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New therapeutic perspectives in irritable bowel syndrome: Targeting low-grade inflammation, immuno-neuroendocrine axis, motility, secretion and beyond

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World Journal of Gastroenterology 2017年第36期23卷 6593-6627页

作者： Emanuele Sinagra Gaetano Cristian Morreale Ghazaleh Mohammadian Giorgio Fusco Valentina Guarnotta Giovanni Tomasello Francesco Cappello Francesca Rossi Georgios Amvrosiadis dario raimondo Gastroenterology and Endoscopy Unit Fondazione Istituto Giuseppe GiglioContrada Pietra Pollastra Pisciotto Euro-Mediterranean Institute of Science and Technology Department of Experimental Biomedicine and Clinical Neuroscience Section of Human AnatomyUniversity of Palermo Unit of Gastroenterology Ospedali Riuniti Villa Sofia-Vincenzo Cervello Department of Medicine Division of Gastroenterology and HepatologyKarolinska InstitutetKarolinska University Hospital Unit of Internal Medicine Ospedali Riuniti Villa Sofia-Vincenzo Cervello Section of Cardio-Respiratory and Endocrine-Metabolic Diseases Biomedical Department of Internal and Specialist MedicineUniversity of Palermo

Irritable bowel syndrome(IBS)is a chronic,recurring,and remitting functional disorder of the gastrointestinal tract characterized by abdominal pain,distention,and changes in bowel *** there are several drugs for IBS,effective and approved treatments for one or more of the symptoms for various IBS subtypes are *** understanding of pathophysiological mechanisms such as the role of impaired bile acid metabolism,neurohormonal regulation,immune dysfunction,the epithelial barrier and the secretory properties of the gut has led to advancements in the treatment of *** regards to therapies for restoring intestinal permeability,multiple studies with prebiotics and probiotics are ongoing,even if to date their efficacy has been *** parallel,much progress has been made in targeting low-grade inflammation,especially through the introduction of drugs such as mesalazine and rifaximin,even if a better knowledge of the mechanisms underlying the low-grade inflammation in IBS may allow the design of clinical trials that test the efficacy and safety of such *** literature review aims to summarize the findings related to new and investigational therapeutic agents for IBS,most recently developed in preclinical as well as Phase 1 and Phase 2clinical studies.

关键词： Therapy Low grade inflammation Motility Secretion Irritable bowel syndrome Immunoendocrine axis

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Use of artificial intelligence in improving adenoma detection rate during colonoscopy:Might both endoscopists and pathologists be further helped

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World Journal of Gastroenterology 2020年第39期26卷 5911-5918页

作者： Emanuele Sinagra Matteo Badalamenti Marcello Maida Marco Spadaccini Roberta Maselli Francesca Rossi Giuseppe Conoscenti dario raimondo Socrate Pallio Alessandro Repici Andrea Anderloni Gastroenterology and Endoscopy Unit Fondazione Istituto San Raffaele GiglioCefalù90015Italy Digestive Endoscopy Unit Division of GastroenterologyHumanitas Clinical and Research Center IRCCSRozzano 20089Italy Gastroenterology and Endoscopy Unit S.Elia-Raimondi HospitalCaltanissetta 93100Italy Endoscopy Unit AOUP Policlinico G.MartinoMessina 98125Italy

Colonoscopy remains the standard strategy for screening for colorectal cancer around the world due to its efficacy in both detecting adenomatous or precancerous lesions and the capacity to remove them *** detection and diagnosis(CAD),thanks to the brand new developed innovations of artificial intelligence,and especially deep-learning techniques,leads to a promising solution to human biases in performance by guarantying decision support during *** application of CAD on real-time colonoscopy helps increasing the adenoma detection rate,and therefore contributes to reduce the incidence of interval cancers improving the effectiveness of colonoscopy screening on critical outcome such as colorectal cancer related ***,a significant reduction in costs is also *** addition,the assistance of the machine will lead to a reduction of the examination time and therefore an optimization of the endoscopic *** aim of this opinion review is to analyze the clinical applications of CAD and artificial intelligence in colonoscopy,as it is reported in literature,addressing evidence,limitations,and future prospects.

关键词： Colonoscopy Artificial intelligence Adenoma detection rate Pathology Endoscopy Computer-aided detection and diagnosis

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Inflammation in irritable bowel syndrome:Myth or newtreatment target?

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世界胃肠病学杂志：英文版 2016年第7期22卷 2242-2255页

作者： Emanuele Sinagra Giancarlo Pompei Giovanni Tomasello Francesco Cappello Gaetano Cristian Morreale Georgios Amvrosiadis Francesca Rossi Attilio Ignazio Lo Monte Aroldo Gabriele Rizzo dario raimondo Gastroenterology and Endoscopy Unit Fondazione Istituto San Raffaele GiglioContrada Pietra Pollastra Pisciotto90015 CefalùItaly PhD Course in Surgical Biotechnology and Regenerative Medicine University of Palermo90100 PalermoItaly Euro-Mediterranean Institute of Science and Technology(IEMEST) 90100 PalermoItaly Pathology Unit Fondazione Istituto San Raffaele GiglioContrada Pietra Pollastra Pisciotto90015 CefalùItaly Department of Experimental Biomedicine and Clinical Neuroscience Section of Human AnatomyUniversity of Palermo90100 PalermoItaly Unit of Gastroenterology Ospedali Riuniti Villa Sofia-Vincenzo Cervello90100 PalermoItaly DICHIRONS Department of SurgicalOncological and Stomatological DisciplinesUniversity of Palermo90100 PalermoItaly Unit of Pathology Ospedali Riuniti Villa Sofia-Vincenzo Cervello90100 PalermoItaly

Low-grade intestinal inflammation plays a key role in the pathophysiology of irritable bowel syndrome(IBS), and this role is likely to be multifactorial. The aim of this review was to summarize the evidence on the spectrum of mucosal inflammation in IBS, highlighting the relationship of this inflammation to the pathophysiology of IBS and its connection to clinical practice. We carried out a bibliographic search in Medline and the Cochrane Library for the period of January 1966 to December 2014, focusing on publications describing an interaction between inflammation and IBS. Several evidences demonstrate microscopic and molecular abnormalities in IBS patients. Understanding the mechanisms underlying low-grade inflammation in IBS may help to design clinical trials to test the efficacy and safety of drugs that target this pathophysiologic mechanism.

关键词： Inflammation Irritable bowel syndrome Mast cells Neuroendocrine cells Pathology

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Could JC virus provoke metastasis in colon cancer?

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World Journal of Gastroenterology 2014年第42期20卷 15745-15749页

作者： Emanuele Sinagra dario raimondo Elena Gallo Mario Stella Mario Cottone Ambrogio Orlando Francesca Rossi Emanuele Orlando Marco Messina Giovanni Tomasello Attilio Ignazio Lo Monte Ennio La Rocca Aroldo Gabriele Rizzo Gastroenterology and Endoscopy Unit Fondazione Istituto San Raffaele-G Giglio Contrada Pietra Pollastra Pisciotto course in Surgical Biotechnology and Regenerative Medicine University of Palermo Euro-Mediterranean Institute of Science and Technology (IEMEST) Unit of Pathology Ospedali Riuniti Villa Sofia - Cervello University of Palermo DIBIMIS Unit of Internal Medicine Ospedali Riuniti Villa Sofia - Cervello University of Palermo Oncology Unit Fondazione Istituto San Raffaele-G Giglio Contrada Pietra Pollastra Pisciotto Department of Surgical and Oncological Disciplines School of Medicine University of Palermo Unità Operativa di Medicina interna e trapiantologia Ospedale San Raffaele

AIM: To evaluate the prevalence of John Cunningham virus(JC virus) in a small cohort of patients with colon cancer and to assess its presence in hepatic ***: Nineteen consecutive patients with histologically diagnosed colon cancer were included in our study, together with ten subjects affected by histologically and serologically diagnosed hepatitis C virus infection. In the patients included in the colon cancer group, JC virus was searched for in the surgical specimen; in the control group, JC virus was searched for in the hepatic biopsy. The difference in the prevalence of JC virus in the hepatic biopsy between the two groups was assessed through the χ2 ***: Four out of 19 patients with colon cancer had a positive polymerase chain reaction(PCR) test for JC virus, and four had liver metastasis. Among the patients with liver metastasis, three out of four had a positive PCR test for JC virus in the surgical specimen and in the liver biopsy; the only patient with liver metastasis with a negative test for JC virus also presented a negative test for JC virus in the surgical specimen. In the control group of patients with hepatitis C infection, none of the ten patients presented JC virus infection in the hepatic biopsy. The difference between the two groups regarding JC virus infection was statistically significant(χ2 = 9.55, P = 0.002).CONCLUSION: JC virus may play a broader role than previously thought, and may be mechanistically involved in the late stages of these tumors.

关键词： John Cunningham virus Colon cancer Me-tastasis

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