scholarly journals Association of Fungi and Archaea of the Gut Microbiota with Crohn’s Disease in Pediatric Patients—Pilot Study

Pathogens ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1119
Author(s):  
Agnieszka Krawczyk ◽  
Dominika Salamon ◽  
Kinga Kowalska-Duplaga ◽  
Tomasz Bogiel ◽  
Tomasz Gosiewski
Keyword(s):  
Crohn’S Disease ◽  
Pilot Study ◽  
Crohn's Disease ◽  
Pediatric Patients ◽  
Control Group ◽  
Healthy Controls ◽  
Stool Samples ◽  
Malassezia Spp ◽  
And Control ◽  
To Receive

The composition of bacteria is often altered in Crohn’s disease (CD), but its connection to the disease is not fully understood. Gut archaea and fungi have recently been suggested to play a role as well. In our study, the presence and number of selected species of fungi and archaea in pediatric patients with CD and healthy controls were evaluated. Stool samples were collected from children with active CD (n = 54), non-active CD (n = 37) and control subjects (n = 33). The prevalence and the number of selected microorganisms were assessed by real-time PCR. The prevalence of Candida tropicalis was significantly increased in active CD compared to non-active CD and the control group (p = 0.011 and p = 0.036, respectively). The number of Malassezia spp. cells was significantly lower in patients with active CD compared to the control group, but in non-active CD, a significant increase was observed (p = 0.005 and p = 0.020, respectively). There were no statistically significant differences in the colonization by archaea. The obtained results indicate possible correlations with the course of the CD; however, further studies of the entire archeobiome and the mycobiome are necessary in order to receive a complete picture.

P054 The impact of intestinal stenosis on the expression of Crohn’s disease in young mice with genetic predisposition

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S161-S161
Author(s):  
I Georgopoulos ◽  
E Mavrigiannaki ◽  
S Stasinopoulou ◽  
G Renieris ◽  
G NIkolakis ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Terminal Ileum ◽  
Suture Technique ◽  
Intraluminal Pressure ◽  
Control Group ◽  
Intestinal Stenosis ◽  
The Creation ◽  
And Control ◽  
The Impact

Abstract Background In the majority of patients, the areas of the intestine affected in Crohn’s disease (CD) are the terminal ileum and less commonly the rectum. The terminal ileum is affected in the majority of genetic animal models of CD as well. Additionally, CD recurs at sites of tight anastomosis or strictures postoperatively. These observations lead to the assumption that increased intraluminal pressure related to the presence of a valve, sphincter or stenosis is associated with CD pathogenesis. We investigated the hypothesis that the creation of a partial intestinal stenosis could have an impact on disease severity, in a genetic animal model of CD (TNFΔare/+). TNFΔare/+ mice overexpress TNFα leading to a Crohn-like colitis in the terminal ileum. Methods Twenty-nine TNFΔare/+ mice, 6 weeks old, were divided into three intervention groups: stenosis, sham and control. In the stenosis group (n = 11), a partial small bowel obstruction was created via a novel triple suture technique, approximately 3 cm from the ileocecal valve. In the control group (n = 9), a loose single suture was placed at the aforementioned site to test the direct effect of the foreign material on the intestinal wall. The sham group (n = 9) received a sham operation. The triple suture stenosis was also performed on wild-type (WT) C57BL/6 mice (group WT, n = 9). 6 weeks post-surgery all animals were sacrificed and samples from the ileum 3 cm proximal and 3 cm distal to the intervention site were collected for histopathological evaluation. The Crohn-like changes were assessed using a modified colitis histological scoring system (based on Katakura et al., JCI 2005; 115: 695–702). Results Proximal to the intervention, the mean colitis score of stenosis group (10.18 ± 0.87) was significantly higher compared with sham (6.33 ± 0.97, p: 0.009) and control group (5.00 ± 0.91, p: 0.001). There was no difference between sham and control group (p: 0.332). No significant differences between the groups were reported distal to the intervention. The triple suture technique led to Crohn-like inflammatory lesions only in the TNFΔare/+ mice, as shown from the significantly increased score compared with WT mice proximal and distal to the stenosis (10.18 ± 0.87 vs. 0.67 ± 0.37, p < 0.001 and 9.20 ± 1.09 vs. 0.33 ± 0.24, p < 0.001). Conclusion The creation of a stenotic segment in the intestine of TNFΔare/+ mice, led to higher colitis score than expected. The probable mechanism is the increased intraluminal pressure proximal to the stenosis. This suggests that mechanical forces contribute as important co-factors in the pathophysiology of CD, in genetically predisposed populations.

scholarly journals P455 Adherence to enteral nutrition therapy by adults with active Crohn’s disease is associated with conscientiousness personality trait

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S406-S407
Author(s):  
C Wall ◽  
A McCombie ◽  
R Mulder ◽  
A Day ◽  
R Gearry
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Personality Trait ◽  
Gastrointestinal Symptoms ◽  
Nutrition Therapy ◽  
Control Group ◽  
Healthy Controls ◽  
Eating Behaviours ◽  
Exclusive Enteral Nutrition

Abstract Background Conscientiousness is a personality trait characterised by the ability to control impulses, delay gratification, set and reach goals, and plan in advance. Conscientious people are more likely to be non-smokers, do physical activity and practice healthy eating behaviours. They are also more likely to be adherent to medication. The aim of this study was to assess whether people with Crohn’s disease who score high on conscientiousness are more likely to be adherent to enteral nutrition (EN) therapy than low scorers. Methods Adults aged 16 to 40 years with newly diagnosed Crohn’s disease or having a flare of disease were invited by their gastroenterologist to use nutrition therapy to induce disease remission. Nutrition therapy was either eight weeks of exclusive enteral nutrition (EN) or two weeks of exclusive EN followed by six weeks of partial EN and one meal per day. A convenience control group of healthy participants with no history of gastrointestinal symptoms was also recruited to use exclusive EN for two weeks. Adherence to EN was self-reported fortnightly using a standardised questionnaire. Non-adherence was defined as patients who repeatedly ate foods while using EN or ate more than one meal per day on partial EN. Patients who could not initiate or did not tolerate the EN formula were included in the non-adherent group. Prior to starting nutrition therapy, conscientiousness was measured using the well-validated conscientiousness subset of the Big Five Inventory. Results Twenty-three (59%) of the 39 patients recruited with Crohn’s disease completed and adhered to the eight-week treatment. Reasons for non-adherence by the 14 patients who did not complete treatment included: could not initiate EN (n = 4), non-response at week 4 (n = 2), intolerance of EN (n = 7) or repeated eating of food or started eating food again prior to the end of treatment (n = 2). Seventeen (81%) of the 21 healthy controls completed and adhered to 2 weeks of exclusive EN. Reasons for non-adherence were could not initiate EN (n = 3) or intolerance of the formula (n = 1). Adherence and completion of EN therapy were associated with a greater mean conscientiousness score 35.57 (95% CI: 32.88, 38.25) compared with the non-adherence group mean 30.13 (95% CI: 26.53, 33.73), p = 0.014. Mean conscientiousness score of the healthy controls who completed exclusive EN was similar to the Crohn’s disease group (36.65 (95% CI: 33.53, 39.77), p > 0.05). Conclusion Conscientiousness was associated with adherence to EN therapy. EN therapy can be a cognitively and emotionally demanding treatment and this personality trait should ideally be considered when determining suitable candidates for EN therapy.

scholarly journals VISCERAL FAT IS INCREASED IN INDIVIDUALS WITH CROHN’S DISEASE: A COMPARATIVE ANALYSIS WITH HEALTHY CONTROLS

2018 ◽  
Vol 55 (2) ◽  
pp. 142-147
Author(s):  
Daniéla Oliveira MAGRO ◽  
Maria Rita Lazzarini BARRETO ◽  
Everton CAZZO ◽  
Michel Gardere CAMARGO ◽  
Paulo Gustavo KOTZE ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Nutritional Status ◽  
Visceral Fat ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Control Group ◽  
Healthy Controls ◽  
Fat Percentage ◽  
Cross Sectional

ABSTRACT BACKGROUND: It is known that obesity is associated with a chronic inflammatory state, but few studies have evaluated visceral fat (VF) content and its role in individuals with Crohn’s disease (CD). OBJETIVE: To compare the nutritional status, body composition and proportion of VF between CD individuals and healthy volunteers. METHODS: Cross-sectional study that enrolled individuals with Crohn’s disease and healthy controls. The stratification according to nutritional status was carried out by means of BMI. The percentage of body fat percentage (%BF) and VF were estimated by means of DEXA. VF proportion was evaluated by means of the VF/BMI and VF/%BF ratios. RESULTS: A total of 78 individuals were included. The control group was comprised of 28 healthy subjects aged 35.39±10 years old (60.7% women); mean BMI=23.94±3.34 kg/m2; mean VF=511.82±448.68 g; mean CRP=0.81±1.78 ng/mL. The CD group was comprised of 50 patients; 11 (22%) were underweight (BMI=18.20±1.97 kg/ m2; %BF=24.46±10.01; VF=217.18±218.95 g; CRP=4.12±4.84 ng/mL); 18 (36%) presented normal weight (BMI=22.43±1.48 kg/m2; %BF=30.92±6.63; VF=542.00±425.47 g and CRP=4.40±1.78 ng/mL); 21 (42%) were overweight or obese (BMI=29.48±3.78 kg/m2; %BF=39.91±7.33; VF=1525.23±672.7 g and CRP=1.33±2.06 ng/mL). The VF/BMI ratio was higher in the CD group when compared to controls (32.41±24.63 vs 20.01±16.23 g per BMI point; P=0.02). Likewise, the VF/%BF was also higher in the CD group (35.21±23.33 vs 15.60±12.55 g per percentage point; P<0.001). CONCLUSION: Among individuals with Crohn’s disease, BMI presents a direct correlation with visceral fat content. These results indicate the presence of an adiposopathy in Crohn’s disease subjects, which is evidenced by a higher visceral fat.

P194 Alexithymia traits are associated with symptom severity and disease activity in IBD patients

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S260-S260
Author(s):  
E Vinni ◽  
K Karaivazoglou ◽  
T Lourida ◽  
M Kalogeropoulou ◽  
E Tourkochristou ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Symptom Severity ◽  
University Hospital ◽  
Control Group ◽  
Healthy Controls ◽  
Psychological Burden ◽  
Emotional Recognition

Abstract Background Alexithymic traits are quite prevalent in patients with inflammatory bowel diseases (IBD) and have been linked with a heightened psychological burden including anxiety, depression, somatization and obsessive-compulsive symptoms. However, there are limited data regarding the association of alexithymia with gastrointestinal symptom severity and disease activity. Methods The current study was conducted at the Division of Gastroenterology of the University Hospital of Patras, in Greece with the collaboration of the Department of Psychiatry. Adult IBD outpatients and healthy controls were enrolled to the study. Alexithymic traits were assessed with the Toronto Alexithymia Scale (TAS-20). Disease activity was assessed with the calculation of the Truelove-Witts Index for ulcerative colitis (UC) patients and the Harvey-Bradsaw Index for Crohn’s disease (CD) patients. Results 57 IBD patients and 50 healthy controls entered the study. 26 (45.6%) IBD patients reported clinically significant alexithymia traits. In addition, IBD patients faced increased difficulties in emotional expression (p=0.024) and reported increased overall alexithymic traits (p=0.033) compared to healthy controls. Moreover, we detected a borderline tendency of IBD patients to exhibit more disturbances in emotional recognition (p=0.067) compared to the control group. Difficulties in emotional recognition were significantly correlated with the presence of nausea (p=0.031), belly pain (p=0.015) and bloating (p=0.018), while overall alexithymic traits were strongly associated with the presence of nausea (p=0.008). Finally, increased disease activity was significantly associated with a higher total alexithymia score in Crohn’s disease (p=0.037) and ulcerative colitis (p=0.047) patients. Conclusion IBD patients report increased alexithymic traits which are associated with more severe gastrointestinal symptomatology and increased disease activity.

scholarly journals Evidence of Disturbed Gut Microbial Metabolic Activity in Pediatric Crohn’s Disease

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Tommy Sundqvist ◽  
Lars Stenhammar ◽  
Bo Tjellström ◽  
Karl-Eric Magnusson ◽  
Tore Midtvedt ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Observational Study ◽  
Gut Microbiota ◽  
Metabolic Activity ◽  
Control Group ◽  
Clinical Implications ◽  
Healthy Controls ◽  
Tryptic Activity ◽  
Microbial Metabolic Activity

Abstract Background Dysbiosis, that is, disturbed gut microbial balance, is well documented in Crohn’s disease (CD). We aimed at studying CD-linked dysbiosis in children by analyzing fecal microbe-associated characteristics, previously not reported in children. Methods This observational study included 28 children with active CD and healthy controls. We assessed the following three indicators of gut microbiota metabolism in the feces: the presence of tryptic activity, the conversion of cholesterol to coprostanol, and the conversion of bilirubin to urobilinogen. Results The fecal tryptic activity was significantly higher in children with active CD compared to the control group (P &lt; 0.01). The fecal coprostanol of the CD children was close to zero and differed significantly from the controls (P &lt; 0.001). Furthermore, the children with CD had very low fecal urobilinogen, differing significantly from the control group (P &lt; 0.001). Conclusions The significant differences in levels of fecal bacterial metabolites in patients with active CD compared to healthy controls reflect major perturbation of gut microbial functions and have not previously been reported in children. This fits well with the prevailing concept of a dysbiotic gut microbiota in CD and may have important clinical implications by bringing the dysbiosis back into balance.

scholarly journals Ovarian Reserve Assessed by the Anti-Mullerian Hormone and Reproductive Health Parameters in Women With Crohn´s Disease, a Case-Control Study

2021 ◽  
pp. S69-S78
Author(s):  
T. Koller ◽  
J. Kollerová ◽  
T. Hlavatý ◽  
B. Kadlečková ◽  
J. Payer
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Reproductive Health ◽  
Ovarian Reserve ◽  
Control Group ◽  
Healthy Controls ◽  
Previous Pregnancy ◽  
Age Related ◽  
Menopausal Women ◽  
Health Parameters

According to several studies, women with Crohn's disease (CD) had reduced fertility, which is mostly due to voluntary decisions and reduced ovarian reserve. In our study, we aimed to compare reproductive health parameters (RHP), previous pregnancy complications and outcomes, and ovarian reserve (OR) assessed by the anti-Mullerian hormone (AMH) in CD patients with healthy controls. In CD patients, we also compared OR according to disease phenotypes. Consecutive pre-menopausal women with CD from two IBD centers were included. The control group consisted of age and BMI-matched healthy controls. We used a questionnaire that included RHP, CD phenotype, and CD activity. Serum AMH was assessed by the Elecsys AMH plus essay. We enrolled 50 patients and 56 controls with a median age of 31 years. All CD patients were in clinical remission. We observed no difference in RHP or AMH (median 2.6 vs. 2.1 ug/l, p = 0.98), or the proportion of low OR (AMH<1,77, 38 vs. 41.1 %, p=0.84). The slope of age-related decrease did not differ between the groups. The subgroup of CD patients after surgery and those older than 30 years with CD for >5years had a steeper decrease in AMH (slope -0.12 vs. -0.29, p = 0.04 and -0.31 vs. -0.2, p = 0.029). In a multivariate analysis, age was the single independent predictor of low OR (OR=1.25). In women with Crohn’s disease, once the disease activity is under control, the reproductive health and ovarian reserve do not substantially differ from healthy controls.

scholarly journals Investigation of TAGAP gene polymorphism (rs1738074) in Turkish pediatric celiac patients

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Melek Pehlivan ◽  
Tülay K. Ayna ◽  
Maşallah Baran ◽  
Mustafa Soyöz ◽  
Aslı Ö. Koçyiğit ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Disease Risk ◽  
Polymerase Chain Reaction Method ◽  
Control Group ◽  
Healthy Children ◽  
Single Nucleotide ◽  
Significant Difference ◽  
Allele Specific ◽  
And Control

Abstract Objectives There are several hypotheses on the effects of the rs1738074 T/C single nucleotide polymorphism in the TAGAP gene; however, there has been no study on Turkish pediatric patients. We aimed to investigate the association of celiac disease (CD) and type 1 diabetes mellitus (T1DM) comorbidity with the polymorphism in the TAGAP gene of Turkish pediatric patients. Methods Totally, 127 pediatric CD patients and 100 healthy children were included. We determined the polymorphism by the allele-specific polymerase chain reaction method. We used IBM SPSS Statistics version 25.0 and Arlequin 3.5.2 for the statistical analyses. The authors have no conflict of interest. Results It was determined that 72% (n=154) of only CD patients had C allele, whereas 28% (n=60) had T allele. Of the patients with celiac and T1DM, 42.5% (n=17) and 57.5% (n=23) had T and C alleles, respectively. Of the individuals in control group, 67% (n=134) had C allele, whereas 33% (n=66) had T allele. Conclusions There was no significant difference in the genotype and allele frequencies between the patient and control groups (p>0.05). There was no significant association between the disease risk and the polymorphism in our study group.

The Effect of Reflexology on Lactation in Women Who Had Cesarean Section: A Randomized Controlled Pilot Study

2021 ◽  
pp. 1-8
Author(s):  
Sevde Aksu ◽  
Pelin Palas Karaca
Keyword(s):  
Pilot Study ◽  
Cesarean Section ◽  
Intervention Group ◽  
Control Group ◽  
Breast Pain ◽  
Randomized Controlled ◽  
Significant Difference ◽  
The Right ◽  
Documentation Tool ◽  
And Control

<b><i>Aim:</i></b> The research was conducted as a randomized controlled pilot study to evaluate the effects of reflexology on lactation in mothers who delivered by cesarean section (CS). <b><i>Methods:</i></b> A single-blind randomized controlled experimental study was conducted with a total of 60 postpartum women in the reflexology application (<i>n</i> = 30) and control groups (<i>n</i> = 30). After the CS, the mothers in the control group were given approximately 3-h routine nursing care after recovering from the effects of anesthesia; the introductory information form was applied, and the Breastfeeding Charting System and Documentation Tool (LATCH) and visual analog scale (VAS) for the signs of the onset of lactation were implemented on the first and second days. Reflexology was applied to the women in the intervention group after an average of 3 h following the mother’s condition had become stable and she had recovered from the effects of anesthesia. Reflexology was applied a total of 20 min – 10 min for the right foot, 10 min for the left foot – twice a day with 8-h intervals on the first and second days after CS. After the last reflexology application, the LATCH and VAS for the signs of the onset of lactation were applied. <b><i>Results:</i></b> Of the women, 70% breastfed their babies within 60 min after delivery; 46.7% of the mothers received breastfeeding training and 81.7% needed support for breastfeeding after the CS. The LATCH breastfeeding scores of the women in the intervention group on both days were significantly higher compared to those of the women in the control group (<i>p</i> &#x3c; 0.001). On the first day after the CS, apart from breast pain, there was no significant difference between the two groups in terms of breast heat and breast tension (<i>p</i> &#x3e; 0.05). On the second day after the CS, apart from breast tension, there was no significant difference between the groups in terms of breast heat and breast pain (<i>p</i> &#x3c; 0.05). In the study, women in the intervention group were found to have higher scores in terms of all three symptoms compared to the control group (<i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> In the study, it was determined that LATCH scores and signs of the onset of breastfeeding increased in the mothers who received reflexology after CS.

scholarly journals Creatine Supplementation for Patients with Inflammatory Bowl Diseases: A Scientific Rationale for a Clinical Trial

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1429
Author(s):  
Theo Wallimann ◽  
Caroline H. T. Hall ◽  
Sean P. Colgan ◽  
Louise E. Glover
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Trial ◽  
Crohn’S Disease ◽  
Pilot Study ◽  
Crohn's Disease ◽  
Single Case ◽  
Initial Period ◽  
Creatine Supplementation

Based on theoretical considerations, experimental data with cells in vitro, animal studies in vivo, as well as a single case pilot study with one colitis patient, a consolidated hypothesis can be put forward, stating that “oral supplementation with creatine monohydrate (Cr), a pleiotropic cellular energy precursor, is likely to be effective in inducing a favorable response and/or remission in patients with inflammatory bowel diseases (IBD), like ulcerative colitis and/or Crohn’s disease”. A current pilot clinical trial that incorporates the use of oral Cr at a dose of 2 × 7 g per day, over an initial period of 2 months in conjunction with ongoing therapies (NCT02463305) will be informative for the proposed larger, more long-term Cr supplementation study of 2 × 3–5 g of Cr per day for a time of 3–6 months. This strategy should be insightful to the potential for Cr in reducing or alleviating the symptoms of IBD. Supplementation with chemically pure Cr, a natural nutritional supplement, is well tolerated not only by healthy subjects, but also by patients with diverse neuromuscular diseases. If the outcome of such a clinical pilot study with Cr as monotherapy or in conjunction with metformin were positive, oral Cr supplementation could then be used in the future as potentially useful adjuvant therapeutic intervention for patients with IBD, preferably together with standard medication used for treating patients with chronic ulcerative colitis and/or Crohn’s disease.

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