关键词： Bone marrow adipose tissue   Bone mass   Crohn's disease   Inflammatory bowel diseases   Ulcerative colitis  

摘要： Bone marrow adipose tissue has not been studied in patients with inactive inflammatory bowel disease. We found that these patients have preserved marrow adiposity even with low bone mass. Factors involved in bone loss in active disease may have long-lasting effects but do not seem to affect bone marrow adiposity. Reduced bone mass is known to occur at varying prevalence in patients with inflammatory bowel diseases (IBD) because of inflammation, malnutrition, and steroid therapy. Osteoporosis may develop in these patients as the result of an imbalanced relationship between osteoblasts and adipocytes in bone marrow. This study aimed to evaluate for the first time bone mass and bone marrow adipose tissue (BMAT) in a particular subgroup of IBD patients characterized by long-term, steroid-free remission. Patients with Crohn's disease (CD;N = 21) and ulcerative colitis (UC;N = 15) and controls (C;N = 65) underwent dual X-ray energy absorptiometry and nuclear magnetic resonance spectroscopy of the L3 lumbar vertebra for BMAT assessment. Both the CD and UC subgroups showed significantly higher proportions of patients than controls with Z-score ae-2.0 at L1-L4 (C 1.54%;CD 19.05%;UC 20%;p = 0.02), but not at other sites. The proportions of CD patients with a T-score E,-1.0 at the femoral neck (C 18.46%;CD 47.62%;p = 0.02) and total hip (C 16.92%;CD 42.86%;p = 0.03) were significantly higher than among controls. There were no statistically significant differences between IBD patients and controls regarding BMAT at L3 (C 28.62 +/- 8.15%;CD 29.81 +/- 6.90%;UC 27.35 +/- 9.80%;p = 0.67). IBD patients in long-term, steroid-free remission may have a low bone mass in spite of preserved BMAT. These findings confirm the heterogeneity of bone disorders in IBD and may indicate that factors involved in bone loss in active disease may have long-lasting effects on these patients.

关键词： INFLAMMATORY bowel diseases   PATIENTS   GADOLINIUM   COHEN'S kappa coefficient (Statistics)   ENDOSCOPY   PEDIATRICS  

摘要： AIM: To investigate concordance of bowel ultrasound and magnetic resonance enterography (MRE) in identifying active disease in children with inflammatory bowel disease. MATERIALS AND METHODS: The imaging of children with inflammatory bowel disease who had undergone bowel ultrasound and MRE within 30 days were retrospectively reviewed, from January 2009 to November 2015. Ultrasound was without oral contrast medium;MRI was conducted with patients unsedated with oral contrast medium and gadolinium. Imaging data included bowel thickness, markers of activity, and complications. Endoscopy and biopsy reports were also reviewed. RESULTS: Forty-nine patients (median age 14 years, 33 male) met the inclusion criteria, and 31 children also had endoscopy within 30 days. Active inflammation was seen in 17.6% of bowel segments at ultrasound and 17.3% at MRE. There was good agreement between ultrasound and MRE on the location and activity of disease (Cohen's kappa 0.75, 95% confidence interval [CI]: 0.66-0.83). One patient had an inflammatory phlegmon detected at MRE only;there was no other significant discrepancy in identifying complications. In patients with histopathology, MRE, and ultrasound demonstrated high specificity 85.1% (77.9-90.6) and 86.6% (79.6-91.8) at the bowel segment level. Technical difficulties, including poor tolerance of oral contrast medium and movement, were more common in MRE. CONCLUSION: There was good concordance between MRE and ultrasound for disease location and activity, and fewer technical difficulties with ultrasound. Bowel ultrasound is useful in children, and its use is advocated. (C) 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

关键词： Anthocyanins   Anti-inflammatory   Anti-oxidant   Co-cultures   Inflammatory bowel disease  

摘要： The overproduction of reactive oxygen species (ROS) and pro-inflammatory mediators is closely related with inflammatory diseases, such as inflammatory bowel disease (IBD). Despite the advances in therapeutics, new and safer strategies are still required. In this context, anthocyanins, highly available in human diet and recognized as health-promoting agents, have been a focus of interest. Thus, the aim of this work was to study the anti-inflammatory potential of a characterized anthocyanin-rich fraction from Portuguese blueberries, as compared with 5-aminosalicylic acid (ASA), a standard anti-inflammatory drug in IBD, by using a co-culture system of intestinal epithelial Caco-2 cells and RAW 264.7 macrophage cells, as a model of colitis. The compounds were pre-incubated in the apical side of a Transwell plate containing a differentiated and polarized Caco-2 cell monolayer, for 3 h, followed by addition of 1 µg/mL lipopolysaccharide to the basolateral side to stimulate the RAW 264.7 cells. After 24 h, the inflammatory process was evaluated in terms of nitric oxide, IL-6 and IL-1β contents in culture supernatants, as well as of intracellular ROS. A monoculture of RAW 264.7 was used for comparison. Our data showed that the production of pro-inflammatory mediators and ROS in both compartments was significantly decreased by anthocyanins, in a higher extent than by 5-ASA. [ABSTRACT FROM AUTHOR]

关键词： Crohn’s disease   Ulcerative colitis   biologic therapy   calcineurin inhibitor   opportunistic infection  

关键词： HIDRADENITIS suppurativa   INFLAMMATORY bowel disease diagnosis   ELECTRONIC health records   LOGISTIC regression analysis   COMORBIDITY  

摘要： The article discusses a study focusing on the hidradenitis suppurativa (HS) inflammatory disease, discussing its association at the time of diagnosis of inflammatory bowel disease (IBD) in U.S. patient population. Topics discussed include the search of electronic medical records in the study, the use of logistic regression analysis to determine concurrent diagnosis, and the possible biological link between the two diseases.

关键词： Crohn's disease   ERAP1   HLA-C   inflammatory bowel disease   ulcerative colitis  

摘要： Large genome-wide analysis studies (GWAS) and meta-analyses have dramatically increased our knowledge of the genetic risk factors of inflammatory bowel disease (IBD), identifying at least 163 loci. The endoplasmic reticulum aminopeptidase-2 (ERAP2) gene has been reported as a potential candidate gene for IBD. GWAS have also shown the potential associations between ERAP single nucleotide polymorphisms (SNP) loci and susceptibility to several autoimmune diseases, and ERAP1 and ERAP2 polymorphisms are related to HLA class I-associated diseases, including ankylosing spondylitis and Behcet's disease. Interestingly, these associations were confined to individuals carrying HLA class I-risk alleles. The aim of this study was to investigate the association of ERAP1 and ERAP2 SNPs with IBD in a Spanish population, analysing their possible interaction with specific HLA-C alleles to IBD susceptibility. A total of 367 individuals were divided into 216 IBD cases and 151 controls. SNP genotyping was performed using TaqMan (R) genotyping assays, whereas HLA-C typing was analysed by sequence-specific oligonucleotide probing. Herein, we report an association of the ERAP1 SNP rs30187 with the HLA-C*07 allele. The existence of shared inflammatory pathways in immunologically related diseases together with the understanding of ERAP1 function may offer clues to novel treatment strategies.

关键词： Transforming growth factor-beta   Inflammatory bowel disease   Dendritic cells   Microbiota   Adhesion molecules  

摘要： Inflammatory bowel disease (IBD) is defined as chronic intestinal inflammation, and includes ulcerative colitis and Crohn's disease. Multiple factors are involved in the pathogenesis of IBD, and the condition is characterized by aberrant mucosal immune reactions to intestinal microbes in genetically susceptible hosts. Transforming growth factor-beta (TGF-beta) is an immune-suppressive cytokine produced by many cell types and activated by integrins. Active TGF-beta binds to its receptor and regulates mucosal immune reactions through the TGF-beta signaling pathway. Dysregulated TGF-beta signaling is observed in the intestines of IBD patients. TGF-beta signal impairment in specific cell types, such as T-cells and dendritic cells, results in spontaneous colitis in mouse models. In addition, specific intestinal microbes contribute to immune homeostasis by modulating TGF-beta production. In this review, we describe the role of TGF-beta in intestinal immunity, focusing on immune cells, epithelium, and intestinal microbes. In addition, we present potential therapeutic strategies for IBD that target TGF-beta.

关键词： non-starch polysaccharide (NSP)   inflammatory bowel disease (IBD)   intervention   mechanism   SCFAs   gut microbiota   immune system   pro-inflammatory cytokines  

摘要： The incidence of inflammatory bowel disease (IBD) has increased considerably over the past few decades. In the present review, we discuss several disadvantages existing in the treatment of IBD and current understandings of the structures, sources, and natures of various kinds of non-starch polysaccharides (NSPs). Available evidences for the use of different sources of NSPs in IBD treatment both in vitro and in vivo are analyzed, including glucan from oat bran, mushroom, seaweed, pectin, gum, prebiotics, etc. Their potential mechanisms, especially their related molecular mechanism of protective action in the treatment and prevention of IBD, are also summarized, covering the anti-inflammation, immune-stimulating, and gut microbiota-modulating activities, as well as short-chain fatty acids (SCFAs) production, anti-oxidative stress accompanied with inflammation, the promotion of gastric epithelial cell proliferation and tissue healing, and the reduction of the absorption of toxins of NSPs, thus ameliorating the symptoms and reducing the reoccurrence rate of IBD. In summary, NSPs exhibit the potential to be promising agents for an adjuvant therapy and for the prevention of IBD. Further investigating of the crosstalk between immune cells, epithelial cells, and gut microorganisms in addition to evaluating the effects of different kinds and different molecular weights of NSPs will lead to well-designed clinical intervention trials and eventually improve the treatment and prevention of IBD.

关键词： inflammatory bowel disease   vagus nerve   vagus nerve stimulation  

摘要： Inflammatory bowel disease (IBD), that is Crohn's disease (CD) and ulcerative colitis, affects about 1.5 million persons in the USA and 2.2 million in Europe. The pathophysiology of IBD involves immunological, genetic and environmental factors. The treatment is medico-surgical but suspensive. Anti-TNF alpha agents have revolutionized the treatment of IBD but have side effects. In addition, a non-negligible percentage of patients with IBD stop or take episodically their treatment. Consequently, a nondrug therapy targeting TNF alpha through a physiological pathway, devoid of major side effects and with a good cost-effectiveness ratio, would be of interest. The vagus nerve has dual anti-inflammatory properties through its afferent (i.e. hypothalamic-pituitary-adrenal axis) and efferent (i.e. the anti-TNF alpha effect of the cholinergic anti-inflammatory pathway) fibres. We have shown that there is an inverse relationship between vagal tone and plasma TNFa level in patients with CD, and have reported, for the first time, that chronic vagus nerve stimulation has anti-inflammatory properties in a rat model of colitis and in a pilot study performed in seven patients with moderate CD. Two of these patients failed to improve after 3 months of vagus nerve stimulation but five were in deep remission (clinical, biological and endoscopic) at 6 months of follow-up and vagal tone was restored. No major side effects were observed. Thus, vagus nerve stimulation provides a new therapeutic option in the treatment of CD.

关键词： Inflammatory bowel disease   Depressive   United States   Population   National survey  

摘要： Background/Aims: There is a paucity of population-based studies on the association between inflammatory bowel disease (IBD) and depression in the U.S. population. We sought to study this association using the National Health and Nutrition Examination Survey (NHANES) database. Methods: We used NHANES data from 2009 to 2010. Our study included 190,269,933 U.S. adults without IBD and 2,325,226 with IBD. We sought to determine whether IBD is an independent risk factor for depressive symptoms (DS) in the U.S. population and studied the independent predictors of DS in IBD population. Results: DS was present in 49% of the IBD population versus 23% of the non-IBD population (p<0.001). During the multivariate analysis, we found that IBD was independently associated with DS in the U.S. population (p=0.002). The independent predictors of DS in the IBD population were older age (p=0.048) and divorced/separated/widowed status (p=0.005). There was nonsignificant increase in suicidal risk in IBD population with DS versus that in non-IBD population with DS (27% vs 12%, respectively, p=0.080). Only 36% of IBD individuals with DS visited mental health professional or psychiatrist within the past year. Conclusions: IBD is independently associated with DS in the U.S. population. Further research is warranted on risk stratification, screening and management of those with IBD who are at risk of depression.