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One more chance of fistula healing in inflammatory bowel disease:Stem cell therapy

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World Journal of Clinical Cases 2018年第12期6卷 493-500页

作者： Erica P Turse Francis E Dailey maliha naseer Edward K Partyka Veysel Tahan Division of Gastroenterology and Hepatology Department of Internal MedicineUniversity of Missouri Health Center

Patients with fistulizing inflammatory bowel disease are traditionally difficult to treat. This patient population often experiences delayed or insufficient healing of fistulas using current standard regimens including anti-biotics, immunomodulators, anti-tumor necrosis factor--α drug, placement of setons, and surgical repair. Several studies over the last ten to fifteen years have been conducted using stem cell therapies with promising results in this patient population. These studies show stem cell therapy in fistulizing disease to be successful in healing between 60%--88% compared to currently 50% with infliximab. Moreover, remission was seen 24 wk to 52 wk in these studies. Further research with a multi--approach treatment using medications, stem cell therapy, and surgical interventions will likely be the future of this innovative treatment approach.

关键词： Crohn’s disease Stem cells Mesenchymal Fistulizing Fistula Inflammatory bowel disease

Interventions to improve sarcopenia in cirrhosis: A systematic review

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World Journal of Clinical Cases 2019年第2期7卷 156-170页

作者： maliha naseer Erica P Turse Ali Syed Francis E Dailey Mallak Zatreh Veysel Tahan Department of Internal Medicine Division of Gastroenterology and Hepatology East Carolina University Department of Internal Medicine Division of Gastroenterology St Joseph Hospital Medical Center/Creighton University Department of Internal Medicine University of Missouri Department of Internal Medicine Division of Gastroenterology and Hepatology University of Missouri

BACKGROUND Sarcopenia, i.e., muscle loss is now a well-recognized complication of cirrhosis and in cases of non-alcoholic fatty liver disease can contribute to accelerate liver fibrosis leading to cirrhosis. Hence, it is imperative to study interventions which targets to improve sarcopenia in *** To examine the relationship between interventions such nutritional supplementation, exercise, combined life style intervention, testosterone replacement and trans jugular intrahepatic portosystemic shunt(TIPS) to improve muscle mass in *** We search PubMed, EMBASE and Cochrane between June-August 2018, without a limiting period and the types of articles(RCTs, clinical trial, comparative study)in adult patients with sarcopenia and cirrhosis. The primary outcome of interest was improvement in muscle mass, strength and physical function interventions mentioned above. In the screening process, 154 full text articles were included in the review and 129 studies were *** We identified 24 studies that met review inclusion criteria. The studies were diverse in terms of the design, setting, interventions, and outcome *** performed only qualitative synthesis of evidence due to heterogeneity amongst studies. Risk of bias was medium in most of the included studies and low quality of evidence showed improvement in the muscle mass, strength and physical function following aerobic exercise. 60% of the included studies on the nutritional intervention, 100% of the studies on testosterone replacement in hypogonadal men and trans-jugular portosystemic shunt were proved to be effective in improving sarcopenia in *** Although the quality of evidence is low, the findings of our systematic review suggest improvement in the sarcopenia in cirrhosis with exercise, nutritional interventions, hormonal and TIPS interventions. High quality randomized controlled trials needed to further strengthen these findings.

关键词： Sarcopenia Cirrhosis Treatment Intervention Nutrition Therapy Exercise Testosterone Trans jugular intrahepatic portosystemic shunt

Endoscopic advances in the management of non-variceal upper gastrointestinal bleeding:A review

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World Journal of Gastrointestinal Endoscopy 2020年第1期12卷 1-16页

作者： maliha naseer Karissa Lambert Ahmed Hamed Eslam Ali Division of Gastroenterology and Hepatology Department of Internal MedicineEast Carolina University

Upper gastrointestinal bleeding is defined as the bleeding originating from the esophagus to the ligament of Treitz and further classified into variceal and nonvariceal gastrointestinal ***-variceal upper gastrointestinal bleeding remains a common clinical problem *** is associated with high mortality,morbidity,and cost of the health care *** the continuous improvement of therapeutic endoscopy,the 30-d readmission rate secondary to rebleeding and associated mortality is an ongoing *** Food and Drug Administration approved traditional or conventional therapeutic endoscopic modalities includes epinephrine injection,argon plasma coagulation,heater probe,and placement of through the scope clip,which can be used alone or in combination to decrease the risk of ***,more attention has been paid to the novel advanced endoscopic devices for primary treatment of the bleeding lesion and as a secondary measure when conventional therapies fail to achieve *** review highlights emerging endoscopic modalities used in the management of non-variceal upper gastrointestinal related bleeding such as over-the-scope clip,Coagrasper,hemostatic sprays,radiofrequency ablation,cryotherapy,endoscopic suturing devices,and endoscopic ultrasound-guided *** this review article,we will also discuss the technical aspects of the common procedures,outcomes in terms of safety and efficacy,and their advantages and limitations in the setting of non-variceal upper gastrointestinal bleeding.

关键词： Non-variceal upper gastrointestinal bleeding Over the scope clip Hemospray Radiofrequency ablation Endoscopic suturing device

Exosomes:A new frontier under the spotlight for diagnosis and treatment of gastrointestinal diseases

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World Journal of Meta-Analysis 2021年第1期9卷 12-28页

作者： maliha naseer Syeda Hadi Ali Syed Amer Safdari Veysel Tahan Division of Gastroenterology and Hepatology Department of Internal MedicineEast Carolina UniversityGreenvilleNC 27834United States Rawalpindi Medical University School of MedicineRawalpindi 46000PunjabPakistan Division of Gastroenterology and Hepatology Department of Internal MedicineUniversity of MissouriColumbiaMO 65212United States Illinois College of Medicine School of MedicineChicagoIL 60612United States

Exosomes are small plasma membrane-bound multivesicular bodies ranging in size from 20-100 *** are degraded fragments of mRNA,microRNA,and enriched in proteins,lipids,and nucleic *** are produced in the endosomes of most eukaryotic cells and once secreted,exosomes are involved in cell to cell communication and remodeling of the matrix in the extracellular *** biogenesis plays a crucial role in cellular development,inflammation,immunity,hemostasis,carcinogenesis,and *** to their unique biochemical and biophysical properties,exosomes serve a variety of functions including biomarkers of diagnostic and prognostic ***,there is an increasing level of evidence to expand our understanding of the exosomes as novel therapeutic *** bowel disease(IBD)such as Crohn's disease and ulcerative colitis,hepatic fibrosis,and gastrointestinal malignancies such as colorectal cancer are the potential avenues where exosomes can be applied as cell therapy and immunotherapy and have shown promising results in several in-vitro and animal *** purpose of this review article is to highlight the emerging role of exosomes as the diagnostic and therapeutic tool in various diseases involving the gastrointestinal tract like IBD,hepatocellular carcinoma,and colon cancer.A thorough literature search was performed on databases such as PubMed,Ovid Medline,and EMBASE to achieve the objectives of this review article.

关键词： Exosomes Gastrointestinal diseases Inflammatory bowel disease Colorectal cancer Hepatocellular carcinoma

Implications of COVID-19 for inflammatory bowel disease:Opportunities and challenges amidst the pandemic

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World Journal of Meta-Analysis 2020年第5期8卷 383-399页

作者： maliha naseer Shiva Poola Francis E Dailey Hakan Akin Veysel Tahan Division of Gastroenterology and Hepatology Department of Internal MedicineEast Carolina UniversityGreenvilleNC 27834United States Department of Internal Medicine/Pediatrics Brody School of Medicine/Vidant Medical CenterGreenvilleNC 27834United States Division of Gastroenterology and Hepatology Department of Internal MedicineUniversity of MissouriColumbiaMO 65212United States

Since the beginning of the coronavirus disease 2019(COVID-19)pandemic various measures have been taken to mitigate the effects of the global health crisis in this unprecedented *** to the World Health Organization,more than 5 million people have been infected with severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)and with more than 300000 deaths attributed to COVID-19 *** is emerging evidence that SARS-CoV-2 utilizes angiotensin-converting enzyme 2 receptors to enter human cells which are found in abundance in the alveoli and *** addition,the infection is noted to be more severe in patients with co-morbid conditions,those who are malnourished,immunosuppressed and *** bowel disease(IBD)which includes ulcerative colitis and Crohn’s disease is chronic remitting and relapsing disorders with intestinal and extraintestinal *** patients are often malnourished and on immunosuppressive medications and there is a hypothetical concern that IBD patients are at substantial risk of COVID-19 *** management of IBD patients is often complex and poses unique challenges for gastroenterologists during the *** purpose of this review article is to summarize the growing level of evidence and understanding of the management of IBD during the COVID-19 pandemic,in the light of international and national gastroenterology society *** performed a thorough literature search on IBD,SARS-CoV-2 and COVID-19 on PubMed,EMBASE,OVID Medline and Google Scholar and pertaining literature was critically examined and *** national and international society guidelines and recommendations,IBD is not a risk factor for SARS-CoV-2 *** patients should continue with their medications and they should follow universal precautions ***,hand and respiratory hygiene and avoidance of health care facilities and public toilets as general *** IBD patients older age,having act

关键词： SARS-CoV-2 COVID-19 Inflammatory bowel disease Crohn’s disease Ulcerative colitis Pandemic

Review of stem cells as promising therapy for perianal disease in inflammatory bowel disease

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World Journal of Transplantation 2018年第4期8卷 97-101页

作者： Francis E Dailey Erica P Turse maliha naseer Jack D Bragg Veysel Tahan Division of Gastroenterology and Hepatology Department of Internal Medicine University of Missouri Health Center Division of Gastroenterology and Hepatology Department of Internal Medicine University of Missouri-Columbia

Those patients with perianal Crohn's disease or ul-cerative colitis experience a difficult to treat disease process with a delayed state and often inability to heal despite current therapies. The approaches currently used to treat these patients with corticosteroids,antibiotics,immunomodulators, anti-tumor necrosis factor-α drug, and surgical repair are limited in their healing ability. This review presents all current literature since emergence in the early 2000s of stem cell therapy for patients with perianal inflammatory bowel disease and analyzes the efficacy, outcomes and safety within these studies.

关键词： Crohn’s disease Stem cells Mesenchymal Perianal disease Fistula Inflammatory bowel disease