RESUMO
Salmonella spp. Remains a major public health problem globally. Biomedicine is the cornerstone of modern health care and could be a solution for antibiotic-resistant Salmonellosis. Although postbiotics seem to be an effective treatment in various clinical conditions, their clinical effects on Salmonella colitis have not been reported. Our previous report revealed that active vitamin D attenuates the severity of Salmonella colitis and invasiveness by reducing inflammation and enhancing the production of antimicrobial peptides. Therefore, we investigated the synergistic effects of butyrate, the most studied postbiotic, and active vitamin D on the severity of Salmonella colitis, invasiveness of Salmonella, and host immune responses, as well as its novel mechanisms, using in vitro and in vivo studies. We demonstrated that a combination of butyrate and active vitamin D (1 alpha, 25-dihydroxyvitamin D3) synergically reduced the severity of Salmonella colitis in C57BL/6 mice and reduced cecal inflammatory mIL-6, mIL-8, mTNF-α, and mIL-1ß mRNA expression, but enhanced the antimicrobial peptide mhBD-3 mRNA, compared to a single treatment. Additionally, upregulated vitamin D receptor (VDR) plays a critical role in the synergistic effects. This suggests combined benefits of butyrate and active vitamin D on Salmonella colitis through VDR-mediated antibacterial and anti-inflammatory responses. The combined use of both supplements could be a potential biomedicine for infectious and autoimmune colitis.
RESUMO
The human pathogen Pseudomonas aeruginosa can rapidly induce fatal sepsis, even in previously healthy infants or children treated with appropriate antibiotics. To reduce antibiotic overuse, exploring novel complementary therapies, such as probiotics that reportedly protect patients against P. aeruginosa infection, would be particularly beneficial. However, the major mechanism underlying the clinical effects is not completely understood. We thus aimed to investigate how probiotics affect IL-8 and human beta-defensin 2 (hBD-2) in P. aeruginosa-infected intestinal epithelial cells (IECs). We infected SW480 IECs with wild type PAO1 P. aeruginosa following probiotic treatment with Lactobacillus rhamnosus GG or Bifidobacterium longum spp. infantis S12, and analysed the mRNA expression and secreted protein of IL-8 and hBD-2, Akt signalling and NOD1 receptor protein expression. We observed that probiotics enhanced hBD-2 expression but suppressed IL-8 responses when administered before infection. They also enhanced P. aeruginosa-induced membranous NOD1 protein expression and Akt activation. The siRNA-mediated Akt or NOD1 knockdown counteracted P. aeruginosa-induced IL-8 or hBD-2 expression, indicating regulatory effects of these probiotics. In conclusion, these data suggest that probiotics exert reciprocal regulation of inflammation and antimicrobial peptides in P. aeruginosa-infected IECs and provide supporting evidence for applying probiotics to reduce antibiotic overuse.
Assuntos
Mediadores da Inflamação/metabolismo , Interleucina-8/metabolismo , Mucosa Intestinal/imunologia , Proteínas Citotóxicas Formadoras de Poros/metabolismo , Probióticos/metabolismo , Infecções por Pseudomonas/imunologia , Pseudomonas aeruginosa/fisiologia , beta-Defensinas/metabolismo , Bifidobacterium longum , Linhagem Celular Tumoral , Humanos , Lacticaseibacillus rhamnosus , Proteína Adaptadora de Sinalização NOD1/genética , Proteína Adaptadora de Sinalização NOD1/metabolismo , Proteínas Proto-Oncogênicas c-akt/genética , Proteínas Proto-Oncogênicas c-akt/metabolismo , Infecções por Pseudomonas/microbiologia , RNA Interferente Pequeno , Transdução de SinaisRESUMO
BACKGROUND: This study investigated the feasibility of early computed tomographic (CT) evaluation and the operative results of pediatric small bowel intussusception with deteriorating ischemic or obstructive symptoms, so-called small bowel intussusception disease (SBID). METHODS: Between 1988 and 1999, among 18 patients surgically proven SBID (conventional group), 12 mimicked ileocolic intussusception and were conventionally managed with abdominal radiography, ultrasonography, reduction enema, and eventually operation. Between 2000 and 2008, we applied a modified approach with inclusion of early CT evaluation if ultrasonography showed a target lesion suspicious for SBID (diameter =3.0 cm and/or atypically located in the paraumbilical or left abdomen). Among 15 surgically proven SBID patients (early CT group), 13 underwent early operation after CT confirmation. The clinical, imaging, and operative findings were compared between the 2 groups. RESULTS: There were no significant differences between the 2 groups in age, gender, clinical presentations, leukocyte count, ultrasonographic features, locations of SBID, or the presence of lead points. Most patients presented with vomiting, abdominal pain, or irritable crying. In comparison with the conventional group, early CT group patients had a significantly shorter duration between admission and surgery (31.44 +/- 30.39 vs 7.47 +/- 5.95 hours; P < .01) and a lower rate of bowel complications (44.4% vs 6.7%; P = .02). CONCLUSION: Pediatric SBID may present with nonspecific symptoms and may mimic ileocolic intussusception leading to delayed operative intervention. Early CT evaluation of patients with suspicious SBID ultrasonographic features is effective in avoiding futile reduction enema and significantly reducing the waiting time for operative management and the resultant incidence of bowel complications.
Assuntos
Enteropatias/cirurgia , Intestino Delgado/cirurgia , Intussuscepção/cirurgia , Dor Abdominal/etiologia , Criança , Pré-Escolar , Estudos de Viabilidade , Feminino , Hematemese/etiologia , Humanos , Enteropatias/diagnóstico por imagem , Intestino Delgado/diagnóstico por imagem , Intussuscepção/diagnóstico por imagem , Programas de Rastreamento , Síndrome de Peutz-Jeghers/diagnóstico por imagem , Síndrome de Peutz-Jeghers/cirurgia , Convulsões/etiologia , Tomografia Computadorizada por Raios X , Ultrassonografia , Vômito/etiologiaRESUMO
Alimentary tract duplications are very rare, with a reported incidence of 1 in 5000 live births. However, it rarely affects the transverse colon. We reported a case of duplication of the transverse colon in a 12-year-old boy with an unusual presentation mimicking megacolon. Barium enema revealed a large sac with massive fecal material retention in the left side of abdomen. Barium filling of the sac displacing bowel loops was noted on the post-evacuation film. He received a segmental resection of the transverse colon including the duplicated colon and end-to-end colo-colostomy. Pathology revealed whole muscle layer of colon compatible with duplication. No other associated anomaly was noted in this case. The case demonstrates three relatively uncommon presentations, including transverse colon location, late manifestation and dilated colon mimicking megacolon radiologically. It also emphasizes that barium enema with post-evacuation film aids in the preoperative diagnosis of duplication.