Inflammatory bowel disease: clinical aspects and treatments

Oral health in inflammatory bowel disease: the overlooked impact and the potential role of salivary calprotectin

BACKGROUND

Inflammatory Bowel Disease (IBD), a chronic condition characterized by gastrointestinal inflammation, is influenced by genetic and environmental factors. Emerging evidence suggests a "mouth-gut axis," with the oral cavity reflecting extra-intestinal manifestations of IBD. This study evaluated the oral health status of IBD patients and the potential of salivary calprotectin (SCP) as a biomarker for assessing IBD activity and oral health.

METHODS

Oral health was assessed in 100 IBD patients [60 with Crohn's disease (CD) and 40 with ulcerative colitis (UC)] and 14 controls. Evaluations included the Decayed, Missing, and Filled Teeth (DMFT) Score, Periodontal Diagnosis and the need for dental or prosthetic treatment. Saliva and stool samples were collected to measure SCP and faecal calprotectin (FCP) levels using the Elia Calprotectin 2 Test. IBD activity was evaluated with FCP, the Harvey-Bradshaw Index for CD, and the Partial Mayo Score for UC.

RESULTS

The DMFT index mean was comparable between IBD patients (mean 7.99, SD 7.73) and controls (mean 10.00, SD 6.49). However, periodontal disease was significantly more prevalent in IBD patients (57% in CD, 70% in UC) than in controls (29%), with severe cases (stages III/IV) more frequent in IBD. Additionally, 89% of IBD patients required dental treatment, and 39% needed prosthetic rehabilitation. SCP levels showed no significant correlation with disease activity or oral health status, while FCP correlated with C-reactive protein and erythrocyte sedimentation rate.

CONCLUSIONS

This study underscores the need for improved oral health management in IBD patients and suggests that SCP may not be a reliable biomarker for monitoring IBD or periodontal disease.

CLINICAL TRIAL NUMBER

Not applicable.

Management of Atherosclerotic Cardiovascular Risk in Inflammatory Bowel Disease: Current Perspectives

Inflammatory bowel disease (IBD) is a complex condition characterized by inflammation of the gastrointestinal system, encompassing Crohn's disease and ulcerative colitis. Patients diagnosed with IBD have an increased risk of atherosclerotic cardiovascular disease. This heightened risk can be attributed to a combination of mechanisms, including traditional risk factors, chronic inflammation, intestinal dysbiosis, increased risk of thrombosis, and the use of certain medications such as corticosteroids. There are significant gaps in current knowledge, particularly regarding the management of risk factors and the use of medications for cardiovascular disease prevention. Similarly, the cardiovascular effects of specific IBD therapies, particularly the newer ones, are not yet fully understood. This review focuses on the epidemiological evidence linking IBD with cardiovascular risk factors and cardiovascular disease. It describes the potential pathophysiological mechanisms underlying this association and examines the challenges involved in accurately assessing cardiovascular risk in these patients, including the utility of complementary tools such as subclinical atherosclerosis detection. Additionally, we consider the potential therapeutic implications for managing these patients. Finally, this review also underscores the importance of multidisciplinary collaboration. Effective teamwork among gastroenterologists, cardiologists, and general practitioners is essential for providing comprehensive care to patients with IBD.

Saudi consensus guidance for the diagnosis and management of inflammatory bowel disease in children and adolescents

ABSTRACT

The management of inflammatory bowel disease (IBD) in children and adolescents is challenging. Clear evidence-based guidelines are required for this population. This article provides recommendations for managing IBD in Saudi children and adolescents aged 6-19 years, developed by the Saudi Ministry of Health in collaboration with the Saudi Society of Clinical Pharmacy and the Saudi Gastroenterology Association. All 57 guideline statements are based on the most up-to-date information for the diagnosis and management of pediatric IBD.

Immunomodulatory effects of calorie restriction and its mimetics: A new potential therapeutic approach for autoimmune diseases

Calorie restriction (CR) is a well known intervention associated with multifaceted anti-aging and pro-longevity health benefits. It induces complex physiological cellular and molecular adaptations, resulting in the fine-tuning of metabolic and immune responses in both homeostatic and diseased states. It has thus been extensively studied both preclinically and clinically, uncovering its therapeutic potential against inflammatory conditions, particularly autoimmune diseases. CR mimetics (CRMs), that is, molecules that mimic CR's effects, have also been widely investigated to counteract inflammatory states associated with numerous diseases, including autoimmunity. However, a comprehensive overview of how CR and CRMs modulate different aspects of immune responses, thereby potentially modifying autoimmunity, is still lacking. Here, we reviewed the latest progress on the impacts of CR and CRMs on the immune system and the current evidence on their potential translation in the clinical management of people with autoimmune diseases. First, we summarized different types of CR and CRMs and their main mechanisms of action. We next reviewed comprehensively how CR and CRMs modulate immune cells and discussed up-to-date preclinical and clinical advances in using CR and CRMs in the context of some of the most common autoimmune diseases. Finally, challenges faced in CR-related research and its translation into the clinic are discussed. SIGNIFICANCE STATEMENT: Calorie restriction (CR) encompasses various approaches for daily or intermittent reduction in calorie intake while maintaining adequate nutrient intake. It acts through cell-intrinsic and -extrinsic pathways to modulate immune cell functions. CR is emerging as a strategy for autoimmune disease management. CR's effects could be partially mimicked by molecules called CR mimetics, which are proposed to achieve CR's effects without reducing food intake. CR and CR mimetics have been tested as promising potential therapeutics in preclinical and clinical autoimmune disease studies.

Parabacteroides goldsteinii Alleviates Intestinal Inflammation in Dextran Sulfate Sodium-Treated Pigs

Intestinal inflammation in piglets leads to diarrhea, decreased immune function, and dysbiosis of the gut microbiota. Probiotics are widely recognized and used in the prevention and control of enteritis in piglets. Parabacteroides goldsteinii (PG) is a probiotic, and there are few reports on the anti-inflammatory properties of this in piglets. Therefore, this study selected 10 Duroc × Landrace × Yorkshire (DLY) piglets aged 50 days and randomly divided them into a control group (CT group) and an experimental group (PG group) for a 14-day experiment. During days 1-7, the PG group established an inflammation model by gavage with 4% dextran sulfate sodium (DSS). The results showed that DSS increased the content of IL-6 and IL-8 (p < 0.05), while it decreased the content of IL-10 in the serum (p < 0.05), For days 8-14, the DSS-treated piglets were administered a 7.9 × 108 CFU/mL PG suspension via gavage. The content of IL-6, IL-8, and IL-10 in the piglets did not differ between the CT and PG groups (p > 0.05). Some beneficial bacteria, such as Lactobacillales and Butyricimonas, were significantly enriched in the PG group (p < 0.05). The PG group showed lower alpha diversity (p < 0.05), and the metabolic pathways exhibited the highest abundance in the KEGG functional prediction analysis. The above studies confirm that PG alleviates intestinal inflammation and changes the gut microbial composition.

SATB2 Loss Is a Sensitive Biomarker for Dysplasia in Inflammatory Bowel Disease

Loss of SATB2 expression has emerged as a promising biomarker for dysplasia in inflammatory bowel disease (IBD), but its sensitivity and specificity remain unclear. We retrospectively evaluated immunohistochemical (IHC) staining of SATB2 and p53 in colorectal biopsies from 37 IBD patients (25 men and 12 women; median age: 48 years) with suspected dysplasia. The cohort included 26 ulcerative colitis (70%) and 11 Crohn's disease (30%). Fourteen patients (38%) developed IBD-associated invasive carcinoma, and 18 (49%) had persistent dysplasia on follow-up. Histologic review identified 80 lesions initially diagnosed as negative (16%), indefinite (39%), low-grade (36%), and high-grade (9%) dysplasia. IHC revealed aberrant p53 in 35 lesions (44%) and SATB2 loss in 42 lesions (53%), with 19 (24%) showing both abnormalities. Reappraisal of diagnoses combining histology and IHC reclassified lesions into indefinite (20%), low-grade (63%), and high-grade (17%) dysplasia. Lesions with SATB2 loss alone were more frequently of lower grade (P = .003). Dysplasia types included 15 conventional dysplasia (19%) and 65 nonconventional dysplasia (81%). The rates of p53 abnormality, SATB2 loss, and their combination were similar in nonconventional dysplasia (45%, 55%, and 75%, respectively) and conventional dysplasia (40%, 47%, and 67%, respectively) and comparable between cancer patients (50%, 56%, and 74%, respectively) and noncancer patients (39%, 50%, and 72%, respectively). Missed dysplasias in cancer patients were all nonconventional, and lesions with p53 abnormality more likely progressed to cancer (P = .002). In conclusion, SATB2 loss is a sensitive marker for IBD-associated dysplasia. Combined use of SATB2 and p53 IHC improves dysplasia detection and reduces false-negative diagnosis, supporting its application into routine diagnostic practice.

Circadian Rhythm Dysregulation in Inflammatory Bowel Disease: Mechanisms and Chronotherapeutic Approaches

Inflammatory bowel disease (IBD), comprising ulcerative colitis (UC) and Crohn's disease (CD), is characterized by chronic intestinal inflammation. Recent research has highlighted the significant interplay between IBD pathogenesis and circadian rhythms. This review synthesizes current evidence regarding circadian regulation in IBD, covering three main areas: (1) circadian rhythms in intestinal physiology, (2) circadian disruption patterns in IBD patients, and (3) the role of clock genes in IBD pathogenesis. We discuss how these findings may inform novel chronotherapeutic approaches for IBD treatment. Future research directions that could facilitate translation of chronobiological insights into clinical applications are also explored.

The impact of inflammatory bowel disease on dementia risk: a current systematic review and meta-analysis

Emerging evidence indicates that inflammatory bowel disease (IBD) and dementia may share underlying pathological mechanisms and risk factors. However, the association between a prior IBD diagnosis and the subsequent risk of dementia remains largely unexplored. We conducted a comprehensive search of PubMed, Embase, and the Cochrane Library up to February 4, 2025, without language restrictions. Two reviewers independently extracted data and evaluated methodological quality and risk of bias. Observational studies comparing dementia risk in IBD and non-IBD populations were included. Pooled effect estimates for odds ratios (OR) were calculated using random-effects models. A total of 10 population-based studies, involving 7,895,339 participants (269,387 with IBD), were included. Meta-analysis of eight studies showed a significant association between IBD and dementia risk (OR 1.17, 95% CI: 1.08-1.27, P = 0.0001). However, IBD was not associated with an increased risk of Alzheimer's disease (AD) (OR 1.15, 95% CI: 0.98-1.36, P = 0.09). Stratified analysis by IBD type revealed a positive association between both ulcerative colitis (UC) and Crohn's disease (CD) and dementia risk (UC: OR 1.15, 95% CI: 1.05-1.25, P = 0.002, I² = 81%; CD: OR 1.26, 95% CI: 1.11-1.43, P = 0.0003, I² = 53%). This study identifies a significant correlation between IBD and dementia, suggesting that IBD patients have an elevated risk of developing dementia. However, current evidence is insufficient to establish a causal relationship. Further research should explore whether effective IBD treatments can mitigate this risk and elucidate the underlying pathophysiological mechanisms connecting these conditions.

Long-acting injectable nanoparticle formulation for sustained release of anti-TNF-α antibody therapeutic in ulcerative colitis treatment

Inflammatory bowel diseases (IBD) are chronic, remitting, and relapsing conditions of the gastrointestinal tract with incompletely elucidated etiology. The anti-TNF-α mAbs represent one of aflash nanocomplexation and flash nanoprecipitation process, resulting in particles with a narrow size distribution and tunable release profile, with the longest in vitro release lasting over four months. These mAb-releasing NPs are then incorporated into hyaluronic acid hydrogel microparticles (MPs) to enhance tissue retention, thus extending the duration of mAb release in vivo. A single i.m. injection of the LAI can maintain the serum mAb level above the therapeutically effective concentration for over 100 days in healthy mice. In a 9-week study using a dextran sulfate-induced chronic colitis model, the anti-TNF-α LAI formulation demonstrates substantial therapeutic efficacy and a better safety profile than free mAb injections. This work demonstrates the effectiveness of this LAI system in maintaining a persistent serum mAb level and its potential as a versatile, safer, and effective delivery system for antibody therapeutics.

The Future of Telehealth-Based Psychological and Mind-Body Interventions for People With Inflammatory Bowel Disease: A Systematic Review

OBJECTIVES

People with inflammatory bowel disease (IBD) suffer from relapsing and remitting symptoms of gastrointestinal upset and are at substantial risk of experiencing comorbid mental distress symptoms. We aimed to conduct a systematic review of the evidence surrounding mental health telehealth interventions for IBD patients.

METHODS

We searched EMBASE, MEDLINE, CINAHL, Scopus, and PsychINFO to systematically identify studies that evaluated the feasibility and acceptability of telehealth-based psychological and mind-body interventions to treat the physical and psychosocial symptoms of IBD patients. Predefined data extraction variables included descriptions of the interventions, participation and dropout rates, and preliminary effectiveness. The data was synthesized using tabular data displayed for quantitative variables and presented as narrative summaries to allow for comparison.

RESULTS

Seven studies including 313 participants met our criteria and were included in the review. All studies evaluated distinct interventions. Participation rates ranged 32.4%-75%, and drop-out rates ranged 0%-33%. Most participants reported improvements in their quality of life and mental symptoms, and high satisfaction within their interventions. The authors of all included studies concluded that their interventions were feasible.

CONCLUSIONS

The evidence to support using telehealth-based psychological and mind-body interventions to support individuals with IBD is limited, but promising. Interventions were positively evaluated, strongly adhered to, and preliminary effectiveness data suggest that these interventions could improve the psychosocial well-being of people with IBD. Future research is warranted to assess the effectiveness of these interventions and to evaluate the barriers to integrating them into IBD care.

Collagen Peptides and Saccharomyces boulardiiCNCM I-745 Attenuate Acetic Acid-Induced Colitis in Rats by Modulating Inflammation and Barrier Permeability

Ulcerative colitis (UC) is an inflammatory bowel disease characterized by recurrent episodes of inflammation and tissue damage, with limited treatment options. This study aimed to investigate the effects of collagen peptides and Saccharomyces boulardii on acetic acid (AA)-induced colitis. Thirty-six male Sprague-Dawley rats were randomly divided into the following four groups: normal control (NC), colitis control (CC), collagen peptide (CP; 0.6 g/kg/day), and S. boulardii (SB; 250 mg/day). Colitis was induced by an intrarectal administration of AA in all groups except NC, and treatments were administered daily for 7 days. The therapeutic effects were evaluated by assessing the disease activity index (DAI), colon mass index, macroscopic and microscopic tissue damage, histopathological changes, zonula occludens (ZO)-1 protein expression, and myeloperoxidase (MPO) activity. The results showed that CP and SB treatments substantially alleviated DAI scores (p < 0.05) and reduced the colon mass index. Colon macroscopic and microscopic damages improved compared to the CC group (p < 0.01). Histologically, both treatments reduced inflammatory cell infiltration, crypt damage, and ulceration, with CP showing a slightly more pronounced effect. Immunohistochemical analysis revealed significant restoration of ZO-1 protein expression in the treated groups, indicating improvement in intestinal barrier integrity (p < 0.01). Furthermore, MPO activity was reduced in both CP and SB groups, significantly in the SB group (p < 0.01). These findings are consistent with previous studies that highlight the anti-inflammatory and barrier-enhancing effects of collagen peptides and probiotics in UC models.

How Does Inflammatory Bowel Disease Impact Outcomes and Costs of Care Following Primary 1- to 2-level Lumbar Fusion for Degenerative Lumbar Disease?

STUDY DESIGN

Retrospective study.

OBJECTIVE

The purpose of this study was to determine whether IBD in patients with degenerative lumbar changes undergoing primary 1-2LF is associated with higher rates of (1) in-hospital length of stay, (2) medical complications, (3) readmissions, and (4) costs of care.

SUMMARY OF BACKGROUND DATA

In the United States, the prevalence of inflammatory bowel disease (IBD) has increased concurrently with an aging population with degenerative disk changes. In these patients, primary 1- to 2-lumbar fusion (1-2LF) is a common procedure to resolve serious complications of the spine. Studies comparing these patient demographics to hospital lengths of stay, postoperative complications, readmission rates, and costs of care are limited in the literature.

METHODS

The inclusion criteria consisted of patients with IBD who underwent 1-2LF, using a 90-day surveillance period, postoperatively. This 90-day surveillance period was used to measure the length of hospital stay, rates of medical complications, rates of readmissions, and overall costs of care. The IBD cohort was matched against a case-matched cohort group.

RESULTS

Patients in the study group had significantly longer in-hospital lengths of stay. In addition, patients in the study group had significantly higher incidence and odds of developing postoperative medical complications within 90 days. Also, study group patients had significantly higher readmission rates. Finally, patients in the study group had significantly higher costs of care than their case-matched cohort.

CONCLUSIONS

This study demonstrated that patients with IBD and degenerative lumbar disease are burdened with longer in-hospital lengths of stay, rates of postoperative medical complications, rates of readmission, and costs of care after undergoing primary 1-2LF.

The emerging role of honeysuckle flower in inflammatory bowel disease

Crohn's disease (CD) and ulcerative colitis (UC), referred to as inflammatory bowel disease (IBD), pose considerable challenges in treatment because they are chronic conditions that easily relapse. The occurrence of IBD continues to rise in developing countries. Nonetheless, the existing therapies for IBD have limitations and fail to address the needs of the patients thoroughly. There is an increasing need for new, safe, and highly effective alternative medications for IBD patients. Traditional Chinese Medicine (TCM) is employed in drug development and disease management due to its wide-range of biological activities, minimal toxicity, and limited side effects. Extensive research has shown that certain TCM exhibits significant therapeutic benefits for IBD treatments. Honeysuckle (Lonicera japonica) was used in TCM research and clinical settings for the treatment of IBD. Bioactive metabolites in L. japonica, such as luteolin, quercetin, cyanidin, chlorogenic acid (CGA), caffeic acid (CA), and saponin, exhibit significant therapeutic benefits for managing IBD. The honeysuckle flower is a potential candidate in the treatment of IBD due to its anti-inflammatory, immune system-regulating, and antioxidant qualities. This paper reviews the metabolites of the honeysuckle flower as a candidate for the treatment of IBD. It discusses the fundamental mechanism of L. japonica and the potential of its bioactive metabolites in the prevention and treatment of IBD.

Reduction of colitis in mice by chemically programmed supramolecular nanoassemblies of vitamin-lipid conjugates

Inflammatory bowel disease (IBD) is a relapsing disorder characterized by uncontrolled chronic inflammation of the gastrointestinal tract, posing a significant therapeutic challenge owing to the limited efficacy and undesirable side effects of current therapeutic options. A key pathological hallmark of IBD is the excessive production of reactive oxygen species (ROS). Hence, therapeutic strategies aimed at reducing ROS levels are promising for relieving these inflammatory conditions. Vitamin C-a natural nutrient for the human body-is well known for its potent antioxidant effects. However, the clinical development of vitamin C as a therapeutic drug has been hindered by its poor stability, rapid metabolism, and inadequate tissue accumulation. Herein, we report that the bioavailability of vitamin C can be enhanced by chemically reprogramming it with a small panel of long-chain fatty acids that aid in the aqueous self-assembly of the resulting drug conjugates to create self-deliverable nanoassemblies, enhancing their inflammation disease-oriented delivery and cellular uptake. In mice with dextran sulfate sodium-induced colitis, the optimal vitamin C-lipid nanoassemblies preferentially accumulated in inflamed colonic tissues following systemic administration and substantially ameliorated disease severity. We extended this strategy to incorporate the clinically approved glucocorticoid budesonide into the vitamin C nanosystem, facilitating a synergistic combination. In the chronic colitis model, the combination treatment reduced inflammation without compromising global immunity. Mechanistically, the treatment modulated the intestinal inflammatory microenvironment and altered the immune cell landscape, partly through regulation of the gut microbiome. Given its anticipated negligible side effects, this novel nanoassembly platform leveraging small-molecule lipidation may become a promising therapeutic for treating various inflammatory diseases.

Sexual Health in Women with Inflammatory Bowel Diseases: A Narrative Review

Background/Objectives: Inflammatory bowel diseases (IBDs), such as Crohn's disease and ulcerative colitis, have a significant impact on overall well-being. Sexual health, a critical component of overall well-being, is often compromised in individuals with IBD, especially in women, owing to physical, psychological, and social factors. This narrative review aims to synthesize the fragmented existing evidence on the impact of IBD on women's sexual health by examining clinical manifestations along with patients' perceptions and lived experiences. Methods: Five databases (CINAHL Complete, Medline, APA PsycInfo, APA PsycArticles, and Psychology and Behavioral Sciences Collection) were searched using keywords related to IBD, sexual health, and women's experiences. Fifteen studies that met the predefined inclusion and exclusion criteria were analyzed. Results: Women with IBD often perceive their bodies as "damaged" or "mutilated," which profoundly affects their self-esteem and sexual satisfaction. Physically, debilitating symptoms such as abdominal pain, diarrhea, and chronic fatigue limit sexual desire and intimacy. Psychological factors, including anxiety, depression, and negative body image, exacerbate these challenges, and compromise emotional well-being and intimate relationships. Social stigma further isolates patients, making it more difficult for them to communicate their sexual needs to both partners and healthcare providers. Strategies such as psychological support, health education, and promoting open communication with partners emerge as promising avenues to improve sexual health and quality of life. Conclusions: IBD profoundly affects women's sexual health by intertwining physical, psychological, and social challenges. A holistic and personalized clinical approach that incorporates sexual well-being into routine care is essential to improve patients' quality of life.

Comparative analysis of Parkinson's and inflammatory bowel disease gut microbiomes reveals shared butyrate-producing bacteria depletion

Epidemiological studies reveal that inflammatory bowel disease (IBD) is associated with an increased risk of Parkinson's disease (PD). Gut dysbiosis has been documented in both PD and IBD, however it is currently unknown whether gut dysbiosis underlies the epidemiological association between both diseases. To identify shared and distinct features of the PD and IBD microbiome, we recruited 54 PD, 26 IBD, and 16 healthy control individuals and performed the first joint analysis of gut metagenomes. Larger, publicly available PD and IBD metagenomic datasets were also analyzed to validate and extend our findings. Depletions in short-chain fatty acid (SCFA)-producing bacteria, including Roseburia intestinalis, Faecalibacterium prausnitzii, Anaerostipes hadrus, and Eubacterium rectale, as well depletion in SCFA-synthesis pathways were detected across PD and IBD datasets, suggesting that depletion of these microbes in IBD may influence the risk for PD development.

Older Adults with Inflammatory Bowel Disease Epidemiology in the United States: 2000-2021

BACKGROUND

As the United States population ages, the incidence and prevalence of inflammatory bowel disease (IBD) among older adults are on the rise.

AIMS

This study provides updated estimates of the IBD burden in older adults and examines changes from 2000 to 2021.

METHODS

We analyzed data on IBD incidence, prevalence, and disability-adjusted life years (DALYs) in older adults (> 70 years) in the United States from the Global Burden of Disease Study 2021, stratified by sex and state. Using the Joinpoint regression model, we evaluated age-standardized rate changes from 2000 to 2021.

RESULTS

The study estimated 11,250 new cases, 180,880 prevalent cases, and 80,410 DALYs from IBD in older adults in the United States in 2021. In 2021, older adults-onset represented 15% of the total IBD population in the United States, a 3% increase since 2000. Between 2000 and 2021, the incidence (Annual percent change [APC]: 0.58%, 95%CI 0.50 to 0.66%) and DALYs rates (APC: 0.34%, 95%CI 0.07 to 0.62%) increased, while the prevalence rates remained stable. Incidence rate increased at a higher extent in older adults-onset IBD in females compared to that of males. Forty-seven states experienced increased older adults-onset IBD incidence rates during this period.

CONCLUSION

From 2000 to 2021, the incidence and disability rates of older adults-onset IBD increased in the United States. Although older males initially had higher incidence rates, the rates have disproportionately increased among older females. The proportion of older adults-onset IBD cases and related disability has also grown, highlighting the urgent need for strategies to address the rising IBD burden in older adults.

Antioxidant Activity and Anti-Inflammatory Effect of Blood Orange By-Products in Treated HT-29 and Caco-2 Colorectal Cancer Cell Lines

Blood orange peel flour (BO-pf)-a by-product of the citrus supply chain-still contains bioactive molecules with known health benefits, such as antiradical scavenging activity or an antiproliferative activity regarding tumors. In vitro studies have demonstrated that orange polyphenols showed potential involvement in necroptosis. In addition to previous research, we tested BO-pf on two colorectal cancer cell lines. Using HT29 and Caco2 cells, our experiments confirmed the regulation of inflammasome expression. They provided valuable insights into how BO-pf influences the cancer cell features (i.e., viability, proliferation, and pro- and anti-inflammatory activity). Notably, BO-pf extract is a rich source of polyphenolic compounds with antioxidant properties. Western blot and real-time PCR analyses showed that treatment with BO-pf extract demonstrated beneficial effects by influencing the expression of both pro-inflammatory cytokines (IL-1β, IL-6) through the modulation of the TLR4/NF-kB/NLRP3 inflammasome signaling. Moreover, the results of this study demonstrate that BO-pf extracts can enhance the expression of anti-inflammatory cytokines, such as IL-10 and TGFβ, suggesting that BO-pf extracts may represent a promising functional ingredient to counteract the intestinal inflammatory responses involved in IBD.

Gut commensals-derived succinate impels colonic inflammation in ulcerative colitis

Gut microbiota-derived metabolites play a crucial role in modulating the inflammatory response in inflammatory bowel disease (IBD). In this study, we identify gut microbiota-derived succinate as a driver of inflammation in ulcerative colitis (UC) by activating succinate-responsive, colitogenic helper T (Th) cells that secrete interleukin (IL)-9. We demonstrate that colitis is associated with an increase in succinate-producing gut bacteria and decrease in succinate-metabolizing gut bacteria. Similarly, UC patients exhibit elevated levels of succinate-producing gut bacteria and luminal succinate. Intestinal colonization by succinate-producing gut bacteria or increased succinate availability, exacerbates colonic inflammation by activating colitogenic Th9 cells. In contrast, intestinal colonization by succinate-metabolizing gut bacteria, blocking succinate receptor signaling with an antagonist, or neutralizing IL-9 with an anti-IL-9 antibody alleviates inflammation by reducing colitogenic Th9 cells. Our findings underscore the role of gut microbiota-derived succinate in driving colitogenic Th9 cells and suggesting its potential as a therapeutic target for treating IBD.

Culture-based characterization of gut microbiota in inflammatory bowel disease

Inflammatory bowel disease (IBD) is characterized by disruptions in the gut microbiome. While most studies on gut dysbiosis in IBD rely on sequencing-based methods, we employed a streamlined culturomics approach to obtain a more comprehensive understanding of gut microbiota imbalance in patients with IBD that may not be captured by sequencing alone. A total of 367 bacteria were identified at the species level, including 211 species from ulcerative colitis patients, 164 species from Crohn's disease (CD) patients, and 263 species from healthy individuals. Consistent with our 16S rRNA gene amplicon sequencing results, a significant decrease in microbial diversity and a severe imbalance, especially in CD patients, were also observed in the culture-based analysis. Our culturomics approach provided additional insights, highlighting dysbiosis in unique anaerobic and Gram-negative species in CD patients. Moreover, species-level findings for Bifidobacterium and Enterobacterales emphasized specific species expansions in IBD patients. Notably, Mediterraneibacter gnavus, Thomasclavelia ramosa, Parabacteroides merdae, and Collinsella aerofaciens are of particular clinical interest due to their correlation with inflammatory biomarkers. This comprehensive analysis underscores the value of integrating a culture-based approach with a genome-based approach to provide complementary insights and therapeutic targets in IBD.

Dual graph-embedded fusion network for predicting potential microbe-disease associations with sequence learning

Recent studies indicate that microorganisms are crucial for maintaining human health. Dysbiosis, or an imbalance in these microbial communities, is strongly linked to a variety of human diseases. Therefore, understanding the impact of microbes on disease is essential. The DuGEL model leverages the strengths of graph convolutional neural network (GCN) and graph attention network (GAT), ensuring that both local and global relationships within the microbe-disease association network are captured. The integration of the Long Short-Term Memory Network (LSTM) further enhances the model's ability to understand sequential dependencies in the feature representations. This comprehensive approach allows DuGEL to achieve a high level of accuracy in predicting potential microbe-disease associations, making it a valuable tool for biomedical research and the discovery of new therapeutic targets. By combining advanced graph-based and sequence-based learning techniques, DuGEL addresses the limitations of existing methods and provides a robust framework for the prediction of microbe-disease associations. To evaluate the performance of DuGEL, we conducted comprehensive comparative experiments and case studies based on two databases, HMDAD, and Disbiome to demonstrate that DuGEL can effectively predict potential microbe-disease associations.

Intestinal epithelial PTPN23 is essential for gut barrier integrity and prevention of fatal bacterial translocation

BACKGROUND AND AIMS

Protein tyrosine phosphatase nonreceptor type 23 (PTPN23) regulates the internalization of growth factor receptors such as the epithelial growth factor receptor (EGFR). Given the crucial function of such receptors in intestinal epithelial cells (IECs), we assessed the involvement of PTPN23 in intestinal homeostasis and epithelial proliferation.

METHODS

We generated mouse models with constitutive (PTPN23fl/flVilCre+/-) or inducible (PTPN23fl/flVilCreERT+/-) deletion of PTPN23 in IEC. To elucidate the functional consequences of PTPN23 deletion in IEC, we performed barrier function studies, flow cytometry, RNAseq, and in vivo experiments applying EGFR inhibition, antibiotic treatment, or co-housing approaches to further delineate the observed phenotype.

RESULTS

Deletion of PTPN23 in IECs resulted in a severe early-onset phenotype in both models. Mice were characterized by elongated colon, epithelial hyperproliferation, splenomegaly, and diarrhea leading to the death of the mice within 3 weeks of PTNP23 deletion. Compromised gut barrier integrity resulted in enhanced bacterial translocation accompanied by reduced IgA transcytosis in PTPN23fl/flVilCreERT+/- compared to wild-type mice. Although EGFR surface expression was increased upon PTPN23-deletion, inhibition of EGFR signaling did not prevent disease. In contrast, and in accordance with defective bacterial handling, antibiotic treatment, but not co-housing, fully rescued the phenotype.

CONCLUSIONS

The absence of PTPN23 in IECs leads to lethal dysregulation of intestinal homeostasis, triggered by bacterial infiltration due to defects in the intestinal epithelial barrier and impaired IgA transcytosis. Thus, we identify PTPN23 as a novel key player in preserving intestinal epithelial homeostasis, ultimately preventing bacterial overgrowth and excessive immune activation in the intestine.

Association of Race and Postoperative Outcomes in Patients with Inflammatory Bowel Disease

BACKGROUND

Previous literature suggests that rates of postoperative complications following inflammatory bowel disease (IBD) surgery differ based on race.

AIMS

The purpose of this study was to examine the association between race and adverse events and wound complications in patients with IBD.

METHODS

This was a retrospective cohort study of the American College of Surgeons National Surgery Quality Improvement Program Inflammatory Bowel Disease Collaborative from 2017 to 2022. The data was collected from 15 high-volume IBD centers across the United States. The data was analyzed using crude and multivariable logistic regressions.

RESULTS

4284 patients were included in the study. Overall rates of adverse events and wound complications were 20.3% and 11.3%, respectively, and did not differ based on race on bivariate analysis. Rates of adverse events were 20.0% vs 24.6% vs 22.1%, p = 0.13 for white, black and other minority subjects, respectively. The adjusted odds of adverse events were higher for black subjects (1.46 [95%CI 1.0-2.1], p = 0.03) compared to white subjects. No difference in adverse events was found between other minority subjects and either black or white subjects (1.29 [0.7-2.3], p = 0.58). Race was not associated with likelihood of wound complications in the final analysis.

CONCLUSIONS

We found that a subset of black patients with IBD continue to experience more adverse events compared to white patients, primarily driven by a higher need for postoperative blood transfusion. Nonetheless, known risk factors, including comorbid conditions, decreased BMI, open surgery, and emergency surgery have a stronger association with postoperative complications than race alone.

Regulation of Ferroptosis in Intestinal Epithelial Cells by Formononetin via the RXRA/PPARG Pathway

Recent studies have revealed that formononetin, a naturally occurring isoflavone found in kudzu root and licorice, has the potential to inhibit ferroptosis in intestinal epithelial cells. Inflammatory bowel disease (IBD) often involves oxidative stress-related pathways, making the modulation of ferroptosis a promising therapeutic avenue. We employed a combination of several techniques to explore how formononetin regulates the retinoid X receptor alpha/peroxisome proliferator activated receptor gamma (RXRA/PPARG) pathway to inhibit ferroptosis in Fetal Human Colonic Epithelial Cells (FHC) induced by RSL3. These techniques included propidium iodide staining, the levels of reactive oxygen species (ROS), Fe2+, malondialdehyde (MDA), and ferroptosis-inhibitory proteins glutathione peroxidase 4 (GPX4) and FTH analysis, Western blot analysis, and gene silencing. Our results demonstrate that formononetin significantly mitigated RSL3-induced ferroptosis as evidenced by reduced cellular levels of ROS, Fe2+, and MDA, alongside an increased expression of GPX4 and FTH. Silencing the RXRA gene reverses the protective effects of formononetin, highlighting that formononetin inhibits ferroptosis in FHC by upregulating the levels of RXRA. These findings provide new molecular targets for potential therapeutic intervention in IBD, suggesting that upregulating RXRA and PPARG expression via formononetin could be a viable strategy to mitigate ferroptosis-associated cellular damage. This could potentially lead to novel treatments for patients suffering from IBD.

Wolfberry Honey and Its Extract Alleviate Dextran Sodium Sulfate-Induced Ulcerative Colitis by Improving Intestinal Barrier Function and Reducing Oxidative Stress and Inflammation

Inflammatory bowel disease (IBD) is a chronic condition characterized by gut inflammation causing persistent diarrhea and abdominal pain. Despite the nutritional benefits of wolfberry honey (from Lycium barbarum L.), its potential to alleviate IBD remains underexplored. This study evaluated the protective effects of wolfberry honey and its extract (wolfberry honey extract [WHE]) against dextran sulfate sodium (DSS)-induced ulcerative colitis (UC) using in vivo and in vitro models. Mice pretreated with wolfberry honey showed significant symptom improvement in DSS-induced UC, linked to reduced expression of proinflammatory markers (Il-1β, Il-6, Tnf-α, and Mcp-1) and increased antioxidant genes (Nrf2, Sod2). Increased Occludin levels indicated improved intestinal barrier function. In vitro, WHE protected DSS-treated Caco-2 cells by lowering reactive oxygen species (ROS), stabilizing mitochondrial membrane potential, and inhibiting TLR4/NF-κB signaling. It enhanced the expression of antioxidant genes and tight junction proteins (ZO-1, Occludin, and Claudin-1). Metabolomic analysis revealed that WHE modulated glycerophospholipid metabolism, increasing phosphatidylcholine and choline levels and decreasing lysophosphatidylcholine levels. These results highlight the potential of wolfberry honey and its extract as nutraceuticals for managing UC through their effects on inflammation, oxidative stress, and intestinal barrier function. Further research is warranted to elucidate their mechanisms of action and assess their long-term therapeutic benefits in IBD management.

Anti-inflammatory effects of heat-killed Lactiplantibacillus argentoratensis BBLB001 on a gut inflammation co-culture cell model and dextran sulfate sodium-induced colitis mouse model

Dysbiosis caused by dietary changes can alter the intestinal bacterial species and is closely associated with inflammatory bowel disease (IBD). Among the possible treatment options, postbiotics, which act to balance the constituent intestinal microflora, have gained substantial attention. Herein, we investigated the anti-inflammatory effects of heat-killed Lactiplantibacillus argentoratensis (hk-LA) BBLB001 isolated from a marine environment using both cell (Caco2/RAW264.7 cell co-culture) and animal (dextran sodium sulfate [DSS]-induced colitis in mice) models. hk-LA BBLB001 markedly reduced IL-8 secretion in Caco-2 cell culture medium after lipopolysaccharide-mediated stimulation of RAW264.7 cells by enhancing the expression of cell adhesion factors.The body weight loss, reduced inflammatory cytokine levels in the serum and colon tissues, colon shortening, and myeloperoxidase activation caused by DSS in mice were alleviated by hk-LA BBLB001. Similar to that in the intestinal cell model, the gene and protein expressions of cell adhesion molecules in the colon tissue were increased upon hk-LA BBLB001 treatment in DSS-induced colitis mice. We observed increased mucin expression and secretory IgA concentration in colon tissues, suggesting that hk-LA BBLB001 intake may benefit pathogen defense and the regulation of intestinal commensal bacteria. Thus, hk-LA BBLB001 may serve as an instrumental postbiotic material in IBD treatment.

A Proteomics Pipeline for Generating Clinical Grade Biomarker Candidates from Data-Independent Acquisition Mass Spectrometry (DIA-MS) Discovery

Clinical biomarker development has been stymied by inaccurate protein quantification from mass spectrometry (MS) discovery data and a prolonged validation process. To mitigate these issues, we created the Targeted Extraction Assessment of Quantification (TEAQ) software package that uses data-independent acquisition analysis from a discovery cohort to select precursors, peptides, and proteins that adhere to analytical criteria required for established targeted assays. TEAQ was applied to DIA-MS data from plasma samples acquired on a new high resolution accurate mass (HRAM) mass spectrometry platform where precursors were evaluated for linearity, specificity, repeatability, reproducibility, and intra-protein correlation based on 8- or 11-point loading curves at three throughputs. This data can be used as a general resource for developing other targeted assays. TEAQ analysis of data from a case and control cohort for inflammatory bowel disease (n=492) identified 1110 signature peptides for 326 quantifiable proteins from the 1179 identified proteins. Applying TEAQ analysis to discovery data will streamline targeted assay development and the transition to validation and clinical studies.

Targeting the Calcium-Sensing Receptor in Chemically Induced Medium-Grade Colitis in Female BALB/C Mice

BACKGROUND/OBJECTIVES

The extracellular calcium-sensing receptor (CaSR) is a multifunctional receptor proposed as a possible drug target for inflammatory bowel disease. We showed previously that CaSR inhibition with NPS 2143, a negative allosteric modulator of the CaSR, somewhat ameliorated the symptoms of chemically induced severe colitis in mice. However, it was unclear whether the potential of CaSR inhibition to reduce colitis may have been overshadowed by the severity of the induced inflammation in our previous study. Therefore, we tested if CaSR inhibition could prevent medium-grade colitis.

METHODS

Female BALB/c mice were treated with NPS 2143 or a vehicle prior to the induction of colitis with 2.5% DSS. On the day of sacrifice, colons and plasma were collected. The histology score was determined based on hematoxylin-eosin-stained sections. Mucin content, proliferation (Ki67), and immune cell infiltration (CD3 and CD20) were quantified based on immunostainings. Gene expression was measured by RT-qPCR.

RESULTS

Treatment with NPS 2143 had no effect on the clinical symptom score of the mice. However, the colons of the mice in the treated group were significantly longer (p < 0.05), and NPS 2143 significantly reduced colon ulceration (p < 0.05). The treatment also significantly reduced the expression of COX2 in the proximal colon and IL-22 in the distal colon. The proliferation of cells in the lymph nodes was significantly lower after the treatment, but no difference was observed in the epithelial cells.

CONCLUSIONS

In summary, while NPS 2143 had an anti-inflammatory effect on medium-grade colitis, this effect appeared to be milder than in severe colitis, as observed previously, indicating that the effectiveness of CaSR inhibition as an anti-inflammatory measure in the colon is proportional to disease severity.

Patient Preferences for Treatment Attributes in Inflammatory Bowel Disease: Results From a Large Survey Across Seven European Countries Using a Discrete Choice Experiment

BACKGROUND

Inflammatory bowel disease requires long-term treatment; therefore, understanding patient preferences is important in aiding informed treatment decision making. This study explored patients' preferences for treatment attributes of available inflammatory bowel disease therapies.

METHODS

Adult patients from 7 European countries who self-reported previous/current treatment for Crohn's disease (CD) or ulcerative colitis (UC) participated in an online survey via the Carenity platform. In a discrete choice experiment, the relative importance of treatment attributes for CD and UC was estimated using conditional logit models. Latent class analysis was conducted to estimate heterogeneous treatment preferences based on patient profiles. Patients' perspectives and preferences regarding their quality of life were assessed.

RESULTS

Across 686 completed survey responses (CD, n = 360; UC, n = 326), the mean patient age was 48 and 50 years, respectively. Patients with CD ranked route of administration as the most important attribute (attribute importance: 32%), preferring subcutaneous over intravenous treatment (P < .001). Patients with UC ranked route of administration and frequency of serious adverse events as the most important attributes (attribute importance: 31% and 23%, respectively), preferring oral (P < .001) and subcutaneous (P < .001) over intravenous treatment and treatment that minimized the risk of serious adverse events (P < .001) or mild adverse events (P < .01). Latent class analyses confirmed the impact of patients' sociodemographic profile on their preferences. All patients prioritized general well-being, energy level, and daily activities as the most important aspects for improvement through treatment.

CONCLUSIONS

Patient preferences for treatment attributes varied among patients with CD or UC, highlighting the importance of personalized care and shared decision making to maximize treatment benefits.

UK medical cannabis registry: an updated analysis of clinical outcomes of cannabis-based medicinal products for inflammatory bowel disease

BACKGROUND

Treatments for inflammatory bowel disease (IBD) remain limited, and cannabis-based medicinal products (CBMPs) provide promise in addressing inflammation and pain. However, long-term data on CBMP efficacy in IBD are scarce. This study examines health-related quality of life (HRQoL) changes in IBD patients treated with CBMPs.

RESEARCH DESIGN AND METHODS

Patients with IBD were identified from the UK Medical Cannabis Registry. Primary outcomes were changes in the short IBD questionnaire (SIBDQ), EQ-5D-5L, single-item sleep quality scale (SQS), and generalized anxiety disorder-7 (GAD-7), from baseline to 18-months after CBMP treatment started. Secondary outcomes were adverse event prevalence.

RESULTS

Analysis of 116 patients with IBD included 94 males (81.03%) with a mean age of 39.52 ± 9.12 years. There were improvements in the SIBDQ, GAD-7, SQS, and EQ-5D-5L Index (p < 0.001). At 18-months, 30 (25.86%) patients achieved a minimal clinically important difference (MCID) in the SIBDQ. Patients with severe baseline anxiety and above-median THC doses were more likely to achieve this MCID (p < 0.050). Twenty (17.24%) patients reported 155 (133.62%) adverse events.

CONCLUSIONS

CBMP treatment was associated with improvement in IBD-specific outcomes in patients and general HRQoL over 18-months. However, causation cannot be inferred. Hence, randomized controlled trials are still required.

Gut Microbiome Alterations Following Oral Serum-Derived Bovine Immunoglobulin Administration in the Management of Dysbiosis

INTRODUCTION

Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are chronic disorders of the gastrointestinal tract associated with gut microbiota dysbiosis and inflammation. Serum-derived bovine immunoglobulin (SBI) is used to manage IBS and IBD and has shown prebiotic-like effects in ex vivo models. Re-establishing a healthy gut microbiome with novel treatments like SBI could help treat the underlying causes of these diseases leading to higher and sustained patient response. The objective of this study was to assess whether supplementation with SBI would improve dysbiosis in IBD and IBS patients.

METHODS

This cross-sectional, single-site study had each participant serving as their own control. Stool samples from 18 patients with either IBS or IBD were analyzed before and after SBI administration. The relative abundance of bacterial diversity was assessed using metagenomic next-generation sequencing-based profiling.

RESULTS

Species diversity statistically significantly increased for measures of richness (Shannon index) (p < 0.0082) and evenness (Gini-Simpson index) (p < 0.0017). Phylum-level changes showed a 2.7-fold increase in Actinobacteria (p = 0.0181), 0.66-fold decrease in Bacteroidetes (p = 0.0401), and 0.38-fold decrease in Proteobacteria (p = 0.0071) after treatment with SBI. At the genus level, the relative abundances showed decreased Alistipes (p = 0.0121) and decreased Bacteroides (p = 0.0108) as well as increased Bifidobacterium (p = 0.0204), compared to pre-treatment levels. At the genus level, a 1.8-fold increase of Bifidobacterium breve (p = 0.0225) occurred upon treatment with SBI.

CONCLUSION

These findings confirm the prebiotic effects of SBI and suggest an additional mechanism of action in managing IBD and IBS symptoms. SBI re-establishes homeostasis in patients with IBD and IBS by decreasing Proteobacteria and increasing Bifidobacteria and species diversity. These insights highlight the promise of new therapeutic strategies for managing IBS and IBD by targeting dysbiosis and underscore the potential of personalized treatments based on a patient's gut microbiome profile.

Effectiveness and safety outcomes after long-term (54 weeks) vedolizumab therapy for Crohn's disease: a prospective, real-world observational study including patient-reported outcomes (POLONEZ II)

BACKGROUND

The Crohn's Disease (CD) Activity Index (CDAI), Inflammatory Bowel Disease (IBD) Questionnaire (IBDQ), and IBD-Fatigue (IBD-F) scale are useful patient-reported outcome (PRO) tools for assessing the treatment benefits of vedolizumab (VDZ) beyond clinical trial endpoints in patients with CD.

OBJECTIVES

To assess clinical response, clinical remission, steroid-free remission, changes from baseline for PROs, and safety in a real-world cohort of patients with moderate-to-severe active CD treated with VDZ.

DESIGN

POLONEZ II was a multicenter, observational, prospective study across 10 Polish centers from April 2020 to October 2023 for 54 weeks in patients with CD eligible for reimbursed VDZ.

METHODS

Primary endpoints at week 54 (W54) were clinical response (⩾70-point reduction in CDAI and >25% reduction vs baseline), remission (CDAI score ⩽150), and steroid-free remission. Other outcomes were changes in PROs (CDAI score and health-related quality of life) and safety. Kaplan-Meier survival analyses were performed.

RESULTS

Of 98 patients with CD, the mean age was 35.2 years, 57.1% were male, and 72.4% had an ileocolonic disease. At W54 (n = 98), 63.3% of patients achieved clinical response, 48.0% remission, and 36.0% steroid-free remission. The durability of clinical response, remission, and steroid-free remission (W14-W54) were 68.9%, 62.9%, and 57.1%, respectively. By W54, a significant reduction in the PROs, such as the total CDAI score (p < 0.001), stool frequency (p < 0.001), abdominal pain score (p < 0.001), IBDQ (p < 0.001), IBD-F (p < 0.05), and fatigue impact on daily activities (p < 0.001), was observed. During VDZ treatment, arthralgia (23.7%-8.7%) and anemia (22.6%-15.9%) decreased between baseline and W54. Non-serious adverse events (SAEs; 12.2%), SAEs (7.1%), and VDZ-related rash (1.0%) were reported. Mean CD-related hospitalization duration decreased from baseline (10.2 days) to the end of the study (5.3 days).

CONCLUSION

POLONEZ II demonstrated long-term real-world benefits of VDZ toward effectiveness, safety, and improved PROs and patients' quality of life.

TRIAL REGISTRATION

ENCePP (EUPAS32716).

Harnessing a Safe Novel Lipid Nanoparticle: Targeted Oral Delivery to Colonic Epithelial and Macrophage Cells in a Colitis Mouse Model

A novel lipid nanoparticle (nLNP), formulated with three essential lipids to mimic ginger-derived exosomal particles, shows strong potential for delivering IL-22 mRNA specifically to the colon, presenting a unique oral drug delivery system for inflammatory bowel disease (IBD). However, its cellular targets and uptake behavior in healthy versus diseased colons remain unclear. Understanding these aspects is crucial for fully elucidating its targeting effectiveness in inflamed colon tissue. This study investigates the nLNP's cellular targets in healthy and diseased mouse colons. Flow cytometry compared nLNP uptake in healthy mice and a DSS-induced acute colitis model. The results revealed efficient internalization of nLNP by colonic epithelial cells in healthy and inflamed mice. In non-inflamed mice, the small number of colonic macrophages resulted in minimal uptake of nLNP by these cells. In inflamed mice, macrophages migrated to the damaged epithelium, where nLNP uptake was significantly increased, highlighting the nLNP's ability to target both epithelial and macrophage cells during inflammation. Additionally, safety assessments showed that the nLNP neither altered in vitro kinase activities nor exhibited immunotoxicity or induced in vivo toxicity at the maximum tolerated oral dose. These findings underscore the nLNP's safety and potential as a promising epithelial/macrophage-targeted drug delivery platform for oral ulcerative colitis (UC) treatment.

A Comparison of Clinical Outcomes of Colectomies for Pediatric and Adult Patients With Inflammatory Bowel Disease

Background: Crohn's disease (CD) and ulcerative colitis (UC) are prevalent in adult and pediatric populations, but their differences are not well studied using national data. We compared the clinical outcomes of these patients using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) databases.Methods: Colectomy cases for CD and UC, the 2 major forms of inflammatory bowel disease (IBD), were compared between adult and pediatric patients using the 2017-2019 ACS NSQIP databases. Various clinical factors were analyzed, with postoperative complications being the primary outcome of interest.Results: We identified 542 pediatric and 5174 adult CD patients and 360 pediatric and 1292 adult UC patients. Adults with CD or UC were more likely to be on steroids preoperatively (CD: 60.15% vs 24.54%; UC: 65.63% vs 51.39%). Children with IBD were more likely to have preoperative transfusions (CD: 1.48% vs .33%; UC: 8.33% vs .62%), systemic inflammatory response syndrome (CD: 3.51% vs .93%; UC: 12.78% vs 3.10%), or sepsis (CD: 1.85% vs .66%; UC: 1.39% vs .31%). Unplanned reoperations were more common among pediatric patients in both disease states compared to adults (CD: 6.27% vs 4.10%; UC: 11.11% vs 4.26%), with P-values for all factors described as ≤.02. Multivariate logistic regression found pediatric age to be associated with higher odds of needing a reoperation among UC patients but not CD patients.Conclusion: Pediatric patients were sicker at the time of surgery, and those with either disease were more likely to require a reoperation within 30 days.

Advancements in the use of AI in the diagnosis and management of inflammatory bowel disease

Inflammatory bowel disease (IBD) causes chronic inflammation of the colon and digestive tract, and it can be classified as Crohn's disease (CD) and Ulcerative colitis (UC). IBD is more prevalent in Europe and North America, however, since the beginning of the 21st century it has been increasing in South America, Asia, and Africa, leading to its consideration as a worldwide problem. Optical colonoscopy is one of the crucial tests in diagnosing and assessing the progression and prognosis of IBD, as it allows a real-time optical visualization of the colonic wall and ileum and allows for the collection of tissue samples. The accuracy of colonoscopy procedures depends on the expertise and ability of the endoscopists. Therefore, algorithms based on Deep Learning (DL) and Convolutional Neural Networks (CNN) for colonoscopy images and videos are growing in popularity, especially for the detection and classification of colorectal polyps. The performance of this system is dependent on the quality and quantity of the data used for training. There are several datasets publicly available for endoscopy images and videos, but most of them are solely specialized in polyps. The use of DL algorithms to detect IBD is still in its inception, most studies are based on assessing the severity of UC. As artificial intelligence (AI) grows in popularity there is a growing interest in the use of these algorithms for diagnosing and classifying the IBDs and managing their progression. To tackle this, more annotated colonoscopy images and videos will be required for the training of new and more reliable AI algorithms. This article discusses the current challenges in the early detection of IBD, focusing on the available AI algorithms, and databases, and the challenges ahead to improve the detection rate.

Clinicopathologic and Molecular Characterization of Inflammatory Bowel Disease-Associated Neuroendocrine Carcinomas and Mixed Neuroendocrine-Non-Neuroendocrine Neoplasms

The pathogenesis of neuroendocrine carcinomas (NECs) and mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs) in the gastrointestinal tract remains poorly understood. This study aims to characterize the clinicopathologic and molecular features of NEC/MiNEN in patients with inflammatory bowel disease (IBD). Eighteen surgically resected IBD-associated intestinal carcinomas with a minimum of 30% neuroendocrine component were collected from 6 academic centers and compared with a control group of 12 IBD-associated carcinomas lacking neuroendocrine differentiation. Both groups exhibited a male predominance and similar age distribution. The NEC/MiNEN group was more likely to have a higher percentage of Crohn disease (9/18 vs 1/12; P = .024), occur in the rectum (9/18 vs 3/12) and small intestine (4/18 vs 0/12) (P < .01), be diagnosed on resection without a preceding biopsy (6/18 vs 0/12; P = .057), and have unidentifiable precursor lesions (10/18 vs 1/12; P = .018) than the control group. Synchronous carcinoma, advanced tumor stage (pT3 and pT4), and lymph node metastasis occurred at similar rates; however, the NEC/MiNEN group had a higher incidence of angiovascular invasion (14/18 vs 4/12; P = .024), distant metastasis (8/18 vs 1/12; P = .049), mortality (8/18 vs 2/12; P = .058), and worse survival (Kaplan-Meier; P = .023) than the control group. All tested cases were mismatch repair proficient. A Ki-67 proliferation index ranged from 25% to 100%. Next-generation sequencing in 11 NEC/MiNEN cases revealed low tumor mutational burdens but complex genetic abnormalities commonly involving TP53 (9/11; 82%), FBXW7 (4/11; 36%), and APC (3/11; 27%) genes, with the other genetic alterations randomly occurring in 1 or 2 cases. The neuroendocrine component, which shared similar molecular alterations as the nonneuroendocrine component, was subcategorized into intermediate (G3a) and high grade (G3b); the higher grade correlated with more genetic alterations. In conclusion, IBD-associated NEC/MiNEN shows diverse histologic features, variable precursor lesions, intricate genetic abnormalities, and aggressive biologic behavior. The classification and grading of gastrointestinal NEC/MiNEN may be refined for better clinical management.

Advancements in the Management of Pediatric and Adult Inflammatory Bowel Disease: A Systematic Review of Treatment Strategies and Long-Term Outcomes

Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis (UC), remains a clinically complex condition in children and adults. This study is a systematic analysis of key developments in the treatment of inflammatory bowel diseases, as well as their efficacy and safety over time. Early diagnosis of pediatric IBD is very important since it affects growth and development in children. New therapeutic approaches like biological agents, small molecules, and gene or targeted drugs have given the medical fraternity new treatment protocols. There is a trend towards more selective therapies for adult IBD, especially for anti-tumor necrosis factor (anti-TNF) biologics, integrin antagonists, and interleukin-12/23 (IL-12/23) inhibitors. This review emphasizes the need for patient management where early intervention leading to mucosal healing has been identified to predict durable outcomes. Systematic analysis of existing literature comparing childhood and adult populations shows that morbidity, pathophysiology, therapeutic outcome, as well as the potential for adverse outcomes are dissimilar, which supports the need for differentiated therapy. This work also looks at long-term consequences of the intervention course, the avoidance of surgery, and an improvement in the quality and stability of life as well as reduction in further development of malignant transformation. The new developing strategy of gut microbiome modification and nutrition support for maintaining remission is also argued. Despite these progresses, issues still persist concerning the effectiveness of treatments, side effects, and patients' compliance. These recommendations give this review a prospective outlook of treatment regimens likely to define the future of IBD management for all age groups.

Unlocking the Potential of Probiotics: A Comprehensive Review on Research, Production, and Regulation of Probiotics

This review provides a comprehensive overview of the current state of probiotic research, covering a wide range of topics, including strain identification, functional characterization, preclinical and clinical evaluations, mechanisms of action, therapeutic applications, manufacturing considerations, and future directions. The screening process for potential probiotics involves phenotypic and genomic analysis to identify strains with health-promoting properties while excluding those with any factor that could be harmful to the host. In vitro assays for evaluating probiotic traits such as acid tolerance, bile metabolism, adhesion properties, and antimicrobial effects are described. The review highlights promising findings from in vivo studies on probiotic mitigation of inflammatory bowel diseases, chemotherapy-induced mucositis, dysbiosis, obesity, diabetes, and bone health, primarily through immunomodulation and modulation of the local microbiota in human and animal models. Clinical studies demonstrating beneficial modulation of metabolic diseases and human central nervous system function are also presented. Manufacturing processes significantly impact the growth, viability, and properties of probiotics, and the composition of the product matrix and supplementation with prebiotics or other strains can modify their effects. The lack of regulatory oversight raises concerns about the quality, safety, and labeling accuracy of commercial probiotics, particularly for vulnerable populations. Advancements in multi-omics approaches, especially probiogenomics, will provide a deeper understanding of the mechanisms behind probiotic functionality, allowing for personalized and targeted probiotic therapies. However, it is crucial to simultaneously focus on improving manufacturing practices, implementing quality control standards, and establishing regulatory oversight to ensure the safety and efficacy of probiotic products in the face of increasing therapeutic applications.

Pyodermatitis-pyostomatitis vegetans: a case report and systematic review focusing on oral involvement

BACKGROUND

Pyodermatitis-pyostomatitis vegetans (PPV) is a rare mucocutaneous disease characterized by multiple pustules and it is considered a marker for inflammatory bowel disease (IBD). The oral manifestations of this condition are referred to as pyostomatitis vegetans (PSV).

PURPOSE

To investigate which features could help in establishing the diagnosis of PSV, with or without cutaneous lesions, based on information retrieved from all cases of PSV described in the literature. A case of PV from the authors was also included in the analysis.

METHODS

An electronic search was undertaken, last updated in August 2022. Inclusion criteria included publications reporting cases of PSV, with the diagnosis confirmed by the pathological examination of oral or skin lesions, and presence of IBD.

RESULTS/CONCLUSIONS

Sixty-two publications with 77 cases of PSV and an associated IBD were included. Features that are helpful in establishing the diagnosis of PSV are snail track appearance of oral lesions, an associated IBD (which is not always symptomatic), evidence of intraepithelial clefting on microscopic examination of oral lesions, and peripheral blood eosinophilia. A gold standard for the management of PSV does not exist and high-level evidence is limited. There is no established therapeutic protocol for PSV and management primarily consists of topical and/or systemic corticosteroids, antirheumatic drugs (sulfasalazine, mesalazine), monoclonal antibody (infliximab, adalimumab) immunosuppressives (azathioprine, methotrexate), antibiotics (dapsone), or a combination of these. The risk of recurrence of oral lesions is considerable when the medication dose is decreased or fully interrupted.

Unveiling ferroptosis as a promising therapeutic avenue for colorectal cancer and colitis treatment

Ferroptosis is a novel type of regulated cell death (RCD) involving iron accumulation and lipid peroxidation. Since its discovery in 2012, various studies have shown that ferroptosis is associated with the pathogenesis of various diseases. Ferroptotic cell death has also been linked to intestinal dysfunction but can act as either a positive or negative regulator of intestinal disease, depending on the cell type and disease context. The continued investigation of mechanisms underlying ferroptosis provides a wealth of potential for developing novel treatments. Considering the growing prevalence of intestinal diseases, particularly colorectal cancer (CRC) and inflammatory bowel disease (IBD), this review article focuses on potential therapeutics targeting the ferroptotic pathway in relation to CRC and IBD.

The association between inflammatory bowel disease and risk of prostate cancer: a population-based retrospective study based on Korean National Health Insurance Service database

Background

The aim of this study was to determine whether inflammatory bowel disease (IBD) is associated with the risk of developing prostate cancer (PCa) through a population-based study.

Materials and methods

Male patients aged ≥40 years, diagnosed with IBD from 2010 to 2013 and without IBD were identified and followed-up till 2019. A matched cohort of male patients with and without IBD in a ratio of 1:4 was created based on age, income level, and Charlson comorbidity index. Multivariate Cox regression analysis was conducted to evaluate the association of IBD with the prescence of PCa and PCa requiring definitive treatment within 1 year of diagnosis. The hazard ratio (HR) and 95% confidence interval (CI) were stratified by Crohn's disease, ulcerative colitis (UC), and subtypes.

Results

After matching, 15,751 IBD patients and 62,346 controls were analyzed. Over a median follow-up period of 96 months, the HR for PCa was significantly increased in patients with IBD (HR: 2.44; 95% CI: 2.08-2.86, P < 0.001). IBD was also associated with PCa requiring definitive treatment within 1 year (HR: 2.67; 95% CI: 2.09-3.42, P < 0.001). In subgroup analysis, UC (HR: 2.83; 95% CI: 2.18-3.69, P < 0.001) showed higher risk of PCa requiring definitive treatment than for Crohn's disease (HR: 2.21; 95% CI: 1.43-3.43, P = 0.0004). All-cause death in patient-diagnosed PCa was the highest in UC of pancolitis (HR: 2.26; 95% CI: 0.99-5.16, P = 0.054), and the lowest in ulcerative proctitis (HR: 0.35; 95% CI: 0.21-0.60, P = 0.0001).

Conclusion

IBD was associated with an increased incidence of PCa in our matched analysis.

Use of Complementary and Alternative Therapies in People with Inflammatory Bowel Disease

Complementary and alternative medicines (CAMs) are frequently discussed by people with Inflammatory Bowel Disease (IBD). The aim of this study is to explore CAM use in Australians with IBD. This cross-sectional study was conducted via an anonymous online survey, predominantly distributed through IBD-specific social media accounts. Data collection occurred over a three-month period in 2021. Descriptive statistics, Chi-Square tests, and binary logistic regression were used to analyse quantitative data. A simple thematic analysis was conducted for qualitative free-text responses. Of the 123 responses, acupuncture (12.2%) and chiropractors (8.9%) were common CAM practitioners accessed. CAM practitioners were perceived to be 'very helpful' compared to mainstream health practitioners. The most common CAM products reported were vitamins (51.2%), probiotics (43.9%), and herbal medicine (30.9%). Common reasons for use were improved perceived improvements to wellbeing or for long-term management of IBD. Females were more likely to access CAM practitioners (OR 12.6, 95% CI 1.62-98.1, p = 0.02). Doctors were the participants' primary source of information (64.2%), although many expressed dissatisfaction with conventional therapy and the desire for a more holistic approach to care. The use of CAMs in this sample was high. Limited research into the efficacy and safety of these therapies may prevent health professionals from discussing their use with patients. Improved communication with health professionals will allow patients to be active partners in their healthcare plans and can heighten patient satisfaction with conventional therapy.

Enhanced anti-inflammatory activity of chlorogenic acid via folic acid-TPGS-modified liposomes encapsulation: characterization and In vivo evaluation on colitis mice

Introduction

Chlorogenic acid (CGA) has been identified to possess salient anti-inflammatory, antioxidant, and anticancer attributes. However, its application is limited by its instability and low bioavailability. Liposomes have been considered effective pharmaceutical delivery vehicles due to their ability to continuously release loaded drugs, improve drug stability, and display good biocompatibility. They can be easily modified by other small molecules to acquire additional biological functions. In this study, we developed and characterized folic acid-TPGS-modified chlorogenic acid liposome (FTCLP) and evaluated its anti-inflammatory activity.

Methods

The successful encapsulation of CGA within FTCLP was confirmed through examination using electron microscopy, fourier-transform infrared spectroscopy (FTIR), and differential scanning calorimetry (DSC). The in vitro release characteristics of FTCLP were evaluated using the dialysis bag membrane method. Meanwhile, a dextran sulfate sodium (DSS) -induced colitis model was employed to investigate the anti-inflammatory effect of FTCLP and its mechanism.

Results

The FTCLP exhibited an encapsulation efficiency (EE) of 84.85 ± 1.20% and a drug loading (DL) of 11.67 ± 0.04%. The particle size of FTCLP was determined to be 150.63 ± 0.71 nm, with a polydispersity index (PDI) of 0.198 ± 0.02 and a zeta potential of 2.61 ± 0.38 mV. The in vitro release profile followed the Higuchi model, indicating sustained-release characteristics. The in vivo study demonstrated that FTCLP treatment was effective in improving the symptoms of DSS-induced inflammatory response, as evidenced by mitigation of weight loss, reduction in the disease activity index (DAI) score, restoration of colon length, and attenuation of colon tissue damage. Furthermore, the levels of pro-inflammatory cytokines, including interferon-gamma (INF-γ), interleukin-1 beta (IL-1β), and interleukin-6 (IL-6), were markedly diminished in both the serum and colon tissue. FTCLP was also observed to suppress the expression of INF-γ, IL-1β, IL-6, tumor necrosis factor-alpha (TNF-α), and nuclear factor kappa B (NF-κB) p65, while concomitantly upregulating the expression of Janus kinase (JAK) and signal transducer and activator of transcription 3 (STAT3). Besides, the administration of FTCLP was found to result in an increase in the abundance of Lactobacillaceae and Peptostreptococcaceae, while decreasing the abundance of Bacteroidaceae, Rikenellaceae, and Helicobacteraceae.

Conclusion

Following encapsulation of CGA within liposomes, FTCLP revealed favorable stability and sustained release properties, and enhanced the anti-inflammatory effects by modulating multiple inflammation-related biomarkers. FTCLP has the potential to be a safe and effective drug for targeted therapy of colitis.

Unraveling the blood microbiome: novel insights into inflammasome responses in Crohn's disease

OBJECTIVE

Crohn's disease (CD), an inflammatory bowel disease with unknown etiology, is influenced by genetic, environmental, and immunological factors. This study aimed to analyze the blood microbiome and inflammasome responses, emphasizing NLRP3 protein expression and IL-1β and IL-18 plasma levels, between Crohn's patients and healthy subjects.

METHODS

A total of 40 volunteers were included in this study. The 16S rRNA technique was used to sequence the V3-V4 regions of the blood sample. NLRP3 protein levels in plasma were ascertained through Western Blot, and IL-1β and IL-18 plasma profiles were examined using ELISA.

RESULTS

Analysis highlighted five unique phyla in patients' plasma, emphasizing the role of the blood microbiome in CD. Compared to controls, Crohn's patients exhibited elevated NLRP3 protein expression. Plasma IL-1β levels were diminished in patients ( P  = 0.0041), whereas IL-18 levels were comparably higher ( P  = 0.8209). In patients with CD, the presence of Staphylococcus sciuri in blood samples highlights its potential role in the disease's onset. The study also underscored the interplay between dietary habits, specifically increased meat consumption, and the progression of CD.

CONCLUSION

Our pioneering research discerns the variations in the blood microbiome and inflammasome responses between Crohn's patients and healthy individuals. Significant microbiome alterations and the detection of the Staphylococcus sciuri pathogen in Crohn's patients were notable. The pronounced NLRP3 protein in patients suggests its potential as a diagnostic biomarker. Future explorations into IL-1β and IL-18 pathways promise to unveil innovative insights into CD.

HIF-1α Pathway Orchestration by LCN2: A Key Player in Hypoxia-Mediated Colitis Exacerbation

In this study, we investigated the role of hypoxia in the development of chronic inflammatory bowel disease (IBD), focusing on its impact on the HIF-1α signaling pathway through the upregulation of lipocalin 2 (LCN2). Using a murine model of colitis induced by sodium dextran sulfate (DSS) under hypoxic conditions, transcriptome sequencing revealed LCN2 as a key gene involved in hypoxia-mediated exacerbation of colitis. Bioinformatics analysis highlighted the involvement of crucial pathways, including HIF-1α and glycolysis, in the inflammatory process. Immune infiltration analysis demonstrated the polarization of M1 macrophages in response to hypoxic stimulation. In vitro studies using RAW264.7 cells further elucidated the exacerbation of inflammation and its impact on M1 macrophage polarization under hypoxic conditions. LCN2 knockout cells reversed hypoxia-induced inflammatory responses, and the HIF-1α pathway activator dimethyloxaloylglycine (DMOG) confirmed LCN2's role in mediating inflammation via the HIF-1α-induced glycolysis pathway. In a DSS-induced colitis mouse model, oral administration of LCN2-silencing lentivirus and DMOG under hypoxic conditions validated the exacerbation of colitis. Evaluation of colonic tissues revealed altered macrophage polarization, increased levels of inflammatory factors, and activation of the HIF-1α and glycolysis pathways. In conclusion, our findings suggest that hypoxia exacerbates colitis by modulating the HIF-1α pathway through LCN2, influencing M1 macrophage polarization in glycolysis. This study contributes to a better understanding of the mechanisms underlying IBD, providing potential therapeutic targets for intervention.

The Increasing Diagnostic Role of Exosomes in Inflammatory Diseases to Leverage the Therapeutic Biomarkers

Inflammatory diseases provide substantial worldwide concerns, affecting millions of people and healthcare systems by causing ongoing discomfort, diminished quality of life, and increased expenses. In light of the progress made in treatments, the limited effectiveness and negative side effects of present pharmaceuticals need a more comprehensive comprehension of the underlying processes in order to develop more precise remedies. Exosomes, which are tiny vesicles that play a vital role in cell communication, have been identified as prospective vehicles for effective delivery of anti-inflammatory medicines, immunomodulators, and gene treatments. Vesicles, which are secreted by different cells, have a crucial function in communicating between cells. This makes them valuable in the fields of diagnostics and therapies, particularly for inflammatory conditions. Exosomes have a role in regulating the immune system, transporting cytokines, and influencing cell signaling pathways associated with inflammation. They consist of proteins, lipids, and genetic information that have an impact on immune responses and inflammation. Scientists are now investigating exosomes as biomarkers for inflammatory disease. This review article aims to develop non-invasive diagnostic techniques with improved sensitivity and specificity. Purpose of this review is a thorough examination of exosomes in pharmacology, specifically emphasizing their origin, contents, and functions, with the objective of enhancing diagnostic and therapeutic strategies for inflammatory conditions. Gaining a comprehensive understanding of the intricate mechanisms involved in exosome-mediated interactions and their impact on immune responses is of utmost importance in order to devise novel approaches for tackling inflammatory disease and enhancing patient care.

The Role of Nanoparticle Morphology on Enhancing Delivery of Budesonide for Treatment of Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a chronic and recurrent inflammatory disease that affects the gastrointestinal tract. The major hurdles impeding IBD treatment are the low targeting efficiency and short retention time of drugs in IBD sites. Nanoparticles with specific shapes have demonstrated the ability to improve mucus retention and cellular uptake. Herein, mesoporous silica nanoparticles (MSNs) with various morphologies were used to deliver budesonide (BUD) for the treatment of IBD. The therapeutic efficacy is strongly dependent on their shapes. The system comprises different shapes of MSNs as carriers for budesonide (BUD), along with Eudragit S100 as the enteric release shell. The encapsulation of Eudragit S100 not only improved the stability of MSNs-BUD in the gastrointestinal tract but also conferred pH-responsive drug release properties. Then, MSNs efficiently deliver BUD to the colon site, and the special shape of MSNs plays a critical role in enhancing their permeability and retention in the mucus layer. Among them, dendritic MSNs (MSND) effectively reduced myeloperoxidase (MPO) activity and levels of inflammatory cytokines in the colon due to long retention time and rapid release in IBD sites, thereby enhancing the therapeutic efficacy against colitis. Given the special shapes of MSNs and pH-responsivity of Eudragit S100, BUD loaded in the voids of MSND (E@MSNs-BUD) could penetrate the mucous layer and be accurately delivered to the colon with minor side effects. This system is expected to complement current treatment strategies for the IBD.

Alterations in tryptophan metabolism and de novo NAD+ biosynthesis within the microbiota-gut-brain axis in chronic intestinal inflammation

Background

Inflammatory bowel disease is an incurable and idiopathic disease characterized by recurrent gastrointestinal tract inflammation. Tryptophan metabolism in mammalian cells and some gut microbes comprise intricate chemical networks facilitated by catalytic enzymes that affect the downstream metabolic pathways of de novo nicotinamide adenine dinucleotide (NAD+) synthesis. It is hypothesized that a correlation exists between tryptophan de novo NAD+ synthesis and chronic intestinal inflammation.

Methods

Transcriptome analysis was performed using high-throughput sequencing of mRNA extracted from the distal colon and brain tissue of Winnie mice with spontaneous chronic colitis and C57BL/6 littermates. Metabolites were assessed using ultra-fast liquid chromatography to determine differences in concentrations of tryptophan metabolites. To evaluate the relative abundance of gut microbial genera involved in tryptophan and nicotinamide metabolism, we performed 16S rRNA gene amplicon sequencing of fecal samples from C57BL/6 and Winnie mice.

Results

Tryptophan and nicotinamide metabolism-associated gene expression was altered in distal colons and brains of Winnie mice with chronic intestinal inflammation. Changes in these metabolic pathways were reflected by increases in colon tryptophan metabolites and decreases in brain tryptophan metabolites in Winnie mice. Furthermore, dysbiosis of gut microbiota involved in tryptophan and nicotinamide metabolism was evident in fecal samples from Winnie mice. Our findings shed light on the physiological alterations in tryptophan metabolism, specifically, its diversion from the serotonergic pathway toward the kynurenine pathway and consequential effects on de novo NAD+ synthesis in chronic intestinal inflammation.

Conclusion

The results of this study reveal differential expression of tryptophan and nicotinamide metabolism-associated genes in the distal colon and brain in Winnie mice with chronic intestinal inflammation. These data provide evidence supporting the role of tryptophan metabolism and de novo NAD+ synthesis in IBD pathophysiology.

Investigation of TLR2 (-196 to -174del) and TLR9 (T-1486C) Gene Polymorphisms Association with Inflammatory Bowel Diseases

BACKGROUND

Inflammatory bowel diseases (IBD), Crohn's disease (CD), and ulcerative colitis (UC) are diseases that result from the combined effects of a predisposing genetic background and several environmental factors, including smoking. Some genes can influence these diseases through genetic inheritance, and their regulation is explained by gene polymorphism. However, Toll-like receptor (TLR) genes have been identified as susceptibility genes for CD and UC.

METHODS

A case-control study was performed on a Turkish population composed of 105 healthy controls and  79 CD, 77 UC patients genotyped by Allele-specific PCR and PCR-RFLP for TLR9 (T-1486C) and TLR 2 (-196 to -174del) gene. Genotype and allele frequencies of TLR9 (T-1486C) and TLR 2 (-196 to -174del) gene polymorphisms compared to allele frequencies in CD and UC patients.

RESULTS

No statistically significant findings were found between the CD, UC patients, and the control group in terms of both genotype distributions and allele frequencies for TLR 9 (T-1486C; rs187084) and TLR 2 (-196 to -174del; rs111200466) gene polymorphisms in a Turkish population (P > 0.05).

CONCLUSION

No association was found between the TLR2 (rs111200466) and TLR 9 (rs187084) gene polymorphisms among IBD patients and the control groups in the Turkish population.

How the Western Diet Thwarts the Epigenetic Efforts of Gut Microbes in Ulcerative Colitis and Its Association with Colorectal Cancer

Ulcerative colitis (UC) is an autoimmune disease in which the immune system attacks the colon, leading to ulcer development, loss of colon function, and bloody diarrhea. The human gut ecosystem consists of almost 2000 different species of bacteria, forming a bioreactor fueled by dietary micronutrients to produce bioreactive compounds, which are absorbed by our body and signal to distant organs. Studies have shown that the Western diet, with fewer short-chain fatty acids (SCFAs), can alter the gut microbiome composition and cause the host's epigenetic reprogramming. Additionally, overproduction of H2S from the gut microbiome due to changes in diet patterns can further activate pro-inflammatory signaling pathways in UC. This review discusses how the Western diet affects the microbiome's function and alters the host's physiological homeostasis and susceptibility to UC. This article also covers the epidemiology, prognosis, pathophysiology, and current treatment strategies for UC, and how they are linked to colorectal cancer.