Studies have shown that chitosan protects against neurodegenerative diseases. However, the precise mechanism remains poorly understood. In this study, we administered chitosan intragastrically to an MPTP-induced mouse...Studies have shown that chitosan protects against neurodegenerative diseases. However, the precise mechanism remains poorly understood. In this study, we administered chitosan intragastrically to an MPTP-induced mouse model of Parkinson's disease and found that it effectively reduced dopamine neuron injury, neurotransmitter dopamine release, and motor symptoms. These neuroprotective effects of chitosan were related to bacterial metabolites, specifically shortchain fatty acids, and chitosan administration altered intestinal microbial diversity and decreased short-chain fatty acid production in the gut. Furthermore, chitosan effectively reduced damage to the intestinal barrier and the blood–brain barrier. Finally, we demonstrated that chitosan improved intestinal barrier function and alleviated inflammation in both the peripheral nervous system and the central nervous system by reducing acetate levels. Based on these findings, we suggest a molecular mechanism by which chitosan decreases inflammation through reducing acetate levels and repairing the intestinal and blood–brain barriers, thereby alleviating symptoms of Parkinson's disease.展开更多
BACKGROUND The intestinal flora(IF)has been linked to risks of non-communicable diseases,especially various cancers,stroke,and Alzheimer’s disease.However,many uncertainties of these associations during different sta...BACKGROUND The intestinal flora(IF)has been linked to risks of non-communicable diseases,especially various cancers,stroke,and Alzheimer’s disease.However,many uncertainties of these associations during different stages of growth,deve-lopment,and aging still exist.Therefore,further in-depth explorations are warranted.AIM To explore the associations of the human IF with disease risks during different stages of growth,development,and aging to achieve more accurate and con-vincing conclusions.METHODS Cohort,cross-sectional,case-control,and Mendelian randomization studies published in the PubMed and Web of Science databases until December 31,2023 were systematically reviewed to clarify the associations of the IF at the genus level with the risks of various non-communicable diseases,which were grouped in accordance with the 10^(th) revision of the International Classification of Diseases.RESULTS In total,57 studies were included to quantitatively examine the influence of the IF on the risks of 30 non-communicable diseases during different stages of growth,development,and aging.Population studies and Mendelian randomization studies confirmed positive associations of the abundances of Bifidobacterium and Ruminococcus with multiple sclerosis.CONCLUSION These findings contribute to a deeper understanding of the roles of the IF and provide novel evidence for effective strategies for the prevention and treatment of non-communicable diseases.In the future,it will be necessary to explore a greater variety of research techniques to uncover the specific mechanisms by which gut microbiota trigger diseases and conduct in-depth studies on the temporal relationship between microbiota alterations and diseases,so as to clarify the causal relationship more accurately.展开更多
Small intestinal villi are essential for nutrient absorption,and their impairment can lead to malabsorption.Small intestinal villous atrophy(VA)encompasses a heterogeneous group of disorders,including immune-mediated ...Small intestinal villi are essential for nutrient absorption,and their impairment can lead to malabsorption.Small intestinal villous atrophy(VA)encompasses a heterogeneous group of disorders,including immune-mediated conditions(e.g.,celiac disease,autoimmune enteropathy,inborn errors of immunity),lymphoproliferative disorders(e.g.,enteropathy-associated T-cell lymphoma),infectious causes(e.g.,tropical sprue,Whipple’s disease),iatrogenic factors(e.g.,Olmesartanassociated enteropathy,graft-vs-host disease),as well as inflammatory and idiopathic types.These disorders are often rare and challenging to distinguish due to overlapping clinical,serological,endoscopic,and histopathological features.Through a systematic literature search using keywords such as small intestinal VA,malabsorption,and specific enteropathies,this review provides a comprehensive overview of diagnostic clues for VA and malabsorption.We systematically summarize the pathological characteristics of each condition to assist pathologists and clinicians in accurately identifying the underlying etiologies.Current studies still have many limitations and lack broader and deeper investigations into these diseases.Therefore,future research should focus on the development of novel diagnostic tools,predictive models,therapeutic targets,and mechanistic molecular studies to refine both diagnosis and management strategies.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 Intestinal ultrasound(IUS)is a safe and effective way for the diagnosis and surveillance of patients with inflammatory bowel disease(IBD).It allows a noninvasive and reproducible follow-up for patients with...BACKGROUND Intestinal ultrasound(IUS)is a safe and effective way for the diagnosis and surveillance of patients with inflammatory bowel disease(IBD).It allows a noninvasive and reproducible follow-up for patients with IBD.AIM To compare the outcomes of colonoscopy and IUS in diagnosing and monitoring patients with IBD.METHODS A prospective study was conducted over a three-year period(January 2021 to April 2024)comparing endoscopic and IUS findings.A total of 101 patients were included in the study(68 with Crohn’s disease and 33 with ulcerative colitis).All patients underwent both IUS and colonoscopy within a 10-day period.RESULTS The study found a strong correlation between bowel thickening on IUS and inflammatory activity(P=0.004),IUS remission and endoscopic remission(P=0.03),IUS and endoscopic location(P=0.04),as well as IUS and computed tomography scan findings for collection diagnosis(P<0.01).CONCLUSION The study’s findings demonstrated excellent results for using IUS in the diagnosis and follow-up of IBD patients.展开更多
BACKGROUND Intestinal ultrasound(IUS)has gained prominence as a safe,non-invasive imaging technique for managing Crohn’s disease(CD),offering real-time evaluation without radiation exposure.AIM To systematically revi...BACKGROUND Intestinal ultrasound(IUS)has gained prominence as a safe,non-invasive imaging technique for managing Crohn’s disease(CD),offering real-time evaluation without radiation exposure.AIM To systematically review the role of IUS in diagnosing,monitoring disease pro-gression,assessing treatment response,and managing complications in CD.METHODS A literature search of PubMed and Embase databases was conducted,identifying 207 original research articles published between 1953 and June 2024.The review focused on diagnostic accuracy,disease monitoring,therapeutic utility,and adva-ncements in IUS applications.RESULTS IUS has shown high diagnostic accuracy for detecting inflammation,particularly in the ileum and colon,with limitations in jejunal and rectal regions.It is effective in assessing disease activity using parameters like bowel wall thickness(BWT)and vascularity and correlates well with endoscopy and magnetic resonance ente-rography.IUS can predict early response to biologics,with reductions in BWT serving as an important marker.In known CD,IUS influences clinical decisions during remission,flares,and therapy evaluations.It reliably detects strictures,fistulas,and therapy-related complications.Small intestinal contrast ultrasound(SICUS)can improve the detection of strictures particularly proximal ones.Tech-niques such as CE-IUS and elastography enhance stricture characterization but require further validation.IUS is also useful in special scenarios like perianal fistulas,pregnancy,post-operative CD,and guiding endoscopic therapy.CONCLUSION IUS is a patient-friendly,cost-effective imaging tool that significantly impacts CD management across various stages.Its integration into clinical practice supports early diagnosis,disease monitoring,and therapeutic adjust-ments.Further studies are warranted to refine advanced techniques and standardize its application for broader use.展开更多
BACKGROUND Postoperative recurrence is common in Crohn’s disease(CD),with endoscopic lesions in a majority of patients by 12 months after surgery.Ileocolonoscopy is the reference standard but is invasive and poorly s...BACKGROUND Postoperative recurrence is common in Crohn’s disease(CD),with endoscopic lesions in a majority of patients by 12 months after surgery.Ileocolonoscopy is the reference standard but is invasive and poorly suited to frequent surveillance.Intestinal ultrasound(IUS)-including small intestine contrast ultrasound and contrast enhanced ultrasound-is a repeatable,noninvasive alternative.AIM To summarize the evidence on the diagnostic accuracy and prognostic value of IUS for detecting postoperative recurrence in CD.METHODS We systematically searched PubMed and EMBASE through June 2025 for original English-language studies evaluating IUS against clinical or endoscopic outcomes in postoperative CD.This scoping review was conducted and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guideline.After screening 259 unique records,41 full texts were assessed and 20 studies were included.RESULTS Bowel wall thickness thresholds of≥5 mm at the neo-terminal ileum predict endoscopic recurrence with sensitivities 81%-94%and specificities 86%-100%;lower cutoffs at the anastomosis(≥3-3.5 mm)also carry risk(data from singlecenter cohorts).Dualsite assessment(neo-terminal ileum+ileocolonic anastomosis)improves performance.Adding Doppler hyperemia or mesenteric lymphadenopathy increases accuracy;combining bowel wall thickness≥3 mm with fecal calprotectin≥50μg/g yields high specificity(approximately 93%-100%)with a negative predictive value of nearly 95%when both are negative.Contrast enhanced ultrasound-based composite scores reach approximately 98%diagnostic accuracy in prospective cohorts.Small intestine contrast ultrasound shows similarly strong early diagnostic performance-for example,an area under the receiver operating characteristic curve up to 0.95 when using ileocolonic anastomosis wall thickness≥3 mm to 3.5 mm plus lesion length,with 82%-94%sensitivity and>90%specificity reported even within 7 days postresection.Overall,IUS shows moderate agreement with endoscopy(κapproximately 0.5-0.8)and stronger prognostic value when performed within 12 months post-surgery.CONCLUSION IUS can be integrated into postoperative surveillance algorithms-particularly within the first year-and can reduce routine endoscopy in selected patients.Research priorities include standardized thresholds and composite scoring,consensus training/competency,and multicenter validation including artificial intelligenceassisted interpretation.展开更多
Objectives:A common side effect of inflammatory bowel disease(IBD)is intestinal fibrosis,which frequently leads to intestinal blockage and stricture formation.Although Thalidomide(THD)has shown anti-fibrotic benefits ...Objectives:A common side effect of inflammatory bowel disease(IBD)is intestinal fibrosis,which frequently leads to intestinal blockage and stricture formation.Although Thalidomide(THD)has shown anti-fibrotic benefits in hepatic and renal models,little is known about how it affects intestinal fibrosis and the underlying processes.The present research examines the molecular targets of THD and its potential as a treatment for intestinal fibrosis brought on by colitis.Methods:Clinical samples from Crohn’s disease(CD)patients with intestinal strictures treated with infliximab(IFX)and THD combined with IFX were collected.Dextran sulfate sodium(DSS)was used to develop a mouse model of intestinal fibrosis in C57BL/6 mice.Anti-tumor necrosis factor-alpha(Anti-TNFα),THD,or a combination of the two were administered to the mice.Body weight,colon length,histology,and disease activity index were used to evaluate the disease’s severity.In vitro,THD was tested on colonic fibroblast lines(CCD-18Co and MPF)to assess its effects on cell proliferation,motility,and transdifferentiation.To examine changes in gene expression and signaling pathway modifications,namely in the phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin(PI3K/AKT/mTOR)pathway,RNA sequencing,qRT-PCR,and Western blotting were carried out.Results:In DSS-induced colitis,THD therapy lowered fibrosis,as seen by downregulated fibrotic markers(α-smooth muscle actin(α-SMA),collagen I,and collagen III)and decreased collagen deposition.Mechanistically,THD prevented fibroblasts from transdifferentiating and decreased their vitality.Furthermore,THD inhitited the PI3K/AKT/mTOR pathway in vivo and in vitro.Conclusion:THD inhibits the PI3K/AKT/mTOR signaling cascade and suppresses colonic fibroblast transdifferentiation,which protects against DSS-induced colitis-associated fibrosis,especially when combined with anti-TNFαtherapy.展开更多
BACKGROUND Inflammatory bowel disease(IBD)is a group of chronic,inflammatory disorders that include Crohn’s disease and ulcerative colitis.IBD arises from the interaction of various environmental and genetic factors....BACKGROUND Inflammatory bowel disease(IBD)is a group of chronic,inflammatory disorders that include Crohn’s disease and ulcerative colitis.IBD arises from the interaction of various environmental and genetic factors.Altered gut permeability and mitochondrial stress in the colonic mucosa are two mechanisms previously implicated in IBD pathogenesis.We have previously demonstrated activation of the mitochondrial unfolded protein response(UPRmt)in the colonic mucosa of IBD patients and linked this activation to pro-inflammatory signaling.Growth differentiation factor 15(GDF15)is an important downstream mediator of the UPRmt.AIM To investigate whether GDF15 has a role in IBD and how GDF15 impacts colonic epithelium.METHODS Circulating levels of GDF15 were assessed in plasma samples from IBD patients and healthy controls using an enzyme-linked immunosorbent assay.To study the effects of GDF15 on the colonic mucosa,we employed two different in vitro culture models:Colonic organoids and T84 cells.RESULTS We found that circulating GDF15 Levels were elevated in IBD patients and correlated with markers of inflammation(C-reactive protein)and intestinal permeability[haptoglobin and lipopolysaccharide-binding protein(LBP)].Additionally,we demonstrated that GDF15 alters the intestinal barrier and increases permeability by decreasing the levels of zonula occludens 1 and claudin 1,critical components of tight junctions.Thus,our findings confirm previous reports of increased circulating GDF15 levels in IBD patients and the activation of UPR^(mt).CONCLUSION In the present study,we describe a novel mechanism in IBD pathophysiology,linking mitochondrial stress to the disruption of the intestinal barrier and increased intestinal permeability.展开更多
Inflammatory bowel disease(IBD),consisting primarily of ulcerative colitis and Crohn’s disease,is a chronic,relapsing inflammatory disorder of the gastrointestinal tract.The pathogenesis of IBD has been thoroughly st...Inflammatory bowel disease(IBD),consisting primarily of ulcerative colitis and Crohn’s disease,is a chronic,relapsing inflammatory disorder of the gastrointestinal tract.The pathogenesis of IBD has been thoroughly studied throughout the past few decades,such as defective gut epithelial barrier,immune responses,genetic predisposition,infections,and dysbiosis.Recent studies have revealed the unexpected importance of intestinal stem cells(ISCs)in the pathophysiology of IBD.The rapid recovery and continuous self-renewal of intestinal epithelial cells depend on ISCs within the crypts.Proliferation and differentiation of ISCs is an important cytological basis for repairing damaged intestinal mucosa.Unfortunately,as a new therapeutic goal in IBD,mucosal healing is difficult to achieve with current treatments.Stem cell therapy is an emerging treatment for IBD that allows mucosal healing by rebuilding the mucosal barrier.In this review,we present the current research progress on the role of ISCs in IBD and discuss stem cell-based therapies that have been specifically designed for its treatment.展开更多
BACKGROUND In the biologic era,postoperative recurrence(POR)of Crohn’s disease(CD)remains a significant concern.The underlying cause of this phenomenon remains unclear at present.AIM To examine whether intestinal fib...BACKGROUND In the biologic era,postoperative recurrence(POR)of Crohn’s disease(CD)remains a significant concern.The underlying cause of this phenomenon remains unclear at present.AIM To examine whether intestinal fibrosis increases the likelihood of POR when antitumor necrosis factor biologics are used following ileocecal resection(ICR).METHODS We performed a single-centre,retrospective cohort study of patients with CD who underwent ICR.Recurrence was defined by endoscopy(Rutgeerts score≥i2),radiography(active inflammation in the neoterminal ileum)or surgery(another resection>3 months post-ICR),and patients were categorised by the presence of intestinal fibrosis on histopathological evaluation.RESULTS Among 102 patients with CD who underwent ICR and received infliximab within 3 months,69(67.6%)had intestinal fibrosis.In addition,60 patients(58.8%)experienced POR in various forms:52.6%,41.2%,and 10.8%had endoscopic,radiographic,and surgical recurrence,respectively.Patients with intestinal fibrosis experienced faster radiographic recurrence(log rank P=0.03).After adjusting for risk factors associated with POR,intestinal fibrosis increased the risk of early radiographic recurrence(adjusted hazard ratio=4;95%confidence interval:1.03-15.56;P=0.045).CONCLUSION Despite the limited sample size,our study revealed a strong correlation between radiographic POR and intestinal fibrosis in patients who received postoperative anti-tumor necrosis factorαprophylaxis.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
The molecular mechanisms by which the autonomic nervous system regulates immune cell function have become a popular research topic.The discovery that vagus nerve stimulation(VNS)alleviates endotoxemia has laid an impo...The molecular mechanisms by which the autonomic nervous system regulates immune cell function have become a popular research topic.The discovery that vagus nerve stimulation(VNS)alleviates endotoxemia has laid an important foundation for further study of the neuroimmune system.This review focuses on the latest insights related to intestinal neurons and macrophages(Mφs)and outlines the mechanisms underlying cholinergic control of inflammation and key electrophysiological VNS approaches for the treatment of inflammatory bowel disease(IBD).Mφs are the most important antigen-presenting cells in the human body and exist in various forms.In the gut,Mφs can maintain the intestinal balance by engulfing and digesting microorganisms.However,macrophage overactivation results in the production of excessive inflammatory mediators,which can damage the intestinal mucosa and induce an inflammatory response,leading to IBD.The role of cholinergic anti-inflammatory mechanisms in immune-mediated IBD have attracted substantial attention.Mφs are a special type of phagocytes that play a crucial role in maintaining intestinal homeostasis and movement.In the intestinal tract,Mφis classified into different subgroups based on its position in the parietal layer and is closely related to the microenvironment.展开更多
Metabolic dysfunction-associated steatotic liver disease is a multifaceted disease associated with obesity,insulin resistance(IR),type 2 diabetes mellitus-in a word,metabolic syndrome-which has been extensively studie...Metabolic dysfunction-associated steatotic liver disease is a multifaceted disease associated with obesity,insulin resistance(IR),type 2 diabetes mellitus-in a word,metabolic syndrome-which has been extensively studied because it is related to an alteration of the normal metabolism of glucose and lipids,ultimately leading to triglyceride accumulation within hepatocytes.This lipid overload triggers an inflammatory status,also influenced by gut-liver axis dysfunction,with gut dysbiosis,which alters intestinal permeability,causing inflammation and IR in a vicious circle.Several approaches have been attempted to treat this condition and stop its poss-ible evolution towards increasingly serious stages,but the first step is always lifestyle modification.The Mediterranean diet seems to be the most reliable for affecting liver steatosis,probably thanks to extra virgin olive oil,a healthy food with a high content of monounsaturated fatty acids and variable concentrations of phenols(oleocanthal)and phenolic alcohols,such as hydroxytyrosol and tyrosol.This review investigates the mechanisms underlying the bidirectional and synergistic relationships among metabolic dysfunction-associated steatotic liver disease,IR,and the gut-liver axis,specifically focusing on the role of extra virgin olive oil as one of the main antioxidant components of the Mediterranean diet.展开更多
AIM: To compare the roles of capsule endoscopy(CE)and double-balloon enteroscopy(DBE) in the diagnosis of obscure small bowel diseases.METHODS: From June 2009 to December 2014, 88 patients were included in this study;...AIM: To compare the roles of capsule endoscopy(CE)and double-balloon enteroscopy(DBE) in the diagnosis of obscure small bowel diseases.METHODS: From June 2009 to December 2014, 88 patients were included in this study; the patients had undergone gastroscopy, colonoscopy, radiological small intestinal barium meal, abdominal computed tomography or magnetic resonance imaging scan and mesenteric angiography, but their diagnoses were still unclear. The patients with gastrointestinal obstructions,fistulas, strictures, or cardiac pacemakers, as well as pregnant women, and individuals who could not accept the capsule-retention or capsule-removal surgery were excluded. Patients with heart, lung and other vital organ failure diseases were also excluded. Everyone involved in this study had undergone CE and DBE. The results were divided into:(1) the definite diagnosis(the diagnosis was confirmed at least by one of the biopsy,surgery, pathology or the drug treatment effects with follow-up for at least 3 mo);(2) the possible diagnosis(a possible diagnosis was suggested by CE or DBE,but not confirmed by the biopsy, surgery or follow-up drug treatment effects); and(3) the unclear diagnosis(no exact causes were provided by CE and DBE for the disease). The detection rate and the diagnostic yield of the two methods were compared. The differencein the etiologies between CE and DBE was estimated,and the different possible etiologies caused by the age groups were also investigated.RESULTS: CE exhibited a better trend than DBE for diagnosing scattered small ulcers(P = 0.242, Fisher's test), and small vascular malformations(χ 2 = 1.810,P = 0.179, Pearson χ 2 test), but with no significant differences, possible due to few cases. However,DBE was better than CE for larger tumors(P =0.018, Fisher's test) and for diverticular lesions with bleeding ulcers(P = 0.005, Fisher's test). All three hemangioma cases diagnosed by DBE in this study(including sponge hemangioma, venous hemangioma,and hemangioma with hamartoma lesions) were all confirmed by biopsy. Two parasite cases were found by CE, but were negative by DBE. This study revealed no obvious differences in the detection rates(DR) of CE(60.0%, 53/88) and DBE(59.1%, 52/88). However,the etiological diagnostic yield(DY) difference was apparent. The CE diagnostic yield was 42.0%(37/88),and the DBE diagnostic yield was 51.1%(45/88).Furthermore, there were differences among the age groups(χ 2 = 22.146, P = 0.008, Kruskal Wallis Test). Small intestinal cancer(5/6 cases), vascular malformations(22/29 cases), and active bleeding(3/4cases) appeared more commonly in the patients over50 years old, but diverticula with bleeding ulcers were usually found in the 15-25-year group(4/7cases). The over-25-year group accounted for the stromal tumors(10/12 cases).CONCLUSION: CE and DBE each have their own advantages and disadvantages. The appropriate choice depends on the patient's age, tolerance, and clinical manifestations. Sometimes CE followed by DBE is necessary.展开更多
BACKGROUND： The well-known functions of bile acids（BAs） are the emulsification and absorption of lipophilic xenobiotics. However, the emerging evidences in the past decade showed that BAs act as signaling molecules...BACKGROUND： The well-known functions of bile acids（BAs） are the emulsification and absorption of lipophilic xenobiotics. However, the emerging evidences in the past decade showed that BAs act as signaling molecules that not only autoregulate their own metabolism and enterohepatic recirculation, but also as important regulators of integrative metabolism by activating nuclear and membrane-bound G protein-coupled receptors. The present review was to get insight into the role of maintenance of BA homeostasis and BA signaling pathways in development and management of hepatobiliary and intestinal diseases.DATA SOURCES： Detailed and comprehensive search of PubM ed and Scopus databases was carried out for original and review articles.RESULTS： Disturbances in BA homeostasis contribute to the development of several hepatobiliary and intestinal disorders, such as non-alcoholic fatty liver disease, liver cirrhosis, cholesterol gallstone disease, intestinal diseases and both hepatocellular and colorectal carcinoma.CONCLUSION： Further efforts made in order to advance the understanding of sophisticated BA signaling network may be promising in developing novel therapeutic strategies related not only to hepatobiliary and gastrointestinal but also systemic diseases.展开更多
Inflammatory bowel diseases(IBD),Crohns disease and ulcerative colitis,are chronic conditions associated with high morbidity and healthcare costs.The natural history of IBD is variable and marked by alternating period...Inflammatory bowel diseases(IBD),Crohns disease and ulcerative colitis,are chronic conditions associated with high morbidity and healthcare costs.The natural history of IBD is variable and marked by alternating periods of flare and remission.Even though the use of newer therapeutic targets has been associated with higher rates of mucosal healing,a great proportion of IBD patients remain symptomatic despite effective control of inflammation.These symptoms may include but not limited to abdominal pain,dyspepsia,diarrhea,urgency,fecal incontinence,constipation or bloating.In this setting,commonly there is an overlap with gastrointestinal(GI)motility and absorptive disorders.Early recognition of these conditions greatly improves patient care and may decrease the risk of mistreatment.Therefore,in this review we describe the prevalence,diagnosis and treatment of GI motility and absorptive disorders that commonly affect patients with IBD.展开更多
The pathogenesis of inflammatory bowel diseases (IBDs) seems to involve a primary defect in one or more of the elements responsible for the maintenance of intestinal homeostasis and oral tolerance. The most important ...The pathogenesis of inflammatory bowel diseases (IBDs) seems to involve a primary defect in one or more of the elements responsible for the maintenance of intestinal homeostasis and oral tolerance. The most important element is represented by the intestinal barrier, a complex system formed mostly by intestinal epithelial cells (IECs). IECs have an active role in producing mucus and regulating its composition; they provide a physical barrier capable of controlling antigen traff ic through the intestinal mucosa. At the same time, they are able to play the role of non-professional antigen presenting cells, by processing and presenting antigens directly to the cells of the intestinal immune system. On the other hand, immune cells regulate epithelial growth and differentiation, producing a continuous bi-directional cross-talk within the barrier. Several alterations of the barrier function have been identif ied in IBD, starting from mucus features up to its components, from epithelial junctions up to the Toll-like receptors, and altered immune responses. It remains to be understood whether these defects are primary causes of epithelial damage or secondary effects. We review the possible role of the epithelial barrier and particularly describe the role of IECs in the pathogenesis of IBD.展开更多
Helicobacter pylori(H.pylori)infection causes changes to the intestinal flora,such as small intestinal bacterial overgrowth,and increases gastric acid secretionstimulating gastrointestinal hormones,mainly gastrin,due ...Helicobacter pylori(H.pylori)infection causes changes to the intestinal flora,such as small intestinal bacterial overgrowth,and increases gastric acid secretionstimulating gastrointestinal hormones,mainly gastrin,due to a decrease in gastric acid caused by atrophic gastritis.In addition,the cellular components of H.pylori travel through the intestinal tract,so the bacterial infection affects the immune system.Therefore,the effects of H.pylori infection are observed not only in the stomach and the proximal duodenum but also in the small and large intestines.In particular,meta-analyses reported that H.pylori-infected individuals had an increased risk of colorectal adenoma and colorectal cancer.Moreover,a recent study reported that the risk of developing colorectal cancer was increased in subjects carrying H.pylori vacuolating cytotoxin A antibody.In addition,it has been reported that H.pylori infection exacerbates the symptoms of Fabry’s disease and familial Mediterranean fever attack and is involved in irritable bowel syndrome and small intestinal ulcers.On the other hand,some studies have reported that the frequency of ulcerative colitis,Crohn’s disease,and celiac disease is low in H.pylori-infected individuals.Thus,H.pylori infection is considered to have various effects on the small and large intestines.However,few studies have reported on these issues,and the details of their effects have not been well elucidated.Therefore,additional studies are needed.展开更多
Along with the rapid development of society, lifestyles and diets have gradually changed. Due to overwhelming material abundance, high fat, high sugar and high protein diets are common. Numerous studies have determine...Along with the rapid development of society, lifestyles and diets have gradually changed. Due to overwhelming material abundance, high fat, high sugar and high protein diets are common. Numerous studies have determined that diet and its impact on gut microbiota are closely related to obesity and metabolic diseases. Different dietary components affect gut microbiota, thus impacting gastrointestinal disease occurrence and development. A large number of related studies are progressing rapidly. Gut microbiota may be an important intermediate link, causing gastrointestinal diseases under the influence of changes in diet and genetic predisposition. To promote healthy gut microbiota and to prevent and cure gastrointestinal diseases, diets should be improved and supplemented with probiotics.展开更多
基金supported by the National Natural Science Foundation of China,Nos. 32260196 (to JY), 81860646 (to ZY) and 31860274 (to JY)a grant from Yunnan Department of Science and Technology,Nos. 202101AT070251 (to JY), 202201AS070084 (to ZY), 202301AY070001-239 (to JY), 202101AZ070001-012, and 2019FI016 (to ZY)。
文摘Studies have shown that chitosan protects against neurodegenerative diseases. However, the precise mechanism remains poorly understood. In this study, we administered chitosan intragastrically to an MPTP-induced mouse model of Parkinson's disease and found that it effectively reduced dopamine neuron injury, neurotransmitter dopamine release, and motor symptoms. These neuroprotective effects of chitosan were related to bacterial metabolites, specifically shortchain fatty acids, and chitosan administration altered intestinal microbial diversity and decreased short-chain fatty acid production in the gut. Furthermore, chitosan effectively reduced damage to the intestinal barrier and the blood–brain barrier. Finally, we demonstrated that chitosan improved intestinal barrier function and alleviated inflammation in both the peripheral nervous system and the central nervous system by reducing acetate levels. Based on these findings, we suggest a molecular mechanism by which chitosan decreases inflammation through reducing acetate levels and repairing the intestinal and blood–brain barriers, thereby alleviating symptoms of Parkinson's disease.
基金Supported by National Natural Science Foundation of China,No.81903398the Research Start-Up Fund for the Introduction of Talents of Sichuan University,No.YJ2021112+4 种基金Medical Youth Innovation Research Project of Sichuan Province,No.Q21016Natural Science Foundation of Sichuan,No.2023NSFSC1927“From 0 to 1”Innovation Project,Sichuan University,No.2023SCUH0026Sichuan Provincial Science and Technology Department 2023 Central Guide Local Project,No.2023ZYD0097Cigar Fermentation Technology Key Laboratory of Tobacco Industry,No.20202309BC530.
文摘BACKGROUND The intestinal flora(IF)has been linked to risks of non-communicable diseases,especially various cancers,stroke,and Alzheimer’s disease.However,many uncertainties of these associations during different stages of growth,deve-lopment,and aging still exist.Therefore,further in-depth explorations are warranted.AIM To explore the associations of the human IF with disease risks during different stages of growth,development,and aging to achieve more accurate and con-vincing conclusions.METHODS Cohort,cross-sectional,case-control,and Mendelian randomization studies published in the PubMed and Web of Science databases until December 31,2023 were systematically reviewed to clarify the associations of the IF at the genus level with the risks of various non-communicable diseases,which were grouped in accordance with the 10^(th) revision of the International Classification of Diseases.RESULTS In total,57 studies were included to quantitatively examine the influence of the IF on the risks of 30 non-communicable diseases during different stages of growth,development,and aging.Population studies and Mendelian randomization studies confirmed positive associations of the abundances of Bifidobacterium and Ruminococcus with multiple sclerosis.CONCLUSION These findings contribute to a deeper understanding of the roles of the IF and provide novel evidence for effective strategies for the prevention and treatment of non-communicable diseases.In the future,it will be necessary to explore a greater variety of research techniques to uncover the specific mechanisms by which gut microbiota trigger diseases and conduct in-depth studies on the temporal relationship between microbiota alterations and diseases,so as to clarify the causal relationship more accurately.
基金Supported by National High-Level Hospital Clinical Research Funding,No.2022-PUMCH-B-022,and No.2022-PUMCH-D-002CAMS Innovation Fund for Medical Sciences,No.CIFMS 2021-1-I2M-003Undergraduate Innovation Program,No.2024dcxm025.
文摘Small intestinal villi are essential for nutrient absorption,and their impairment can lead to malabsorption.Small intestinal villous atrophy(VA)encompasses a heterogeneous group of disorders,including immune-mediated conditions(e.g.,celiac disease,autoimmune enteropathy,inborn errors of immunity),lymphoproliferative disorders(e.g.,enteropathy-associated T-cell lymphoma),infectious causes(e.g.,tropical sprue,Whipple’s disease),iatrogenic factors(e.g.,Olmesartanassociated enteropathy,graft-vs-host disease),as well as inflammatory and idiopathic types.These disorders are often rare and challenging to distinguish due to overlapping clinical,serological,endoscopic,and histopathological features.Through a systematic literature search using keywords such as small intestinal VA,malabsorption,and specific enteropathies,this review provides a comprehensive overview of diagnostic clues for VA and malabsorption.We systematically summarize the pathological characteristics of each condition to assist pathologists and clinicians in accurately identifying the underlying etiologies.Current studies still have many limitations and lack broader and deeper investigations into these diseases.Therefore,future research should focus on the development of novel diagnostic tools,predictive models,therapeutic targets,and mechanistic molecular studies to refine both diagnosis and management strategies.
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 Intestinal ultrasound(IUS)is a safe and effective way for the diagnosis and surveillance of patients with inflammatory bowel disease(IBD).It allows a noninvasive and reproducible follow-up for patients with IBD.AIM To compare the outcomes of colonoscopy and IUS in diagnosing and monitoring patients with IBD.METHODS A prospective study was conducted over a three-year period(January 2021 to April 2024)comparing endoscopic and IUS findings.A total of 101 patients were included in the study(68 with Crohn’s disease and 33 with ulcerative colitis).All patients underwent both IUS and colonoscopy within a 10-day period.RESULTS The study found a strong correlation between bowel thickening on IUS and inflammatory activity(P=0.004),IUS remission and endoscopic remission(P=0.03),IUS and endoscopic location(P=0.04),as well as IUS and computed tomography scan findings for collection diagnosis(P<0.01).CONCLUSION The study’s findings demonstrated excellent results for using IUS in the diagnosis and follow-up of IBD patients.
文摘BACKGROUND Intestinal ultrasound(IUS)has gained prominence as a safe,non-invasive imaging technique for managing Crohn’s disease(CD),offering real-time evaluation without radiation exposure.AIM To systematically review the role of IUS in diagnosing,monitoring disease pro-gression,assessing treatment response,and managing complications in CD.METHODS A literature search of PubMed and Embase databases was conducted,identifying 207 original research articles published between 1953 and June 2024.The review focused on diagnostic accuracy,disease monitoring,therapeutic utility,and adva-ncements in IUS applications.RESULTS IUS has shown high diagnostic accuracy for detecting inflammation,particularly in the ileum and colon,with limitations in jejunal and rectal regions.It is effective in assessing disease activity using parameters like bowel wall thickness(BWT)and vascularity and correlates well with endoscopy and magnetic resonance ente-rography.IUS can predict early response to biologics,with reductions in BWT serving as an important marker.In known CD,IUS influences clinical decisions during remission,flares,and therapy evaluations.It reliably detects strictures,fistulas,and therapy-related complications.Small intestinal contrast ultrasound(SICUS)can improve the detection of strictures particularly proximal ones.Tech-niques such as CE-IUS and elastography enhance stricture characterization but require further validation.IUS is also useful in special scenarios like perianal fistulas,pregnancy,post-operative CD,and guiding endoscopic therapy.CONCLUSION IUS is a patient-friendly,cost-effective imaging tool that significantly impacts CD management across various stages.Its integration into clinical practice supports early diagnosis,disease monitoring,and therapeutic adjust-ments.Further studies are warranted to refine advanced techniques and standardize its application for broader use.
文摘BACKGROUND Postoperative recurrence is common in Crohn’s disease(CD),with endoscopic lesions in a majority of patients by 12 months after surgery.Ileocolonoscopy is the reference standard but is invasive and poorly suited to frequent surveillance.Intestinal ultrasound(IUS)-including small intestine contrast ultrasound and contrast enhanced ultrasound-is a repeatable,noninvasive alternative.AIM To summarize the evidence on the diagnostic accuracy and prognostic value of IUS for detecting postoperative recurrence in CD.METHODS We systematically searched PubMed and EMBASE through June 2025 for original English-language studies evaluating IUS against clinical or endoscopic outcomes in postoperative CD.This scoping review was conducted and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guideline.After screening 259 unique records,41 full texts were assessed and 20 studies were included.RESULTS Bowel wall thickness thresholds of≥5 mm at the neo-terminal ileum predict endoscopic recurrence with sensitivities 81%-94%and specificities 86%-100%;lower cutoffs at the anastomosis(≥3-3.5 mm)also carry risk(data from singlecenter cohorts).Dualsite assessment(neo-terminal ileum+ileocolonic anastomosis)improves performance.Adding Doppler hyperemia or mesenteric lymphadenopathy increases accuracy;combining bowel wall thickness≥3 mm with fecal calprotectin≥50μg/g yields high specificity(approximately 93%-100%)with a negative predictive value of nearly 95%when both are negative.Contrast enhanced ultrasound-based composite scores reach approximately 98%diagnostic accuracy in prospective cohorts.Small intestine contrast ultrasound shows similarly strong early diagnostic performance-for example,an area under the receiver operating characteristic curve up to 0.95 when using ileocolonic anastomosis wall thickness≥3 mm to 3.5 mm plus lesion length,with 82%-94%sensitivity and>90%specificity reported even within 7 days postresection.Overall,IUS shows moderate agreement with endoscopy(κapproximately 0.5-0.8)and stronger prognostic value when performed within 12 months post-surgery.CONCLUSION IUS can be integrated into postoperative surveillance algorithms-particularly within the first year-and can reduce routine endoscopy in selected patients.Research priorities include standardized thresholds and composite scoring,consensus training/competency,and multicenter validation including artificial intelligenceassisted interpretation.
文摘Objectives:A common side effect of inflammatory bowel disease(IBD)is intestinal fibrosis,which frequently leads to intestinal blockage and stricture formation.Although Thalidomide(THD)has shown anti-fibrotic benefits in hepatic and renal models,little is known about how it affects intestinal fibrosis and the underlying processes.The present research examines the molecular targets of THD and its potential as a treatment for intestinal fibrosis brought on by colitis.Methods:Clinical samples from Crohn’s disease(CD)patients with intestinal strictures treated with infliximab(IFX)and THD combined with IFX were collected.Dextran sulfate sodium(DSS)was used to develop a mouse model of intestinal fibrosis in C57BL/6 mice.Anti-tumor necrosis factor-alpha(Anti-TNFα),THD,or a combination of the two were administered to the mice.Body weight,colon length,histology,and disease activity index were used to evaluate the disease’s severity.In vitro,THD was tested on colonic fibroblast lines(CCD-18Co and MPF)to assess its effects on cell proliferation,motility,and transdifferentiation.To examine changes in gene expression and signaling pathway modifications,namely in the phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin(PI3K/AKT/mTOR)pathway,RNA sequencing,qRT-PCR,and Western blotting were carried out.Results:In DSS-induced colitis,THD therapy lowered fibrosis,as seen by downregulated fibrotic markers(α-smooth muscle actin(α-SMA),collagen I,and collagen III)and decreased collagen deposition.Mechanistically,THD prevented fibroblasts from transdifferentiating and decreased their vitality.Furthermore,THD inhitited the PI3K/AKT/mTOR pathway in vivo and in vitro.Conclusion:THD inhibits the PI3K/AKT/mTOR signaling cascade and suppresses colonic fibroblast transdifferentiation,which protects against DSS-induced colitis-associated fibrosis,especially when combined with anti-TNFαtherapy.
基金Supported by the Ministerio de Ciencia,Innovación y Universidades(Spain),No.IJCI-2017-31466the Consejería de Salud y Familia de la Junta de Andalucía,Spain,No.PI-0244-2021+12 种基金No.PI-0245-2021No.PI-0131-2020FEDER funds/Consejería de Economía y Conocimiento,Empresas y Universidad,de la Junta de Andalucía(“A way to make Europe”)(“Andalucía se mueve con Europa”,University of Málaga,No.UMA20-FEDERJA-081No.UMA20-FEDERJA-074the Consejería de Empleo,Empresa y Trabajo Autónomo de la Junta de Andalucía(Investigo program),No.MA-INV-0031-2022-04Sara Borrell grant from the Instituto de Salud Carlos III(ISCIII),No.CD23/00117PFIS contract from the ISCIII,No.FI23-00016Juan Rodés contract from the ISCIII,No.JR22/00067the Miguel Servet program from the ISCIII,No.CP23/00088the Nicolas Monardes Program from the Consejería de Salud de la Junta de Andalucía(Spain),No.RC-0005-2020the Consejería Salud y Familias-Junta de Andalucía,No.RH-0078-2021the University of Málaga(Incorporación de Doctores del II Plan Propio de Investigación,Transferencia y Divulgación Científica de la Universidad de Málaga en 2023)the Miguel Servet program from ISCIII,Spain,No.CP22/00050.
文摘BACKGROUND Inflammatory bowel disease(IBD)is a group of chronic,inflammatory disorders that include Crohn’s disease and ulcerative colitis.IBD arises from the interaction of various environmental and genetic factors.Altered gut permeability and mitochondrial stress in the colonic mucosa are two mechanisms previously implicated in IBD pathogenesis.We have previously demonstrated activation of the mitochondrial unfolded protein response(UPRmt)in the colonic mucosa of IBD patients and linked this activation to pro-inflammatory signaling.Growth differentiation factor 15(GDF15)is an important downstream mediator of the UPRmt.AIM To investigate whether GDF15 has a role in IBD and how GDF15 impacts colonic epithelium.METHODS Circulating levels of GDF15 were assessed in plasma samples from IBD patients and healthy controls using an enzyme-linked immunosorbent assay.To study the effects of GDF15 on the colonic mucosa,we employed two different in vitro culture models:Colonic organoids and T84 cells.RESULTS We found that circulating GDF15 Levels were elevated in IBD patients and correlated with markers of inflammation(C-reactive protein)and intestinal permeability[haptoglobin and lipopolysaccharide-binding protein(LBP)].Additionally,we demonstrated that GDF15 alters the intestinal barrier and increases permeability by decreasing the levels of zonula occludens 1 and claudin 1,critical components of tight junctions.Thus,our findings confirm previous reports of increased circulating GDF15 levels in IBD patients and the activation of UPR^(mt).CONCLUSION In the present study,we describe a novel mechanism in IBD pathophysiology,linking mitochondrial stress to the disruption of the intestinal barrier and increased intestinal permeability.
文摘Inflammatory bowel disease(IBD),consisting primarily of ulcerative colitis and Crohn’s disease,is a chronic,relapsing inflammatory disorder of the gastrointestinal tract.The pathogenesis of IBD has been thoroughly studied throughout the past few decades,such as defective gut epithelial barrier,immune responses,genetic predisposition,infections,and dysbiosis.Recent studies have revealed the unexpected importance of intestinal stem cells(ISCs)in the pathophysiology of IBD.The rapid recovery and continuous self-renewal of intestinal epithelial cells depend on ISCs within the crypts.Proliferation and differentiation of ISCs is an important cytological basis for repairing damaged intestinal mucosa.Unfortunately,as a new therapeutic goal in IBD,mucosal healing is difficult to achieve with current treatments.Stem cell therapy is an emerging treatment for IBD that allows mucosal healing by rebuilding the mucosal barrier.In this review,we present the current research progress on the role of ISCs in IBD and discuss stem cell-based therapies that have been specifically designed for its treatment.
基金Supported by the National Natural Science Foundation of China,No.82200621the Original Research Projects,Shanghai Ninth People’s Hospital,No.2022LHA08 and No.YBKB202220.
文摘BACKGROUND In the biologic era,postoperative recurrence(POR)of Crohn’s disease(CD)remains a significant concern.The underlying cause of this phenomenon remains unclear at present.AIM To examine whether intestinal fibrosis increases the likelihood of POR when antitumor necrosis factor biologics are used following ileocecal resection(ICR).METHODS We performed a single-centre,retrospective cohort study of patients with CD who underwent ICR.Recurrence was defined by endoscopy(Rutgeerts score≥i2),radiography(active inflammation in the neoterminal ileum)or surgery(another resection>3 months post-ICR),and patients were categorised by the presence of intestinal fibrosis on histopathological evaluation.RESULTS Among 102 patients with CD who underwent ICR and received infliximab within 3 months,69(67.6%)had intestinal fibrosis.In addition,60 patients(58.8%)experienced POR in various forms:52.6%,41.2%,and 10.8%had endoscopic,radiographic,and surgical recurrence,respectively.Patients with intestinal fibrosis experienced faster radiographic recurrence(log rank P=0.03).After adjusting for risk factors associated with POR,intestinal fibrosis increased the risk of early radiographic recurrence(adjusted hazard ratio=4;95%confidence interval:1.03-15.56;P=0.045).CONCLUSION Despite the limited sample size,our study revealed a strong correlation between radiographic POR and intestinal fibrosis in patients who received postoperative anti-tumor necrosis factorαprophylaxis.
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.82574996Xi’an Science and Technology Plan Project,No.23YXYJ0162+4 种基金Shaanxi Province Traditional Chinese Medicine Research and Innovation Talent Plan Project,No.TZKN-CXRC-16Project of Shaanxi Administration of Traditional Chinese Medicine,No.SZY-KJCYC-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 for the Year 2025,No.2025-04the Fifth Batch of Outstanding Clinical Talents in Traditional Chinese Medicine Project of Shaanxi Province,Shaanxi Traditional Chinese Medicine Letter[2025],No.6.
文摘The molecular mechanisms by which the autonomic nervous system regulates immune cell function have become a popular research topic.The discovery that vagus nerve stimulation(VNS)alleviates endotoxemia has laid an important foundation for further study of the neuroimmune system.This review focuses on the latest insights related to intestinal neurons and macrophages(Mφs)and outlines the mechanisms underlying cholinergic control of inflammation and key electrophysiological VNS approaches for the treatment of inflammatory bowel disease(IBD).Mφs are the most important antigen-presenting cells in the human body and exist in various forms.In the gut,Mφs can maintain the intestinal balance by engulfing and digesting microorganisms.However,macrophage overactivation results in the production of excessive inflammatory mediators,which can damage the intestinal mucosa and induce an inflammatory response,leading to IBD.The role of cholinergic anti-inflammatory mechanisms in immune-mediated IBD have attracted substantial attention.Mφs are a special type of phagocytes that play a crucial role in maintaining intestinal homeostasis and movement.In the intestinal tract,Mφis classified into different subgroups based on its position in the parietal layer and is closely related to the microenvironment.
文摘Metabolic dysfunction-associated steatotic liver disease is a multifaceted disease associated with obesity,insulin resistance(IR),type 2 diabetes mellitus-in a word,metabolic syndrome-which has been extensively studied because it is related to an alteration of the normal metabolism of glucose and lipids,ultimately leading to triglyceride accumulation within hepatocytes.This lipid overload triggers an inflammatory status,also influenced by gut-liver axis dysfunction,with gut dysbiosis,which alters intestinal permeability,causing inflammation and IR in a vicious circle.Several approaches have been attempted to treat this condition and stop its poss-ible evolution towards increasingly serious stages,but the first step is always lifestyle modification.The Mediterranean diet seems to be the most reliable for affecting liver steatosis,probably thanks to extra virgin olive oil,a healthy food with a high content of monounsaturated fatty acids and variable concentrations of phenols(oleocanthal)and phenolic alcohols,such as hydroxytyrosol and tyrosol.This review investigates the mechanisms underlying the bidirectional and synergistic relationships among metabolic dysfunction-associated steatotic liver disease,IR,and the gut-liver axis,specifically focusing on the role of extra virgin olive oil as one of the main antioxidant components of the Mediterranean diet.
文摘AIM: To compare the roles of capsule endoscopy(CE)and double-balloon enteroscopy(DBE) in the diagnosis of obscure small bowel diseases.METHODS: From June 2009 to December 2014, 88 patients were included in this study; the patients had undergone gastroscopy, colonoscopy, radiological small intestinal barium meal, abdominal computed tomography or magnetic resonance imaging scan and mesenteric angiography, but their diagnoses were still unclear. The patients with gastrointestinal obstructions,fistulas, strictures, or cardiac pacemakers, as well as pregnant women, and individuals who could not accept the capsule-retention or capsule-removal surgery were excluded. Patients with heart, lung and other vital organ failure diseases were also excluded. Everyone involved in this study had undergone CE and DBE. The results were divided into:(1) the definite diagnosis(the diagnosis was confirmed at least by one of the biopsy,surgery, pathology or the drug treatment effects with follow-up for at least 3 mo);(2) the possible diagnosis(a possible diagnosis was suggested by CE or DBE,but not confirmed by the biopsy, surgery or follow-up drug treatment effects); and(3) the unclear diagnosis(no exact causes were provided by CE and DBE for the disease). The detection rate and the diagnostic yield of the two methods were compared. The differencein the etiologies between CE and DBE was estimated,and the different possible etiologies caused by the age groups were also investigated.RESULTS: CE exhibited a better trend than DBE for diagnosing scattered small ulcers(P = 0.242, Fisher's test), and small vascular malformations(χ 2 = 1.810,P = 0.179, Pearson χ 2 test), but with no significant differences, possible due to few cases. However,DBE was better than CE for larger tumors(P =0.018, Fisher's test) and for diverticular lesions with bleeding ulcers(P = 0.005, Fisher's test). All three hemangioma cases diagnosed by DBE in this study(including sponge hemangioma, venous hemangioma,and hemangioma with hamartoma lesions) were all confirmed by biopsy. Two parasite cases were found by CE, but were negative by DBE. This study revealed no obvious differences in the detection rates(DR) of CE(60.0%, 53/88) and DBE(59.1%, 52/88). However,the etiological diagnostic yield(DY) difference was apparent. The CE diagnostic yield was 42.0%(37/88),and the DBE diagnostic yield was 51.1%(45/88).Furthermore, there were differences among the age groups(χ 2 = 22.146, P = 0.008, Kruskal Wallis Test). Small intestinal cancer(5/6 cases), vascular malformations(22/29 cases), and active bleeding(3/4cases) appeared more commonly in the patients over50 years old, but diverticula with bleeding ulcers were usually found in the 15-25-year group(4/7cases). The over-25-year group accounted for the stromal tumors(10/12 cases).CONCLUSION: CE and DBE each have their own advantages and disadvantages. The appropriate choice depends on the patient's age, tolerance, and clinical manifestations. Sometimes CE followed by DBE is necessary.
基金supported by a grant from the Ministry of Education,Science and Technological Development,Republic of Serbia(III 41012)
文摘BACKGROUND： The well-known functions of bile acids（BAs） are the emulsification and absorption of lipophilic xenobiotics. However, the emerging evidences in the past decade showed that BAs act as signaling molecules that not only autoregulate their own metabolism and enterohepatic recirculation, but also as important regulators of integrative metabolism by activating nuclear and membrane-bound G protein-coupled receptors. The present review was to get insight into the role of maintenance of BA homeostasis and BA signaling pathways in development and management of hepatobiliary and intestinal diseases.DATA SOURCES： Detailed and comprehensive search of PubM ed and Scopus databases was carried out for original and review articles.RESULTS： Disturbances in BA homeostasis contribute to the development of several hepatobiliary and intestinal disorders, such as non-alcoholic fatty liver disease, liver cirrhosis, cholesterol gallstone disease, intestinal diseases and both hepatocellular and colorectal carcinoma.CONCLUSION： Further efforts made in order to advance the understanding of sophisticated BA signaling network may be promising in developing novel therapeutic strategies related not only to hepatobiliary and gastrointestinal but also systemic diseases.
文摘Inflammatory bowel diseases(IBD),Crohns disease and ulcerative colitis,are chronic conditions associated with high morbidity and healthcare costs.The natural history of IBD is variable and marked by alternating periods of flare and remission.Even though the use of newer therapeutic targets has been associated with higher rates of mucosal healing,a great proportion of IBD patients remain symptomatic despite effective control of inflammation.These symptoms may include but not limited to abdominal pain,dyspepsia,diarrhea,urgency,fecal incontinence,constipation or bloating.In this setting,commonly there is an overlap with gastrointestinal(GI)motility and absorptive disorders.Early recognition of these conditions greatly improves patient care and may decrease the risk of mistreatment.Therefore,in this review we describe the prevalence,diagnosis and treatment of GI motility and absorptive disorders that commonly affect patients with IBD.
文摘The pathogenesis of inflammatory bowel diseases (IBDs) seems to involve a primary defect in one or more of the elements responsible for the maintenance of intestinal homeostasis and oral tolerance. The most important element is represented by the intestinal barrier, a complex system formed mostly by intestinal epithelial cells (IECs). IECs have an active role in producing mucus and regulating its composition; they provide a physical barrier capable of controlling antigen traff ic through the intestinal mucosa. At the same time, they are able to play the role of non-professional antigen presenting cells, by processing and presenting antigens directly to the cells of the intestinal immune system. On the other hand, immune cells regulate epithelial growth and differentiation, producing a continuous bi-directional cross-talk within the barrier. Several alterations of the barrier function have been identif ied in IBD, starting from mucus features up to its components, from epithelial junctions up to the Toll-like receptors, and altered immune responses. It remains to be understood whether these defects are primary causes of epithelial damage or secondary effects. We review the possible role of the epithelial barrier and particularly describe the role of IECs in the pathogenesis of IBD.
文摘Helicobacter pylori(H.pylori)infection causes changes to the intestinal flora,such as small intestinal bacterial overgrowth,and increases gastric acid secretionstimulating gastrointestinal hormones,mainly gastrin,due to a decrease in gastric acid caused by atrophic gastritis.In addition,the cellular components of H.pylori travel through the intestinal tract,so the bacterial infection affects the immune system.Therefore,the effects of H.pylori infection are observed not only in the stomach and the proximal duodenum but also in the small and large intestines.In particular,meta-analyses reported that H.pylori-infected individuals had an increased risk of colorectal adenoma and colorectal cancer.Moreover,a recent study reported that the risk of developing colorectal cancer was increased in subjects carrying H.pylori vacuolating cytotoxin A antibody.In addition,it has been reported that H.pylori infection exacerbates the symptoms of Fabry’s disease and familial Mediterranean fever attack and is involved in irritable bowel syndrome and small intestinal ulcers.On the other hand,some studies have reported that the frequency of ulcerative colitis,Crohn’s disease,and celiac disease is low in H.pylori-infected individuals.Thus,H.pylori infection is considered to have various effects on the small and large intestines.However,few studies have reported on these issues,and the details of their effects have not been well elucidated.Therefore,additional studies are needed.
文摘Along with the rapid development of society, lifestyles and diets have gradually changed. Due to overwhelming material abundance, high fat, high sugar and high protein diets are common. Numerous studies have determined that diet and its impact on gut microbiota are closely related to obesity and metabolic diseases. Different dietary components affect gut microbiota, thus impacting gastrointestinal disease occurrence and development. A large number of related studies are progressing rapidly. Gut microbiota may be an important intermediate link, causing gastrointestinal diseases under the influence of changes in diet and genetic predisposition. To promote healthy gut microbiota and to prevent and cure gastrointestinal diseases, diets should be improved and supplemented with probiotics.
