Role of serum calprotectin in diagnosis of inflammatory bowel diseases in patients with ankylosing spondylitis (preliminary results)

Background. Patients with inflammatory bowel diseases (IBD) often have lesions of the musculoskeletal system, which is an extra-intestinal manifestation and mainly belongs to the group of seronegative spondyloarthritis (SPA). Ankylosing spondylitis (AS) is one of the main forms of diseases from the group of spondyloarthritis, associated with IBD. The frequency of AS in patients with IBD is of interest for elucidating the general pathophysiology of diseases. Colonoscopy is required to diagnose intestinal pathology. Colonoscopy in patients with AS to detect IBD, especially in the absence of intestinal symptoms, is very diffcult. Mainly for the diagnosis of IBD, the defnition of fecal calprotectin is used. Recently, there has been an interest in serum calprotectin, an increase in which is associated with a higher activity of the disease and is a marker of the intensity of inflammation in the intestine. However, there is currently no consensus on the clinical signifcance for serum calprotectin.The aim. To evaluate the role of serum calprotectin in diagnosis of inflammatory bowel disease in patients with ankylosing spondylitis.Materials and methods. In the analysis were included 50 patients with AS, fulflling the modifed New York criteria, among them were 36 (72%) men and 14 (28%) women, the mean age of patients was 42.5 ± 9.9, mean disease duration was 13.4 ± 8.7 years. All patients were examined with ESR, CRP, FC (range: 100–1800 µg/g), esophagogastroduodenoscopy, colonoscopy and quantitative analysis of the SC level using ELISA (Buhlmann MRP8/14 ELISA, range: 0.4–3.9 µg/ml).Results. All patients had a high disease activity, mean BASDAI was 5.3 ± 1.8, mean ASDAS CRP was 3.7 ± 1.01, mean ASDAS ESR was 3.6 ± 1.01. 78% patients had high FC level (more than 100 µg/g), while only 18% patients had an increase of SC level. IBD were diagnosed in 11 cases: 6 (12%) patients with CD and 5 (10%) patients with UC, in the remaining cases (78%) was no intestinal pathology. Only two patients with IBD had a high SC level. SC level was more correlated with ESR (r = 0.5) and CRP (r = 0.5) (p < 0.05) levels, than with FC level (r = 0.4) (p < 0.05).Conclusion. The results have shown that there was currently insuffcient data to assess the possibility of using SC in the diagnosis of IBD in patients with AS. There was a signifcant association between the SC, CRP and ESR, but not fecal calprotectin. Potentially SC may be more representative for systemic inflammation than intestinal inflammation.

Species-Specific Effects of Microplastics On Juvenile Fishes

Microplastics contamination have been extensively reported in aquatic ecosystem and organisms. It is wildly acknowledged that the ingestion, accumulation and elimination of microplastics in fishes are species-specific, which mainly depending on the feeding behavior. This study aims to investigate the effects of microplastics on the morphology and inflammatory response in intestines of fishes with different feeding types. Largemouth bass (carnivorous fish), grass carp (herbivorous fish) and Jian carp (omnivorous fish) were used as organism model. The contributing concentration and size of microplastics are explored as well as the response time and legacy effect in fishes. Two different sizes of polystyrene microplastics (8 μm and 80 nm) were set at three concentrations. And samples were analyzed at different exposure times and depuration times. Histological analysis indicated that multiple abnormalities in intestines are presented in three species fishes after acute exposure microplastics. The mRNA abundance of immune-related genes in the intestine tissues of fishes were significantly induced or restrained. There were differential expressions of genes coping with differential sizes and concentrations of microplastics exposure in different fishes. The reason for the difference effects of microplastics on fishes was still unclear but could be due to the difference in the structure and function of the digestive system. These results provide a theoretical basis to further analysis of the mechanism of fish intestinal pathology caused by microplastics.

A 3D printable device allowing fast and reproducible longitudinal preparation of mouse intestines

Accurate and reproducible analysis of mouse small and large intestinal lumen is key for research involving intestinal pathology in preclinical models. Currently, there is no easily accessible, standardized method that allows researchers of different skill levels to consistently dissect intestines in a time-efficient manner. Here, we describe the design and use of the 3D printed “Mouse Intestinal Slicing Tool” (MIST), which can be used to longitudinally prepare murine intestines for further analysis. We benchmarked the MIST against a commonly used procedure involving scissors to make a longitudinal cut along the intestines. Use of the MIST halved the time per mouse to prepare the intestines and outperformed alternative methods in smoothness of the cutting edge and general reproducibility. By sharing the plans for printing the MIST, we hope to contribute a uniformly applicable method for saving time and increasing consistency in studies of the mouse gastrointestinal tract.

Multiomics Study Reveals Enterococcus and Subdoligranulum Are Beneficial to Necrotizing Enterocolitis

Necrotizing enterocolitis (NEC) is a life-threatening disease for premature infants with low body weight. Due to its fragile gut microbiome and successful treatment of fecal microbiota transplantation (FMT) for intestinal disease, we aimed to reveal the multiple-omics changes after FMT and/or sulperazone treatment. In this study, 2-week-old newborn rabbits were used to simulate the NEC model and grouped into healthy control, NEC, sulperazone treatment, FTM treatment, and FMT and sulperazone combination treatment. We evaluated the intestinal pathology and survival to define the benefit from each treatment and performed microbiome and transcriptome analysis to reveal the changes in microcosmic level, which could be helpful to understand the pathogenesis of NEC and develop new strategy. We found NEC rabbits benefit more from the combination of FMT and sulperazone treatment. Combination treatment reverses a lot of microorganisms dysregulated by NEC and showed the most similar transcript profiler with healthy control. Moreover, a combination of FMT and sulperazone significantly prolonged the survival of NEC rabbits. Function enrichment showed that metabolism and viral life cycle are the most significant changes in NEC. FMT is a common therapy method for NEC. Meanwhile, in the severe situation of NEC with intestinal infection, the first therapy strategy is preferred the third-generation cephalosporin, among which sulperazone is used widely and the effect is remarkable. So, we used sulperazone to treat the rabbits with the NEC. In this research, we aim to explore the different effects on NEC between FMT and sulperazone as well as the combination. Considering the microbiome and transcriptome result, we make a conclusion that the Enterococcus and Subdoligranulum benefits NEC by influencing the bacterial phages and butyrate production, respectively.

An integrated approach to the pathogenetic therapy of constipation

The data on the causes of defecation disorders, mechanisms of normal defecation, and pathogenetic aspects of constipation are presented. Functional gastrointestinal disorders are considered as a common pathology of the gastrointestinal tract, which is based on combined morphological and physiological abnormalities associated with visceral hypersensitivity, disorders of gastrointestinal motility, protective mucous barrier, immune function and the composition of the intestinal microbiota. The article discusses the possibility of using the drinking medicinal mineral water Zajecicka Horka (Zayechitskaya bitter) for intestinal pathology and other functional gastrointestinal disorders.

Histopathological study of endoscopic biopsies of large intestine

The large intestine is a site of a variety of diseases. The lesions tend to occur affecting different age groups ranging from early childhood to late adulthood. Patients may present with very vague clinical symptoms ranging from abdominal pain, loose stools, vomiting, diarrhoea, bleeding per rectum, and change in bowel habit. Patients presenting with repeated symptoms related to lower intestinal pathology are advised to undergo colonoscopic examination.To study clinico-pathological correlation of endoscopic biopsies of large intestine and to study spectrum of large intestinal lesions.The study was conducted at a tertiary care hospital from August 2018 to July 2020. All endoscopic biopsy samples were included in this study. All endoscopic biopsies were performed by high definition colonoscope. Clinical and endoscopic correlation with histopathological diagnosis was performed and results were generated.Total 133 cases were included in this study, out of 133 patients 86 were males and 47 were females. Patients showed wide age range from 11 years to 80 years. There were 25 patients each in age group of 31-40 years and 61-70 years. The most common presenting complaint was loose stools in 66 cases. The most common endoscopic finding was erythema in 82 cases. Out of 133 cases, 105 cases were non neoplastic, 08 cases were benign neoplastic and 20 cases were malignant neoplastic on histopathology.Colonoscopy is very high yielding and safe procedure to perform.Colonoscopic biopsies are proven to be of great importance. Clinical, endoscopic and histopathological correlation is always advisable in large intestinal pathology for early diagnosis and treatment.

Fasting increases microbiome-based colonization resistance and reduces host inflammatory responses during an enteric bacterial infection

Reducing food intake is a common host response to infection, yet it remains unclear whether fasting is detrimental or beneficial to an infected host. Despite the gastrointestinal tract being the primary site of nutrient uptake and a common route for infection, studies have yet to examine how fasting alters the host’s response to an enteric infection. To test this, mice were fasted before and during oral infection with the invasive bacterium Salmonella enterica serovar Typhimurium. Fasting dramatically interrupted infection and subsequent gastroenteritis by suppressing Salmonella’s SPI-1 virulence program, preventing invasion of the gut epithelium. Virulence suppression depended on the gut microbiota, as Salmonella’s invasion of the epithelium proceeded in fasting gnotobiotic mice. Despite Salmonella’s restored virulence within the intestines of gnotobiotic mice, fasting downregulated pro-inflammatory signaling, greatly reducing intestinal pathology. Our study highlights how food intake controls the complex relationship between host, pathogen and gut microbiota during an enteric infection.

NanH Is Produced by Sporulating Cultures of Clostridium perfringens Type F Food Poisoning Strains and Enhances the Cytotoxicity of C. perfringens Enterotoxin

ABSTRACT Clostridium perfringens type F food poisoning (FP) strains cause one of the most common foodborne illnesses. This FP develops when type F FP strains sporulate in the intestines and produce C. perfringens enterotoxin (CPE), which is responsible for the diarrhea and abdominal cramps of this disease. While C. perfringens can produce up to three different sialidases, the current study surveyed FP strains, which confirmed the results of a previous study that they consistently carry the nanH sialidase gene, often as their only sialidase gene. NanH production was found to be associated with sporulating cultures of the surveyed type F FP strains, including SM101 (a transformable derivative of a FP strain). The sporulation-associated regulation of NanH production by strain SM101 growing in modified Duncan-Strong medium (MDS) was shown to involve Spo0A, but it did not require the completion of sporulation. NanH production was not necessary for either the growth or sporulation of SM101 when cultured in MDS. In those MDS cultures, NanH accumulated in the sporulating mother cell until it was released coincidently with CPE. Since CPE becomes extracellular when mother cells lyse to release their mature spores, this indicates that mother cell lysis is also important for NanH release. The copresence of NanH and CPE in supernatants from lysed sporulating cultures was shown to enhance CPE cytotoxicity for Caco-2 cells. This enhancement was attributable to NanH increasing CPE binding and could be replicated with purified recombinant NanH. These in vitro findings suggest that NanH may be an accessory virulence factor during type F FP. IMPORTANCE Clostridium perfringens type F strains cause the second most common bacterial foodborne illness in the United States. C. perfringens enterotoxin (CPE) is responsible for the diarrhea and cramping symptoms of this food poisoning (FP). Previous studies showed that NanI sialidase can enhance CPE activity in vitro. While many type F FP strains do not produce NanI, they do consistently make NanH sialidase. This study shows that, like CPE, NanH is produced by sporulating type F FP strains and then released extracellularly when their sporulating cells lyse to release their mature spore. NanH was shown to enhance CPE cytotoxicity in vitro by increasing CPE binding to cultured Caco-2 cells. This enhancement could be important because many type F FP strains produce less CPE than necessary (in a purified form) to cause intestinal pathology in animal models. Therefore, NanH represents a potential accessory virulence factor for type F FP.

How Oral Specialists Can Help Diagnose and Manage Extra-Digestive Inflammatory Bowel Disease Complications

Identification of extra-digestive manifestations of inflammatory bowel disease (IBD) is essential. The oral cavity is a preferential site in which gingival enlargement may be one of these manifestations. We present, in this article, two original cases and a concept map that highlights the need for a close collaboration between the dental surgeon or oral specialist, the dermatologist, and the gastroenterologist. In the first case, the strictly local management of a systemic IBD oral complication, can relieve and answer the patient’s complaint without modifying or disrupting the systemic treatment already implemented by the gastroenterologists. In the second case, the dental surgeon’s diagnosis of gingival enlargement turns out to be the inaugural manifestation of Crohn’s disease and allows early treatment of the intestinal pathology. These two cases illustrate the close link between the oral cavity and IBD. Knowledge and multidisciplinary management of these manifestations such as proposed in the concept map are essential for clinicians for the early diagnosis and the improvement of the oral and general quality of life of patients suffering from IBD.