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Causal relationship between inflammatory bowel disease and gingivitis or periodontal disease: A two-sample Mendelian randomized analysis 炎症性肠病与牙龈炎或牙周病之间的因果关系:双样本孟德尔随机分析
Pub Date : 2023-06-01 DOI: 10.1097/JN9.0000000000000010
Yi-Chao Ma, Wen-Qi Li, Chen Wei, Fei Wang, Yiqun Liao, Bin Zhao, Yuji Chen, Qi Zhao, Jie Qiu, Dong Tang
Abstract Background Observational studies have shown that inflammatory bowel disease (IBD), such as ulcerative colitis (UC) and Crohn disease (CD), is associated with gingivitis and periodontal disease (GP). This study aims to investigate whether there is a causal relationship between IBD and GP. Methods This study assessed the causal relationship between IBD and GP through a two-sample Mendelian randomization (MR) study. The required data were obtained through the IEU OpenGWAS project. Instrumental variable screening and the MR and sensitivity analyses were performed using the “TwoSampleMR” R package. Results IBD, UC, and CD may have a causal effect on GP (IBD, inverse variance weighting [IVW] OR = 1.05, 95% CI = 1.00–1.10, P = 0.03; UC, IVW OR = 1.05, 95% CI = 1.00–1.11, P = 0.03; CD, weighted median OR = 1.06, 95% CI = 1.00–1.13, P = 0.04; simple mode OR = 1.15, 95% CI = 1.02–1.31, P = 0.03). Scatterplots, forest plots, and funnel plots showed a significant relationship between IBD and GP and confirmed the robustness of the model. In sensitivity testing, no horizontal pleiotropy or heterogeneity was found in this study. Conclusions This study found a possible causal relationship between IBD (UC and CD) and GP, which deserves to be considered in clinical practice.
摘要 背景 观察性研究表明,溃疡性结肠炎(UC)和克罗恩病(CD)等炎症性肠病(IBD)与牙龈炎和牙周病(GP)有关。本研究旨在探讨 IBD 与 GP 之间是否存在因果关系。方法 本研究通过双样本孟德尔随机化(MR)研究评估 IBD 与 GP 之间的因果关系。所需数据通过 IEU OpenGWAS 项目获得。使用 "TwoSampleMR "R软件包进行了工具变量筛选、MR分析和敏感性分析。结果 IBD、UC 和 CD 可能对 GP 有因果影响(IBD,逆方差加权 [IVW] OR = 1.05,95% CI = 1.00-1.10,P = 0.03;UC,IVW OR = 1.05,95% CI = 1.00-1.11,P = 0.03;CD,加权中位数 OR = 1.06,95% CI = 1.00-1.13,P = 0.04;简单模式 OR = 1.15,95% CI = 1.02-1.31,P = 0.03)。散点图、森林图和漏斗图显示了 IBD 与 GP 之间的显著关系,并证实了模型的稳健性。在敏感性测试中,本研究未发现水平多向性或异质性。结论 本研究发现 IBD(UC 和 CD)与 GP 之间可能存在因果关系,值得在临床实践中加以考虑。
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引用次数: 0
Value of combining the serum d-lactate, diamine oxidase, and endotoxin levels to predict gut-derived infections in cancer patients 结合血清 d-乳酸盐、二胺氧化酶和内毒素水平预测癌症患者肠道感染的价值
Pub Date : 2023-06-01 DOI: 10.1097/JN9.0000000000000011
Shou-Mei Yang, Xiao-Dan Zhang, Huai-Xing Ma, Dan Wu, Xing Liu, Hao-Bin Yu, Shi-Wei Li, Wen-Jun Gao, Wei-Wei Liu, Su-Yi Li
Abstract Objective This is a retrospective observational cohort study. The objective of this retrospective observational cohort study was to evaluate the value of the combined serum d-lactic acid, diamine oxidase (DAO), and endotoxin levels to predict intestinal barrier impairment and gut-derived infection (GDI) in cancer patients. Methods Cancer patients receiving chemotherapy or palliative care treatment at our hospital were enrolled in the study. The serum concentrations of DAO, d-lactic acid, and endotoxin were determined using the intestinal barrier function biochemical index analysis system. The patients' infection information came from the hospital's Medicom Prescription Automatic Screening System and the medical records. Three hundred fifty-three cancer patients were included in the study (53.8% female, 73.7% cancer stage IV, 27.8% had bowel obstruction). Results The total incidence of GDI was 33.4% (118/353). The median length of hospital stay was 16 days for patients with GDI, compared with 7 days for patients without GDI (P < 0.001). The media hospitalization costs were ¥27,362.35 for patients with GDI compared with ¥11,614.08 for patients without GDI (P < 0.001). The serum concentrations of DAO, d-lactic acid, and endotoxin were significantly higher in patients with GDI. As malignant bowel obstruction (MBO) worsened, the concentrations of DAO, d-lactic acid, and endotoxin increased. Multivariate logistic regression models revealed that the DAO, endotoxin, IL-6, and C-reactive protein levels were significantly associated with an increased risk of GDI. In addition, we also found a fivefold increased risk of infection in patients with MBO compared with those without bowel obstruction (OR = 6.210, P < 0.001). All of the areas under the receiver operating characteristic curve (AUCs) for DAO, d-lactate, and endotoxin to predict GDI were <0.7 (AUC = 0.648, P < 0.001; AUC = 0.624, P < 0.01; AUC = 0.620, P < 0.01, respectively). However, when the parameters were combined (DAO + d-lactate + endotoxin), the predictive power increased significantly (AUC = 0.797, P < 0.001). Moreover, combining these intestinal barrier indicators and the presence of MBO had better power to predict GDI than either alone (AUC = 0.837, P < 0.001). Conclusions Combining the serum DAO, d-lactic acid, and endotoxin levels was a better predictor of GDI than any of the indicators alone, and combining these with the diagnosis of MBO could further improve the efficacy for predicting GDI.
摘要 目的 这是一项回顾性队列观察研究。本项回顾性队列研究旨在评估血清 d-乳酸、二胺氧化酶(DAO)和内毒素水平对预测癌症患者肠道屏障受损和肠源性感染(GDI)的价值。方法 将在我院接受化疗或姑息治疗的癌症患者纳入研究。使用肠道屏障功能生化指标分析系统测定血清中DAO、d-乳酸和内毒素的浓度。患者的感染信息来自医院的Medicom处方自动筛选系统和病历。研究共纳入 353 名癌症患者(53.8% 为女性,73.7% 为癌症 IV 期,27.8% 有肠梗阻)。结果 GDI 的总发生率为 33.4%(118/353)。GDI 患者的中位住院时间为 16 天,而无 GDI 患者的中位住院时间为 7 天(P < 0.001)。GDI 患者的媒体住院费用为 27,362.35 日元,而非 GDI 患者的媒体住院费用为 11,614.08 日元(P < 0.001)。GDI 患者血清中的 DAO、d-乳酸和内毒素浓度明显更高。随着恶性肠梗阻(MBO)的恶化,DAO、d-乳酸和内毒素的浓度也随之升高。多变量逻辑回归模型显示,DAO、内毒素、IL-6 和 C 反应蛋白水平与 GDI 风险的增加显著相关。此外,我们还发现与无肠梗阻的患者相比,MBO 患者的感染风险增加了五倍(OR = 6.210,P < 0.001)。DAO、d-乳酸盐和内毒素预测 GDI 的接收器操作特征曲线下面积(AUC)均小于 0.7(分别为 AUC = 0.648,P <0.001;AUC = 0.624,P <0.01;AUC = 0.620,P <0.01)。然而,如果将这些参数结合起来(DAO + d-乳酸盐 + 内毒素),预测能力会显著提高(AUC = 0.797,P < 0.001)。此外,将这些肠道屏障指标和 MBO 的存在结合起来预测 GDI 的能力比单独使用其中任何一个指标都要强(AUC = 0.837,P < 0.001)。结论 将血清 DAO、d-乳酸和内毒素水平结合在一起比单独使用任何一项指标都能更好地预测 GDI,将这些指标与 MBO 诊断结合在一起可进一步提高预测 GDI 的效果。
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引用次数: 0
The emerging role of fasting-mimicking diets in cancer treatment 空腹模拟饮食在癌症治疗中的新作用
Pub Date : 2023-06-01 DOI: 10.1097/JN9.0000000000000015
Yu-Jia Zhai, Pei-Yao Si, Ming-Li Liu, Lan Huang
Abstract Cancer is one of the most common causes of morbidity and mortality worldwide. The high demand for specific nutrients and the sensitivity to nutritional deficiencies are newly recognized features of cancer cells. Dietary interventions can suppress tumor demand for particular nutrients and alter certain nutrients to target a tumor's metabolic vulnerability. Cyclic fasting or fasting-mimicking diets (FMDs) are popular approaches that can reduce nutrient intake over a specific period. Accumulating evidence suggests that FMDs attenuate tumor growth by altering the energy metabolism of cancer cells. Furthermore, FMDs potentiate the sensitivity of tumors to conventional cancer treatments and limit adverse events. Recent findings also highlight the potential value of FMDs in boosting antitumor immune surveillance. However, clinical trials regarding the impact of FMDs on cancer patients remain limited and controversial. Here, we provide the latest information on the effects of FMDs on cancer progression and treatment, focusing on future clinical applications.
摘要 癌症是全世界最常见的发病和死亡原因之一。对特定营养素的高需求和对营养缺乏的敏感性是新近认识到的癌细胞特征。饮食干预可抑制肿瘤对特定营养素的需求,并改变某些营养素,以针对肿瘤的代谢脆弱性。周期性禁食或禁食模拟饮食(FMD)是一种流行的方法,可在特定时期内减少营养素的摄入。越来越多的证据表明,FMD 可通过改变癌细胞的能量代谢来抑制肿瘤生长。此外,FMD 还能增强肿瘤对常规癌症治疗的敏感性,并限制不良反应的发生。最近的研究结果还强调了 FMDs 在增强抗肿瘤免疫监视方面的潜在价值。然而,有关 FMDs 对癌症患者影响的临床试验仍然有限且存在争议。在此,我们将提供有关 FMD 对癌症进展和治疗的影响的最新信息,重点关注未来的临床应用。
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引用次数: 0
Role of selenium in cell death 硒在细胞死亡中的作用
Pub Date : 2023-06-01 DOI: 10.1097/JN9.0000000000000009
Pengning Gao, Chuanlin Wang, Jia-Li Xu, Shan-Ling Liu, Lan Zhou
Abstract Selenium is an essential nutrient closely related to redox homeostasis in the body. A redox imbalance will adversely affect the microenvironment inside and outside the cell, leading to cell death. Various types of cell death have been discovered in recent years, but the role(s) of selenium and the associated mechanism(s) of action require further elaboration. We review the roles and mechanisms of action of selenium in cell necrosis, apoptosis, ferroptosis, autophagy, and pyroptosis. Under normal conditions, selenium inhibits cell necrosis, apoptosis, ferroptosis, autophagy, and pyroptosis by downregulating the nuclear factor κB pathway, upregulating antiapoptotic proteins, decreasing oxidative stress, increasing antioxidant enzyme activity, enhancing the mTOR pathway, and downregulating the NLRP3/caspase-1 pathway, thereby helping to maintain the normal physiological functions of cells. On the other hand, selenium deficiency leads to activation of the PI3K/AKT and Notch/Hes1 pathways, causing a significant increase in the level of oxidative stress in the organism, resulting in cell necrosis, apoptosis, and pyroptosis. In the case of malignancy, the in vivo metabolite of inorganic selenium, hydrogen selenide, plays an antitumor role by inducing apoptosis and ferroptosis in tumor cells because of its high redox activity. In conclusion, an adequate level of selenium in the body is essential for maintaining normal cellular physiological functions and reducing fibrotic alterations. Furthermore, the in vivo metabolites of inorganic selenium may have some clinical value in antitumor therapy.
摘要 硒是一种与体内氧化还原平衡密切相关的必需营养素。氧化还原失衡会对细胞内外的微环境产生不利影响,导致细胞死亡。近年来发现了各种类型的细胞死亡,但硒的作用和相关作用机制还需要进一步阐述。我们回顾了硒在细胞坏死、凋亡、铁凋亡、自噬和热凋亡中的作用和作用机制。在正常情况下,硒通过下调核因子κB通路、上调抗凋亡蛋白、降低氧化应激、提高抗氧化酶活性、增强mTOR通路和下调NLRP3/caspase-1通路来抑制细胞坏死、凋亡、铁凋亡、自噬和热噬,从而帮助维持细胞的正常生理功能。另一方面,缺硒会导致 PI3K/AKT 和 Notch/Hes1 通路被激活,使机体氧化应激水平显著升高,从而导致细胞坏死、凋亡和热解。在恶性肿瘤中,无机硒的体内代谢产物硒化氢因其氧化还原活性高,可诱导肿瘤细胞凋亡和铁跃迁,从而发挥抗肿瘤作用。总之,体内充足的硒对维持正常的细胞生理功能和减少纤维化改变至关重要。此外,无机硒的体内代谢产物可能在抗肿瘤治疗中具有一定的临床价值。
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引用次数: 0
Multiple pulmonary ground-glass nodules: Challenges and advances 多发性肺磨玻璃结节:挑战与进步
Pub Date : 2023-06-01 DOI: 10.1097/JN9.0000000000000013
Fei-Fei Guo, Jue Huang, Fei Chen, Jiuwei Cui
Abstract Multiple pulmonary ground-glass nodules (GGNs), a typical clinical manifestation of multiple primary lung cancers (MPLCs), are of great significance for the early screening, diagnosis, and accurate treatment of lung cancer. Thus, the recent increase in the detection rate of multiple pulmonary GGNs has attracted much attention. However, compared with the more widely studied single GGNs, evaluating GGNs is more challenging because of the uncertainty of the etiology, difficult differential diagnosis, and lack of optimal management standards and guidelines. Most current solutions for multiple GGNs are based on the management experiences and principles of a single GGN. Therefore, it is necessary to obtain better understanding of multiple GGNs and to optimize the diagnostic methods and treatments. Both the existing challenges and potential of new methods for diagnosing and treating multiple pulmonary GGNs are reviewed and discussed in this article, with the aim of providing a reference for the clinical management of this highly prevalent condition.
摘要 多发性肺磨玻璃结节(GGN)是多发性原发性肺癌(MPLC)的典型临床表现,对肺癌的早期筛查、诊断和准确治疗具有重要意义。因此,近年来肺多发性 GGNs 检出率的提高引起了广泛关注。然而,与研究较多的单发 GGN 相比,由于病因不确定、鉴别诊断困难、缺乏最佳管理标准和指南,评估 GGN 更具挑战性。目前针对多发性 GGN 的大多数解决方案都是基于单一 GGN 的管理经验和原则。因此,有必要更好地了解多发性 GGN,优化诊断方法和治疗手段。本文对诊断和治疗多发性肺GGN的现有挑战和新方法的潜力进行了回顾和讨论,旨在为这种高发疾病的临床管理提供参考。
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引用次数: 0
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Journal of Nutritional Oncology
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