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Microbiome as an endocrine organ and its relationship with eye diseases: Effective factors and new targeted approaches. 作为内分泌器官的微生物组及其与眼疾的关系:有效因素和新的针对性方法。
Pub Date : 2024-09-22 DOI: 10.4291/wjgp.v15.i5.96446
Leila Haghshenas, Sara Banihashemi, Yalda Malekzadegan, Roberto Catanzaro, Amir Moghadam Ahmadi, Francesco Marotta

Microbiome is an endocrine organ that refers to both the complicated biological system of microbial species that colonize our bodies and their genomes and surroundings. Recent studies confirm the connection between the microbiome and eye diseases, which are involved in the pathogenesis of eye diseases, including age-related macular disorders, diabetic retinopathy, glaucoma, retinitis pigmentosa, dry eye, and uveitis. The aim of this review is to investigate the microbiome in relation to eye health. First, a brief introduction of the characteristics of the gut microorganisms terms of composition and work, the role of dysbiosis, the gut microbiome and the eye microbiome in the progression of eye illnesses are highlighted, then the relationship among the microbiome and the function of the immune system and eye diseases, the role of inflammation and aging and the immune system, It has been reviewed and finally, the control and treatment goals of microbiome and eye diseases, the role of food factors and supplements, biotherapy and antibiotics in relation to microbiome and eye health have been reviewed.

微生物组是一个内分泌器官,既指定植于我们体内的微生物物种的复杂生物系统,也指它们的基因组和周围环境。最近的研究证实了微生物组与眼部疾病之间的联系,微生物组参与了眼部疾病的发病机理,包括老年性黄斑病变、糖尿病视网膜病变、青光眼、视网膜色素变性、干眼症和葡萄膜炎。本综述旨在研究微生物组与眼睛健康的关系。首先,简要介绍肠道微生物的组成和工作特点,强调菌群失调、肠道微生物组和眼部微生物组在眼部疾病进展中的作用,然后介绍微生物组与免疫系统功能和眼部疾病之间的关系、最后,综述了微生物组和眼部疾病的控制和治疗目标、食物因素和补充剂、生物疗法和抗生素在微生物组和眼部健康中的作用。
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引用次数: 0
Team players in the pathogenesis of metabolic dysfunctions-associated steatotic liver disease: The basis of development of pharmacotherapy. 代谢功能障碍相关性脂肪性肝病发病机制中的团队参与者:药物疗法发展的基础。
Pub Date : 2024-08-22 DOI: 10.4291/wjgp.v15.i4.93606
Shahid Habib

Nutrient metabolism is regulated by several factors. Social determinants of health with or without genetics are the primary regulator of metabolism, and an unhealthy lifestyle affects all modulators and mediators, leading to the adaptation and finally to the exhaustion of cellular functions. Hepatic steatosis is defined by presence of fat in more than 5% of hepatocytes. In hepatocytes, fat is stored as triglycerides in lipid droplet. Hepatic steatosis results from a combination of multiple intracellular processes. In a healthy individual nutrient metabolism is regulated at several steps. It ranges from the selection of nutrients in a grocery store to the last step of consumption of ATP as an energy or as a building block of a cell as structural component. Several hormones, peptides, and genes have been described that participate in nutrient metabolism. Several enzymes participate in each nutrient metabolism as described above from ingestion to generation of ATP. As of now several publications have revealed very intricate regulation of nutrient metabolism, where most of the regulatory factors are tied to each other bidirectionally, making it difficult to comprehend chronological sequence of events. Insulin hormone is the primary regulator of all nutrients' metabolism both in prandial and fasting states. Insulin exerts its effects directly and indirectly on enzymes involved in the three main cellular function processes; metabolic, inflammation and repair, and cell growth and regeneration. Final regulators that control the enzymatic functions through stimulation or suppression of a cell are nuclear receptors in especially farnesoid X receptor and peroxisome proliferator-activated receptor/RXR ligands, adiponectin, leptin, and adiponutrin. Insulin hormone has direct effect on these final modulators. Whereas blood glucose level, serum lipids, incretin hormones, bile acids in conjunction with microbiota are intermediary modulators which are controlled by lifestyle. The purpose of this review is to overview the key players in the pathogenesis of metabolic dysfunction-associated steatotic liver disease (MASLD) that help us understand the disease natural course, risk stratification, role of lifestyle and pharmacotherapy in each individual patient with MASLD to achieve personalized care and target the practice of precision medicine. PubMed and Google Scholar databases were used to identify publication related to metabolism of carbohydrate and fat in states of health and disease states; MASLD, cardiovascular disease and cancer. More than 1000 publications including original research and review papers were reviewed.

营养代谢受多种因素调节。健康的社会决定因素(无论是否有遗传因素)是新陈代谢的主要调节器,而不健康的生活方式会影响所有调节器和介质,导致细胞功能的适应和最终衰竭。肝脂肪变性的定义是肝细胞中脂肪含量超过 5%。在肝细胞中,脂肪以甘油三酯的形式储存在脂滴中。肝脂肪变性是多种细胞内过程的综合结果。健康人的营养代谢由多个步骤调节。从在杂货店挑选营养物质到最后一步消耗作为能量或细胞结构成分的 ATP。有几种激素、肽和基因参与了营养代谢。如上文所述,从摄入到产生 ATP,每种营养物质的新陈代谢都有几种酶参与。目前,一些出版物揭示了营养代谢的复杂调控过程,其中大多数调控因素都是双向的,因此很难理解事件发生的时间顺序。胰岛素激素是所有营养物质在餐前和空腹状态下新陈代谢的主要调节因子。胰岛素直接或间接地对参与新陈代谢、炎症和修复以及细胞生长和再生这三大细胞功能过程的酶产生影响。通过刺激或抑制细胞来控制酶功能的最终调节因子是核受体,尤其是类法尼丝 X 受体和过氧化物酶体增殖激活受体/RXR 配体、脂肪连通素、瘦素和脂肪素。胰岛素激素对这些最终调节因子有直接影响。而血糖水平、血脂、增量素激素、胆汁酸以及微生物群则是受生活方式控制的中间调节剂。本综述旨在概述代谢功能障碍相关性脂肪性肝病(MASLD)发病机制中的关键因素,帮助我们了解每个代谢功能障碍相关性脂肪性肝病患者的疾病自然病程、风险分层、生活方式和药物治疗的作用,从而实现个性化治疗,实现精准医疗。我们使用 PubMed 和 Google Scholar 数据库来查找与健康和疾病状态下碳水化合物和脂肪代谢、MASLD、心血管疾病和癌症有关的出版物。对包括原创研究和综述论文在内的 1000 多篇出版物进行了审查。
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引用次数: 0
Link between irritable bowel syndrome, depression, and colorectal cancer risk in young patients: Age-matched nationwide population-based study. 年轻患者肠易激综合征、抑郁与结直肠癌风险之间的联系:全国人口年龄匹配研究
Pub Date : 2024-06-24 DOI: 10.4291/wjgp.v15.i3.93408
Sai Priyanka Mellacheruvu, Sai Prasanna Lekkala, Sukhjinder Chauhan, Adil Sarvar Mohammed, Sravya R Mundla, Ankita Shenoy, Bilal Khan Mohammed, Jerrin Bawa, Shantha Nallapothula, Priyatham Gurram, Akhil Jain, Rupak Desai, Mohammed Mustafa Nayeem

Background: There exists a link between irritable bowel syndrome (IBS) and depression. Similarly, chronic depression is known to increase the risk of cancer in general. In this population-based analysis, we investigated the prevalence and the odds of colorectal cancer (CRC) in young-depressed patients with IBS.

Aim: To investigate the relationship between IBS and CRC in young, depressed patients using a nationally representative United States inpatient sample.

Methods: The 2019 National Inpatient Sample was used to identify young (18-44 years) patients admitted with comorbid depression in the presence vs absence of IBS using relevant International Classification of Diseases, Tenth Revision, Clinical Modification codes. Primary endpoint was the prevalence and odds of CRC in age matched (1:1) young-depressed cohort hospitalized with IBS (IBS+) vs without IBS (IBS-). Multivariable regression analysis was performed adjusting for potential confounders.

Results: Age-matched (1:1) young-depressed IBS+ (83.9% females, median age 36 years) and IBS- (65.8% females, median age 36 years) cohorts consisted of 14370 patients in each group. IBS+ cohort had higher rates of hypertension, uncomplicated diabetes, hyperlipidemia, obesity, peripheral vascular disease, chronic obstructive pulmonary disease, hypothyroidism, prior stroke, prior venous thromboembolism, anxiety, bipolar disorder, and borderline personality disorder (P < 0.005) vs the IBS- cohort. However, prior myocardial infarction, acquired immunodeficiency syndrome, dementia, smoking, alcohol abuse, and drug abuse (P < 0.005) are high in IBS- cohort. The rate of CRC was comparable in both cohorts [IBS+ n = 25 (0.17%) vs IBS- n = 35 (0.24%)]. Compared to the IBS- cohort, the odds ratio (OR) of developing CRC was not significantly higher [OR 0.71, 95% confidence interval (CI) 0.23-2.25)] in IBS+ cohort. Also, adjusting for baseline sociodemographic and hospital characteristics and relevant comorbidities, the OR was found to be non-significant (OR 0.89, 95%CI 0.21-3.83).

Conclusion: This nationwide propensity-matched analysis revealed comparable prevalence and risk of CRC in young-depressed patients with vs without IBS. Future large-scale prospective studies are needed to evaluate the long-term effects of depression and its treatment on CRC risk and outcomes in IBS patients.

背景:肠易激综合征(IBS)与抑郁症之间存在联系。同样,慢性抑郁症也会增加患癌症的风险。在这项基于人群的分析中,我们调查了患有肠易激综合征的年轻抑郁患者中结肠直肠癌(CRC)的患病率和几率。目的:使用具有全国代表性的美国住院病人样本,调查年轻抑郁患者中肠易激综合征与 CRC 之间的关系:方法:利用2019年全国住院患者样本,使用相关的《国际疾病分类》第十版临床修订代码,识别合并抑郁症的年轻(18-44岁)住院患者中是否存在肠易激综合征。主要终点是在年龄匹配(1:1)的年轻抑郁症患者队列中,伴有肠易激综合征(IBS+)与不伴有肠易激综合征(IBS-)的住院患者的 CRC 患病率和几率。在调整潜在混杂因素后进行了多变量回归分析:年龄匹配(1:1)的年轻抑郁 IBS+(83.9%为女性,中位年龄为 36 岁)和 IBS-(65.8%为女性,中位年龄为 36 岁)队列各由 14370 名患者组成。IBS+ 组群与 IBS- 组群相比,高血压、无并发症糖尿病、高脂血症、肥胖、外周血管疾病、慢性阻塞性肺病、甲状腺功能减退、既往中风、既往静脉血栓栓塞、焦虑、双相情感障碍和边缘型人格障碍的发病率更高(P < 0.005)。然而,在肠易激综合征队列中,既往心肌梗死、获得性免疫缺陷综合征、痴呆、吸烟、酗酒和滥用药物(P < 0.005)的比例较高。两个队列中的乳腺癌发病率相当[IBS+ n = 25 (0.17%) vs IBS- n = 35 (0.24%)]。与肠易激综合征-队列相比,肠易激综合征+队列中患乳腺癌的几率比(OR)并没有明显增加[OR 0.71,95% 置信区间(CI)0.23-2.25]。此外,在对基线社会人口学特征、医院特征和相关合并症进行调整后,发现OR并不显著(OR 0.89, 95%CI 0.21-3.83):这项全国范围内的倾向匹配分析显示,患有肠易激综合征的年轻抑郁症患者与未患有肠易激综合征的患者的发病率和罹患乳腺癌的风险相当。未来需要开展大规模的前瞻性研究,以评估抑郁症及其治疗对 IBS 患者的 CRC 风险和预后的长期影响。
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引用次数: 0
Novel, non-colonizing, single-strain live biotherapeutic product ADS024 protects against Clostridioides difficile infection challenge in vivo. 新型、非定植性、单一菌株的活生物治疗产品ADS024可在体内抵御艰难梭菌感染挑战。
Pub Date : 2023-08-24 DOI: 10.4291/wjgp.v14.i4.71
Christopher K Murphy, Michelle M O'Donnell, James W Hegarty, Sarah Schulz, Colin Hill, R Paul Ross, Mary C Rea, Ronald Farquhar, Laurent Chesnel

Background: The Centers for Disease Control and Prevention estimate that Clostridioides difficile (C. difficile) causes half a million infections (CDI) annually and is a major cause of total infectious disease death in the United States, causing inflammation of the colon and potentially deadly diarrhea. We recently reported the isolation of ADS024, a Bacillus velezensis (B. velezensis) strain, which demonstrated direct in vitro bactericidal activity against C. difficile, with minimal collateral impact on other members of the gut microbiota. In this study, we hypothesized that in vitro activities of ADS024 will translate in vivo to protect against CDI challenge in mouse models.

Aim: To investigate the in vivo efficacy of B. velezensis ADS024 in protecting against CDI challenge in mouse models.

Methods: To mimic disruption of the gut microbiota, the mice were exposed to vancomycin prior to dosing with ADS024. For the mouse single-dose study, the recovery of ADS024 was assessed via microbiological analysis of intestinal and fecal samples at 4 h, 8 h, and 24 h after a single oral dose of 5 × 108 colony-forming units (CFU)/mouse of freshly grown ADS024. The single-dose study in miniature swine included groups that had been pre-dosed with vancomycin and that had been exposed to a dose range of ADS024, and a group that was not pre-dosed with vancomycin and received a single dose of ADS024. The ADS024 colonies [assessed by quantitative polymerase chain reaction (qPCR) using ADS024-specific primers] were counted on agar plates. For the 28-d miniature swine study, qPCR was used to measure ADS024 levels from fecal samples after oral administration of ADS024 capsules containing 5 × 109 CFU for 28 consecutive days, followed by MiSeq compositional sequencing and bioinformatic analyses to measure the impact of ADS024 on microbiota. Two studies were performed to determine the efficacy of ADS024 in a mouse model of CDI: Study 1 to determine the effects of fresh ADS024 culture and ADS024 spore preparations on the clinical manifestations of CDI in mice, and Study 2 to compare the efficacy of single daily doses vs dosing 3 times per day with fresh ADS024. C. difficile challenge was performed 24 h after the start of ADS024 exposure. To model the human distal colon, an anerobic fecal fermentation system was used. MiSeq compositional sequencing and bioinformatic analyses were performed to measure microbiota diversity changes following ADS024 treatment. To assess the potential of ADS024 to be a source of antibiotic resistance, its susceptibility to 18 different antibiotics was tested.

Results: In a mouse model of CDI challenge, single daily doses of ADS024 were as efficacious as multiple daily doses in protecting against subsequent challenge by C. difficile

背景:美国疾病控制与预防中心估计,艰难梭菌(C.difficile)每年导致50万例感染(CDI),是美国全部传染病死亡的主要原因,导致结肠炎症和潜在的致命腹泻。我们最近报道了ADS024的分离,这是一种维莱岑芽孢杆菌(B.velezensis)菌株,它对艰难梭菌具有直接的体外杀菌活性,对肠道微生物群的其他成员的副作用最小。在这项研究中,我们假设ADS024的体外活性将在体内转化,以保护小鼠模型免受CDI攻击。目的:研究B.velezensis ADS024在小鼠模型中对CDI攻击的体内保护作用。方法:为了模拟肠道微生物群的破坏,小鼠在给药ADS024之前暴露于万古霉素。对于小鼠单剂量研究,在单次口服5×108菌落形成单位(CFU)/小鼠的新鲜生长的ADS024后4小时、8小时和24小时,通过肠道和粪便样本的微生物分析来评估ADS024的回收率。在小型猪中进行的单剂量研究包括预先给药万古霉素并暴露于ADS024剂量范围的组,以及未预先给药阿霉素并接受单剂量ADS024的组。在琼脂平板上计数ADS024菌落[通过使用ADS024特异性引物的定量聚合酶链式反应(qPCR)评估]。在28天的小型猪研究中,连续28天口服含有5×109CFU的ADS024胶囊后,使用qPCR测量粪便样本中的ADS2024水平,然后进行MiSeq成分测序和生物信息学分析,以测量ADS024对微生物群的影响。进行了两项研究来确定ADS024在CDI小鼠模型中的疗效:研究1确定新鲜ADS024培养物和ADS024孢子制剂对小鼠CDI临床表现的影响,研究2比较每日单次给药与每日3次给药的疗效。艰难梭菌激发在ADS024暴露开始后24小时进行。为了模拟人类远端结肠,使用了厌氧粪便发酵系统。进行MiSeq成分测序和生物信息学分析,以测量ADS024处理后微生物群多样性的变化。为了评估ADS024作为抗生素耐药性来源的潜力,测试了其对18种不同抗生素的易感性。结果:在CDI攻击的小鼠模型中,单次每日剂量的ADS024在预防艰难梭菌病原体诱导的疾病的后续攻击方面与多次每日剂量的一样有效。基于在小鼠中单次给药后24小时或在小型猪中单次剂量后72小时未恢复ADS024菌落的观察结果,ADS024未显示定植的证据。在对小型猪进行的28天重复剂量研究中,使用平板和qPCR方法在粪便样本中未检测到ADS024。在人类远端结肠模型中进行的系统发育分析表明,ADS024对健康的人类结肠微生物群具有选择性影响,类似于在小型猪中进行的体内研究。安全性评估表明,ADS024对所有测试的抗生素都敏感,而计算机测试显示,脱靶活性或毒力和抗生素耐药性机制的可能性很低。结论:我们的研究结果证明了ADS024在小鼠模型中对CDI攻击的体内保护作用,支持使用ADS024预防标准抗生素治疗后复发的CDI。
{"title":"Novel, non-colonizing, single-strain live biotherapeutic product ADS024 protects against <i>Clostridioides difficile</i> infection challenge <i>in vivo</i>.","authors":"Christopher K Murphy,&nbsp;Michelle M O'Donnell,&nbsp;James W Hegarty,&nbsp;Sarah Schulz,&nbsp;Colin Hill,&nbsp;R Paul Ross,&nbsp;Mary C Rea,&nbsp;Ronald Farquhar,&nbsp;Laurent Chesnel","doi":"10.4291/wjgp.v14.i4.71","DOIUrl":"https://doi.org/10.4291/wjgp.v14.i4.71","url":null,"abstract":"<p><strong>Background: </strong>The Centers for Disease Control and Prevention estimate that <i>Clostridioides difficile</i> (<i>C. difficile</i>) causes half a million infections (CDI) annually and is a major cause of total infectious disease death in the United States, causing inflammation of the colon and potentially deadly diarrhea. We recently reported the isolation of ADS024, a <i>Bacillus velezensis</i> (<i>B. velezensis</i>) strain, which demonstrated direct <i>in vitro</i> bactericidal activity against <i>C. difficile</i>, with minimal collateral impact on other members of the gut microbiota. In this study, we hypothesized that <i>in vitro</i> activities of ADS024 will translate <i>in vivo</i> to protect against CDI challenge in mouse models.</p><p><strong>Aim: </strong>To investigate the <i>in vivo</i> efficacy of <i>B. velezensis</i> ADS024 in protecting against CDI challenge in mouse models.</p><p><strong>Methods: </strong>To mimic disruption of the gut microbiota, the mice were exposed to vancomycin prior to dosing with ADS024. For the mouse single-dose study, the recovery of ADS024 was assessed <i>via</i> microbiological analysis of intestinal and fecal samples at 4 h, 8 h, and 24 h after a single oral dose of 5 × 10<sup>8</sup> colony-forming units (CFU)/mouse of freshly grown ADS024. The single-dose study in miniature swine included groups that had been pre-dosed with vancomycin and that had been exposed to a dose range of ADS024, and a group that was not pre-dosed with vancomycin and received a single dose of ADS024. The ADS024 colonies [assessed by quantitative polymerase chain reaction (qPCR) using ADS024-specific primers] were counted on agar plates. For the 28-d miniature swine study, qPCR was used to measure ADS024 levels from fecal samples after oral administration of ADS024 capsules containing 5 × 10<sup>9</sup> CFU for 28 consecutive days, followed by MiSeq compositional sequencing and bioinformatic analyses to measure the impact of ADS024 on microbiota. Two studies were performed to determine the efficacy of ADS024 in a mouse model of CDI: Study 1 to determine the effects of fresh ADS024 culture and ADS024 spore preparations on the clinical manifestations of CDI in mice, and Study 2 to compare the efficacy of single daily doses <i>vs</i> dosing 3 times per day with fresh ADS024. <i>C. difficile</i> challenge was performed 24 h after the start of ADS024 exposure. To model the human distal colon<b>,</b> an anerobic fecal fermentation system was used. MiSeq compositional sequencing and bioinformatic analyses were performed to measure microbiota diversity changes following ADS024 treatment. To assess the potential of ADS024 to be a source of antibiotic resistance, its susceptibility to 18 different antibiotics was tested.</p><p><strong>Results: </strong>In a mouse model of CDI challenge, single daily doses of ADS024 were as efficacious as multiple daily doses in protecting against subsequent challenge by <i>C. difficile</i> ","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/28/WJGP-14-71.PMC10505952.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41171583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk assessment of hepatitis E transmission through tissue allografts 同种异体组织移植传播戊型肝炎的风险评估
Pub Date : 2022-03-22 DOI: 10.4291/wjgp.v13.i2.50
R. Villalba, V. Mirabet
Hepatitis E virus (HEV) is a small non-enveloped single stranded RNA virus whose genotypes 3 and 4 have been associated with zoonotic transmission in industrialized countries. HEV infection is considered the main cause of acute hepatitis worldwide. In some cases, transfusion of blood components or organ transplantation have been reported as the source of infection. We have conducted a literature review on the risk of transmission through cell and tissue allografts. Although no case was found, measures to control this risk should be taken when donor profile (based upon geographical and behavioural data) recommended it. Issues to be considered in donor screening and tissue processing to assess and to reduce the risk of HEV transmission are approached.
戊型肝炎病毒(HEV)是一种小型无包膜单链RNA病毒,其基因型3和4与工业化国家的人畜共患传播有关。在世界范围内,HEV感染被认为是急性肝炎的主要原因。在某些情况下,输血或器官移植被报道为感染源。我们对通过细胞和组织同种异体移植传播的风险进行了文献回顾。虽然没有发现病例,但当捐助者情况(根据地理和行为数据)建议时,应采取措施控制这种风险。探讨了在供体筛选和组织处理中需要考虑的问题,以评估和降低戊型肝炎传播的风险。
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引用次数: 1
Application of electron microscopy in gastroenterology 电子显微镜在胃肠病学中的应用
Pub Date : 2022-03-22 DOI: 10.4291/wjgp.v13.i2.41
M. Iwamuro, Haruo Urata, Takehiro Tanaka, Hiroyuki Okada
Electron microscopy has long been used in research in the fields of life sciences and materials sciences. Transmission and scanning electron microscopy and energy-dispersive X-ray spectroscopy (EDX) analyses have also been performed in the field of gastroenterology. Electron microscopy and EDX enable (1) Observation of ultrastructural differences in esophageal epithelial cells in patients with gastroesophageal reflux and eosinophilic esophagitis; (2) Detection of lanthanum deposition in the stomach and duodenum; (3) Ultrastructural and elemental analyses of enteroliths and bezoars; (4) Detection and characterization of microorganisms in the gastrointestinal tract; (5) Diagnosis of gastrointestinal tumors with neuroendocrine differentiation; and (6) Analysis of gold nanoparticles potentially used in endoscopic photodynamic therapy. This review aims to foster a better understanding of electron microscopy applications by reviewing relevant clinical studies, basic research findings, and the state of current research carried out in gastroenterology science.
电子显微镜在生命科学和材料科学领域的研究中应用已久。透射和扫描电子显微镜和能量色散x射线光谱(EDX)分析也在胃肠病学领域进行。(1)胃食管反流与嗜酸性粒细胞性食管炎患者食管上皮细胞超微结构差异的观察;(2)胃、十二指肠镧沉积检测;(3)肠石和牛黄的超微结构和元素分析;(4)胃肠道微生物的检测与鉴定;(5)胃肠道肿瘤神经内分泌分化诊断;(6)金纳米颗粒在内窥镜光动力治疗中的潜在应用分析。本文旨在通过对胃肠病学相关临床研究、基础研究成果和研究现状的综述,加深对电子显微镜应用的了解。
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引用次数: 0
Comparison of cytokine and phosphoprotein profiles in idiopathic and Crohn’s disease-related perianal fistula 特发性和克罗恩病相关肛周瘘的细胞因子和磷蛋白谱比较
Pub Date : 2019-11-13 DOI: 10.4291/wjgp.v10.i4.42
J. Haddow, O. Musbahi, T. Macdonald, C. Knowles
BACKGROUND Perianal fistulae are either primary (idiopathic) or secondary [commonly associated with Crohn’s disease, (CD)]. It is assumed, although not proven, that the pathophysiology differs. AIM To systematically compare the clinical phenotypes, cytokine and phosphoprotein profiles of idiopathic and CD-related perianal fistulae. METHODS Sixty-one patients undergoing surgery for perianal fistula were prospectively recruited (48 idiopathic, 13 CD) into a cohort study. Clinical data, including the Perineal Disease Activity Index (PDAI) and EQ-5D-5L were collected. Biopsies of the fistula tract, granulation tissue, internal opening mucosa and rectal mucosa were obtained at surgery. Concentrations of 30 cytokines and 39 phosphoproteins were measured in each biopsy using a magnetic bead multiplexing instrument and a chemiluminescent antibody array respectively. Over 12000 clinical and 23500 laboratory measurements were made. RESULTS The PDAI was significantly higher (indicating more active disease) in the CD group with a mean difference of 2.40 (95%CI: 0.52-4.28, P = 0.01). Complex pathoanatomy was more prevalent in the CD group, namely more multiple fistulae, supralevator extensions, collections and rectal thickening. The IL-12p70 concentration at the internal opening specimen site was significantly higher (median difference 19.7 pg/mL, 99%CI: 0.2-40.4, P = 0.008) and the IL-1RA/IL-1β ratio was significantly lower in the CD group at the internal opening specimen site (median difference 15.0, 99%CI = 0.4-50.5, P = 0.008). However in the remaining 27 cytokines and all 39 of the phosphoproteins across the four biopsy sites, no significant differences were found between the groups. CONCLUSION CD-related perianal fistulae are more clinically severe and anatomically complex than idiopathic perianal fistulae. However, overall there are no major differences in cytokine and phosphoprotein profiles.
背景肛瘘是原发性(特发性)或继发性[通常与克罗恩病(CD)有关]。虽然没有得到证实,但病理生理学是不同的。目的系统比较特发性和CD相关性肛周瘘的临床表型、细胞因子和磷蛋白谱。方法前瞻性招募61例接受肛周瘘手术的患者(48例特发性,13例CD)进行队列研究。收集临床数据,包括腓疾病活动指数(PDAI)和EQ-5D-5L。术中对瘘管、肉芽组织、内口黏膜和直肠黏膜进行了活检。分别使用磁珠多路复用仪器和化学发光抗体阵列在每次活检中测量30种细胞因子和39种磷蛋白的浓度。进行了超过12000次临床和23500次实验室测量。结果CD组的PDAI明显高于对照组(表明疾病更活跃),平均差异为2.40(95%CI:0.52-42.28,P=0.01)。CD组更常见复杂的病理解剖,即多发瘘、提上肌扩张、集合和直肠增厚。CD组在内部开放标本部位的IL-12p70浓度显著较高(中位差异19.7 pg/mL,99%CI:0.2-40.4,P=0.008),IL-1RA/IL-1β比率显著较低(中位差值15.0,99%CI=0.4-50.5,P=0.008活检部位,两组之间没有发现显著差异。结论CD相关性肛周瘘比特发性肛周瘘在临床上更严重,在解剖学上更复杂。然而,总体而言,细胞因子和磷蛋白谱没有重大差异。
{"title":"Comparison of cytokine and phosphoprotein profiles in idiopathic and Crohn’s disease-related perianal fistula","authors":"J. Haddow, O. Musbahi, T. Macdonald, C. Knowles","doi":"10.4291/wjgp.v10.i4.42","DOIUrl":"https://doi.org/10.4291/wjgp.v10.i4.42","url":null,"abstract":"BACKGROUND Perianal fistulae are either primary (idiopathic) or secondary [commonly associated with Crohn’s disease, (CD)]. It is assumed, although not proven, that the pathophysiology differs. AIM To systematically compare the clinical phenotypes, cytokine and phosphoprotein profiles of idiopathic and CD-related perianal fistulae. METHODS Sixty-one patients undergoing surgery for perianal fistula were prospectively recruited (48 idiopathic, 13 CD) into a cohort study. Clinical data, including the Perineal Disease Activity Index (PDAI) and EQ-5D-5L were collected. Biopsies of the fistula tract, granulation tissue, internal opening mucosa and rectal mucosa were obtained at surgery. Concentrations of 30 cytokines and 39 phosphoproteins were measured in each biopsy using a magnetic bead multiplexing instrument and a chemiluminescent antibody array respectively. Over 12000 clinical and 23500 laboratory measurements were made. RESULTS The PDAI was significantly higher (indicating more active disease) in the CD group with a mean difference of 2.40 (95%CI: 0.52-4.28, P = 0.01). Complex pathoanatomy was more prevalent in the CD group, namely more multiple fistulae, supralevator extensions, collections and rectal thickening. The IL-12p70 concentration at the internal opening specimen site was significantly higher (median difference 19.7 pg/mL, 99%CI: 0.2-40.4, P = 0.008) and the IL-1RA/IL-1β ratio was significantly lower in the CD group at the internal opening specimen site (median difference 15.0, 99%CI = 0.4-50.5, P = 0.008). However in the remaining 27 cytokines and all 39 of the phosphoproteins across the four biopsy sites, no significant differences were found between the groups. CONCLUSION CD-related perianal fistulae are more clinically severe and anatomically complex than idiopathic perianal fistulae. However, overall there are no major differences in cytokine and phosphoprotein profiles.","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43817358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
Neutropenic enterocolitis: A clinico-pathological review 中性粒细胞减少性小肠结肠炎:临床病理回顾
Pub Date : 2019-10-15 DOI: 10.4291/wjgp.v10.i3.36
R. Xia, Xuchen Zhang
Neutropenic enterocolitis (NE) is a predominantly cecum-based disease with high mortality seen in patients post chemotherapy. The pathogenesis of NE is poorly understood and probably multifactorial involving mucosal injury, neutropenia, and impaired host defense to intestinal organisms. The clinical presentation is characterized as ileocolonic inflammation and bowel wall thickening in patients with neutropenia, fever, and abdominal pain. The pathological features of NE include patchy necrosis, hemorrhage, ulcer, edema, perforation, infiltrating organisms, and characteristically, depletion of inflammatory cells (neutrophils). NE should always be considered as a possible diagnosis in immunosuppressed patients, especially those receiving chemotherapy. High clinical and histological diagnostic discordance rate exists. High index of clinical suspicion and prompt appropriate personalized management are essential to achieve a lower mortality rate.
中性粒细胞减少性小肠结肠炎(NE)是一种主要以盲肠为基础的疾病,化疗后患者死亡率高。NE的发病机制尚不清楚,可能是多因素的,包括粘膜损伤、中性粒细胞减少和宿主对肠道生物的防御受损。临床表现为回结肠炎症和肠壁增厚,伴有中性粒细胞减少、发热和腹痛。NE的病理特征包括斑片状坏死、出血、溃疡、水肿、穿孔、浸润性生物,以及典型的炎症细胞(中性粒细胞)耗竭。对于免疫抑制的患者,尤其是接受化疗的患者,应始终将NE视为可能的诊断。存在较高的临床和组织学诊断不符合率。高临床怀疑指数和及时适当的个性化治疗是实现低死亡率的必要条件。
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引用次数: 21
Immune checkpoint inhibitor-induced diarrhea/colitis: Endoscopic and pathologic findings. 免疫检查点抑制剂诱导的腹泻/结肠炎:内镜和病理结果
Pub Date : 2019-09-10 DOI: 10.4291/wjgp.v10.i2.17
Tsutomu Nishida, Hideki Iijima, Shiro Adachi

The indications of immune checkpoint inhibitors (ICPIs) for cancer treatment have rapidly expanded, and their use is increasing in clinical settings worldwide. Despite the considerable clinical benefits of ICPIs, frequent immune-related adverse events (irAEs) have become nonnegligible concerns. Among irAEs, ICPI-induced colitis/diarrhea is frequent and recognized not only by oncologists but also by gastroenterologists or endoscopists. The endoscopic findings show similarity to those of inflammatory bowel disease to a certain extent, particularly ulcerative colitis, but do not seem to be identical. The pathological findings of ICPI-induced colitis may vary among drug classes. They show acute or chronic inflammation, but it may depend on the time of colitis suggested by colonoscopy, including biopsy or treatment intervention. In the case of chronic inflammation determined by biopsy, the endoscopy findings may overlap with those of inflammatory bowel disease. Here, we provide a comprehensive review of ICPI-induced colitis based on clinical, endoscopic and pathologic findings.

免疫检查点抑制剂(ICPI)用于癌症治疗的适应症迅速扩大,其在全球临床环境中的应用也在增加。尽管ICPI具有相当大的临床益处,但频繁的免疫相关不良事件(irAE)已成为不可忽视的问题。在irAE中,ICPI诱导的结肠炎/腹泻是常见的,不仅肿瘤学家认识到,胃肠病学家或内镜学家也认识到。内镜检查结果在一定程度上与炎症性肠病,特别是溃疡性结肠炎的检查结果相似,但似乎并不相同。ICPI诱导的结肠炎的病理学表现可能因药物类别而异。它们表现为急性或慢性炎症,但可能取决于结肠镜检查建议的结肠炎时间,包括活检或治疗干预。在通过活检确定的慢性炎症的情况下,内窥镜检查结果可能与炎症性肠病的结果重叠。在此,我们根据临床、内镜和病理结果对ICPI诱导的结肠炎进行了全面的综述。
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引用次数: 0
Successful management of adhesion related small bowel ischemia without intestinal resection: A case report and review of literature 无肠切除术成功治疗粘连性小肠缺血1例报告及文献复习
Pub Date : 2019-09-10 DOI: 10.4291/wjgp.v10.i2.29
P. Vassiliu, Vasiliki Ntella, George Theodoroleas, Zisis Mantanis, Ioanna Pentara, E. Papoutsi, A. Mastoraki, N. Arkadopoulos
BACKGROUND Intraabdominal adhesions develop spontaneously or after an inflammatory process or surgical procedure in the abdomen. They are the most common cause of small bowel obstruction (SBO). SBO occasionally leads to intestinal ischemia (InIs) which can be a life-threatening condition that requires management as soon as possible. We herein report a case of SBO with InIs presented in our institution and treated without intestinal resection. CASE SUMMARY A 34-year-old man presented at the emergency department after a 12-h-onset diffuse abdominal pain, bloating and nausea. He had a history of traumatic right hepatectomy 11 years ago as well as adhesiolysis and resection of a long part of small bowel 2 years ago. An abdominal computed tomography (CT) showed dilated loops that led to the diagnosis of SBO. Due to deteriorating lactic acidosis, the patient was operated. Torsion of the small bowel around an adhesion led to 2.30 m of ischemic ileum. After the application of N/S 40 °C for 20 min, the intestine showed signs of improvement and it was decided to avoid resection and instead temporary close the abdomen with vacuum-pack technique. At the second-look laparotomy 48 h later, the intestine appeared normal. The patient was discharged on the 8th post-op day in excellent condition. CONCLUSION In case of SBO caused by adhesions, extreme caution is needed if InIs is present, as the clinical signs are mild and you should rely for diagnosis in CT findings and lactate levels. Conservative surgical approach could reverse the effects of InIs, if performed quickly, so that intestinal resection is avoided and should be used even when minimum signs of viability are present.
背景腹腔粘连是自发发生的,或者是在腹部炎症过程或外科手术后发生的。它们是小肠梗阻(SBO)最常见的原因。SBO偶尔会导致肠缺血(InIs),这可能是一种危及生命的情况,需要尽快治疗。我们在此报告了一例在我们的机构中出现的伴有InIs的SBO,并在没有进行肠道切除的情况下进行了治疗。病例摘要:一名34岁男子在发病12小时后出现弥漫性腹痛、腹胀和恶心,随后到急诊科就诊。他11年前有外伤性右肝切除术的病史,2年前有粘连松解术和小肠长部切除术。腹部计算机断层扫描(CT)显示扩张环,从而诊断为SBO。由于乳酸酸中毒恶化,病人接受了手术。粘连周围的小肠扭转导致2.30米的缺血性回肠。在应用N/S 40°C 20分钟后,肠道出现好转迹象,决定避免切除,而是用真空包技术暂时闭合腹部。48小时后第二次剖腹探查时,肠道显示正常。患者于术后第8天出院,情况良好。结论在由粘连引起的SBO的情况下,如果存在InIs,则需要格外小心,因为临床症状较轻,应根据CT检查结果和乳酸水平进行诊断。如果快速进行,保守的手术方法可以逆转InIs的影响,从而避免肠道切除,即使在存在最低生存迹象的情况下也应该使用。
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引用次数: 3
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世界胃肠病理生理学杂志(电子版)(英文版)
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