Etiology Of Inflammatory Bowel Disease Research Articles

A221 EFFECT OF PROXIMITY TO A SPECIALTY TERTIARY CENTRE ON OUTCOMES IN INFLAMMATORY BOWEL DISEASE: A POPULATION-BASED RETROSPECTIVE COHORT STUDY

Abstract Background The etiology of inflammatory bowel disease (IBD) is unknown; however, developed nations such as Canada ranking amongst the highest worldwide. With many diseases patients in urban and rural areas have different access to care and resources. Purpose To describe the differences in outpatient healthcare utilization, use of biologic agents and complication of IBD based on proximity to a tertiary health care centre. Method A retrospective cohort study was conducted comparing IBD patients seen in IBD clinics at affiliated with Western University in London, Canada between August 2019 – December 2019. IBD patients were compared on their use of outpatient healthcare utilization, biologic agents and IBD complications based on their proximity to a tertiary care centre (>100 km and <100 km). Patients residing >100 km from a tertiary centre were termed “rural” while <100 km from a tertiary centre were termed “urban.” Retrospective chart review occurred over a six-month period between January to June 2021. Result(s) A total of 481 were reviewed. Of those, 97 (UC, n=29; CD, n=68) and 95 (UC, n=30; CD, n=65) met inclusion for the urban and rural groups respectively. Patient demographics were similar between the two groups except IBD disease location with pancolitis seen more commonly in urban patients compared to ileocolonic in rural patients (urban, n=39; rural, n=34). IBD patients in both groups had similar number of appointments (urban, n=20.1 ± 13.8; rural, n=17.5 ± 12.1) and endoscopic procedures (urban, n= 4.9 ± 3.1; rural, n= 4.7 ± 3.2) with their gastroenterologists. More urban patients were managed with no therapy for their IBD (urban, n=16; rural, n=5). A higher rate of rural patients were managed with biologics (urban, n=56; rural, n=66) and combination therapy (urban, n=16; rural, n=27). The most common related IBD-related complications were IBD flares (urban, n=55; rural, n=60), intestinal strictures (urban, n=25; rural, n=34), intestinal obstructions (urban, n=10; rural, n=23) and rectal/genitourinary fistulas (urban, n=6; rural, n=21). Similar numbers of intra-abdominal surgery were seen between both groups with partial bowel resection (urban, n=13; rural, n=12) and right hemicolectomy (urban, n=10; rural, n=18) as the predominant surgery in urban and rural patients, respectively. Conclusion(s) This study demonstrated outpatient healthcare utilization when attending specialty gastroenterology appointments and outpatient endoscopies were numerically similar in rural and urban patients. IBD patient residing further from a tertiary care centre were numerically more likely to be managed with biologics and combination therapy. However the dataset is small and generalizations cannot be made. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared

A176 ASSOCIATIONS OF ANTIBIOTICS, HORMONAL THERAPIES, ORAL CONTRACEPTIVES, AND LONG-TERM NSAIDS WITH INFLAMMATORY BOWEL DISEASE: RESULTS FROM THE PROSPECTIVE URBAN RURAL EPIDEMIOLOGY (PURE) STUDY

A176 ASSOCIATIONS OF ANTIBIOTICS, HORMONAL THERAPIES, ORAL CONTRACEPTIVES, AND LONG-TERM NSAIDS WITH INFLAMMATORY BOWEL DISEASE: RESULTS FROM THE PROSPECTIVE URBAN RURAL EPIDEMIOLOGY (PURE) STUDY

A273 INCREASING THE REPRESENTATION OF INDIANS IN MICROBIOME RESEARCH: HOW DOES THEIR GUT MICROBIOME DIFFER?

Abstract Background During the 1900s when industrialization was on the rise in western countries, inflammatory bowel disease (IBD) began to present itself and continually increase over the decades. Now, newly industrialized countries such as India are following this same pattern, and with a population reaching over one billion, India is projected to have one of the highest IBD prevalence worldwide. Furthermore, pediatric diagnoses of IBD are more frequently reported in India and in Indian children living in Canada, suggesting this disease may present differently in those of Indian descent. While the etiology of IBD remains unclear, a gut microbiome that is no longer symbiotic with its host is a key player. However, Indians are one of the least represented in microbiome research, therefore we cannot accurately assess the role of their gut microbiome in IBD. To effectively understand the nature of IBD in Indians, we must first define their gut microbiome. Purpose Our study characterizes the microbiome of Indians living in India to explore how it differs from Canadians of European descent. Method Stool samples from healthy volunteers (ages 18-55) were collected from Indians in India and Euro-Canadians in Kelowna, BC. Microbial DNA was extracted for 16S sequencing on the Illumina MiSeq platform and QIIME2 was used for microbiome analysis. Result(s) We will discuss the similarities and differences comparing the gut microbiome of Indians to Euro-Canadians, further highlighting the need for more microbiome research of this demographic. Conclusion(s) Our research aims to increase representation of Indians in microbiome research in the hopes of improving our knowledge of the predispositions to IBD, which will aid in the information required to develop effective preventive measures. With elevated risk for IBD in Indians residing in Canada, future studies should also aim to analyze if the gut microbiome in Indians change as they migrate and adopt the westernized lifestyle. Disclosure of Interest None Declared

Mas-related G protein-coupled receptors in gastrointestinal dysfunction and inflammatory bowel disease: A review.

Inflammatory bowel disease (IBD) is a chronic debilitating condition, hallmarked by persistent inflammation of the gastrointestinal tract. Despite recent advances in clinical treatments, the aetiology of IBD is unknown, and a large proportion of patients are refractory to pharmacotherapy. Understanding IBD immunopathogenesis is crucial to discern the cause of IBD and optimise treatments. Mas-related G protein-coupled receptors (Mrgprs) are a family of approximately 50 G protein-coupled receptors that were first identified over 20 years ago. Originally known for their expression in skin nociceptors and their role in transmitting the sensation of itch in the periphery, new reports have described the presence of Mrgprs in the gastrointestinal tract. In this review, we consider the impact of these findings and assess the evidence that suggests that Mrgprs may be involved in the disrupted homeostatic processes that contribute to gastrointestinal disorders and IBD. LINKED ARTICLES: This article is part of a themed issue Therapeutic Targeting of G Protein-Coupled Receptors: hot topics from the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists 2021 Virtual Annual Scientific Meeting. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v181.14/issuetoc.

Deoxynivalenol at No-Observed Adverse-Effect Levels Aggravates DSS-Induced Colitis through the JAK2/STAT3 Signaling Pathway in Mice.

The etiology of inflammatory bowel diseases (IBDs) involves complex genetic and environmental factors such as mycotoxin contamination. Deoxynivalenol (DON), a well-known mycotoxin, contaminates food and feed and can induce intestinal injury and inflammatory response. The dose of DON in many foods is also below the limit, although the dose of DON exceeds the limit. The present study aims to evaluate the effects of the nontoxic dose of DON on colitis induced by dextran sodium sulfate (DSS) and the mechanism in mice. The results showed a nontoxic dose of DON at 50 μg/kg bw per day exacerbated DSS-induced colitis in mice as demonstrated by increased disease activity index, decreased colon length, increased morphological damage, decreased occludin and mucoprotein 2 expression, increased IL-1β and TNF-α expression, and decreased IL-10 expression. DON at 50 μg/kg bw per day enhanced JAK2/STAT3 phosphorylation induced by DSS. Adding JAK2 inhibitor AG490 attenuated the aggravating effects of DON on DSS-induced colitis by reversing the morphological damage, occludin and mucoprotein 2 expression increased, IL-1β and TNF-α expression increased, and IL-10 expression decreased. Taken together, a nontoxic dose of DON could aggravate DSS-induced colitis via the JAK2/STAT3 signaling pathway. This suggests that DON, below the standard limit dose, is also a risk for IBD and may be harmful to the health of humans and animals, which could provide the basis for establishing limits for DON.

Biodegradable Polymeric Nanoparticles Loaded with Flavonoids: A Promising Therapy for Inflammatory Bowel Disease.

Inflammatory bowel disease (IBD) is a group of disorders that cause chronic non-specific inflammation in the gastrointestinal (GI) tract, primarily affecting the ileum and colon. The incidence of IBD has risen sharply in recent years. Despite continuous research efforts over the past decades, the aetiology of IBD is still not fully understood and only a limited number of drugs are available for its treatment. Flavonoids, a ubiquitous class of natural chemicals found in plants, have been widely used in the prevention and treatment of IBD. However, their therapeutic efficacy is unsatisfactory due to poor solubility, instability, rapid metabolism, and rapid systemic elimination. With the development of nanomedicine, nanocarriers can efficiently encapsulate various flavonoids and subsequently form nanoparticles (NPs), which greatly improves the stability and bioavailability of flavonoids. Recently, progress has also been made in the methodology of biodegradable polymers that can be used to fabricate NPs. As a result, NPs can significantly enhance the preventive or therapeutic effects of flavonoids on IBD. In this review, we aim to evaluate the therapeutic effect of flavonoid NPs on IBD. Furthermore, we discuss possible challenges and future perspectives.

Roxadustat protect mice from DSS-induced colitis in vivo by up-regulation of TLR4

BackgroundThe incidence of inflammatory bowel disease (IBD) is growing in the population. At present, the etiology of inflammatory bowel disease remains unclear, and there is no effective and low-toxic therapeutic drug. The role of the PHD-HIF pathway in relieving DSS-induced colitis is gradually being explored. MethodsWild-type C57BL/6 mice were used as a model of DSS-induced colitis to explore the important role of Roxadustat in alleviating DSS-induced colitis. High-throughput RNA-Seq and qRT-PCR methods were used to screen and verify the key differential genes in the colon of mice between normal saline (NS) and Roxadustat groups. ResultsRoxadustat could alleviate DSS-induced colitis. Compared with the mice in the NS group, TLR4 were significantly up-regulated in the Roxadustat group. TLR4 KO mice were used to verify the role of TLR4 in the alleviation of DSS-induced colitis by Roxadustat. ConclusionRoxadustat has a repairing effect on DSS-induced colitis, and may alleviate DSS-induced colitis by targeting the TLR4 pathway and promote intestinal stem cell proliferation.

Deoxycholic acid exacerbates intestinal inflammation by modulating interleukin-1β expression and tuft cell proportion in dextran sulfate sodium-induced murine colitis.

The etiology of inflammatory bowel disease (IBD) remains unclear. However, intestinal metabolism is known to be critical in the pathogenesis of IBD. Bile acid is one of the main intestinal metabolites, and its role in the pathogenesis of IBD is worthy of investigation. This study investigated the role of deoxycholic acid (DCA), a bile acid, in the pathogenesis of IBD. Peripheral serum metabolomics, fecal metabolomics, and microbiome analyses were performed on patients with IBD and healthy controls. Flow cytometry, real-time quantitative polymerase chain reaction, western blotting, enzyme-linked immunosorbent assay, immunohistochemical staining, and immunofluorescence analysis were used to evaluate cytokines in the inflamed colonic mucosa and immune cells and tuft cells in the intestine of mice with dextran sulfate sodium (DSS)-induced colitis. In total, 156 patients with IBD and 58 healthy controls were enrolled. DCA levels in the serum and feces of patients with IBD were significantly decreased compared to the controls. This decrease was associated with a decrease in the abundance of intestinal flora, including Firmicutes, Clostridia, Ruminnococcaceae, and Lachnospiraceae. Additionally, interleukin (IL)-1β levels in the serum of patients with active Crohn's disease were significantly increased compared with the healthy controls. Moreover, in DCA-treated DSS-induced mice, the expression of IL-1β and the proportion of CD3+ and CD4+ T cells increased while the number of intestinal tuft cells decreased, compared with the DSS group. In IBD patients, the decreased DCA levels in serum and fecal samples are associated with disturbances in gut microflora diversity and abundance. Possible mechanisms by which DCA affects immunity in DSS-induced murine colitis include increasing IL-1β secretion, reducing the number of tuft cells in the mucosa, and activating CD4+ and CD3+ T cells to exaggerate immune responses, consequently worsening intestinal inflammation.

P856 Associations of antibiotics, hormonal therapies, oral contraceptives, and long-term NSAIDs with Inflammatory Bowel Disease: results from the Prospective Urban Rural Epidemiology (PURE) study

Abstract Background Several medications have been considered to contribute to the aetiology of inflammatory bowel disease (IBD). This study assessed the association between medication use and risk of developing IBD using the Prospective Urban Rural Epidemiology (PURE) cohort. Methods This was a prospective cohort study of 133,137 individuals between the ages of 20-80 from 24 countries. Country-specific validated questionnaires documented baseline and follow-up medication use. Participants were followed prospectively at least every 3 years. The main outcome was development of IBD, including Crohn’s disease (CD) and ulcerative colitis (UC). Short-term (baseline but not follow-up use) and long-term use (baseline and subsequent follow-up use) was evaluated. Results are presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results During the median follow-up of 11.0 years [interquartile range (IQR) 9.2-12.2], we recorded 571 incident cases of IBD (143 CD and 428 UC). Higher risk of incident IBD was associated with baseline antibiotic use [aOR: 2.81 (95% CI: 1.67-4.73), p=0.0001] and hormonal medication use [aOR: 4.43 (95% CI: 1.78-11.01), p=0.001]. Among females, previous or current oral contraceptive use was also associated with IBD development [aOR: 2.17 (95% CI: 1.70-2.77), p=5.02E-10]. NSAID users were also observed to have increased risk of IBD [aOR: 1.80 (95% CI: 1.23-2.64), p=0.002], which was driven by long-term users [aOR: 5.58 (95% CI: 2.26-13.80), p<0.001]. All significant results were consistent in direction for CD and UC with low heterogeneity. Conclusion Antibiotics, hormonal medications, oral contraceptives, and long-term NSAID use were associated with increased odds of incident IBD after adjustment for covariates.

The Role of the Microbiome in the Etiology of Inflammatory Bowel Diseases.

Inflammatory bowel diseases (IBDs) result from dysregulated immune responses to environmental and microbial triggers in genetically susceptible hosts. Many clinical observations and animal studies support the role of the microbiome in the pathogenesis of IBD. Restoration of the fecal stream leads to postoperative Crohn's recurrence, while diversion can treat active inflammation. Antibiotics can be effective in prevention of postoperative Crohn's recurrence and in pouch inflammation. Several gene mutations associated with Crohn's risk lead to functional changes in microbial sensing and handling. However, the evidence linking the microbiome to the IBD is largely correlative, given the difficulty in studying the microbiome before disease occurs. Attempts to modify the microbial triggers of inflammation have had modest success to date. Exclusive enteral nutrition can treat Crohn's inflammation though no whole food diet to date has been shown to treat inflammation. Manipulation of the microbiome through fecal microbiota transplant and probiotics have had limited success. Further focus on early changes in the microbiome and functional consequences of microbial changes through the study of metabolomics are needed to help advance the field.

Hirschsprung-associated inflammatory bowel disease: A multicenter study from the APSA Hirschsprung disease interest group

A small number of Hirschsprung disease (HD) patients develop inflammatory bowel disease (IBD)-like symptoms after pullthrough surgery. The etiology and pathophysiology of Hirschsprung-associated IBD (HD-IBD) remains unknown. This study aims to further characterize HD-IBD, to identify potential risk factors and to evaluate response to treatment in a large group of patients. Retrospective study of patients diagnosed with IBD after pullthrough surgery between 2000 and 2021 at 17 institutions. Data regarding clinical presentation and course of HD and IBD were reviewed. Effectiveness of medical therapy for IBD was recorded using a Likert scale. There were 55 patients (78% male). 50% (n=28) had long segment disease. Hirschsprung-associated enterocolitis (HAEC) was reported in 68% (n=36). Ten patients (18%) had Trisomy 21. IBD was diagnosed after age 5 in 63% (n=34). IBD presentation consisted of colonic or small bowel inflammation resembling IBD in 69% (n=38), unexplained or persistent fistula in 18% (n=10) and unexplained HAEC >5 years old or unresponsive to standard treatment in 13% (n=7). Biological agents were the most effective (80%) medications. A third of patients required a surgical procedure for IBD. More than half of the patients were diagnosed with HD-IBD after 5 years old. Long segment disease, HAEC after pull through operation and trisomy 21 may represent risk factors for this condition. Investigation for possible IBD should be considered in children with unexplained fistulae, HAEC beyond the age of 5 or unresponsive to standard therapy, and symptoms suggestive of IBD. Biological agents were the most effective medical treatment. Level 4.

Development of a 32-gene signature using machine learning for accurate prediction of inflammatory bowel disease

Inflammatory bowel disease (IBD) is a chronic inflammatory condition caused by multiple genetic and environmental factors. Numerous genes are implicated in the etiology of IBD, but the diagnosis of IBD is challenging. Here, XGBoost, a machine learning prediction model, has been used to distinguish IBD from healthy cases following elaborative feature selection. Using combined unsupervised clustering analysis and the XGBoost feature selection method, we successfully identified a 32-gene signature that can predict IBD occurrence in new cohorts with 0.8651 accuracy. The signature shows enrichment in neutrophil extracellular trap formation and cytokine signaling in the immune system. The probability threshold of the XGBoost-based classification model can be adjusted to fit personalized lifestyle and health status. Therefore, this study reveals potential IBD-related biomarkers that facilitate an effective personalized diagnosis of IBD.

Inflammatory Bowel Disease: A focus on the Role of Probiotics in Ulcerative Colitis

Inflammatory bowel disease (IBD) is a cluster of disorders of the gastrointestinal tract characterized by chronic inflammation and imbalance of the gut microbiota in a genetically vulnerable host. Crohn’s disease and ulcerative colitis (UC) are well-known types of IBD, and due to its high prevalence, IBD has attracted the attention of researchers globally. The exact etiology of IBD is still unknown; however, various theories have been proposed to provide some explanatory clues that include gene-environment interactions and dysregulated immune response to the intestinal microbiota. These diseases are manifested by several clinical symptoms that depend on the affected segment of the intestine such as diarrhea, abdominal pain, and rectal bleeding. In this era of personalized medicine, various options are developing starting from improved intestinal microecology, small molecules, exosome therapy, to lastly stem cell transplantation. From another aspect, and in parallel to pharmacological intervention, nutrition, and dietary support have shown effectiveness in IBD management. There is an increasing evidence supporting the benefit of probiotics in the prophylaxis and treatment of IBD. There are several studies that have demonstrated that different probiotics alleviate UC. The present review summarizes the progress in the IBD studies focusing and exploring more on the role of probiotics as a potential adjunct approach in UC management.

Evaluating the influence of environmental risk factors on inflammatory bowel diseases: a case-control study.

This study aimed to examine the environmental factors associated in Iranian patients with inflammatory bowel disease (IBD). The role of environmental factors in the development of IBD remains uncertain. In this case-control study, the patients with IBD referred to the Taleghani Hospital, Tehran, Iran, were recruited from 2017 to 2019. Controls were matched by sex. Data were collected using the designed questionnaire and also valid questionnaire such Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) for sleep quality and anxiety/depression, respectively. Conditional logistic regression models were used to estimate adjusted odds ratios (ORs). The study population included 200 individuals: 100 (50%) IBD patients and 100 (50%) controls. Age under 50, marital status, sleep difficulties, vitamin D insufficiency, anxiety/depression, dietary fiber deficit, post-menopausal hormone treatment, oral contraceptives, and antibiotics were all prognostic factors for IBD on the univariate analysis (P< 0.005). In multivariate analysis, the risk of IBD was significantly increased with 50 years (OR: 6.699, 95%CI: 3.271-8.662, P=0.017), abnormal sleep status (OR: 6.383, 95%CI: 3.389-7.19, P=0.001), and using oral contraceptive (OR: 7.426, 95%CI: 5.327-9.865, P=0.001). However, the risk of IBD was significantly decreased with older age (OR: 0.795, 95%CI: 0.697-0.907, P=0.001) and married status (OR: 0.008, 95%CI: 0.001-0.438, P=0.018). Data suggest that the environmental factors play a significant role in the etiology of IBD and probably on the disease course. While the evidence for some factors is strong, many factors require further supportive data.

Роль бактериальных, грибковых и вирусных инфекций в патогенезе воспалительных заболеваний кишечника

Inflammatory bowel disease (IBD) is a group of phenotypically similar diseases characterized by multiple organ damage with predominant localization in the gastrointestinal tract and conditionally divided into two nosologies, ulcerative colitis (UC) and Crohn's disease (CD). IBD is closely associated with taxonomic and functional dysbiosis, however, to date, no study has confirmed that a single specific microorganism is the direct cause of IBD according to Koch’s postulates. The complexity of the etiology and pathogenesis of IBD determines the high interest in studying the infectious factor, not as the only causally significant factor, but as a trigger and/or comorbid one. The review summarizes current data on the involvement of the most important microorganisms (pathogens, opportunistic microorganisms, and pathobionts) in the pathogenesis of UC and CD and considers their possible role in the induction, progression, and course of IBD. A possible relationship between IBD and bacteria belonging to the phyla Pseudomonadota ( Proteobacteria), Bacillota ( Firmicutes), Actinomycetota ( Actinobacteria), and Spirochaetota, archaea, fungi, and eukaryotic viruses is discussed. Bacteria such as adhesive-invasive strains of Escherichia coli (AIEC), Salmonella enterica Typhimurium, Campylobacter jejuni, Campylobacter concisus, enterohepatic species of Helicobacter (including Helicobacter bilis), Proteus spp., Aeromonas spp., Klebsiella pneumoniae, Yersinia enterocolitica, Clostridioides difficile, Enterococcus spp., Staphylococcus aureus, Mycobacterium avium subsp. paratuberculosis and Brachyspira spp. The involvement of methanogenic archaea, such as Methanobrevibacter smithii and Methanosphaera stadtmanae, in immunoinflammatory processes in IBD has been shown. The pro-inflammatory role of intestinal fungi Candida albicans, which produces the cytolytic toxin candidalysin, Candida tropicalis, which forms polymicrobial biofilms, and Debaryomyces hansenii, has been revealed. The role of eukaryotic viruses such as herpesviruses (cytomegalovirus, Epstein–Barr virus, human herpesvirus 6), enteropathogenic viruses (norovirus), enterovirus B, hepatitis B virus (Orthohepadnavirus) in the development of IBD is discussed. Particular attention is paid to the possible role of the SARS-CoV-2 (COVID-19) virus as a trigger of IBD. Key words: inflammatory bowel disease, infections, archaea, bacteria, viruses, fungi, dysbiosis, gut microbiota

Мелатонин как перспективный фактор коррекции кишечного микробиома при воспалительных заболеваниях кишечника

Inflammatory bowel diseases (IBD) include ulcerative colitis and Crohn's disease. The etiology and pathogenesis of IBD remain unclear, the most common hypothesis being that an abnormal immune response against the gut microbiome is triggered by environmental factors in genetically predisposed individuals. The disadvantages of first-line therapy for IBD are the occurrence of side effects in more than 30% of patients. In this regard, the development of new safe drugs that act mainly locally is relevant. The aim of the work is to analyze current data on the mechanisms of action, effects on the intestinal microbiome of melatonin in the context of possible use in IBD. Melatonin (MT) is a biologically active substance, synthesized in the body from tryptophan, and realizes its effects through MT-dependent and MT-independent receptors located in the cell membrane and nucleus. MT is involved in the regulation of circadian rhythms, has antioxidant and immunomodulatory effects. In experimental modeling of IBD and in clinical conditions, MT reduces the severity of the inflammatory process in the wall of the colon by interrupting the processes of lipid peroxidation and inactivation of free radicals, as well as by acting through specific receptors on the function of blood cells of lymphoid organs. MT in IBD leads to a qualitative and quantitative change in the intestinal microbiome, elimination of signs of dysbiosis, an increase in the number of short-chain fatty acid producers - Actinomycetota (Actinobacteria) and a decrease in the number of bacteria that increase the permeability of the intestinal barrier - Bacteroidota (Bacteroidetes). Presumably, MT has a bacteriostatic effect by binding free iron and acting on the NF-kB and STAT1 signaling pathways, which may be a factor in the correction of colon dysbiosis in IBD. Data on the effect of MT on the composition of the intestinal microbiome are a prerequisite for further preclinical studies and the possible use of melatonin in IBD in clinical practice.

Characterization of serum polyunsaturated fatty acid profile in patients with inflammatory bowel disease

Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the digestive tract. The aetiology and pathogenesis of IBD are complex, which may lead to metabolic disorders. As a kind of metabolite, polyunsaturated fatty acid (PUFA) is closely related to IBD. The aim of this study was to explore the correlation between the serum PUFAs and the pathogenesis of IBD. The study is a hospital-based case-control study. The serum free PUFAs of all participants, including 104 patients with IBD and 101 normal controls, were detected by liquid chromatography-mass spectrometry (LC-MS). Compared with the normal control, the levels of C18:2, α-C18:3 (ALA), ɤ-C18:3, C20:4 (AA), C20:5 (EPA), ω-3 C22:5, ω-6 C22:5 and C22:6 (DHA) PUFAs in patients with Crohn's disease (CD) were obviously decreased. However, in patients with ulcerative colitis (UC), the levels of AA, EPA, ω-3 C22:5, ω-6 C22:5 and DHA were downregulated. The concentrations of seven PUFAs were significantly downregulated in the active CD group. In addition, four PUFAs had comparatively higher levels in the remission UC group. The present study revealed substantial differences in the levels of serum fatty acids between normal controls and patients with IBD. In detail, patients with CD were deficient in PUFAs, including the essential fatty acids. Moreover, as the disease activity aggravated, some PUFAs decreased dramatically.

Role of probiotics in inflammatory bowel disease

Inflammatory bowel disease (IBD) consists of ulcerative colitis (UC) and Crohn’s disease (CD). The global incidence of IBD is increasing recently. Westernization is hypothesized to play role in this phenomenon. Inflammation is the basic etiology of IBD. Genetic and environmental factors are important determinants of IBD. Gastrointestinal microorganism is a component of the environmental factors. Balanced-state microorganism environment is important to maintain normal gastrointestinal function. Dysbiosis, an imbalance in beneficial and pathogenic gastrointestinal microorganism, may elicit inflammation and result in IBD. Dysbiosis causes increased pro-inflammatory activity, decreased anti-inflammatory activity, disrupted gastrointestinal mucosal barrier, and prolonged inflammation. Probiotics are hoped to mend the dysbiosis and alleviate inflammation along with disease course. Studies in human reported that administration of probiotics along with standard therapy for UC gives promising result. In contrast, probiotics have little or no positive effect in CD. Probiotics as adjunctive therapy may be considered in managing patients with UC but not with CD.

Role of probiotics in inflammatory bowel disease

Inflammatory bowel disease (IBD) consists of ulcerative colitis (UC) and Crohn’s disease (CD). The global incidence of IBD is increasing recently. Westernization is hypothesized to play role in this phenomenon. Inflammation is the basic etiology of IBD. Genetic and environmental factors are important determinants of IBD. Gastrointestinal microorganism is a component of the environmental factors. Balanced-state microorganism environment is important to maintain normal gastrointestinal function. Dysbiosis, an imbalance in beneficial and pathogenic gastrointestinal microorganism, may elicit inflammation and result in IBD. Dysbiosis causes increased pro-inflammatory activity, decreased anti-inflammatory activity, disrupted gastrointestinal mucosal barrier, and prolonged inflammation. Probiotics are hoped to mend the dysbiosis and alleviate inflammation along with disease course. Studies in human reported that administration of probiotics along with standard therapy for UC gives promising result. In contrast, probiotics have little or no positive effect in CD. Probiotics as adjunctive therapy may be considered in managing patients with UC but not with CD.

The novel sustained 3-hydroxybutyrate donor poly-D-3-hydroxybutyric acid prevents inflammatory bowel disease through upregulation of regulatory T-cells.

Inflammatory bowel disease (IBD) is a chronic persistent intestinal disorder, with ulcerative colitis and Crohn's disease being the most common. However, the physio-pathological development of IBD is still unknown. Therefore, research on the etiology and treatment of IBD has been conducted using a variety of approaches. Short-chain fatty acids such as 3-hydroxybutyrate (3-HB) are known to have various physiological activities. In particular, the production of 3-HB by the intestinal microflora is associated with the suppression of various inflammatory diseases. In this study, we investigated whether poly-D-3-hydroxybutyric acid (PHB), a polyester of 3-HB, is degraded by intestinal microbiota and works as a slow-release agent of 3-HB. Further, we examined whether PHB suppresses the pathogenesis of IBD models. As long as a PHB diet increased 3-HB concentrations in the feces and blood, PHB suppressed weight loss and histological inflammation in a dextran sulfate sodium-induced IBD model. Furthermore, PHB increased the accumulation of regulatory T cells in the rectum without affecting T cells in the spleen. These results indicate that PHB has potential applications in treating diseases related to the intestinal microbiota as a sustained 3-HB donor. We show for the first time that biodegradable polyester exhibits intestinal bacteria-mediated bioactivity toward IBD. The use of bioplastics, which are essential materials for sustainable social development, represents a novel approach to diseases related to dysbiosis, including IBD.