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Growth hormone regulates intestinal ion transport through a modulation of the constitutive nitric oxide synthase-nitric oxide-cAMP pathway

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World Journal of Gastroenterology 2006年第29期12卷 4710-4715页

作者： Roberto Berni Canani Pia Cirillo Giuseppe Mallardo Vittoria Buccigrossi Annalisa Passariello Serena Ruotolo Giulio De Marco Francesco Porcaro alfredo guarino Department of Pediatrics University Federico Ⅱ Naples 80131 Italy

AIM： Growth hormone （GH） directly interacts with the enterocyte stimulating ion absorption and reducing ion secretion induced by agonists of cAMR Since nitric oxide （NO） is involved in the regulation of transepithelial ion transport and acts as a second messenger for GH hemodynamic effects, we tested the hypothesis that NO may be involved in the resulting effects of GH on intestinal ion transport. METHODS： Electrical parameters reflecting transepithelial ion transport were measured in Caco-2 cell monolayers mounted in Ussing chambers and exposed to GH and cholera toxin （CT） alone or in combination, in the presence or absence of the NO synthase （NOS） inhibitor, Nω-nitro-L-arginine methyl ester （L-NAME）. Similar experiments were conducted to determine cAMP and nitrite/nitrate concentrations. NOS expression was assayed by Western blot analysis. RESULTS： L-NAME causes total abrogation of absorptive and antisecretory effects by GH on intestinal ion transport, In addition, L-NAME was able to inhibit the GH-effects on intracellular cAMP concentration under basal conditions and in response to CT, GH induced a Ca^2＋ -dependent increase of nitrites/nitrates production, indicating the involvement of the constitutive rather than the inducible NOS isoform, which was directly confirmed by Western blot analysis. CONCLUSION： These results suggest that the GH effects on intestinal ion transport, either under basal conditions or in the presence of cAMP-stimulated ion secretion, are mediated at an intracellular level by the activity of cNOS.

关键词： Nitric oxide synthase Cholera toxin Intestinal ion secretion cAMP Enterocyte

Probiotics for gastrointestinal disorders: Proposed recommendations for children of the Asia-Pacific region

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World Journal of Gastroenterology 2017年第45期23卷 7952-7964页

作者： Donald Cameron Quak Seng Hock Musal Kadim Neelam Mohan Eell Ryoo Bhupinder Sandhu Yuichiro Yamashiro Chen Jie Hans Hoekstra alfredo guarino Department of Gastroenterology and Clinical Nutrition Royal Children’s Hospital Yong Loo Lin School of Medicine National University of Singapore Child Health Department Cipto Mangunkusumo HospitalUniversity of Indonesia Department of Pediatric Gastroenterology Hepatology And Liver Transplantation Department of Pediatrics Gachon UniversityGil Gachon Children’s Hosptial Department of Paediatric Gastroenterology Royal Hospital for Children Probiotics Research Laboratory Juntendo University Graduate School of Medicine The Children’s Hospital Zhejiang University School of Medicine Department of Pediatrics Hieronymus Bosch Hospital Unit of Pediatrics Infectious Diseases and Clinical Nutrition of the Department of Translational Medical Science-Section of Pediatrics University of Naples Federico II

Recommendations for probiotics are available in several regions. This paper proposes recommendations for probiotics in pediatric gastrointestinal diseases in the Asia-Pacific region. Epidemiology and clinical patterns of intestinal diseases in Asia-Pacific countries were discussed. Evidence-based recommendations and randomized controlled trials in the region were revised. Cultural aspects,health management issues and economic factors were also considered. Final recommendations were approved by applying the Likert scale and rated using the GRADE system. Saccharomyces boulardii CNCM I-745(Sb) and Lactobacillus rhamnosus GG(LGG) were strongly recommended as adjunct treatment to oral rehydration therapy for gastroenteritis. Lactobacillus reuteri could also be considered. Probiotics may be considered for prevention of(with the indicated strains): antibiotic-associated diarrhea(LGG or Sb); Clostridium difficile-induced diarrhea(Sb); nosocomial diarrhea(LGG); infantile colic(L reuteri) and as adjunct treatment of Helicobacter pylori(Sb and others). Specific probiotics with a history of safe use in preterm and term infants may be considered in infants for prevention of necrotizing enterocolitis. There is insufficient evidence for recommendations in other conditions. Despite a diversity of epidemiological,socioeconomical and health system conditions,similar recommendations apply well to Asia pacific countries. These need to be validated with local randomized-controlled trials.

关键词： Lactobacillus rhamnosus Gastroenteritis Guidelines Probiotics Children Recommendations Asia-Pacific Saccharomyces boulardii

Gastrointestinal and liver infections in children undergoing antineoplastic chemotherapy in the years 2000

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World Journal of Gastroenterology 2016年第25期22卷 5853-5866页

作者： Elio Castagnola Eliana Ruberto alfredo guarino Infectious Diseases Unit Istituto Giannina Gaslini Department of Translational Medical Science Section of Pediatrics University of Naples Federico II

AIM: To review gastrointestinal and liver infections in children undergoing antineoplastic chemotherapy. To look at gut microflora features in oncology ***: We selected studies published after year 2000, excluding trials on transplanted pediatric patients. We searched English language publications in MEDLINE using the keywords: "gastrointestinal infection AND antineoplastic chemotherapy AND children", "gastrointestinal infection AND oncology AND children", "liver infection AND antineoplastic chemotherapy AND children", "liver abscess AND chemotherapy AND child", "neutropenic enterocolitis AND chemotherapy AND children", "thyphlitis AND chemotherapy AND children", "infectious diarrhea AND children AND oncology", "abdominal pain AND infection AND children AND oncology", "perianal sepsis AND children AND oncology", "colonic pseudo-obstruction A N D o n c o l o g y A N D c h i l d A N D c h e m o t h e r a p y ", "microflora AND children AND malignancy", "microbiota AND children AND malignancy", "fungal flora AND children AND malignancy". We also analysed evidence from several articles and book ***: Gastrointestinal and liver infections represent a major cause of morbidity and mortality in children undergoing antineoplastic chemotherapy. Antineoplastic drugs cause immunosuppression in addition to direct toxicity, predisposing to infections, although the specific risk is variable according to disease and host features. Common pathogens potentially induce severe diseases whereas opportunistic microorganisms may attack vulnerable hosts. Clinical manifestations can be subtle and not specific. In addition, several conditions are rare and diagnostic process and treatments are not standardized. Diagnosis may be challenging, however early diagnosis is needed for quick and appropriate interventions. Interestingly, the source of infectionin those children can be exogenous or endogenous. Indeed, mucosal damage may allow the penetrance of endogenous micr

关键词： Gastrointestinal tract Liver Microflora Infection Oncology Chemotherapy Children

Impact of chronic kidney disease on mortality in older adults treated with pacemaker implantation

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Journal of Geriatric Cardiology 2017年第10期14卷 597-603页

作者： Fabio Fabbian alfredo De Giorgi Matteo guarino Michele Malagu Matteo Bertini Department of Medical Sciences Clinical Medical Unit University Hospital St. Anna University of Ferrara Ferrara Italy Department of Medical Sciences Cardiology Unit University Hospital St. Anna University of Ferrara Ferrara Italy

Objective To investigate whether chronic kidney disease could negatively impact survival in older adults needing pacemaker implantation after admission for bradyarrhythmias. Methods This retrospective observational study considered 538 older adults consecutively admitted, who had been followed-up for 31 ± 20 months. Subjects with poor short-term prognosis were excluded. Charlson comorbidity index （CCI） and estimated glomerular filtration rate （eGFR） was calculated, along with the independent relationship between all-cause mortality and clinical data. Hazard Ratio （HR） was calculated by Cox regression analysis. Results Mean age of the population was 85 ± 3.7 years, and causes for implantation were atrioventricular block in 51.9% and other bradyarrhythmias in 48.1% of cases. Mean eGFR was 58.3 ± 24 mL/min per 1.73 m2, and mean CCI was 3.65 ± 2.28. Death for all-causes was recorded in 213 subjects. Deceased patients were older, had lower eGFR, higher comorbidity, higher prevalence of myocardial infarction, congestive heart failure, cerebrovascular disease, dementia and chronic pulmonary disease. Age （HR： 1.081, 95% CI： 1.044-1.119; P 〈 001）, CCI （HR： 1.651, 95% CI： 1.286-2.121, P 〈 001） and eGFR 〈 45 mL/min per 1.73 m2 （HR： 1.360, 95% CI： 1.024-1.806; P = 0.033） were predictors of death. Conclusions Renal dysftmction, as well as comorbidity, impacts negatively survival of older adults treated with pacemaker implantation because of bradyarrhythmias.

关键词： Bradyarrhythmias Charlson comorbidity index Chronic kidney disease Comorbidity Glomerular filtration rate Mortality Pacemaker