关键词： inflammatory bowel disease   anti-inflammatory activity   Zingiber officinale   Terminalia chebula   Aucklandia lappa  

摘要： Many medicinal plants have been used traditionally in East Asia for the treatment of gastrointestinal disease and inflammation. The aim of this study was to evaluate the anti-inflammatory activity of 350 extracts (175 water extracts and 175 ethanol extracts) from 71 single plants, 97 mixtures of two plants, and seven formulations based on traditional medicine, to find herbal formulations to treat inflammatory bowel disease (IBD). In the in vitro screening, nitric oxide (NO), tumor necrosis factor (TNF)-alpha, and interleukin (IL)-6 levels were determined in LPS-treated RAW264.7 cells and the TNF-alpha induced monocyte-epithelial cell adhesion assay was used for the evaluation of the anti-inflammatory activity of the compounds. Dextran sulfate sodium (DSS)-induced colitis model and 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis model were used to evaluate the therapeutic effect against IBD of the samples selected from the in vitro screening. KM1608, composed of Zingiber officinale, Terminalia chebula and Aucklandia lappa, was prepared based on the screening experiments. The oral administration of KM1608 significantly attenuated the severity of colitis symptoms, such as weight loss, diarrhea, and rectal bleeding, in TNBS-induced colitis. In addition, inflammatory mediators, such as myeloperoxidase, TNF-alpha, and IL-6 levels decreased in the lysate of colon tissues treated with KM1608. Collectively, KM1608 ameliorated colitis through the regulation of inflammatory responses within the colon, which indicated that KM1608 had potential for the treatment of IBD.

关键词： Crohn's disease   Incidence   Prevalence   Ulcerative colitis  

摘要： Background: The burden of Crohn's disease (CD) and ulcerative colitis (UC) has never been estimated in the Republic of San Marino, the third smallest nation of the world. Aims: To assess the occurrence and clinical features of CD and UC in San Marino during the last 35 years. Methods: We retrospectively evaluated the prevalence, incidence, and main clinical aspects of CD and UC from 1980 to 2014, crossing data from various sources. Results: Prevalence rates (per 100,000) on December 31, were 241 for CD (263 in males and 220 in females) and 311 for UC (370 in males and 255 in females). The specific incidence of UC steadily increased from 4.6 (95% CI: 1.5-10.6) in 1980-1984 to 12.4 (95% CI: 7.6-19.1) in 2010-2014;CD incidence showed a higher proportional increase, from 1.8 (95% CI: 0.2-6.6) in 1980-1984 to 17.9 (95% CI: 12.0-25.7) in 2010-2014. The main clinical features of CD and UC (activity and location at diagnosis, extra-intestinal manifestations, disease progression overtime, therapies, and hospitalizations) were analyzed. Conclusions: This study provides the first epidemiological report on CD and UC in San Marino, showing specific traits and overall higher prevalence and incidence rates than previously reported in neighbor Areas. (C) 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

摘要： INTRODUCTION:Most studies on fractures in inflammatory bowel disease (IBD) are based on patients from tertiary centers or patients followed up before the introduction of immunomodulators or biologics. In addition, the role of corticosteroids in fracture risk has rarely been ***:We conducted a nationwide population-based cohort study of 83,435 patients with incident IBD (ulcerative colitis [UC]: n = 50,162, Crohn's disease [CD]: n = 26,763, and IBD unclassified: 6,510) and 825,817 reference individuals from 1964 to 2014. Using multivariable Cox regression, we estimated hazard ratios (HRs) for hip fracture and any fracture and the association with cumulative corticosteroid ***:During 1,225,415 person-years of follow-up in patients with IBD, there were 2,491 first-time hip fractures (203/100,000 person-years) compared with 20,583 hip fractures during 12,405,642 person-years in reference individuals (159/100,000 person-years). This corresponded to an HR of 1.42 (95% confidence interval [CI] = 1.36-1.48). The risk for hip fracture was higher in CD compared with UC (P < 0.001). Inflammatory bowel disease was also associated with any fracture (IBD: HR = 1.18;95% CI = 1.15-1.20). Hazard ratios for hip fracture had not changed since the introduction of immunomodulators or biologics. Increasing exposure to corticosteroids was associated with hip fracture in both IBD and non-IBD individuals (P < 0.001), but only in elderly (>60 years) patients with IBD. The association between IBD and hip fracture was nonsignificant among individuals without corticosteroids (HR = 1.11;95% CI = 0.86-1.44).CONCLUSIONS:Inflammatory bowel disease (CD and UC) is associated with an increased risk of hip fracture and any fracture, but not in individuals without a history of corticosteroid treatment. The association between corticosteroids and hip fracture was restricted to elderly patients with IBD.

关键词： aHR   adjusted hazard ratio   CD   Crohn disease   CI   confidence interval   IBD   inflammatory bowel disease   ICD-10   International Classification of Diseases, 10th revision   IR   incidence rate   PsA   psoriatic arthritis   UC   ulcerative colitis  

摘要： In psoriasis patients, incidence rates of Crohn disease (CD) and ulcerative colitis (UC) have been increased in epidemiological studies and certain clinical trials, yet the association remains poorly understood. We studied a 20-year nationwide cohort of 235,038 Danish adults with psoriasis and a 1: 1 matched reference group. Less than 1% of psoriasis patients developed CD or UC during follow-up. Incidence rates of CD were highest for younger women with psoriasis and patients with concurrent psoriatic arthritis, whereas men with psoriasis had particularly high incidence rates of UC compared with their non-psoriasis peers. Adjusted hazard ratios of CD were 1.84 (95% confidence interval [CI] = 1.47-2.29) and 2.38 (95% CI = 1.62-3.49) among psoriasis patients treated with topical and systemic nonbiologic therapy, respectively. No definite CD cases occurred during biologic therapy. For UC, adjusted hazard ratios were 1.49 (95% CI = 1.29-1.72), 1.51 (95% CI = 1.14e2.01), and 1.23 (95% CI = 0.39-3.86, P = 0.7197) for psoriasis patients receiving topical, systemic nonbiologic, and biologic therapy, respectively. Time to CD (but not UC) diagnosis was significantly longer for psoriasis patients compared with the general population, and patients receiving systemic treatment had the longest time to CD and UC. Psoriasis was associated with increased risk of CD and UC. Particular risk factors included sex and psoriatic arthritis.