Prevention of stress-induced erosive gastritis by parenteral administration of arachidonic acid

Exploring Cytokines as Potential Target in Peptic Ulcer Disease: A Systematic Update

Peptic ulcer disease (PUD) is a widespread condition that affects millions of people each year, with an incidence rate of 0.1%-1.5%, and has a significant impact on human health. A range of stimuli, such as Helicobacter pylori, non-steroidal anti-inflammatory drugs, hyperacidity, stress, alcohol, smoking, and idiopathic disease states, can produce a sore in the gastrointestinal mucosal layer. For individuals infected with H. pylori, 2%-3% remain asymptomatic throughout their life. Although PUD treatments are available, genetic variations occurring in individuals because of geographical dissimilarity and antibiotic resistance pose limitations. Specifically, inflammatory cytokine gene polymorphisms have received immense attention in recent years because they appear to affect the severity and duration of stomach inflammation, which is induced by H. pylori infection, contributing to the initiation of PUD. In such a context, in-depth knowledge of interleukins may aid in the discovery of new targets and provide precautionary approaches for the treatment of PUD. This review aims to give insights into the importance of several interleukins that cognate with PUD and contribute to ulcer progression or healing by activating or dampening the host immunity. Furthermore, the available targets with clinical evidence have been explored in this review.

Mesenchymal stem cell-mediated immunomodulation in cell therapy of neurodegenerative diseases

Dysfunction of immune responses has been identified to involve in the pathogenesis of various neurodegenerative diseases. Abnormal activation of glia cells and/or infiltration of peripheral adaptive immune cells always sustains neuroinflammation and the disease progression. Obviously, the regulation of neuroinflammation has become a potential therapeutic strategy against neurodegenerative diseases. Mesenchymal stem cells (MSCs) exhibit complex interactions with various immune cells including T cells, macrophages and especially resident glia cells in the central nervous system. In response to tissue injury signals, MSCs adopt specific phenotype to suppress or promote immune responses depending on the inflammatory microenvironment they reside. Therefore, manipulation of MSCs may hold great potentials to improve MSC-based therapy on neurodegenerative diseases. Here we review MSC-mediated immunomodulation in cell therapy of neurodegenerative diseases, providing fundamental information for guiding appropriate applications of MSCs in clinical settings.

Effect of psychogenic stress on gastrointestinal function

This review summarizes the studies published over the last twenty years on the effects of psychogenic stress on gastrointestinal function, using animal models. The effects of stress on gastric ulceration have received wide attention and the central and local mechanisms of mucosal damage have been, for the most part, clearly delineated. In comparison, relatively few studies have focused on the impact of stress on intestinal and colonic physiology, even though its influence on intestinal motility, mucosal permeability and inflammation has been established. More work is necessary in this field, especially considering the importance of irritable bowel syndrome in modern society.

Gastrointestinal surface protection and mucosa reconditioning

BACKGROUND

There is increasing evidence that preservation of the ecology of the gastrointestinal tract and the surface protection system--surfactants, mucus, and fiber--is important for the outcome in postoperative trauma patients, patients after bone marrow and liver transplantation, and patients with HIV or AIDS. Approximately 50% of the nourishment of the small intestine and > 80% of the nourishment of the large intestine comes from the lumen. This is especially deleterious to the large intestine. Within less than a week of intestinal starvation--even in the presence of intense parenteral nutrition--a mucosal atrophy is observed, promoting translocation of potentially pathogenic microorganisms. Enteral nutrition is crucial to the outcome in many of these conditions. If however, such a nutrition is based on simple carbohydrates, peptides, amino acids, or fatty acids, most of the nutrition administered will be absorbed in the upper gastrointestinal tract. Complex fibers and proteins can be regarded as nutrients especially destined to the lower gastrointestinal tract. They are fermented by the probiotic flora, normally colonizing the colonic mucosa, and the necessary nutrients: short-chain fatty acids and amino acids such as arginine and glutamine are produced at the level of the colonic mucosa. Careless antibiotic treatment reduces or eliminates this flora, induces local mucosal starvation, and makes the patients vulnerable to opportunistic infections and microbial intestinal translocation.

METHODS AND RESULTS

In this review the role of the different ingredients of the surface protection system are discussed. A program to recondition the intestines, particularly the colonic mucosa by resupply of species-specific lactobacilli, surfactants, amino acids (especially glutamine), and oat fiber (beta-glucans) is suggested. Extensive experience in animal models and early experience in a patient population are summarized and discussed. Oat has been chosen as a substrate for fermentation because it contains 100 times more of membrane lipids (surfactants) than any other food, has a favorable amino acid pattern (rich in glutamine), and is rich in water-soluble, fermentable-fiber beta-glucans. More than 1000 isolates of human-specific lactobacilli have been studied. Some strains, especially those of plantarum type, have proven effective in colonizing the colonic mucosa, suppressing the potentially pathogenetic flora, and may have other probiotic effects as well.

CONCLUSION

A totally new enteral formula has been designed based on probiotic bacteria and fiber and aimed at colonizing the intestinal mucosa with a local probiotic effect and fermentation of fiber.