Short-chain fatty acids,metabolites produced by the fermentation of dietary fiber by gut microbiota,have garnered significant attention due to their correlation with neurodegenerative diseases,particularly Parkinson’...Short-chain fatty acids,metabolites produced by the fermentation of dietary fiber by gut microbiota,have garnered significant attention due to their correlation with neurodegenerative diseases,particularly Parkinson’s disease.In this review,we summarize the changes in short-chain fatty acid levels and the abundance of short-chain fatty acid-producing bacteria in various samples from patients with Parkinson’s disease,highlighting the critical role of gut homeostasis imbalance in the pathogenesis and progression of the disease.Focusing on the nervous system,we discuss the molecular mechanisms by which short-chain fatty acids influence the homeostasis of both the enteric nervous system and the central nervous system.We identify key processes,including the activation of G protein-coupled receptors and the inhibition of histone deacetylases by short-chain fatty acids.Importantly,structural or functional disruptions in the enteric nervous system mediated by these fatty acids may lead to abnormalα-synuclein expression and gastrointestinal dysmotility,which could serve as an initiating event in Parkinson’s disease.Furthermore,we propose that short-chain fatty acids help establish communication between the enteric nervous system and the central nervous system via the vagal nerve,immune circulation,and endocrine signaling.This communication may shed light on their potential role in the transmission ofα-synuclein from the gut to the brain.Finally,we elucidate novel treatment strategies for Parkinson’s disease that target short-chain fatty acids and examine the challenges associated with translating short-chain fatty acid-based therapies into clinical practice.In conclusion,this review emphasizes the pivotal role of short-chain fatty acids in regulating gut-brain axis integrity and their significance in the pathogenesis of Parkinson’s disease from the perspective of the nervous system.Moreover,it highlights the potential value of short-chain fatty acids in early intervention for Parkinson’s disease.Future research into the molecular mechanisms of short-chain fatty acids and their synergistic interactions with other gut metabolites is likely to advance the clinical translation of innovative short-chain fatty acid-based therapies for Parkinson’s disease.展开更多
Critically ill patients have a variety of complex pathologies and are in a multifarious state of catabolism supplanted by external and internal factors.Early enteral nutrition(EEN)is defined as the initiation of enter...Critically ill patients have a variety of complex pathologies and are in a multifarious state of catabolism supplanted by external and internal factors.Early enteral nutrition(EEN)is defined as the initiation of enteral feeding within 24-48 hours of hospitalization.Previous studies show the benefits of EEN include supporting the healing process through preservation of the gut mucosa,modulation of the immune response,and suppression of inflammation.However,recent studies suggest the advantages of EEN may not be as robust as previously believed.This review aims to discuss the outcomes of EEN when used in different critical care settings while managing complex disease states such as burns,sepsis,pancreatitis,and upper gastrointestinal bleeding.Evidence indicates that EEN has a positive impact on patient outcomes,hospital costs,length of intensive care unit stay,and preventing complications.展开更多
Objective:Diabetes-induced gastrointestinal(GI)motility disorders are increasingly prevalent.Damage to the enteric nervous system(ENS),composed primarily of enteric neurons and glial cells,is an essential mechanism in...Objective:Diabetes-induced gastrointestinal(GI)motility disorders are increasingly prevalent.Damage to the enteric nervous system(ENS),composed primarily of enteric neurons and glial cells,is an essential mechanism involved in these disorders.Although electroacupuncture(EA)has shown the potential to mitigate enteric neuronal loss,its mechanism is not fully understood.Additionally,the effects of EA on enteric glial cells have not been investigated.Enteric neural precursor cells(ENPCs)contribute to the structural and functional integrity of the ENS,yet whether EA enhances their differentiation into enteric neurons and glial cells remains unexplored.This study investigates whether EA promotes ENS repair through enhancing ENPC-derived neurogenesis and gliogenesis and elucidates the potential molecular mechanisms involved.Methods:Transgenic mice were used to trace Nestin+/nerve growth factor receptor(Ngfr)+ENPCs labeled with green fluorescent protein(GFP)in vivo.Mice were randomly divided into four groups:control,diabetes mellitus(DM),DM+sham EA,and DM+EA.The effects of EA on diabetic mice were evaluated by GI motility,ENS structure,and ENPC differentiation.Glial cell line-derived neurotrophic factor(GDNF)/Ret signaling was detected to clarify the underlying molecular mechanisms.Results:EA alleviated diabetes-induced GI motility disorders,as indicated by reduced whole gut transit time,shortened colonic bead expulsion time,and enhanced smooth muscle contractility.Furthermore,EA attenuated diabetes-induced losses of enteric neurons and glial cells,thereby restoring ENS integrity.Notably,EA reversed the diabetes-induced decrease in ENPCs and significantly increased the absolute number and the proportion of ENPC-derived enteric neurons.However,immunofluorescence analyses revealed no colocalization between EA-induced glial fibrillary acidic protein+glial cells and GFPlabeled ENPCs.Mechanistically,GDNF/Ret signaling was elevated in intestinal tissues and upregulated in ENPCs in EA-treated diabetic mice.Conclusion:EA facilitates ENS repair by promoting Nestin+/Ngfr+ENPC differentiation into enteric neurons via upregulation of GDNF/Ret signaling,and driving enteric gliogenesis from non-Nestin+/Ngfr+ENPCs.These findings highlight EA's role in ameliorating diabetes-induced GI dysmotility through ENPC-derived ENS restoration.展开更多
BACKGROUND There is an increased maturation of laparoscopic intracorporeal anastomosis techniques.However,research on its application for small bowel stoma reversal in patients with Crohn's disease(CD)is limited.T...BACKGROUND There is an increased maturation of laparoscopic intracorporeal anastomosis techniques.However,research on its application for small bowel stoma reversal in patients with Crohn's disease(CD)is limited.Therefore,in this study,we compared the perioperative outcomes between laparoscopic intracorporeal ileostomy reversal(LIIR)and open ileostomy reversal(OIR).AIM To compare the safety,feasibility,bowel function recovery,and short-and longterm LIIR and OIR outcomes in patients with CD.METHODS This study included patients who underwent ileal reversal for CD between January 2021 and January 2023 at our institution.The baseline data,postoperative recovery,and complication indicators were retrospectively analyzed.Logistic regression analysis was conducted to explore factors that significantly influenced the development of enteral nutrition intolerance-related symptoms.RESULTS Notably,15 of the 45 patients in this study underwent OIR,and the remaining 30 received LIIR.Notably,no statistically significant differences were found between the two groups regarding clinical baseline characteristics,operation time,intraoperative hemorrhage,anastomotic site,enterolysis range,first postoperative flatus,postoperative complications,reoperation rate,or incidence of postoperative enteral nutrition intolerance.Compared with the OIR group,the LIIR group had a shorter postoperative hospital stay(P=0.045),lower incidence of enteral nutrition intolerance symptoms(P=0.019),and earlier postoperative total enteral nutrition initiation(P=0.033);however,it incurred higher total hospital costs(P=0.038).Furthermore,multivariate logistic regression analysis revealed that the duration of surgery and anastomotic technique were independent risk factors for postoperative symptoms of enteral nutrition intolerance(P<0.05).CONCLUSION Laparoscopic intracorporeal anastomosis for ileostomy reversal is safe and feasible.Patients who underwent this technique demonstrated improved tolerance to postoperative enteral nutrition and quicker resumption of total enteral nutrition.展开更多
BACKGROUND Congenital short bowel syndrome(CSBS)is a rare disorder characterized by a congenital shortage in the length of the small intestines,resulting in compromised intestinal functionality,frequently accompanied ...BACKGROUND Congenital short bowel syndrome(CSBS)is a rare disorder characterized by a congenital shortage in the length of the small intestines,resulting in compromised intestinal functionality,frequently accompanied by congenital intestinal malrotation.This study summarizes the experience of enteral and parenteral nutrition(PN)schemes for two cases of CSBS accompanied by intestinal malrotation to provide a reference for this condition.CASE SUMMARY Case 1 underwent surgical intervention 23 days after birth,but experienced postoperative intolerance to oral feeding.Consequently,the patient was transitioned to nasal feeding for 6 months while concurrently receiving round-the-clock PN.Despite ongoing adjustments to the caloric intake of enteral and PN throughout the treatment,cholestatic liver injury persisted.Furthermore,this child developed malnutrition by the age of 1 year.Case 2 received surgical intervention on 2 days after birth,demonstrating favorable tolerance for enteral feeding and intermittent PN.The child exhibited satisfactory growth and development without any associated complications.CONCLUSION CSBS is rarely encountered in clinical practice and is often accompanied by congenital intestinal malrotation.It can be improved with early diagnosis and active surgical intervention.Thus,we recommend early initiation of total PN,which is a highly effective measure in promoting early growth and development.展开更多
BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nu...BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nutrition(EEN) and the role of biomarkers in managing ICU-AW.METHODS: This retrospective, observational cohort study included 180 patients at risk of malnutrition admitted to the emergency intensive care unit of the First Affiliated Hospital of Xiamen University Hospital from January 2022 to December 2023. Patients were divided into ICU-AW group and non-ICU-AW group according to whether they developed ICU-AW, or categorized into EEN and parenteral nutrition(PN) groups according to nutritional support. ICU-AW was diagnosed using the Medical Research Council score. The primary outcome was the occurrence of ICU-AW.RESULTS: The significant factors associated with ICU-AW included age, sex, type of nutritional therapy, mechanical ventilation(MV), body mass index(BMI), blood urea nitrogen(BUN), and creatinine(Cr) levels(P<0.05). The PN group developed ICU-AW earlier than did the EEN group, with a significant difference observed(log-rank P<0.001). Among biomarkers for ICU-AW, the mean prealbumin(PAB)/C-reactive protein(CRP) ratio had the highest diagnostic accuracy(area under the curve [AUC] 0.928, 95% confidence interval [95% CI] 0.892–0.946), surpassing the mean Cr/BUN ratio(AUC 0.740, 95% CI 0.663–0.819) and mean transferrin levels(AUC 0.653, 95% CI 0.574–0.733).CONCLUSION: Independent risk factors for ICU-AW include female sex, advanced age, PN, MV, lower BMI, and elevated BUN and Cr levels. EEN may potentially delay ICU-AW onset, and the PAB/CRP ratio may be an effective diagnostic marker for this condition.展开更多
Background Necrotic enteritis(NE)can cause intestinal barrier dysfunction in broilers,leading to secondary liver injury(SLI).In this process,the gut-liver axis plays a crucial role.Lonicerae flos and turmeric extracts...Background Necrotic enteritis(NE)can cause intestinal barrier dysfunction in broilers,leading to secondary liver injury(SLI).In this process,the gut-liver axis plays a crucial role.Lonicerae flos and turmeric extracts(LTE),containing chlorogenic acid and curcumin,have been reported to possess anti-inflammatory,and antioxidant properties.Based on these potential biological benefits,this study aims to investigate the reparative effects of LTE on the intestinal barrier dysfunction in NE-infected broilers and assess its therapeutic efficacy in alleviating SLI.By elucidating the regulatory mechanisms of LTE on gut-liver axis health,this research provides new insights into the prevention and treatment of NE in broilers.Results LTE improved body weight and average daily gain while reducing intestinal lesion scores,coccidia oocysts,and Clostridium perfringens counts in NE broilers(P<0.05).LTE enhanced intestinal morphology and up-regulated the expression of tight junction protein genes(CLDN1,TJP1)and MUC2,suppressed pro-inflammatory cytokine and myeloperoxidase(MPO)levels,and minimized endotoxin(ET)accumulation in NE broilers(P<0.05).Furthermore,LTE alleviated oxidative stress in ileal cells and protected mitochondrial structure and function in NE broilers.NE infection induced intestinal permeability in broilers,leading to increased serum pro-inflammatory cytokines and intestinal-derived endotoxin levels,which caused liver damage.LTE significantly reduced liver pathologic damage,pro-inflammatory cytokine levels,aspartate transaminase,alanine aminotransferase,and ROS levels in NE broilers(P<0.05).Additionally,16S rRNA sequencing revealed that NE significantly increased the relative abundance of Barnesiella and decreased the relative abundance of Bacteroidota,Desulfobacterota and Bacteroides in the cecum of broilers.LTE enhanced intestinal microbiota diversity and reduced the segregation of intestinal microbiota induced by NE infection.Conclusions In summary,LTE can alleviate NE and SLI by modulating the microbiota,inhibiting inflammation and oxidative stress,and ameliorating mitochondrial dysfunction,thereby enhancing gut-liver axis health and growth performance.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
Intestinal drug-resistant pathogens,e.g.,Salmonella enterica subsp.enterica serovar Typhimurium(S.Tm)and enteropathogenic Escherichia coli(E.coli),frequently cause life-threatening infectious enteritis.Probiotic-based...Intestinal drug-resistant pathogens,e.g.,Salmonella enterica subsp.enterica serovar Typhimurium(S.Tm)and enteropathogenic Escherichia coli(E.coli),frequently cause life-threatening infectious enteritis.Probiotic-based therapy is a promising way to eliminate drug-resistant pathogens for treatment of infectious enteritis,but its colonizing and therapeutic efficacy after oral administration are limited.Here,we developed a facile therapeutic agent to treat infectious enteritis by co-assembly of the peptide nanodrug melittin-loaded MSN grafted by polysaccharide-binding protein(MMPB)with the famous probiotic bacteria Lactobacillus plantarum(Lac)and Bifidobacterium animalis subsp.lactis(Bif).The nanodrug was composed of the antimicrobial peptide melittin and mesoporous silica nanoparticles exposing the artificial polysaccharide-binding protein.Owing to presence of the artificial protein on the MMPB surface,the nanodrug strongly bound and cross-linked the probiotic cells,forming the Lac+Bif+MMPB co-assembly.During co-incubation with the kanamycin-resistant E.coli strain(Ecka),the co-assembly strongly reduced the viability of Ecka,leading to the increase in the ratio of probiotic to Ecka from 1.6 to 9.2.After oral administration of the co-assembly to themice pre-colonized by Ecka,Lac+Bif+MMPB almost eliminated the kanamycin-resistant gene in the intestine,and led to 2-3-fold higher levels of the probiotic cells than the nanodrug MMPB or the combined probiotics Lac+Bif.More importantly,in the mice suffering from enteritis caused by drug-resistant S.Tm,the co-assembly remarkably recovered the mouse body weight,reduced intestine colonization of S.Tm cells,and decreased the levels of pro-inflammatory cytokines in both serum and colons.This study realized the synthetic biology technique-mediated abiotic/biotic co-assembly for efficient treating infectious enteritis induced by drug-resistant pathogens.展开更多
Background Clostridium perfringens is a pathogen that secretes multiple toxins,impacting humans and animals.It can cause intestinal diseases such as necrotic enteritis.Although tannins inhibit C.perfringens proliferat...Background Clostridium perfringens is a pathogen that secretes multiple toxins,impacting humans and animals.It can cause intestinal diseases such as necrotic enteritis.Although tannins inhibit C.perfringens proliferation,the precise underlying mechanisms are unclear.Objective This study integrated transcriptomics and metabolomics to systematically investigate the mechanism by which tannins,specifically pentagalloylglucose(PGG)and tannic acid(TA),inhibit C.perfringens and potential pathways to alleviate infection in vivo.Results Ion concentration measurements,flow cytometric analysis,and transmission electron microscopy revealed that PGG and TA damaged the cell membrane structure of C.perfringens,triggering cytoplasmic content leakage.Additionally,PGG and TA significantly affected C.perfringens at the transcriptional and metabolic levels.Bioinformatics analysis revealed that PGG and TA induced amino acid restriction,disrupted energy metabolism,and impeded the ability of C.perfringens to sense and respond to the external environment.In an in vitro C.perfringens-infected intestinal cell model,PGG and TA boundαtoxin,significantly reduced the mRNA expression of inflammatory factors,and improved intestinal barrier function and cell viability.Compared to PGG,TA exhibited stronger inhibitory activity against C.perfringens and binding toαtoxin.In vivo,PGG and TA alleviated C.perfringens-induced weight loss in mice,improved intestinal villi morphology,and reduced intestinal inflammation and tight junction gene dysregulation.Conclusion These findings indicate that tannins inhibit C.perfringens,improve gut tissue integrity and reduce inflammation,demonstrating their multi-target effects of resisting intestinal diseases caused by harmful bacteria.This offers new insights for plant polyphenol-based strategies against necrotic enteritis.展开更多
Rationale:Enteric fever is a major public health problem in developing and underdeveloped counties.Extraintestinal manifestations in typhoid are estimated in 27%cases and are associated with severe and complicated dis...Rationale:Enteric fever is a major public health problem in developing and underdeveloped counties.Extraintestinal manifestations in typhoid are estimated in 27%cases and are associated with severe and complicated diseases.Patients concerns:We report three cases of enteric fever with rare extra intestinal manifestations.Diagnoses:Enteric fever with acute motor-sensory axonal neuropathy,enteric fever with myocarditis,and enteric fever with splenic vein thrombosis.Interventions:All patients were treated with antibiotics.Additionally,Patient 1 was treated with桇immunoglobulin;Patient 2 was treated with vasopressors and anti-cardiac remodeling drugs like ramipril and metoprolol;Patient 3 was treated with anticoagulation with low molecular weight heparin.Outcomes:All patients improved clinically and were followed up on outpatient.Lessons:The diagnosis of enteric fever is challenging and there is an urgent need for prompt-targeted management for better outcomes.Especially in endemic zones and in non-endemic zones as a disease of emporiatric significance.展开更多
BACKGROUND Colorectal cancer is a prevalent malignancy with suboptimal postoperative recovery outcomes.Enhancing recovery and prolonging disease-free survival remains a critical challenge.This study investigates facto...BACKGROUND Colorectal cancer is a prevalent malignancy with suboptimal postoperative recovery outcomes.Enhancing recovery and prolonging disease-free survival remains a critical challenge.This study investigates factors influencing the efficacy of probiotics combined with enteral nutrition in postoperative patients with colorectal cancer.AIM To identify predictors of therapeutic efficacy for probiotics combined with enteral nutrition in postoperative patients with colorectal cancer.METHODS A retrospective study was conducted with 511 patients with colorectal cancer who underwent surgery and received probiotics and enteral nutrition from January 2022 to March 2025.Patients were categorized into the“good efficacy group”(n=279)and“poor efficacy group”(n=232)based on outcomes observed 3 months post-surgery.Variables assessed included gut microbiota composition,nutritional intake,immune and inflammatory markers,and demographic characteristics.RESULTS Patients with favorable outcomes were typically younger,had higher caloric,protein,and fiber intake,and displayed enhanced intestinal mucosal barrier function with elevated levels of Bifidobacterium and Lactobacillus.Immune markers such as immunoglobulin A,immunoglobulin M,immunoglobulin G,and CD4+/CD8+T-cell ratios were significantly higher in the good efficacy group.High numbers of Fusobacterium nucleatum and Bacteroides fragilis and levels of tumor necrosis factor-alpha and interleukin-6 were associated with poor efficacy.Multivariate analysis identified age,tumor node metastasis stage,protein intake,and gut microbiota composition as significant predictors of therapeutic success.CONCLUSION The efficacy of combining probiotics with enteral nutrition in postoperative patients with colorectal cancer was influenced by age,nutritional intake,microbiota balance,immune status,and inflammatory markers.展开更多
Background Necrotic enteritis(NE)is an economically important disease of broiler chickens caused by Clostridium perfringens(CP).The pathogenesis,or disease process,of NE is still not clear.This study aimed to identify...Background Necrotic enteritis(NE)is an economically important disease of broiler chickens caused by Clostridium perfringens(CP).The pathogenesis,or disease process,of NE is still not clear.This study aimed to identify the alterations of metabolites and metabolic pathways associated with subclinical or clinical NE in CP infected birds and to investi-gate the possible variations in the metabolic profile of birds infected with different isolates of CP.Methodology Using a well-established NE model,the protein content of feed was changed abruptly before expos-ing birds to CP isolates with different toxin genes combinations(cpa,cpb2,netB,tpeL;cpa,cpb2,netB;or cpa,cpb2).Metabolomics analysis of jejunal contents was performed by a targeted,fully quantitative LC-MS/MS based assay.Results This study detected statistically significant differential expression of 34 metabolites including organic acids,amino acids,fatty acids,and biogenic amines,including elevation of butyric acid at onset of NE in broiler chickens.Subsequent analysis of broilers infected with CP isolates with different toxin gene combinations confirmed an eleva-tion of butyric acid consistently among 21 differentially expressed metabolites including organic acids,amino acids,and biogenic amines,underscoring its potential role during the development of NE.Furthermore,protein-metabolite network analysis revealed significant alterations in butyric acid and arginine-proline metabolisms.Conclusion This study indicates a significant metabolic difference between CP-infected and non-infected broiler chickens.Among all the metabolites,butyric acid increased significantly in CP-infected birds compared to non-infected healthy broilers.Logistic regression analysis revealed a positive association between butyric acid(coefficient:1.23,P<0.01)and CP infection,while showing a negative association with amino acid metabolism.These findings suggest that butyric acid could be a crucial metabolite linked to the occurrence of NE in broiler chickens and may serve as an early indicator of the disease at the farm level.Further metabolomic experiments using different NE animal models and field studies are needed to determine the specificity and to validate metabolites associated with NE,regardless of predisposing factors.展开更多
BACKGROUND The enteric nervous system(ENS),often referred to as the"second brain",plays a vital role in regulating gastrointestinal(GI)functions such as motility,secretion,and immune responses.Located within...BACKGROUND The enteric nervous system(ENS),often referred to as the"second brain",plays a vital role in regulating gastrointestinal(GI)functions such as motility,secretion,and immune responses.Located within the walls of the gastrointestinal tract,the ENS is involved in several GI disorders,including functional gastrointestinal disorders like irritable bowel syndrome(IBS),motility disorders such as gastroparesis,and conditions like inflammatory bowel diseases(IBD)and congenital aganglionosis.Understanding the mechanisms and therapeutic potential of the ENS is crucial for advancing treatment options for these conditions.AIM To review the therapeutic targeting of the ENS in treating gastrointestinal disorders,with a focus on the mechanisms of action,current therapies,and emerging treatment strategies.METHODS This review adhered to Preferred Reporting Items for Systematic Reviews and Meta-analyses 2009 guidelines and included a comprehensive literature search across PubMed,Scopus,and Google Scholar from 2010 onwards.Studies were selected based on their exploration of the structure,function,and pathology of the ENS in relation to gastrointestinal diseases,particularly motility disorders and inflammation.Articles were evaluated for therapeutic strategies,including pharmacological,surgical,and gene-based interventions.RESULTS The ENS is found to regulate essential functions like peristalsis,secretion,and immune responses,and its dysfunction leads to a variety of gastrointestinal diseases.Recent studies highlight several promising therapies targeting ENS neurotransmitters,including serotonin receptor modulators,prokinetic agents,and neuroprotective strategies aimed at enteric glial cells.These approaches have shown promise in treating conditions like IBS,gastroparesis,and IBD.Additionally,bioelectronic therapies and stem cell-based treatments are emerging as potential therapies for ENS regeneration.CONCLUSION Targeting the ENS offers novel therapeutic avenues for treating gastrointestinal disorders.Advances in pharmacological treatments,gene therapy,and neuromodulation techniques show great promise in restoring ENS function and improving clinical outcomes.While current research remains in early stages,future studies focusing on personalized medicine and the gut-brain axis could lead to more effective treatments for complex gastrointestinal diseases.展开更多
Objective:To investigate the clinical efficacy of Modified Gegen Qinlian Decoction combined with probiotics(Clostridium butyricum live capsules)in treating radiation enteritis(RE)in tumor patients,as well as its regul...Objective:To investigate the clinical efficacy of Modified Gegen Qinlian Decoction combined with probiotics(Clostridium butyricum live capsules)in treating radiation enteritis(RE)in tumor patients,as well as its regulatory effect on the structure of intestinal flora,providing clinical evidence for the integrated traditional Chinese and Western medicine treatment of radiation enteritis.Methods:A total of 40 patients with radiation enteritis admitted to the Oncology Department of Linfen Central Hospital from September 2023 to December 2024 were selected and divided into an observation group and a control group according to the random number table method,with 20 cases in each group.The control group was treated with Clostridium butyricum live capsules,while the observation group was treated with Modified Gegen Qinlian Decoction in addition to the treatment given to the control group.Both groups received a 4-week treatment course.Intestinal function indicators and changes in intestinal flora structure were compared between the two groups before and after treatment,and clinical efficacy was evaluated.Results:After 4 weeks of treatment,the total effective rate in the observation group versus the control group was(95.00%vs 65.00%),with a statistically significant difference(P<0.05).The fecal formation rate in the observation group(85.00%vs 60.00%)was significantly higher than that in the control group,and the defecation frequency(2.15±0.42 vs 3.85±0.65)times/day was significantly lower than that in the control group,with statistically significant differences(P<0.05).After treatment,the quantities of Bifidobacterium(6.85±0.72 L vs 5.23±0.61 L)gCFU/g and Lactobacillus(6.52±0.68 L vs 4.98±0.57 L)gCFU/g in the observation group were significantly higher than those in the control group,while the quantities of Escherichia coli(4.12±0.53 L vs 5.67±0.65 L)gCFU/g and Staphylococcus(3.85±0.48 L vs 5.23±0.59 L)gCFU/g were significantly lower than those in the control group,with statistically significant differences(P<0.05).Conclusion:Clinical studies have confirmed that the synergistic treatment of radiation enteritis with Modified Gegen Qinlian Decoction and probiotics can significantly improve patients’clinical symptoms and restore the balance of intestinal flora,providing an effective regimen for clinical treatment.展开更多
Objective:To study the application effect of early postoperative enteral nutrition in the nursing care of elderly patients with gastric cancer.Methods:Sixty elderly patients with gastric cancer admitted to the hospita...Objective:To study the application effect of early postoperative enteral nutrition in the nursing care of elderly patients with gastric cancer.Methods:Sixty elderly patients with gastric cancer admitted to the hospital from January 2022 to January 2024 were selected and divided into groups according to the random number table method.The control group(n=30)received routine nursing after surgery,while the observation group(n=30)received early enteral nutrition nursing after surgery.The perioperative indexes,nutritional indexes before and after nursing,humoral and cellular immune indexes before and after nursing,gastrointestinal hormone levels before and after nursing,and the incidence of postoperative complications were compared between the two groups.Results:The perioperative indexes of the observation group were better than those of the control group(P<0.05).Before nursing,there was no significant difference in the nutritional indexes between the two groups(P>0.05).After nursing,the nutritional indexes of the observation group were better than those of the control group(P<0.05).Before nursing,there was no significant difference in the humoral and cellular immune indexes between the two groups(P>0.05).After nursing,the humoral and cellular immune indexes of the observation group were better than those of the control group(P<0.05).Before nursing,there was no significant difference in the gastrointestinal hormone levels between the two groups(P>0.05).After nursing,the gastrointestinal hormone levels of the observation group were better than those of the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).Conclusion:For elderly patients with gastric cancer,early enteral nutrition nursing after surgery can improve their nutritional indexes and gastrointestinal hormone levels,enhance their immune ability,and prevent the incidence of postoperative complications,with good effects.展开更多
BACKGROUND Colonic anastomotic leakage(AL)remains a feared complication of colorectal surgery.Usually,a defunctioning stoma or a proximal colostomy is performed to reduce the AL rate but cannot completely prevent AL.M...BACKGROUND Colonic anastomotic leakage(AL)remains a feared complication of colorectal surgery.Usually,a defunctioning stoma or a proximal colostomy is performed to reduce the AL rate but cannot completely prevent AL.Moreover,defunctioning colostomy is associated with high morbidity.This study assessed the feasibility of completely preventing colonic AL using total enteric flow diversion without a defunctioning stoma in a pig model of colonic AL.AIM To determine the feasibility of preventing colonic AL via total enteric flow diversion in pigs.METHODS A total of 14 pigs underwent surgery to create colon anaesthesia with severe defects for establishing the AL model.The pigs were then randomized into the control group(n=7),which received no further therapy,and a diversion group(n=7),which underwent placement of a modified ileostomy tube to divert the enteric contents from the colon externally.The general condition,serum Creactive protein level,white blood cell count,5-day incidence of colon AL,and development of abdominal abscesses were evaluated.RESULTS A modified ileostomy tube with a balloon was placed and pressurized to 20 kPa at a distance of 10-20 cm proximal to the ileocecal valve,effectively obstructing the intestine without causing injury and efficiently diverting the enteric contents.In the diversion group,no cases of peritonitis or abscess were observed.In contrast,all pigs in the control group developed either abdominal abscesses or peritonitis.CONCLUSION Instead of ileostomy or colostomy,the total enteric flow diversion technique with the placement of a modified ileostomy tube and balloon in the ileum can effectively or completely prevent colon AL.展开更多
BACKGROUND Malnutrition exacerbates the deterioration in patients with advanced gas-trointestinal tumors.AIM To analyze the effect of enteral nutritional support based on Nutrition Risk Screening 2002(NRS2002)risk ass...BACKGROUND Malnutrition exacerbates the deterioration in patients with advanced gas-trointestinal tumors.AIM To analyze the effect of enteral nutritional support based on Nutrition Risk Screening 2002(NRS2002)risk assessment on nutritional function in patients with gastrointestinal tumors.METHODS One hundred twelve patients from April 2022 to April 2024 were included for observation and were divided into a control group and an observation group by random number method,56 each.Both groups received treatment for four consecutive weeks.The control group received routine enteral nutrition support,while the observation group received enteral nutrition support based on the NRS2002 risk assessment.Nutritional function,intestinal mucosal barrier function,quality of life,and complication rate were compared between the two groups.Statistical analysis was completed using SPSS26.0 and Excel.RESULTS After nutritional intervention,transferrin,albumin,hemoglobin,and diamine oxidase levels in the observation group were higher than those in the control group,while C-reactive protein,tumor necrosis factorα,and quality of life scores were lower,with significant differences(P<0.05).There was no significant difference in complications between groups(P>0.05),but the complication rate was lower in the observation group.CONCLUSION Enteral nutritional support based on NRS2002 risk assessment for patients with gastrointestinal tumors positively impacts nutritional status and promotes intestinal mucosal barrier function recovery.Patients’quality of life improved,and the incidence of adverse reactions decreased,indicating clinical promotion and application value.展开更多
BACKGROUND Environmental enteric dysfunction(EED)is a subclinical condition caused by fecal-oral contamination leading to enteric inflammation and dysbiosis.Bile acids serve to facilitate lipid digestion and absorptio...BACKGROUND Environmental enteric dysfunction(EED)is a subclinical condition caused by fecal-oral contamination leading to enteric inflammation and dysbiosis.Bile acids serve to facilitate lipid digestion and absorption,regulate metabolic pathways associated with childhood growth and inflammation,and may be affected by EED.AIM To investigate bile acid metabolism in Bangladeshi children with EED and its association with growth impairment.METHODS We conducted a cross-sectional study of 100 Bangladeshi infants(aged 6-9 months)and quantified serum and fecal bile acids using LC-MS/MS.We compared profiles to a control group of 6 American children(6-12 months)and 80 older Bangladeshi children(aged 2 years).RESULTS Bangladeshi infants had higher levels of plasma unconjugated primary(65.23%vs 44.25%,P=0.003)and sulfated primary bile acids(12.98%vs<0.001%,P=0.01),with lower primary conjugated bile acids(0.69%vs 2.74%,P≤0.001)compared to American children.Stool unconjugated primary bile acids were inversely associated with weight-for-age[regression coefficient(β)=-0.01,P=0.01]and height-for-age Z scores(β=-0.01,P=0.03).Conjugated secondary bile acids were inversely associated with small intestine bacterial overgrowth(β=-1096.68,P=0.05).Fecal myeloperoxidase was associated with sulfated secondary bile acids(β=-0.40,P=0.04).Compared to 2-year-old children,the Bangladeshi infant’s serum had higher levels of unconjugated primary bile acids(65.23%vs 9.20%,P≤0.001)and lower levels of primary conjugated bile acids(0.69%vs 80.38%,P≤0.001).CONCLUSION Our data suggests an age-dependent defect in conjugation of primary bile acids in Bangladeshi children with compensatory hydrophilic shunting.Additionally,bile acid profiles are associated with intestinal overgrowth.展开更多
Gastric retention is a common complication in individuals receiving enteral nutrition(EN)via a nasogastric tube,increasing the risk of aspiration pneumonia and causing unnecessary interruptions in nutritional support....Gastric retention is a common complication in individuals receiving enteral nutrition(EN)via a nasogastric tube,increasing the risk of aspiration pneumonia and causing unnecessary interruptions in nutritional support.Given its clinical significance,establishing effective,evidence-based,and standardized manage-ment strategies is essential for bettering patient outcomes and mitigating compli-cations.This review systematically synthesized the diagnostic criteria,assessment methods,influencing factors,management procedures,and intervention strategies for gastric retention in EN patients.Although no universal consensus exists re-garding gastric residual volume(GRV)thresholds,evidence indicates that EN can continue at high GRV levels in the absence of gastrointestinal symptoms.Bedside ultrasound emerged as a non-invasive,and precise method GRV assessment,offering potential to standardize clinical practice.Key risk factors for gastric retention include neurological disorders and EN infusion rates exceeding 100 mL/h.Effective management strategies encompass non-pharmacological inter-ventions,pharmacological agents,and traditional Chinese medicine(TCM)the-rapies.This review underscored the need for integrated,multi-modal manage-ment strategies and recommended the adoption of bedside ultrasound and stan-dardized protocols to optimize EN delivery and improve patient outcomes.Large-scale,multicenter clinical trials should be a priority for future investigation to verify the effectiveness of TCM therapies and develop personalized intervention plans for high-risk patients.展开更多
基金supported by the National Key R&D Program of China,No.2021YFC2501200(to PC).
文摘Short-chain fatty acids,metabolites produced by the fermentation of dietary fiber by gut microbiota,have garnered significant attention due to their correlation with neurodegenerative diseases,particularly Parkinson’s disease.In this review,we summarize the changes in short-chain fatty acid levels and the abundance of short-chain fatty acid-producing bacteria in various samples from patients with Parkinson’s disease,highlighting the critical role of gut homeostasis imbalance in the pathogenesis and progression of the disease.Focusing on the nervous system,we discuss the molecular mechanisms by which short-chain fatty acids influence the homeostasis of both the enteric nervous system and the central nervous system.We identify key processes,including the activation of G protein-coupled receptors and the inhibition of histone deacetylases by short-chain fatty acids.Importantly,structural or functional disruptions in the enteric nervous system mediated by these fatty acids may lead to abnormalα-synuclein expression and gastrointestinal dysmotility,which could serve as an initiating event in Parkinson’s disease.Furthermore,we propose that short-chain fatty acids help establish communication between the enteric nervous system and the central nervous system via the vagal nerve,immune circulation,and endocrine signaling.This communication may shed light on their potential role in the transmission ofα-synuclein from the gut to the brain.Finally,we elucidate novel treatment strategies for Parkinson’s disease that target short-chain fatty acids and examine the challenges associated with translating short-chain fatty acid-based therapies into clinical practice.In conclusion,this review emphasizes the pivotal role of short-chain fatty acids in regulating gut-brain axis integrity and their significance in the pathogenesis of Parkinson’s disease from the perspective of the nervous system.Moreover,it highlights the potential value of short-chain fatty acids in early intervention for Parkinson’s disease.Future research into the molecular mechanisms of short-chain fatty acids and their synergistic interactions with other gut metabolites is likely to advance the clinical translation of innovative short-chain fatty acid-based therapies for Parkinson’s disease.
文摘Critically ill patients have a variety of complex pathologies and are in a multifarious state of catabolism supplanted by external and internal factors.Early enteral nutrition(EEN)is defined as the initiation of enteral feeding within 24-48 hours of hospitalization.Previous studies show the benefits of EEN include supporting the healing process through preservation of the gut mucosa,modulation of the immune response,and suppression of inflammation.However,recent studies suggest the advantages of EEN may not be as robust as previously believed.This review aims to discuss the outcomes of EEN when used in different critical care settings while managing complex disease states such as burns,sepsis,pancreatitis,and upper gastrointestinal bleeding.Evidence indicates that EEN has a positive impact on patient outcomes,hospital costs,length of intensive care unit stay,and preventing complications.
基金supported by the National Natural Science Foundation of China(No.81700471 and No.82270583)the National Key Research and Development Program of China(No.2022YFC2504005)。
文摘Objective:Diabetes-induced gastrointestinal(GI)motility disorders are increasingly prevalent.Damage to the enteric nervous system(ENS),composed primarily of enteric neurons and glial cells,is an essential mechanism involved in these disorders.Although electroacupuncture(EA)has shown the potential to mitigate enteric neuronal loss,its mechanism is not fully understood.Additionally,the effects of EA on enteric glial cells have not been investigated.Enteric neural precursor cells(ENPCs)contribute to the structural and functional integrity of the ENS,yet whether EA enhances their differentiation into enteric neurons and glial cells remains unexplored.This study investigates whether EA promotes ENS repair through enhancing ENPC-derived neurogenesis and gliogenesis and elucidates the potential molecular mechanisms involved.Methods:Transgenic mice were used to trace Nestin+/nerve growth factor receptor(Ngfr)+ENPCs labeled with green fluorescent protein(GFP)in vivo.Mice were randomly divided into four groups:control,diabetes mellitus(DM),DM+sham EA,and DM+EA.The effects of EA on diabetic mice were evaluated by GI motility,ENS structure,and ENPC differentiation.Glial cell line-derived neurotrophic factor(GDNF)/Ret signaling was detected to clarify the underlying molecular mechanisms.Results:EA alleviated diabetes-induced GI motility disorders,as indicated by reduced whole gut transit time,shortened colonic bead expulsion time,and enhanced smooth muscle contractility.Furthermore,EA attenuated diabetes-induced losses of enteric neurons and glial cells,thereby restoring ENS integrity.Notably,EA reversed the diabetes-induced decrease in ENPCs and significantly increased the absolute number and the proportion of ENPC-derived enteric neurons.However,immunofluorescence analyses revealed no colocalization between EA-induced glial fibrillary acidic protein+glial cells and GFPlabeled ENPCs.Mechanistically,GDNF/Ret signaling was elevated in intestinal tissues and upregulated in ENPCs in EA-treated diabetic mice.Conclusion:EA facilitates ENS repair by promoting Nestin+/Ngfr+ENPC differentiation into enteric neurons via upregulation of GDNF/Ret signaling,and driving enteric gliogenesis from non-Nestin+/Ngfr+ENPCs.These findings highlight EA's role in ameliorating diabetes-induced GI dysmotility through ENPC-derived ENS restoration.
基金Supported by Chongqing Municipal Health Commission Medical Research Project,No.2023WSJK104.
文摘BACKGROUND There is an increased maturation of laparoscopic intracorporeal anastomosis techniques.However,research on its application for small bowel stoma reversal in patients with Crohn's disease(CD)is limited.Therefore,in this study,we compared the perioperative outcomes between laparoscopic intracorporeal ileostomy reversal(LIIR)and open ileostomy reversal(OIR).AIM To compare the safety,feasibility,bowel function recovery,and short-and longterm LIIR and OIR outcomes in patients with CD.METHODS This study included patients who underwent ileal reversal for CD between January 2021 and January 2023 at our institution.The baseline data,postoperative recovery,and complication indicators were retrospectively analyzed.Logistic regression analysis was conducted to explore factors that significantly influenced the development of enteral nutrition intolerance-related symptoms.RESULTS Notably,15 of the 45 patients in this study underwent OIR,and the remaining 30 received LIIR.Notably,no statistically significant differences were found between the two groups regarding clinical baseline characteristics,operation time,intraoperative hemorrhage,anastomotic site,enterolysis range,first postoperative flatus,postoperative complications,reoperation rate,or incidence of postoperative enteral nutrition intolerance.Compared with the OIR group,the LIIR group had a shorter postoperative hospital stay(P=0.045),lower incidence of enteral nutrition intolerance symptoms(P=0.019),and earlier postoperative total enteral nutrition initiation(P=0.033);however,it incurred higher total hospital costs(P=0.038).Furthermore,multivariate logistic regression analysis revealed that the duration of surgery and anastomotic technique were independent risk factors for postoperative symptoms of enteral nutrition intolerance(P<0.05).CONCLUSION Laparoscopic intracorporeal anastomosis for ileostomy reversal is safe and feasible.Patients who underwent this technique demonstrated improved tolerance to postoperative enteral nutrition and quicker resumption of total enteral nutrition.
文摘BACKGROUND Congenital short bowel syndrome(CSBS)is a rare disorder characterized by a congenital shortage in the length of the small intestines,resulting in compromised intestinal functionality,frequently accompanied by congenital intestinal malrotation.This study summarizes the experience of enteral and parenteral nutrition(PN)schemes for two cases of CSBS accompanied by intestinal malrotation to provide a reference for this condition.CASE SUMMARY Case 1 underwent surgical intervention 23 days after birth,but experienced postoperative intolerance to oral feeding.Consequently,the patient was transitioned to nasal feeding for 6 months while concurrently receiving round-the-clock PN.Despite ongoing adjustments to the caloric intake of enteral and PN throughout the treatment,cholestatic liver injury persisted.Furthermore,this child developed malnutrition by the age of 1 year.Case 2 received surgical intervention on 2 days after birth,demonstrating favorable tolerance for enteral feeding and intermittent PN.The child exhibited satisfactory growth and development without any associated complications.CONCLUSION CSBS is rarely encountered in clinical practice and is often accompanied by congenital intestinal malrotation.It can be improved with early diagnosis and active surgical intervention.Thus,we recommend early initiation of total PN,which is a highly effective measure in promoting early growth and development.
文摘BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nutrition(EEN) and the role of biomarkers in managing ICU-AW.METHODS: This retrospective, observational cohort study included 180 patients at risk of malnutrition admitted to the emergency intensive care unit of the First Affiliated Hospital of Xiamen University Hospital from January 2022 to December 2023. Patients were divided into ICU-AW group and non-ICU-AW group according to whether they developed ICU-AW, or categorized into EEN and parenteral nutrition(PN) groups according to nutritional support. ICU-AW was diagnosed using the Medical Research Council score. The primary outcome was the occurrence of ICU-AW.RESULTS: The significant factors associated with ICU-AW included age, sex, type of nutritional therapy, mechanical ventilation(MV), body mass index(BMI), blood urea nitrogen(BUN), and creatinine(Cr) levels(P<0.05). The PN group developed ICU-AW earlier than did the EEN group, with a significant difference observed(log-rank P<0.001). Among biomarkers for ICU-AW, the mean prealbumin(PAB)/C-reactive protein(CRP) ratio had the highest diagnostic accuracy(area under the curve [AUC] 0.928, 95% confidence interval [95% CI] 0.892–0.946), surpassing the mean Cr/BUN ratio(AUC 0.740, 95% CI 0.663–0.819) and mean transferrin levels(AUC 0.653, 95% CI 0.574–0.733).CONCLUSION: Independent risk factors for ICU-AW include female sex, advanced age, PN, MV, lower BMI, and elevated BUN and Cr levels. EEN may potentially delay ICU-AW onset, and the PAB/CRP ratio may be an effective diagnostic marker for this condition.
基金provided by the precise assessment of the combined toxic effects of major mycotoxins on monogastric animals(2023YFD1301002).
文摘Background Necrotic enteritis(NE)can cause intestinal barrier dysfunction in broilers,leading to secondary liver injury(SLI).In this process,the gut-liver axis plays a crucial role.Lonicerae flos and turmeric extracts(LTE),containing chlorogenic acid and curcumin,have been reported to possess anti-inflammatory,and antioxidant properties.Based on these potential biological benefits,this study aims to investigate the reparative effects of LTE on the intestinal barrier dysfunction in NE-infected broilers and assess its therapeutic efficacy in alleviating SLI.By elucidating the regulatory mechanisms of LTE on gut-liver axis health,this research provides new insights into the prevention and treatment of NE in broilers.Results LTE improved body weight and average daily gain while reducing intestinal lesion scores,coccidia oocysts,and Clostridium perfringens counts in NE broilers(P<0.05).LTE enhanced intestinal morphology and up-regulated the expression of tight junction protein genes(CLDN1,TJP1)and MUC2,suppressed pro-inflammatory cytokine and myeloperoxidase(MPO)levels,and minimized endotoxin(ET)accumulation in NE broilers(P<0.05).Furthermore,LTE alleviated oxidative stress in ileal cells and protected mitochondrial structure and function in NE broilers.NE infection induced intestinal permeability in broilers,leading to increased serum pro-inflammatory cytokines and intestinal-derived endotoxin levels,which caused liver damage.LTE significantly reduced liver pathologic damage,pro-inflammatory cytokine levels,aspartate transaminase,alanine aminotransferase,and ROS levels in NE broilers(P<0.05).Additionally,16S rRNA sequencing revealed that NE significantly increased the relative abundance of Barnesiella and decreased the relative abundance of Bacteroidota,Desulfobacterota and Bacteroides in the cecum of broilers.LTE enhanced intestinal microbiota diversity and reduced the segregation of intestinal microbiota induced by NE infection.Conclusions In summary,LTE can alleviate NE and SLI by modulating the microbiota,inhibiting inflammation and oxidative stress,and ameliorating mitochondrial dysfunction,thereby enhancing gut-liver axis health and growth performance.
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.
基金supported by National Natural Science Foundation of China(32170102)Natural Science Foundation of Tianjin(25JCLMJC00400)the Fundamental Research Funds for the Central Universities(63253191).
文摘Intestinal drug-resistant pathogens,e.g.,Salmonella enterica subsp.enterica serovar Typhimurium(S.Tm)and enteropathogenic Escherichia coli(E.coli),frequently cause life-threatening infectious enteritis.Probiotic-based therapy is a promising way to eliminate drug-resistant pathogens for treatment of infectious enteritis,but its colonizing and therapeutic efficacy after oral administration are limited.Here,we developed a facile therapeutic agent to treat infectious enteritis by co-assembly of the peptide nanodrug melittin-loaded MSN grafted by polysaccharide-binding protein(MMPB)with the famous probiotic bacteria Lactobacillus plantarum(Lac)and Bifidobacterium animalis subsp.lactis(Bif).The nanodrug was composed of the antimicrobial peptide melittin and mesoporous silica nanoparticles exposing the artificial polysaccharide-binding protein.Owing to presence of the artificial protein on the MMPB surface,the nanodrug strongly bound and cross-linked the probiotic cells,forming the Lac+Bif+MMPB co-assembly.During co-incubation with the kanamycin-resistant E.coli strain(Ecka),the co-assembly strongly reduced the viability of Ecka,leading to the increase in the ratio of probiotic to Ecka from 1.6 to 9.2.After oral administration of the co-assembly to themice pre-colonized by Ecka,Lac+Bif+MMPB almost eliminated the kanamycin-resistant gene in the intestine,and led to 2-3-fold higher levels of the probiotic cells than the nanodrug MMPB or the combined probiotics Lac+Bif.More importantly,in the mice suffering from enteritis caused by drug-resistant S.Tm,the co-assembly remarkably recovered the mouse body weight,reduced intestine colonization of S.Tm cells,and decreased the levels of pro-inflammatory cytokines in both serum and colons.This study realized the synthetic biology technique-mediated abiotic/biotic co-assembly for efficient treating infectious enteritis induced by drug-resistant pathogens.
基金The China Agriculture Research System Program(Project No.CARS-41-G04)Shenyang Governmental Science and Technology Program(Project No.22316-2-02)supported this work.
文摘Background Clostridium perfringens is a pathogen that secretes multiple toxins,impacting humans and animals.It can cause intestinal diseases such as necrotic enteritis.Although tannins inhibit C.perfringens proliferation,the precise underlying mechanisms are unclear.Objective This study integrated transcriptomics and metabolomics to systematically investigate the mechanism by which tannins,specifically pentagalloylglucose(PGG)and tannic acid(TA),inhibit C.perfringens and potential pathways to alleviate infection in vivo.Results Ion concentration measurements,flow cytometric analysis,and transmission electron microscopy revealed that PGG and TA damaged the cell membrane structure of C.perfringens,triggering cytoplasmic content leakage.Additionally,PGG and TA significantly affected C.perfringens at the transcriptional and metabolic levels.Bioinformatics analysis revealed that PGG and TA induced amino acid restriction,disrupted energy metabolism,and impeded the ability of C.perfringens to sense and respond to the external environment.In an in vitro C.perfringens-infected intestinal cell model,PGG and TA boundαtoxin,significantly reduced the mRNA expression of inflammatory factors,and improved intestinal barrier function and cell viability.Compared to PGG,TA exhibited stronger inhibitory activity against C.perfringens and binding toαtoxin.In vivo,PGG and TA alleviated C.perfringens-induced weight loss in mice,improved intestinal villi morphology,and reduced intestinal inflammation and tight junction gene dysregulation.Conclusion These findings indicate that tannins inhibit C.perfringens,improve gut tissue integrity and reduce inflammation,demonstrating their multi-target effects of resisting intestinal diseases caused by harmful bacteria.This offers new insights for plant polyphenol-based strategies against necrotic enteritis.
文摘Rationale:Enteric fever is a major public health problem in developing and underdeveloped counties.Extraintestinal manifestations in typhoid are estimated in 27%cases and are associated with severe and complicated diseases.Patients concerns:We report three cases of enteric fever with rare extra intestinal manifestations.Diagnoses:Enteric fever with acute motor-sensory axonal neuropathy,enteric fever with myocarditis,and enteric fever with splenic vein thrombosis.Interventions:All patients were treated with antibiotics.Additionally,Patient 1 was treated with桇immunoglobulin;Patient 2 was treated with vasopressors and anti-cardiac remodeling drugs like ramipril and metoprolol;Patient 3 was treated with anticoagulation with low molecular weight heparin.Outcomes:All patients improved clinically and were followed up on outpatient.Lessons:The diagnosis of enteric fever is challenging and there is an urgent need for prompt-targeted management for better outcomes.Especially in endemic zones and in non-endemic zones as a disease of emporiatric significance.
基金Supported by Zunyi Science and Technology Plan Project,No.Zunshi Kehe HZ Zi(2023)No.49.
文摘BACKGROUND Colorectal cancer is a prevalent malignancy with suboptimal postoperative recovery outcomes.Enhancing recovery and prolonging disease-free survival remains a critical challenge.This study investigates factors influencing the efficacy of probiotics combined with enteral nutrition in postoperative patients with colorectal cancer.AIM To identify predictors of therapeutic efficacy for probiotics combined with enteral nutrition in postoperative patients with colorectal cancer.METHODS A retrospective study was conducted with 511 patients with colorectal cancer who underwent surgery and received probiotics and enteral nutrition from January 2022 to March 2025.Patients were categorized into the“good efficacy group”(n=279)and“poor efficacy group”(n=232)based on outcomes observed 3 months post-surgery.Variables assessed included gut microbiota composition,nutritional intake,immune and inflammatory markers,and demographic characteristics.RESULTS Patients with favorable outcomes were typically younger,had higher caloric,protein,and fiber intake,and displayed enhanced intestinal mucosal barrier function with elevated levels of Bifidobacterium and Lactobacillus.Immune markers such as immunoglobulin A,immunoglobulin M,immunoglobulin G,and CD4+/CD8+T-cell ratios were significantly higher in the good efficacy group.High numbers of Fusobacterium nucleatum and Bacteroides fragilis and levels of tumor necrosis factor-alpha and interleukin-6 were associated with poor efficacy.Multivariate analysis identified age,tumor node metastasis stage,protein intake,and gut microbiota composition as significant predictors of therapeutic success.CONCLUSION The efficacy of combining probiotics with enteral nutrition in postoperative patients with colorectal cancer was influenced by age,nutritional intake,microbiota balance,immune status,and inflammatory markers.
基金support for the project was provided by Chicken Farmers of Saskatchewan(424357)Canadian Poultry Research Council(424854)+1 种基金Natural Sciences and Engineering Research Council of Canada(424679)Saskatchewan Agriculture Development Fund(426954).
文摘Background Necrotic enteritis(NE)is an economically important disease of broiler chickens caused by Clostridium perfringens(CP).The pathogenesis,or disease process,of NE is still not clear.This study aimed to identify the alterations of metabolites and metabolic pathways associated with subclinical or clinical NE in CP infected birds and to investi-gate the possible variations in the metabolic profile of birds infected with different isolates of CP.Methodology Using a well-established NE model,the protein content of feed was changed abruptly before expos-ing birds to CP isolates with different toxin genes combinations(cpa,cpb2,netB,tpeL;cpa,cpb2,netB;or cpa,cpb2).Metabolomics analysis of jejunal contents was performed by a targeted,fully quantitative LC-MS/MS based assay.Results This study detected statistically significant differential expression of 34 metabolites including organic acids,amino acids,fatty acids,and biogenic amines,including elevation of butyric acid at onset of NE in broiler chickens.Subsequent analysis of broilers infected with CP isolates with different toxin gene combinations confirmed an eleva-tion of butyric acid consistently among 21 differentially expressed metabolites including organic acids,amino acids,and biogenic amines,underscoring its potential role during the development of NE.Furthermore,protein-metabolite network analysis revealed significant alterations in butyric acid and arginine-proline metabolisms.Conclusion This study indicates a significant metabolic difference between CP-infected and non-infected broiler chickens.Among all the metabolites,butyric acid increased significantly in CP-infected birds compared to non-infected healthy broilers.Logistic regression analysis revealed a positive association between butyric acid(coefficient:1.23,P<0.01)and CP infection,while showing a negative association with amino acid metabolism.These findings suggest that butyric acid could be a crucial metabolite linked to the occurrence of NE in broiler chickens and may serve as an early indicator of the disease at the farm level.Further metabolomic experiments using different NE animal models and field studies are needed to determine the specificity and to validate metabolites associated with NE,regardless of predisposing factors.
文摘BACKGROUND The enteric nervous system(ENS),often referred to as the"second brain",plays a vital role in regulating gastrointestinal(GI)functions such as motility,secretion,and immune responses.Located within the walls of the gastrointestinal tract,the ENS is involved in several GI disorders,including functional gastrointestinal disorders like irritable bowel syndrome(IBS),motility disorders such as gastroparesis,and conditions like inflammatory bowel diseases(IBD)and congenital aganglionosis.Understanding the mechanisms and therapeutic potential of the ENS is crucial for advancing treatment options for these conditions.AIM To review the therapeutic targeting of the ENS in treating gastrointestinal disorders,with a focus on the mechanisms of action,current therapies,and emerging treatment strategies.METHODS This review adhered to Preferred Reporting Items for Systematic Reviews and Meta-analyses 2009 guidelines and included a comprehensive literature search across PubMed,Scopus,and Google Scholar from 2010 onwards.Studies were selected based on their exploration of the structure,function,and pathology of the ENS in relation to gastrointestinal diseases,particularly motility disorders and inflammation.Articles were evaluated for therapeutic strategies,including pharmacological,surgical,and gene-based interventions.RESULTS The ENS is found to regulate essential functions like peristalsis,secretion,and immune responses,and its dysfunction leads to a variety of gastrointestinal diseases.Recent studies highlight several promising therapies targeting ENS neurotransmitters,including serotonin receptor modulators,prokinetic agents,and neuroprotective strategies aimed at enteric glial cells.These approaches have shown promise in treating conditions like IBS,gastroparesis,and IBD.Additionally,bioelectronic therapies and stem cell-based treatments are emerging as potential therapies for ENS regeneration.CONCLUSION Targeting the ENS offers novel therapeutic avenues for treating gastrointestinal disorders.Advances in pharmacological treatments,gene therapy,and neuromodulation techniques show great promise in restoring ENS function and improving clinical outcomes.While current research remains in early stages,future studies focusing on personalized medicine and the gut-brain axis could lead to more effective treatments for complex gastrointestinal diseases.
基金Four“batches”innovation project of invigorating medicine through science and technology of Shanxi province(Project No.:2023XM059)。
文摘Objective:To investigate the clinical efficacy of Modified Gegen Qinlian Decoction combined with probiotics(Clostridium butyricum live capsules)in treating radiation enteritis(RE)in tumor patients,as well as its regulatory effect on the structure of intestinal flora,providing clinical evidence for the integrated traditional Chinese and Western medicine treatment of radiation enteritis.Methods:A total of 40 patients with radiation enteritis admitted to the Oncology Department of Linfen Central Hospital from September 2023 to December 2024 were selected and divided into an observation group and a control group according to the random number table method,with 20 cases in each group.The control group was treated with Clostridium butyricum live capsules,while the observation group was treated with Modified Gegen Qinlian Decoction in addition to the treatment given to the control group.Both groups received a 4-week treatment course.Intestinal function indicators and changes in intestinal flora structure were compared between the two groups before and after treatment,and clinical efficacy was evaluated.Results:After 4 weeks of treatment,the total effective rate in the observation group versus the control group was(95.00%vs 65.00%),with a statistically significant difference(P<0.05).The fecal formation rate in the observation group(85.00%vs 60.00%)was significantly higher than that in the control group,and the defecation frequency(2.15±0.42 vs 3.85±0.65)times/day was significantly lower than that in the control group,with statistically significant differences(P<0.05).After treatment,the quantities of Bifidobacterium(6.85±0.72 L vs 5.23±0.61 L)gCFU/g and Lactobacillus(6.52±0.68 L vs 4.98±0.57 L)gCFU/g in the observation group were significantly higher than those in the control group,while the quantities of Escherichia coli(4.12±0.53 L vs 5.67±0.65 L)gCFU/g and Staphylococcus(3.85±0.48 L vs 5.23±0.59 L)gCFU/g were significantly lower than those in the control group,with statistically significant differences(P<0.05).Conclusion:Clinical studies have confirmed that the synergistic treatment of radiation enteritis with Modified Gegen Qinlian Decoction and probiotics can significantly improve patients’clinical symptoms and restore the balance of intestinal flora,providing an effective regimen for clinical treatment.
文摘Objective:To study the application effect of early postoperative enteral nutrition in the nursing care of elderly patients with gastric cancer.Methods:Sixty elderly patients with gastric cancer admitted to the hospital from January 2022 to January 2024 were selected and divided into groups according to the random number table method.The control group(n=30)received routine nursing after surgery,while the observation group(n=30)received early enteral nutrition nursing after surgery.The perioperative indexes,nutritional indexes before and after nursing,humoral and cellular immune indexes before and after nursing,gastrointestinal hormone levels before and after nursing,and the incidence of postoperative complications were compared between the two groups.Results:The perioperative indexes of the observation group were better than those of the control group(P<0.05).Before nursing,there was no significant difference in the nutritional indexes between the two groups(P>0.05).After nursing,the nutritional indexes of the observation group were better than those of the control group(P<0.05).Before nursing,there was no significant difference in the humoral and cellular immune indexes between the two groups(P>0.05).After nursing,the humoral and cellular immune indexes of the observation group were better than those of the control group(P<0.05).Before nursing,there was no significant difference in the gastrointestinal hormone levels between the two groups(P>0.05).After nursing,the gastrointestinal hormone levels of the observation group were better than those of the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).Conclusion:For elderly patients with gastric cancer,early enteral nutrition nursing after surgery can improve their nutritional indexes and gastrointestinal hormone levels,enhance their immune ability,and prevent the incidence of postoperative complications,with good effects.
基金Supported by the Fundamental Research Funds for the Central Universities of Central South University,No.2024XQLH027.
文摘BACKGROUND Colonic anastomotic leakage(AL)remains a feared complication of colorectal surgery.Usually,a defunctioning stoma or a proximal colostomy is performed to reduce the AL rate but cannot completely prevent AL.Moreover,defunctioning colostomy is associated with high morbidity.This study assessed the feasibility of completely preventing colonic AL using total enteric flow diversion without a defunctioning stoma in a pig model of colonic AL.AIM To determine the feasibility of preventing colonic AL via total enteric flow diversion in pigs.METHODS A total of 14 pigs underwent surgery to create colon anaesthesia with severe defects for establishing the AL model.The pigs were then randomized into the control group(n=7),which received no further therapy,and a diversion group(n=7),which underwent placement of a modified ileostomy tube to divert the enteric contents from the colon externally.The general condition,serum Creactive protein level,white blood cell count,5-day incidence of colon AL,and development of abdominal abscesses were evaluated.RESULTS A modified ileostomy tube with a balloon was placed and pressurized to 20 kPa at a distance of 10-20 cm proximal to the ileocecal valve,effectively obstructing the intestine without causing injury and efficiently diverting the enteric contents.In the diversion group,no cases of peritonitis or abscess were observed.In contrast,all pigs in the control group developed either abdominal abscesses or peritonitis.CONCLUSION Instead of ileostomy or colostomy,the total enteric flow diversion technique with the placement of a modified ileostomy tube and balloon in the ileum can effectively or completely prevent colon AL.
文摘BACKGROUND Malnutrition exacerbates the deterioration in patients with advanced gas-trointestinal tumors.AIM To analyze the effect of enteral nutritional support based on Nutrition Risk Screening 2002(NRS2002)risk assessment on nutritional function in patients with gastrointestinal tumors.METHODS One hundred twelve patients from April 2022 to April 2024 were included for observation and were divided into a control group and an observation group by random number method,56 each.Both groups received treatment for four consecutive weeks.The control group received routine enteral nutrition support,while the observation group received enteral nutrition support based on the NRS2002 risk assessment.Nutritional function,intestinal mucosal barrier function,quality of life,and complication rate were compared between the two groups.Statistical analysis was completed using SPSS26.0 and Excel.RESULTS After nutritional intervention,transferrin,albumin,hemoglobin,and diamine oxidase levels in the observation group were higher than those in the control group,while C-reactive protein,tumor necrosis factorα,and quality of life scores were lower,with significant differences(P<0.05).There was no significant difference in complications between groups(P>0.05),but the complication rate was lower in the observation group.CONCLUSION Enteral nutritional support based on NRS2002 risk assessment for patients with gastrointestinal tumors positively impacts nutritional status and promotes intestinal mucosal barrier function recovery.Patients’quality of life improved,and the incidence of adverse reactions decreased,indicating clinical promotion and application value.
基金Supported by Children’s Hospital Foundation at VCU,No.1K23HD097282(to Donowitz JR)National Institutes of Health,No.5R01AI043596(to Donowitz JR)+6 种基金Bill and Melinda Gates Foundation,No.OPP1017093VA Merit Award,No.1I01BX005730VA ShEEP Grants,No.1 IS1 BX004777-01National Institutes of Health Grant,No.2R56DK115377-05A1PIDS Summer Research Scholars AwardVCU SOM Dean’s Summer Research Fellowshipand Research Career Scientist Award from the Department of Veterans Affairs,No.IK6BX004477.
文摘BACKGROUND Environmental enteric dysfunction(EED)is a subclinical condition caused by fecal-oral contamination leading to enteric inflammation and dysbiosis.Bile acids serve to facilitate lipid digestion and absorption,regulate metabolic pathways associated with childhood growth and inflammation,and may be affected by EED.AIM To investigate bile acid metabolism in Bangladeshi children with EED and its association with growth impairment.METHODS We conducted a cross-sectional study of 100 Bangladeshi infants(aged 6-9 months)and quantified serum and fecal bile acids using LC-MS/MS.We compared profiles to a control group of 6 American children(6-12 months)and 80 older Bangladeshi children(aged 2 years).RESULTS Bangladeshi infants had higher levels of plasma unconjugated primary(65.23%vs 44.25%,P=0.003)and sulfated primary bile acids(12.98%vs<0.001%,P=0.01),with lower primary conjugated bile acids(0.69%vs 2.74%,P≤0.001)compared to American children.Stool unconjugated primary bile acids were inversely associated with weight-for-age[regression coefficient(β)=-0.01,P=0.01]and height-for-age Z scores(β=-0.01,P=0.03).Conjugated secondary bile acids were inversely associated with small intestine bacterial overgrowth(β=-1096.68,P=0.05).Fecal myeloperoxidase was associated with sulfated secondary bile acids(β=-0.40,P=0.04).Compared to 2-year-old children,the Bangladeshi infant’s serum had higher levels of unconjugated primary bile acids(65.23%vs 9.20%,P≤0.001)and lower levels of primary conjugated bile acids(0.69%vs 80.38%,P≤0.001).CONCLUSION Our data suggests an age-dependent defect in conjugation of primary bile acids in Bangladeshi children with compensatory hydrophilic shunting.Additionally,bile acid profiles are associated with intestinal overgrowth.
基金Supported by Zhejiang Province Medical and Health Technology Planning Project,No.2019332856.
文摘Gastric retention is a common complication in individuals receiving enteral nutrition(EN)via a nasogastric tube,increasing the risk of aspiration pneumonia and causing unnecessary interruptions in nutritional support.Given its clinical significance,establishing effective,evidence-based,and standardized manage-ment strategies is essential for bettering patient outcomes and mitigating compli-cations.This review systematically synthesized the diagnostic criteria,assessment methods,influencing factors,management procedures,and intervention strategies for gastric retention in EN patients.Although no universal consensus exists re-garding gastric residual volume(GRV)thresholds,evidence indicates that EN can continue at high GRV levels in the absence of gastrointestinal symptoms.Bedside ultrasound emerged as a non-invasive,and precise method GRV assessment,offering potential to standardize clinical practice.Key risk factors for gastric retention include neurological disorders and EN infusion rates exceeding 100 mL/h.Effective management strategies encompass non-pharmacological inter-ventions,pharmacological agents,and traditional Chinese medicine(TCM)the-rapies.This review underscored the need for integrated,multi-modal manage-ment strategies and recommended the adoption of bedside ultrasound and stan-dardized protocols to optimize EN delivery and improve patient outcomes.Large-scale,multicenter clinical trials should be a priority for future investigation to verify the effectiveness of TCM therapies and develop personalized intervention plans for high-risk patients.
