IBD on PubMed

TLR-7 activation enhances IL-22-mediated colonization resistance against vancomycin-resistant enterococcus.

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TLR-7 activation enhances IL-22-mediated colonization resistance against vancomycin-resistant enterococcus.

Sci Transl Med. 2016 Feb 24;8(327):327ra25

Authors: Abt MC, Buffie CG, Sušac B, Becattini S, Carter RA, Leiner I, Keith JW, Artis D, Osborne LC, Pamer EG

Abstract
Antibiotic administration can disrupt the intestinal microbiota and down-regulate innate immune defenses, compromising colonization resistance against orally acquired bacterial pathogens. Vancomycin-resistant Enterococcus faecium (VRE), a major cause of antibiotic-resistant infections in hospitalized patients, thrives in the intestine when colonization resistance is compromised, achieving extremely high densities that can lead to bloodstream invasion and sepsis. Viral infections, by mechanisms that remain incompletely defined, can stimulate resistance against invading bacterial pathogens. We report that murine norovirus infection correlates with reduced density of VRE in the intestinal tract of mice with antibiotic-induced loss of colonization resistance. Resiquimod (R848), a synthetic ligand for Toll-like receptor 7 (TLR-7) that stimulates antiviral innate immune defenses, restores expression of the antimicrobial peptide Reg3γ and reestablishes colonization resistance against VRE in antibiotic-treated mice. Orally administered R848 triggers TLR-7 on CD11c(+) dendritic cells, inducing interleukin-23 (IL-23) expression followed by a burst of IL-22 secretion by innate lymphoid cells, leading to Reg3γ expression and restoration of colonization resistance against VRE. Our findings reveal that an orally bioavailable TLR-7 ligand that stimulates innate antiviral immune pathways in the intestine restores colonization resistance against a highly antibiotic-resistant bacterial pathogen.

PMID: 26912904 [PubMed - indexed for MEDLINE]

Organoids derived from digestive tract, liver, and pancreas.

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Organoids derived from digestive tract, liver, and pancreas.

J Dig Dis. 2016 Jan;17(1):3-10

Authors: Xu AT, Tong JL, Ran ZH

Abstract
Lgr5 marks stem cells in digestive epithelial tissues by lineage tracing, and in vitro ever-expansion of Lgr5 stem cells form organoids, which can be directed to differentiate into functional somatic cells. Organoids derived from gastrointestinal epithelium even recapitulate the morphologic features of their in vivo counterpart. Culture conditions are also modified to establish cancer organoids from individual patients. With great genetic stability during derivation and expansion, organoids retain either single mutation in patients with inherited disease or multiple mutations of cancer tissues. Together with efficient gene-editing protocol, organoids are emerging as powerful in vitro disease models.

PMID: 26666830 [PubMed - indexed for MEDLINE]

A Population-based Study of Intensive Care Unit Admissions in Rheumatoid Arthritis.

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A Population-based Study of Intensive Care Unit Admissions in Rheumatoid Arthritis.

J Rheumatol. 2016 Jan;43(1):26-33

Authors: Peschken CA, Hitchon CA, Garland A, Bernstein CN, Chen H, Fransoo R, Marrie RA

Abstract
OBJECTIVE: We aimed to determine the incidence of and mortality after critical illness in rheumatoid arthritis (RA) compared with the general population, and to describe the risks for and characteristics of critical illness in patients with RA.
METHODS: We used population-based administrative data from the Data Repository at the Manitoba Centre for Health Policy from 1984 to 2010, and linked clinical data from an intensive care unit (ICU) database to identify all persons with RA in the province requiring ICU admission. We identified a population-based control group, matched by age, sex, socioeconomic status, and region of residence. The incidence of ICU admission, reasons for, and mortality after ICU admission were compared between populations using age- and sex-standardized rates, rate ratios, Cox proportional hazards models, and logistic regression models.
RESULTS: We identified 10,078 prevalent and 5560 incident cases of RA. After adjustment, the risk for ICU admission was higher for RA (HR 1.65, 95% CI 1.50-1.83) versus the matched general population. From 2000-2010, the annual incidence of ICU admission among prevalent patients was about 1% in RA, with a crude 10-year incidence of 8%. Compared with the general population admitted to ICU, 1 year after ICU admission, mortality was increased by 40% in RA. Cardiovascular disorders were the most common reason for ICU admission in RA.
CONCLUSION: Patients with RA have a higher risk for admission to the ICU than the general population and increased mortality 1 year after admission. Even with advances in management, RA remains a serious disease with significant morbidity.

PMID: 26628597 [PubMed - indexed for MEDLINE]

Abdominal imaging and patient education resources: enhancing the radiologist-patient relationship through improved communication.

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Abdominal imaging and patient education resources: enhancing the radiologist-patient relationship through improved communication.

Abdom Radiol (NY). 2016 Nov 12;

Authors: Hansberry DR, Ayyaswami V, Sood A, Prabhu AV, Agarwal N, Deshmukh SP

Abstract
INTRODUCTION: The relative ease of Internet access and its seemingly endless amount of information creates opportunities for Americans to research medical diseases, diagnoses, and treatment plans. Our objective is quantitative evaluation of the readability level of patient education websites, written for the lay public, pertaining to common radiologic diagnostic test, and radiologic diagnoses specific to abdominal imaging.
METHODS: In October 2015, 10 search terms were entered in the Google search engine, and the top 10 links for each term were collected and independently examined for their readability level using 10 well-validated quantitative readability scales. Search terms included CT abdomen, MRI abdomen, MRI enterography, ultrasound abdomen, X-ray abdomen, cholecystitis, diverticulitis, hepatitis, inflammatory bowel disease, and pancreatitis. Websites not written exclusively for patients were excluded from the analysis.
RESULTS: As a group, the 100 articles were assessed at an 11.7 grade level. Only 2% (2/100) were written at the National Institutes of Health (NIH), and American Medical Association (AMA) suggested 3rd to 7th grade level to meet the 8th grade average reading level in the United States. In fact, 49% were written at a level that required a high school education or higher (greater than 12th grade).
CONCLUSIONS: With websites like radiologyinfo.org, generating over a million visitors a month, it is that clear there is a public interest in learning about radiology. However, given the discordance between the level of readability of the majority of the Internet articles and the NIH and AMA guidelines noted in this study on abdominal imaging readability, it is likely that many readers do not fully benefit from these resources on abdominal imaging.

PMID: 27838772 [PubMed - as supplied by publisher]

Prediction of short- and medium-term efficacy of biosimilar infliximab therapy. Do trough levels and antidrug antibody levels or clinical and biochemical markers play a more important role?

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Prediction of short- and medium-term efficacy of biosimilar infliximab therapy. Do trough levels and antidrug antibody levels or clinical and biochemical markers play a more important role?

J Crohns Colitis. 2016 Nov 12;:

Authors: Gonczi L, Vegh Z, Golovics PA, Rutka M, Gecse KB, Bor R, Farkas K, Szamosi T, Bene L, Gasztonyi B, Kristóf T, Lakatos L, Miheller P, Palatka K, Papp M, Patai Á, Salamon Á, Tóth GT, Vincze Á, Biro E, Lovasz BD, Kurti Z, Szepes Z, Molnár T, Lakatos PL

Abstract
BACKGROUND AND AIMS: Biosimilar infliximab CT-P13 received European Medicines Agency (EMA) approval in June 2013 for all indications of the originator product. In the present study we aimed to evaluate the predictors of short- and medium-term clinical outcome in patients treated with the biosimilar infliximab at the participating IBD centres in Hungary.
METHODS: Demographic data were collected and a harmonized monitoring strategy was applied. Clinical and biochemical activity were evaluated at weeks 14, 30 and 54. Trough level (TL) and anti-drug antibody (ADA) concentration were measured by ELISA (LT-005, Theradiag, France) at baseline at 14, 30 and 54 weeks and in 2 centres at weeks 2 and 6.
RESULTS: 291 consecutive IBD patients (184 CD/107 UC) were included. In UC, TLs at week 2 were predicting both clinical response and remission at week 14 and 30 (clinical response/remission at week 14: AUC=0.81, p<0.001, cut-off: 11.5μg/ml/AUC=0.79, p<0.001, cut-off: 15.3μg/ml; clinical response/remission at week 30: AUC=0.79, p=0.002, cut-off:11.5 μg/ml/AUC=0.74, p=0.006, cut-off: 14.5μg/ml), while ADA positivity at week 14 was inversely associated with clinical response at week 30 (58.3%vs.84.8%,p=0.04). Previous anti-TNF exposure was inversely associated with short-term clinical remission (week 2: 18.8% vs. 47.8%, p=0.03, at week 6: 38.9% vs. 69.7%, p=0.013, at week 14: 37.5% vs. 2.5%, p=0.06). In CD, TLs at week 2 were predicting short term- (week 14 response/remission, AUCTLweek2=0.715/0.721, p=0.05/0.005) but not medium-term clinical efficacy. In addition, early ADA status by week 14 (p=0.04-0.05 for week 14 and 30), early clinical response (p<0.001 for week 30/54) and normal CRP at week 14 (p=0.005-0.0001) and previous anti-TNF exposure (p=0.03-0.0001 for week 14, 30 and 54) were associated with short-and medium-term clinical response and remission.
CONCLUSIONS: In UC, early TLs were predictive for short-and medium term clinical efficacy, while in CD, week 2 TLs were associated only with short-term clinical outcomes.

PMID: 27838610 [PubMed - as supplied by publisher]

Gastrointestinal complications and extraintestinal manifestations of inflammatory bowel disease in Taiwan: A population-based study.

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Gastrointestinal complications and extraintestinal manifestations of inflammatory bowel disease in Taiwan: A population-based study.

J Chin Med Assoc. 2016 Nov 9;:

Authors: Hsu YC, Wu TC, Lo YC, Wang LS

Abstract
BACKGROUND: Despite a rising incidence of inflammatory bowel disease (IBD) in Taiwan, the clinical presentation of IBDs in this population has yet to be well characterized. Therefore, the aim of our study was to identify and describe the clinical features of gastrointestinal (GI) complications and extraintestinal manifestations (EIMs) of IBDs in the Taiwanese population.
METHODS: We conducted a retrospective study between 1998 and 2011, with relevant medical information extracted from the National Health Insurance Research Database. The diagnoses of IBD, GI complications, and EIMs were defined from the health registry using the appropriate International Classification of Diseases 9 codes.
RESULTS: A total of 3153 patients with IBDs were identified: 611 with Crohn's disease (CD) and 2542 with ulcerative colitis, with GI complications and EIMs identified in 22.2% and 11.9% of cases, respectively. CD was associated with an increased incidence of intestinal fistula, perforation, obstruction, peritonitis and perianal disease, and ulcerative colitis with benign neoplasm of the colon. Colorectal cancer developed in 0.35% of patients. Children with CD characteristically have more complex intestinal complications. The prevalence of EIMs was higher in females and in CD, with peripheral arthritis identified as the most common EIMs, overall. The rate of major EIMs affecting the articular, cutaneous, and visual systems was lower than the rate reported in Western countries.
CONCLUSION: Our study found that CD had a more complicated course, with a higher incidence of GI complications and EIMs. However, the prevalence of intestinal complications, perianal disease, and major EIMs was less common than in Western countries. This study provided a distinct clinical feature of IBD in Taiwan.

PMID: 27838292 [PubMed - as supplied by publisher]

Low prevalence of dysplastic polyps in patients with ulcerative colitis.

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Low prevalence of dysplastic polyps in patients with ulcerative colitis.

Clin Res Hepatol Gastroenterol. 2016 Nov 9;:

Authors: Laish I, Shurani A, Barkay O, Konikoff FM, Naftali T

Abstract
BACKGROUND AND AIMS: Patients with ulcerative colitis (UC) are prone to colorectal cancer and dysplastic polyps and also have sporadic adenomas. There is scant information, however, relating the prevalence of sporadic adenomas in UC patients compared with normal subjects. The aim of this study was to assess the prevalence of all dysplastic lesions in UC and compare the prevalence of adenomas to that in the general population.
METHODS: A single-center retrospective study, in which all patients with diagnosed UC were followed during a ten-year period. The incidence of polyps and colorectal cancers were recorded and compared to that of an age-matched group in the general population who had screening colonoscopy.
RESULTS: A total of 229 UC patients were included compared with 450 age-matched subjects who underwent a single colonoscopy. The average number of colonoscopies per UC patient was 3. The rate of sporadic adenomas among UC patients (9.6%), as well as the rate of all dysplastic polyps (11.2%) in these patients, were significantly lower than the rate of adenomas among the control population (24%; OR 0.33-0.44; P<0.0001). Despite this, the rates of colon cancer were comparable between the groups (2.1% vs. 1.5%, P=0.55).
CONCLUSIONS: In spite of the observed lower rate of dysplastic polyps in UC patients, this should not preclude tight surveillance in this high-risk population.

PMID: 27838112 [PubMed - as supplied by publisher]

[A case of idiopathic myointimal hyperplasia of mesenteric veins].

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[A case of idiopathic myointimal hyperplasia of mesenteric veins].

Ann Pathol. 2016 Nov 9;:

Authors: Cauchois A, Desfourneaux V, Kammerer-Jacquet SF, Bouguen G, Rioux-Leclercq N, Henno S

Abstract
The idiopathic myointimal hyperplasia of mesenteric veins is a rare pathology, affecting recto-sigmoid and mimicking clinically an inflammatory chronic disease of the bowel. Only about fifteen cases have been reported in the literature. This lesion is characterized by a myointimal thickening of the mesenteric veins, without inflammatory infiltrate of the vascular wall, differentiating it from vasculitis. We present here the case of a 48-year-old man, in whom the diagnosis of ulcerative colitis then digestive vasculitis had first been raised.

PMID: 27838074 [PubMed - as supplied by publisher]

Th9 cells in inflammatory bowel diseases.

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Th9 cells in inflammatory bowel diseases.

Semin Immunopathol. 2016 Nov 11;

Authors: Weigmann B, Neurath MF

Abstract
Inflammatory bowel diseases are chronic, relapsing, immunologically mediated disorders of the gastrointestinal tract. Emerging evidence suggests a critical functional role of transcription factors and T cell-related cytokines in ulcerative colitis and Crohn's disease. Gut-residing T cells from patients with inflammatory bowel disease produce high amounts of IL-9. Experimental models of colitis highlighted that IL-9-producing T cells critically interfered with an intact barrier function of the intestinal epithelium by impacting cellular proliferation and tight junction molecules. The blockade of IL-9 was suited to significantly ameliorate the disease activity and severity in experimental models of inflammatory bowel disease thereby suggesting that targeting IL-9 might function as a novel targeted approach for therapy.

PMID: 27837255 [PubMed - as supplied by publisher]

Thalidomide is a therapeutic agent that is effective in inducing and maintaining endoscopic remission in adult CD patients.

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Thalidomide is a therapeutic agent that is effective in inducing and maintaining endoscopic remission in adult CD patients.

Clin Res Hepatol Gastroenterol. 2016 Nov 8;:

Authors: Zhu Z, Li M, Shu X, Bai A, Long S, Liu D, Lu N, Zhu X, Liao W

Abstract
BACKGROUND AND AIMS: Previous studies have indicated that thalidomide may be effective in achieving clinical remission and response; however, there is a lack of studies on its effect in endoscopic remission. The aim of this study was to assess the efficacy and safety of thalidomide in inducing and maintaining endoscopic remission.
METHODS: A retrospective study was conducted in adult Crohn's disease (CD) patients treated with thalidomide. Patients were assessed based on their medical records. Endoscopy was performed after 4-6 months of thalidomide administration, and the simple endoscopic score for CD (SES-CD) was obtained.
RESULTS: Twenty of the 21 (95.2%) eligible patients were recruited. Endoscopic remission was achieved in 7 of the 14 (50%) endoscopy active patients who received thalidomide treatment, whereas 10 (71.4%) patients showed an endoscopy response. The other 6 patients in endoscopic remission still maintained remission after thalidomide treatment. The SES-CD in endoscopy active patients was significantly reduced after thalidomide treatment (P<0.05). A total of 32 adverse events occurred in 17 of the 21 (81.0%) patients. Adverse events resolved spontaneously in 11 (64.7%) patients and resulted in treatment discontinuation and dose reduction in 4 (19.1%) and 2 (9.5%) patients, respectively.
CONCLUSIONS: Thalidomide therapy is effective in inducing and maintaining endoscopic remission in adult CD patients. However, side effects may limit its clinical use in CD treatment.

PMID: 27836485 [PubMed - as supplied by publisher]

Mechanism-Based Strategies for the Management of Autoimmunity and Immune Dysregulation in Primary Immunodeficiencies.

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Mechanism-Based Strategies for the Management of Autoimmunity and Immune Dysregulation in Primary Immunodeficiencies.

J Allergy Clin Immunol Pract. 2016 Nov - Dec;4(6):1089-1100

Authors: Walter JE, Farmer JR, Foldvari Z, Torgerson TR, Cooper MA

Abstract
A broad spectrum of autoimmunity is now well described in patients with primary immunodeficiencies (PIDs). Management of autoimmune disease in the background of PID is particularly challenging given the seemingly discordant goals of immune support and immune suppression. Our growing ability to define the molecular underpinnings of immune dysregulation has facilitated novel targeted therapeutics. This review focuses on mechanism-based treatment strategies for the most common autoimmune and inflammatory complications of PID including autoimmune cytopenias, rheumatologic disease, and gastrointestinal disease. We aim to provide guidance regarding the rational use of these agents in the complex PID patient population.

PMID: 27836058 [PubMed - in process]

Impact of Microbes on the Pathogenesis of Primary Biliary Cirrhosis (PBC) and Primary Sclerosing Cholangitis (PSC).

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Impact of Microbes on the Pathogenesis of Primary Biliary Cirrhosis (PBC) and Primary Sclerosing Cholangitis (PSC).

Int J Mol Sci. 2016 Nov 09;17(11):

Authors: Mattner J

Abstract
Primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC) represent the major clinical entities of chronic cholestatic liver diseases. Both disorders are characterized by portal inflammation and slowly progress to obliterative fibrosis and eventually liver cirrhosis. Although immune-pathogenic mechanisms have been implicated in the pathogenesis of PBC and PSC, neither disorder is considered to be a classical autoimmune disease, as PSC and PBC patients do not respond to immune-suppressants. Furthermore, the decreased bile flow resulting from the immune-mediated tissue assault and the subsequent accumulation of toxic bile products in PBC and PSC not only perpetuates biliary epithelial damage, but also alters the composition of the intestinal and biliary microbiota and its mutual interactions with the host. Consistent with the close association of PSC and inflammatory bowel disease (IBD), the polyclonal hyper IgM response in PBC and (auto-)antibodies which cross-react to microbial antigens in both diseases, an expansion of individual microbes leads to shifts in the composition of the intestinal or biliary microbiota and a subsequent altered integrity of epithelial layers, promoting microbial translocation. These changes have been implicated in the pathogenesis of both devastating disorders. Thus, we will discuss here these recent findings in the context of novel and alternative therapeutic options.

PMID: 27834858 [PubMed - in process]

Demineralized Freeze Dried Bone Allograft With Amniotic Membrane in the Treatment of Periodontal Intrabony Defects - 12 Month Randomized Controlled Clinical Trial.

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Demineralized Freeze Dried Bone Allograft With Amniotic Membrane in the Treatment of Periodontal Intrabony Defects - 12 Month Randomized Controlled Clinical Trial.

J Periodontol. 2016 Nov 11;:1-18

Authors: Sali DD, Pauline George J

Abstract
AIM: The goal of randomized controlled clinical study was to compare the clinical and radiological outcomes of the combination of Open flap debridement, Amniotic membrane and Demineralized Freeze Dried bone Allograft with Open flap debridement and Demineralized Freeze Dried bone Allograft alone in the management of periodontal intrabony defects.
METHOD: 10 patients with bilaterally similar intrabony defects were selected. Each of the intrabony defects were randomly allocated for control and test groups. Control group (n= 10) received open flap debridement (OFD) and Demineralized Freeze Dried bone Allograft (DFDBA) while the test group (n=10) received OFD, DFDBA and Amniotic membrane. Pocket Probing Depth reduction (PPD), Clinical Attachment Level (CAL) gain and radiographic bone gain were assessed.
RESULTS: Both the groups demonstrated statistically significant PPD reduction, CAL gain and radiographic bone gain. The Intrabony defect (IBD) reduction of 1.78 ± 0.04 mm in radiovisiography (RVG) and 2.02 ± 0.83 mm in cone beam computed tomography (CBCT) with defect resolution of 58.28 % (RVG) and 58.24 % (CBCT) was noted in test group when compared to control group.
CONCLUSION: All the parameters measured showed similar improvement such as PPD reduction, CAL gain, IBD reduction and defect resolution with OFD + DFDBA + AM and OFD + DFDBA, no statistical significant difference was observed between the two groups .

PMID: 27834121 [PubMed - as supplied by publisher]

Concurrent Resolution of Chronic Diarrhea Likely Due to Crohn's Disease and Infection with Mycobacterium avium paratuberculosis.

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Concurrent Resolution of Chronic Diarrhea Likely Due to Crohn's Disease and Infection with Mycobacterium avium paratuberculosis.

Front Med (Lausanne). 2016;3:49

Authors: Singh SV, Kuenstner JT, Davis WC, Agarwal P, Kumar N, Singh D, Gupta S, Chaubey KK, Kumar A, Misri J, Jayaraman S, Sohal JS, Dhama K

Abstract
Examination of samples of stool from a 61-year-old male patient, presenting with the clinical symptoms of Crohn's disease (CD), revealed massive shedding of acid fast bacilli with the morphology of Mycobacterium avium paratuberculosis (MAP), the causative agent of Johne's disease in cattle. MAP was cultured from the stool. Biotyping of the bacterium isolated from cultures of stool demonstrated, it was the Indian Bison biotype of MAP, the dominant biotype infecting livestock and humans in India. Based on this finding and because the patient was unresponsive to standard therapy used in India to treat patients with gastrointestinal inflammatory disorders, the patient was placed on a regimen of multi-antibiotic therapy, currently used to treat tuberculosis and CD. After 1 year of treatment, the patient's health was restored, concurrent with cessation of shedding of MAP in his stool. This patient is the first case shown to shed MAP from the stool who was cured of infection with antibiotics and who was concurrently cured of clinical signs of CD.

PMID: 27833911 [PubMed - in process]

General Diseases Influence on Peri-Implantitis Development: a Systematic Review.

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General Diseases Influence on Peri-Implantitis Development: a Systematic Review.

J Oral Maxillofac Res. 2016 Jul-Sep;7(3):e5

Authors: Guobis Z, Pacauskiene I, Astramskaite I

Abstract
OBJECTIVES: To systematically review the influence of systemic diseases or medications used in their treatment on the dental implant therapy success.
MATERIAL AND METHODS: The search strategy was implemented on the National Library of Medicine database (MEDLINE) (Ovid) and EMBASE electronic databases between January 2006 and January 2016. Human studies with available English articles analysing the relationship between dental implant therapy success and systemic diseases, such as diabetes mellitus, AIDS/HIV, rheumatoid arthritis, osteoporosis, Crohn's disease, cardiovascular diseases, scleroderma, Sjögren's syndrome, lichen planus, ectodermal dysplasia, post-transplantation status, were included in present review according to the PRISMA guidelines. The review protocol was registered on PROSPERO system with the code CRD42016033662.
RESULTS: Present review included forty one retrospective and prospective follow-up studies, case-control studies, case report series and cohort studies. Despite some limitations this study reveals positive results of implantation in most systemic conditions that should be interpreted with caution. Influence of cardiovascular diseases on the dental implantation success should be explored deeply, because of controversial results and likelihood of comorbidity expressed by a history of cardiovascular diseases and periodontitis. There is only a weak relationship with bone density in osteoporosis and implant failure. All the other diseases did not show significant effect on implantation success.
CONCLUSIONS: Recent studies with low strength of evidence and controversy show that systemic diseases may have potential effect on the success of implantation, but further detailed studies are needed to provide these findings.

PMID: 27833730 [PubMed - in process]

Mucosal Prevalence and Interactions with the Epithelium Indicate Commensalism of Sutterella spp.

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Mucosal Prevalence and Interactions with the Epithelium Indicate Commensalism of Sutterella spp.

Front Microbiol. 2016;7:1706

Authors: Hiippala K, Kainulainen V, Kalliomäki M, Arkkila P, Satokari R

Abstract
Sutterella species have been frequently associated with human diseases, such as autism, Down syndrome, and inflammatory bowel disease (IBD), but the impact of these bacteria on health still remains unclear. Especially the interactions of Sutterella spp. with the host are largely unknown, despite of the species being highly prevalent. In this study, we addressed the interaction of three known species of Sutterella with the intestinal epithelium and examined their adhesion properties, the effect on intestinal barrier function and the pro-inflammatory capacity in vitro. We also studied the relative abundance and prevalence of the genus Sutterella and Sutterella wadsworthensis in intestinal biopsies of healthy individuals and patients with celiac disease (CeD) or IBD. Our results show that Sutterella spp. are abundant in the duodenum of healthy adults with a decreasing gradient toward the colon. No difference was detected in the prevalence of Sutterella between the pediatric IBD or CeD patients and the healthy controls. Sutterella parvirubra adhered better than the two other Sutterella spp. to differentiated Caco-2 cells and was capable of decreasing the adherence of S. wadsworthensis, which preferably bound to mucus and human extracellular matrix proteins. Furthermore, only S. wadsworthensis induced an interleukin-8 production in enterocytes, which could be due to different lipopolysaccharide structures between the species. However, its pro-inflammatory activity was modest as compared to non-pathogenic Escherichia coli. Sutterella spp. had no effect on the enterocyte monolayer integrity in vitro. Our findings indicate that the members of genus Sutterella are widely prevalent commensals with mild pro-inflammatory capacity in the human gastrointestinal tract and do not contribute significantly to the disrupted epithelial homeostasis associated with microbiota dysbiosis and increase of Proteobacteria. The ability of Sutterella spp. to adhere to intestinal epithelial cells indicate that they may have an immunomodulatory role.

PMID: 27833600 [PubMed - in process]

Anti-inflammatory Effects of Herbal Preparations STW5 and STW5-II in Cytokine-Challenged Normal Human Colon Cells.

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Anti-inflammatory Effects of Herbal Preparations STW5 and STW5-II in Cytokine-Challenged Normal Human Colon Cells.

Front Pharmacol. 2016;7:393

Authors: Schneider M, Efferth T, Abdel-Aziz H

Abstract
Inflammatory bowel diseases (IBD) are chronic relapsing intestinal disorders characterized by up-regulation of pro-inflammatory cytokines followed by invasion of immune cells to the intestinal lamina propria. Standard therapies consist of anti-inflammatory or immunosuppressive drugs. Since clinical efficiency is not satisfactory and the established drugs have massive side effects, new strategies to treat IBD are required. Herein, we investigate the protective effect of the fixed combination herbal preparations STW5 and STW5-II and the contribution of the corresponding single components in an in vitro inflammation model. The normal human colon epithelial cell line, NCM460, was treated with STW5, STW5-II or their single components for 4 h followed by experimental conditions comparable to induction of colitis. A pro-inflammatory cytokine cocktail consisting of TNF-α, IL-β, and IFN-γ was used to simulate inflammatory stimuli normally caused by immune cells. The effects on NCM460 cells were investigated by enzyme-linked immunoassay and Proteome Profiler(®). Levels of IP-10, MCP-1, I-TAC, Groα, and IL-8 were elevated in chemokine-treated cells compared to untreated cells, but significantly reduced upon pretreatment with STW5 or STW5-II. However, the single compounds revealed only little effects on protein expression. Furthermore, we investigated the effect of both combination preparations on pro-inflammatory transcription factors of the STAT family using Western blot. In addition, we tested the effects on upstream MAPK p38. Both, STW5 and STW5-II did not show any effect on MAPK p38, but were effective in reducing phosphorylated levels of STAT1. In conclusion, both combination preparations act in an anti-inflammatory manner by influencing cytokine secretion via reduced activity of the JAK/STAT1 pathway. Relevant differences between STW5 and STW5-II were not found indicating similar efficacies.

PMID: 27833553 [PubMed - in process]

The relationship between the immune system and oral manifestations of inflammatory bowel disease: a review.

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The relationship between the immune system and oral manifestations of inflammatory bowel disease: a review.

Cent Eur J Immunol. 2016;41(3):302-310

Authors: Vasovic M, Gajovic N, Brajkovic D, Jovanovic M, Zdravkovaic N, Kanjevac T

Abstract
Inflammatory bowel diseases (IBDs) are chronic, relapsing inflammatory diseases characterized by exacerbations and remissions of the gastrointestinal tract, clinically manifested as Crohn's disease and ulcerative colitis. The etiology of IBDs is considered to be multi factorial, comprising environmental, immune, microbial and genetic factors. Clinical signs may include abdominal pain, frequent bloody diarrheas, mucorrhea, vomiting, fever, fatigue or weight loss. Changes in the oral cavity often precede intestinal symptoms. Inflammatory bowel disease leads to a significant deterioration of oral health, which indicates that cooperation between the dentist and the gastroenterologist is necessary when considering patients' welfare. Patients with IBD have an altered immune response, but microorganisms of the oral cavity may also be responsible for its modification. This review paper discusses the correlation between the immune system and inflammatory bowel disease manifestations in the oral cavity.

PMID: 27833449 [PubMed - in process]

Efficacy of thioguanine treatment in inflammatory bowel disease: A systematic review.

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Efficacy of thioguanine treatment in inflammatory bowel disease: A systematic review.

World J Gastroenterol. 2016 Oct 28;22(40):9012-9021

Authors: Meijer B, Mulder CJ, Peters GJ, van Bodegraven AA, de Boer NK

Abstract
AIM: To critically assess the available literature regarding the efficacy of thioguanine treatment in inflammatory bowel disease (IBD) patients, irrespective of the (hepato-) toxicity profile.
METHODS: A systematic literature search of the MEDLINE database using PubMed was performed using the keywords "thioguanine", "6-TG", "thioguanine", "inflammatory bowel disease", "IBD", "Crohn's disease", "Ulcerative colitis" and "effectiveness" in order to identify relevant articles published in English starting from 2000. Reference lists of the included articles were cross-checked for missing articles. Reviewed manuscripts concerning the effectiveness of thioguanine treatment in IBD were reviewed by the authors and the data were extracted. Data were subsequently analyzed with descriptive statistics. Due to the lack of standardized outcomes, a formal meta-analysis was not performed.
RESULTS: A total of 11 applicable studies were found that involved the effectiveness of thioguanine therapy in IBD. Eight studies were conducted in a prospective manner, in the remaining three studies, data was collected retrospectively. In total, 353 IBD-patients (225 patients with Crohn's disease, 119 with ulcerative colitis and nine with unclassified IBD) with prior azathioprine/mercaptopurine resistance and/or intolerance (n = 321) or de novo thioguanine administration (n = 32) were included for analysis, of which 228 (65%) had clinical improvement on thioguanine therapy, based on standard IBD questionnaires, biochemical parameters or global physician assessments. Short-term results were based on 268 treatment years (median follow-up 9 mo, range 3-22 mo) with a median daily dose of 20 mg (range 10-80 mg). Discontinuation, mostly due to adverse events, was reported in 72 patients (20%).
CONCLUSION: The efficacy of thioguanine therapy in IBD patients intolerant to conventional thiopurine therapy is observed in 65%, with short term adverse events in 20% of patients.

PMID: 27833392 [PubMed - in process]

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