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Paradoxical association between dyspepsia and autoimmune chronic atrophic gastritis:Insights into mechanisms,pathophysiology,and treatment options

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World Journal of Gastroenterology 2023年第23期29卷 3733-3747页

作者： Roberta Elisa Rossi Alessandra Elvevi Valentina Sciola Francesco Vito Mandarino silvio danese Pietro Invernizzi Sara Massironi Gastroenterology and Endoscopy Unit IRCCS Humanitas Research HospitalRozzano 20089MilanItaly Gastroenterology Unit Fondazione IRCCS San Gerardo dei TintoriMonza 20900Italy and Department of Medicine and SurgeryUniversity of Milano-BicoccaMonza 20900Italy Gastroenterology and Endoscopy Unit Fondazione IRCCS Ca’Granda Ospedale Maggiore PoliclinicoMilano 20100Italy Department of Gastroenterology and Endoscopy IRCCS Ospedale San RaffaeleMilan 20132Italy School of Medicine Vita-Salute San Raffaele UniversityMilan 20132Italy

BACKGROUND Autoimmune gastritis(AIG)is a progressive,chronic,immune-mediated inflammatory disease characterized by the destruction of gastric parietal cells leading to hypo/anacidity and loss of intrinsic factor.Gastrointestinal symptoms such as dyspepsia and early satiety are very common,being second in terms of frequency only to anemia,which is the most typical feature of AIG.AIM To address both well-established and more innovative information and knowledge about this challenging disorder.METHODS An extensive bibliographical search was performed in PubMed to identify guidelines and primary literature(retrospective and prospective studies,systematic reviews,case series)published in the last 10 years.RESULTS A total of 125 records were reviewed and 80 were defined as fulfilling the criteria.CONCLUSION AIG can cause a range of clinical manifestations,including dyspepsia.The pathophysiology of dyspepsia in AIG is complex and involves changes in acid secretion,gastric motility,hormone signaling,and gut microbiota,among other factors.Managing dyspeptic symptoms of AIG is challenging and there are no specific therapies targeting dyspepsia in AIG.While proton pump inhibitors are commonly used to treat dyspepsia and gastroesophageal reflux disease,they may not be appropriate for AIG.Prokinetic agents,antidepressant drugs,and non-pharmacological treatments may be of help,even if not adequately evidence-based supported.A multidisciplinary approach for the management of dyspepsia in AIG is recommended,and further research is needed to develop and validate more effective therapies for dyspepsia.

关键词： Dyspepsia Dyspeptic symptoms Gastro-intestinal symptoms Autoimmune gastritis Chronic autoimmune atrophic gastritis Treatment

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Intestinal microbiota in inflammatory bowel disease:Friend of foe?

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World Journal of Gastroenterology 2011年第5期17卷 557-566页

作者： Francesca Fava silvio danese Inflammatory Bowel Disease Unit Istituto Clinico HumanitasVia Manzoni 11320089 RozzanoMilanoItaly

Inflammatory bowel disease(IBD) arises from disruption of immune tolerance to the gut commensal microbiota,leading to chronic intestinal inflammation and mucosal damage in genetically predisposed hosts.In healthy individuals the intestinal microbiota have a symbiotic relationship with the host organism and possess important and unique functions,including a metabolic function(i.***.digestion of dietary compounds and xenobiotics,fermentation of undigestible carbohydrates with production of short chain fatty acids),a mucosal barrier function(i.***.by inhibiting pathogen invasion and strengthening epithelial barrier integrity),and an immune modulatory function(i.***.mucosal immune system priming and maintenance of intestinal epithelium homeostasis).A fine balance regulates the mechanism that allows coexistence of mammals with their commensal bacteria.In IBD this mechanism of immune tolerance is impaired because of several potential causative factors.The gut microbiota composition and activity of IBD patients are abnormal,with a decreased prevalence of dominant members of the human commensal microbiota(i.e.Clostridium Ⅸa and Ⅳ groups,Bacteroides,bifidobacteria) and a concomitant increase in detrimental bacteria(i.***.sulphate-reducing bacteria,Escherichia coli).The observed dysbiosis is concomitant with defective innate immunity and bacterial killing(i.***.reduced mucosal defensins and IgA,malfunctioning phagocytosis) and overaggressive adaptive immune response(due to ineffective regulatory T cells and antigen presenting cells),which are considered the basis of IBD pathogenesis.However,we still do not know how the interplay between these parameters causes the disease.Studies looking at gut microbial composition,epithelial integrity and mucosal immune markers in genotyped IBD populations are therefore warranted to shed light on this obscure pathogenesis.

关键词：肠道菌群炎症粘膜免疫系统鸡传染性法氏囊病微生物组成免疫耐受共生关系硫酸盐还原菌

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What's hot in inflammatory bowel disease in 2011?

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World Journal of Gastroenterology 2011年第5期17卷 545-546页

作者： silvio danese IBD Center Division of GastroenterologyIRCCS Istituto Clinico HumanitasVia Manzoni 5620089RozzanoMilanItaly

Ulcerative colitis and Crohn's disease(CD) are the two major forms of inflammatory bowel disease(IBD).In this highlight topic series of articles,the most recent advances in the IBD field are reviewed,especially the newly described cytokines,including the therapeutic implications for their manipulation.In addition,the interplay between the intestinal microbiota and the host is reviewed,including the role of defensins and dysbiosis in CD pathogenesis.Finally,the importance of the non immune systems such as endothelial cells and the hemostatic system are highlighted as new players in IBD pathogenesis.

关键词：溃疡性结肠炎炎症血管内皮细胞发病机制 IBD 细胞因子肠道菌群免疫系统

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Why people should run after positive affective experiences instead of health benefits

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Journal of Sport and Health Science 2024年第4期13卷 445-450页

作者： silvio Maltagliati Philippe Sarrazin Layan Fessler Mael Lebreton Boris Cheval University of Grenoble Alpes SENSGrenoble 38000France Paris School of Economics Paris 75014France Swiss Center for Affective Sciences University of GenevaGeneva 1202Switzerland Laboratory for Behavioral Neurology and Imaging of Cognition Department of Fundamental NeurosciencesUniversity of GenevaGeneva 1202Switzerland Laboratory for the Study of Emotion Elicitation and Expression(E3Lab) Department of PsychologyUniversity of GenevaGeneva 1202Switzerland

Over time,physical activity(PA)has shifted from being a necessity to being an alternative.As a result,levels of PA have sharply decreased.1 Today,we are facing a worldwide pandemic of physical inactivity,with one death every 6 s attributed to insufficient PA.2 To counteract this trend,a tremendous effort is being made to promote regular PA across the lifespan,mainly through the dissemination of knowledge about the health benefits of accumulating sufficient PA.

关键词： sharply benefits attributed

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Familial aggregation in inflammatory bowel disease:Is it genes or environment?

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World Journal of Gastroenterology 2011年第22期17卷 2715-2722页

作者： Tiago Nunes Gionata Fiorino silvio danese Miquel Sans Department of Gastroenterology Hospital Clinic i Provincial/IDIBAPS CIBER EHD 08036 Barcelona Spain Division of Gastroenterology IRCCS Istituto Clinico Humanitas Rozzano Milan 20089 Italy

Inflammatory bowel disease (IBD) develops in genetically susceptible individuals due to the influence of environmental factors, leading to an abnormal recognition of microbiota antigens by the innate immune system which triggers an exaggerated immune response and subsequent bowel tissue damage. IBD has been more frequently found in families, an observation that could be due to either genetic, environmental or both types of factors present in these families. In addition to expanding our knowledge on IBD pathogenesis, defining the specific contribution to familial IBD of each one of these factors might have also clinical usefulness. We review the available evidence on familial IBD pathogenesis.

关键词：肠道疾病环境因素家族鸡传染性法氏囊病基因聚集发病机制免疫系统

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Mucosal biomarkers in inflammatory bowel disease:Key pathogenic players or disease predictors?

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World Journal of Gastroenterology 2010年第21期16卷 2616-2625页

作者： Franco Scaldaferrii Carmen Correale Antonio Gasbarrini silvio danese Department of Internal Medicine Catholic University of Rome00168 RomeItaly Division of Gastroenterology IRCCSIstituto Clinico Humanitas20089 RozzanoMilanItaly

Inflammatory bowel diseases(IBDs) are chronic inflammatory disorders of the bowel,including ulcerative colitis and Crohn's disease.A single etiology has not been identified,but rather the pathogenesis of IBD is very complex and involves several major and minor contributors,employing different inflammatory pathways which have different roles in different patients.Although new and powerful medical treatments are available,many are biological drugs or immunosuppressants,which are associated with significant side effects and elevated costs.As a result,the need for predicting disease course and response to therapy is essential.Major attempts have been made at identifying clinical characteristics,concurrent medical therapy,and serological and genetic markers as predictors of response to biological agents.Only few reports exist on how mucosal/tissue markers are able to predict clinical behavior of the disease or its response to therapy.The aim of this paper therefore is to review the little information available regarding tissue markers as predictors of response to therapy,and reevaluate the role of tissue factors associated with disease severity,which can eventually be ranked as "tissue factor predictors".Five main categories are assessed,including mucosal cytokines and chemokines,adhesion molecules and markers of activation,immune and non-immune cells,and other mucosal components.Improvement in the design and specificity of clinical studies are mandatory to be able to classify tissue markers as predictors of disease course and response to specific therapy,obtain the goal of achieving "personalized pathogenesisoriented therapy" in IBD.

关键词： Inflammatory bowel disease Crohn’s disease Ulcerative colitis Disease course predictors Cytokines Chemokines Intestinal mucosa

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Risk of postoperative recurrence and postoperative management of Crohn's disease

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World Journal of Gastroenterology 2011年第27期17卷 3213-3219页

作者： Antonino Spinelli Matteo Sacchi Gionata Fiorino silvio danese Marco Montorsi Department and Chair of General Surgery University of MilanIstituto Clinico Humanitas IRCCSVia Manzoni 5620089RozzanoMilanItaly IBD Unit Department of GastroenterologyIstituto Clinico Humanitas IRCCSVia Manzoni 5620089RozzanoMilanItaly

Crohn's disease (CD) is a chronic inflammatory disease of the digestive tract with systemic manifestations. Etiology is unknown, even if immunological, genetic and environmental factors are involved. The majority of CD patients require surgery during their lifetime due to progressive bowel damage, but, even when all macroscopic lesions have been removed by surgery, the disease recurs in most cases. Postoperative management represents therefore a crucial mean for preventing recurrence. Several drugs and approaches have been proposed to achieve this aim. Endoscopic inspection of the ileocolic anastomosis within 1 year from surgery is widely encouraged, given that endoscopic recurrence is one of the greatest predictors for clinical recurrence. A strategy should be planned only after stratifying patients according to their individual risk of recurrence, avoiding unnecessary therapies when possible benefits are reduced, and selecting high-risk patients for more aggressive intervention.

关键词：术后管理复发风险手术摘除慢性炎症环境因素消化道免疫学

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Hybrid robust fault detection and isolation of satellite reaction wheel actuators

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Journal of Control and Decision 2024年第1期11卷 117-131页

作者： H.Abbasi Nozari S.J.Sadati Rostami Paolo Castaldi silvio Simani Faculty of Electrical and Computer Engineering Babol Noshirvani University of TechnologyBabolIran Department of Electrical Electronic and Information EngineeringUniversity of BolognaCesenaItaly Department of Engineering University of FerraraFerraraItaly

In this paper,a combined robust fault detection and isolation scheme is studied for satellite system subject to actuator faults,external disturbances,and parametric uncertainties.The proposed methodology incorporates a residual generation module,including a bank of filters,into an intelligent residual evaluation module.First,residual filters are designed based on an improved nonlinear differential algebraic approach so that they are not affected by external disturbances.The residual evaluation module is developed based on the suggested series and parallel forms.Further,a new ensemble classification scheme defined as blended learning integrates heterogeneous classifiers to enhance the performance.A wide range of simulations is carried out in a high-fidelity satellite simulator subject to the constant and time-varying actuator faults in the presence of disturbances,manoeuvres,uncertainties,and noises.The obtained results demonstrate the effectiveness of the proposed robust fault detection and isolation method compared to the traditional nonlinear differential algebraic approach.

关键词： Robust fault detection and isolation reaction wheels blended learning series and parallel fault detection and isolation forms satellite attitude control system

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Etiopathogenesis of inflammatory bowel diseases

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World Journal of Gastroenterology 2006年第30期12卷 4807-4812页

作者： silvio danese Claudio Fiocchi Division of Gastroenterology Istituto Clinico Humanitas-IRCCS in Gastroenterology Milan Italy Department of Pathobiology and Department of Gastroenterology and Hepatology the Cleveland Clinic Foundation Cleveland Ohio United States

理论解释煽动性的肠疾病(IBD ) 的发病机理自从 Crohn 的疾病(CD ) 和 ulcerative (UC ) 被建议了作为疾病的二种主要形式被认出。尽管在 CD 和 UC 的织物损坏的准确原因和机制还得完全被理解，足够的进步发生了作为有效接受下列假设：I... 详细信息

理论解释煽动性的肠疾病(IBD ) 的发病机理自从 Crohn 的疾病(CD ) 和 ulcerative (UC ) 被建议了作为疾病的二种主要形式被认出。尽管在 CD 和 UC 的织物损坏的准确原因和机制还得完全被理解，足够的进步发生了作为有效接受下列假设：IBD 是在环境因素，微生物引起的因素，和肠的免疫系统之中作为一个复杂相互作用的结果发生在遗传上易受影响的个人的不恰当的有免疫力的回答。在环境因素的一张几乎无穷的表之中，吸烟为 UC 为 CD 和一个保护的因素作为一个风险因素被识别了。在微生物引起的因素之中，没有有说服力的证据显示古典传染代理人引起 IBD，当作为具有中央重要性对正常伤寒植物群装证据点到反常有免疫力的回答时。内脏发炎被天生以及适应的免疫系统的房间调停，与非有免疫力的房间的另外的贡献，例如上皮，间充质并且 endothelial，和血小板。

关键词：肠炎发病机制慢性炎症治疗

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Management of cerebral amyloid angiopathy and atrial fibrillation:We are still far from precision medicine

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World Journal of Cardiology 2024年第5期16卷 231-239页

作者： Liuba Fusco Zefferino Palamà Antonio Scarà Alessio Borrelli Antonio Gianluca Robles Gabriele De Masi DeLuca silvio Romano Luigi Sciarra Department of Cardiology University Hospital of NorthamptonshireNorthampton NN15BDUnited Kingdom Department of Cardiology Casa di Cura Villa VerdeTaranto 70124Italy Department of Life Health and Environmental SciencesUniversity of l'AquilaL'Aquila 67100Italy Department of Cardiology GVM Care and ResearchSan Carlo di Nancy HospitalRome 00100Italy

The use of anticoagulation therapy could prove to be controversial when trying to balance ischemic stroke and intracranial bleeding risks in patients with concurrent cerebral amyloid angiopathy(CAA)and atrial fibrillation(AF).In fact,CAA is an age-related cerebral vasculopathy that predisposes patients to intracerebral hemorrhage.Nevertheless,many AF patients require oral systemic dose-adjusted warfarin,direct oral anticoagulants(such as factor Xa inhibitors)or direct thrombin inhibitors to control often associated with cardioembolic stroke risk.The prevalence of both CAA and AF is expected to rise,due to the aging of the population.This clinical dilemma is becoming increasingly common.In patients with coexisting AF and CAA,the risks/benefits profile of anticoagulant therapy must be assessed for each patient individually due to the lack of a clear-cut consensus with regard to its risks in scientific literature.This review aims to provide an overview of the management of patients with concomitant AF and CAA and proposes the implementation of a risk-based decision-making algorithm.

关键词： Anticoagulation Atrial fibrillation Cerebral amyloid angiopathy Intracerebral hemorrhage Stroke Watchman Secondary prevention Left atrial appendage closure

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