关键词： anxiety   colitis   depression   gut-brain axis   inflammatory bowel disease  

摘要： IntroductionInflammatory bowel disease (IBD) is a chronic relapsing and remitting disorder characterised by inflammation of the gastrointestinal tract. There is a growing consensus that IBD is associated with anxiety- and depression-related symptoms. Psychological symptoms appear to be more prevalent during active disease states with no difference in prevalence between Crohn's disease and ulcerative colitis. Behavioural disturbances including anxiety- and depression-like symptoms have also been observed in animal models of *** likely mechanisms underlying the association are discussed with particular reference to communication between the gut and brain. The close bidirectional relationship known as the gut-brain axis includes neural, hormonal and immune communication links. Evidence is provided for a number of interacting factors including activation of the inflammatory response system in the brain, the hypothalamic-pituitary-adrenal axis, and brain areas implicated in altered behaviours, changes in blood brain barrier integrity, and an emerging role for gut microbiota and response to probiotics in *** impact of psychological stress in models of IBD remains somewhat conflicted, however, it is weighted in favour of stress or early stressful life events as risk factors in the development of IBD, stress-induced exacerbation of inflammation and *** is recommended that patients with IBD be screened for psychological disturbance and treated accordingly as intervention can improve quality of life and may reduce relapse rates.

关键词： Smoking   Crohn's disease   Ulcerative colitis   Asia   Environment  

摘要： BackgroundCigarette smoking is thought to increase the risk of Crohn's disease (CD) and exacerbate the disease course, with opposite roles in ulcerative colitis (UC). However, these findings are from Western populations, and the association between smoking and inflammatory bowel disease (IBD) has not been well studied in Asia. AimsWe aimed to compare the prevalence of smoking at diagnosis between IBD cases and controls recruited in China, India, and the USA, and to investigate the impact of smoking on disease *** recruited IBD cases and controls between 2014 and 2018. All participants completed a questionnaire about demographic characteristics, environmental risk factors and IBD *** recruited 337 participants from China, 194 from India, and 645 from the USA. In China, CD cases were less likely than controls to be current smokers (adjusted odds ratio [95% CI] 0.4 [0.2-0.9]). There was no association between current or former smoking and CD in the USA. In China and the USA, UC cases were more likely to be former smokers than controls (China 14.6 [3.3-64.8];USA 1.8 [1.0-3.3]). In India, both CD and UC had similar current smoking status to controls at diagnosis. Current smoking at diagnosis was significantly associated with greater use of immunosuppressants (4.4 [1.1-18.1]) in CD cases in *** found heterogeneity in the associations of smoking and IBD risk and outcomes between China, India, and the USA. Further study with more adequate sample size and more uniform definition of smoking status is warranted.

关键词： Intestinal Diseases   Biopsy   NOBELIUM   Inflammatory Bowel Diseases  

关键词： intestinal microbiota   Inflammatory bowel disease   inflammation  

摘要： Inflammatory bowel diseases (IBD) are a group of chronic diseases of increasing worldwide prevalence characterized by gastrointestinal (GI) inflammation leading to debilitating symptoms and complications. The contribution of the intestinal microbiota to the pathogenesis and etiology of these diseases is an area of active research interest. Here, we discuss key mechanisms underlying the chronic inflammation seen in IBD as well as evidence implicating the intestinal microbiota in the development and potentiation of that inflammation. We also discuss recently published work in areas of interest within the field of microbial involvement in IBD pathogenesis - the importance of proper microecology within the GI tract, the evidence that the intestinal microbiota transduces environmental and genetic risk factors for IBD, and the mechanisms by which microbial products contribute to communication between microbe and host. There is an extensive body of published research on the evidence for microbial involvement in IBD;the goal of this review is to highlight the growing edges of the field where exciting and innovative research is pushing the boundaries of the conceptual framework of the role of the intestinal microbiota in IBD pathogenesis.

关键词： Inflammatory bowel disease   Vitamin D-3   Oral administration   Inflammatory disease   Nanostructured lipid carrier  

摘要： The active form of vitamin D-3, 1,25(OH)(2)D-3 has been found to exert multiple effects on the suppression of progression of inflammatory bowel disease (IBD). Vitamin D-3 has been gathering attention as a therapy for IBD. However, the clinical trials conducted to date revealed that a relatively high dosage of vitamin D-3 was required to see a significant therapeutic effect. Thus, effective formulation and delivery of vitamin D-3 to colonic inflammatory lesions will be required. Herein we describe the preparation of a nanostructured lipid carrier (NLC) for the encapsulation of 1,25(OH)(2)D-3 for colonic delivery via oral administration. The optimized fabrication procedure enabled the incorporation of 1,25(OH)(2)D-3 in the NLC by minimizing the destruction of chemically unstable 1,25(OH)(2)D-3. The obtained NLCs orally delivered 1,25(OH)(2)D-3 to the colon in mice and maintained a high concentration of 1,25(OH)(2)D-3 in the colonic tissue for at least 12 h. The NLC showed multiple effects on the suppression of symptoms of colitis induced by dextran sodium sulfate, namely maintaining crypt structure, reducing the tissue concentration of inflammatory cytokines, suppressing the infiltration of polymorphonuclear leukocytes, and augmenting anti-inflammatory CX3CR1high macrophages. Our NLCs containing 1,25(OH)(2)D-3 may be an alternative treatment for IBD therapy.

摘要： Helicobacter pylori has coexisted with humans for approximately 60,000 years and greater than 50% of the global population is infected with H. pylori. H. pylori was successfully cultured in vitro in 1983 and studies of H. pylori have achieved substantial advances over the last 35 years. Since then, H. pylori has been characterized as the primary pathogenic factor for chronic gastritis, peptic ulcer, and gastric malignancy. Numerous patients have received H. pylori eradication treatment, but only 1-2% of H. pylori-infected individuals ultimately develop gastric cancer. Recently, numerous epidemiological and basic experimental studies suggested a role for chronic H. pylori infection in protecting against inflammatory bowel disease (IBD) by inducing systematic immune tolerance and suppressing inflammatory responses. Here we summarize the current research progress on the association between H. pylori and IBD, and further describe the detailed molecular mechanism underlying H. pylori-induced dendritic cells (DCs) with the tolerogenic phenotype and immunosuppressive regulatory T cells (Tregs). Based on the potential protective role of H. pylori infection on IBD, we suggest that the interaction between H. pylori and the host is complicated, and H. pylori eradication treatment should be administered with caution, especially for children and young adults.

关键词： ATM   bioactives   gut microbiota   IBD   obesity  

摘要： Current views support the concept that obesity is linked to a worsening of the course of inflammatory bowel diseases (IBDs). Gut microbiota and adipose tissue macrophage (ATM) are considered key mediators or contributors in obesity-associated intestinal inflammation. Dietary components can have direct or indirect effects on “normal” or “healthy” microbial composition and participate in adiposity and metabolic status with gut inflammation. In this perspective, we highlight food-derived bioactives that have a potential application in the prevention of obesity-exacerbated IBD, targeting energy metabolism, M1 (classical activated)-M2 (alternatively activated) macrophage polarization, and gut microbiota.

关键词： Faecal miRNA   IBD   Intestinal microbiota  

摘要： Reasons underlying the individual differences in the clinical manifestations of inflammatory bowel diseases (IBD) and the mechanism by which the host screens the intestinal microbiota remain unclear. The presence of miRNA in faeces might be a potential clue into differences in gut microbiota among these patients. In this study, we analysed the differences in miRNA levels in faecal samples from 117 patients diagnosed with IBD. There was a significant difference in faecal miRNAs between healthy subjects and those with inactive IBD. Further analysis showed that some miRNAs might indicate the severity of IBD activity and prognosis. Sequencing analysis of the 16S RNA V4 region in faecal microbiota in these IBD patients revealed significant differences in the phylogenetic architecture between subjects with active or inactive IBD and between IBD patients and healthy subjects. Finally, in vitro studies showed that these differentially expressed miRNAs have different effects on the proliferative activity of the intestinal microorganisms Fusobacterium nucleatum (Fn), Escherichia coli (E. coli) and segmental filamentous bacteria (SFB). We observed the dynamic uptake of miRNA by these bacteria using flow cytometry. This study reveals a potential link between faecal miRNA, intestinal microbiota, IBD activity and prognosis. (C) 2018 Elsevier Inc. All rights reserved.

关键词： Crohn's disease   Ulcerative colitis   Paediatrics   Integrin antagonist  

摘要： Background: Vedolizumab is safe and effective in adult patients with Crohn's disease (CD) and ulcerative colitis (UC);however, data in children with inflammatory bowel disease (IBD) are scarce. Therefore, we evaluated vedolizumab use in a cohort of Austrian paediatric patients with IBD. Methods: Twelve patients (7 female;7 CD;5 UC), aged 8-17 years (median, 15 years), with severe IBD who received vedolizumab after tumour necrosis factor a antagonist treatment were retrospectively analysed. Clinical activity scores, relevant laboratory parameters, and auxological measures were obtained at infusion visits. Results: In the CD group, 1/7 patient discontinued therapy due to a severe systemic allergic reaction;1/7 and 2/7 patients achieved complete and partial response, respectively, at week 14;and 3/7 patients discontinued therapy due to a primary non-response or loss of response. In the UC group, complete clinical remission was achieved at weeks 2, 6, and 14 in 2/5, 1/5 and 1/5 patients respectively;partial response was observed in one patient at week 2. CD activity scores did not significantly change from baseline to week 38 (median 475 vs. 40 points, p = 1,0), while median UC activity scores changed from 70 to 5 points (p < 0,001). Substantial weight gain and increased albumin and haemoglobin levels were observed in both groups. Conclusion: These results demonstrate that vedolizumab can be an effective treatment for individual paediatric patients with IBD who are unresponsive, intolerant, or experience a loss of efficacy in other therapies. However, vedolizumab appears to be more effective in paediatric UC than in paediatric CD.

关键词： Crohn's disease   Immunosuppressant   Inflammatory bowel diseases   Thyroid neoplasms   Ulcerative colitis  

摘要： Background: Potential risk of thyroid cancer in patients with inflammatory bowel disease has not been well investigated. The aim of the study was to reveal the relationship between history of inflammatory bowel disease and risk of thyroid cancer. Methods: First, 1392 patients with inflammatory bowel disease and 1392 controls were included in a case-control study. All patients did not receive immunosuppressive therapy. A multivariate logistic regression analysis was adopted to determine the relationship between history of inflammatory bowel disease and risk of thyroid cancer. Second, a literature search was performed and eight articles were collected. Pooled odds ratios with 95% confidence intervals were reported for relevant risk estimates in fixed or random effect model. Results: In the case-control study, thyroid cancer was more common in patients with inflammatory bowel disease than in controls (P = 0.032). After Bonferroni correction, association of thyroid cancer risk with history of total inflammatory bowel disease or its two subtypes was not found. In the meta-analysis, patients with total inflammatory bowel disease or ulcerative colitis showed an increased risk of thyroid cancer, but patients with Crohn's disease did not. Furthermore, inflammatory bowel disease patients with immunosuppressive therapy showed an increased risk of the cancer, but patients without immunosuppressive therapy did not have this finding. Conclusions: Risk of thyroid cancer probably elevates in patients with inflammatory bowel disease. Inflammatory bowel disease (particularly ulcerative colitis) itself and use of immunosuppressant might contribute to the development of the cancer.