Lower Digestive Tract Research Articles

Failure of the Ottawa Score to Predict the Risk of Recurrent Venous Thromboembolism in Cancer Patients: The Prospective PREDICARE Cohort Study.

Recurrent venous thromboembolism (VTE) despite curative anticoagulation is frequent in patients with cancer. Identifying patients with a high risk of recurrence could have therapeutic implications. A prospective study was designed to validate the Ottawa risk score of recurrent VTE in cancer patients. In a prospective multicenter observational cohort, adult cancer patients with a recent diagnosis of symptomatic or incidental lower limb deep vein thrombosis or pulmonary embolism (PE) were treated with tinzaparin for 6 months. The primary endpoint was the recurrence of symptomatic or asymptomatic VTE within the first 6 months of treatment. All clinical events were centrally reviewed and adjudicated. Time-to-event outcomes were estimated by the Kalbfleisch and Prentice method to take into account the competing risk of death. A C-statistic value of > 0.70 was needed to validate the Ottawa score. A total of 409 patients were included and analyzed on an intention-to-treat basis. Median age was 68 years, 60.4% of patients had PE, and VTE was symptomatic in 271 patients (66.3%). The main primary sites were lung (31.3%), lower digestive tract (14.4%), and breast (13.9%) cancers. The Ottawa score was high (≥ 1) in 58% of patients. The 6-month cumulative incidence of recurrent VTE was 7.3% (95% confidence interval [CI]: 4.9-11.1) overall, and 5.0% (95% CI: 2.3-10.8) versus 9.1% (95%CI: 6.1-13.6) in the Ottawa low versus high risk groups, respectively. The C-statistic value was 0.60 (95% CI: 0.55-0.65). In this prospective cohort of patients with cancer receiving tinzaparin for VTE, the Ottawa score failed to accurately predict recurrent VTE.

Effect of milk replacer allowance on calf faecal bacterial community profiles and fermentation

BackgroundThe nutrition of calves from birth until weaning is predominantly from liquid (milk or milk-based) feeds. Liquid feed allowances are often restricted during artificial rearing to accelerate the development of the rumen by promoting solid feed intake. Liquid feeds bypass the rumen and are digested in the lower digestive tract, however, the influence of different types of milk feeds, and their allowances, on the calf hindgut microbiota is not well understood. In this study, faecal samples from 199 calves raised on three different allowances of milk replacer: 10% of initial bodyweight (LA), 20% of initial bodyweight (HA), and ad libitum (ADLIB), were collected just prior to weaning. Bacterial community structures and fermentation products were analysed, and their relationships with calf growth and health parameters were examined to identify potential interactions between diet, gut microbiota and calf performance.ResultsDifferences in the total concentrations of short-chain fatty acids were not observed, but higher milk replacer allowances increased the concentrations of branched short-chain fatty acids and decreased acetate to propionate ratios. The bacterial communities were dominated by Ruminococcaceae, Lachnospiraceae and Bacteroides, and the bacterial diversity of the ADLIB diet group was greater than that of the other diet groups. Faecalibacterium was over three times more abundant in the ADLIB compared to the LA group, and its abundance correlated strongly with girth and body weight gains. Milk replacer intake correlated strongly with Peptococcus and Blautia, which also correlated with body weight gain. Bifidobacterium averaged less than 1% abundance, however its levels, and those of Clostridium sensu stricto 1, correlated strongly with initial serum protein levels, which are an indicator of colostrum intake and passive transfer of immunoglobulins in early life.ConclusionsHigher milk replacer intakes in calves increased hindgut bacterial diversity and resulted in bacterial communities and short chain fatty acid profiles associated with greater protein fermentation. Increased abundances of beneficial bacteria such as Faecalibacterium, were also observed, which may contribute to development and growth. Moreover, correlations between microbial taxa and initial serum protein levels suggest that colostrum intake in the first days of life may influence microbiota composition at pre-weaning.

Value of endoscopy with narrow-band imaging and probe-based confocal laser endomicroscopy in the diagnosis of preneoplastic lesions of gastrointestinal tract.

Introduction: Amongst all malignant tumors, cancers of the digestive tract rank first in terms of yearly deaths. Patients above 60 years of age are the most affected, as the diagnosis is frequently made in advanced stages of the disease when therapy is less effective. Our study aimed to evaluate the efficiency of narrow-band imaging (NBI) endoscopy and probe-based confocal laser endomicroscopy (pCLE) in the correct diagnosis of preneoplastic lesions in the upper and lower digestive tract. Patients, Materials and Methods: We included 46 patients with digestive preneoplastic lesions, who underwent either upper or lower digestive endoscopy, followed by NBI and pCLE. We recorded 5–10 frames per each lesion, from different angles and distances during white-light endoscopy and selected frames from full recordings of NBI and pCLE. Usual preparation was used for the endoscopic procedures; pCLE required in vivo administration of 10% Sodium Fluorescein as a contrast agent. Pathology was performed in case of solid tumors. Three medical professionals with different levels of training, blinded to the results, interpreted the data. Results: The experienced physician correlated very well the NBI findings with pathology (0.93, p=0.05), while the resident physician and the experienced nurse obtain lower, albeit still statistically significant, values (0.73 and 0.62, respectively). For pCLE, the experienced physician obtained near-perfect correlation with pathology (0.96), followed closely by the resident physician (0.93). The nurse obtained a modest correlation (0.42). All examiners obtained approximately equal performances in discerning between malignant and benign lesions. Conclusions: Digestive endoscopy in NBI mode proved its effectiveness. Even less experienced endoscopists can achieve good results, while an experienced nurse can positively influence the diagnosis. In the case of pCLE, when available, it can greatly reduce diagnostic times, while requiring higher expertise and specialty training.

Analysis of correlation between fecal and alveolar lavage fluid flora of ventilator-associated pneumonia patients based on 16S rRNA sequencing technology

To investigate the changes and correlation of intestinal and pulmonary microecological structures in patients with ventilator-associated pneumonia (VAP). A prospective observational study was conducted. Thirty-one patients with VAP admitted to the department of critical care medicine of General Hospital of Ningxia Medical University from May 1st 2019 to May 1st 2020 were enrolled. Feces and alveolar lavage fluid samples from patients with the same day, feces and alveolar lavage specimen flora composition and the structure of biological information analysis by 16S rRNA sequencing technologies, the comprehensive sequencing results, and clinical data of patients were analyzed. (1) The diversity (abundance and diversity) of flora in the alveolar lavage fluid of VAP patients was higher than that of fecal flora. Among them, Ace index, Chao index and Shannon index describing the abundance of flora showed statistically significant differences [Ace index: 305.89 (214.39, 458.66) vs. 204.51 (165.15, 247.61), Chao index: 259.83 (194.20, 459.31) vs. 187.67 (153.28, 234.01), Shannon index: 3.01 (2.39, 3.54) vs. 2.55 (1.86, 2.95), all P < 0.05], but there was no significant difference in Simpson index describing diversity [0.14 (0.08, 0.27) vs. 0.19 (0.10, 0.33), P > 0.05]. (2) In the sequencing results of feces and alveolar lavage fluid of VAP patients, there were some intestinal related bacteria groups with high abundance, such as Escherichia-Shigella, Faecalibacterium, Bacteroides, and Lachnospira, etc. (3) In 31 VAP patients, suspicious pathogenic bacteria was found in 20 cases (6 cases of Streptococcus viridans, 5 cases of Escherichia coli, 3 cases of Klebsiella pneumoniae, 3 cases of Acinetobacter baumannii, 2 cases of Staphylococcus aureus, 1 case of Pseudomonas aeruginosa), and the same suspected pathogens also existed in the 17 patients' alveolar lavage and waste sequencing. (4) Fourteen VAP patients combined with sepsis, 14 patients without sepsis were selected for sample size matching. The results showed that, Jaccard similarity index to describe lung-correlation of intestinal flora in VAP with sepsis group was significantly elevated, and the difference was statistically significant (0.24±0.08 vs. 0.19±0.06, P < 0.01). There is a certain correlation between pulmonary and intestinal flora in VAP patients. In addition to the exclusion of pulmonary infection caused by environmental and upper respiratory micro-inhalation, the lower digestive tract may also be source of infection.

Diversity and physical properties of rumen microbial ecosystem of West African dwarf rams fed ammonium sulphate-fortified diets

Ammonium sulphate is a feed additive used in ruminant feeds mainly for stabilization of the intestinal flora, enhance the development of the adult rumen microflora, improve digestion and nitrogen flow towards lower digestive tract and improve meat and milk production. In the study the diversity of rumen microbial ecosystem of WAD rams fed ammonium sulphatefortified diets at 0, 2.5, 5.0 and 7.5g/kg to the concentrate diet as T1, T2, T3 and T4 respectively was assessed. Sixteen WAD rams with average body weight of 12.20+0.12 kg were used and fed for 109 days, each treatment had four replicates. In a completely randomized design and differences among treatment means were examined using least significant difference, each ram was fed at 5% of their body weight at 60:40 levels of experimental diet and wilted guinea grass as basal diet. Variables measured were: S. typhimurium, E. coli, bacteria, fungi and protozoa. The results indicated that establishment of the microbial population of diets consisting of 7.5g/kg (NH ) SO were significantly higher 4 2 4 in bacteria and fungi than the control diet (P&lt;0.05). It was concluded that fortification a 7.5g/kg (NH ) SO give a better understanding of the role of rumen microbes and the 4 2 4 establishment of the microbial population, which help to maintain the host's health and improve animal performance.

Contribution of Serotonin 3A Receptor to Motor Function and Its Expression in the Gastrointestinal Tract

Introduction: The serotonin 3A receptor (5-HT_3AR) is involved in vomiting and gastrointestinal motility. However, it is not well understood the expression pattern of 5-HT_3AR in the gut immunohistochemically and how much contribution of 5-HT_3AR to upper or lower intestinal motility. Objectives: We investigated the contribution of 5-HT_3AR to gastrointestinal motor function by using 5-HT_3AR KO mice and sought to identify 5-HT_3AR-expressing cells via immunohistochemical staining using 5-HT_3AR-GFP reporter mice. Methods: The expression of 5-HT_3AR was measured in each section of the gut through real-time PCR. The motor function of the stomach and colon was assessed via the ¹³C-octanoic acid breath test and colonic bead expulsion test, respectively, using 5-HT_3AR KO mice. 5-HT_3AR-expressing cells in the muscle layer of the gut were identified by immunohistochemical staining using 5-HT_3AR-GFP reporter mice. Results: 5-HT_3AR was expressed throughout the digestive tract, and 5-HT_3AR expression in the stomach and lower digestive tract was higher than that in the other sections. Motor function in the stomach and colon was lower in 5-HT_3AR KO mice than in WT mice. As a result of immunohistochemical staining using GFP reporter mice, cholinergic neurons and PDGFRα⁺ cells were shown to express 5-HT_3AR. In contrast, 5-HT_3AR indicated by GFP fluorescence was rarely detected in ICC and smooth muscle cells. Conclusions: These results show that 5-HT_3AR is highly expressed in the stomach and large intestine and that the activation of 5-HT_3AR accelerates gastric emptying and large intestine transit. Additionally, 5-HT_3AR is highly expressed in cholinergic neurons and some interstitial cells, such as PDGFRα⁺ cells.

The Role of the Gut Microbiome in Cattle Production and Health: Driver or Passenger?

Ruminant production systems face significant challenges currently, driven by heightened awareness of their negative environmental impact and the rapidly rising global population. Recent findings have underscored how the composition and function of the rumen microbiome are associated with economically valuable traits, including feed efficiency and methane emission. Although omics-based technological advances in the last decade have revolutionized our understanding of host-associated microbial communities, there remains incongruence over the correct approach for analysis of large omic data sets. A global approach that examines host/microbiome interactions in both the rumen and the lower digestive tract is required to harness the full potential of the gastrointestinal microbiome for sustainable ruminant production. This review highlights how the ruminant animal production community may identify and exploit the causal relationships between the gut microbiome and host traits of interest for a practical application of omic data to animal health and production.

Analysis of endoscopic submucosal dissection training system construction

Objective To investigate the prerequisites for endoscopists, who were chosen to receive endoscopic submucosal dissection (ESD) training. Methods A total of 41 trainees, who attended ESD training in the endoscopic center of Nanjing Drum Tower Hospital from January 2017 to June 2018 were enrolled in the study. The general information of the subjects were collected, including name, age, gender, the number of gastroscopy and colonoscopy independently performed before training, the independent usage of narrow band image (NBI), magnifying endoscopy (ME), endoscopic mucosal resection (EMR), ESD, endoscopic ultrasonography (EUS), and endoscopic retrograde cholangiopancreatography (ERCP) before training. And then every trainee independently finished four in vitro experiments of pig esophagus ESD. The specimen area and operating time were recorded, and the operating speed was calculated. Linear regression analysis was used to analyze the affecting factors of operating speed of ESD. Results Among the 41 trainees, 26 were male and 15 were female, with age of 36.07±4.44 years. The specimen area, operating time and operating speed of pig esophagus ESD was 4.67±1.61 cm2, 24.54±5.97 min, and 0.19±0.05 cm2/min, respectively. Univariate linear regression analysis showed that the number of gastroscopy (n>5 000, P=0.001 8) and colonoscopy (n>3 000, P=0.000 1), the detect number of early cancer in upper digestive tract (n>30, P=0.000 3) and lower digestive tract (n>10, P=0.019 7), and the usage of ME (P=0.047 8), EMR (P=0.019 6) and ESD (P=0.000 3) before training were statistically correlated with the operating speed of ESD. Carrying out NBI (P=0.532 9), ERCP (P=0.500 7) and EUS (P=0.766 8) before training were not statistically correlated with the operating speed of ESD. The operating speed of ESD was negatively correlated with the perforation rate of ESD (P<0.000 1). According to multivariable linear regression model, the usage of EMR (P=0.029) and ESD (P=0.034) were statistically correlated with the operating speed of ESD. Conclusion ESD trainees, who have the number of gastroscopy more than 5 000, the number of colonoscopy more than 3 000, the detect number of early cancer more than 30 in upper digestive tract and 10 in lower digestive tract, and the usage of ME, EMR and ESD before training, can get a better training effect. The study provides a theoretical basis for selecting appropriate ESD trainees. Key words: Animal models; In vitro; Endoscopic submucosal dissection; Operating training; Dissection time

Loopography Examination For Colon Cancer Cases In Tangerang District Public Hospital

Loopography examination technique is a radiological examination technique in lower digestive tract (colon) by inserting a positive contrast media into the colon through an artificial hole in abdominal area. This examination aims to evaluate the anatomy and physiology function from distal section of colon to anus with ca colon clinical. This research was conducted in radiology installation of Tangerang District General Hospital during November to December 2018, using a qualitative descriptive method with a literature study approach and interview. The results found that loopography examination in Tangerang District General Hospital did not require special preparation. The kind of contrast media used is a water-soluble contrast media such as iohexol with a ratio of 1: 3 mixed with NaCl. This loopography contrast media can be inserted through the clean stoma or anal. The routine projections performed for loopography examination in Tangerang District General Hospital are Plan photos of Abdomen, Antero Posterior (AP) and Lateral. But sometimes Oblique projection is also used as an addition if is less obvious anatomy due to overlap/superposition.

The effect of group B streptococcus on maternal and infants’ prognosis in Guizhou, China

Group B Streptococcus (GBS) is a kind of opportunistic pathogenic bacteria and mainly strikes the lower digestive tract and genitourinary tract. It is a major risk factor for neonatal babies, seriously threatening their lives. In the present study, we aimed to detect the GBS colonization in late pregnant women, and to study the effect of GBS on maternal and infants’ prognosis. Pregnant women with a gestational age of 35–37 weeks were enrolled in the study. Real-time polymerase chain-reaction (RT-PCR) was used to detect the colonization of GBS in the vaginal and rectal secretions for late pregnant women according to the screening guidelines. Chi-square test was applied to analyze the relationship between GBS colonization and clinical characteristics. A follow-up of 6 weeks was performed on the puerpera and infants after delivery. The positive rate of GBS was 12.6% in late pregnant women. GBS carrier state was positively related to several pregnancy outcomes, including intrauterine infection, premature rupture of membranes, postpartum hemorrhage, fetal distress and puerperal infection, as well as to part neonatal outcomes, containing neonatal infection, neonatal pneumonia and neonatal sepsis (all P < 0.05). GBS infection in late pregnant women results in adverse effects on maternal and neonatal outcomes.

Peanut Gastrointestinal Delivery Oral Immunotherapy in Adolescents: Results of the Build–up Phase of a Randomized, Double–Blind, Placebo-Controlled Trial (PITA Study)

To assess the efficacy and safety using a new approach to oral immunotherapy in which high-risk peanut-allergic adolescents ingested sealed capsules of incrementally increasing amounts of peanut protein. In most published studies, peanut is administered in a vehicle food. The authors hypothesized that bypassing the upper digestive tract could improve efficacy because the lower digestive tract, the main anatomic site of oral tolerance, would be targeted, and sealed capsules would circumvent taste aversion.Adolescents with peanut allergy were recruited for the study. Inclusion criteria included having a clinical reaction within 60 minutes after ingestion of peanut and demonstration of sensitization either by skin prick test (wheal >3 mm) or serum immunoglobulin E >12 IU/mL for peanut or >5.8 IU/mL for Ara h2 peanut component. Exclusion criteria included a teenager’s history of severe anaphylaxis requiring ICU support; severe persistent asthma; poorly controlled atopic dermatitis; concomitant severe food allergy to egg, milk, nuts, or sunflower seed; and/or inability to manage a severe allergic reaction. All patients underwent an initial double-blind, placebo-controlled food challenge (DBPCFC) with sealed capsules containing peanut protein; to be included in the study, the adolescent had to have a convincing objective reaction occurring after a cumulate intake of >20 and ≤400 mg of peanut protein.Patients were randomly assigned 2:1 to active treatment (peanut) or placebo (sunflower). Patients ingested a daily treatment dose of peanut protein or placebo via sealed gelatin capsules starting at 2 mg; doses were incrementally increased every 2 weeks up to 400 mg over a 24-week period. A second DBPCFC was performed at the end of the build-up phase. Cumulative ingestion of >400 mg of peanut protein without symptoms was the definition of desensitization.Fifty-one patients were screened, 21 patients were excluded because they tolerated 400 mg of peanut protein at the initial DBPCFC, and 30 patients were enrolled because they had a positive initial DBPCFC. Of these 30 enrolled patients, 21 were allocated to the peanut group and 9 were allocated to the placebo group. Two patients assigned to the peanut group withdrew from the study because of side effects; 1 of these patients experienced a severe adverse event (AE) but had inadvertently ingested twice the investigated amount. An additional 2 patients in the peanut group were unable to increase their intake threshold >400 mg but did increase their threshold level six- and sevenfold, respectively. Unresponsiveness to >400 mg of peanut protein was achieved in 17 of 21 (81%) patients with peanut allergy. Only 1 of 9 patients in the placebo group achieved this level of unresponsiveness. The number of patients experiencing AEs was not different between the 2 groups, but in the treated group, the number of AEs per patient was higher and AEs were more severe. Digestive AEs were more frequent in the treated group (P = .02). Oropharyngeal symptoms were equally frequent in both groups; no dysphagia or signs of eosinophilic esophagitis were noted.The PITA trial demonstrated an effective and safe way to induce peanut desensitization in high-risk adolescents with peanut allergy by using sealed capsules of peanut protein.Parents ask me every day when they can start their child on oral immunotherapy; they are worried if they wait too long that they will miss the window of opportunity for their child to overcome their food allergy. This study is promising because the researchers specifically targeted high-risk adolescents with peanut allergy, demonstrating that even older children and teenagers can successfully be desensitized. Food aversion (taste and smell) is a significant issue for many patients with food allergy; using the sealed capsules made this a moot point. Additional studies are warranted to further explore the safety and efficacy of this approach in larger groups of patients.

Fibre digestion by rumen microbiota — a review of recent metagenomic and metatranscriptomic studies

Plant biomass is the most abundant renewable resource on the planet, and the biopolymers of lignocellulose are the foundation of ruminant production systems. Optimizing the saccharification of lignocellulosic feeds is a crucial step in their bioconversion to ruminant protein. Plant cell walls are chemically heterogeneous structures that have evolved to provide structural support and protection to the plant. Ruminants are the most efficient digesters of lignocellulose due to a rich array of bacteria, archaea, fungi, and protozoa within the rumen and lower digestive tract. Metagenomic and metatranscriptomic studies have enhanced the current understanding of the composition, diversity, and function of the rumen microbiome. There is particular interest in identifying the carbohydrate-active enzymes responsible for the ruminal degradation of plant biomass. Understanding the roles of cellulosomes- and polysaccharide-utilising loci in ruminal fibre degradation could provide insight into strategies to enhance forage utilisation by ruminants. Despite advancements in “omics” technology, the majority of rumen microorganisms are still uncharacterised, and their ability to act synergistically is still not understood. By advancing our current knowledge of rumen fibre digestion, there may be opportunity to further improve the productive performance of ruminants fed forage diets.

Synthesis of 11C-labeled DNA polymerase-β inhibitor 5-methoxyflavone and PET/CT imaging thereof

Introduction“Cell-cycle hypothesis” is emerging in recent years to suggest that aberrant cell cycle re-entry of differentiated neurons leads to a remarkable genetic disequilibrium which is likely to be the primary cause of neuronal apoptosis. DNA polymerase-β is involved in neuronal DNA replication during cell cycle re-entry, thus constituting a promising target for Alzheimer's disease treatment. Recently, 5-methoxyflavone was identified as a candidate molecule endowed with good biological activity and selectivity on the DNA pol-β in multiple in vitro AD models. In vivo assays, especially the brain uptake of 5-methoxyflavone, is need to be evaluated for further development for AD treatment. We report herein the synthesis of 11C-labeled 5-methoxyflavone, and the evaluation of in vivo properties of 5-[11C]methoxyflavone in rodents. MethodsThe strategy for synthesis of 5-[11C]methoxyflavone was developed by treating precursor 5-hydroxyflavone with [11C]CH3I and KOH in anhydrous DMF. 5-[11C]Methoxyflavone was purified, then evaluated in mice by using PET/CT imaging. ResultsThe 5-[11C]methoxyflavone was synthesized conveniently in an average decay corrected yield of 22% (n = 3) with a radiochemical purity >99%. The average molar radioactivity of 5-[11C]methoxyflavone was 383 GBq/μmol. The average concentration was 0.107 μg/mL. PET/CT imaging in mice showed 5-[11C]methoxyflavone rapidly passed through the blood-brain barrier with 8.36 ± 0.61%ID/g at 2 min post injection, and the radioactivity accumulation in brain was still noticeable with 2.48 ± 0.59%ID/g at 28 min post injection. The clearance rate was 3.37 (brain2 min/brain28 min ratio). The blood and muscle uptakes were low. The lung displayed high initial uptake and subsequent rapid clearance, while the liver and kidney displayed a relatively slow clearance. Real-time imaging showed that 5-[11C]methoxyflavone accumulated immediately in the heart, then transferred to the liver and intestine, and was not observed in lower digestive tract. Conclusions5-[11C]Methoxyflavone was synthesized conveniently in one step. The results of PET/CT imaging in C57BL/6 mice suggested 5-[11C]methoxyflavone possesses appropriate pharmacokinetic properties and favorable brain uptake, thus being proved to be suitable for further development for AD treatment.

Protective effects of the combination Bifidobacterium longum plus lactoferrin against NSAID-induced enteropathy.

Nonsteroidal anti-inflammatory drugs can exert detrimental effects in the lower digestive tract. The aim of this study was to examine the protective effects of a combination of the probiotic Bifidobacterium longum BB536 (Bifidobacterium) with the prebiotic lactoferrin in a rat model of diclofenac-induced enteropathy. Enteropathy was induced in 40-wk-old male rats by intragastric diclofenac (4 mg/kg twice daily for 14 d). Lactoferrin (100 mg/kg twice daily), Bifidobacterium (2.5 × 106 CFU/rat twice daily) or their combination were administered 1 h before diclofenac. At the end of treatments, the ileum was processed for the evaluation of histologic damage, myeloperoxidase (MPO) and malondialdehyde (MDA) levels, as well as the expression of Toll-like receptors 2 and 4 (TLR-2/-4) and the activation of downstream signaling molecules (MyD88 and nuclear factor [NF]-κB p65). Blood hemoglobin and fecal calprotectin were also assessed. Diclofenac induced intestinal damage, along with increments of MPO and MDA, overexpression of TLR-2, TLR-4, MyD88, and NF-κB p65, increased fecal calprotectin and decreased blood hemoglobin levels. Lactoferrin or Bifidobacterium alone prevented diclofenac-induced enteric damage, and the changes in blood hemoglobin, MPO, MDA, fecal calprotectin, and NF-κB p65. Bifidobacterium, but not lactoferrin, decreased TLR-4 expression, although none of them affected MyD88 overexpression. TLR-2 expression was slightly enhanced by all treatments. The combined administration of lactoferrin and Bifidobacterium reduced further the intestinal damage, and restored MPO and blood hemoglobin levels. Diclofenac induced ileal mucosal lesions by activation of inflammatory and pro-oxidant mechanisms. These detrimental actions were prevented by the combination of lactoferrin with Bifidobacterium likely through the modulation of TLR-2/-4/NF-κB proinflammatory pathways.

A new approach for analyzing an adhesive bacterial protein in the mouse gastrointestinal tract using optical tissue clearing

Several bacterial moonlighting proteins act as adhesion factors, which are important for bacterial colonization of the gastrointestinal (GI) tract. However, little is known about the adherence properties of moonlighting proteins in the GI tract. Here, we describe a new approach for visualizing the localization of moonlighting protein-coated fluorescent microbeads in the whole GI tract by using a tissue optical clearing method, using elongation factor Tu (EF-Tu) as an example. As a bacterial cell surface-localized protein mimic, recombinant EF-Tu from Lactobacillus reuteri was immobilized on microbeads. EF-Tu-coating promoted the interaction of the microbeads with a Caco-2 cell monolayer. Next, the microbeads were orally administered to mice. GI whole tissues were cleared in aqueous fructose solutions of increasing concentrations. At 1 h after administration, the microbeads were diffused from the stomach up to the cecum, and after 3 h, they were diffused throughout the intestinal tract. In the lower digestive tract, EF-Tu-beads were significantly more abundant than non-coated control beads, suggesting that EF-Tu plays an important role in the persistence of the microbeads in the GI tract. The new approach will help in evaluating how moonlighting proteins mediate bacterial colonization.

Функциональные нарушения двигательной активности пищеварительного тракта и их коррекция с использованием остеопатического воздействия у больных целиакией

The article presents the results of clinical effectiveness of osteopathic correction methods in the treatment of motor-evacuation disorders of the digestive tract in celiac patients based on a comparison of clinical and instrumental data. Materials and methods: 26 patients with celiac disease aged from 18 to 35 years old, in which General clinical, endoscopic and PEGEG studies revealed disorders of motor activity of the digestive tract. The examined patients had been carried out 5 sessions of osteopathic procedures to correct their motor-evacuation disorders of the gastrointestinal tract (GI). Results: the examined patients were observed to have osteopathic disorders, indicating regional somatic dysfunction and combined motility disorders of the upper and lower digestive tract in both phases of the PEGEG. The use of osteopathic correction, aimed at mobilizing the compensatory-adaptive mechanisms of the body, was effective for discontinuing gastroenterological symptoms, normalization of propulsive and tonic activity of the gastrointestinal tract. Conclusion: osteopathic correction can be used in the treatment of patients with motility disfunction of the digestive tract.

Colonoscopic findings in patients younger than 40 years

ObjectiveTo analyze the main endoscopic findings in patients under 40 years of age and the main indications for colonoscopy in these patients. MethodsA retrospective study with 362 reports of patients under 40 years of age who underwent colonoscopy from January 2014 to June 2017 at the colonoscopy service of the General Hospital Roberto Santos. Colon preparation was performed with mannitol and the patients underwent sedation as the anesthetist criteria. ResultsOf the 362 patients analyzed, 192 (53%) were female. The mean age was 25 years (25.58±11.95). The most frequent indications were inflammatory bowel disease in 24.3% (88) of the patients, bleeding in the lower digestive tract in 24% (87), and chronic diarrhea in 20.2% (73). The main colonoscopic findings were polyposis in 21.3% (77) of the patients and inflammatory alterations in 20.7% (75). ConclusionWith the analysis of the data provided by the colonoscopies, it was possible to conclude that, when the investigation is adequate and the examination is well indicated, even under the age of 40, colonoscopy can help in the diagnostic and treatment of several pathologies, including those that may increase the risk of colorectal cancer.

Helicobacter pylori infection and inflammatory bowel disease: a crosstalk between upper and lower digestive tract

Helicobacter pylori has coexisted with humans for approximately 60,000 years and greater than 50% of the global population is infected with H. pylori. H. pylori was successfully cultured in vitro in 1983 and studies of H. pylori have achieved substantial advances over the last 35 years. Since then, H. pylori has been characterized as the primary pathogenic factor for chronic gastritis, peptic ulcer, and gastric malignancy. Numerous patients have received H. pylori eradication treatment, but only 1–2% of H. pylori-infected individuals ultimately develop gastric cancer. Recently, numerous epidemiological and basic experimental studies suggested a role for chronic H. pylori infection in protecting against inflammatory bowel disease (IBD) by inducing systematic immune tolerance and suppressing inflammatory responses. Here we summarize the current research progress on the association between H. pylori and IBD, and further describe the detailed molecular mechanism underlying H. pylori-induced dendritic cells (DCs) with the tolerogenic phenotype and immunosuppressive regulatory T cells (Tregs). Based on the potential protective role of H. pylori infection on IBD, we suggest that the interaction between H. pylori and the host is complicated, and H. pylori eradication treatment should be administered with caution, especially for children and young adults.

The advances of genetics research on Hirschsprung's disease.

Hirschsprung's disease (HSCR) is a rare and complex congenital disorder characterized by the absence of the enteric neurons in lower digestive tract with an incidence of 1/5 000. Affected infant usually suffer from severe constipation with megacolon and distended abdomen, and face long‐term complications even after surgery. In the last 2 decades, great efforts and progresses have been made in understanding the genetics and molecular biological mechanisms that underlie HSCR. However, only a small fraction of the genetic risk can be explained by the identified mutations in the previously established genes. To search novel genetic alterations, new study designs with advanced technologies such as genome/exome‐wide association studies (GWASs/EWASs) and next generation sequencing (NGS) on target genes or whole genome/exome, were applied to HSCR. In this review, we summaries the current development of the genetics researches on HSCR based on GWASs/EWASs and NGS, focusing on the newly discovered variants and genes, and their potential roles in HSCR pathogenesis.

Mucosal disease-like lesions caused by HoBi-like pestivirus in Brazilian calves in 2010–2011: Clinical, pathological, immunohistochemical, and virological characterization

A HoBi-like pestivirus was first described in 2004 in a Brazilian fetal bovine serum that was exported to Germany. Nevertheless, it is believed that the virus had been present since the 1990’s, when it was detected in buffalos of Brazilian origin. Reproductive and respiratory diseases have been reported since 2001 in cattle, and more recently, diseases accompanied by a clinical presentation of mucosal disease-like (MD-like lesions have been reported as well. In the present study, the authors reported the oldest case of MD--like in cattle, associated with a HoBi-like pestivirus infection. Diarrhea, anorexia, nasal discharge, hypersalivation, and weakness were observed in 20 calves. For two of the animals, clinical follow-ups were performed. Following their death, necropsy was performed on these two calves. The main gross alterations observed were ulcers and erosions in the upper and lower digestive tract and interdigital dermatitis. Clinical history, gross findings, histopathological examination, immunohistochemistry, RT-PCR, and virus isolation were determined as suitable tools for the diagnosis of a MD-like outbreak, caused by a HoBi-like pestivirus.