Disorders Of Gastrointestinal Tract Research Articles

A Study of Potential Drug-Drug Interactions in Peptic Ulcer Patients in Dr. M. Djamil Hospital Padang in 2019

A peptic ulcer is a gastrointestinal tract disorder caused by excessive secretion of acid and pepsin by the gastric mucosa. The combined use of drugs in peptic ulcer management may potentially cause drug-to-drug interactions. Drug interactions are caused when two or more drugs interact and may affect the effectiveness of the other drugs. This study aims to analyze the potential drug reactions in peptic ulcer patients in the internal medicine ward of Dr. M. Djamil General Hospital Padang in 2019. This study was a descriptive, non-experimental study with retrospective data, while data analysis used Drugs.com and Medscape applications. The study results revealed that 29 patients fit the inclusion criteria and 5 (16.6%) potential drug pharmacokinetic interactions. The severity of drug interactions shows 4 cases (80%) with moderate severity potential and 1 case (20%) with minor severity potential. The study concluded that there were potential drug interactions in peptic ulcer patients in the internal medicine ward of Dr. M. Djamil General Hospital Padang in 2019.

Gastrointestinal Tract Disorders in Patients with Diabetes

Gastrointestinal Tract Disorders in Patients with Diabetes

Colorectal polyp detection in colonoscopy images using YOLO-V8 network

Gastrointestinal tract disorders, including colorectal cancer (CRC), impose a significant health burden in Europe, with rising incidence rates among both young and elderly populations. Timely detection and removal of polyps, the precursors to CRC, are vital for prevention. Conventional colonoscopy, though effective, is prone to human errors. To address this, we propose an artificial intelligence-based polyp detection system using the YOLO-V8 network. We constructed a diverse dataset from multiple publicly available sources and conducted extensive evaluations. YOLO-V8 m demonstrated impressive performance, achieving 95.6% precision, 91.7% recall, and 92.4% F1-score. It outperformed other state-of-the-art models in terms of mean average precision. YOLO-V8 s offered a balance between accuracy and computational efficiency. Our research provides valuable insights into enhancing polyp detection and contributes to the advancement of computer-aided diagnosis for colorectal cancer.

The structure of gastrointestinal tract pathology in patients receiving hemodialysis treatment

BACKGROUND. Hemodialysis patients are characterized by a wide range of concomitant diseases, including cardiovascular, bone mineral, nutritional, cognitive, various metabolic disorders and anemia. Meanwhile, gastrointestinal tract disorders in these patients remains largely unexplored. Patients receiving treatment with programmed hemodialysis are characterized by a wide range of concomitant diseases, including cardiovascular, bone mineral, nutritional, cognitive, various metabolic disorders and anemia. Meanwhile, the pathology of the gastrointestinal tract in this category of patients remains largely unexplored.AIM: to investigate the structure of digestive diseases in patients receiving hemodialysis treatment.PATIENTS AND METHODS. This study included 180 hemodialysis patients. The median age was 60[47;68] years. Gastrointestinal Symptoms Questionnaire (GSQ) was used to evaluate gastrointestinal symptoms over the last month. The results of abdomen ultrasound, gastroscopy, colonoscopy, and complex laboratory examination were also analyzed.RESULTS. The overall prevalence of gastrointestinal symptoms was 77.2 % (139/180). The most frequent complaints were constipation (46.8 %) and abdominal pain (41 %). The most common stool frequency was one bowel action per day. The third, fourth, fifth type of stool according to the Bristol Stool Form Scale were noted by the majority of participants. Abdominal ultrasound revealed diffuse liver changes in 115 (63.9 %), signs of cirrhosis – in 7(3.9 %) patients. Ultrasound pathology of the gallbladder was represented by anomalies of its shape in 11.1 %, signs of chronic cholecystitis – in 10 %, stones (sludge) – in 7.2 %, polyps – in 2.2 % of patients. Diffuse changes in pancreatic parenchyma, steatosis, pseudocysts and dilatation of the main pancreatic duct were diagnosed respectively in 39(21,7 %), 21(11,7 %), 10(5,6 %) and 3(1.7 %) hemodialysis patients. According to 154 gastroscopies, the most common endoscopic finding in the stomach was chronic gastritis, detected in 86(55.8 %) of the subjects. Erosive gastritis was diagnosed in 22(14.3 %), gastric ulcer – in 3(2.0 %) patients. Endoscopic duodenal pathology was represented by erythematous duodenitis in 53(34.4 %), erosive duodenitis in 15(9.7 %), ulcer in 2(1.3 %), duodenal bulb abnormalities in 23(14.9 %) patients. Combined gastric and duodenal lesions were found in 88(57.1 %) patients. Сolonoscopy was performed in 56 patients, of whom 15 (26.8 %) had signs of colitis (mainly sigmoiditis), 2(3.6 %) – diverticulitis, 10(17.9 %) – diverticulosis, 12(21.4 %) – colon polyps, 8(14.3 %) – angiodysplasia mucosa, in 3(5.4 %) – dolichocolon. Despite the abundance of gastrointestinal symptoms and instrumental findings, no significant deviations in laboratory parameters (including an increase in AST, ALT, total bilirubin, amylase, lipase) were found.CONCLUSION. Hemodialysis patients are characterized by a high prevalence of gastrointestinal symptoms and various pathological changes in the gastrointestinal tract, the diagnosis and treatment of which require an individual multidisciplinary approach.

Therapeutic potential of Zingiber roseum Roxb.

Zingiber roseum Roxb, commonly known as the pink porcelain lily or pink ginger, is a plant species celebrated for its ornamental beauty and intriguing medicinal properties. Traditionally, the plant is being used by traditional healers for the treatment of disorders of gastrointestinal tract in Kheri district of Uttar Pradesh. This plant has been reported to be used in traditional healing system in other parts of the world especially Southeast Asia. Its appropriation with any of the classical drug has not been done till date. Plant has been reported to contain a wide variety of phytochemicals which make it a potential plant drug to be used for therapeutic purposes. In pharmacological screening studies, biological activities like Antioxidant, Antimicrobial, Immunomodulatory, Anticancer, Antiviral, Antifungal, Anti-inflammatory and many more have been demonstrated in different plant parts and fractions. Plant is considered to be native to Southeast Asia. It has been designated as endangered in IUCN plant list and needs attention. Present paper is an attempt to review different aspects pertaining to Z. roseum including botanical characteristics, phytochemical composition, and diverse therapeutic applications of Zingiber roseum.

Profiling of the fecal microbiota and circulating microRNA-16 in IBS subjects with Blastocystis infection : a case–control study

Irritable bowel syndrome (IBS) is a prevalent gastrointestinal (GI) tract disorder. Although the main reason for IBS is not clear, the interaction between intestinal microorganisms and the gut barrier seems to play an important role in pathogenesis of IBS. The current study aimed to investigate the effect of Blastocystis on the gut microbiota profile and the circulation levels of microRNA (mir)-16 of IBS patients compared to healthy subjects. Stool and blood samples were collected from 80 participants including 40 samples from each IBS and healthy group. Upon DNA extraction from stool samples, barcoding region and quantitative real-time PCR were analyzed to investigate Blastocystis and the microbiota profile, respectively. RNA was extracted from serum samples of included subjects and the expression of mir-16 was evaluated using stem-loop protocol and qreal-time PCR. Significant changes between IBS patients and healthy controls was observed in Firmicutes, Actinobacteria, Faecalibacterium, and Alistipes. In IBS patients, the relative abundance of Bifidobacteria was directly correlated with the presence of Blastocystis, while Alistipes was decreased with Blastocystis. Lactobacillus was significantly increased in Blastocystis carriers. In healthy subjects, the relative abundance of Bifidobacteria was decreased, but Alistipes was increased in Blastocystis carriers. The changes in the Firmicutes/Bacteroidetes ratio was not significant in different groups. The relative expression of mir-16 in Blastocystis-negative IBS patients and healthy carriers was significantly overexpressed compared to control group. The presence of Blastocystis, decreased the relative expression of mir-16 in IBS patients compared to Blastocystis-negative IBS patients. The present study revealed that Blastocystis has the ability to change the abundance of some phyla/genera of bacteria in IBS and healthy subjects. Moreover, Blastocystis seems to modulate the relative expression of microRNAs to control the gut atmosphere, apply its pathogenicity, and provide a favor niche for its colonization.

Effectiveness and safety of drugs for the treatment of gastroparesis: evidence-based medicine data. Review

Gastroparesis is a motility disorder of the upper gastrointestinal tract, characterized by delayed emptying of the stomach from solid substances, in the absence of any mechanical signs of obstruction of the stomach or duodenum. The etiology of gastroparesis is heterogeneous, but there are three well‑known subtypes: diabetic, iatrogenic, resulting from upper gastrointestinal surgery or medication, and idiopathic gastroparesis. Despite recently updated guidelines for the management of patients with gastroparesis, this condition remains difficult to diagnose and treat. A recent systematic review and network meta‑analysis of randomized controlled trials (RCTs) evaluated the efficacy and safety of all drugs tested in patients with gastroparesis. The only FDA‑approved drug is metoclopramide, a dopamine D2 antagonist and weak 5‑HT4 agonist, which in gastroparesis is approved for a maximum of three months of treatment due to endocrine, cardiac, and neurologic side effects. The results of the conducted meta‑analysis confirmed the effectiveness of dopamine antagonists in gastroparesis. Domperidone has been the subject of a warning due to an increased risk of QT prolongation on the electrocardiogram, but pharmacoepidemiological data suggest that this is rare, and ventricular arrhythmia occurs only in 0.02% of patients treated with the drug. A meta‑analysis suggested that clebopride, another dopamine antagonist, is an effective drug for gastroparesis, ranking first among effects on global symptoms, although this was shown in only one RCT, and the drug is not yet available in many countries, including the USA. The tachykinin‑1 antagonists aprepitant and tradipitant ranked third and fifth, respectively, for effects on global symptoms of gastroparesis, but when examined for effects on global symptoms according to drug class, they ranked second. Although 5‑HT4 agonists have not been shown to be sufficiently effective, trials of velosetrag are ongoing, and prucalopride was superior to placebo in a one cross‑over study included in the meta‑analysis.

Precision Endoscopy in Peroral Myotomies for Motility Disorders of the Upper Gastrointestinal Tract: Current Insights and Prospective Avenues-A Comprehensive Review.

Our review delves into the realm of peroral endoscopic myotomies (POEMs) in the upper gastrointestinal tract (UGT). In recent years, POEMs have brought about a revolution in the treatment of UGT motility disorders. Esophageal POEM, the first to be introduced, has now been validated as the primary treatment for achalasia. Subsequently developed, G-POEM displays promising results in addressing refractory gastroparesis. Over time, multiple endoscopic myotomy techniques have emerged for the treatment of Zenker's diverticulum, including Z-POEM, POES, and hybrid approaches. Despite the well-established efficacy outcomes, new challenges arise in the realm of POEMs in the UGT. For esophageal POEM, the future scenario lies in customizing the myotomy extent to the minimum necessary, while for G-POEM, it involves identifying patients who can optimally benefit from the treatment. For ZD, it is crucial to validate an algorithm that considers various myotomy options according to the diverticulum's size and in relation to individual patients. These challenges align with the concept of precision endoscopy, personalizing the technique for each subject. Within our text, we comprehensively examine each myotomy technique, analyzing indications, outcomes, and adverse events. Additionally, we explore the emerging challenges posed by myotomies within the context of the evolving field of precision endoscopy.

QbD assisted development of inhalable spray-dried erlotinib procubosomal system for the effective management of non-small cell lung cancer

Non-small cell lung cancer (NSCLC) is the most common and leading cause of cancer deaths worldwide. Erlotinib (ERL), an epidermal growth factor receptor (EGFR) kinase inhibitor, has been used as a primary prescription for the effective treatment of metastatic NSCLC. However, it has poor aqueous solubility, extensive first-pass metabolism, oral administration-related toxicities, and inconveniences for cancer patients with gastrointestinal tract (GIT) disorders that limit its therapeutic potential. To resolve the above challenges, inhalable ERL-loaded spray-dried procubosomal powder (ERL-SDPP) was developed employing a Box-Behnken design that exhibit impressive characteristics including a device removal efficiency (DRE) of 84.7 ± 2.37 %, aerosolization efficiency (AE) of 18.1 ± 0.75, fine particle fraction (FPFTSI) of 33.7 ± 1.28 %, drug content (DC) of 93.6 ± 3.9 %, and a reconstituted cubosome size (PS) of 453.87 ± 14.65 nm. During in-vitro characterization, the optimized inhalable ERL-SDPP formulation was found to have 96.2 ± 3.98 % entrapment efficiency, −28.6 ± 1.38 mV zeta potential, and 3.29 ± 0.53 μm mass median aerodynamic diameter (MMAD). In-vitro drug release studies revealed sustained release behavior of ERL from ERL-SDPP lasting up to 36 h, demonstrating the increased dissolution profile and stability of ERL-SDPP in simulated lung fluids compared to pure ERL. In-vitro cytotoxicity studies utilizing A549 cell lines uncovered the greater potential of ERL-SDPP formulation, with a ∼1.5-fold reduction in IC50 compared to pure ERL, after 24 h treatment. In-vivo pharmacokinetic parameters revealed that inhalable ERL-SDPP exhibited a 1.76-fold and 6.25-fold higher AUC than oral and intravenous administered ERL, respectively. Organ distribution studies confirmed enhanced retention and accumulation of ERL in lungs after administration of inhalable ERL-SDPP compared to oral ERL, thereby reducing the dose and related systemic toxicities. Thus, the developed inhalable ERL-SDPP has shown promise to improve therapeutic potential against NSCLC through a site-specific sustained drug delivery system as it requires lower doses and limits systemic side effects.

Gastrointestinal tract disorders classification using ensemble of InceptionNet and proposed GITNet based deep feature with ant colony optimization.

Computer-aided classification of diseases of the gastrointestinal tract (GIT) has become a crucial area of research. Medical science and artificial intelligence have helped medical experts find GIT diseases through endoscopic procedures. Wired endoscopy is a controlled procedure that helps the medical expert in disease diagnosis. Manual screening of the endoscopic frames is a challenging and time taking task for medical experts that also increases the missed rate of the GIT disease. An early diagnosis of GIT disease can save human beings from fatal diseases. An automatic deep feature learning-based system is proposed for GIT disease classification. The adaptive gamma correction and weighting distribution (AGCWD) preprocessing procedure is the first stage of the proposed work that is used for enhancing the intensity of the frames. The deep features are extracted from the frames by deep learning models including InceptionNetV3 and GITNet. Ant Colony Optimization (ACO) procedure is employed for feature optimization. Optimized features are fused serially. The classification operation is performed by variants of support vector machine (SVM) classifiers, including the Cubic SVM (CSVM), Coarse Gaussian SVM (CGSVM), Quadratic SVM (QSVM), and Linear SVM (LSVM) classifiers. The intended model is assessed on two challenging datasets including KVASIR and NERTHUS that consist of eight and four classes respectively. The intended model outperforms as compared with existing methods by achieving an accuracy of 99.32% over the KVASIR dataset and 99.89% accuracy using the NERTHUS dataset.

Gastrointestinal bleeding in children: diagnosis, analysis, and structure

The incidence of gastrointestinal bleeding is a significant concern among adult patients with gastrointestinal tract (GIT) disorders, as it is a leading cause of mortality. However, there is growing evidence of changes in the pattern of gastrointestinal pathologies among children, primarily attributed to an increasing number of cases related to peptic ulcer disease (PUD) and erosive processes of the GIT. Purpose - to investigate the prevalence and analyze changes in the structure of GIT diseases in children complicated by upper gastrointestinal bleeding (GIB), based on esophagogastroduodenoscopy (EGD) data. Materials and methods. Based on the clinic’s records, a total of 4,457 children underwent EGD at the Regional Medical Center of Family Health in Dnipro. Among them, 1,393 (31.25%) patients were admitted to the surgical department with suspected GIB. In 201 (14.4%) cases, EGD was performed during active bleeding to determine its origin. The utilization of EGD during the acute phase in patients with suspected GIB is considered highly effective for both diagnosing the bleeding source and initiating early-stage treatment. The data were processed using the methods of variation statistics using the Statistica v 6.1 software package. To compare the relative indicators, the Pearson Hi-quadrat test (χ2) and the two-sided Fisher’s exact test (TCF) were used. The critical level of statistical significance (p) was accepted as <0.05. Results. To conduct a comparative analysis of diagnosed cases of GIB, two groups of children with endoscopically confirmed GIB were formed: the Group I (n=125) representing the period of 2012-2013, and the Group II (n=201) - the period of 2020-2021. The results revealed an increase of 1.6 times in the number of patients with upper GIT diseases accompanied by bleeding in the Group II. Additionally, a significant rise in the frequency of GIT diseases, specifically erosive esophagitis, was observed. The number of patients with erosive esophagitis tripled in the Group II compared to the Group I. Conclusions. In recent years, there has been a notable rise in GIT diseases accompanied by upper GIB. The number of such cases increased by 1.6 times, from 125 to 201 patients. Notably, there is a pronounced increase in the incidence of erosive esophagitis, particularly among children in the early and younger age groups. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Self-perceived halitosis and its social impact on females: A cross-sectional study.

Halitosis refers to socially unacceptable levels of breath odors. This affects the social life and psychological well-being of individuals. The purpose of this study was to evaluate the prevalence of self-perceived halitosis (SPH) among females and its effect on social life. This was a cross-sectional study. A previously validated questionnaire was distributed electronically through a secure link. The questionnaire consisted of 5 different parts that collected information on sociodemographic, medical history, oral hygiene and other health habits. It also included questions related to participant's knowledge and perception of halitosis and its social impact. All females who were at least 18 years were invited to participate. Data were transferred for analysis using the Statistical Package for Social Sciences program for Windows (IBM SPSS Statistics Version 26, Chicago, IL). Simple descriptive statistics such as frequency distributions and percentages were calculated for the study variables. The relationship between the variables and SPH was also evaluated using the chi-squared test of independence at 95% confidence (P ≤ .05). In total, 1089 subjects completed the questionnaire. The SPH prevalence was 62% among females. The correlation between SPH and sinusitis, gastrointestinal tract disorders, periodontal diseases were significant (P < .05). In addition, subjects with good tooth brushing habits reported no halitosis (91.6%) compared to subjects with poor tooth brushing habits who reported no halitosis (8.9%), and the difference was statistically significant (P < .001). Not using floss and tounge cleaners daily was significantly related to self-reported halitosis (P < .001). Females who reported SPH indicated that they were hesitant to talk to others (68.1%), uncomfortable around others (80.5%), did not like meeting others (44.2%), avoided by others (15%), and that halitosis affected their personal life (31.9%). This association was statistically significant for all variables of social life (P < .001). The prevalence of SPH is high and can have an incapacitating effect on females social lives. The management of halitosis includes active involvement of dental professionals and the incorporation of psychological support.

Modulation of chicken gut contractility by Melissa officinalis—ex vivo study

Melissa officinalis (lemon balm) has a long history of being used in traditional medicine for the treatment of gastrointestinal tract disorders in human thanks to its spasmolytic and stress reducing effects. These pharmacological properties have been confirmed in laboratory animals. Unfortunately, in the case of veterinary medicine, the effect of lemon balm on gut contractility has been never subjected to a detailed investigation. On the other hand, there is urgent need of new drugs that could be safely used in animals for both, causative and symptomatic treatment. In broiler chicken, one of the major health concerns includes gastrointestinal disorders with gut hypermotility. Thus, it is crucial to verify the potential utility of Melissa officinalis extract in gastrointestinal dysmotilities. The aim of the study was to analyze the effect of lemon balm extract and some of its active ingredients on chicken intestine motility. The study was performed on isolated proximal and distal jejunum preparations collected from broiler chicken which underwent routine slaughter procedure. The effect of lemon balm and 3 phenolic acids (rosmarinic, chlorogenic, and lithospermic) was verified under isometric conditions, toward spontaneous and acetylcholine (ACh)-induced smooth muscle activity. Surprisingly, M. officinalis turned out to be rather a myocontractile agent as it increased ACh-provoked contractility of proximal and distal jejunum strips and also intensified the spontaneous activity of distal jejunum. Only in the case of proximal intestine lemon balm extract diminished the force of spontaneous motoric activity up to approx. Sixty-seven percent of the control conditions. None of the tested phenolic acids displayed analog effect with the whole plant extract. In fact in the case of ACh-induced contractility, the acids had the opposite, that is, myorelaxant, effect than the extract, with a small exception of lithospermic acid in distal jejunum. Thus, it is impossible to assign one or more individual constituents to the effect of the whole Melissa officinalis extract. The obtained results do not support the use of lemon balm extract in broiler diseases which are accompanied by gut motility disturbances, including diarrhea.

Prevalence, Characteristics, and Treatment of Hemorrhoids During Pregnancy: A Nationwide Population-Based Cohort Study in Taiwan.

Background: Hemorrhoids, a gastrointestinal tract disorder, are common during pregnancy. However, large-scale epidemiological studies on hemorrhoids during pregnancy are limited. Therefore, this study used analyzed data from a nationwide population-based database to investigate the prevalence, characteristics, and treatment of hemorrhoids in Taiwan. Materials and Methods: This retrospective population-based study used data from the National Health Insurance Research Database and Taiwan Birth Certificate Application to collect the medical records of women who were pregnant at any time during 2009-2018. Hemorrhoids was defined by International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) (455. X) and International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) (K64.X, O22.4X) with related treatment. Results: We enrolled 1,608,804 deliveries in 1,070,708 women. The proportion of hemorrhoids increased with age in both primipara and multipara women. Of the pregnant women, 31% received oral medication, and 93.2% used the topical ointment to treat their hemorrhoids. Few patients (1.8%) required procedure or surgery during pregnancy, and 41.4% of those patients underwent procedure or surgery in their first trimester. The cumulative incidence of hemorrhoids during pregnancy was significantly higher in women with a history of hemorrhoids and those with multifetal pregnancies. No significant difference in the incidence of hemorrhoids was observed between multiparous and primiparous women. Conclusion: Women with a history of hemorrhoids or those carrying multiple fetuses had an increased risk of hemorrhoids during pregnancy. The most commonly used treatment for hemorrhoids during pregnancy was topical ointments, with only a small proportion (1.8%) of patients requiring procedure or surgery.

Prevalence of Clostridioides difficile in dogs (Canis familiaris) with gastrointestinal disorders in Rio de Janeiro

Clostridioides difficile infections (CDI) have a high morbidity and mortality rate and have always been considered a nosocomial disease. Nonetheless, the number of cases of community-acquired CDI is increasing, and new evidence suggests additional C. difficile reservoirs exist. Pathogenic C. difficile strains have been found in livestock, domestic animals, and meat, so a zoonotic transmission has been proposed. ObjectiveThe goal of this study was to isolate C. difficile strains in dogs at a veterinary clinic in Rio de Janeiro, Brazil, and characterize clinical and pathological findings associated with lower gastrointestinal tract disorders. MethodsFifty stool samples and biopsy fragments from dogs were obtained and cultured in the CDBA selective medium. All suggestive C. difficile colonies were confirmed by MALDI-TOF MS and PCR (tpi gene). Vancomycin, metronidazole, moxifloxacin, erythromycin, and rifampicin were tested for antibiotic susceptibility. Biofilm, motility assays, and a PCR for the toxins (tcdA, tcdB, and cdtB), as well as ribotyping, were also performed. ResultsBlood samples and colonic biopsy fragments were examined in C. difficile positive dogs. Ten animals (20%) tested positive for C. difficile by using stool samples, but not from biopsy fragments. Most C. difficile strains were toxigenic: six were A+B+ belonging to RT106; two were A+B+ belonging to RT014/020; and two were A-B- belonging to RT010. All strains were biofilm producers. In the motility test, 40% of strains were as motile as the positive control, CD630 (RT012). In the disc diffusion test, two strains (RT010) were resistant to erythromycin and metronidazole; and another to metronidazole (RT014/020). In terms of C. difficile clinicopathological correlations, no statistically significant morphological changes, such as pseudomembranous and "volcano" lesions, were observed. Regarding hematological data, dogs positive for C. difficile had leucopenia (p = 0.02) and lymphopenia (p = 0.03). There was a significant correlation between senility and the presence of C. difficile in the dogs studied (p = 0,02). ConclusionsAlthough C. difficile has not been linked to canine diarrheal disorders, it appears to be more common in dogs with intestinal dysfunctions. The isolation of ribotypes frequently involved in human CDI outbreaks around the world supports the theory of C. difficile zoonotic transmission.

Capsulated Cellular Nanosponges for the Treatment of Experimental Inflammatory Bowel Disease.

Inflammatory bowel disease (IBD) is a chronic gastrointestinal tract disorder characterized by uncontrolled inflammatory responses to the disrupted intestinal epithelial barrier and gut microbiome dysbiosis. Currently available small-molecule immunosuppressive agents and anticytokine biologics show limited potency, mainly due to the complexity of the inflammatory network involved in IBD. Here, we develop an oral formulation of macrophage membrane-coated nanoparticles capsulated in enteric polymer-coated gelatin capsules (denoted "cp-MΦ-NPs") for IBD treatment. The capsules protect the nanoparticles from gastric degradation and allow for targeted delivery to the colon. At the inflamed colon, cp-MΦ-NPs act as macrophage decoys that bind and neutralize pro-inflammatory cytokines. The in vivo treatment efficacy of cp-MΦ-NPs is tested in a mouse model of dextran sulfate sodium-induced colitis. In both prophylactic and delayed treatment regimens, the oral delivery of cp-MΦ-NPs significantly alleviates IBD severity, reflected by reduced intestinal inflammation and intestinal barrier restoration. Overall, cp-MΦ-NPs provide a biomimetic nanomedicine strategy for the treatment of IBD.

Garcinol-Attenuated Gastric Ulcer (GU) Experimentally Induced in Rats Via Affecting Inflammation, Cell Proliferation, and DNA Polymerization.

Gastric ulcer (GU) is one of the most critical gastrointestinal tract disorders. Garcinolis a polyisoprenylated benzophenone in Garcinia fruit with antioxidant and anti-inflammatory priorities. We aimed to assess the protective effects of garcinolagainst GU induced in rats. We investigated garcinol'seffects on DNA polymerization via mammalian targets of rapamycin(mTOR) and cyclin D1, cell proliferation viaproliferating cell nuclear antigen (PCNA), inflammatory pathway viacyclooxygenase-2 (COX2), TNF-α, and IL-1β, and anti-inflammatory pathwayvia IL-4 and IL10. In our study, we administered a single oral dose of 80 mg/kg of indomethacin to rats to induce GU. Some of the rats were given a treatment of 50 mg/kg of garcinol. We examined the expressions of mTOR, cyclin D1, PCNA, COX2, TNF-α, and IL-1β/4/10 in the gastric tissues. Furthermore, we stained sections of the gastric tissues with Masson trichrome. The areas of gastric tissues in the GU group showed severe hemorrhage and extensive fibrosis. Treating GU rats with garcinol prevented bleeding and ameliorated the fibrosis caused ingastric cells by GU. Moreover, treatment with garcinol significantly decreased the expression of mTOR, cyclin D1, PCNA, COX2, TNF-α, and IL-1β associated with elevation of IL-4 and IL-10. Garcinol has been found to provide therapeutic benefits in rats with induced GU. These benefits may be due to its ability to decrease the expression of DNA polymerization markers, cell proliferation markers, and inflammatory markers at the gene and protein levels.

Localization and Classification of Gastrointestinal Tract Disorders Using Explainable AI from Endoscopic Images

Globally, gastrointestinal (GI) tract diseases are on the rise. If left untreated, people may die from these diseases. Early discovery and categorization of these diseases can reduce the severity of the disease and save lives. Automated procedures are necessary, since manual detection and categorization are laborious, time-consuming, and prone to mistakes. In this work, we present an automated system for the localization and classification of GI diseases from endoscopic images with the help of an encoder–decoder-based model, XceptionNet, and explainable artificial intelligence (AI). Data augmentation is performed at the preprocessing stage, followed by segmentation using an encoder–decoder-based model. Later, contours are drawn around the diseased area based on segmented regions. Finally, classification is performed on segmented images by well-known classifiers, and results are generated for various train-to-test ratios for performance analysis. For segmentation, the proposed model achieved 82.08% dice, 90.30% mIOU, 94.35% precision, and 85.97% recall rate. The best performing classifier achieved 98.32% accuracy, 96.13% recall, and 99.68% precision using the softmax classifier. Comparison with the state-of-the-art techniques shows that the proposed model performed well on all the reported performance metrics. We explain this improvement in performance by utilizing heat maps with and without the proposed technique.

The gut microbiota-brain axis in neurological disorder.

The gut microbiota (GM) plays an important role in the physiology and pathology of the host. Microbiota communicate with different organs of the organism by synthesizing hormones and regulating body activity. The interaction of the central nervous system (CNS) and gut signaling pathways includes chemical, neural immune and endocrine routes. Alteration or dysbiosis in the gut microbiota leads to different gastrointestinal tract disorders that ultimately impact host physiology because of the abnormal microbial metabolites that stimulate and trigger different physiologic reactions in the host body. Intestinal dysbiosis leads to a change in the bidirectional relationship between the CNS and GM, which is linked to the pathogenesis of neurodevelopmental and neurological disorders. Increasing preclinical and clinical studies/evidence indicate that gut microbes are a possible susceptibility factor for the progression of neurological disorders, including Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS) and autism spectrum disorder (ASD). In this review, we discuss the crucial connection between the gut microbiota and the central nervous system, the signaling pathways of multiple biological systems and the contribution of gut microbiota-related neurological disorders.

Palmitoylethanolamide counteracts high-fat diet-induced gut dysfunction by reprogramming microbiota composition and affecting tryptophan metabolism.

Obesity is associated with gastrointestinal (GI) tract and central nervous system (CNS) disorders. High-fat diet (HFD) feeding-induced obesity in mice induces dysbiosis, causing a shift toward bacteria-derived metabolites with detrimental effects on metabolism and inflammation: events often contributing to the onset and progression of both GI and CNS disorders. Palmitoylethanolamide (PEA) is an endogenous lipid mediator with beneficial effects in mouse models of GI and CNS disorders. However, the mechanisms underlining its enteroprotective and neuroprotective effects still need to be fully understood. Here, we aimed to study the effects of PEA on intestinal inflammation and microbiota alterations resulting from lipid overnutrition. Ultramicronized PEA (30 mg/kg/die per os) was administered to HFD-fed mice for 7 weeks starting at the 12th week of HFD regimen. At the termination of the study, the effects of PEA on inflammatory factors and cells, gut microbial features and tryptophan (TRP)-kynurenine metabolism were evaluated. PEA regulates the crosstalk between the host immune system and gut microbiota via rebalancing colonic TRP metabolites. PEA treatment reduced intestinal immune cell recruitment, inflammatory response triggered by HFD feeding, and corticotropin-releasing hormone levels. In particular, PEA modulated HFD-altered TRP metabolism in the colon, rebalancing serotonin (5-HT) turnover and reducing kynurenine levels. These effects were associated with a reshaping of gut microbiota composition through increased butyrate-promoting/producing bacteria, such as Bifidobacterium, Oscillospiraceae and Turicibacter sanguinis, with the latter also described as 5-HT sensor. These data indicate that the rebuilding of gut microbiota following PEA supplementation promotes host 5-HT biosynthesis, which is crucial in regulating intestinal function.