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Salem MB, El-Lakkany NM, Seif el-Din SH, Hammam OA, Samir S. Diosmin alleviates ulcerative colitis in mice by increasing Akkermansia muciniphila abundance, improving intestinal barrier function, and modulating the NF-κB and Nrf2 pathways. Heliyon 2024; 10:e27527. [PMID: 38500992 PMCID: PMC10945203 DOI: 10.1016/j.heliyon.2024.e27527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 03/20/2024] Open
Abstract
Ulcerative colitis is a common type of inflammatory bowel disease that affects millions of individuals around the world. Traditional UC treatment has focused on suppressing immune responses rather than treating the underlying causes of UC, which include oxidative stress, inflammation, and microbiota dysbiosis. Diosmin (DIO), a naturally occurring flavonoid, possesses antioxidant and anti-inflammatory properties. This study aimed to assess the efficacy of DIO in treating dextran-sulfate sodium (DSS)-induced colitis, and to investigate some of its underlying mechanisms, with an emphasis on Akkermansia muciniphila abundance, inflammatory markers, and intestinal barrier function. C57BL/6 mice were given 4% (w/v) DSS to induce colitis. DSS-induced mice were administered DIO (100 and 200 mg/kg) or sulfasalazine orally for 7 days. Every day, the disease activity index (DAI) was determined by recording body weight, diarrhea, and bloody stool. Changes in fecal A. muciniphila abundance, colonic MUC1 and MUC2 expression, as well as oxidative stress and inflammatory markers were all assessed. Histopathological changes, colonic PIK3PR3 and ZO-1 levels, and immunohistochemical examinations of occludin and claudin-1, were investigated. DIO administration resulted in a dose-dependent decrease in DAI, as well as increase in A. muciniphila abundance and MUC2 expression while decreasing MUC1 expression. DIO also dramatically reduced colonic oxidative stress and inflammation by regulating the NF-κB and Nrf2 cascades, restored intestinal barrier integrity by inhibiting PIK3R3 and inducing ZO-1, and improved occludin/claudin-1 gene expression and immunostaining. This study provides the first evidence that DIO preserves intestinal barrier integrity and increases A. muciniphila abundance in DSS-induced colitis. However, more research is required to explore the impact of DIO on the overall composition and diversity of the gut microbiota. Likewise, it will be important to fully understand the molecular mechanisms by which A. muciniphila maintains intestinal barrier function and its potential use as an adjuvant in the treatment of UC.
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Affiliation(s)
- Maha Badr Salem
- Department of Pharmacology, Theodor Bilharz Research Institute, Warrak El-Hadar, Imbaba, Giza, 12411, Egypt
| | - Naglaa Mohamed El-Lakkany
- Department of Pharmacology, Theodor Bilharz Research Institute, Warrak El-Hadar, Imbaba, Giza, 12411, Egypt
| | - Sayed Hassan Seif el-Din
- Department of Pharmacology, Theodor Bilharz Research Institute, Warrak El-Hadar, Imbaba, Giza, 12411, Egypt
| | - Olfat Ali Hammam
- Department of Pathology, Theodor Bilharz Research Institute, Warrak El-Hadar, Imbaba, Giza, 12411, Egypt
| | - Safia Samir
- Department of Biochemistry and Molecular Biology, Theodor Bilharz Research Institute, Warrak El-Hadar, Imbaba, Giza, 12411, Egypt
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Chen H, Qian Y, Jiang C, Tang L, Yu J, Zhang L, Dai Y, Jiang G. Butyrate ameliorated ferroptosis in ulcerative colitis through modulating Nrf2/GPX4 signal pathway and improving intestinal barrier. Biochim Biophys Acta Mol Basis Dis 2024; 1870:166984. [PMID: 38061600 DOI: 10.1016/j.bbadis.2023.166984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/30/2023]
Abstract
Oxidative stress and intestinal inflammation are main pathological features of ulcerative colitis (UC). Ferroptosis, characterized by iron accumulation and lipid peroxidation, is closely related to the pathologic process of UC. 16S rRNA sequencing for intestinal microbiota analysis and gas chromatography-mass spectrometry (GC-MS) for short-chain fatty acid (SCFA) contents clearly demonstrated lower amounts of butyrate-producing bacteria and butyrate in colitis mice. However, the precise mechanisms of sodium butyrate (NaB) in treating UC remain largely unclear. We found that ferroptosis occurred in colitis models, as evidenced by the inflammatory response, intracellular iron level, mitochondria ultrastructural observations and associated protein expression. NaB inhibited ferroptosis in colitis, significantly rescued weight loss and colon shortening in mice and reduced inflammatory lesions and mitochondrial damage. Furthermore, NaB improved intestinal barrier integrity and markedly suppressed the expression of pro-ferroptosis proteins. Conversely, the protein expression of anti-ferroptosis markers including nuclear factor erythroid-related Factor 2 (Nrf2) and glutathione peroxidase 4 (GPX4), was significantly upregulated with NaB treatment. Moreover, the knockdown of Nrf2 reversed the anti-colitis effect of NaB. Taken together, NaB exhibited a protective effect by ameliorating ferroptosis in experimental colitis through Nrf2/GPX4 signaling and improving intestinal barrier integrity, which provides a novel mechanism for NaB prevention of UC.
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Affiliation(s)
- Hangping Chen
- Department of Pharmacy, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou 311200, Zhejiang, China
| | - Yifan Qian
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3 East Qingchun Road, Hangzhou 310016, Zhejiang, China
| | - Chensheng Jiang
- Department of Gastroenterology, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Yiwu 322099, Zhejiang, China
| | - Leilei Tang
- Department of Pharmacy, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou 311200, Zhejiang, China
| | - Jiawen Yu
- Department of Pharmacy, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou 311200, Zhejiang, China
| | - Lingdi Zhang
- Department of Pharmacy, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou 311200, Zhejiang, China
| | - Yiyang Dai
- Department of Gastroenterology, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Yiwu 322099, Zhejiang, China.
| | - Guojun Jiang
- Department of Pharmacy, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou 311200, Zhejiang, China.
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Zheng W, Jia J, Tang S, Song S, Ai C. Undaria pinnatifida fucoidan contributes to anti-inflammation activity of Bacteroides in fiber-deficient mice via modulation of gut microbiota and protection of intestinal barrier integrity. Int J Biol Macromol 2023; 252:126256. [PMID: 37572807 DOI: 10.1016/j.ijbiomac.2023.126256] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/31/2023] [Accepted: 08/08/2023] [Indexed: 08/14/2023]
Abstract
Bacteroides as potential probiotics has several health benefits to the host, but its practical application faces many challenges due to its inherent properties. In this study, Bacteroides strains isolated from human feces alleviated colonic inflammation in mice, as evidenced by increased colon length and reduced tissue damage. Further study showed that anti-inflammation activity of Bacteroides strains was disturbed by dietary fiber deficiency (FD), which disrupted the balance between gut microbiota and colonic mucus layer, leading to a thinning of colonic mucus layer. A combination of Bacteroides strains and Undaria pinnatifida fucoidan (UPF) better alleviated colonic inflammation than either of them, including increases in the densities of goblet cells and glycoproteins and reduction in intestinal epithelial damage, pro-inflammatory cytokines and oxidative stress. The underlying mechanisms can be attributed to that UPF-induced alterations of mucosal microbiota cannot only directly benefit host health but also create an ecological condition that facilitates Bacteroides strains exert their healthy properties. In addition, both Bacteroides strains and UPF improved FD-induced lipid metabolism abnormality, mainly involving glycerophospholipid metabolism pathway. This study suggests that the application of Bacteroides has certain limitations, and UPF can be developed as a probiotic adjuvant for Bacteroides to enhance human health.
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Affiliation(s)
- Weiyun Zheng
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, PR China
| | - Jinhui Jia
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, PR China
| | - Shuangru Tang
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, PR China
| | - Shuang Song
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, PR China; National & Local Joint Engineering Laboratory for Marine Bioactive Polysaccharide Development and Application, Dalian Polytechnic University, Dalian 116034, PR China
| | - Chunqing Ai
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, PR China; National & Local Joint Engineering Laboratory for Marine Bioactive Polysaccharide Development and Application, Dalian Polytechnic University, Dalian 116034, PR China.
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Liu W, Zhang T, Wang J, Zhao G, Hou Y. Protective Effect of Akkermansia muciniphila on the Preeclampsia-Like Mouse Model. Reprod Sci 2023; 30:2623-2633. [PMID: 36920671 DOI: 10.1007/s43032-023-01206-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/26/2023] [Indexed: 03/16/2023]
Abstract
Preeclampsia (PE) is known as a metabolism-related complication of pregnancy related to gut dysbiosis including the decreased abundance of Akkermansia muciniphila (A. muciniphila). However, the modulatory role of A. muciniphila as a supplement for PE remains ambiguous. This study investigated the effect of A. muciniphila administration on PE-like mice and its underlying mechanisms. A total of twenty-four C57BL/6 mice were randomly assigned into three groups. PE-like symptoms were induced by continuous injection of L-NAME intraperitoneally from gestational day (GD) 11 to GD18 combined with oral administration of pasteurized A. muciniphila during GD14-18 or not. Mice were sacrificed at GD19 to collect for further evaluation. Decreased A. muciniphila was observed in a successfully established PE-like model than normotensive pregnant control (NP), inversely correlated to increased systolic blood pressure blood and 24-h proteinuria. After supplementing with A. muciniphila, mice showed significantly minimized blood pressure and protein expression in urine, increased number of pups and weight of both embryos and placentas. In addition, colonies of bacteria, inflammatory cytokines (TNF-α and IL-6), and metabolic products of lipids including TC, FC, and TG were alleviated by A. muciniphila in the placentas. Among proteins linked with bowel barrier functions, diminished 2-AG and growing ZO-1 and occludin were attributable to A. muciniphila. Also, enhanced Treg/Th17 ratios were found in the intestines of mice treated with A. muciniphila. A. muciniphila facilitated alleviating PE-like symptoms and was beneficial as a novel probiotic therapeutic agent for PE.
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Affiliation(s)
- Wei Liu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157, Xiwu Road, Xincheng District, Xi'an, 710004, Shaanxi, China.
| | - Tingting Zhang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157, Xiwu Road, Xincheng District, Xi'an, 710004, Shaanxi, China
| | - Juanni Wang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157, Xiwu Road, Xincheng District, Xi'an, 710004, Shaanxi, China
| | - Gang Zhao
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157, Xiwu Road, Xincheng District, Xi'an, 710004, Shaanxi, China
| | - Yuemin Hou
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157, Xiwu Road, Xincheng District, Xi'an, 710004, Shaanxi, China
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Yan J, Xi Z, Guo J, Xu L, Sun X, Sha W, Liu M, Zhao S, Dai E, Xu Y, Xu H, Qu H. LuQi Formula relieves ventricular remodeling through improvement of HIF-1α-mediated intestinal barrier integrity. Chin Med 2023; 18:90. [PMID: 37507786 PMCID: PMC10386699 DOI: 10.1186/s13020-023-00803-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Ventricular remodeling is the adaptive process in which the heart undergoes changes due to stress, leading to heart failure (HF). The progressive decline in cardiac function is considered to contribute to intestinal barrier impairment. LuQi Formula (LQF) is a traditional Chinese medicine preparation widely used in the treatment of ventricular remodeling and HF. However, the role of LQF in the impairment of intestinal barrier function induced by ventricular remodeling remains unclear. MATERIALS AND METHODS Ventricular remodeling was induced in rats by permanently ligating the left anterior descending branch coronary artery, and cardiac function indexes were assessed using echocardiography. Heart and colon tissue morphology were observed by hematoxylin-eosin, Masson's trichrome and Alcian Blue Periodic acid Schiff staining. Myocardial cell apoptosis was detected using TUNEL and immunohistochemistry. Circulatory levels of brain natriuretic peptide (BNP), intestinal permeability markers endotoxin, D-lactate and zonulin, as well as inflammatory cytokines tumor necrosis factor alpha and interleukin-1 beta were measured by Enzyme-linked immunosorbent assay. Expression levels of tight junction (TJ) proteins and hypoxia-inducible factor-1 alpha (HIF-1α) in colon tissue were detected by immunofluorescence, immunohistochemistry and western blotting. Cardiac function indexes and intestinal permeability markers of patients with HF were analyzed before and after 2-4 months of LQF treatment. RESULTS LQF protected cardiac function and alleviated myocardial fibrosis and apoptosis in rats with ventricular remodeling. LQF protected the intestinal barrier integrity in ventricular remodeling rats, including maintaining colonic tissue morphology, preserving the number of goblet cells and normal expression of TJ proteins. Furthermore, LQF upregulated the expression of HIF-1α protein in colon tissue. Intervention with a HIF-1α inhibitor weakened the protective effect of LQF on intestinal barrier integrity. Moreover, a reduction of HIF-1α aggravated ventricular remodeling, which could be alleviated by LQF. Correspondingly, the circulating levels of intestinal permeability markers and BNP in HF patients were significantly decreased, and cardiac function markedly improved following LQF treatment. CONCLUSIONS We demonstrated that LQF effectively protected cardiac function by preserving intestinal barrier integrity caused by ventricular remodeling, at least partially through upregulating HIF-1α expression.
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Affiliation(s)
- Jirong Yan
- Institute of Cardiovascular Disease of Integrated Traditional Chinese and Western Medicine, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai, 201203, China
| | - Zhichao Xi
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, No. 1200, Cailun Road, Shanghai, 201203, China
- Engineering Research Center of Shanghai Colleges for TCM New Drug Discovery, Shanghai, 201203, China
| | - Jiaying Guo
- Institute of Cardiovascular Disease of Integrated Traditional Chinese and Western Medicine, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai, 201203, China
| | - Lin Xu
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, No. 1200, Cailun Road, Shanghai, 201203, China
- Engineering Research Center of Shanghai Colleges for TCM New Drug Discovery, Shanghai, 201203, China
| | - Xueyang Sun
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, No. 1200, Cailun Road, Shanghai, 201203, China
- Engineering Research Center of Shanghai Colleges for TCM New Drug Discovery, Shanghai, 201203, China
| | - Wanjing Sha
- Institute of Cardiovascular Disease of Integrated Traditional Chinese and Western Medicine, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai, 201203, China
| | - Milin Liu
- Institute of Cardiovascular Disease of Integrated Traditional Chinese and Western Medicine, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai, 201203, China
| | - Shenyu Zhao
- Institute of Cardiovascular Disease of Integrated Traditional Chinese and Western Medicine, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai, 201203, China
| | - Enrui Dai
- Institute of Cardiovascular Disease of Integrated Traditional Chinese and Western Medicine, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai, 201203, China
| | - Yu Xu
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, No. 1200, Cailun Road, Shanghai, 201203, China
- Engineering Research Center of Shanghai Colleges for TCM New Drug Discovery, Shanghai, 201203, China
| | - Hongxi Xu
- Institute of Cardiovascular Disease of Integrated Traditional Chinese and Western Medicine, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai, 201203, China.
| | - Huiyan Qu
- Institute of Cardiovascular Disease of Integrated Traditional Chinese and Western Medicine, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai, 201203, China.
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Tian Y, Pan Z, Lan L, Chang Y, Zhao T, Fu Z, Wu S, Deng T, Cao M, Wang W, Bi Y, Yang R, Yang Lee BJ, Liu Q. Amelioration of intestinal barrier function and reduction of blood lead level in adult women with recurrent spontaneous abortion by a novel product of dietary fiber mixture, Holofood. J Health Popul Nutr 2023; 42:63. [PMID: 37420277 DOI: 10.1186/s41043-023-00394-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/29/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND The elevated circulating toxins secondary to the impairment of intestinal barrier integrity commonly elicit a chronic inflammatory response and finally contribute to multiple diseases. These toxins, including bacterial by-products and heavy metals, are the potent risk factors for the development of recurrent spontaneous abortion (RSA). Preclinical evidence suggests that several dietary fibers can restore intestinal barrier function and decrease the accumulation of heavy metals. However, it is uncertain whether treatment with a newly developed blend of dietary fibers product (Holofood) benefits patients with RSA. METHODS In this trial, we enrolled 70 adult women with RSA, who were randomly assigned into the experiment group and the control group in a 2:1 ratio. Upon the basis of conventional therapy, subjects in the experiment group (n = 48) received 8 weeks oral administration with Holofood three times daily at a dose of 10 g each time. Subjects without Holofood consumption were set as the control (n = 22). Blood samples were collected for the determinations of metabolic parameters, heavy mental lead, and the indices related to intestinal barrier integrity (D-lactate, bacterial endotoxin, and diamine oxidase activity). RESULTS The reduction amplitude in blood lead from baseline to week 8 was 40.50 ± 54.28 (μg/L) in the experiment group as compared with 13.35 ± 36.81 (μg/L) in the control group (P = 0.037). The decreased level of serum D-lactate from baseline to week 8 was 5.58 ± 6.09 (mg/L) in the experiment group as compared with - 2.38 ± 8.90 (mg/L, P < 0.0001) in the control group. The change in serum DAO activity from baseline to week 8 was 3.26 ± 2.23 (U/L) in the experiment group as compared with - 1.24 ± 2.22 (U/L, P < 0.0001) in the control group. Participants who received Holofood had a greater decline in blood endotoxin from baseline to week 8 than those in the control group. Moreover, by comparing with the self-baseline, Holofood consumption significantly decreased the blood levels of lead, D-lactate, bacterial endotoxin, and DAO activity. CONCLUSION Our results suggest that Holofood affords a clinically relevant improvements in blood lead level and intestinal barrier dysfunction in patients with RSA.
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Affiliation(s)
- Ye Tian
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, Chinese People's Liberation Army General Hospital, Beijing, 100853, China
- Shenzhen Key Laboratory of Fertility Regulation, Center of Assisted Reproduction and Embryology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, 518053, China
| | - Zhiyuan Pan
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, China
| | - Liling Lan
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, No. 3012, Fuqiang Road, Futian District, Shenzhen, 518028, China
| | - Yuxiao Chang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, China
| | - Ting Zhao
- Guangzhou First People's Hospital, Guangzhou, 510180, China
| | - Zhihong Fu
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, No. 3012, Fuqiang Road, Futian District, Shenzhen, 518028, China
| | - Shuhua Wu
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, No. 3012, Fuqiang Road, Futian District, Shenzhen, 518028, China
| | - Tianqin Deng
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, No. 3012, Fuqiang Road, Futian District, Shenzhen, 518028, China
| | - Meilan Cao
- Center of Assisted Reproduction and Embryology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, 518053, China
| | - Weizhou Wang
- Department of Obstetrics and Gynecology, The Seventh Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100007, China
| | - Yujing Bi
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, China
| | - Ruifu Yang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, China
| | - B J Yang Lee
- Beijing Future Science & Technology Development Co., Ltd., Rm. 1702A #1 Guanhu International Plaza, 105 Yaojiayuan Road, Chaoyang District, Beijing, 100025, China.
| | - Qingzhi Liu
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, No. 3012, Fuqiang Road, Futian District, Shenzhen, 518028, China.
- Center of Assisted Reproduction and Embryology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, 518053, China.
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Huang S, Xie Z, Han J, Wang H, Yang G, Li M, Zhou G, Wang Y, Li L, Li L, Zeng Z, Yu J, Chen M, Zhang S. Protocadherin 20 maintains intestinal barrier function to protect against Crohn's disease by targeting ATF6. Genome Biol 2023; 24:159. [PMID: 37407995 DOI: 10.1186/s13059-023-02991-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/15/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Intestinal barrier dysfunction plays a central role in the pathological onset of Crohn's disease. We identify the cadherin superfamily member protocadherin 20 (PCDH20) as a crucial factor in Crohn's disease. Here we describe the function of PCDH20 and its mechanisms in gut homeostasis, barrier integrity, and Crohn's disease development. RESULTS PCDH20 mRNA and protein expression is significantly downregulated in the colonic epithelium of Crohn's disease patients and mice with induced colitis compared with controls. In mice, intestinal-specific Pcdh20 knockout causes defects in enterocyte proliferation and differentiation, while causing morphological abnormalities. Specifically, the deletion disrupts barrier integrity by unzipping adherens junctions via β-catenin regulation and p120-catenin phosphorylation, thus aggravating colitis in DSS- and TNBS-induced colitis mouse models. Furthermore, we identify activating transcription factor 6 (ATF6), a key chaperone of endoplasmic reticulum stress, as a functional downstream effector of PCDH20. By administering a selective ATF6 activator, the impairment of intestinal barrier integrity and dysregulation of CHOP/β-catenin/p-p120-catenin pathway was reversed in Pcdh20-ablated mice with colitis and PCDH20-deficient colonic cell lines. CONCLUSIONS PCDH20 is an essential factor in maintaining intestinal epithelial homeostasis and barrier integrity. Specifically, PCDH20 helps to protect against colitis by tightening adherens junctions through the ATF6/CHOP/β-catenin/p-p120-catenin axis.
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Affiliation(s)
- Shanshan Huang
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Zhuo Xie
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Jing Han
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Huiling Wang
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
- Department of Clinical Laboratory, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, 450003, Henan Province, People's Republic of China
- People's Hospital of Henan University, Kaifeng, 475000, Henan Province, People's Republic of China
| | - Guang Yang
- Department of Minimally Invasive & Interventional Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, Guangdong Province, People's Republic of China
| | - Manying Li
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Gaoshi Zhou
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Ying Wang
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Lixuan Li
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Li Li
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Zhirong Zeng
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Jun Yu
- Institute of Digestive Disease and Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Li Ka Shing Institute of Health Sciences, CUHK Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong, 999077, People's Republic of China
| | - Minhu Chen
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou, 510080, Guangdong Province, People's Republic of China.
| | - Shenghong Zhang
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou, 510080, Guangdong Province, People's Republic of China.
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Chang SY, Lee JH, Oh HJ, An JW, Song DC, Cho HA, Park SH, Jeon KH, Cho SY, Kim DJ, Kim MS, Cho JH. Effect of different ratios of phytogenic feed additives on growth performance, nutrient digestibility, intestinal barrier integrity, and immune response in weaned pigs challenged with a pathogenic Escherichia coli. J Anim Sci 2023:7160321. [PMID: 37167436 DOI: 10.1093/jas/skad148] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Indexed: 05/13/2023] Open
Abstract
This study was conducted to investigate the effects of supplementing different ratios of phytogenic feed additives (PFA) to weaned pigs challenged with pathogenic Escherichia coli (E. coli) on growth performance, nutrient digestibility, intestinal barrier integrity, and immune response, and to determine the optimal mixing ratio for PWD prevention. A total of 48 4-week-old weaned pigs with initial body weight of 8.01 ± 0.39 kg were placed in individual metabolic cages, and then randomly assigned to eight treatment groups. The eight treatments were as follows: a basal diet without E. coli challenge (negative control, NC), a basal diet with E. coli challenge (positive control, PC), PC with supplementing 0.1% mixture of 20 % bitter citrus extract (BCE), 10% microencapsulated blend of thymol and carvacrol (MEO), and 70% excipient (T1), PC with supplementing 0.1% mixture of 10% MEO, 20% premixture of grape seed & grape marc extract, green tea, and hops (PGE), and 60% excipient (T2), PC with supplementing 0.1% mixture of 10% BCE, 10% MEO, 10% PGE, and 70% excipient (T3), PC with supplementing 0.1% mixture of 20% BCE, 20% MEO, and 60% excipient (T4), PC with supplementing 0.1 % mixture of 20% MEO, 20% PGE, and 60% excipient (T5), and PC with supplementing 0.1 % mixture of 10% BCE, 20% MEO, 10% PGE, and 60% excipient (T6). The experiments progressed in 16 days, including 5 days before and 11 days after the first E. coli challenge (d 0). In the E. coli challenge treatments, all pigs were orally inoculated by dividing a total of 10 mL of E. coli F 18 for 3 consecutive days from d 0 post-inoculation (PI). Compared with the PC group, the PFA2 and PFA6 groups significantly increased (P < 0.05) feed efficiency and decreased (P < 0.05) diarrhea during the entire period. At d 11 PI, the PFA6 group significantly improved (P < 0.05) gross energy digestibility compared to the PFA1 group. The PFA6 group significantly decreased (P < 0.05) tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) in serum and increased (P < 0.05) the villus height to crypt depth ratio (VH:CD). The PFA2 significantly decreased (P < 0.05) the relative protein expression of calprotectin in the ileum. In conclusion, improvements in growth performance, diarrhea reduction, and immunity enhancement are demonstrated when 10% BCE, 20% MEO, 10% PGE, and 60% excipient are mixed.
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Affiliation(s)
- Se Yeon Chang
- Department of Animal Science, Chungbuk National University, Cheongju 28644, South Korea
| | - Ji Hwan Lee
- Department of Poultry Science, University of Georgia, Athens, GA 30602, United States
| | - Han Jin Oh
- Department of Animal Science, Chungbuk National University, Cheongju 28644, South Korea
| | - Jae Woo An
- Department of Animal Science, Chungbuk National University, Cheongju 28644, South Korea
| | - Dong Cheol Song
- Department of Animal Science, Chungbuk National University, Cheongju 28644, South Korea
| | - Hyun Ah Cho
- Department of Animal Science, Chungbuk National University, Cheongju 28644, South Korea
| | - Se Hyun Park
- Department of Animal Science, Chungbuk National University, Cheongju 28644, South Korea
| | - Kyeong Ho Jeon
- Department of Animal Science, Chungbuk National University, Cheongju 28644, South Korea
| | | | | | | | - Jin Ho Cho
- Department of Animal Science, Chungbuk National University, Cheongju 28644, South Korea
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Li J, Bai J, Si X, Jia H, Wu Z. Benzo[a]pyrene induces epithelial tight junction disruption and apoptosis via inhibiting the initiation of autophagy in intestinal porcine epithelial cells. Chem Biol Interact 2023; 374:110386. [PMID: 36754226 DOI: 10.1016/j.cbi.2023.110386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/29/2023] [Accepted: 02/05/2023] [Indexed: 02/10/2023]
Abstract
Ingestion of food contaminated with benzo[a]pyrene (B[a]P) poses health risks to animals and humans. However, the toxicity of B[a]P exposure on the intestinal barrier function and underlying mechanisms remain obscure. In the present study, intestinal porcine epithelial cells (IPEC-1) were challenged with different doses of B[a]P and its deleterious effects were determined. We found that B[a]P exposure led to impaired intestinal tight junction function as evidenced by reduced transepithelial electric resistance, increased permeability, and downregulated intestinal tight junction protein levels. Further study demonstrated that B[a]P treatment induced cell cycle arrest, and resulted in oxidative damage-related apoptosis in IPEC-1 cells. Intriguingly, we observed an inhibition of autophagy and an activation of unfolded protein response (UPR) in B[a]P-challenged cells, when compared with controls. To investigate the role of autophagy on B[a]P-induced epithelial tight junction disruption and apoptosis, cells were cotreated with B[a]P and rapamycin, and rapamycin dramatically improved intestinal tight junction and reduced apoptosis, indicating a protective effect of autophagy for the cells in response to B[a]P treatment. We also explored the role of UPR in B[a]P-induced cellular damage by using 4-phenylbutyric acid, an antagonist of UPR. Interestingly, B[a]P-induced apoptosis and dysfunction of the intestinal tight junction were exacerbated by 4-phenylbutyric acid, and the 4-phenylbutyric acid didn't ameliorate the inhibitory effects of B[a]P on microtubule-associated protein 1 light chain 3 (LC3-II) and lysosomal-associated membrane protein 2 (LAMP2) in IPEC-1 cells. These novel findings provided herein indicated that B[a]P induces intestinal epithelial tight junction disruption and apoptotic cell death via inhibiting autophagy in IPEC-1 cells.
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Affiliation(s)
- Jun Li
- State Key Laboratory of Animal Nutrition, Department of Companion Animal Science, Nutrition and Feed Science, China Agricultural University, Beijing, 100193, PR China
| | - Jun Bai
- State Key Laboratory of Animal Nutrition, Department of Companion Animal Science, Nutrition and Feed Science, China Agricultural University, Beijing, 100193, PR China
| | - Xuemeng Si
- State Key Laboratory of Animal Nutrition, Department of Companion Animal Science, Nutrition and Feed Science, China Agricultural University, Beijing, 100193, PR China
| | - Hai Jia
- State Key Laboratory of Animal Nutrition, Department of Companion Animal Science, Nutrition and Feed Science, China Agricultural University, Beijing, 100193, PR China
| | - Zhenlong Wu
- State Key Laboratory of Animal Nutrition, Department of Companion Animal Science, Nutrition and Feed Science, China Agricultural University, Beijing, 100193, PR China; Beijing Advanced Innovation Center for Food Nutrition and Human Health, China Agricultural University, Beijing, 100193, China.
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10
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Eum SY, Schurhoff N, Teglas T, Wolff G, Toborek M. Circadian disruption alters gut barrier integrity via a ß-catenin-MMP-related pathway. Mol Cell Biochem 2023; 478:581-595. [PMID: 35976519 PMCID: PMC9938043 DOI: 10.1007/s11010-022-04536-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 08/04/2022] [Indexed: 10/15/2022]
Abstract
We evaluated the mechanistic link between circadian rhythms and gut barrier permeability. Mice were subjected to either constant 24-h light (LL) or 12-h light/dark cycles (LD). Mice housed in LL experienced a significant increase in gut barrier permeability that was associated with dysregulated ß-catenin expression and altered expression of tight junction (TJ) proteins. Silencing of ß-catenin resulted in disruption of barrier function in SW480 cells, with ß-catenin appearing to be an upstream regulator of the core circadian components, such as Bmal1, Clock, and Per1/2. In addition, ß-catenin silencing downregulated ZO-1 and occludin TJ proteins with only limited or no changes at their mRNA levels, suggesting post transcriptional regulation. Indeed, silencing of ß-catenin significantly upregulated expression of matrix metallopeptidase (MMP)-2 and MMP-9, and blocking MMP-2/9 activity attenuated epithelial disruption induced by ß-catenin silencing. These results indicate the regulatory role of circadian disruption on gut barrier integrity and the associations between TJ proteins and circadian rhythms, while demonstrating the regulatory role of ß-catenin in this process.
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Affiliation(s)
- Sung Yong Eum
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, 33155, USA
| | - Nicolette Schurhoff
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, 33155, USA
| | - Timea Teglas
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, 33155, USA
| | - Gretchen Wolff
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, 33155, USA
- Institute for Diabetes and Cancer (IDC), Helmholtz Diabetes Center, Helmholtz Centre Munich, Neuherberg, Germany
- Joint Heidelberg-IDC Translational Diabetes Program, Inner Medicine 1, Heidelberg University Hospital, Heidelberg, Germany
| | - Michal Toborek
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, 33155, USA.
- Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065, Katowice, Poland.
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Suite 528, 1011 NW 15th Street, Miami, FL, 33136, USA.
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Zou T, Xie F, Liang P, Chen J, Wang Z, Du M, You J. Polysaccharide-rich fractions from Enteromorpha prolifera improve hepatic steatosis and gut barrier integrity in high-fat diet-induced obese mice linking to modulation of gut microbiota. Biomed Pharmacother 2023; 157:114034. [PMID: 36434956 DOI: 10.1016/j.biopha.2022.114034] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 11/24/2022] Open
Abstract
Polysaccharides from Enteromorpha prolifera (EP) possess important benefits in the management of obesity and associated metabolic diseases, but to date, the underlying mechanism linking this alleviative effect of EP to gut microbiota remains obscure. This study aimed to investigate the effects of EP in improving lipid metabolism disorders and intestinal barrier disruption in mice with high-fat diet (HFD), and its association with modulation of gut microbiota. C57BL/6 mice were fed a control diet or a HFD with or without 5% EP for 12 weeks. Factors related to lipid metabolism, insulin signaling and intestinal barrier integrity, as well as the involvement of gut microbiota and metabolites, were measured. EP supplementation reduced HFD-induced adiposity and mitigated insulin resistance, hepatic steatosis and elevation of serum lipopolysaccharides (LPS). HFD impaired intestinal barrier integrity while improved due to EP. Moreover, EP administration ameliorated HFD-induced gut dysbiosis, as revealed by the increased short-chain fatty acid (SCFA)-producing bacteria (e.g., Bacteroides, Parabacteroides, Alloprevotella, and Ruminococcus) and gut barrier-protective Akkermansia muciniphila and decreased endotoxin-producing bacteria (e.g., Desulfovibrionaceae and Bilophila), accompanied by enrichment in intestinal SCFA content and reduction in circulating LPS level. The change of dominant bacterial genera is significantly correlated with improved metabolic profiles and intestinal permeability induced by EP. In conclusion, our results indicate that EP can attenuate HFD-induced metabolic disorders along with restoration of gut barrier integrity and lowering of circulating endotoxin, and these improvements are associated with modulation of gut microbiota composition and related metabolites. These data deepen mechanistic understanding of the anti-obesity and metabolic improving effects of EP.
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Affiliation(s)
- Tiande Zou
- Jiangxi Province Key Laboratory of Animal Nutrition, Jiangxi Agricultural University, Nanchang 330045, Jiangxi, China
| | - Fei Xie
- Jiangxi Province Key Laboratory of Animal Nutrition, Jiangxi Agricultural University, Nanchang 330045, Jiangxi, China
| | - Pengbo Liang
- Jiangxi Province Key Laboratory of Animal Nutrition, Jiangxi Agricultural University, Nanchang 330045, Jiangxi, China
| | - Jun Chen
- Jiangxi Province Key Laboratory of Animal Nutrition, Jiangxi Agricultural University, Nanchang 330045, Jiangxi, China
| | - Zirui Wang
- Jiangxi Province Key Laboratory of Animal Nutrition, Jiangxi Agricultural University, Nanchang 330045, Jiangxi, China
| | - Min Du
- Laboratory of Nutrigenomics and Growth Biology, Department of Animal Sciences, Washington State University, Pullman, WA 99164, USA
| | - Jinming You
- Jiangxi Province Key Laboratory of Animal Nutrition, Jiangxi Agricultural University, Nanchang 330045, Jiangxi, China.
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12
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Lin G, Li S, Huang J, Gao D, Lu J. Hypoosmotic stress induced functional alternations of intestinal barrier integrity, inflammatory reactions, and neurotransmission along gut-brain axis in the yellowfin seabream (Acanthopagrus latus). Fish Physiol Biochem 2021; 47:1725-1738. [PMID: 34480680 DOI: 10.1007/s10695-021-01011-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 08/24/2021] [Indexed: 06/13/2023]
Abstract
The gut-brain axis plays a major role in multiple metabolic regulation processes, but studies regarding its responses to environmental stress in fish are still limited. In this study, we performed transcriptome sequencing analysis and enzyme-linked immunosorbent assay (ELISA) in yellowfin seabream (Acanthopagrus latus) exposed to environments with different water salinity (freshwater: 0 ppt; low-saline water: 3 ppt; brackish water: 6 ppt). According to transcriptome analysis, 707 and 1477 genes were identified as differentially expressed genes (DEGs) between freshwater and brackish water treatments in the brain and gut, respectively. Brain DEGs were significantly enriched into a set of Gene Ontology terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways associated with signal transduction, most of which were downregulated. Gut DEGs were enriched into a neurotransmission-relevant KEGG pathway tryptophan metabolism, and the downregulated DEGs were enriched into the KEGG pathway focal adhesion. ELISA demonstrated significant physiological responses of the brain and gut across treatments, as determined by the concentrations of tight junction protein ZO-2, interleukin 1β, and serotonin. Under hypoosmotic stress, the functions of the gut-brain axis are altered via impairment of intestinal barrier integrity, by disturbance of gut-brain neurotransmission, and through tissue-damaging inflammatory reactions. Our work identified candidate genes which showed significantly differential expression in the gut-brain axis when yellowfin seabream encountered hypoosmotic stress, which could shed lights on the understanding of the potential osmotic regulation mechanisms of the gut-brain axis in teleost.
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Affiliation(s)
- Genmei Lin
- School of Marine Sciences, Sun Yat-Sen University, Zhuhai, 519082, China
| | - Shizhu Li
- School of Marine Sciences, Sun Yat-Sen University, Zhuhai, 519082, China
| | - Junrou Huang
- School of Marine Sciences, Sun Yat-Sen University, Zhuhai, 519082, China
| | - Dong Gao
- School of Marine Sciences, Sun Yat-Sen University, Zhuhai, 519082, China
| | - Jianguo Lu
- School of Marine Sciences, Sun Yat-Sen University, Zhuhai, 519082, China.
- Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai, 519080, China.
- Guangdong Provincial Key Laboratory of Marine Resources and Coastal Engineering, Guangzhou, 510275, Guangdong, China.
- Pearl River Estuary Marine Ecosystem Research Station, Ministry of Education, Zhuhai, 519000, China.
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13
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Deng X, Wang Y, Tian L, Yang M, He S, Liu Y, Khan A, Li Y, Cao J, Cheng G. Anneslea fragrans Wall. ameliorates ulcerative colitis via inhibiting NF-κB and MAPK activation and mediating intestinal barrier integrity. J Ethnopharmacol 2021; 278:114304. [PMID: 34116185 DOI: 10.1016/j.jep.2021.114304] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/10/2021] [Accepted: 06/02/2021] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Anneslea fragrans Wall. is traditionally used as a folk medicine in treating indigestion, fever, dysentery, diarrhea, and liver inflammation in China, Vietnam and Cambodia. However, its anti-inflammatory activity and mechanism under a safety therapeutic dose as well as the main chemical components have not yet been fully investigated. AIM OF THE STUDY This study aimed to explore the therapeutic effect and possible molecular mechanisms of aqueous-methanol extract (AFE) of A. fragrans leaves on dextran sodium sulfate (DSS)-induced ulcerative colitis (UC) mice and illustrate its potent anti-inflammatory chemical compounds. MATERIALS AND METHODS The AFE was obtained and then analyzed by high performance liquid chromatography (HPLC). Phytochemical investigation on the AFE was carried out to isolate and characterize its major components. The acute toxicity test was performed to provide the safety information of AFE. Subsequently, the protective effect of AFE on DSS-induced UC was evaluated by physiological changes, histopathological and immunohistochemical analysis, and the expressions of antioxidant enzyme, pro-inflammatory cytokines and anti-inflammatory cytokines. The expressions of target proteins in nuclear factor-kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) were determined by western blot analysis. The tight junction (TJ) proteins in colon tissue were performed by immunohistochemical technique for evaluating the intestinal barrier integrity. RESULTS HPLC guided isolation of AFE resulted into two dihydrochalcones, which were elucidated as vacciniifolin (1) and confusoside (2). Acute toxicity evaluation revealed that median lethal dose (LD50) of AFE was greater than 5000 mg/kg. Furthermore, AFE significantly attenuated ulcerative colitis symptoms, suppressed myeloperoxidase activity, and increased the expression of superoxide dismutase and glutathione. AFE treatment could also reduce the levels of tumor necrosis factor-α, interleukin-1β, and interleukin-6 and increase the levels of interleukin-4 and interleukin-10 in colon tissues and serum of DSS-induced UC mice. In addition, AFE significantly increased the expression of zonula occludens-1, occludin and claudin-1, and inhibited the phosphorylation of target protein of the NF-κB and MAPK signaling pathways in colon tissue. CONCLUSION Dihydrochalcone glycosides are the major chemical constituents in AFE. AFE ameliorated DSS-induced UC in mice by inhibiting the inflammatory response via modulation of NF-κB and MAPK pathways and maintaining the intestinal barrier function, indicating that the plant A. fragrans could be used as a therapeutic candidate for ulcerative colitis.
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Affiliation(s)
- Xiaocui Deng
- Faculty of Agriculture and Food, Kunming University of Science and Technology, Kunming, 650500, China
| | - Yudan Wang
- Faculty of Agriculture and Food, Kunming University of Science and Technology, Kunming, 650500, China
| | - Lei Tian
- Faculty of Agriculture and Food, Kunming University of Science and Technology, Kunming, 650500, China
| | - Meilian Yang
- Faculty of Agriculture and Food, Kunming University of Science and Technology, Kunming, 650500, China
| | - Shuyue He
- Faculty of Agriculture and Food, Kunming University of Science and Technology, Kunming, 650500, China
| | - Yaping Liu
- Faculty of Agriculture and Food, Kunming University of Science and Technology, Kunming, 650500, China
| | - Afsar Khan
- Department of Chemistry, COMSATS University Islamabad, Abbottabad Campus, Abbottabad, 22060, Pakistan
| | - Yanping Li
- College of Pharmaceutic Science, Yunnan University of Traditional Chinese Medicine, Kunming, 650000, China
| | - Jianxin Cao
- Faculty of Agriculture and Food, Kunming University of Science and Technology, Kunming, 650500, China
| | - Guiguang Cheng
- Faculty of Agriculture and Food, Kunming University of Science and Technology, Kunming, 650500, China.
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14
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Bao X, Wu J. Impact of food-derived bioactive peptides on gut function and health. Food Res Int 2021; 147:110485. [PMID: 34399481 DOI: 10.1016/j.foodres.2021.110485] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/10/2021] [Accepted: 05/23/2021] [Indexed: 12/14/2022]
Abstract
The gastrointestinal tract (GIT) is the largest interface between our body and the environment. It is an organ system extending from the mouth to the anus and functions for food intake, digestion, transport and absorption of nutrients, meanwhile providing protection from environmental factors, like toxins, antigens, and pathogens. Diet is one of the leading factors modulating the function of the GIT. Bioactive peptides presenting naturally in food or derived from food proteins during digestion or processing have been revealed multifunctional in diverse biological processes, including maintaining gut health and function. This review summarizes the available evidence regarding the effects of food-derived bioactive peptides on gut function and health. Findings and insights from studies based on in vitro and animal models are discussed. The gastrointestinal mucosa maintains a delicate balance between immune tolerance to nutrients and harmful components, which is crucial for the digestive system's normal functions. Dietary bioactive peptides positively impact gastrointestinal homeostasis by modulating the barrier function, immune responses, and gut microbiota. However, there is limited clinical evidence on the safety and efficacy of bioactive peptides, much less on the applications of dietary peptides for the treatment or prevention of diseases related to the GIT. Further study is warranted to establish the applications of bioactive peptides in regulating gut health and function.
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15
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Takayama S, Katada K, Takagi T, Iida T, Ueda T, Mizushima K, Higashimura Y, Morita M, Okayama T, Kamada K, Uchiyama K, Handa O, Ishikawa T, Yasukawa Z, Okubo T, Itoh Y, Naito Y. Partially hydrolyzed guar gum attenuates non-alcoholic fatty liver disease in mice through the gut-liver axis. World J Gastroenterol 2021; 27:2160-2176. [PMID: 34025071 PMCID: PMC8117741 DOI: 10.3748/wjg.v27.i18.2160] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/12/2021] [Accepted: 04/21/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The gut-liver axis has attracted much interest in the context of chronic liver disease pathogenesis. Prebiotics such as dietary fibers were shown to attenuate non-alcoholic fatty liver disease (NAFLD) by modulating gut microbiota. Partially hydrolyzed guar gum (PHGG), a water-soluble dietary fiber, has been reported to alleviate the symptoms of various intestinal diseases and metabolic syndromes. However, its effects on NAFLD remain to be fully elucidated. AIM To determine whether treatment with PHGG attenuates NAFLD development in mice through the gut-liver axis. METHODS Seven-week-old male C57BL/6J mice with increased intestinal permeability were fed a control or atherogenic (Ath) diet (a mouse model of NAFLD) for 8 wk, with or without 5% PHGG. Increased intestinal permeability was induced through chronic intermittent administration of low-dose dextran sulfate sodium. Body weight, liver weight, macroscopic findings in the liver, blood biochemistry [aspartate aminotransferase (AST) and alanine aminotransferase (ALT), total cholesterol, triglyceride, free fatty acids, and glucose levels], liver histology, myeloperoxidase activity in liver tissue, mRNA expression in the liver and intestine, serum endotoxin levels in the portal vein, intestinal permeability, and microbiota and short-chain fatty acid (SCFA) profiles in the cecal samples were investigated. RESULTS Mice with increased intestinal permeability subjected to the Ath diet showed significantly increased serum AST and ALT levels, liver fat accumulation, liver inflammatory (tumor necrosis factor-α and monocyte chemotactic protein-1) and fibrogenic (collagen 1a1 and α smooth muscle actin) marker levels, and liver myeloperoxidase activity, which were significantly attenuated by PHGG treatment. Furthermore, the Ath diet combined with increased intestinal permeability resulted in elevated portal endotoxin levels and activated toll-like receptor (TLR) 4 and TLR9 expression, confirming that intestinal permeability was significantly elevated, as observed by evaluating the lumen-to-blood clearance of fluorescein isothiocyanate-conjugated dextran. PHGG treatment did not affect fatty acid metabolism in the liver. However, it decreased lipopolysaccharide signaling through the gut-liver axis. In addition, it significantly increased the abundance of cecal Bacteroides and Clostridium subcluster XIVa. Treatment with PHGG markedly increased the levels of SCFAs, particularly, butyric acid, acetic acid, propionic acid, and formic acid, in the cecal samples. CONCLUSION PHGG partially prevented NAFLD development in mice through the gut-liver axis by modulating microbiota and downstream SCFA profiles.
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Affiliation(s)
- Shun Takayama
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Kazuhiro Katada
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Tomohisa Takagi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Department of Medical Innovation and Translational Medical Science, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Takaya Iida
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Tomohiro Ueda
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Katsura Mizushima
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Yasuki Higashimura
- Department of Food Science, Ishikawa Prefectural University, Nonoichi 921-8836, Japan
| | - Mayuko Morita
- Department of Health Care Nutrition, Showa Gakuin Junior College, Ichikawa 272-0823, Japan
| | - Tetsuya Okayama
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Kazuhiro Kamada
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Kazuhiko Uchiyama
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Osamu Handa
- Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Kurashiki 701-0192, Japan
| | - Takeshi Ishikawa
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Zenta Yasukawa
- Department of Nutrition, Taiyo Kagaku Co. Ltd, Yokkaichi 510-0844, Japan
| | - Tsutomu Okubo
- Department of Nutrition, Taiyo Kagaku Co. Ltd, Yokkaichi 510-0844, Japan
| | - Yoshito Itoh
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Yuji Naito
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
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Pu J, Chen D, Tian G, He J, Zheng P, Mao X, Yu J, Huang Z, Luo J, Luo Y, Yu B. Effects of benzoic acid, Bacillus coagulans and oregano oil combined supplementation on growth performance, immune status and intestinal barrier integrity of weaned piglets. ACTA ACUST UNITED AC 2020; 6:152-159. [PMID: 32542195 PMCID: PMC7283367 DOI: 10.1016/j.aninu.2020.02.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 01/27/2020] [Accepted: 02/27/2020] [Indexed: 01/23/2023]
Abstract
This experiment was conducted to investigate the effects of benzoic acid, Bacillus coagulans and oregano oil combined supplementation on growth performance, immune status and intestinal barrier integrity of piglets. In a 26-d experiment, 25 piglets were randomly assigned to 5 treatments: 1) a basal diet, negative control (NC), 2) NC added with antibiotics, positive control (PC); 3) NC added with benzoic acid at 3,000 g/t and Bacillus coagulans at 400 g/t (AB); 4) NC added with benzoic acid at 3,000 g/t and oregano oil at 400 g/t (AO); 5) NC added with 3,000 g/t benzoic acid and Bacillus coagulans at 400 g/t and oregano oil at 400 g/t (ABO). On d 27, all piglets were euthanized to obtain jejunal mucosa to measure immune status and intestinal barrier integrity. Results showed that pigs fed AB diet increased the final body weight and average daily body weight gain and decreased the ratio of feed to gain compared with NC group (P < 0.05). Compared with NC group, AB, AO and ABO decreased serum tumor necrosis factor-α concentration and ABO decreased interleukin-1β concentration in serum and jejunal mucosa (P < 0.05). Compared with NC group, AB up-regulated mRNA expressions of sodium-glucose cotransporte1, claudin-1, occludin and mucin2 in jejunal mucosa and the populations of Bifidobacterium and Bacillus in cecal digesta (P < 0.05). Compared with NC group, ABO increased jejunal mucosal occludin mRNA abundance and Bifidobacterium population in cecal digesta, and decreased Escherichia coli population in cecal digesta (P < 0.05). Furthermore, AB and ABO increased Bacillus population in cecal digesta compared with PC group (P < 0.05). These results indicated that dietary AB supplementation could improve growth performance and intestinal barrier integrity of piglets when fed antibiotic-free diets, which was possibly associated with the improvement of immune status and intestinal microflora. Dietary ABO supplementation is also beneficial to improve immune status and intestinal barrier integrity and microflora of piglets.
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Affiliation(s)
- Junning Pu
- Key Laboratory for Animal Disease-Resistance Nutrition, Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130, China
| | - Daiwen Chen
- Key Laboratory for Animal Disease-Resistance Nutrition, Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130, China
| | - Gang Tian
- Key Laboratory for Animal Disease-Resistance Nutrition, Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130, China
| | - Jun He
- Key Laboratory for Animal Disease-Resistance Nutrition, Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130, China
| | - Ping Zheng
- Key Laboratory for Animal Disease-Resistance Nutrition, Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130, China
| | - Xiangbing Mao
- Key Laboratory for Animal Disease-Resistance Nutrition, Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130, China
| | - Jie Yu
- Key Laboratory for Animal Disease-Resistance Nutrition, Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130, China
| | - Zhiqing Huang
- Key Laboratory for Animal Disease-Resistance Nutrition, Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130, China
| | - Junqiu Luo
- Key Laboratory for Animal Disease-Resistance Nutrition, Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130, China
| | - Yuheng Luo
- Key Laboratory for Animal Disease-Resistance Nutrition, Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130, China
| | - Bing Yu
- Key Laboratory for Animal Disease-Resistance Nutrition, Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Chengdu, 611130, China
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Raj D, Tomar B, Lahiri A, Mulay SR. The gut-liver-kidney axis: Novel regulator of fatty liver associated chronic kidney disease. Pharmacol Res 2019; 152:104617. [PMID: 31881272 DOI: 10.1016/j.phrs.2019.104617] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/09/2019] [Accepted: 12/21/2019] [Indexed: 12/12/2022]
Abstract
Increased interest in understanding the liver-kidney axis in health and disease during the last decade unveiled multiple recent evidence that suggested a strong association of fatty liver diseases with chronic kidney disease (CKD). Low-grade systemic inflammation is thought to be the major contributing factor to the pathogenesis of CKD associated with fatty liver. However, other contributing factors largely remained unclear, for example, gut microbiota and intestinal barrier integrity. Homeostasis of the gut microbiome is very crucial for the health of an individual. Imbalance in the gut microbiota leads to various diseases like fatty liver disease and CKD. On the contrary, disease conditions can also distinctly change gut microbiota. In this review, we propose the pathogenic role of the gut-liver-kidney axis in the development and progression of CKD associated with chronic fatty liver diseases, either non-alcoholic fatty liver disease or non-alcoholic steatohepatitis in experimental models and humans. Further, we discuss the therapeutic potential and highlight the future research directions for therapeutic targeting of the gut-liver-kidney axis.
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Affiliation(s)
- Desh Raj
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow, 226031, India; Academy of Scientific and Innovative Research (AcSIR), New Delhi, 110001, India
| | - Bhawna Tomar
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow, 226031, India
| | - Amit Lahiri
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow, 226031, India; Academy of Scientific and Innovative Research (AcSIR), New Delhi, 110001, India
| | - Shrikant R Mulay
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow, 226031, India; Academy of Scientific and Innovative Research (AcSIR), New Delhi, 110001, India.
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18
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Vojdani A, Vojdani E, Kharrazian D. Fluctuation of zonulin levels in blood vs stability of antibodies. World J Gastroenterol 2017; 23:5669-5679. [PMID: 28883692 PMCID: PMC5569281 DOI: 10.3748/wjg.v23.i31.5669] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 06/30/2017] [Accepted: 07/12/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the measurement of zonulin level and antibodies of zonulin and other tight junction proteins in the blood of controls and celiac disease patients.
METHODS This study was conducted to assess the variability or stability of zonulin levels vs IgA and IgG antibodies against zonulin in blood samples from 18 controls at 0, 6, 24 and 30 h after blood draw. We also measured zonulin level as well as zonulin, occludin, vinculin, aquaporin 4 and glial fibrillary acidic protein antibodies in the sera of 30 patients with celiac disease and 30 controls using enzyme-linked immunosorbent assay methodology.
RESULTS The serum zonulin level in 6 out of 18 subjects was low or < 2.8 ng/mL and was very close to the detection limit of the assay. The other 12 subjects had zonulin levels of > 2.8 ng/mL and showed significant fluctuation from sample to sample. Comparatively, zonulin antibody measured in all samples was highly stable and reproducible from sample to sample. Celiac disease patients showed zonulin levels with a mean of 8.5 ng/mL compared to 3.7 ng/mL in controls (P < 0.0001). Elevation of zonulin level at 2SD above the mean was demonstrated in 37% of celiac disease patients, while antibodies against zonulin, occludin and other tight junction proteins was detected in up to 86% of patients with celiac disease.
CONCLUSION Due to its fluctuation, a single measurement of zonulin level is not recommended for assessment of intestinal barrier integrity. Measurement of IgG and IgA antibodies against zonulin, occludin, and other tight junction proteins is proposed for the evaluation of the loss of intestinal barrier integrity.
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Affiliation(s)
- Aristo Vojdani
- Department of Preventive Medicie, Loma Linda University, Evans Hall, Loma Linda, CA 92354, United States
- Immunosciences Lab., Inc., Los Angeles, CA 90035, United States
| | - Elroy Vojdani
- Regenera Wellness, Los Angeles, CA 90025 United States
| | - Datis Kharrazian
- Harvard Medical School, Boston, MA 02115, United States
- TRANSCEND Research, Department of Neurology, Massachusetts General Hospital, Charlestown, MA 02129, United States
- Loma Linda University School of Medicine, Loma Linda, CA 92354, United States
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Bauman BD, Meng J, Zhang L, Louiselle A, Zheng E, Banerjee S, Roy S, Segura BJ. Enteric glial-mediated enhancement of intestinal barrier integrity is compromised by morphine. J Surg Res 2017; 219:214-221. [PMID: 29078884 DOI: 10.1016/j.jss.2017.05.099] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 04/29/2017] [Accepted: 05/25/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND The opioid epidemic is a growing concern, and emerging evidence suggests that morphine use may be associated with sepsis. Enteric glial cells (EGCs) are the most numerous cell type in the enteric nervous system and regulate gastrointestinal function through the production of trophic factors, including glial-derived neurotrophic factor (GDNF). We sought to determine the effect of morphine on enteric glia and hypothesized that morphine contributes to EGC dysfunction and increased gut permeability. MATERIALS AND METHODS Rat intestinal epithelial cells (IECs) and EGC lines were purchased from ATCC. Immunocytochemistry was used to evaluate the impact of EGCs on IEC barrier proteins and detect the μ-opioid receptor. Co-culture assays were used to determine the effect of EGCs, GDNF, and morphine on barrier integrity. Quantitative polymerase chain reaction and western blotting were performed to determine the impact of morphine in GDNF production. Transepithelial resistance of IEC-6 cell monolayers was measured in the presence of EGC-conditioned media (EGC-CM) and morphine treated EGC-CM using electrical cell impedance sensing. RESULTS EGC-CM enhanced tight junction organization in IECs. IEC barrier integrity was enhanced when co-cultured with unstimulated EGCs or with GDNF alone; this barrier protective effect was lost with morphine-treated EGCs. GDNF RNA and protein expression were decreased by morphine treatment. Transepithelial resistance was decreased in IEC confluent monolayers when exposed to morphine-treated EGC-CM compared with control. CONCLUSIONS Morphine compromises intestinal epithelial cell barrier function through a mechanism which appears to involve GDNF. Further studies are warranted to delineate the role of enteric glial cell function in opioid signaling and sepsis.
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Affiliation(s)
- Brent D Bauman
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Jingjing Meng
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Lei Zhang
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | | | - Eugene Zheng
- University of Minnesota Medical School, Minneapolis, Minnesota
| | - Santanu Banerjee
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Sabita Roy
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Bradley J Segura
- Department of Surgery and Pediatrics, University of Minnesota, Minneapolis, Minnesota.
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