Clinical and Experimental Gastroenterology最新文献

{"title":"\"Let Food Be Thy Medicine\": Diet and Supplements in Irritable Bowel Syndrome.","authors":"Neha V Patel","doi":"10.2147/CEG.S321054","DOIUrl":"https://doi.org/10.2147/CEG.S321054","url":null,"abstract":"<p><strong>Overview: </strong>The purpose of this review is to introduce options for dietary therapies and supplements for the treatment of irritable bowel syndrome (IBS). IBS is a common condition with heterogeneity in pathogenesis and clinical presentation. Current treatment options are targeted at symptom relief with medications. Patients naturally pursue dietary modifications when dealing with symptoms. Dietary therapy for IBS has been poorly studied in the past; however, newer evidence suggests the use of certain diets, such as the low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet, as an intervention in patients with IBS for symptom improvement. Exclusion strategies are frequently tried, such as gluten restriction or lactose avoidance, but lack quality evidence behind their use. Additionally, supplements, such as fiber, probiotics, and peppermint oil, have also been used for IBS with more recent data suggesting the use of these supplements with specific caveats.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"14 ","pages":"377-384"},"PeriodicalIF":2.4,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fe/5b/ceg-14-377.PMC8473929.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39472536","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}

{"title":"Gastro-Intestinal Symptoms and Autism Spectrum Disorder: A Potential Link [Response to Letter].","authors":"Eric D Shah","doi":"10.2147/CEG.S337372","DOIUrl":"https://doi.org/10.2147/CEG.S337372","url":null,"abstract":"","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"14 ","pages":"375-376"},"PeriodicalIF":2.4,"publicationDate":"2021-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/d6/ceg-14-375.PMC8448504.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39437602","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}

{"title":"In Vitro Modelling of Barrier Impairment Associated with Gastro-Oesophageal Reflux Disease (GERD).","authors":"Marisa Meloni,&nbsp;Paolo Buratti,&nbsp;Francesco Carriero,&nbsp;Laura Ceriotti","doi":"10.2147/CEG.S325346","DOIUrl":"https://doi.org/10.2147/CEG.S325346","url":null,"abstract":"<p><strong>Purpose: </strong>A novel experimental model based on a 3D reconstructed human oesophageal epithelium model (HO2E) has been developed to investigate the structural and functional changes of the oesophageal epithelium following exposure to a solution of HCl 0.1 N (pH = 1.2) mirroring GERD microenvironment condition.</p><p><strong>Methods: </strong>The barrier structure modification after the exposure to the acid solution on HO2E tissues was investigated immediately after damage induction and after 1 hour post incubation and compared to HO2E tissues exposed to phosphate buffered saline solution. Immunofluorescence (IF) was applied to quantify the expression and localization of barrier function proteins: Claudin-1 (CLDN-1), Claudin-4 (CLDN-4), Zonulin-1 (ZO-1), E-Cadherin and Mucin-1 (MUC1). Barrier functionality was measured by TEER.</p><p><strong>Results: </strong>In the acidic microenvironment, TEER measurement has shown some limitations and results were not applicable, whereas the evaluation of protein localization and quantification provided clear and robust evidence of the damage which occurred to the epithelium barrier structure. CLDN-4 expression significantly decreased after exposure to acid. ZO-1 protein appeared upregulated immediately after exposure to HCl and was mainly localized in the cytoplasm and not on the cell membrane. This different localization was also observed for CLND-1. CLDN-1, MUC1 and, to a lower extent, ZO-1 expression increased during the post-incubation period.</p><p><strong>Conclusion: </strong>The relevant tissue biomarkers identified, CLDN-1 and MUC1, can be used to monitor TJ structure and epithelial barrier recovery after acid-induced damage which, in our experimental conditions, were non-destructive and suitable for recovery studies. The established model can be useful to investigate the mechanism of action of formulations acting on this specific pathophysiological condition and/or designed to potentiate the physiological defense mechanisms of oesophageal mucosa.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"14 ","pages":"361-373"},"PeriodicalIF":2.4,"publicationDate":"2021-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/a8/ceg-14-361.PMC8436176.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39422256","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}

{"title":"Phosphomannose Isomerase High Expression Associated with Better Prognosis in Pancreatic Ductal Adenocarcinoma.","authors":"Zahra Alipour,&nbsp;Diana Agostini-Vulaj,&nbsp;Jennifer Findeis-Hosey,&nbsp;Lei Liu,&nbsp;Raul S Gonzalez,&nbsp;Michael G Drage,&nbsp;Hannah Krigman,&nbsp;Zhongren Zhou","doi":"10.2147/CEG.S316492","DOIUrl":"https://doi.org/10.2147/CEG.S316492","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer-related death in the United States. The need for increased patient survival has not been met for PDAC. The addition of mannose to conventional chemotherapy leads to accumulation of mannose metabolite in cancer cells and increases subsequent cell death. This susceptibility to mannose depends on the levels of phosphomannose isomerase (PMI). The cancer cells with lower levels of PMI are more sensitive to mannose than cells with higher levels. In this study, we investigated the association of PMI expression with clinical and pathological features of PDAC cases.</p><p><strong>Methods: </strong>PMI antibody immunohistochemistry (AbCam) was performed on tissue microarrays from 235 PDAC by a standard protocol on Ventana automated immunostainer. The PMI intensity was graded (0-3) and the proportion of positivity was scored. Correlation of PMI expression with staging and survival was analyzed.</p><p><strong>Results: </strong>Of the 235 cases, 51.5% (n=121) cases demonstrated grade 2 intensity with 90.1% of these (n=109) showing positivity in ≥70% of tumor cells. Ninety-eight (41.7%) cases exhibited grade 3 intensity with 94.9% (n=93) of these cases showing ≥70% reactivity. Sixteen cases (6.8%) were nonreactive (intensity grade 0-1). Intensity of PMI expression was associated with significantly better prognosis as assessed by median survival in months (M): grade 0-1 intensity group: 11.2 M; grade 2 intensity group: 25.2 M; and grade 3 intensity group: 33.2 M (p=0.03). A minority (6.8%) of PDACs show non-high PMI expression with poorer prognosis.</p><p><strong>Discussion: </strong>Mannose may be a particularly useful adjunct with chemotherapy to treat this aggressive subgroup. PMI expression is also a potential biomarker to predict the prognosis of PDAC.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"14 ","pages":"353-360"},"PeriodicalIF":2.4,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/1e/ceg-14-353.PMC8421669.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39407823","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}

{"title":"Patient Preference and Adherence to Aminosalicylates for the Treatment of Ulcerative Colitis.","authors":"Kartikeya Tripathi,&nbsp;Jeffrey Dong,&nbsp;Brooke F Mishkin,&nbsp;Joseph D Feuerstein","doi":"10.2147/CEG.S237653","DOIUrl":"https://doi.org/10.2147/CEG.S237653","url":null,"abstract":"<p><p>Ulcerative colitis (UC) is a chronic inflammatory disorder that requires sustained treatment for optimal outcomes. The 5-aminosalicylate (5-ASA) class of medications are first-line for the treatment of mild-to-moderate UC but suffer from suboptimal adherence rates in real-world settings. This review summarizes the literature on adherence and patient preference to 5-ASA in patients with UC. We begin by highlighting key studies that measure real-world adherence rates, as well as some of the pitfalls associated with certain techniques. We examine the data on the consequences of non-adherence, which range from decreased quality of life and higher risk of colorectal cancer at the individual level to increased costs to the overall healthcare system. We then turn to the reasons and risk factors for non-adherence and summarize the current understanding of the barriers towards adherence. Afterwards, we describe the research on patient preferences between 5-ASA formulations and dosing regimen. Finally, we summarize the evidence regarding interventions to improve 5-ASA adherence. While adherence remains a challenge in practice, understanding the current state of the field can better inform future efforts towards increasing adherence, and thus clinical outcomes, in UC.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"14 ","pages":"343-351"},"PeriodicalIF":2.4,"publicationDate":"2021-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ec/db/ceg-14-343.PMC8412827.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39407821","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}

{"title":"Anti-Integrins for the Treatment of Inflammatory Bowel Disease: Current Evidence and Perspectives.","authors":"John Gubatan, Kian Keyashian, Samuel J S Rubin, Jenny Wang, Cyrus A Buckman, Sidhartha Sinha","doi":"10.2147/CEG.S293272","DOIUrl":"10.2147/CEG.S293272","url":null,"abstract":"<p><p>Leukocyte trafficking to the gastrointestinal tract is recognized to play a role in the pathogenesis of inflammatory bowel disease (IBD). Integrins are expressed on immune cells and interact with cell adhesion molecules (CAM) to mediate leukocyte trafficking. Blockade of the gut-tropic integrin α4β7 and its subunits has been exploited as a therapeutic target in IBD. Natalizumab (anti-α4) is approved for moderate to severe Crohn's disease (CD), but its use is limited due to potential risk of progressive multifocal leukoencephalopathy. Vedolizumab (anti-α4β7) is approved for the treatment of ulcerative colitis (UC) and CD. It is the most widely used anti-integrin therapy in IBD and has been shown to be effective in both induction and maintenance therapy, with a favorable safety profile. Several models incorporating clinical, genetic, immune, gut microbial, and vitamin D markers to predict response to vedolizumab in IBD have been developed. Etrolizumab (anti-β7) blocks leukocyte trafficking via α4β7 and cell adhesion via αEβ7 integrins. Large phase 3 clinical trials evaluating efficacy of etrolizumab in the induction and maintenance of patients with IBD are underway. Other investigational anti-integrin therapies include abrilumab (anti-α4β7 IgG2), PN-943 (orally administered and gut-restricted α4β7 antagonist peptide), AJM300 (orally active small molecule inhibitor of α4), and ontamalimab (anti-MAdCAM-1 IgG).</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"14 ","pages":"333-342"},"PeriodicalIF":2.4,"publicationDate":"2021-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ca/96/ceg-14-333.PMC8402953.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39371375","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}

{"title":"Gastro-Intestinal Symptoms and Autism Spectrum Disorder: A Potential Link [Letter].","authors":"Syeda Lamiya Mir,&nbsp;Abdul Moiz Sahito,&nbsp;Irfan Ullah","doi":"10.2147/CEG.S333529","DOIUrl":"https://doi.org/10.2147/CEG.S333529","url":null,"abstract":"1Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan; 2Kabir Medical College, Gandhara University, Peshawar, Pakistan Dear editor Moudgal et al published an article in Clinical and Experimental Gastroenterology titled “Systemic Disease Associations with Disorders of Gut–Brain Interaction and Gastrointestinal Transit: A Review”. We want to express our gratitude to the authors for publishing such a thorough review study and would like to make some suggestions. The paper discussed a variety of multisystem illnesses and their pathophysiological links to disorders of gut brain interface (DGBI) and gastrointestinal motor dysfunction, presenting gastroenterologists with a foundation for differential diagnosis. Although the article mentioned most of the systemic disorders, we noticed the lack of the overlap of GI symptoms and autism spectrum disorder (ASD) core symptoms. Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder which manifests as variable phenotypes with different subendo-phenotypes that may represent GI abnormalities. A meta-analysis carried out in 2014 by McElhanon et al, showed that children with ASD, unlike the comparison groups, expressed significantly more general GI symptoms: diarrhea, abdominal pain, and constipation. Recent studies have shown the shared pathogenic factors and pathophysiological mechanisms revealing the possible link between GI and ASD disturbances, including inflammation of intestine with or without autoimmunity, visceral hypersensitivity with functional abdominal pain and autonomic dysfunction with GI reflux and dysmotility. Absent or slow acquirement of bowel training secondary to trouble with sensory processing and motor problems may lead to altered GI motility and defecation physiology. Research carried out by Afzal et al concluded moderate-to-severe constipation in 36% of children with ASD compared to 9% in a control population. The diagnosis of GI disorders in patients with ASD can be very challenging due to the behavioral expressions, thus, doctors recommend using less invasive methods of investigation before hospitalization. In his research, Wasilewska et al concluded that GI disorders in children with ASD may vary greatly in their nature and localization. Due to the phenotypical representation as comorbidity of ASD and GI disorders, we suggest treating this situation as an “overlap syndrome”. Children with ASD who have GI disease and are experiencing unexplained anxiety, self-injury, sleep deprivation, aggression, and agitation will benefit from this concept. We have made significant progress in our studies of ASD; however, Correspondence: Syeda Lamiya Mir Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan Email lamiyamir@gmail.com","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"14 ","pages":"331-332"},"PeriodicalIF":2.4,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ac/49/ceg-14-331.PMC8396065.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39371374","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}

{"title":"Colorectal Endoscopic Submucosal Dissection: An Update on Best Practice.","authors":"Tara Keihanian, Mohamed O Othman","doi":"10.2147/CEG.S249869","DOIUrl":"10.2147/CEG.S249869","url":null,"abstract":"<p><p>Endoscopic submucosal dissection (ESD) is a method of en-bloc resection of neoplastic colorectal lesions which is less invasive compared to surgical resection. Lesion stratification, architecture recognition and estimation of depth of invasion are crucial for patient selection. Expert endoscopists have integrated a variety of classification systems including Paris, lateral spreading tumor (LST), narrow band imaging (NBI), international colorectal endoscopic (NICE) and Japanese NBI expert team (JNET) in their day-to-day practice to enhance lesion detection accuracy. Major societies recommend ESD for LST-non granular (NG), Kudo-VI type, large depressed and protruded colonic lesions with shallow submucosal invasion. Chance of submucosal invasion enhances with increased depth as well as tumor location and size. In comparison to endoscopic mucosal resection (EMR), ESD has a lowerl recurrence rate and higher curative resection rate, making it superior for larger colonic lesions management. Major complications such as bleeding and perforation could be seen in up to 11% and 16% of patients, respectively. In major Western countries, performing ESD is challenging due to limited number of expert providers, lack of insurance coverage, and unique patient characteristics such as higher BMI and higher percentage of previously manipulated lesions.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"14 ","pages":"317-330"},"PeriodicalIF":2.5,"publicationDate":"2021-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a0/e4/ceg-14-317.PMC8349195.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39298582","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}

{"title":"Association Between Patients' Immunoglobulin E Levels and Difficulty Eradicating <i>Helicobacter pylori</i>.","authors":"Kayoko Ozeki,&nbsp;Takahisa Furuta,&nbsp;Toshiyuki Ojima","doi":"10.2147/CEG.S322512","DOIUrl":"https://doi.org/10.2147/CEG.S322512","url":null,"abstract":"<p><strong>Background: </strong><i>Helicobacter pylori</i> is a cause of gastric cancer, and thus the eradication of this bacterium is very important. The success rate of primary eradication has been dramatically increased by the introduction of potassium-competitive acid blockers. However, <i>H. pylori</i> cannot be eradicated in all patients, and the contributing factors need to be clarified.</p><p><strong>Aim: </strong>Because allergy status may be a factor and considering research linking hay fever with eradication failure, the purpose of this study was to examine blood immunoglobulin E levels as a contributing factor in patients who were unable to eradicate <i>H. pylori</i> in a single eradication treatment and who underwent multiple eradication attempts.</p><p><strong>Methods: </strong>Questionnaire data were collected from 250 patients who visited the Department of Gastroenterology, Hamamatsu University School of Medicine, for <i>H. pylori</i> eradication. In addition, non-specific IgE levels in the blood were measured and analyzed with one-way analysis of variance. Multinomial logistic regression analysis was performed to examine the association between the number of eradication attempts and the IgE level (< 500 vs ≥ 500 IU/mL).</p><p><strong>Results: </strong>The mean IgE values were 188.4, 211.9, and 744.0 IU/mL in patients with one, two, and three or more eradication attempts, respectively (P < 0.05). The results of multinomial logistic regression analysis showed that attempting eradication three or more times was significantly associated with high levels of IgE, even after consideration of antibiotic sensitivity.</p><p><strong>Conclusion: </strong><i>H. pylori</i> eradication was less likely in patients with high IgE. It is thus necessary to study the appropriate regimen for patients with high IgE levels.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"14 ","pages":"311-316"},"PeriodicalIF":2.4,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/50/94/ceg-14-311.PMC8325756.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39272769","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}

{"title":"Erratum: Toxic Megacolon: Background, Pathophysiology, Management Challenges and Solutions [Corrigendum].","authors":"","doi":"10.2147/CEG.S329394","DOIUrl":"https://doi.org/10.2147/CEG.S329394","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2147/CEG.S200760.].</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"14 ","pages":"309-310"},"PeriodicalIF":2.4,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ba/34/ceg-14-309.PMC8302810.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39254043","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}