Inflammatory Bowel Syndrome Research Articles

Design of Colon Specific Delivery of Sulfasalazine Loaded Nanoparticles for Inflammatory Bowel Syndrome: Application of Experimental Design

Sulfasalazine is the first line treatment for Inflammatory Bowel syndrome. Conventional formulation have poor targeting properties for colon site.Therefore designof colon specific nanoparticles (NP) is an ideal for better therapeutic outcome. The study aims to formulate and evaluate polymeric Nanoparticles loaded with Sulfasalazine to target the colon. The nanoparticles were prepared by Nano-precipitation method using pH dependent polymer and the prepared nanoparticles were evaluated for FTIR, morphology, pH, Viscosity, Entrapment efficiency, particle size and zeta potential etc. The nanoparticles were used to formulate core tablet and core tablets were coated with Eudragit S100. The tablets were evaluated for hardness, friability, thickness, weight variation and In vitro release study. Totally six formulations were developed for preliminary trial with varying concentration of polymers. From the preliminary trial, code F2batch was found to be best formulation. The F2batch was fitted to central composite design with two independent factors i.e. Concentration of Eudragit S100 (X1) and polyvinyl alcohol (X2) with four dependent variables i.e. Entrapment efficiency -Y1; Hardness- Y2; Friability-Y3 and In-vitro drug release- Y4. The formulation (code R6) was found to be the optimizedformulation. The optimized colon targeted tablets provide satisfactory release and might be suitable for colon targeting of sulfasalazine with better therapeutic effect.

Intersecting Pathways: Nonalcoholic Fatty Liver Disease and Psoriasis Duet-A Comprehensive Review.

Psoriasis is a chronic, immune-mediated, inflammatory disease that has a major impact on patients' quality of life. Common psoriasis-associated comorbidities include cardiovascular diseases, psoriatic arthritis, inflammatory bowel syndromes, type-2 diabetes, and metabolic syndrome. Nonalcoholic fatty liver disease (NAFLD) is affecting a substantial portion of the population and is closely linked with psoriasis. The interplay involves low-grade chronic inflammation, insulin resistance, and genetic factors. The review presents the pathophysiological connections between psoriasis and nonalcoholic fatty liver disease, emphasizing the role of cytokines, adipokines, and inflammatory cascades. The "hepato-dermal axis" is introduced, highlighting how psoriatic inflammation potentiates hepatic inflammation and vice versa. According to the new guidelines, the preliminary examination for individuals with psoriasis should encompass evaluations of transaminase levels and ultrasound scans as part of the initial assessment for this cohort. Considering the interplay, recent guidelines recommend screening for NAFLD in moderate-to-severe psoriasis cases. Treatment implications arise, particularly with medications impacting liver function. Understanding the intricate relationship between psoriasis and NAFLD provides valuable insights into shared pathogenetic mechanisms. This knowledge has significant clinical implications, guiding screening practices, treatment decisions, and the development of future therapeutic approaches for these chronic conditions.

Enhancing Vitamin D3 Efficacy: Insights from Complexation with Cyclodextrin Nanosponges and Its Impact on Gut-Brain Axes in Physiology and IBS Syndrome.

Vitamin D3 (VitD3) plays a crucial role in various cellular functions through its receptor interaction. The biological activity of Vitamin D3 can vary based on its solubility and stability. Thus, the challenge lies in maximizing its biological effects through its complexation within cyclodextrin (βNS-CDI 1:4) nanosponges (NS) (defined as VitD3NS). Therefore, its activity has been evaluated on two different gut-brain axes (healthy gut/degenerative brain and inflammatory bowel syndrome gut/degenerative brain axis). At the gut level, VitD3-NS mitigated liposaccharide-induced damage (100 ng/mL; for 48 h), restoring viability, integrity, and activity of tight junctions and reducing ROS production, lipid peroxidation, and cytokines levels. Following intestinal transit, VitD3-NS improved the neurodegenerative condition in the healthy axis and the IBS model, suggesting the ability of VitD3-NS to preserve efficacy and beneficial effects even in IBS conditions. In conclusion, this study demonstrates the ability of this novel form of VitD3, named VitD3-NS, to act on the gut-brain axis in healthy and damaged conditions, emphasizing enhanced biological activity through VitD3 complexation, as such complexation increases the beneficial effect of vitamin D3 in both the gut and brain by about 50%.

Effects of pectin's degree of methyl esterification on TLR2-mediated IL-8 secretion and tight junction gene expression in intestinal epithelial cells: influence of soluble TLR2.

This study investigates the anti-inflammatory effects of pectins with different degrees of methyl esterification (DM) on intestinal epithelial cells (IECs) expressing low and high levels of TLR2. It also studies the influence of soluble TLR2 (sTLR2) which may be enhanced in patients with inflammatory bowel syndrome on the inflammation-attenuating effects of pectins. Also, it examines the impact of pectins on tight junction gene expression in IECs. Lemon pectins with DM18 and DM88 were characterized, and their effects on TLR2-1-induced IL8 gene expression and secretion were investigated in low-TLR2 expressing Caco-2 and high-TLR2 expressing DLD-1 cells. The results demonstrate that both DM18 and DM88 pectins can counteract TLR2-1-induced IL-8 expression and secretion, with more pronounced effects observed in DLD-1 cells expressing high levels of TLR2. Furthermore, the presence of sTLR2 does not interfere with the attenuating effects of low DM18 pectin and may even support its anti-inflammatory effects in Caco-2 cells. The impact of pectins and sTLR2 on tight junction gene expression also demonstrates cell-type-dependent effects. Overall, these findings suggest that low DM pectins possess potent anti-inflammatory properties and may influence tight junction gene expression in IECs, thereby contributing to the maintenance of gut homeostasis.

Probiotics and Its Therapeutic Effects: A Review

Mankind has been exploiting microorganisms involuntarily from the very beginning until Louis Pasteur proposed the role of microorganisms in fermentation. However, the ability of these microorganisms to reshape the human life came into frame through the pioneering studies by ‘The father of Probiotics’, Ellie Metchnikoff in the beginning of 20th century. Replacement of putrefactive bacteria in the gut micro biome by probiotics microorganisms has shown to restore and maintain the gastrointestinal health. Probiotics by definition is “live microorganisms which when administered in adequate amounts confer a health benefit on the host”. Though the most common strains of probiotics employed are Lactobacillus and Bifidobacterium sp., the prospect of other microorganisms are still being explored. This review mainly focuses on the potential therapeutic effects of probiotics on different classes of diarrhea such as acute infectious diarrhea, traveler’s diarrhea, Antibiotic associated diarrhea, inflammatory Bowel Syndrome, Necrotizing Enterocolitis as well as the its effects on various skin diseases such as Atopic dermatitis, Psoriasis, Acne, Rosacea along with some miscellaneous effects Hypercholestremia, wounds, urogenital tract infections, etc.

Probiotic Properties and Anti-inflammatory Activity of Bacillus spp. Isolated from Ethnically Fermented Soybean

Bacillus spp. probiotics used as feed additives can form spores and tolerate the harsh conditions of the human digestive system and are beneficial for the treatment of inflammatory bowel syndrome. Since reports on probiotics and anti-inflammatory properties of Bacillus spp. isolated from the fermented food of Northeast India have not been explored much. The present study focused on Bacillus spp. BN5, AY5, and AN8, possessing these desired properties. In the probiotics study, the isolates were screened for their tolerance to acid and bile salt, auto-aggregation, hydrophobicity, cholesterol assimilation, antibiotic resistance, and antagonistic properties. It was found that these isolates possessed the desirable probiotic traits. The Bacillus spp. culture and their supernatant were also screened for their ability to reduce LPS-induced inflammation in murine macrophage (RAW 264.7) cells. All the Bacillus spp. culture and their supernatant treatments were found to reduced the Nitric oxide (NO) production by LPS-induced cell lines. The supernatant of LPS-induced cell lines were also analyzed to measure the level of inflammatory cytokine production. It was found that the levels of TNF-α, IL-6, and IL-1β were reduced after co-treatment with LPS and Bacillus spp. culture or LPS and Bacillus spp. supernatant. Results suggested that the Bacillus spp. are potential probiotic candidates with anti-inflammatory properties.

Histologic findings in Ogilvie’s syndrome

Abstract Introduction/Objective Ogilvie Syndrome also known as acute colonic pseudo-obstruction is a rare condition characterized by massive dilation of the colon in the absence of a mechanical obstruction. Leading risk factors include critically ill or hospitalized patients with electrolyte disturbances, in the setting of surgery or trauma. It can be managed conservatively, but if unrecognized and untreated, can lead to life-threatening complications such as ischemic colitis. The purpose of this report is to describe a case with this complication and its relevant histopathological findings. Methods/Case Report A 79-year-old male who had recently undergone radical cystoprostatectomy for urothelial carcinoma presented with significant abdominal distention and unstable vital signs. CT scan showed severe cecal dilation with pneumatosis and portal venous gas concerning for ischemia and perforation. The patient subsequently underwent total colectomy. Grossly, the segment of colon showed areas of mucosal sloughing with a hyperemic and indurated serosal surface. Microscopically, the sections showed surface erosions, acute inflammatory exudate (pseudomembranes), attenuated crypts, crypt cytoplasmic mucin loss and vascular congestion, compatible with ischemic changes. In the absence of recent major surgery and critical condition pointing towards Ogilvie's syndrome, these findings can elicit the differential diagnosis of infectious colitis, drug-mediated injury, and inflammatory bowel syndrome. Results (if a Case Study enter NA) N/A Conclusion This case highlights that Ogilvie’s syndrome can histologically manifest as ischemic colitis and emphasizes that in absence of clinical impression of this syndrome a broader differential diagnosis should be entertained.

Fabrication, Characterization and in vitro Evaluation of Prednisolone Sustained Release Multiparticulate System for Colonic Targeting

Background: Prednisolone (PRD) is orally prescribed for inflammatory bowel syndrome (IBS) as the upper GIT is the main site of absorption; therefore, long-term PRD dosing decreases therapeutic effectiveness through systemic side effects. Objective: This work focused on formulating sustained-release alginate beads as a multiparticulate system for colon targeting using prednisolone (PRD) to be filled in an HPMC capsule. Methods: PRD beads were prepared by the ionotropic gelation technique using sodium alginate as the primary polymer and inulin, guar gum, and pectin as secondary polymers. In addition to the impact of polymer type and quantity, other factors were investigated: The CaCl2 concentration and tween 80 addition Thirteen formulations were successfully prepared, and their properties, such as bead size, morphology, percentage of encapsulation efficiency, yield, DL, in vitro release study in GIT buffer media, IBS media, SEM, and FTIR, were assessed. Results: The study showed that the beads were close in size, and the size was not an obstacle for loading the beads in HPMC capsules. Further, yield%, EE%, and DL% increased according to the bead’s content increase. Conclusions: The optimum formula was F3 that coated HPMC capsules with Eudragit S-100, which gave sustained release profiles in GIT and IBS simulating media, and F13 that could last the release in different pH media, pH 1.2, 6.8, and 7.4.

Anti-inflammatory Activity of Azima tetracantha Root Bark Extract in Rats

Inflammation is associated with many pathological conditions such as arthritis, inflammatory bowel syndrome, cancer, etc. The side effects associated with the long term use of current anti-inflammatory drugs necessitates the need for the development of new drug with fewer side effects. The present study was aimed at evaluating anti-oxidant and anti-inflammatory activity of Azima tetracantha root bark, a plant widely used by tribal people and in Siddha medicine for the treatment of arthritis and rheumatism. Aqueous and methanolic extracts of Azima tetracantha root bark were prepared. Total phenol, flavoid, alkaloid, terpenoid and saponin content were analyzed. The anti-oxidant activity was determined by DPPH assay and total antioxidant capacity. The anti-inflammatory activity was evaluated by carrageenan induced paw edema model in rats. The total phenol and flavonoid contents were higher in methanolic extract compared to aqueous extract. The extracts were found to have anti-oxidant activity and dose-dependent anti-inflammatory activity in both male and female rats with highest average inhibition at 400 mg/kg. The results confirm the traditional use of this plant against inflammatory disorders and could be source for the development of novel drugs.

Irritable Bowel syndrome and Psychiatric Comorbidities: A narrative review

Irritable bowel syndrome (IBS) is the most commonly diagnosed illness by gastroenterologists. These symptoms occur widely in the general population at all ages and in both sexes. The condition is a considerable health-care burden, accounting for approximately half of all referrals to gastrointestinal clinics. The prevalence of IBS varies according on geographic region, demographic, and diagnostic criteria employed. IBS pathogenesis is complicated and poorly understood. Gut microbiota, small intestinal bacterial overgrowth (SIBO), visceral hypersensitivity, disruption of the gut-brain axis, psychosocial distress, and altered GI motility all are proposed as potential risk factors. Inflammatory bowel syndrome (IBS) is associated with considerable psychosocial comorbidities, which have an impact on patient quality of life, disease progression, and health-care expenditures. The present article reviews the latest evidence on the aetiology IBS, with a focus on psychiatric comorbidities and available management available.

Clinical Approach to Recurrent Voiding Dysfunction, Dysuria, and Pelvic Pain Persisting for at Least 3 Months.

There are several patients with urination problems and urethral and pelvic discomfort. Usually, these patients’ symptoms are persistent and ambiguous; therefore, it is difficult to find underlying diseases associated with the patient’s symptoms. In addition, there are various conditions such as overactive bladder, cystitis, and interstitial cystitis/bladder pain syndrome (IC/BPS). Sometimes patients with other chronic disorders such as fibromyalgia, inflammatory bowel syndrome, and vulvodynia show urination problems and pelvic pain. Thus, a patient-centered approach is important to find the cause of chronic urination problems and pelvic pain. Moreover, IC/BPS should be considered during the diagnostic process because the clinical characteristics of IC/BPS are diverse. In this narrative review, we suggest an integral approach for the diagnosis and treatment of IC/ BPS.

Prevalence of irritable bowel syndrome and functional dyspepsia and their relationship with generalized anxiety disorder among medical students in Karachi.

To assess the prevalence of inflammatory bowel syndrome and functional dyspepsia in medical students and their relationship with generalised anxiety disorder and other relevant factors. The descriptive cross-sectional study was conducted in Karachi from August to November 2020 after approval from the ethics review board of Jinnah Sindh Medical University, and comprised students of either gender aged at least 18 years from different medical colleges in the city. Data was collected using validated tools Rome III criteria for inflammatory bowel syndrome and functional dyspepsia and Generalised Anxiety Disorder-7. Data was analysed using SPSS 26. Of the 305 subjects, 185(60.70%) were male and 120(39.30%) were female. The overall mean age was 21.43±2.13 years. The prevalence of inflammatory bowel syndrome was 17(5.57%), while that of functional dyspepsia was 2(0.66%). Further, 122(40%) students had minimal anxiety, 112(36.72%) mild, 43(14.10%) moderate and 28(9.18%) had severe anxiety. There was no significant relationship of either inflammatory bowel syndrome or functional dyspepsia diagnosis with generalised anxiety disorder (p>0.05), but a significant relationship existed between inflammatory bowel syndrome diagnosis and generalised anxiety disorder score (p=0.041). Significant relationships were found between inflammatory bowel syndrome diagnosis and use of non-steroidal anti-inflammatory drugs. The relationship of generalised anxiety disorder diagnosis with gender and probiotic use was significant (p<0.05), and so was the relationship of generalised anxiety disorder score with gender and level of physical activity (p<0.05). Medical students with a higher generalised anxiety disorder score and those who used non-steroidal anti-inflammatory drugs frequently had a higher likelihood of developing inflammatory bowel syndrome.

Bacillus amyloliquefaciens Enriched Camel Milk Attenuated Colitis Symptoms in Mice Model.

Fermented camel’s milk has various health beneficial prebiotics and probiotics. This study aimed to evaluate the preventive efficacy of Bacillus amyloliquefaciens enriched camel milk (BEY) in 2-, 4- and 6-Trinitrobenzenesulfonic acid (TNBS)-induced colitis mice models. To this end, the immune modulatory effects of Bacillus amyloliquefaciens (BA) on TNF-α challenged HT29 colon cells were estimated using the cell proliferation and cytokines ELISA method. BEY was prepared using the incubation method and nutritional value was quantified by comparing it to commercial yogurt. Furthermore, TNBS-induced colitis was established and the level of disease index, pathological scores, and inflammatory markers of BEY-treated mice using macroscopic and microscopic examinations, qPCR and immunoblot were investigated. The results demonstrate that BA is non-toxic to HT29 colon cells and balanced the inflammatory cytokines. BEY reduced the colitis disease index, and improved the body weight and colon length of the TNBS-induced mice. Additionally, Myeloperoxidase (MPO) and pro-inflammatory cytokines (IL1β, IL6, IL8 and TNF-α) were attenuated by BEY treatment. Moreover, the inflammatory progress mRNA and protein markers nuclear factor kappa B (NFκB), phosphatase and tensin homolog (PTEN), proliferating cell nuclear antigen (PCNA), cyclooxygenase-2 (COX-2) and occludin were significantly down-regulated by BEY treatment. Interestingly, significant suppression of PCNA was observed in colonic tissues using the immunohistochemical examination. Treatment with BEY increased the epigenetic (microRNA217) interactions with PCNA. In conclusion, the BEY clearly alleviated the colitis symptoms and in the future could be used to formulate a probiotic-based diet for the host gut health and control the inflammatory bowel syndrome in mammals.

Rome IV Diagnostic Criteria for Functional Gastrointestinal Disorders in Patients with Chronic Hepatitis C Virus.

BACKGROUND: Patients with chronic hepatitis C virus (HCV) usually have different abdominal complaints without any organic lesions. The functional cause of these complaints is claimed in most patients. This study aimed to evaluate functional gastrointestinal disorders (FGIDs) in patients with chronic hepatitis C using Rome IV diagnostic criteria. METHODS: This study included 1506 participants (1006 patients with chronic HCV, and 500 controls). All individuals were subjected to taking thorough medical history, basic investigations (complete blood counts, liver and renal functions tests), international normalized ratio (INR), alpha-fetoprotein, HCV RNA PCR (polymerase chain reaction), abdominal ultrasonography, and upper gastrointestinal tract (GIT) endoscopy for patients only), and Rome IV diagnostic questionnaire. RESULTS: Patients with HCV had symptoms of FGIDs including functional dyspepsia (FD) (P=0.009), early satiety (P=0.002), postprandial distress (P=0.02), epigastric pain (P=0.03), Inflammatory bowel syndrome (IBS) (P<0.001), IBS predominant constipation (P<0.001), IBS predominant diarrhea (P<0.001), and IBS mixed (P<0.001). There were multiple factors for the prediction of FD in patients with HCV, including high body mass index (BMI), education level, positive polymerase chain reaction (PCR), and fibrosis stage. Also, there were multiple factors for the prediction of IBS in patients with HCV, including male gender, high BMI, urban residence, education level, positive PCR, and fibrosis stage. CONCLUSIONS: FD is a prevalent finding in obese patients with HCV and with higher fibrosis scores. IBS is also prevalent in male patients with HCV.

A195 GEOEPIDEMIOLOGICAL CHANGES DUE TO ALTERATIONS IN DIAGNOSTIC ROME CRITERIA FOR IRRITABLE BOWEL SYNDROME

Abstract Background Irritable bowel syndrome (IBS) is a positive diagnosis based on consensus opinions. The Rome (R) criteria, have gone through 4 rounds. R4 restricted diagnosis of IBS over R3, reducing global prevalence. Previously, there were no correlations of world distributions of IBS and Inflammatory Bowel Disease [IBD](Lovell). There are also epidemiological studies showing relationships between IBD and national wealth. Aims We reevaluate relationships among different R criteria and latitude(Lat), lactose digestion status (LNP), human development index(HDI), gross domestic product/capita(GDP/c), Crohn’s disease (CD and ulcerative colitis (UC) incidence(i) and prevalence(p). Methods Literature on world prevalence of national IBS (Oka,Sperber), IBD rates (Ng), and GDP (Lopez Ruiz) (4) were sought on PubMed and Google Scholar.National HDI(08 or 2016) were available on the internet (http://hdr.undp.org/en/data). National lactase distributions and latitudes were quoted (Szilagyi). Target dates were for the year 2008±8yrs. After log transformation of IBD incidence, Pearson’s correlations were carried out.(strong at; r ≥0.7, moderate ≥0.5, weak ≤ 0.49, negligible ≤ 0.3). (significance was p&amp;lt;0.05). Results Correlations of HDI08 and HDI16 was 0.98. Comparisons of R2 and a composite based on Manning, R 1 and 2 (Lovell) was r = 0.96 (N21 countries), Correlation of R 3 and 4 were r = 0.85 (N17). Correlations of R2 and R3 or R4 were negligible (r = -0.2 (n15) and -0.12 (N22). Correlations of R2 and both economic metrics were weak but significant (r = 0.42 – r = 0.49, p &amp;lt; 0.03 - &amp;lt; 0.001). However, correlations of metrics with R3 were non significant and negligible with R4. Comparisons of R2 with LNP or Lat were negligible, but those of R3 or R4 with Lat were significant. Comparisons of R3 with CDp showed a strong correlation while R4 showed a weak but significant correlation with UCi. R2 had negligible correlations with IBD. Conclusions Although, these results are based on limited data variations in R criteria have changed relations with IBS prevalence.Earlier R criteria showed increased IBS in poorer nations. The recent R3 and R4 criteria are independent of national economy, but show more relations with increasing latitudes. Consequences of the change include R3 and 4 reflecting western society symptoms perhaps linking it more with IBD.It is unclear if this new relationship incorporates an irritable inflammatory bowel syndrome (Gajula).The generalizability therefore of the new R4 criteria may still be limited. Table: Rome criteria compared to variables. Statistical significance * &amp;lt; 0.03, ** ≤ 0.05 Funding Agencies None

Gut Reaction: The Impact of a Film on Public Understanding of Gastrointestinal Conditions

Chronic gastrointestinal (GI) tract conditions, such as inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are common conditions associated with disordered bowel movements and significant pain. However, discussion of bowel habits is often regarded as taboo and public understanding of what exactly IBD, IBS and related conditions are, and how they impact the lives of those individuals with such conditions is poorly understood. To provide a platform for enhancing public engagement of chronic bowel conditions, a short film was made (Gut Reaction) examining the lives of four individuals with different bowel conditions and what scientists and clinicians are doing to help alleviate the pain experienced by such individuals. The study design involved screening the film at a science festival where a pre- and post-film survey was conducted alongside follow up semi-structured interviews with a small subset of those who had expressed willingness to engage in such an interview. Although films have been used for public engagement and health campaigns, there is a lack of a robust evaluation of such methods. As such, there is no knowledge of impacts and outcomes, jeopardising funding of such projects (Haenssgen, 2019). Overall, the pre- and post-film surveys demonstrated that the film had increased the attendees’ understanding of chronic bowel conditions, how they are treated, what research is on-going and the likelihood of discussing bowel conditions with friends and family. The follow-up interviews were analysed through the constant comparative coding process. The analysis revealed that participants have a strong belief that bowel conditions need to be part of normal conversations, and the understanding of such conditions, and the people who experience them, needs to be improved by society. Our participants hold that this is crucial for people who experience from such conditions, not least to be able to access help sooner and suffer less. Finally, our participants discussed two strategies to achieve this societal openness and tackle the sense of shame around these issues: one involving role models and the other the media. In summary, Gut Reaction appeared to have met its objectives of improving the viewers’ awareness and understanding of chronic bowel conditions, as well as removing some of the stigma and taboo that surround discussions about these conditions. Consequently, the implications of this study are that making short films around taboo topics are an appropriate method to improve awareness and societal understanding of such topics.

A natural plant fiber for gut inflammatory diseases: A randomized, double-blind, parallel group, reference controlled study

Background: Recent studies indicate that imbalanced gut microbiota and gut inflammation lead to various gut-related disorders. Natural dietary supplementation is a complementary approach to address gut inflammation and gut-related disorders. In this context, Consolax®developed, a patent-filed innovative plant fiber formula with prebiotic, antioxidant, anti-inflammatory, and immunomodulatory properties. This study aimed to assess the efficacy and safety of Consolax® on gut health/inflammation among human subjects with imbalanced gut microbiota, gut inflammation, and inflammatory bowel syndrome. Methods: We conducted a randomized, double-blind, parallel reference-controlled study among 24 of 29 subjects screened for the Rome IV Diagnostic Criteria for functional inflammatory disease, predominantly irritable bowel syndrome. The subjects were randomized into the test and reference groups (each, n=12). The test group underwent supplementation with Consolax® powder 5 g daily (b.i.d.) and the reference group received the reference product (psyllium husk powder) at the same dose of 5 g daily (b.i.d.). Both supplements were administered orally for 30 days along with standard care. Efficacy and safety outcomes were evaluated at four different time intervals, days 7+2 (visit 1), 14+2 (visit 2), 21+2 (visit 3), and 30+2 (visit 4). Results: Consolax® supplementation lowered abdominal pain (based on the Visual Analog Scale) within the treatment groups during visits 3 and 4 compared to the baseline. Beneficial bacterial levels increased (p<0.0139) among Consolax®-supplemented subjects during visit 4 and pathogenic bacterial levels (p<0.004) decreased within and between the groups. The test group showed increased stool consistency (p<0.0005) and significantly improved (p<0.0005) spontaneous complete bowel movement during visit 4. The study results further underlie the anti-inflammatory properties of the test product which reflected in decreased inflammatory marker levels. Conclusion: Consolax® is efficacious with excellent tolerability and safety for patients with imbalanced gut microbiota and in addressing overall gut health issues.

The oral and gut microbiota: beyond a short communication

Introduction. The current treatment and prevention of oral disorders, dental caries, periodontal and gum diseases, follow a very non-specific control of plaque as the main causative factor. The main therapeutically approach is carried out on the sole perspective to keep the levels of oral bacteria in an acceptable range compatible with one-way vision of oral-mouth health, as something completely separated from a systemic microbial homeostasis (dysbiosis) concomitant present in the gut. A sealed compartmental view which sees separate and incommunicable responses to a specific condition without considering the presence of interacting confounding factors can negatively influence the diagnosis a diseases and of course its progression. A general non-specific antimicrobial with more general antiplaque therapy based mainly on oral care products together with surgery interventions represent at the moment the only mechanical responses in treating oral diseases. Material and method. The present paper is a narrative review concening interractions between oral and gut microbiota, with a focus on the interdisciplinary approach in antimicrobial treatment. Pubmed, Cochrane Library database were used for searching engines. Key words used were as follows: “inflammatory bowel syndrome (IBS)”, “ulcerative colitis”, “oral dysbiosis”, “gut dysbiosis”, “probiotics”, “periodontitis”. Results and discussions. Literature research showed that there are few issues to be discussed the ever increasing resistance to antibiotics, the high consumption of industrial food and sugars and their negatively effect on gut and oral microbiota. There is a need to highlight and develop a novel philosophical approach in the treatments for oral diseases that will necessarily involve non-conventional antimicrobial solutions. Such approaches should preferably reduce the consumption of both intestinal and oral microbiota, that are intimately connected and host approximately well over 1000 different species of bacteria at 108–109 bacteria per mL of mucous and saliva. Preventive approaches based upon the restoration of the microbial ecological balance, rather than elimination of the disease associated species, have been proposed. Conclusions. Having both oral-gut microbiota screened is an essential moment that influence the healthy immune modulatory and regenerative capacity of the body and, the new proposed formula integrates a wider screen on the patients where oral condition is strictly evaluated together with gut screen; therefore any proposed treatment will be inevitably sustained by the use of prebiotics and probiotics to promote health-associated bacterial growth. Keywords: inflammatory bowel syndrome (IBS), ulcerative colitis, oral dysbiosis, gut dysbiosis, probiotics, periodontitis,

The effects of Levilactobacillus brevis on the physiological parameters and gut microbiota composition of rats subjected to desynchronosis

BackgroundAll living organisms have developed during evolution complex time-keeping biological clocks that allowed them to stay attuned to their environments. Circadian rhythms cycle on a near 24 h clock. These encompass a variety of changes in the body ranging from blood hormone levels to metabolism, to the gut microbiota composition and others. The gut microbiota, in return, influences the host stress response and the physiological changes associated with it, which makes it an important determinant of health. Lactobacilli are traditionally consumed for their prophylactic and therapeutic benefits against various diseases, namely, the inflammatory bowel syndrome, and even emerged recently as promising psychobiotics. However, the potential role of lactobacilli in the normalization of circadian rhythms has not been addressed.ResultsTwo-month-old male rats were randomly divided into three groups and housed under three different light/dark cycles for three months: natural light, constant light and constant darkness. The strain Levilactobacillus brevis 47f was administered to rats at a dose of 0.5 ml per rat for one month and The rats were observed for the following two months. As a result, we identified the biomarkers associated with intake of L. brevis 47f. Changing the light regime for three months depleted the reserves of the main buffer in the cell—reduced glutathione. Intake of L. brevis 47f for 30 days restored cellular reserves of reduced glutathione and promoted redox balance. Our results indicate that the levels of urinary catecholamines correlated with light/dark cycles and were influenced by intake of L. brevis 47f. The gut microbiota of rats was also influenced by these factors. L. brevis 47f intake was associated with an increase in the relative abundance of Faecalibacterium and Roseburia and a decrease in the relative abundance of Prevotella and Bacteroides.ConclusionsThe results of this study show that oral administration of L. brevis 47f, for one month, to rats housed under abnormal lightning conditions (constant light or constant darkness) normalized their physiological parameters and promoted the gut microbiome's balance.

Impact of teduglutide, a GLP-2 agonist, on inflammatory bowel disease-associated short bowel syndrome: a tertiary single-center study

Rationale: Teduglutide (TED), a GLP2 agonist, have been shown to exert anti-inflammatory effects on the intestinal mucosa in murine preclinical models and evaluated with a positive trend in a phase 2a randomized controlled trial in non-short bowel syndrome (SBS) Crohn’s disease (CD) patients.