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Diet and microbiota in inflammatory bowel disease: The gut in disharmony

World Journal of Gastroenterology 2017年第12期23卷 2124-2140页

作者： Davy CM Rapozo Claudio Bernardazzi heitor siffert pereira de souza Coordenacao de Pesquisa Instituto Nacional de Cancer Servico de Gastroenterologia e Laboratório Multidisciplinar de Pesquisa Departamento de Clínica MédicaHospital Universitário Clementino Fraga FilhoUniversidade Federal do Rio de Janeiro D’Or Institute for Research and Education Rua Diniz Cordeiro 30BotafogoRio de JaneiroRJ 22281-100Brazil

Bacterial colonization of the gut shapes both the local and the systemic immune response and is implicated in the modulation of immunity in both healthy and disease states. Recently, quantitative and qualitative changes in the composition of the gut microbiota have been detected in Crohn's disease and ulcerative colitis, reinforcing the hypothesis of dysbiosis as a relevant mechanism underlying inflammatory bowel disease(IBD) pathogenesis. Humans and microbes have coexisted and co-evolved for a long time in a mutually beneficial symbiotic association essential for maintaining homeostasis. However, the microbiome is dynamic, changing with age and in response to environmental modifications. Among such environmental factors, food and alimentary habits, progressively altered in modern societies, appear to be critical modulators of the microbiota, contributing to or co-participating in dysbiosis. In addition, food constituents such as micronutrients are important regulators of mucosal immunity, with direct or indirect effects on the gut microbiota. Moreover, food constituents have recently been shown to modulate epigenetic mechanisms, which can result in increased risk for the development and progression of IBD. Therefore, it is likely that a better understanding of the role of different food components in intestinal homeostasis and the resident microbiota will be essential for unravelling the complex molecular basis of the epigenetic, genetic and environment interactions underlying IBD pathogenesis as well as for offering dietary interventions with minimal side effects.

关键词： Diet Microbiota Epigenetics Crohn’s disease Ulcerative colitis

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Damage-associated molecular patterns in inflammatory bowel disease:From biomarkers to therapeutic targets

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World Journal of Gastroenterology 2018年第41期24卷 4622-4634页

作者： Hayandra Ferreira Nanini Claudio Bernardazzi Fernando Castro heitor siffert pereira de souza Servico de Gastroenterologia e Laboratorio Multidisciplinar de Pesquisa Departamento de Clinica MedicaHospital Universitario Clementino Fraga FilhoUniversidade Federal do Rio de JaneiroRio de JaneiroRJ 21941-913Brazil D’Or Institute for Research and Education(IDOR) Rua Diniz Cordeiro 30BotafogoRio de JaneiroRJ 22281-100Brazil

The chronic inflammatory process underlying inflammatory bowel disease (IBD), comprising Crohn's disease and ulcerative colitis, derives from the interplay of several components in a genetically susceptible host. These components include environmental elements and gut microbiota a dysbiosis. For decades, immune abnormalities have been investigated as critically important in IBD pathogenesis, and attempts to develop effective therapies have predominantly targeted the immune system. Nevertheless, immune events represent only one of the constituents contributing to IBD pathogenesis within the context of the complex cellular and molecular network underlying chronic intestinal inflammation. These factors need to be appreciated within the milieu of nonimmune components. Damage-associated molecular patterns (DAMPs), which are essentially endogenous stress proteins expressed or released as a result of cell or tissue damage, have been shown to act as direct proinflammatory mediators. Excessive or persistent signalling mediated by such molecules can underlie several chronic inflammatory disorders, including IBD. The release of endogenous DAMPs amplifies the inflammatory response driven by immune and non-immune cells and promotes epigenetic reprogramming in *** effects determine pathologic changes,which may sustain chronic intestinal inflammation and also underlie specific disease *** addition to highlighting the potential use of DAMPs such as calprotectin as biomarkers,research on DAMPs may reveal novel mechanistic associations in IBD pathogenesis and is expected to uncover putative therapeutic targets.

关键词： Damage-associated molecular patterns Environmental factors Epigenetics Inflammatory bowel disease Therapeutic targets

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Ecological study of gastric cancer in Brazil:Geographic and time trend analysis

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World Journal of Gastroenterology 2014年第17期20卷 5036-5044页

作者： César Augusto Amorim Jéssica Pronestino Moreira Luisa Rial Antonio José Carneiro Homero Soares Foga?a Celeste Elia Ronir Raggio Luiz heitor siffert pereira de souza Servi?o de Gastroenterologia Departamento de Clínica MédicaHospital UniversitárioUniversidade Federal do Rio de JaneiroRio de JaneiroRJ 21941-913Brazil Instituto de Epidemiologia e Saúde Coletiva Universidade Federal do Rio de JaneiroRio de JaneiroRJ 21941-913Brazil

AIM: To investigate the geographic distributions and time trends of gastric cancer (GC) incidence and mortality in Brazil.

关键词： Gastric cancer Ecological study Hospitalization Lethality rate

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Serum 1,3-beta-D-glucan as a noninvasive test to predict histologic activity in patients with inflammatory bowel disease

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World Journal of Gastroenterology 2021年第9期27卷 866-885页

作者： Katia Farias e Silva Hayandra F Nanini Cynthia Machado Cascabulho Siane L B Rosas Patricia T Santana Antonio Joséde V Carneiro Elias Anaissie Marcio Nucci heitor siffert pereira de souza department of Clinical Medicine School of MedicineFederal University of Rio de JaneiroRio de Janeiro 21941-913Brazil Laboratory of Innovations in Therapies Education and BioproductsInstituto Oswaldo CruzRio de Janeiro 21040-360Brazil Clinical Trial and Consulting Services CincinnatiOH 45267United States Internal Medicine D'Or Institute for Research and Education(IDOR)Rio de Janeiro 22281-100Brazil

BACKGROUND 1,3-beta-D-glucan(BG)is a ubiquitous cell wall component of gut *** hypothesized that the serum levels of BG could reflect active intestinal inflammation in patients with inflammatory bowel *** To determine whether the serum BG concentrations correlate with intestinal *** A prospective observational study was performed in a tertiary referral center,from 2016 to 2019,in which serum BG was determined in 115 patients with Crohn’s disease(CD),51 with ulcerative colitis(UC),and 82 controls using a photometric detection *** activity was determined by ileocolonoscopy,histopathology,magnetic resonance enterography,and biomarkers,including fecal calprotectin(FC),C-reactive protein,and a panel of *** ability of BG to detect active vs inactive disease was assessed using the area under the receiver operating characteristic *** subgroup analysis,serial BG was used to assess the response to therapeutic *** The serum BG levels were higher in CD patients than in controls(P=0.0001).The BG levels paralleled the endoscopic activity in CD patients and histologic activity and combined endoscopic and histologic activity in both CD and UC *** area under the curve(AUC)in receiver operating characteristic analysis to predict endoscopic activity was 0.694[95%confidence interval(CI):0.60-0.79;P=0.001]in CD,and 0.662(95%CI:0.51-0.81;P=0.066)in UC *** AUC in receiver operating characteristic analysis to predict histologic activity was 0.860(95%CI:0.77-0.95;P<0.001)in CD,and 0.786(95%CI:0.57-0.99;P=0.015)in UC *** cut-off values of BG for both endoscopic and histologic activity were 60μg/mL in CD,and 40μg/mL in UC *** analysis showed that the results based on BG of 40 and 60μg/mL were more specific for predicting endoscopic activity(71.8%and 87.2%for CD;and 87.5%and 87.5%for UC,respectively)than FC(53.3%and 66.7%for CD;and 20%and 80%for UC,respectively);and

关键词： Crohn’s disease Ulcerative colitis Inflammatory bowel disease Beta-glucan Histologic activity Noninvasive test

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Use of butyrate or glutamine in enema solution reduces inflammation and fibrosis in experimental diversion colitis

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World Journal of Gastroenterology 2012年第32期18卷 4278-4287页

作者： Rodrigo Goulart Pacheco Christiano Costa Esposito Lucas CM Müller Morgana TL Castelo-Branco Leonardo pereira Quintella Vera Lucia A Chagas heitor siffert P de souza Alberto Schanaider department of Surgery Experimental Surgery CenterSurgical Sciences Postgraduate ProgramMedical SchoolFederal University of Rio de JaneiroRio de JaneiroRJ 21941-913Brazil Laboratory of Cellular Immunology Department of Histology and EmbryologyInstitute of Biomedical SciencesFederal University of Rio de JaneiroRio de JaneiroRJ 21941-913Brazil department of Pathology Medical SchoolFederal University of Rio de JaneiroRio de JaneiroRJ 21941-913Brazil department of Internal Medicine Hospital Universitario Clementino Fraga FilhoFederal University of Rio de JaneiroRio de JaneiroRJ 21941-913Brazil

AIM:To investigate whether butyrate or glutamine enemas could diminish inflammation in experimental diversion ***:Wistar specific pathogen-free rats were submitted to a Hartmann's end colostomy and treated with enemas containing glutamine,butyrate,or *** were administered twice a week in the excluded segment of the colon from 4 to 12 wk after the surgical ***-up colonoscopy was performed every 4 wk for 12 *** effect of treatment was evaluated using video-endoscopic and histologic scores and measuring interleukin-1β,tumor necrosis factor-alpha,and transforming growth factor beta production in organ cultures by enzyme linked immunosorbent ***:Colonoscopies of the diverted segment showed mucosa with hyperemia,increased number of vessels,bleeding and mucus *** with either glutamine or butyrate induced significant reductions in both colonoscopic(P densities of collagen fibers in tissue(P = 0.015;P = 0.001),the number of goblet cells(P = 0.021;P = 0.029),and the rate of apoptosis within the epithelium(P = 0.043;P = 0.011) to normal *** high levels of cytokines in colon explants from rats with diversion colitis significantly decreased to normal values after treatment with butyrate or ***:The improvement of experimental diversion colitis following glutamine or butyrate enemas highlights the importance of specific luminal nutrients in the homeostasis of the colonic mucosa and supports their utilization for the treatment of human diversion colitis.

关键词： Diversion colitis Butyrate Glutamine Shortchain fatty acids Cytokines

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Therapeutic and prophylactic thalidomide in TNBS-induced colitis: Synergistic effects on TNF-α, IL-12 and VEGF production

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World Journal of Gastroenterology 2007年第15期13卷 2166-2173页

作者： Ana Teresa Carvalho heitor souza Antonio Jose Carneiro Morgana Castelo-Branco Kalil Madi Alberto Schanaider Flavia Silva Fernando Antonio pereira Júnior Márcia G pereira Cláudio Tortori Ilana Dines Jane Carvalho Eduardo Rocha Celeste Elia departamento de Clínica Médica Hospital Universitário Clementino Fraga Filho Brazil departamento de Histologia e Embriologia Laboratório de Imunologia Celular Instituto de Ci(e|^)ncias BiomédicasUniversidade Federal do Rio de Janeiro21941-590Brazil Laboratório Multidisciplinar de Pesquisa Anatomia Patológica Hospital Universitário Clementino Fraga FilhoBrazil e Cirurgia Experimental Hospital Universitário Clementino Fraga Filho Brazil

AIM： To evaluated the therapeutic and prophylactic effect of thalidomide on 2, 4, 6-trinitrobenzene sulfonic acid （TNBS）-induced colitis. Thalidomide has been reported to downregulate the expression of tumor necrosis factor α （TNF-α）, IL-12, and vascular endothelial growth factor （VEGF）, hallmarks of intestinal inflammation in Crohn＇s disease （CD）. METHODS： Male Wistar rats were divided in five groups of ten animals each. Four groups received a rectal infusion of TNBS in ethanol. The first group was sacrificed 7 d after colitis induction. The second and third groups received either thalidomide or placebo by gavage and were sacrificed at 14 d. The fourth group received thalidomide 6 h before TNBS administration, and was sacrificed 7 d after induction. The fifth group acted as the control group and colitis was not induced. Histological inflammatory scores of the colon were performed and lamina propria CD4＋ T cells, macrophages, and VEGF＋ cells were detected by immunohistochemistry. TNF-α and IL-12 were quantified in the supernatant of organ cultures by ELISA. RESULTS： Significant reduction in the inflammatory score and in the percentage of VEGF＋ cells was observed in the group treated with thalidomide compared with animals not treated with thalidomide. Both TNF-α and IL-12 levels were significantly reduced among TNBS induced colitis animals treated with thalidomide compared with animals that did not receive thalidomide. TNF-α levels were also significantly reduced among the animals receiving thalidomide prophylaxis compared with untreated animals with TNBS-induced colitis. Intestinal levels of TNF-α and IL-12 were significantly correlated with the inflammatory score and the number of VEGF＋ cells. CONCLUSION： Thalidomide significantly attenuates TNBS-induced colitis by inhibiting the intestinal production of TNF-α, IL-12, and VEGF. This effect may support the use of thalidomide as an alternate approach in selected patients with CD.

关键词： Thalidomide Experimental colitis Inflammatory bowel disease Tumor necrosis factor α IL-12 Vascular endothelial growth factor

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