Treatment Of Gastrointestinal Diseases Research Articles

Preservation by lyophilization of a human intestinal microbiota: influence of the cultivation pH on the drying outcome and re-establishment ability.

SummaryFaecal microbiota transplantation is an emerging medical concept for the treatment of gastrointestinal diseases. This concept, however, has disadvantages as low storability of stool and intensive donor screening. A solution to overcome these problems would be the preservation of an in vitro microbiota through freeze–drying. However, the influence of the entire preservation process, including cultivation and lyophilization, has not been assessed so far. In this study, the influences of the process steps cultivation, drying and re‐cultivation were determined with cell count, production of metabolites, microbial composition and diversity in the system as evaluation criteria. All pH conditions resulted in stable, culturable communities after re‐cultivation. Cell count, richness, diversity and microbial composition were affected by freeze–drying, but these effects were reversible and vanished during re‐cultivation. Hence, the re‐cultivated system did not differ from the system before drying. The metabolism, measured by short‐chain fatty acids as indicators, showed slight changes due to natural dynamics. Consequently, the cultivation prior to drying was identified to have more influence than the drying itself on the preservation process and therefore the biggest potential for optimization. Hence, the highest similarity with the initial stool sample was obtained with pH 6.0 ‐ 6.5 during cultivation.

The underlying rationality of Chinese medicine herb pair Coptis chinensis and Dolomiaea souliei: From the perspective of metabolomics and intestinal function

Ethnopharmacological relevanceThe combination of Coptis chinensis (RC) and Dolomiaea souliei (VR) has long been used as a classic herb pair for the treatment of gastrointestinal diseases, but the underlying mechanisms remain unknown. Materials and methodsIn this study, the rationality of evidence-based RC and VR combination was explored from the perspective of metabolism, gut microbiota and gastrointestinal function. ResultsAfter 5 weeks treatment, VR extracts (700 mg/kg) and RC alkaloids (800 mg/kg) showed no toxic effect on mice. However, RC administration significantly decreased the body weight of mice. Gastric emptying, gastrointestinal motility function and the absorption of FITC dextran were retarded in the mice of RC group, taking RC along with low dose VR (RC-VRL) and high dose VR (RC-VRH) reversed the impaired gastrointestinal function caused by RC. RC administration significantly increased villus height/crypt depth value. Notably, VR administration increased the number of crypts in mice ileum and reduced villus height/crypt depth value in VR and RC combination group. RC treatment significantly increased the expression of occludin compared to NC group; RC-VRL treatment reversed this tendency. While, VR administration increased ZO1 expression by 99.4% compared to NC mice. As for gut microbiota, RC gavage decreased the gut microbiota diversity, but gut microbiota in VR group was similar to NC group, and VR and RC combination increased gut microbiota diversity. RC administration obviously increased the proportion of Akkermansia muciniphila, Bacteroides thetaiotaomicron, Parabacteroides distasonis, and Escherichia coli, compared to NC mice. VR treatment increased the richness of Bacteroides thetaiotaomicron, Parabacteroides distasonis. RC-VRL and RC-VRH treatment dose-dependently increased the richness of Rikenellaceae RC9, Lactobacillus, and decreased the abundance of Psychrobacter, Bacteroides and Ruminococcus in mice. Serum metabolomic analysis revealed that RC gavage significantly down regulated 76 metabolites and up regulated 31 metabolites. VR treatment significantly down regulated 30 metabolites and up regulated 12 metabolites. Weight loss caused by RC may attribute to the elevated methylxanthine level in mice. The potential adverse effects caused by high dose RC intake may partially alleviate by high serum contents of adenosine, inosine and urolithin A resulted from VR coadministration. ConclusionVR may alleviate RC caused “fluid retention” via normalizing gastrointestinal function, gut microbiota and modulating the perturbed metabolism.

Особенности иммунного ответа на инфекцию Helicobacter pylori у детей с бронхиальной астмой

Актуальность. Течение бронхиальной астмы у детей нередко сопровождается заболеваниями желудочно-кишечного тракта (ЖКТ), ассоциированными с Helicobacter pylori (H.pylori)-инфекцией. Наличие H.рylori способствует активации и поддержанию воспалительного процесса с высвобождением цитокинов и медиаторов воспаления и последующими системными эффектами. Цель исследования: изучение особенностей продукции интерферона-γ (IFN-γ) и интерлейкина‑4, -5 и -13 (IL‑4, -5, -13) как маркеров интенсивности аллергического воспаления у детей, больных бронхиальной астмой, инфицированных H.pylori. Материалы и методы. Обследовано 120 детей в возрасте от 6 до 18 лет с бронхиальной астмой. Идентификация H.pylori проводилась дыхательным хелик-тестом (ООО «АМА», Россия). Сывороточные концентрации IFN-γ и IL‑4, -5 и -13 определялись методом иммуноферментного анализа (тест-наборы Diaklone, Франция) до и через 7 дней после окончания лечения патологии ЖКТ. Статистическую обработку проводили с помощью методов вариационной статистики, реализованных в пакете прикладных программ Statistica 6.1. Результаты. У 78 детей с бронхиальной астмой была диагностирована патология ЖКТ, в том числе у 37 человек — ассоциированная с инфекцией H.рylori. Для изучения влияния H.pylori на течение бронхиальной астмы дети были разделены на 3 группы: I группа — 37 детей с бронхиальной астмой и патологией ЖКТ, инфицированных H.pylori, II — 41 Н.pylori-негативный ребенок с бронхиальной астмой и патологией ЖКТ, III — 42 Н.pylori-негативных ребенка с бронхиальной астмой без патологии ЖКТ. Длительность заболевания бронхиальной астмой в I группе составила 7,80 ± 0,17 года, во II — 5,90 ± 0,26 года, в III группе — 3,90 ± 0,48 года (p < 0,05). Наличие Н.рylori-инфекции у детей с бронхиальной астмой сопровождалось более низкими концентрациями IFN-γ по сравнению с детьми II группы (соответственно 8,47 ± 0,14 пг/мл и 9,69 ± 0,32 пг/мл, р < 0,05). Уровень IL‑13 в сыворотке крови был достоверно выше у детей I группы по сравнению с пациентами II группы (8,74 ± 0,22 пг/мл и 7,21 ± 0,35 пг/мл соответственно, р < 0,05). Сывороточные концентрации IL‑4 и -5 были повышены во всех исследуемых группах по сравнению с группой контроля и не зависели от наличия инфекции Н.рylori. После лечения патологии пищеварительного тракта отмечалось улучшение показателей контроля над бронхиальной астмой, которое сопровождалось достоверным снижением концентраций IFN-γ и IL‑13 в I группе детей и IFN-γ и IL‑5 и -13 — во II группе. Вывод. Наличие инфекции H.рylori у детей с гастродуоденальной патологией, протекающей на фоне бронхиальной астмы, сопровождается дисбалансом иммунного ответа, который выражается в снижении выработки IFN-γ, IL‑4 и увеличением IL‑13 по сравнению с Н.рylori-негативными детьми. Лечение патологии ЖКТ сопровождается снижением IFN-γ и исследуемых цитокинов, что клинически способствует улучшению параметров контроля над бронхиальной астмой.

Gastrointestinal tract damage under COVID-19 conditions

This review is devoted to the issues of the clinical picture, approaches to the diagnosis and treatment of gastrointestinal diseases in the new coronavirus SARS-CoV-2.

EFFECT OF GM-CSF ON THE FUNCTIONAL STATE OF THYMUS IN THE TREATMENT OF GASTROINTESTINAL DISEASES IN PIGLETS

The effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) on the functional state of the thymus in the treatment of gastrointestinal diseases in piglets was studied. The experiment was carried out on a large pig breeding farm in the Voronezh region. For the experiment, 3 groups of 20 sick piglets at the age of 5-7 days were formed in which gastrointestinal diseases of bacterial etiology were registered. The group 5 was the control, and the piglets of it did not receive treatment, the piglets of group 2 received the drug Quinocol, and the piglets of group 3 – Quinocol in combination with GM-CSF. Histological and immunohistochemical studies were carried out according to commonly accepted methods. As a result, a significant (p<0.01) decrease in CD-3 positive cells in the field of view by 12% in group 3 was shown, which was a consequence of cell migration from the thymus to peripheral organs. There were no significant differences in the number of PAX-5 cells.

Fermentation characteristics and the dynamic trend of chemical components during fermentation of Massa Medicata Fermentata

As a representative of traditionally fermented Chinese medicine, Massa Medicata Fermentata (MMF) shows the functions of invigorating the spleen and stomach and promoting digestion, which plays an important role in the treatment of gastrointestinal diseases. The fermentation mechanism and the key factors that affect the quality of MMF have not been revealed yet, which has become an urgent issue that limits its clinical application. This article aims to systematically and comprehensively reveal the transformation of physical properties and the dynamic trend of chemical components including substrate components, volatile components, and lactic acid as anaerobic fermentation product during MMF fermentation. Along with obvious hyphae growth observed for MMF, the weight of MMF decreased, and the moisture and temperature increased. Through the quantified 14 components from substrate, ferulic acid increased from 45.53 ± 6.94 to 141.89 ± 78.40 μg/g, while glycosides and phenolic acids declined except caffeic acid. Also, within the 66 volatile components analyzed, alcohols and acids increased, while aldehydes and ketones decreased. Lactic acid was not detected in the fermentation substrate, but an apparent increase in lactic acid content was observed along with the increased fermentation days, resulting in 2.54 ± 0.15 mg/g on day 8. Based on the tested components, the fermentation process of MMF was discriminated into three distinct stages by principal component analysis, and an optimal fermentation time of four days was proposed. The results of this study will be of great significance to clarify the characteristics of fermentation and conduce to improving quality standards of MMF.

Reactive Oxygen Species-Responsive Polyether Micelle Nanomaterials for Targeted Treatment of Ulcerative Colitis.

As one of the most challenging inflammatory diseases, the incidence of ulcerative colitis (UC) is increasing year by year, but the existing therapeutic drugs are not effective and lack of targeting. Nanomaterials are expected to become promising delivery system due to their good targeting effects. Here, we designed a nanomaterial sensitive to reactive oxygen species, which can be used to treat IBD, especially UC. It is a self-assembled polyether micelle that can be oxidized at the inflammation site where the concentration of reactive oxygen increases, and effectively release the encapsulated budesonide (Bud). Experiments have proved that for DSS-induced colitis, the synthetic drug-loaded nanoparticles have excellent therapeutic effects, can effectively repair intestinal barrier, and significantly improve the damaged colon tissue. At the same time, it has a beneficial regulatory effect on inflammatory factors. Molecular mechanism studies have shown that it achieves its therapeutic effects by activating the peroxisome proliferators-activated receptors-γ (PPAR-γ) pathway and inhibiting the nuclear factor (NF)-κB pathway. This study proves that oral nano-micelles have an important impact on improving the efficacy of UC treatment drugs and have far-reaching significance for the targeted treatment of gastrointestinal diseases.

The indications for performing colonoscopy in Iranian children – a cross-sectional study

Background: Colonoscopy is the gold standard dia­gnostic method for colon diseases providing an excellent view of the mucosal surface of the colon and terminal ileum. Colonoscopy in children is indicated for dia­gnosis and treatment of gastrointestinal diseases. In this study, we evaluated the reasons for performing colonoscopy in children. Methods: This was a descriptive cross-sectional study including all children referred for colonoscopy to the Gastroenterology clinic affiliated with the Shiraz University of Medical Sciences. The children were selected by a convenient sampling method. Statistical analysis was conducted in the SPSS 22 software. Results: From 389 children referred for colonoscopy, 203 were boys and 186 were girls. The mean age was 8.36 ±4.8 years. The most common reason for colonoscopy was rectal bleeding (63.5%) with the most prevalent dia­gnoses being juvenile polyp and inflammatory bowel disease, each accounting for 11.3% patients. Conclusions: The most common findings of colonoscopy were polyp, IBD and colon inflammation, and the most prevalent symptoms leading to colonoscopy were rectal bleeding, chronic diarrhea, IBD treatment follow-up, suspected IBD and abdominal pain. The high prevalence of pediatric patients presenting with these symptoms indicates the increasing importance of colonoscopy in these patients. Keywords colonoscopy, gastrointestinal bleeding, inflammatory bowel disease, gastrointestinální onemocnění

Terazosin Stimulates Pgk1 to Remedy Gastrointestinal Disorders.

Gastrointestinal disease is the most common health concern that occurs due to environmental, infectious, immunological, psychological, and genetic stress. Among them, the most frequent diseases are gastric ulcer (GU) and ulcerative colitis (UC). DSS-induced UC and ethanol-stimulated GU models resemble the pathophysiology of human gastrointestinal disease. The current study was designed to explore the anti-oxidation, anti-inflammation, anti-cell death properties of terazosin, an α-adrenergic receptor antagonist, in vivo and in vitro. Our results indicate that terazosin dramatically activates Pgk1, and upregulates glycose metabolism, evidenced by the enhanced ATP production and higher LDH enzymatic activity. Also, terazosin significantly enhances p-AKT expression and inhibits NF-κB p65 activation through abrogating the phosphorylation of IKBα, as well as lowers Caspase-1 and GSDMD expression. The findings in this study demonstrate that terazosin exhibits anti-inflammatory effects by downregulating NF-κB-GSDMD signal pathway, along with enhancing glycolysis for gastrointestinal disease treatment. Meanwhile, we also find terazosin ameliorates ethanol-induced gastric mucosal damage in mice. Collectively, as a clinical drug, terazosin should be translated into therapeutics for gastrointestinal disease soon.

Gut microbiota and metabolic changes towards improved gut health with supplementation of Woodfordia fruticosa, a medicinal plant: An in vitro study

Woodfordia fruticosa flowers are used as an important component in various fermentation-based traditional medicinal formulations for the treatment of gastrointestinal ailments. In the study, extract of flowers (WfE) was evaluated for its gut microbiota (GM) modulatory properties using in vitro fermentation experiments. WfE supplementation (0.5 and 1 mg/mL) led to significant changes in GM composition by increasing beneficial populations (8–44%) of genus Bifidobacterium, Akkermansia and Lactobacillus while decreasing pathogenic forms (35–91%) such as Bacteroides, Parabacteroides and Alistipes. Functional pathway prediction indicated upregulation of gluco-related metabolism, vitamin production, decrease in insulin resistance and lipopolysaccharide biosynthesis. Metabolomics (1H NMR) revealed significant increase in butyric acid (≥48%) and other SCFAs (17–49%) and glycerylphosphorylcholine (55–85%), with decrease in trimethylamine (4–9%), and trimethylamine oxide (31–38%). Results indicated WfE to be a novel source of functional food ingredient/ supplement and its potential application in an unexplored area of “food phytoceuticals” for maintenance of gut homeostasis. Industrial relevanceMedicinal plants with a long history of use in the treatment of gastrointestinal diseases could be novel sources of functional food ingredients that can have application in gut health. WfE was effective in modifying the gut microbial environment constructively by increasing beneficial microbial populations, suppressing opportunistic pathogenic forms, and also generating key metabolites associated with gut protective functions. WfE has potential industrial application as a functional food ingredient/supplement particularly in decreasing pathogenic populations reported to be involved in manifestation of inflammation, IBD, IBS, and metabolic syndrome.

Nanoparticle-assembled bioadhesive coacervate coating with prolonged gastrointestinal retention for inflammatory bowel disease therapy

A key challenge for the effective treatment of gastrointestinal diseases including inflammatory bowel disease is to develop an orally administered drug delivery system capable of prolonged retention in the gastrointestinal tract. Herein we report a bioadhesive liquid coacervate based on hydrogen bonding-driven nanoparticle assembly. Free from electrostatic interactions, our fluid nanoparticle-assembled coacervate demonstrates significant pH- and salt-independent structural stability and forms a physically adhesive coating on a large surface area of intestinal tract with an extended residence time of more than 2 days to mediate the sustained release of preloaded water-soluble small molecule drugs in vivo. The orally administered drug-laden nanoparticle-assembled coacervate significantly mitigates the symptoms of inflammatory bowel disease, restores the diversity of gut microbiota, reduces systemic drug exposure, and improves the therapeutic efficacy in a rat acute colitis model compared with the oral administration of the same amount of drug in solution form. We suggest that the nanoparticle-assembled coacervate provides a promising drug delivery platform for management and treatment of numerous gastrointestinal diseases where controlled drug release with extended residence time is desired.

MORPHOGENESIS OF THE WALL OF GLANDULAR PART OF THE STOMACH IN CHICKENS DURING POSTNATAL PERIOD OF ONTOGENESIS

Knowledge about the morphological features of the structure and functions of the digestive organs provide the basis for rational and effective use of feed, prevention and treatment of gastrointestinal diseases in poultry. In this regard, the study of the morphogenesis of the digestive system in birds and the mechanisms of their regulation is of great importance. The object of the study was the glandular part of the stomach (proventriculus) in chickens of Shaver 579 strain. The material for macro- and microscopic examinations was selected from birds at age of 1, 30, 60, 90, 120, 150, 180, 210, 240, 270, and 300 days and 1, 2, and 3 years; it was fixed in a 10% neutral formalin solution and embedded into paraffin according to conventional methods. For submicroscopic examinations, the material was selected from hens of this strain at age of 180 days. The structure of epitheliocytes in the superficial epithelium and secretory cells of the deep glands was studied in ultrathin sections. Digital indicators of research results were statistically processed by a personal computer using Microsoft Excel program. The glandular stomach in chickens is a direct extension of the esophagus and has the form of a thick-walled tube, the wall of which is formed by mucous, muscular, and serous membranes. The superficial epithelium of the mucosa is represented by cylindrical epithelial cells that are located within the basal membrane. They are linked to each other by different types of contacts and have a well-defined polar differentiation. The lobules of the deep glands are formed by cells with well-developed synthesizing organelles and secretory granules. The morphogenesis of the glandular part of the stomach in chickens according to age aspect is manifested by changes in morphometric parameters of the thickness and the area of the membranes of its wall. The wall thickness increases (between the folds 4223.23 ± 189.25 and in the area of the folds 5561.32 ± 45.01 μm) unevenly in chickens up to age of 240 days. The most developed membrane of the wall of the glandular stomach is the mucosa. Its area increases (by 82.14 ± 0.56%) in chickens up to age of 180 days, and area of muscular and serous membranes decreases (by 15.54 ± 0.65 and 2.32 ± 0.33%, respectively). In older birds, the thickness of the wall and the area of the membranes of the glandular stomach do not change significantly.

Ethnobotanical survey: A comprehensive review of medicinal plants used in treatment of gastro intestinal diseases in Kano state, Nigeria.

BackgroundThis work provides the ethnobotanical data concerning the traditional use of medicinal plants in Kano State- Nigeria and its uses for the treatment of gastrointestinal disease which has been poorly investigated. The aim of this study was to review the actual knowledge about the medicinal plants used to treat gastrointestinal diseases by traditional medical practitioners living in Kano metropolis. The objectives were to determine the local (Hausa) and scientific names of the plants used in the treatment of gastrointestinal diseases in Kano State, Nigeria; to document and analyse the traditional and ethnobotanical knowledge inherited by traditional medical practitioners in Kano State- Nigeria. MethodThe ethnobotanical data was collected from 30 traditional medical practitioners, 5 each from each Local Government Area making up the core Kano metropolis (Dala, Fagge, Tarauni, Kano Municipal, Gwale and Nassarawa). By means of a structured questionnaire focusing on the local (Hausa) names of the medicinal plants, their medicinal uses, the plant parts used, methods of preparation and route of administration to patients. ResultsThe survey identified a total of 33 plant species belonging to 24 families. The Moraceae family was the most commonly used plant family representing 17.4% of all the medicinal plants species recorded in this study. The plant parts most frequently used were the leaves (47.8 %), followed by the bark/stem (34.8 %), roots (10.9 %), whole plant (4.3 %) and the seeds (2.2 %). Most of the traditional medical practitioners obtained their extracts by decoction of the medicinal plants. The most often recurring gastrointestinal disease treated by the practitioners was stomach ache (36.5 %), followed by diarrhoea (30.8 %), and dysentery (19.2 %) using one or more of the medicinal plants reported in this study for preparing such treatments. The three (3) most frequently used plants according to this study were: Bridelia ferruginea (90.0 %), Psidium guajava (90.0 %) and Khaya senegalensis (83.3 %). The survey revealed that the bark of both Bridelia ferruginea and Khaya senegalensis were the parts used for the herbal preparation while the leaves of Psidium guajava were used. The main method of preparation was decoction and was administered orally. Conclusion: The traditional medical practitioners in Kano metropolis possess a wealth of information on medicinal plants and their applications. This ethnobotanical survey can help scientists and researchers in identifying those plants with medicinal properties that may be useful in the development of new drugs.

Robotics in Gastrointestinal Endoscopy

Recent advances in endoscopic technology allow clinicians to not only detect digestive diseases early, but also provide appropriate treatment. The development of various therapeutic endoscopic technologies has changed the paradigm in the treatment of gastrointestinal diseases, contributing greatly to improving the quality of life of patients. The application of robotics for gastrointestinal endoscopy improves the maneuverability and therapeutic ability of gastrointestinal endoscopists, but there are still technical limitations. With the development of minimally invasive endoscopic treatment, clinicians need more sophisticated and precise endoscopic instruments. Novel robotic systems are being developed for application in various clinical fields, to ultimately develop into minimally invasive robotic surgery to lower the risk to patients. Robots for endoscopic submucosal dissection, autonomous locomotive robotic colonoscopes, and robotic capsule endoscopes are currently being developed. In this review, the most recently developed innovative endoscopic robots were evaluated according to their operating mechanisms and purpose of use. Robotic endoscopy is an innovative treatment platform for future digestive endoscopy.

Nutrition and Healthy Aging: Prevention and Treatment of Gastrointestinal Diseases.

Nutritional well-being is a fundamental aspect for the health, autonomy and, therefore, the quality of life of all people, but especially of the elderly. It is estimated that at least half of non-institutionalized elderly people need nutritional intervention to improve their health and that 85% have one or more chronic diseases that could improve with correct nutrition. Although prevalence estimates are highly variable, depending on the population considered and the tool used for its assessment, malnutrition in the elderly has been reported up to 50%. Older patients are particularly at risk of malnutrition, due to multiple etiopathogenetic factors which can lead to a reduction or utilization in the intake of nutrients, a progressive loss of functional autonomy with dependence on food, and psychological problems related to economic or social isolation, e.g., linked to poverty or loneliness. Changes in the aging gut involve the mechanical disintegration of food, gastrointestinal motor function, food transit, intestinal wall function, and chemical digestion of food. These alterations progressively lead to the reduced ability to supply the body with adequate levels of nutrients, with the consequent development of malnutrition. Furthermore, studies have shown that the quality of life is impaired both in gastrointestinal diseases, but especially in malnutrition. A better understanding of the pathophysiology of malnutrition in elderly people is necessary to promote the knowledge of age-related changes in appetite, food intake, homeostasis, and body composition in order to better develop effective prevention and intervention strategies to achieve healthy aging.

Bacteriophages and their potential for treatment of gastrointestinal diseases.

Although bacteriophages have been overshadowed as therapeutic agents by antibiotics for decades, the emergence of multidrug-resistant bacteria and a better understanding of the role of the gut microbiota in human health and disease have brought them back into focus. In this Perspective, we briefly introduce basic phage biology and summarize recent discoveries about phages in relation to their role in the gut microbiota and gastrointestinal diseases, such as inflammatory bowel disease and chronic liver disease. In addition, we review preclinical studies and clinical trials of phage therapy for enteric disease and explore current challenges and potential future directions.

An update on fecal microbiota transplantation for the treatment of gastrointestinal diseases.

Our understanding of the microbiome and its implications for human health and disease continues to develop. Fecal microbiota transplantation (FMT) is now an established treatment for recurrent Clostridioides difficile infection. There is also increasing evidence for the efficacy of FMT in inducing remission for mild-moderate ulcerative colitis. However, for other indications, data for FMT are limited, with randomized controlled trials rare, typically small and often conflicting. Studies are continuing to explore the role of FMT for many other conditions, including Crohn's disease, functional gut disorders, metabolic syndrome, modulating responses to chemotherapy, eradication of multidrug resistant organisms, and the gut-brain axis. In light of safety, logistical, and regulatory challenges, there is a move to standardized products including narrow spectrum consortia. However, the mechanisms underpinning FMT remain incompletely understood, including the role of non-bacterial components, which may limit success of novel microbial approaches.

The essential oil composition of Artemisia jacutica Drob. from the flora of Buryatia, Russia

This paper represents the results of the GC-MS analysis of the essential oil’s composition of Artemisia jacutica Drob. collected within the Republic of Buryatia in 2015-2020. A. jacutica is an East Siberian endemic plant which has been widely used in folk medicine of Yakutia for the treatment of gastrointestinal diseases. 59 compounds were identified in total, which were represented by mono- and sesquiterpenoids. Neryl-2-methylbutanoate, neryl-hexanoate, γ-eudesmol, and chamazulene were constant components of the oil, whereas γ-eudesmol and chamazulene predominated (the content reaches over 40%). Essential oils of A. jacutica collected in different years were characterized by a stable set of dominant constituents, while the content of sesquiterpenoids was over 92%. The samples of the 2018-2020 years of collection had a greater variety of constituents (31-36 compounds): derivatives of nerol, geraniol, 1,8-cineole, seline-4-diene, compared to the 2015-2017 samples.

Investigation of Azithromycin Minimum Inhibitory Concentration Values and Carbapenem Resistance in Salmonella and Shigella Clinical Isolates

Increasing resistance to first-line antibiotics used in the treatment of infections caused by Salmonella and Shigella species is emerging. Azithromycin presents a good alternative treatment option for Salmonella and Shigella infections. However, there are limited data regarding the susceptibility of azithromycin in Turkey. In this study, we aimed to evaluate the susceptibility of Salmonella and Shigella species to azithromycin, to determine and compare the minimum inhibitory concentration (MIC) values and disk diffusion zone diameters. In addition, susceptibility to meropenem and first-line antibiotic options in isolates was also investigated. A total of 170 Salmonella, 76 Shigella clinical isolates collected between 2014 and 2018 in our hospital were tested for their susceptibility to azithromycin, meropenem, ampicillin, pefloxacin, trimetoprim-sulfamethoxazole, ceftazidime, and cefotaxime. Isolates were identified by matrix-assisted laser desorption ionization time of flight mass spectrometry. The isolates were confirmed and serotyped by the reference laboratory using the conventional slide agglutination method. Susceptibility of the isolates to azithromycin and other antibiotics was evaluated by Kirby-Bauer disk diffusion method. MIC values of azithromycin were determined by the reference broth microdilution method. Combined disk diffusion test was used for the detection of extended spectrum beta-lactamase (ESBL) production. Polymerase chain reaction was performed for macrolide and carbapenem resistance genes and the detected resistance genes were confirmed by sequencing. Of the 76 Shigella isolates tested, 64 (84.2%) were identified as Shigella sonnei, 10 (13.2%) as Shigella flexneri, one (1.3%) as Shigella boydii, and one (1.3%) as Shigella dysenteriae. Among the 170 Salmonella isolates, 131 (77%) were identified as Salmonella enteritidis, 11(6.5%) as Salmonella Typhimurium, 8 (4.7%) as Salmonella Kentucky, 5 (2.9%) as Salmonella Paratyphi B, 4 (2.4%) as Salmonella Infantis, 3 (1.8%) as Salmonella Cholerasuis, and 8 (4.7%) as other serovars (Salmonella Agona, Salmonella Dabou, Salmonella Gallinarum, Salmonella Hadar, Salmonella Muenchen, Salmonella Newport, Salmonella Paratyphi C, Salmonella Senftenberg), respectively. ESBL production was determined as 7.9% (6/76) in Shigella isolates and 2.9% (5/170) in Salmonella isolates. A carbapenem resistant S.Senftenberg isolate positive for the blaOXA-48 resistance gene was detected in our study. Meropenem MIC value of the isolate was detected as > 32 µg/ml with gradient diffusion test. Among all isolates, only one S.boydii isolate was detected as resistant to azithromycin with a MIC value of 128 µg/ml. The isolate was positive for the existence of mphA gene by PCR. In the disk diffusion test, azithromycin inhibition zone diameters were ≥ 12 mm in all of the tested isolates, except for the azithromycin-resistant isolate, and the azithromycin MICs were determined as ≤ 16 µg/ ml by broth microdilution. Increasing resistance to commonly used antibiotics in Salmonella and Shigella species is emerging. The detection of a carbapenem-resistant Salmonella isolate in our study indicates that the spread of carbapenem resistance to other Enterobacterales species may cause global problems. Antimicrobial susceptibility testing of azithromycin for Salmonella and Shigella species has been difficult to establish due to the lack of approval in vitro breakpoints for all species. Consequently, our data shows that azithromycin exhibits as a good alternative therapeutic choice for the treatment of gastrointestinal diseases caused by Salmonella and Shigella species. Further studies are needed to provide appropriate in vitro breakpoints supported by clinical data.

Smart pills for gastrointestinal diagnostics and therapy.

Ingestible smart pills have the potential to be a powerful clinical tool in the diagnosis and treatment of gastrointestinal disease. Though examples of this technology, such as capsule endoscopy, have been successfully translated from the lab into clinically used products, there are still numerous challenges that need to be overcome. This review gives an overview of the research being done in the area of ingestible smart pills and reports on the technical challenges in this field.