Evaluación de actividad física como coadyuvante terapéutico para pacientes con enfermedad inflamatoria intestinal: una revisión / Evaluation of physical activity as a therapeutic adjuvant for patients with inflammatory bowel disease: A systematic review

Resumen La enfermedad inflamatoria intestinal (EII) incluye la enfermedad de Crohn (EC) y la colitis ulcerosa (CU). El tratamiento farmacológico en la EII presenta pérdida de eficacia y efectos secundarios, por esta razón es necesario el planteamiento de estrategias alternativas, como la práctica de actividad física (AF), como coadyuvante terapéutico. El propósito de este estudio fue evaluar la efectividad de las intervenciones de AF como herramienta para aumentar la condición física, la calidad de vida relacionada con la salud (CVRS) y mejorar la sintomatología en pacientes con EC y CU, identificando el componente de AF óptimo. Se realizó una revisión mediante una búsqueda en las bases electrónicas de datos Medline (PubMed), SciELO y Cochrane Library Plus, que incluyó ensayos controlados aleatorios de los últimos 10 años que relacionaran la EII y la AF, hasta el 31 de enero de 2022. Se incluyeron 4 estudios con un total de 133 pacientes. La realización de AF de pacientes con EII (CU y EC) aumentó (p>0.05) la capacidad física, la masa muscular esquelética, la densidad mineral ósea y la CVRS, incrementando significativamente (p<0,05) el estado de ánimo. Además, disminuyó significativamente (p<0,05) la inflamación intestinal y las manifestaciones extraintestinales. Se observó una tendencia de reducción (p>0,05) de la fatiga, la tensión arterial y la restauración de la microbiota. La AF moderada y realizada regularmente durante un mínimo de 8 semanas, favorece la mejoría del paciente con EII a nivel físico, psicológico, la CVRS y la sintomatología.

Abstract Inflammatory bowel disease (IBD) includes Crohn's disease (CD) and ulcerative colitis (UC). Pharmacological treatment in IBD presents a loss of efficacy and side effects, inviting to consider alternative strategies, such as the practice of physical activity (PA), as a therapeutic adjuvant. The purpose of this review was to evaluate the effectiveness of PA interventions as a tool to increase physical fitness, and health-related quality of life (HRQoL) and improve the symptomatology in patients with CD and UC, identifying the optimal PA component. The review was performed, by searching the electronic databases Medline (PubMed), SciELO, and Cochrane Library Plus, including randomized controlled trials from the last 10 years that related to IBD and PA, until January 31, 2022. We found four studies with a total of 133 patients. The performance of PA in patients with IBD (UC and CD) increases (p>0.05) physical capacity, skeletal muscle mass, bone mineral density, and HRQoL, significantly (p<0.05) increasing mood. In addition, it significantly (p<0.05) decreases intestinal inflammation and extraintestinal manifestations. A trend of reduction (p>0.05) of fatigue, blood pressure, and microbiota restoration was observed. Moderate PA and performed regularly for a minimum of eight weeks, favors the improvement of the IBD patient at the physical, psychological, HRQoL, and symptomatology levels.

Biodegradable Poly(ε-Caprolactone) Active Films Loaded with MSU-X Mesoporous Silica for the Release of α-Tocopherol.

In this study, new active PCL (poly(ε-caprolactone)) films containing α-tocopherol (TOC) and MSU-X mesoporous silica were prepared by melt blending. The studied additives were directly incorporated into the polymer matrix or by impregnating TOC into MSU-X silica (PCL-IMP). Thermal, optical, oxygen and water barrier properties as well as oxidation onset parameters, were studied. Films containing MSU-X and/or TOC showed a significant increase in oxidative onset temperature (OOT) and oxidative induction time (OIT), improving thermal stability against materials oxidation by the addition of mesoporous silica and TOC into the polymer matrix. In addition, the effect of MSU-X addition on the migration behaviour of α-tocopherol from active films was investigated at 40 °C using 50% (v/v) ethanol as fatty food simulant, showing PCL-IMP films the lower release content and diffusion coefficient (3.5 × 10-15 cm2 s-1). Moreover, radical scavenging (DPPH and ABTS) and antibacterial activity against E. coli and S. aureus were favoured by the release of α-tocopherol in the developed films. The obtained results have demonstrated the potential of the new PCL-based active formulations for TOC controlled release in antioxidant and antibacterial food packaging applications.

Combined effect of cellulose nanocrystals, carvacrol and oligomeric lactic acid in PLA_PHB polymeric films.

Biodegradable multicomponent films based on poly(lactic acid) (PLA) and poly(3-hydroxybutyrate) (PHB) plasticized with oligomeric lactic acid (OLA), reinforced with synthetized cellulose nanocrystals (CNC) and modified by a natural additive with antimicrobial activity (carvacrol) were formulated and processed by extrusion. Morphological, mechanical, thermal, migration and barrier properties were tested to determine the effect of different components in comparison with neat poly(lactic acid). Results showed the positive effect of CNC in the five components based films, with the increase of the Young's modulus of the PLA_PHB_10Carv_15OLA, associated with an increase in the elongation at break (from 150% to 410%), by showing an OTR reduction of 67%. Disintegrability in compost conditions and enzymatic degradation were tested to evaluate the post-use of these films. All formulations disintegrated in less than 17 days, while proteinase K preferentially degraded the amorphous regions, and crystallinity degree of the nanocomposite films increased as a consequence of enzyme action.

Agaricus bisporus and its by-products as a source of valuable extracts and bioactive compounds.

Edible mushrooms constitute an appreciated nutritional source for humans due to their low caloric intake and their high content in carbohydrates, proteins, dietary fibre, phenolic compounds, polyunsaturated fatty acids, vitamins and minerals. It has been also demonstrated that mushrooms have health-promoting benefits. Cultivation of mushrooms, especially of the most common species Agaricus bisporus, represents an increasingly important food industry in Europe, but with a direct consequence in the increasing amount of by-products from their industrial production. This review focuses on collecting and critically investigating the current data on the bioactive properties of Agaricus bisporus as well as the recent research for the extraction of valuable functional molecules from this species and its by-products obtained after industrial processing. The state of the art regarding the antimicrobial, antioxidant, anti-allergenic and dietary compounds will be discussed for novel applications such as nutraceuticals, additives for food or cleaning products.