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1.
Gut Microbes ; 13(1): 1-28, 2021.
Article in English | MEDLINE | ID: mdl-33874858

ABSTRACT

Clostridium butyricum is a butyrate-producing human gut symbiont that has been safely used as a probiotic for decades. C. butyricum strains have been investigated for potential protective or ameliorative effects in a wide range of human diseases, including gut-acquired infection, intestinal injury, irritable bowel syndrome, inflammatory bowel disease, neurodegenerative disease, metabolic disease, and colorectal cancer. In this review we summarize the studies on C. butyricum supplementation with special attention to proposed mechanisms for the associated health benefits and the supporting experimental evidence. These mechanisms center on molecular signals (especially butyrate) as well as immunological signals in the digestive system that cascade well beyond the gut to the liver, adipose tissue, brain, and more. The safety of probiotic C. butyricum strains appears well-established. We identify areas where additional human randomized controlled trials would provide valuable further data related to the strains' utility as an intervention.


Subject(s)
Butyrates/metabolism , Clostridium butyricum/immunology , Clostridium butyricum/metabolism , Immunity , Probiotics , Animals , Dietary Supplements , Host Microbial Interactions , Humans , Inflammation/immunology , Inflammation/microbiology , Irritable Bowel Syndrome/immunology , Irritable Bowel Syndrome/microbiology , Metabolic Diseases/immunology , Metabolic Diseases/microbiology , Neoplasms/immunology , Neoplasms/microbiology , Neurodegenerative Diseases/immunology , Neurodegenerative Diseases/microbiology , Symbiosis
2.
J Tradit Chin Med ; 40(6): 897-907, 2020 12.
Article in English | MEDLINE | ID: mdl-33258340

ABSTRACT

OBJECTIVE: To evaluate the effectiveness and safety of a Shenlingbaizhu (SLBZ) formula in the treatment of irritable bowel syndrome (IBS). The effectiveness of SLBZ with or without conventional treatment was compared to that of conventional treatment alone. METHODS: A comprehensive literature search of four Chinese electronic databases, three English language databases, and two English language trial registries from inception to June 2019 was performed. Two authors independently screened the citations and retrieved full publications of randomized trials on the use of SLBZ with or without conventional treatment for IBS. The methodological quality of the trials was assessed with the Cochrane Collaboration's tool for assessing the risk of bias. Data were extracted and subjected to Meta-analysis to compare the efficacy of the SLBZ formula with or without conventional treatment to conventional treatment alone. RESULTS: Thirteen trials (comprising a total of 868 patients with IBS) were included in this review. The risk of bias of all 13 included trials was assessed as moderate. The SLBZ formula was associated with significant improvements in cure rate [relative risk (RR) score of 2.38, 95% confidence interval (CI) 1.43 to 3.95, I 2 = 0%; 8 trials, n = 487, fixed-effects model (FEM)], diarrhea severity score [mean difference (MD) score of -0.62, 95% CI -1.05 to -0.20, I 2 = 88%; 4 trials, n = 286, random effects model (REM)], abdominal pain severity score (MD score of -0.61, 95% CI -0.70 to -0.52, I 2 = 63%; 4 trials, n = 286, FEM), and abdominal distention severity score (MD score of -0.88, 95% CI -1.54 to -0.21, I 2 = 91%; 3 trials, n = 226, REM) compared to the conventional treatment alone. Adverse events were reported in five trials but only one of these indicated any adverse events associated with SLBZ. CONCLUSION: Based on the 13 trials reviewed here, the SLBZ formula with or without conventional treatment appeared to be safe and more effective in improving the cure rate and reducing the severity of diarrhea, abdominal pain, and abdominal distention compared to conventional treatment alone. However, these trials only generated a moderate quality of evidence, and well-designed and high-quality random controlled trials of the SLBZ formula for the treatment of IBS are required to confirm the efficacy of this treatment option.


Subject(s)
Drugs, Chinese Herbal/therapeutic use , Irritable Bowel Syndrome/drug therapy , Drugs, Chinese Herbal/adverse effects , Humans , Irritable Bowel Syndrome/immunology , Randomized Controlled Trials as Topic , Treatment Outcome
3.
Oxid Med Cell Longev ; 2020: 2974268, 2020.
Article in English | MEDLINE | ID: mdl-32908629

ABSTRACT

Spleen qi deficiency (SQD) syndrome is one of the basic traditional Chinese medicine (TCM) syndromes related to various diseases including chronic inflammation and hypertension and guides the use of many herbal formulae. However, the biological basis of SQD syndrome has not been clearly elucidated due to the lack of appropriate methodologies. Here, we propose a network pharmacology strategy integrating computational, clinical, and experimental investigation to study the biological basis of SQD syndrome. From computational aspects, we used a powerful disease gene prediction algorithm to predict the SQD syndrome biomolecular network which is significantly enriched in biological functions including immune regulation, oxidative stress, and lipid metabolism. From clinical aspects, SQD syndrome is involved in both the local and holistic disorders, that is, the digestive diseases and the whole body's dysfunctions. We, respectively, investigate SQD syndrome-related digestive diseases including chronic gastritis and irritable bowel syndrome and the whole body's dysfunctions such as chronic fatigue syndrome and hypertension. We found innate immune and oxidative stress modules of SQD syndrome biomolecular network dysfunction in chronic gastritis patients and irritable bowel syndrome patients. Lymphocyte modules were downregulated in chronic fatigue syndrome patients and hypertension patients. From experimental aspects, network pharmacology analysis suggested that targets of Radix Astragali and other four herbs commonly used for SQD syndrome are significantly enriched in the SQD syndrome biomolecular network. Experiments further validated that Radix Astragali ingredients promoted immune modules such as macrophage proliferation and lymphocyte proliferation. These findings indicate that the biological basis of SQD syndrome is closely related to insufficient immune response including decreased macrophage activity and reduced lymphocyte proliferation. This study not only demonstrates the potential biological basis of SQD syndrome but also provides a novel strategy for exploring relevant molecular mechanisms of disease-syndrome-herb from the network pharmacology perspective.


Subject(s)
Drugs, Chinese Herbal/pharmacology , Qi , Spleen/pathology , Animals , Chronic Disease , Fatigue Syndrome, Chronic/genetics , Fatigue Syndrome, Chronic/immunology , Gastritis/genetics , Gastritis/immunology , Gene Expression Regulation/drug effects , Hypertension/genetics , Hypertension/immunology , Irritable Bowel Syndrome/genetics , Irritable Bowel Syndrome/immunology , Lymphocytes/immunology , Mice , Phenotype , Protein Interaction Maps/drug effects , RAW 264.7 Cells , Reproducibility of Results , Signal Transduction/drug effects , Spleen/drug effects , Spleen/immunology , Syndrome , Transcription, Genetic/drug effects
4.
Nutrients ; 12(6)2020 Jun 07.
Article in English | MEDLINE | ID: mdl-32517330

ABSTRACT

Probiotics possibly affect local and systemic immune reactions and maintain the intestinal immune homeostasis in healthy individuals and patients with diseases such as irritable bowel syndrome (IBS). In this single-center, blinded trial, we enrolled 40 individuals (20 patients with IBS and 20 healthy individuals) whose blood and fecal samples were collected before and after a 21-day administration of a product comprising Lactobacillus spp., larch arabinogalactan, and colostrum. The percentage of HLA-DR+ natural killer (NK) cells was higher in healthy individuals (p = 0.03) than in patients with IBS after product supplementation. In the fecal samples of patients with IBS, we observed a decline in IL-6, IFN-γ, TNF-α, and secretory IgA levels and, simultaneously, an increase in IL-10 and IL-17A levels after supplementation, although non-significant, whereas, in healthy individuals, we observed a significant decline in IL-6 and IFN-γ levels after supplementation (p < 0.001). Nevertheless, we observed a clinical improvement of symptoms in 65-75% of patients with IBS and the complete resolution of the initial symptoms in five of the 20 patients. We also observed a possible prophylactic effect by the inducing system antiviral impact accompanied by a trend for local immune tolerance in the gut in healthy individuals, where it is the desirable state.


Subject(s)
Colostrum/physiology , Dietary Supplements , Galactans/administration & dosage , Immune Tolerance , Intestinal Mucosa/immunology , Intestinal Mucosa/metabolism , Irritable Bowel Syndrome/diet therapy , Irritable Bowel Syndrome/immunology , Killer Cells, Natural/immunology , Lactobacillus , Larix/chemistry , Lymphocyte Activation/immunology , Adult , Cytokines/metabolism , Female , Galactans/isolation & purification , Healthy Volunteers , Homeostasis , Humans , Immunoglobulin A, Secretory/metabolism , Irritable Bowel Syndrome/prevention & control , Male , Middle Aged , Treatment Outcome , Young Adult
5.
J Tradit Chin Med ; 40(2): 245-252, 2020 04.
Article in English | MEDLINE | ID: mdl-32242390

ABSTRACT

OBJECTIVE: To explore the underlying mechanism of action of Tongxieyaofang decoction in rats with visceral hypersensitivity using proteomics technology. METHODS: Twenty-four female Sprague-Dawley rats were randomly divided into three groups: control group, irritable bowel syndrome (IBS) group and Tongxieyaofang treatment group. An IBS model, characterized as visceral hypersensitivity, was established using the odour of mothballs as conditional stimulation and colorectal distension combined with classic physical restraint as non-conditional stimulation. Rats were intragastrically treated with Tongxieyaofang (2 or 4 mL·kg-1·d-1) for 4 weeks. On the 45th day, the rats were dissected and the colonic mucosal proteins were extracted. Differential protein spots were screened by fluorescent two-dimensional differential gel electrophoresis (2D-DIGE), and identified by matrix-assisted laser desorption/ionisation time of flight mass spectrometry (MALDI-TOF-MS). Western blotting experiments were performed to verify the changes observed in 2D-DIGE and MALDI-TOF-MS. RESULTS: It was found that the visceral sensitivity of rats in the Tongxieyaofang treatment group (4 mL/kg) was lower than that in the IBS group (P < 0.01). Sixty-one protein spots were differentially expressed between the IBS group and the Tongxieyaofang treatment group. Of these, 23 spots were upregulated in the Tongxieyaofang treatment group, while 38 spots were downregulated. Three specific proteins were successfully identified from the five protein spots with the most obvious changes. The two upregulated proteins were transgelin (TAGLN) and acetaldehyde dehydrogenase 2 (Aldh2) and the downregulated protein was cytokeratin 8 (CK8). CONCLUSION: Tongxieyaofang can dose-dependently ameliorate visceral hypersensitivity in rats and the mechanism of action may involve the upregulation of TAGLN and Aldh2 and the downregulation of CK8.


Subject(s)
Colon/immunology , Drugs, Chinese Herbal/administration & dosage , Irritable Bowel Syndrome/drug therapy , Viscera/immunology , Aldehyde Dehydrogenase, Mitochondrial/genetics , Aldehyde Dehydrogenase, Mitochondrial/immunology , Animals , Colon/drug effects , Disease Models, Animal , Female , Humans , Intestinal Mucosa/drug effects , Intestinal Mucosa/immunology , Irritable Bowel Syndrome/genetics , Irritable Bowel Syndrome/immunology , Keratin-8/genetics , Keratin-8/immunology , Microfilament Proteins/genetics , Microfilament Proteins/immunology , Muscle Proteins/genetics , Muscle Proteins/immunology , Rats , Rats, Sprague-Dawley , Viscera/drug effects
6.
World J Gastroenterol ; 25(32): 4696-4714, 2019 Aug 28.
Article in English | MEDLINE | ID: mdl-31528095

ABSTRACT

BACKGROUND: About one-third of refractory irritable bowel syndrome (IBS) cases are caused by gastrointestinal (GI) infection/inflammation, known as post-infectious/post-inflammatory IBS (PI-IBS). Although it is known that intestinal microbiota and host NOD-like receptor family pyrin domain containing 6 (NLRP6) inflammsome signaling are closely related to PI-IBS and moxibustion has a therapeutic effect on PI-IBS, whether moxibustion regulates the intestinal flora and host NLRP6 events in PI-IBS remains unclear. AIM: To examine the regulatory effect of moxibustion on intestinal microbiota and host NLRP6 inflammatory signaling in PI-IBS. METHODS: Sprague-Dawley rats were divided into a normal control group, a model control group, a mild moxibustion group, and a sham mild moxibustion group. PI-IBS rats in the mild moxibustion group were treated with moxibusiton at bilateral Tianshu (ST 25) and Zusanli (ST36) for 7 consecutive days for 10 min each time. The sham group rats were given the same treatment as the mild moxibustion group except the moxa stick was not ignited. Abdominal withdrawal reflex (AWR) score was measured to assess the visceral sensitivity, and colon histopathology and ultrastructure, colonic myeloperoxidase (MPO) activity, and serum C-reactive protein (CRP) level were measured to evaluate low-grade colonic inflammation in rats. The relative abundance of selected intestinal bacteria in rat feces was detected by 16S rDNA PCR and the NLRP6 inflammsome signaling in the colon was detected by immunofluorescence, qRT-PCR, and Western blot. RESULTS: The AWR score was significantly decreased and the low-grade intestinal inflammation reflected by serum CRP and colonic MPO levels was inhibited in the mild moxibustion group compared with the sham group. Mild moxibustion remarkably increased the relative DNA abundances of Lactobacillus, Bifidobacterium, and Faecalibacterium prausnitzii but decreased that of Escherichia coli in the gut of PI-IBS rats. Additionally, mild moxibustion induced mRNA and protein expression of intestine lectin 1 but inhibited the expression of IL-1ß, IL-18, and resistance-like molecule ß by promoting the NLRP6 and reducing the mRNA and protein expression of apoptosis-associated speck-like protein containing CARD (ASC) and cysteinyl-aspartate-specific proteinase 1 (Caspase-1). The relative DNA abundances of Lactobacillus, Bifidobacteria, Faecalibacterium prausnitzii, and Escherichia coli in each group were correlated with the mRNA and protein expression of NLRP6, ASC, and Caspase-1 in the colon. CONCLUSION: These findings indicated that mild moxibustion can relieve low-grade GI inflammation and alleviate visceral hypersensitivity in PI-IBS by regulating intestinal microbes and controlling NLRP6 inflammasome signaling.


Subject(s)
Gastrointestinal Microbiome/immunology , Inflammation/therapy , Irritable Bowel Syndrome/therapy , Moxibustion/methods , Signal Transduction/immunology , Animals , Disease Models, Animal , Humans , Inflammasomes/immunology , Inflammasomes/metabolism , Inflammation/complications , Inflammation/immunology , Intestinal Mucosa/immunology , Intestinal Mucosa/microbiology , Irritable Bowel Syndrome/immunology , Male , Rats , Rats, Sprague-Dawley , Receptors, Angiotensin/immunology , Receptors, Angiotensin/metabolism , Receptors, Vasopressin/immunology , Receptors, Vasopressin/metabolism , Specific Pathogen-Free Organisms , Trinitrobenzenesulfonic Acid/administration & dosage , Trinitrobenzenesulfonic Acid/immunology
7.
Expert Rev Gastroenterol Hepatol ; 13(4): 345-359, 2019 Apr.
Article in English | MEDLINE | ID: mdl-30791775

ABSTRACT

INTRODUCTION: Irritable Bowel Syndrome (IBS) is a bowel disorder leading to symptoms such as abdominal pain, modifications in the motility and bowel habits, distention, bloating, and gas. Vitamin D (VD) may interfere in a plethora of cellular mechanisms, and act directly or indirectly in the regulation of the microbiome, the release of anti-microbial peptides, modulation of the immune system and inflammation processes; which in turn, may positively interfere with the altered gut function. The main purpose of this review was to survey studies involving the impacts of VD on IBS. Area covered: Eligible studies including the term VD and IBS were searched in the MEDLINE-PubMed and EMBASE (2009-2018). VD may act direct or indirectly in the regulation of the gut microbiome, immune response, and psychosocial factors that may be included in the list of IBS triggering factors. Expert opinion: Once VD plays an essential role in many processes associated with IBS, its deficiency may be associated with IBS, and the supplementation could help in the therapeutic approach for this condition. For these reasons, the understanding of the association of VD in IBS is indispensable for the development of new strategies that could improve the quality of life of the patient.


Subject(s)
Bacteria/drug effects , Dietary Supplements , Gastrointestinal Microbiome/drug effects , Intestines/drug effects , Irritable Bowel Syndrome/drug therapy , Vitamin D Deficiency/drug therapy , Vitamin D/therapeutic use , Animals , Bacteria/pathogenicity , Dietary Supplements/adverse effects , Host-Pathogen Interactions , Humans , Intestines/immunology , Intestines/microbiology , Irritable Bowel Syndrome/epidemiology , Irritable Bowel Syndrome/immunology , Irritable Bowel Syndrome/microbiology , Prognosis , Risk Factors , Vitamin D/adverse effects , Vitamin D Deficiency/epidemiology , Vitamin D Deficiency/immunology , Vitamin D Deficiency/microbiology
8.
Iran J Immunol ; 15(3): 186-196, 2018 Sep.
Article in English | MEDLINE | ID: mdl-30246694

ABSTRACT

BACKGROUND: Given the variations in clinical presentation and physiopathological mechanisms in irritable bowel syndrome (IBS) subtypes, it is an acknowledged fact that the response to treatments can be disparate. OBJECTIVE: To assess the effect of vitamin D on inflammatory cytokines (IL-17, IL-10, TNF-α), and biomarkers of oxidative stress (total antioxidant capacity (TAC), and malondialdehyde (MDA)) among IBS patients. METHODS: A double-blind, randomized, placebo-controlled 6-month intervention study was carried out on 90 IBS patients (85 were analyzed), as defined by the Rome III criteria. Study participants were randomly assigned to receive either 50,000 IU vitamin D3 or a placebo fortnightly. RESULTS: Vitamin D supplementation significantly reduced the IL-17 and MDA serum levels (P<0.05) and observably increased the TAC and IL-10 serum levels (P<0.05), compared with the placebo group. Comparing different bowel habit subtypes, we observed that it was only in diarrhea predominant IBS (IBS-D) that vitamin D supplementation was able to significantly reduce the serum levels of TNF-α and IL-17 (P<0.05). However, in all subtypes, IL-10 and TAC increased, while MDA decreased (P<0.05) in vitamin D group, compared to the placebo group. CONCLUSION: Vitamin D3 supplementation reduces the serum IL-17 and MDA levels, and augments the serum IL-10 and TAC levels in IBS patients, particularly in IBS-D subtype. Thus, the present study demonstrates the beneficial effects of vitamin D on patients with IBS-D.


Subject(s)
Cholecalciferol/metabolism , Interleukin-10/metabolism , Interleukin-17/metabolism , Irritable Bowel Syndrome/immunology , Malondialdehyde/metabolism , Adolescent , Adult , Aged , Antioxidants/metabolism , Down-Regulation , Female , Humans , Male , Middle Aged , Young Adult
9.
Medicine (Baltimore) ; 97(21): e10877, 2018 May.
Article in English | MEDLINE | ID: mdl-29794793

ABSTRACT

BACKGROUND: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder associated with visceral hypersensitivity. Increased expression of colonic TRPV1 and decreased expression of microRNA-199 are implicated in the pathogenesis of visceral hypersensitivity in IBS-D patients. Acupuncture is one of the frequently used complementary and alternative therapies for the treatment of IBS. The existing clinical studies mostly use IBS-SSS or other subjective scales, so there is a lack of objective biochemical evidence regarding the effect of acupuncture on IBS. Therefore, we designed this study to investigate whether acupuncture alleviate visceral hypersensitivity by influencing the expression of TRPV1 and microRNA-199. METHOD: This study is a randomized, sham-controlled trial involving 40 patients and 10 healthy volunteers. A total of 40 eligible patients with IBS-D will be randomly assigned to a traditional acupuncture group or sham acupuncture group in a 1:1 ratio. Patients will receive 3 acupuncture treatment sessions per week for 12 consecutive weeks, for a total of 36 sessions during the study. The primary outcome measure is the IBS-Symptom Severity Score (IBS-SSS). Secondary outcomes are Visceral Pain Scale and levels of TRPV1 and microRNA-199 in colonic tissues. Healthy volunteers will not receive any clinical intervention. The safety of interventions will be assessed at every visit. DISCUSSION: The purpose of this trial is to evaluate the efficacy of acupuncture for IBS-D through IBS-SSS and Visceral Pain Scale. Furthermore, we want to explore the intervention mechanism of acupuncture in improving visceral hypersensitivity by analyzing the colonic TRPV1 and microRNA-199. TRIAL REGISTRATION: This trial is registered with Chinese Clinical Trials Register, ChiCTR-IOR- 17010860(http://www.chictr.org.cn/showproj.aspx?proj=18445).


Subject(s)
Acupuncture Therapy/methods , Colon/immunology , Hypersensitivity/immunology , Irritable Bowel Syndrome/immunology , Acupuncture Therapy/statistics & numerical data , Adolescent , Adult , Aged , Colon/physiopathology , Complementary Therapies/methods , Female , Humans , Hypersensitivity/genetics , Hypersensitivity/therapy , Irritable Bowel Syndrome/genetics , Irritable Bowel Syndrome/physiopathology , Irritable Bowel Syndrome/therapy , Male , MicroRNAs/metabolism , Middle Aged , Pain Measurement/methods , Severity of Illness Index , TRPV Cation Channels/metabolism , Treatment Outcome , Young Adult
10.
Adv Ther ; 35(3): 289-310, 2018 03.
Article in English | MEDLINE | ID: mdl-29498019

ABSTRACT

Irritable bowel syndrome (IBS), one of the most frequent digestive disorders, is characterized by chronic and recurrent abdominal pain and altered bowel habit. The origin seems to be multifactorial and is still not well defined for the different subtypes. Genetic, epigenetic and sex-related modifications of the functioning of the nervous and immune-endocrine supersystems and regulation of brain-gut physiology and bile acid production and absorption are certainly involved. Acquired predisposition may act in conjunction with infectious, toxic, dietary and life event-related factors to enhance epithelial permeability and elicit mucosal microinflammation, immune activation and dysbiosis. Notably, strong evidence supports the role of bacterial, viral and parasitic infections in triggering IBS, and targeting microbiota seems promising in view of the positive response to microbiota-related therapies in some patients. However, the lack of highly predictive diagnostic biomarkers and the complexity and heterogeneity of IBS patients make management difficult and unsatisfactory in many cases, reducing patient health-related quality of life and increasing the sanitary burden. This article reviews specific alterations and interventions targeting the gut microbiota in IBS, including prebiotics, probiotics, synbiotics, non-absorbable antibiotics, diets, fecal transplantation and other potential future approaches useful for the diagnosis, prevention and treatment of IBS.


Subject(s)
Gastrointestinal Microbiome , Irritable Bowel Syndrome , Patient Care Management/methods , Quality of Life , Diet Therapy , Dietary Supplements , Gastrointestinal Microbiome/drug effects , Gastrointestinal Microbiome/physiology , Humans , Irritable Bowel Syndrome/immunology , Irritable Bowel Syndrome/microbiology , Irritable Bowel Syndrome/psychology , Irritable Bowel Syndrome/therapy
11.
J Med Food ; 20(5): 474-484, 2017 May.
Article in English | MEDLINE | ID: mdl-28452565

ABSTRACT

Irritable bowel syndrome (IBS) is a functional gastrointestinal disease with complex pathophysiology involving the brain-gut axis. To assess the effects of Wasabia koreana (WK) on IBS, we employed a mouse model of colonic zymosan injection presenting with diarrhea-predominant IBS-like symptoms. Oral WK administration significantly diminished stool score, suppressed colon length and weight change, and minimized body weight loss without affecting food intake. In WK-treated mice, the submucosal thickening and epithelial lining of the colon were inhibited and were similar to those of naïve mice. Infiltration of mast cells into the colon and serum tumor necrosis factor-α levels were markedly suppressed. These effects were comparable to those of sulfasalazine, an anti-inflammatory drug. Furthermore, the number of visceral pain-related behaviors was significantly decreased, and locomotion activities measured in the elevated plus maze and open field tests were significantly increased by WK in a dose-dependent manner compared with amitriptyline, an antidepressant. These changes were accompanied by reduced FosB2 expression in the brain. Taken together, these data suggest that WK may have potential as a medicinal food for IBS by acting on inflammatory diarrhea and neural activity.


Subject(s)
Irritable Bowel Syndrome/drug therapy , Plant Extracts/administration & dosage , Wasabia/chemistry , Zymosan/adverse effects , Animals , Colon/drug effects , Colon/immunology , Disease Models, Animal , Humans , Irritable Bowel Syndrome/chemically induced , Irritable Bowel Syndrome/immunology , Male , Mice , Mice, Inbred C57BL , Plant Extracts/analysis , Tumor Necrosis Factor-alpha/immunology
12.
J Gastroenterol Hepatol ; 32 Suppl 1: 64-68, 2017 Mar.
Article in English | MEDLINE | ID: mdl-28244671

ABSTRACT

Prebiotics are non-digestible selectively fermented dietary fibers that specifically promote the growth of one or more bacterial genera in the gastrointestinal tract and thus provide health benefit to the host. The two most investigated prebiotics being the inulin-type fructans and galacto-oligosaccharides. Prebiotic specificity is mediated through species-specific gene clusters within saccharolytic bacteria controlled by signaling sensors for various substrates. Prebiotic health benefits are attributed to immune regulation and bacterial metabolite production. In humans, prebiotic supplementation leads to increased growth of specific gut microbiota (e.g., bifidobacteria), immune modulation, and depending on the bacterial augmentation, short-chain fatty acid production. Irritable bowel syndrome and Crohn's disease are gastrointestinal disorders associated with reductions in some gut bacteria and greater mucosal inflammation. Prebiotic supplementation studies have shown some promise at low doses for modulation of the gut bacteria and reduction of symptoms in IBS; however, larger doses may have neutral or negative impact on symptoms. Studies in Crohn's disease have not shown benefit to bacterial modulation or inflammatory response with prebiotic supplementation. Dietary restriction of fermentable carbohydrates (low FODMAP diet), which restricts some naturally occurring prebiotics from the diet, has shown efficacy in improving symptoms in irritable bowel syndrome, but it lowers the numbers of some key gut microbiota. Further research is required on the effect of prebiotics in gastrointestinal disorders and, in particular, on their use in conjunction with the low FODMAP diet.


Subject(s)
Crohn Disease/diet therapy , Dietary Supplements , Fructans , Galactose , Gastrointestinal Microbiome , Irritable Bowel Syndrome/diet therapy , Oligosaccharides , Prebiotics , Bifidobacterium/growth & development , Crohn Disease/immunology , Crohn Disease/microbiology , Diet, Carbohydrate-Restricted , Disaccharides/administration & dosage , Disaccharides/adverse effects , Humans , Irritable Bowel Syndrome/immunology , Irritable Bowel Syndrome/microbiology , Monosaccharides/administration & dosage , Monosaccharides/adverse effects , Oligosaccharides/administration & dosage , Oligosaccharides/adverse effects , Polymers/administration & dosage , Polymers/adverse effects
13.
Aliment Pharmacol Ther ; 45(7): 909-922, 2017 04.
Article in English | MEDLINE | ID: mdl-28164346

ABSTRACT

BACKGROUND: Intestinal immune activation is involved in irritable bowel syndrome (IBS) pathophysiology. While most dietary approaches in IBS involve food avoidance, there are fewer indications on food supplementation. Palmithoylethanolamide, structurally related to the endocannabinoid anandamide, and polydatin are dietary compounds which act synergistically to reduce mast cell activation. AIM: To assess the effect on mast cell count and the efficacy of palmithoylethanolamide/polydatin in patients with IBS. METHODS: We conducted a pilot, 12-week, randomised, double-blind, placebo-controlled, multicentre study assessing the effect of palmithoylethanolamide/polydatin 200 mg/20 mg or placebo b.d. on low-grade immune activation, endocannabinoid system and symptoms in IBS patients. Biopsy samples, obtained at screening visit and at the end of the study, were analysed by immunohistochemistry, enzyme-linked immunoassay, liquid chromatography and Western blot. RESULTS: A total of 54 patients with IBS and 12 healthy controls were enrolled from five European centres. Compared with controls, IBS patients showed higher mucosal mast cell counts (3.2 ± 1.3 vs. 5.3 ± 2.7%, P = 0.013), reduced fatty acid amide oleoylethanolamide (12.7 ± 9.8 vs. 45.8 ± 55.6 pmol/mg, P = 0.002) and increased expression of cannabinoid receptor 2 (0.7 ± 0.1 vs. 1.0 ± 0.8, P = 0.012). The treatment did not significantly modify IBS biological profile, including mast cell count. Compared with placebo, palmithoylethanolamide/polydatin markedly improved abdominal pain severity (P < 0.05). CONCLUSIONS: The marked effect of the dietary supplement palmithoylethanolamide/polydatin on abdominal pain in patients with IBS suggests that this is a promising natural approach for pain management in this condition. Further studies are now required to elucidate the mechanism of action of palmithoylethanolamide/polydatin in IBS. ClinicalTrials.gov number, NCT01370720.


Subject(s)
Abdominal Pain/diet therapy , Analgesics/therapeutic use , Dietary Supplements , Ethanolamines/therapeutic use , Glucosides/therapeutic use , Irritable Bowel Syndrome/diet therapy , Palmitic Acids/therapeutic use , Stilbenes/therapeutic use , Abdominal Pain/immunology , Adult , Amides , Cell Count , Double-Blind Method , Female , Humans , Irritable Bowel Syndrome/immunology , Male , Mast Cells/immunology , Middle Aged , Young Adult
15.
Acta Pharmacol Sin ; 36(6): 708-15, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25960135

ABSTRACT

AIM: The herbal prescription Chang'an II is derived from a classical TCM formula Tong-Xie-Yao-Fang for the treatment of liver-qi stagnation and spleen deficiency syndrome of irritable bowel syndrome (IBS). In this study we investigated the effects of Chang'an II on the intestinal mucosal immune barrier in a rat post-inflammation IBS (PI-IBS) model. METHODS: A rat model of PI-IBS was established using a multi-stimulation paradigm including early postnatal sibling deprivation, bondage and intrarectal administration of TNBS. Four weeks after TNBS administration, the rats were treated with Chang'an II (2.85, 5.71 and 11.42 g · kg(-1) · d(-1), ig) for 14 d. Intestinal sensitivity was assessed based on the abdominal withdrawal reflex (AWR) scores and fecal water content. Open field test and two-bottle sucrose intake test were used to evaluate the behavioral changes. CD4(+) and CD8(+) cells were counted and IL-1ß and IL-4 levels were measured in intestinal mucosa. Transmission electron microscopy was used to evaluate ultrastructural changes of the intestinal mucosal barrier. RESULTS: PI-IBS model rats showed significantly increased AWR reactivity and fecal water content, and decreased locomotor activity and sucrose intake. Chang'an II treatment not only reduced AWR reactivity and fecal water content, but also suppressed the anxiety and depressive behaviors. Ultrastructural study revealed that the gut mucosal barrier function was severely damaged in PI-IBS model rats, whereas Chang'an II treatment relieved intestinal mucosal inflammation and repaired the gut mucosal barrier. Furthermore, PI-IBS model rats showed a significantly reduced CD4(+)/CD8(+) cell ratio in lamina propria and submucosa, and increased IL-1ß and reduced IL-4 expression in intestinal mucosa, whereas Chang'an II treatment reversed PI-IBS-induced changes in CD4(+)/CD8(+) cell ratio and expression of IL-1ß and IL-4. CONCLUSION: Chang'an II treatment protects the intestinal mucosa against PI-IBS through anti-inflammatory, immunomodulatory and anti-anxiety effects.


Subject(s)
Anti-Inflammatory Agents/pharmacology , Colitis/drug therapy , Colon/drug effects , Drugs, Chinese Herbal/pharmacology , Gastrointestinal Agents/pharmacology , Intestinal Mucosa/drug effects , Irritable Bowel Syndrome/drug therapy , Wound Healing/drug effects , Animals , Animals, Newborn , Behavior, Animal/drug effects , CD4-Positive T-Lymphocytes/drug effects , CD4-Positive T-Lymphocytes/immunology , CD4-Positive T-Lymphocytes/metabolism , CD8-Positive T-Lymphocytes/drug effects , CD8-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/metabolism , Colitis/chemically induced , Colitis/immunology , Colitis/metabolism , Colitis/pathology , Colitis/psychology , Colon/immunology , Colon/metabolism , Colon/ultrastructure , Disease Models, Animal , Drug Combinations , Feces/chemistry , Feeding Behavior/drug effects , Food Preferences/drug effects , Immunity, Mucosal/drug effects , Inflammation Mediators/metabolism , Interleukin-1beta/metabolism , Interleukin-4/metabolism , Intestinal Mucosa/immunology , Intestinal Mucosa/metabolism , Intestinal Mucosa/ultrastructure , Irritable Bowel Syndrome/chemically induced , Irritable Bowel Syndrome/immunology , Irritable Bowel Syndrome/metabolism , Irritable Bowel Syndrome/pathology , Irritable Bowel Syndrome/psychology , Male , Medicine, Chinese Traditional , Motor Activity/drug effects , Pain Threshold/drug effects , Rats, Sprague-Dawley , Trinitrobenzenesulfonic Acid
16.
Tech Coloproctol ; 19(5): 269-73, 2015 May.
Article in English | MEDLINE | ID: mdl-25820513

ABSTRACT

The psycho-neuroendocrine-immune approach relies on the concept of considering diseases from a holistic point of view: the various components (psyche, nervous system, endocrine system, and immune system) control the diseased organ/apparatus and in turn are influenced by a feedback mechanism. In this article, we will consider the psycho-neuroendocrine-immune approach to coloproctological disorders, by providing clinical cases and discussing them in light of this approach.


Subject(s)
Abdominal Pain/immunology , Constipation/psychology , Fissure in Ano/therapy , Growth Hormone/physiology , Holistic Health , Irritable Bowel Syndrome/immunology , Abdominal Pain/therapy , Adult , Biofeedback, Psychology , Constipation/therapy , Empty Sella Syndrome/complications , Enteric Nervous System/physiopathology , Female , Fissure in Ano/etiology , Humans , Irritable Bowel Syndrome/therapy , Male , Middle Aged , Wound Healing
18.
J Nutr ; 145(5): 915-22, 2015 May.
Article in English | MEDLINE | ID: mdl-25716554

ABSTRACT

BACKGROUND: Although never evaluated for efficacy, n-3 (ω-3) long-chain polyunsaturated fatty acids (LCPUFAs) are commercially offered as treatment for irritable bowel syndrome (IBS). OBJECTIVE: This study was designed to investigate, in a mast cell-dependent model for visceral hypersensitivity, whether this pathophysiologic mechanism can be reversed by dietary LCPUFA treatment via peroxisome proliferator-activated receptor γ (PPARG) activation. METHODS: Maternally separated rats were subjected to hypersensitivity-inducing acute stress at adult age. Reversal was attempted by protocols with tuna oil-supplemented diets [4% soy oil (SO) and 3% tuna oil (SO-T3) or 3% SO and 7% tuna oil (SO-T7)] and compared with control SO diets (7% or 10% SO) 4 wk after stress. The PPARG agonist rosiglitazone was evaluated in a 1 wk preventive protocol (30 mg · kg⁻¹ · d⁻¹). Erythrocytes were assessed to confirm LCPUFA uptake and tissue expression of lipoprotein lipase and glycerol kinase as indicators of PPARG activation. Colonic mast cell degranulation was evaluated by toluidine blue staining. In vitro, human mast cell line 1 (HMC-1) cells were pretreated with rosiglitazone, eicosapentaenoic acid, or docosahexaenoic acid, stimulated with phorbol 12-myristate 13-acetate (PMA) and calcium ionophore or compound 48/80 and evaluated for tumor necrosis factor α (TNF-α) and ß-hexosaminidase release. RESULTS: Stress led to visceral hypersensitivity in all groups. Hypersensitivity was not reversed by SO-T3 or control treatment [prestress vs. 24 h poststress vs. posttreatment area under the curve; 76 ± 4 vs. 128 ± 12 (P < 0.05) vs. 115 ± 14 and 82 ± 5 vs. 127 ± 16 (P < 0.01) vs. 113 ± 19, respectively]. Comparison of SO-T7 with its control showed similar results [74 ± 6 vs. 103 ± 13 (P < 0.05) vs. 115 ± 17 and 66 ± 3 vs. 103 ± 10 (P < 0.05) vs. 117 ± 11, respectively]. Erythrocytes showed significant LCPUFA uptake in the absence of colonic PPARG activation. Rosiglitazone induced increased PPARG target gene expression, but did not prevent hypersensitivity. Mast cell degranulation never differed between groups. Rosiglitazone and LCPUFAs significantly reduced PMA/calcium ionophore-induced TNF-α release but not degranulation of HMC-1 cells. CONCLUSION: Dietary LCPUFAs did not reverse stress-induced visceral hypersensitivity in maternally separated rats. Although further research is needed, claims concerning LCPUFAs as a treatment option in IBS cannot be confirmed at this point and should be regarded with caution.


Subject(s)
Autonomic Nervous System/physiopathology , Colon/innervation , Dietary Supplements , Disease Models, Animal , Fatty Acids, Omega-3/therapeutic use , Fish Oils/therapeutic use , Irritable Bowel Syndrome/diet therapy , Animals , Animals, Newborn , Autonomic Nervous System/drug effects , Autonomic Nervous System/immunology , Biomarkers/blood , Biomarkers/metabolism , Cell Degranulation/drug effects , Cell Line , Colon/drug effects , Colon/immunology , Colon/metabolism , Erythrocytes/drug effects , Erythrocytes/enzymology , Erythrocytes/metabolism , Fatty Acids, Omega-3/administration & dosage , Fatty Acids, Omega-3/metabolism , Female , Fish Oils/administration & dosage , Fish Oils/metabolism , Hypoglycemic Agents/pharmacology , Intestinal Mucosa/drug effects , Intestinal Mucosa/immunology , Intestinal Mucosa/innervation , Intestinal Mucosa/metabolism , Irritable Bowel Syndrome/immunology , Irritable Bowel Syndrome/metabolism , Irritable Bowel Syndrome/physiopathology , Male , Mast Cells/drug effects , Mast Cells/immunology , Mast Cells/physiology , Maternal Deprivation , PPAR gamma/antagonists & inhibitors , PPAR gamma/metabolism , Rats, Long-Evans , Tuna
19.
Curr Opin Gastroenterol ; 31(2): 166-71, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25612261

ABSTRACT

PURPOSE: of review Those who suffer from irritable bowel syndrome (IBS) have long reported the frequent precipitation of their symptoms in relation to food ingestion and have often been convinced that certain foods were especially problematic. However, until very recently, research on the responses to food or individual dietary constituents, in IBS, has been scarce. This review addresses recent literature on diet and IBS. RECENT FINDINGS: The complexity of food-symptom interactions in IBS is being revealed in recent and ongoing research. Such studies have revealed the variable effects of fibre in IBS and the susceptibility of IBS individuals to the ingestion of poorly digested and absorbed carbohydrates. The latter has led to the widespread adoption of the low-fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) diet. Less certain is the role of another widely adopted dietary strategy, gluten restriction. Diet-microbe interactions are critical to the homeostasis of the gut microbiome in health and may well be disturbed in disease; enthusiasm continues, therefore, for the use of probiotics in IBS. SUMMARY: Food is a common precipitant of symptoms in IBS and recent research has focused on the role(s) of individual dietary constituents in IBS and on fibre, FODMAPs, gluten and probiotics, in particular. Each may have a role in certain IBS sufferers.


Subject(s)
Calcium Channel Blockers/therapeutic use , Diet, Gluten-Free , Irritable Bowel Syndrome/diet therapy , Plant Oils/therapeutic use , Probiotics/therapeutic use , Humans , Irritable Bowel Syndrome/immunology , Mentha piperita , Practice Guidelines as Topic
20.
Lik Sprava ; (7-8): 75-82, 2015.
Article in Ukrainian | MEDLINE | ID: mdl-27491155

ABSTRACT

The effect of the combination nucleinat and alfagin in a complex of medical rehabilitation at the level of circulating immune complexes (CIC) in serum of patients and their molecular composition with irritable bowel syndrome (IBS), against neurocirculatory dystonia (NeD). It is established that the combination of nucleinat and alfagin in medical rehabilitation of patients with this comorbid disorders contributes to the normalization of the total concentration of the CEC and their molecular composition, which indicates the validity of the application of the pathogenesis combinations of drugs in complex medical rehabilitation of patients with lBS against NCD.


Subject(s)
Constipation/drug therapy , Dystonia/drug therapy , Interferon Inducers/therapeutic use , Irritable Bowel Syndrome/drug therapy , Nucleic Acids/therapeutic use , Phytotherapy/methods , Plant Extracts/therapeutic use , Adult , Antigen-Antibody Complex/blood , Case-Control Studies , Constipation/complications , Constipation/immunology , Constipation/pathology , Dystonia/complications , Dystonia/immunology , Dystonia/pathology , Eleutherococcus/chemistry , Female , Humans , Irritable Bowel Syndrome/complications , Irritable Bowel Syndrome/immunology , Irritable Bowel Syndrome/pathology , Male , Middle Aged , Panax/chemistry , Plant Extracts/chemistry , Plants, Medicinal
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