关键词： Glucagon-like peptide-2 dimer   Inflammatory bowel disease   Inflammatory cytokine   Apoptosis   Therapeutic benefit  

摘要： Inflammatory bowel disease (IBD) is a chronic, recurrent, and remitting inflammatory disease resulting from immune dysregulation in the gut. As a clinically frequent disease, it can affect individuals throughout their lives, with multiple complications. Glucagon-like peptide 2 (GLP-2) is a potent epithelium-specific intestinal growth factor. However, native GLP-2 has a relatively short half-life in human circulation because of extensive renal clearance and rapid degradation by the proteolytic enzyme dipeptidyl peptidase-IV (DPP-IV). Previously, We prepared a recombinant GLP-2 variant (GLP-22), which has increased half-life and activity as compared to the [Gly(2)]GLP-2 monomer. The aim of the present study was to investigate the protective potential of GLP-22 in IBD models. LPS-induced in vitro model and dextran sulfate sodium (DSS)-induced in vivo model were used to study the anti-inflammatory and therapeutic effect of GLP-22. We found that treated with GLP-2 showed a significantly reduction in the secretion of inflammatory cytokines. Furthermore, GLP-22 alleviated symptoms of DSS-induced colitis. GLP-22 treated mice displayed an increase in body weight, lower colitis scores, and fewer mucosal damage compared with GLP-2 treated mice. MPO activities, protein expression of NLRP3 and COX2 in the colon tissues were significantly reduced in GLP-22 groups. Importantly, the ameliorative effect of GLP-22 was related to anti-apoptosis effect in colon tissues. These findings demonstrated that GLP-22 may offer a superior therapeutic benefit over [Gly(2)]GLP-2 monomer for treatment of IBD.

关键词： Collagenous colitis   Crohn's disease   epidemiology   lymphocytic colitis   Helicobacter pylori   ulcerative colitis  

摘要： AimPrevious studies have found an increased risk for microscopic colitis (MC) associated with proton pump inhibitors. In patients with ulcerative colitis (UC) or Crohn's disease (CD), proton pump inhibitors have been associated with an increased risk for IBD flares and impaired outcomes. The aim of this study was to test the epidemiological associations between gastro-oesophageal reflux disease (GERD) and MC, UC or CD in a large database. MethodThe Miraca Life Sciences Database is a national electronic repository of histopathological records of patients distributed throughout the entire USA. A case-control study evaluated whether the presence of Barrett's metaplasia, erosive oesophagitis on endoscopy or histological signs of reflux oesophagitis, clinical diagnosis of GERD or any GERD type affected the occurrence of MC, UC or CD among 228506 subjects undergoing bidirectional endoscopy. Multivariate logistic regression analyses were used to calculate ORs and their 95% CI for the risk of MC, UC or CD associated with various types of GERD and were adjusted for age, sex and presence of Helicobacter pylori. ResultsThe analysis revealed an inverse relationship between GERD and different types of inflammatory bowel disease. The inverse relationships applied similarly to MC (mean=0.62, 95% CI: 0.58-0.66), UC (mean=0.89, 95% CI: 0.81-0.97) and CD (mean=0.76, 95% CI: 0.69-0.85). It also applied to different forms of GERD, with a trend towards more pronounced inverse relationships associated with Barrett's metaplasia or erosive oesophagitis than clinical diagnosis of GERD. ConclusionGastro-oesophageal reflux disease is inversely associated with all forms of inflammatory bowel disease, such as MC, UC, or CD.

关键词： Irritable bowel syndrome   Inflammatory bowel disease   Depression   Anxiety   Meta-analysis  

摘要： Background: The prevalence of comorbid depression is high in chronic gastrointestinal disorders, including irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). For these two disorders in particular, the findings have not been consistent. This meta-analysis systematically compares the rates and severity of comorbid depression between IBS and IBD patients. Methods: A systematic literature search was conducted using PubMed, PsycINFO, Embase, Cochrane Library, Wan Fang, SinoMed, Chinese National Knowledge Infrastructure from their inception date to September 12, 2017 for comparative studies on IBS and IBD patients. Standardized mean differences (SMDs) and odds ratios (OR) of comorbid depression were calculated using random effect models. Data on comorbid anxiety in the included studies were also extracted and analyzed. Results: Altogether, 22 studies with 1,244 IBS and 1,048 IBD patients were included. While there was no significant group difference in the prevalence of depression (10 studies, OR=1.18, 95% CI: 0.87-1.60, P=0.29), the IBS group had more severe depression (pooled SMD=0.18, 95% CI: 0.04-0.33, P=0.01) and anxiety than the IBD group (pooled SMD=0.31, 95% CI: 0.14-0.49, P=0.0006). Sixteen (72.7%) studies were assessed as 'high quality' using the Newcastle-Ottawa Scale (NOS). Conclusions: Although the prevalence of comorbid depression was similar between groups, IBS patients had more severe comorbid depressive and anxiety symptoms compared to IBD patients. Appropriate assessment and treatment of depressive and anxiety symptoms in these patient groups should be implemented.

摘要： The article discusses the proceedings of the session conducted by clinicians Miles Parkes, Ashwin Ananthakrishnan and Ian Lawrance which evaluated the therapeutic efficacy of the drug vedolizumab in inflammatory bowel disease, where it targets various cell populations which are present in the gastrointestinal system. Topics discussed include the drug targeting the alpha-4-beta-7 integrin protein and its influence on the gut microbiome composition.

摘要： The article discusses the different aspects related to diagnosis of inflammatory bowel disease (IBD). It talks about the diagnosis of Crohn's disease or ulcerative colitis during the prognosis. It discusses the assessment of the risk and biomarkers to be developed for correct prediction. It also discusses the clinical trials and the aggressive therapies.

关键词： INFLAMMATORY bowel diseases   APPETITE loss   GASTROPARESIS   VOMITING   VEDOLIZUMAB  

关键词： Brachytherapy   high dose rate   inflammatory bowel disease   low dose rate   prostate cancer   toxicity  

摘要： Aims: Inflammatory bowel disease (IBD) has historically been considered a risk factor for increased bowel toxicity in patients receiving pelvic external beam radiotherapy. The risk is reduced in intensity-modulated radiotherapy compared with three-dimensional conformal radiotherapy. The effect of brachytherapy has been less extensively researched. Despite the increased dose to the gross tumour volume and decreased dose to organs at risk, previous studies have recommended avoidance of low dose rate (LDR) brachytherapy in patients with IBD, due to increased bowel toxicity. We investigated the effect of high dose rate (HDR) brachytherapy in IBD. Materials and methods: Eleven IBD patients across four different sites (in the UK and Spain) who received HDR brachytherapy, between 2012 and 2015, were followed for up to 12 months. Acute bowel and urinary toxicity data were collected and recorded. Results: The median length of follow-up was 6 months (range between 6 weeks and 12 months). Five patients had Crohn's disease and six patients had ulcerative colitis. Only one patient (with Crohn's disease) had active disease at the time of treatment. This patient reported no bowel toxicity. Of the remaining patients, two suffered grade 1 diarrhoea (at 6 weeks and 6 months);three suffered grade 1 proctitis (at 6 weeks and 6 months). There was no grade >= 2 bowel toxicity. The most severe toxicity was grade 2 urinary frequency in one patient (at 6 weeks). Discussion: This small, prospective case series suggests that, in the short term, HDR brachytherapy is safe and well tolerated in IBD patients. Therefore, IBD should not automatically disqualify patients from, at least, HDR brachytherapy. The reason why these results differ from previous LDR studies possibly reflects the benefit of inverse planning, which more readily achieves rectal dose constraints in HDR brachytherapy. (C) 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.