Paving the way towards a weight‐loss intervention study in obese patients with inflammatory bowel disease

The complement and contact systems may be involved in the pathophysiological process of inflammatory bowel disease (IBD). C1 inhibitor (C1INH) is the most important inhibitor of both the complement and contact systems. We evaluated the role of these systems and the effect of both active and inactive forms of C1INH (iC1INH) in dextran sulfate sodium (DSS)-induced colitis mouse model. Three percent DSS was used in drinking water to induce colitis in complement C3-deficient (C3−/−) mice, bradykinin type 2 receptor deficient (Bk2R−/−) mice, and C57BL/6 mice. After ten days DSS exposure, C3−/− mice exhibited markedly less weight loss than wild-type (WT) mice (12 ± 3.3% vs. 30 ± 1.2%, P < 0.05) and developed a milder disease-activity index (DAI), histological score, colon shortening, and myeloperoxidase (MPO) elevation ( P < 0.05, respectively). The Bk2R−/− mice were not protected from the disease. Seven-day treatment with either native C1INH or iC1INH reduced the severity of the disease in WT mice, as indicated by decreased weight loss (15 ± 1.8%, 14 ± 2.1% vs. 30 ± 1.2%, P < 0.05, respectively), DAI, intestinal tissue damage, and MPO elevation compared with untreated WT DSS control mice ( P < 0.05, respectively). These findings suggest that complement plays a role in the development of DSS-induced colitis and that blockade of the complement system might be useful for the acute phase of IBD treatment. C1INH, however, leads to an amelioration of DSS-induced colitis via a mechanism that does not involve the inhibition of complement or contact system activation but does result in significant suppression of leukocyte infiltration.

Download Full-text

The Influence of Probiotics on the Firmicutes/Bacteroidetes Ratio in the Treatment of Obesity and Inflammatory Bowel disease

Microorganisms ◽

10.3390/microorganisms8111715 ◽

2020 ◽

Vol 8 (11) ◽

pp. 1715

Author(s):

Spase Stojanov ◽

Aleš Berlec ◽

Borut Štrukelj

Keyword(s):

Inflammatory Bowel Disease ◽

Weight Loss ◽

Gastrointestinal Tract ◽

Bowel Disease ◽

Important Influence ◽

Considerable Evidence ◽

Bacterial Phyla ◽

Genus Lactobacillus ◽

Inflammatory Bowel ◽

Treatment Of Obesity

The two most important bacterial phyla in the gastrointestinal tract, Firmicutes and Bacteroidetes, have gained much attention in recent years. The Firmicutes/Bacteroidetes (F/B) ratio is widely accepted to have an important influence in maintaining normal intestinal homeostasis. Increased or decreased F/B ratio is regarded as dysbiosis, whereby the former is usually observed with obesity, and the latter with inflammatory bowel disease (IBD). Probiotics as live microorganisms can confer health benefits to the host when administered in adequate amounts. There is considerable evidence of their nutritional and immunosuppressive properties including reports that elucidate the association of probiotics with the F/B ratio, obesity, and IBD. Orally administered probiotics can contribute to the restoration of dysbiotic microbiota and to the prevention of obesity or IBD. However, as the effects of different probiotics on the F/B ratio differ, selecting the appropriate species or mixture is crucial. The most commonly tested probiotics for modifying the F/B ratio and treating obesity and IBD are from the genus Lactobacillus. In this paper, we review the effects of probiotics on the F/B ratio that lead to weight loss or immunosuppression.

Download Full-text

Are Patient-Reported Outcome Measures the Way to go in Inflammatory Bowel Disease?

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2014/748938 ◽

2014 ◽

Vol 28 (10) ◽

pp. 535-535

Author(s):

Subrata Ghosh

Keyword(s):

Inflammatory Bowel Disease ◽

Outcome Measures ◽

Bowel Disease ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Patient Reported ◽

Inflammatory Bowel ◽

The Way

Download Full-text

New Insights into Inflammatory Bowel Disease Pathophysiology: Paving the Way for Novel Therapeutic Targets

Current Drug Targets ◽

10.2174/138945008784221170 ◽

2008 ◽

Vol 9 (5) ◽

pp. 413-418 ◽

Cited By ~ 28

Author(s):

Tommaso Stefanelli ◽

Alberto Malesci ◽

Alessandro Repici ◽

Stefania Vetrano ◽

Silvio Danese

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Therapeutic Targets ◽

Inflammatory Bowel ◽

Novel Therapeutic ◽

The Way

Download Full-text

Association between Inflammatory Bowel Disease and Pancreatitis: A PRISMA-Compliant Systematic Review

Gastroenterology Research and Practice ◽

10.1155/2020/7305241 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Pengfan Li ◽

Kanjun Chen ◽

Zheng Mao ◽

Yue Luo ◽

Yan Xue ◽

...

Keyword(s):

Systematic Review ◽

Inflammatory Bowel Disease ◽

Weight Loss ◽

Acute Pancreatitis ◽

Abdominal Pain ◽

Chronic Pancreatitis ◽

Bowel Disease ◽

Chronic Diarrhea ◽

Inflammatory Bowel ◽

Correlative Studies

Background/Objectives. This systematic review was conducted to investigate the association between pancreatitis and IBD. Methods. MEDLINE, Embase, and CENTRAL were systematically searched for correlative studies till 2 November 2019. RevMan5.3 was used to estimate relevance. Results. Three studies with 166008 participants were included. The risk of pancreatitis significantly increased in the patients with CD (OR, 3.40; 95% CI, 2.70-4.28; P<0.00001) and UC (OR, 2.49; 95% CI, 1.91-3.26; P<0.00001). Increased risks of CD (OR, 12.90; 95% CI, 5.15-32.50; P<0.00001) and UC (OR, 2.80; 95% CI, 1.00-7.86; P=0.05) were found in patients with chronic pancreatitis. As for patients with acute pancreatitis, there were significant association of CD (OR, 3.70; 95% CI, 1.90-7.60; P=0.0002), but were not UC. Conclusions. The evidence confirmed an association between pancreatitis and IBD. When pancreatitis patients have chronic diarrhea and mucus blood stool or IBD patients have repeated abdominal pain and weight loss, they should consult pancreatic and gastrointestinal specialists.

Download Full-text

Bariatric Surgery in Patients With Inflammatory Bowel Disease: A Case-Control Study from the GETAID

Inflammatory Bowel Diseases ◽

10.1093/ibd/izab249 ◽

2021 ◽

Author(s):

Catherine Reenaers ◽

Arnaud de Roover ◽

Laurent Kohnen ◽

Maria Nachury ◽

Marion Simon ◽

...

Keyword(s):

Bariatric Surgery ◽

Inflammatory Bowel Disease ◽

Weight Loss ◽

Bowel Disease ◽

Small Sample ◽

Control Group ◽

Prevalence Of Obesity ◽

History Of ◽

Inflammatory Bowel ◽

Small Sample Sizes

Abstract Background The prevalence of obesity and the number of bariatric surgeries in both the general population and in patients with inflammatory bowel disease (IBD) have increased significantly in recent years. Due to small sample sizes and the lack of adequate controls, no definite conclusions can be drawn from the available studies on the safety and efficacy of bariatric surgery (BS) in patients with IBD. Our aim was to assess safety, weight loss, and deficiencies in patients with IBD and obesity who underwent BS and compare findings to a control group. Methods Patients with IBD and a history of BS were retrospectively recruited to centers belonging to the Groupe d’Etude Thérapeutique des Affections Inflammatoires du Tube Digestif (GETAID). Patients were matched 1:2 for age, sex, body mass index (BMI), hospital of surgery, and type of BS with non-IBD patients who underwent BS. Complications, rehospitalizations, weight, and deficiencies after BS were collected in cases and controls. Results We included 88 procedures in 85 patients (64 Crohn’s disease, 20 ulcerative colitis, 1 unclassified IBD) with a mean BMI of 41.6 ± 5.9 kg/m2. Bariatric surgery included Roux-en-Y gastric bypass (n = 3), sleeve gastrectomy (n = 73), and gastric banding (n = 12). Eight (9%) complications were reported, including 4 (5%) requiring surgery. At a mean follow-up of 34 months, mean weight was 88.6 ± 22.4 kg. No difference was observed between cases and controls for postoperative complications (P = .31), proportion of weight loss (P = .27), or postoperative deficiencies (P = .99). Conclusions Bariatric surgery is a safe and effective procedure in patients with IBD and obesity; outcomes in this patient group were similar to those observed in a control population.

Download Full-text

THE ONSET OF CLINICAL MANIFESTATIONS IN INFLAMMATORY BOWEL DISEASE PATIENTS

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201800000-73 ◽

2018 ◽

Vol 55 (3) ◽

pp. 290-295

Author(s):

Viviane Gomes NÓBREGA ◽

Isaac Neri de Novais SILVA ◽

Beatriz Silva BRITO ◽

Juliana SILVA ◽

Maria Carolina Martins da SILVA ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Weight Loss ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Disease ◽

Clinical Manifestations ◽

Inflammatory Bowel ◽

The Mean ◽

Mean Time

ABSTRACT BACKGROUND: The diagnosis of inflammatory bowel disease is often delayed because of the lack of an ability to recognize its major clinical manifestations. OBJECTIVE: Our study aimed to describe the onset of clinical manifestations in inflammatory bowel disease patients. METHODS: A cross-sectional study. Investigators obtained data from interviews and the medical records of inflammatory bowel disease patients from a reference centre located in Brazil. RESULTS: A total of 306 patients were included. The mean time between onset of symptoms and diagnosis was 28 months for Crohn’s disease and 19 months for ulcerative colitis. The main clinical manifestations in Crohn’s disease patients were weight loss, abdominal pain, diarrhoea and asthenia. The most relevant symptoms in ulcerative colitis patients were blood in the stool, faecal urgency, diarrhoea, mucus in the stool, weight loss, abdominal pain and asthenia. It was observed that weight loss, abdominal pain and distension, asthenia, appetite loss, anaemia, insomnia, fever, nausea, perianal disease, extraintestinal manifestation, oral thrush, vomiting and abdominal mass were more frequent in Crohn’s patients than in ulcerative colitis patients. The frequencies of urgency, faecal incontinence, faeces with mucus and blood, tenesmus and constipation were higher in ulcerative colitis patients than in Crohn’s disease patients. The mean time from the onset of clinical symptoms to the diagnosis of Crohn’s disease was 37 months for patients with ileocolonic location, 26 months for patients with ileum location and 18 months for patients with colon location. In ulcerative colitis patients, the mean time from the onset of symptoms to diagnosis was 52 months for proctitis, 12 months for left-sided colitis and 12 months for extensive colitis. CONCLUSION: Ulcerative colitis presented a high frequency of intestinal symptoms, and Crohn’s disease showed a high frequency of systemic manifestations at the onset of manifestation. There was a long delay in diagnosis, but individuals with more extensive disease and more obvious symptoms showed a shorter delay.

Download Full-text