibility,disorders of the intestinal flora,damage to the intestinal mucosal barrier,and abnormal intestinal mucosal immunity.On the basis of the progress in research on the structure of the intestinal microbiota involved in IBD,the influence of genetics on the intestinal barrier and intestinal microbiota;the metagenomics,metatranscriptomics,and metabolomics of the intestinal microbiota involved in IBD;and treatments such as probiotics and fecal microbiota transplantation are important for the future treatment of IBD and the development of drugs for effective treatment.
文摘BACKGROUND Ferroptosis is a newly recognized form of regulated cell death characterized by iron-dependent accumulation of lipid reactive oxygen species.It has been extensively studied in various diseases,including cancer,Parkinson’s disease,and stroke.However,its precise role and underlying mechanisms in ischemia/reperfusion injury,particularly in the intestinal ischemia-reperfusion(IIR),remain unclear.In current work,we aimed to investigate the participation of histone lactylation during IIR progression.AIM To investigate the role of mitochondrial alanyl-tRNA synthetase 2(AARS2)in ferroptosis and its epigenetic regulation of acyl-CoA synthetase long-chain family member 4(ACSL4)through histone lactylation during IIR injury.METHODS We established a mouse model to mimic IIR and conducted AARS2 knockdown as treatment.The expression of AARS2 in intestinal tissues was measured by western blot.The integrity of intestinal tissues was detected by hematoxylin and eosin staining,serum fatty acid-binding protein,protein levels of ZO-1 and occluding.An in vitro hypoxia-reperfusion(H/R)cell model was established,and cell viability was measured by CCK-8.The in vitro and in vivo ferroptosis was determined by the accumulation of Fe2+and malondialdehyde(MDA).The epigenetic regulation of ACSL4 by AARS2 was detected by chromatin immunoprecipitation(ChIP)assay and luciferase reporter assay.RESULTS We observed a notable elevated AARS2 level in intestinal tissue of mice in IIR model group,which was reversed by shAARS2 treatment.Knockdown of AARS2 repressed alleviated intestinal barrier disruption and repressed the accumulation of ferroptosis biomarker Fe2+and MDA during IIR.The in vitro results showed that shAARS2 alleviated impaired cell viability caused by H/R,as well as repressed ferroptosis.Knockdown of AARS2 notably downregulated the RNA and protein expression of ACSL4.Mechanistically,knockdown of AARS2 downregulated the enrichment of H3K18 La modification on AARS2,as well as suppressed its promoter activity.Overexpression of AARS2 could abolish the protective effects of shACSL4 in vitro.CONCLUSION The elevation of AARS2 during IIR led to cell ferroptosis via epigenetically upregulating the expression of ACSL4.Our findings presented AARS2 as a promising therapeutic target for IIR.
基金Supported by the Ministry of Science and Technology of China,No.2022YFF1203300National Key Research and Development Program,No.2023YFC2307001China Postdoctoral Science Foundation,No.2023TQ0125 and No.2024M751031.
文摘Diet and nutrition significantly influence health, largely by regulating intestinalnutrient absorption. The intestinal epithelium, as the primary site for nutrientuptake, undergoes continuous renewal driven by precise regulation of intestinalstem cells (ISCs). Nutrient sensing and metabolism are key determinants of ISCfate, making ISCs a central link between nutrient metabolism and the regulationof intestinal tissue renewal and homeostasis. Understanding how ISCs respond ormake adaptations to nutritional signals is therefore vital for maintaining intestinalhomeostasis. Recent studies have spotlighted the origin and identity of ISCs andbroadened our insight into the plasticity and function of ISCs under differentconditions. Mitochondria, the central hubs of energy production and metabolicsignals provided by dietary components and metabolic substrates, such as glucose,amino acids, and lipids, govern the intricate balance between self-renewal anddifferentiation of ISCs. This review highlights the importance of nutrient sensing,metabolic regulation, and mitochondrial function in the specification of ISC fate.A thorough understanding of these mechanisms paves the way for the developmentof stem cell-based therapy for the mucosal healing of gastrointestinaldiseases and diet intervention to foster body health.
文摘BACKGROUND Rotavirus(RV),a primary cause of diarrhea-related mortality in 2021,has been shown to damage intestinal epithelial cells while upregulating intestinal stem cells(ISCs)activities.ISCs within the crypt niche drive the continuous self-renewal of intestinal epithelium,preserving its barrier functions.Paneth cells secrete antimicrobial peptide and signaling molecules within the intestine crypt,thereby playing a crucial role in intestinal immune defense and providing ISCs functional support.However,the regulatory function of Paneth cells under pathological conditions,such as RV infection,remains unclear.AIM To determine the impact of RV infection on Paneth cells and how Paneth cells regulate ISCs during intestinal injury repair.METHODS We constructed a reference genome for the RV enteric cytopathogenic human orphan virus strain and reanalyzed published single-cell RNA sequencing data to investigate Paneth cell responses to RV-induced intestinal injury.We derived Paneth-ISC communication networks using CellChat,tracked ISC differentiation with pseudotime analysis,and validated our findings in leucine-rich repeat-containing G protein-coupled receptor 5-enhanced green fluorescent protein-internal ribosomal entry site-Cre recombinase estrogen receptor variant 2 mice and organoids via immunofluorescence,flow cytometry,and reverse transcription quantitative polymerase chain reaction.RESULTS We found that RV directly infects Paneth cells,leading to a reduction in mature Paneth cells and an increase in kallikrein 1-high immature Paneth cells.Paneth-ISC communication was significantly enhanced.In particular,the bone morphogenic protein 7(BMP7)-activin A receptor type 2B/BMP receptor type 1A-Smad pathway was upregulated post-infection,suggesting that Paneth cells suppress excessive ISC proliferation.Functional validation confirmed activation of this pathway.CONCLUSION Paneth cells regulate ISC proliferation during RV infection by activating BMP7 signaling,limiting excessive stem cell expansion and preserving crypt homeostasis for effective epithelial repair.
基金Supported by 2023 Government-funded Project of the Outstanding Talents Training Program in Clinical Medicine,No.ZF2023165Key Research and Development Projects of Hebei Province,No.18277731DNatural Science Foundation of Hebei Province,No.H202423105.
文摘In this editorial,we discuss the findings reported by Wang et al in the latest issue of the World Journal of Gastrointestinal Oncology.Various research methodologies,including microbiome analysis,assert that the Tzu-Chi Cancer-Antagonizing and Life-Protecting II Decoction of Chinese herbal compounds mitigates inflammatory responses by inhibiting the NF-κB signaling pathway.This action helps maintain the dynamic equilibrium of the intestinal microecology and lessens chemotherapy-induced gastrointestinal damage.The efficacy of these compounds is intimately linked to the composition of intestinal microbes.These compounds regulate intestinal microecology by virtue of their specific compatibility and effectiveness,thereby enhancing the overall therapeutic outcomes of cancer chemotherapy.Nonetheless,the exact mechanisms underlying these effects warrant further investigation.Multi-omics technologies offer a systematic approach to elucidate the mechanisms and effectiveness of Chinese herbal compounds in vivo.This manuscript reviews the application of multi-omics technologies to Chinese herbal compounds and explores their potential role in modulating the gastrointestinal microenvironment following cancer chemotherapy,thus providing a theoretical foundation for their continued use in adjunct cancer treatment.
文摘BACKGROUND Lung cancer is the most prevalent malignant tumor in human body,and is characterized by a high level of malignancy.The most common metastatic sites include the liver,bone,brain,and adrenal gland,while lung cancer resulting in gastrointestinal tract metastasis is uncommon.CASE SUMMARY A 74-years-old man with lung cancer was hospitalized owing to blood in the stool,The cause was identified as metastasis to the small intestine,and the patient subsequently underwent radical resection of the small intestine tumor.Currently,the overall condition of the patient is good,and undergoing combined chemotherapy.CONCLUSION Early intervention in patients with metastatic tumors can significantly improve prognosis.
基金Israel Cancer Research FoundationSamuel Waxman Cancer Research FoundationCore funding from Tel Aviv University。
文摘It is increasingly recognized that young,chow-fed inbred mice poorly model the com-plexity of human carcinogenesis.In humans,age and adiposity are major risk factors for malignancies,but most genetically engineered mouse models(GEMM)induce car-cinogenesis too rapidly to study these influences.Standard strains,such as C57BL/6,commonly used in GEMMs,further limit the exploration of aging and metabolic health effects.A similar challenge arises in modeling periodontitis,a disease influenced by aging,diabesity,and genetic architecture.We propose using diverse mouse popula-tions with hybrid vigor,such as the Collaborative Cross(CC)×Apc ^(Min) hybrid,to slow disease progression and better model human colorectal cancer(CRC)and comorbidi-ties.This perspective highlights the advantages of this model,where delayed car-cinogenesis reveals interactions with aging and adiposity.Unlike Apc ^(Min) mice,which develop cancer rapidly,CC×Apc ^(Min) hybrids recapitulate human-like progression.This facilitates the identification of modifier loci affecting inflammation,diet susceptibility,organ size,and polyposis distribution.The CC×Apc ^(Min) model offers a transformative platform for studying CRC as a disease of adulthood,reflecting its complex inter-play with aging and comorbidities.The insights gained from this approach will en-hance early detection,management,and treatment strategies for CRC and related conditions.
基金Supported by The National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-129.
文摘BACKGROUND Chronic intestinal pseudo-obstruction(CIPO)is a rare and debilitating disorder,characterized by severe impairments in gastrointestinal motility.The affected sites include the enteric/intrinsic autonomic nerves(neuropathy),intestinal smooth muscle cells(myopathy),and interstitial cells of Cajal(mesenchymopathy).The etiology can be genetic,idiopathic,or acquired.Owing to its nonspecific clinical presentation and lack of definitive diagnostic methods,misdiagnosis of CIPO is common.CASE SUMMARY This case involved an older male with insidious onset in adolescence who presented with postprandial bloating,intermittent diarrhea,and weight loss.During the disease course,the patient experienced two episodes of intestinal obstruction.Imaging revealed multisegmental digestive tract abnormalities(gastric emptying disorder,significant duodenal dilatation,and segmental jejunal dilatation).Whole-exome sequencing revealed a rare MYH11 mutation[NM_0010-40113.2:C.5819del(p.Pro1940HisfsTer91)],confirming hereditary myopathic CIPO.CONCLUSION This report adds to our current understanding of CIPO etiology by reinforcing the role of MYH11 variants in the pathogenesis of the CIPO phenotype.
文摘BACKGROUND Small intestinal bacterial overgrowth(SIBO)is suspected and excluded frequently in functional gastrointestinal(GI)disorders.Children presenting with various esophago-gastro-duodenal(upper GI)symptoms are rarely subjected to investig-ations for SIBO.AIM To estimate the frequency of SIBO in children having functional upper GI sym-ptoms(as cases)and to compare the result of the SIBO status to that of the con-trols.METHODS Children aged 6 to 18 who presented with upper GI symptoms were selected for the study.All children were subjected to upper GI endoscopy before being advised of any proton pump inhibitors(PPIs).Children with normal endoscopy were assigned as cases,and children having any endoscopic lesion were design-ated as controls.Both groups were subjected to a glucose-hydrogen breath test by Bedfont Gastrolyser.RESULTS A total of 129 consecutive children who were naive to PPIs and had normal ba-seline investigations were included in the study.Among them,67 patients had endoscopic lesions and served as the control group,with six cases being excluded due to the presence of Helicobacter pylori in gastric biopsies.Sixty-two children with normal endoscopy results formed the case group.In the case group,35 children(59%)tested positive for hydrogen breath tests,compared to 13 children(21%)in the control group.The calculated odds ratio was 5.38(95%confidence interval:2.41-12.0),which was statistically significant.Further analysis of symptoms revealed that nausea,halitosis,foul-smelling eructation,and epigastric fullness were positive predictors of SIBO.CONCLUSION It is worthwhile to investigate and treat SIBO in all children presenting with upper GI symptoms that are not explained by endoscopy findings.
文摘BACKGROUND Congenital intestinal atresia(CIA)is a common intestinal malformation in the neonatal period,and surgery is currently the main treatment method.The choice of postoperative feeding is crucial for the recovery of gastrointestinal function in children.AIM To compare and analyze the effects of different postoperative feeding methods on gastrointestinal function reconstruction in newborns with CIA.METHODS Twenty-six children diagnosed with neonatal CIA,treated with minimally invasive surgery at Shijiazhuang Maternal and Child Health Hospital between January 2021 and May 2024,were selected for this single-center prospective randomized controlled study.They were divided into two groups using envelope randomization:Enteral nutrition(EN)group(n=13)and parenteral nutrition(PN)group(n=13).Baseline and clinical characteristics were collected,and recovery time of bowel sounds and time to first defecation were used as evaluation indices for gastrointestinal functional reconstruction.Differences between the groups were analyzed using t-test,χ2 test,and Fisher’s exact test.Spearman’s correlation tests and linear regression models were employed to analyze factors influencing time to first defecation.RESULTS The time to bowel sound recovery(51.54 vs 65.85,P=0.013)and first defecation(58.15 vs 76.62,P<0.001)was shorter in the EN group compared to the PN group.Clinical improvements in the EN group,including discharge weight(P=0.044),hospital stay(P=0.027),white blood cell count(P=0.023),albumin content(P=0.013),and direct bilirubin content(P=0.018),were also better than those in the PN group.No substantial differences in postoperative complications were found between the groups.Correlation analysis indicated that abdominal infection and operation time may relate to time to first defecation.Linear regression analysis demonstrated a considerable association between EN feeding and shorter time to first defecation.Abdominal infection and an operation time>2 hours may be risk factors for prolonged time to first defecation.CONCLUSION EN substantially promotes the recovery of gastrointestinal function after CIA in neonates and can improve clinical outcomes in children.Future research should explore optimal EN practices to enhance clinical application and child health.
文摘BACKGROUND Gastrointestinal diseases in young children are often anatomic or inflammatory in nature and can present with symptoms similar to those of Cow’s milk protein allergy(CMPA),complicating diagnosis.This case series highlights 3 pediatric patients initially misdiagnosed with CMPA,emphasizing the need for a thorough evaluation.CASE SUMMARY Case 1:A 3-year-old child with chronic abdominal distension and constipation was initially treated for CMPA and was later diagnosed with Hirschsprung disease through rectal biopsy.Surgical intervention involved a laparoscopic colostomy followed by a pull-through procedure,leading to a successful recovery.Case 2:A 2-month-old infant presented with greenish-yellow vomiting and abdominal distension.Initially misdiagnosed with CMPA,further investigation using barium studies revealed partial intestinal malrotation.The patient underwent a laparoscopic Ladd’s procedure and recovered well.Case 3:A 6-month-old infant with persistent vomiting and failure to thrive had been treated for CMPA.Detailed imaging studies indicated achalasia.The child underwent a Heller myotomy,which resulted in significant symptom improvement and weight gain CONCLUSION Thorough evaluation of gastrointestinal symptoms is necessary in children.A high suspicion for alternative diagnoses will prevent delays in accurate diagnosis and proper treatment,leading to improved outcomes.
基金supported by China Agriculture Research System Program(Project No.CARS-41-G04)。
文摘Background Necrotic enteritis(NE)in broiler chickens leads to significant economic losses in poultry production.This study examined the inhibitory effects of usnic acid and tannic acid on coccidia,sporozoite,and Clostridium perfringens and assessed their influence on growth performance and intestinal health in NE-challenged broilers through in vitro and in vivo experiments.Methods The in vitro experiment included 5 treatment groups:the negative control(NC),2μmol/L diclazuril(DZ),30μmol/L usnic acid(UA),90μmol/L tannic acid(TA),and 15μmol/L usnic acid^(+)45μmol/L tannic acid(UTA)groups.The in vivo experiment involved 320 broilers divided into four groups:PC(NE-challenged),SA(500 mg/kg salinomycin premix^(+)NE-challenged),UA(300 mg/kg usnic acid^(+)NE-challenged),and UTA(300 mg/kg usnic acid^(+)500 mg/kg tannic acid^(+)NE-challenged)groups.Results In the in vitro study,the UA,TA,and UTA treatments significantly increased apoptosis in coccidian oocysts and sporozoites,lowered the mitochondrial membrane potential(P<0.05),and disrupted the oocyst structure compared with those in the NC group.UA and TA had inhibitory effects on C.perfringens,with the strongest inhibition observed in the UTA group.The in vivo results demonstrated that the SA group presented significantly improved growth performance on d 13,21,and 28(P<0.05),whereas the UA and UTA groups presented improvements on d 13 and 21(P<0.05).The SA,UA,and UTA treatments reduced the intestinal lesion scores by d 28 and the fecal coccidian oocyst counts from d 19 to 21(P<0.05).Compared with the PC group,the UA and UTA groups presented lower intestinal sIgA levels and CD8^(+)cell percentages(P<0.05),with a trend toward a reduced CD3^(+)cell percentage(P=0.069).The SA,UA,and UTA treatments significantly reduced the serum diamine oxidase activity,crypt depth,and plateletderived growth factor levels in the intestinal mucosa while increasing the villus height to crypt depth ratio and number of goblet cells(P<0.05).The UTA treatment also significantly increased the acetate and butyrate concentrations in the cecum(P<0.05).With respect to the gut microbiota,significant changes inβdiversity in the ileum and cecum were observed in the SA,UA,and UTA groups,indicating that the microbial community compositions differed among the groups.Romboutsia dominated the SA group,Bacillales dominated the UA group,and Lactobacillales and Lachnospirales dominated the UTA group in the ileal microbiota.In the cecal microbiota,Lactobacillus,Butyricicoccus,and Blautia abundances were significantly elevated in the UTA group(P<0.05).Conclusion Usnic acid and tannic acid induce apoptosis in coccidia and sporozoites by lowering the mitochondrial membrane potential.Both usnic acid alone and in combination with tannic acid alleviate NE-induced adverse effects in broilers by modulating intestinal immunity,altering the microbial composition,and improving intestinal barrier function.Compared with usnic acid alone,the combination of usnic acid and tannic acid had superior effects,providing a promising basis for the development of effective feed additive combinations.
