肠道菌群与溃疡性结肠炎患者血清ET、SOCS-3、TLRs水平的相关性

目的探究肠道菌群改变与溃疡性结肠炎(UC)患者血清内毒素(ET)、外周血细胞因子信号传导抑制蛋白-3(SOCS-3)及Toll样受体(TLRs)水平的相关性,为后续研究提供参考。方法选择我院2018年1月至2019年2月收治的75例UC患者按照入组时疾病状态分为活动期组(39例)和缓解期组(36例)。选择同期40例健康体检者作为对照组。检测患者粪便样品中肠道菌群种类和数量,并检测患者血清中ET、SOCS-3、TLRs水平。结果活动期组、缓解期组及对照组患者肠道拟杆菌、双歧杆菌、真杆菌、消化球菌、乳杆菌、小梭菌、肠球菌及肠杆菌数量存在明显差异,其中活动期组患者肠道拟杆菌、双歧杆菌、真杆菌、消化球菌及乳杆菌数量最低,小梭菌、肠球菌及肠杆菌数量最高(均P0.05)。3组患者血清ET、SOCS-3、TLR-4水平存在明显差异,其中活动期组患者血清ET[(0.13±0.02)EU/mL]及TLR-4[(13.91±2.18)ng/mL]水平最高,SOCS-3[(33.82±9.18)mg/mL]水平最低(均P0.05)。肠道中拟杆菌、真杆菌、消化球菌、乳杆菌及双歧杆菌水平是影响患者ET及TLR-4的独立保护因素且为影响SOCS-3的独立危险因素(均P0.05)。小梭菌、肠球菌及肠杆菌水平是影响患者ET及TLR-4的独立危险因素且为影响SOCS-3的独立保护因素(均P0.05)。结论活动期UC患者肠道菌群及ET、SOCS-3、TLRs水平均存在显著异常,肠道菌群改变是影响UC患者血清ET、SOCS-3、TLRs水平的独立影响因素。     

血清免疫炎症相关蛋白复合物、25-羟维生素D、脂肪细胞因子与炎症性肠病患者疾病活动性和肠道菌群的相关性研究

摘要 目的：探讨血清免疫炎症相关蛋白复合物（IIRPCs）、25-羟维生素D[25（OH）D]、脂肪细胞因子（Chemerin）与炎症性肠病（IBD）患者疾病活动性和肠道菌群的相关性。方法：选取2020年12月～2021年12月我院收治的150例IBD患者,其中溃疡性结肠炎（UC）组65例、克罗恩病（CD）组85例,另取同期健康体检者70例作为对照组,检测并比较三组血清IIRPCs、25（OH）D、Chemerin水平。此外,UC组和CD组患者分别根据克罗恩病活动指数（CDAI）和溃疡性结肠炎的改良梅奥（Mayo）评分分为活动期组、缓解期组,分别比较UC组和CD组患者活动期组与缓解期组间的血清IIRPCs、25（OH）D、Chemerin水平、肠道菌群差异,并作相关性分析。结果：IBD患者的血清IIRPCs、Chemerin水平高于对照组,而25（OH）D水平低于对照组（P＜0.05）;UC组血清IIRPCs、Chemerin水平高于CD组,25（OH）D水平低于CD组（P＜0.05）。活动期UC、CD患者的血清IIRPCs、Chemerin水平以及肠球菌、肠杆菌、酵母菌、拟杆菌数量均高于缓解期UC、CD患者,而血清25（OH）D水平以及双歧杆菌、乳酸杆菌数量均低于缓解期UC、CD患者（P＜0.05）。Pearsonn相关性分析结果显示,UC、CD患者的血清IIRPCs、Chemerin水平与肠球菌、肠杆菌、酵母菌、拟杆菌数量呈正相关,与双歧杆菌、乳酸杆菌数量呈负相关（P＜0.05）;UC、CD患者的血清25（OH）D水平与肠球菌、肠杆菌、酵母菌、拟杆菌数量呈负相关,与双歧杆菌、乳酸杆菌数量呈正相关（P＜0.05）。结论：血清IIRPCs、25（OH）D、Chemerin与IBD患者的疾病活动性、肠道菌群有关,检测上述指标对评估IBD患者病情程度有一定价值。     

溃疡性结肠炎患者血清IL-1β、C反应蛋白及髓过氧化物酶水平与肠道菌群的关系CSCD

目的 探讨溃疡性结肠炎患者血清白细胞介素（IL）-1β、C反应蛋白（CRP）及髓过氧化物酶（MPO）水平与肠道菌群的关系,为该类患者的治疗提供参考。方法 选取2022年2月至2023年2月我院100例溃疡性结肠炎患者作为研究组,以同期50例健康体检者作为对照组。两组对象均行IL-1β、CRP、MPO水平检测及肠道菌群检测。比较研究组与对照组,研究组中活动期与缓解期患者IL-1β、CRP、MPO水平及肠道菌群变化,以Pearson相关分析法分析溃疡性结肠炎患者IL-1β、CRP、MPO水平与肠道菌群的关系。结果 与对照组比较,研究组患者IL-1β、CRP、MPO水平均升高,肠道乳杆菌、双歧杆菌数量均减少,肠球菌、肠杆菌数量均增多（均P<0.05）。研究组中,与缓解期患者比较,活动期患者IL-1β、CRP、MPO水平均升高,肠道乳杆菌、双歧杆菌数量均减少,肠球菌、肠杆菌数量均增多（均P<0.05）。Pearson相关性分析显示,溃疡性结肠炎患者血清IL-1β、CRP、MPO水平与肠道双歧杆菌、乳杆菌数量均呈负相关,与肠杆菌、肠球菌数量均呈正相关（均P<0.05）。结论 溃疡性结肠炎患者血清IL-1β、CRP、MPO水平与肠道菌群变化密切相关。     

酪酸梭菌二联活菌对慢性乙肝患者乙肝病毒DNA 及肠道菌群比值的影响

目的探究酪酸梭菌二联活菌对慢性乙肝患者乙肝病毒(HBV)DNA及肠道菌群比值的影响。方法选取2017年6月至2018年9月我院传染科诊治的80例慢性乙肝患者进行研究,按照随机数字表分为观察组(40例)与对照组(40例)。对照组患者采用常规治疗,观察组在对照组基础上采用酪酸梭菌二联活菌胶囊治疗。收集治疗前与治疗2周后患者血清及粪便标本,观察血清及粪便中HBV DNA、9种肠道菌群数量、血清细胞因子、肝功能指标及患者不良反应。结果观察组患者血清HBV DNA阴转率(30.0%)高于粪便HBV DNA阴转率(15.0%)。观察组患者肠道双歧杆菌、肠杆菌科细菌数量治疗前后差值明显低于对照组(均P0.05),而肠球菌数量治疗前后差值明显高于对照组(P0.05)。观察组患者肠道肠杆菌科细菌/肠球菌比值、肠杆菌科细菌/梭菌属比值、肠杆菌科细菌/白假丝酵母比值、肠杆菌科细菌/拟杆菌属比值、肠杆菌科细菌/普雷沃氏菌属比值、肠杆菌科细菌/瘤胃球菌属比值治疗前后差值明显小于对照组(均P0.05);观察组肠球菌/双歧杆菌比值、肠球菌/乳杆菌比值、肠球菌/梭菌属比值、肠球菌/白假丝酵母比值、肠球菌/拟杆菌属比值、肠球菌/瘤胃球菌属比值、梭菌属/双歧杆菌比值、白假丝酵母/双歧杆菌比值、普雷沃氏菌属/双歧杆菌比值治疗前后差值大于对照组(均P0.05)。观察组患者IL-17A、IL-17C、IL-17D、IL-17F治疗前后差值明显低于对照组(均P0.05)。与对照组比较,观察组患者谷丙转氨酶、谷草转氨酶、谷氨酰转肽酶治疗前后差值较高,总胆红素治疗前后差值较低(均P0.05)。观察组患者总不良反应率(12.5%)明显低于对照组总不良反应率(32.5%)。结论酪酸梭菌二联活菌治疗慢性乙肝患者有助于降低乙肝病毒DNA及IL-17家族成员水平,改善肠道菌群比值紊乱,安全可靠。     

酪酸梭菌-双歧杆菌二联活菌制剂对慢性腹泻患者肠道菌群的影响

给慢性腹泻病人口服酪酸梭菌-双歧杆菌二联活菌制剂,然后检测患者服药前后的肠道菌群变化.患者服用药品后,葡萄球菌、酵母菌、消化球菌、真杆菌和小梭菌的数量无明显变化,肠杆菌、肠球菌的数量明显减少,拟杆菌、双歧杆菌、乳杆菌的数量明显增加,其中肠球菌、肠杆菌、拟杆菌和双歧杆菌的变化有显著性(P﹤0.05),提示酪酸梭菌-双歧杆菌二联活菌制剂对慢性腹泻病人的肠道菌群具有明显的影响、具有增殖拟杆菌、双歧杆菌和乳杆菌的作用.     

益生菌联合抗幽门螺杆菌治疗对 消化性溃疡患者的疗效

目的探讨益生菌联合抗幽门螺杆菌(H.pylori)治疗对消化性溃疡患者的疗效及其对患者肠道菌群的影响。方法将120例经14 C呼气试验(14 C-UBT)检测确定为H.pylori感染阳性的消化性溃疡患者随机分为观察组和对照组,每组60例。其中,对照组采用四联疗法(奥美拉唑+阿莫西林+克拉霉素+铋剂)治疗,观察组采用四联疗法联合益生菌治疗;比较两组患者H.pylori根除情况、溃疡愈合质量及不良反应情况。治疗前后留取全部患者的新鲜粪便标本进行细菌培养,比较两组患者肠道菌群数量和肠道微生物定植抗力(B/E值)。结果观察组患者H.pylori根除率和溃疡愈合率分别为88.3%、95.0%,显著高于对照组的70.0%和76.7%(P0.05),不良反应率为3.3%,显著低于对照组的20.0%(P0.05)。与治疗前比,对照组患者治疗后肠道内产气荚膜梭菌、双歧杆菌及乳杆菌数量显著减少(P0.05),肠杆菌、肠球菌及酵母菌数量显著增加(P0.05),B/E值显著降低(P0.05);观察组患者治疗后双歧杆菌和乳杆菌数量均显著增加(P0.05),产气荚膜梭菌数量显著减少(P0.05),肠杆菌、肠球菌及酵母菌数量无明显变化(P0.05),B/E值显著升高(P0.05)。结论常规抗H.pylori治疗易引起消化性溃疡患者肠道菌群紊乱,降低肠道定植抗力。益生菌联合治疗可有效改善患者肠道微生态,提高H.pylori根除率和溃疡愈合质量,减少不良反应。     

不同严重程度溃疡性结肠炎患者机体炎症状态和TLRs表达与肠道菌群失调的相关性

目的 探讨不同严重程度溃疡性结肠炎（UC）患者机体炎症状态和Toll样受体（TLRs）表达与肠道菌群紊乱的关系。方法 选取2021年1月至2022年1月我院诊治的102例UC患者作为研究组，以同期50例体格检查健康者作为对照组，对两组受试者的肠道菌群进行检测，同时检测患者TLR2、TLR4、TLR5、TLR9以及C反应蛋白（CRP）、白细胞介素（IL）6表达水平。指标间的关系采用Pearson相关性分析。结果 研究组患者肠道双歧杆菌、嗜酸乳杆菌、拟杆菌数量均低于对照组，大肠埃希菌、肠球菌数量均高于对照组，且研究组中活动期患者肠道双歧杆菌、嗜酸乳杆菌、拟杆菌数量低于缓解期患者，而大肠埃希菌、肠球菌数量均高于缓解期患者（均P<0.05）。研究组患者TLR2、TLR4、TLR5、TLR9相对表达量均高于对照组，且研究组中活动期患者TLRs相对表达量均高于缓解期患者（均P<0.05）。研究组患者CRP、IL-6水平均高于对照组，且研究组中活动期患者CRP、IL-6水平均高于缓解期患者（均P<0.05）。Pearson相关性分析结果显示，不同疾病严重程度UC患者机体炎症状态和T...     

炎症性肠病患者肠道菌群分布及其与炎症指标和免疫球蛋白水平的关系

目的研究炎症性肠病(inflammatory bowel disease,IBD)患者肠道菌群分布特点及其与血清髓过氧化物酶(MPO)、C反应蛋白(CRP)、免疫球蛋白表达的关系。方法选择2015年5月至2018年5月在延安市中医医院诊断治疗的65例炎症性肠病患者为观察组,另选取于本院体检的65例无消化系统疾病者作为对照组,分析两组患者肠道菌群分布特点以及血清MPO、CRP和免疫球蛋白表达情况,同时分析其相关性。结果观察组患者肠道乳杆菌(t=6.128,P<0.001)、双歧杆菌(t=14.029,P<0.001)、肠球菌(t=7.858,P<0.001)、真杆菌(t=15.220,P<0.001)水平显著低于对照组。观察组患者血清MPO(t=21.016,P<0.001)、CRP(t=58.970,P<0.001)水平显著高于对照组,IgA(t=2.967,P=0.004)、IgM(t=4.859,P<0.001)、IgG(t=19.828,P<0.001)水平显著低于对照组。相关性分析显示,IBD患者IgA、IgM、IgG水平与肠道乳杆菌、双歧杆菌、肠球菌、真杆菌数量均呈正相关,血清MPO、CRP水平与肠道乳杆菌、双歧杆菌、肠球菌、真杆菌数量均呈负相关(均P<0.05)。结论在炎症性肠病的发展中,肠道菌群与血清MPO、CRP水平及免疫球蛋白水平均具有相关性,可作为IBD患者诊断和治疗的依据。     

中药"神曲"对肠易激综合征患者肠道菌群的调节和临床疗效的研究

目的探讨中药"神曲"对肠易激综合征(IBS)病人肠道微生态环境的调节及临床治疗作用.方法(1)健康人17例,IBS(以腹泻为主型)患者34例(按ROMEⅡ诊断标准),取粪便做双歧杆菌、类杆菌、乳杆菌、肠球菌及肠杆菌的培养,对比2组菌数量的差别;(2)随机将34例患者分为3组,分别给予思密达、思密达加丽珠肠乐及思密达加神曲水煎液口服,治疗2周后,复查粪便菌培养,对比各组治疗前后的细菌数量变化,并观察临床疗效;(3)菌群的定性定量检测,采用厌氧菌及需氧菌培养法;(4)统计学处理,用SPSS 11.0软件,一般情况的比较用t检验;各菌群数量的比较用F检验;治疗有效率的比较用x2检验.结果(1)健康人组与治疗前患者组各菌群的对比IBS患者粪便中类杆菌、双歧杆菌与乳杆菌数量较健康人组增加(P＜0.05),肠球菌、肠杆菌数量较正常人组下降(P＜0.05).(2)治疗后思密达组患者粪便中厌氧菌种有所增加,需氧菌种有所减少,但差异无显著性(P＞0.05).(3)神曲组患者经治疗后,粪便中乳杆菌明显增多(P＜0.01),双歧杆菌增加(P＜0.05),肠杆菌减少(P＜0.05);与丽珠肠乐组治疗后乳杆菌、双歧杆菌及肠杆菌菌群数量比较,差异无显著性(P＞0.05);与治疗后思密达组各菌群比较,差异有显著性(P＜0.05).(4)神曲组与丽珠肠乐组,临床治疗总有效率明显高于思密达组(P＜0.05).结论中药"神曲"有调节IBS患者肠道菌群的作用,能增加肠道有益菌的数量,改善临床症状.     

实时荧光定量PCR法研究溃疡性结肠炎患者肠道双歧杆菌属、柔嫩梭菌属及拟杆菌属量的变化

目的应用荧光定量PCR技术对人粪便内双歧杆菌属、柔嫩梭菌属及拟杆菌属进行定量检测,揭示肠道相关菌群改变在溃疡性结肠炎（ulcerative colitis,UC）发病中的作用及意义。方法分别设计双歧杆菌属、柔嫩梭菌属及拟杆菌属的特异性引物。收集溃UC患者粪便标本60份及正常对照标本60份,提取细菌基因组DNA,应用实时荧光定量PCR反应测定细菌的数量。结果UC患者组双歧杆菌属及柔嫩梭菌属的数量较正常对照组明显减少（P〈0．05）,而拟杆菌属的数量较正常对照组明显增多（P〈0．05）,差异有统计学意义。结论UC患者粪便中双歧杆菌属及柔嫩梭菌属的数量较正常对照明显减少,而拟杆菌属的数量较正常对照明显增多,提示肠道菌群与UC的发生、发展有一定的关系。     

Relationships between serum IGF-1, IGFBP-2, interleukin-1beta and interleukin-6 in inflammatory bowel disease

AIMS: To study the relationships between serum IGF-1, IGFBP-3 and IGFBP-2 and interleukin (IL)-1beta and IL-6 in inflammatory bowel disease (IBD). METHODS: Thirty-seven patients (18 males, 19 females, aged 8.8-26.1 years) with IBD (Crohn's disease, CD, n = 17, and ulcerative colitis, UC, n = 20) were studied. Patients were in relapse or remission according to established criteria. Serum IGF-1, IGFBP-3, IGFBP-2, IL-1beta and IL-6 levels were determined in patients and 15 healthy controls (aged 8.2-19.0 years). RESULTS: IGF-1 levels were lower in patients with CD in relapse compared with controls (p < 0.05). IGFBP-2 levels were higher in CD in relapse compared with other groups (all p < 0.05). In CD and UC patients (n = 37), IGF-1 levels were inversely correlated with the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). IGFBP-2 levels correlated positively with ESR and IL-1beta. IL-6 levels correlated positively with ESR and CRP. IL-1beta levels were elevated in CD in relapse compared to controls (p < 0.05) and were higher in UC in relapse than in other groups (all p < 0.05). In combined CD/UC patients in relapse (n = 20), IL-1beta levels were higher (p < 0.05) in patients with recto-sigmoiditis (n = 5) than in other patients. CONCLUSIONS: IGF-1, IGFBP-2 levels were related to IL levels, disease activity and anatomical distribution, consistent with active inflammation modifying the IGF-IGFBP system, possibly relevant to disturbance of growth.     

Expression of Toll-like receptor 2 (TLR2), TLR4, and CD14 in biopsy samples of patients with inflammatory bowel diseases: upregulated expression of TLR2 in terminal ileum of patients with ulcerative colitis.

Dysregulation of innate and adaptive intestinal immune responses to bacterial microbiota is supposed to be involved in pathogenetic mechanisms of inflammatory bowel diseases (IBDs). We investigated expression of Toll-like receptor 2 (TLR2), TLR4, and their transmembrane coreceptor CD14 in biopsy samples from patients with IBD and in non-inflamed gut mucosa from controls. Small intestine and colon samples were obtained by colonoscopy from patients with Crohn's disease (CD), ulcerative colitis (UC), and controls. Immunohistochemical analysis of cryostat sections using polyclonal and monoclonal antibodies specific for TLR2, TLR4, and CD14 showed a significant increase in TLR2 expression in the terminal ileum of patients with inactive and active UC against controls. Significant upregulation of TLR4 expression relative to controls was found in the terminal ileum and rectum of UC patients in remission and in the terminal ileum of CD patients with active disease. CD14 expression was upregulated in the terminal ileum of CD patients in remission and with active disease, in the cecum of UC patients in remission and with active disease, and in rectum of UC patients with active disease. Hence, dysregulation of TLR2, TLR4, and CD14 expression in different parts of the intestinal mucosa may be crucial in IBD pathogenesis.     

益生菌在儿童炎症性肠病中的应用

炎症性肠病(inflammatory bowel disease,IBD)是一种原因不明的慢性非特异性肠道炎性疾病,主要包括溃疡性结肠炎(ulcerative colitis,UC)、克罗恩病(Crohn′s disease,CD)和未定型的炎症性肠病(IBD-unclassified,IBDU)。随着对肠道微生物与IBD关系认识的不断加深,许多研究发现肠道菌群的生态失调在IBD的发病中起着重要作用。益生菌在儿童IBD治疗中具有良好前景,但仍缺乏有效的证据来确证益生菌疗效,并指导临床对益生菌的种类和剂量等进行选择。现有研究表明,益生菌对儿童IBD的治疗具有特异性,在诱导和维持UC缓解效果明显,但在诱导CD缓解、维持CD缓解和预防术后并发症及复发方面效果并不理想。     

Body Mass Index Is Associated with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Background

Prior work suggested that patients with inflammatory bowel diseases (IBD) have lower body mass index (BMI) than controls and patients with lower BMI have more serious complications.

Goal

The study was aimed to find relationship between BMI in patients with and without IBD, investigate effects of medicine therapy and disease stages on patients’ BMI.

Methods

Potentially eligible studies were identified through searching PubMed, Cochrane and Embase databases. Outcome measurements of mean BMI and the number of patients from each study were pooled by a random-effect model. Publication bias test, sensitivity analysis and subgroup analysis were conducted.

Results

A total of 24 studies containing 1442 patients and 2059 controls were included. Main results were as follows: (1) BMI in Crohn’s disease (CD) patients was lower than that in health controls (-1.88, 95% CI -2.77 to -1.00, P< 0.001); (2) Medical therapy significantly improved BMI of CD patients (with therapy: -1.58, -3.33 to 0.16; without: -2.09, 95% CI -3.21 to -0.98) while on the contrary not significantly improving BMI of UC patients (with therapy: -0.24, 95% CI -3.68 to 3.20; without: -1.34, 95% CI -2.87 to 0.20, P = 0.57); (3) Both CD and UC patients in active phase showed significantly greater BMI difference compared with controls than those in remission (CD patients: remission: -2.25, 95% CI -3.38 to -1.11; active phase: -4.25, 95% CI -5.58 to -2.92, P = 0.03; UC patients: remission: 0.4, 95% CI -2.05 to 2.84; active phase: -5.38, -6.78 to -3.97, P = 0.001).

Conclusions

BMI is lower in CD patients; medical therapy couldn’t improve BMI of IBD patients; the state of disease affects BMI of CD patients and UC patients.     

Colonic expression and synthesis of interleukin 13 and interleukin 15 in inflammatory bowel disease

A dysregulated local immune reaction with unbalanced cytokine expression seems essential in inflammatory bowel disease (IBD), i.e. ulcerative colitis (UC) and Crohn's disease (CD). Since the roles of interleukin (IL-)13 and IL-15 remain unclear, this study aimed at studying intestinal expression of IL-13 and IL-15 in IBD. Methods: In colonic biopsies from 24 UC, 18 CD, and 12 controls IL-13 and IL-15 were measured using ELISA, and their gene expressions were assessed by RT-PCR. Leukocytes were visualised histochemically. Results: Concentrations of IL-13 were decreased in UC (median 56 pg/mg tissue; interquartile range 30-99 pg/mg) compared to CD (82 pg/mg tissue; 41-122;P=0.004) and controls (83 pg/mg tissue; 18-134;P>0.05), and lower in active UC (53 pg/mg tissue; 33-96) than in inactive UC (80 pg/mg tissue; 65-99;P=0.02). IL-15 concentrations were higher in CD patients (34 pg/mg tissue; 24-53) as compared to controls (20 pg/mg tissue; 15-21;P=0.001) whilst being 22 pg/mg tissue (15-32) in UC. IL-13 mRNA and IL-15 mRNA were detected in 20% and 15%, respectively. Infiltration of leukocytes correlated inversely with IL-13 levels (P=0.02). Conclusion: Active UC is associated with decreased colonic IL-13 suggesting that IL-13 levels are diminished as a part of UC exacerbations, or that exacerbations follow active downregulation of IL-13.     

The insulin-like growth factor system and markers of inflammation in adult patients with inflammatory bowel disease

BACKGROUND AND OBJECTIVES: Catabolism and growth impairment are well-known complications of inflammatory bowel disease (IBD). Recent studies have demonstrated significant changes in the IGF system in IBD patients. The aim of the present study was to investigate correlations between the IGF system and markers of inflammation in IBD. METHODS: A cross-sectional study comprising 99 IBD patients (Crohn's disease (CD, n = 50) and ulcerative colitis (UC, n = 49)). Correlations between markers of inflammation and IGF-I, IGF-II and IGFBP-3 were examined in CD and UC patients in remission and relapse. The patients were clinically scored using Crohn's Disease Activity Index (CDAI) for CD patients and Activity Index (AI) for UC patients. RESULTS: In the UC group we found correlations between IGF-I and CRP (r(s) = Spearman's rho) (r(s) = -0.40, p < 0.01) and albumin (r(s) = 0.46, p < 0.001), IGFBP-3 and albumin (r(s) = 0.36, p < 0.01) and AI score (r(s) = -0.31, p < 0.05). IGF-II correlated with CRP (r(s) = -0.42, p < 0.01), IL-6 (r(s) = -0.65, p < 0.001), albumin (r(s) = 0.41, p < 0.01), AI score (r(s) = -0.30, p < 0.05) and orosomucoid (r(s) = -0.47, p < 0.001). In the CD group we found correlations between IGF-I and CRP (r(s) = -0.40, p < 0.05), and albumin (r(s) = -0.46, p < 0.01), IGFBP-3 and albumin (r = 0.36, p < 0.01). IGF-II correlated with IL-6 (r(s) = -0.65, p < 0.001), albumin (r(s) = 0.41, p < 0.01), CDAI score (r(s) = -0.30, p < 0.05) and orosomucoid (r(s) = -0.47, p < 0.001). CONCLUSIONS: IGF-I, IGF-II and IGFBP-3 are correlated to albumin and IGF-I and IGF-II are correlated to CRP in IBD patients. Further, IGF-II is correlated to IL-6 in IBD patients. This may suggest a correlation between inflammation and the IGF system with involvement in muscle and bone catabolism in IBD.     

Pyostomatitis vegetans associated with inflammatory bowel disease--report of two cases

Pyostomatitis vegetans (PV) is a rare, chronic mucocutaneous disorder associated with inflammatory bowel disease (IBD). Oral lesions of PV are distinct and present as multiple white or yellow pustules with an erythematous base that coalesce and undergo necrosis to form a typical "snail tracks" appearance. Two cases of PV associated with IBD--one with Crohn's disease (CD) and the other with ulcerative colitis (UC) are reported. In the first case, adalimumab therapy brought the oral and gastrointestinal manifestations to complete remission. In the second case, the remission was achieved with systemic steroid therapy, but the disease relapsed after therapy discontinuation. Azathioprine was added leading to sustained remission of PV. Because of persistent active intestinal manifestation of UC, in spite of immunosuppressive therapy, infliximab was introduced. With the therapy remission of intestinal manifestation of UC was achieved as well. Our cases confirm previously reported good experience with immunomodulators and biologics in the treatment of PV. But, before using them we have to exclude an infectious etiology of oral lesions.     

Novel, objective, multivariate biomarkers composed of plasma amino acid profiles for the diagnosis and assessment of inflammatory bowel disease

Background

Inflammatory bowel disease (IBD) is a chronic intestinal disorder that is associated with a limited number of clinical biomarkers. In order to facilitate the diagnosis of IBD and assess its disease activity, we investigated the potential of novel multivariate indexes using statistical modeling of plasma amino acid concentrations (aminogram).

Methodology and Principal Findings

We measured fasting plasma aminograms in 387 IBD patients (Crohn''s disease (CD), n = 165; ulcerative colitis (UC), n = 222) and 210 healthy controls. Based on Fisher linear classifiers, multivariate indexes were developed from the aminogram in discovery samples (CD, n = 102; UC, n = 102; age and sex-matched healthy controls, n = 102) and internally validated. The indexes were used to discriminate between CD or UC patients and healthy controls, as well as between patients with active disease and those in remission. We assessed index performances using the area under the curve of the receiver operating characteristic (ROC AUC). We observed significant alterations to the plasma aminogram, including histidine and tryptophan. The multivariate indexes established from plasma aminograms were able to distinguish CD or UC patients from healthy controls with ROC AUCs of 0.940 (95% confidence interval (CI): 0.898–0.983) and 0.894 (95%CI: 0.853–0.935), respectively in validation samples (CD, n = 63; UC, n = 120; healthy controls, n = 108). In addition, other indexes appeared to be a measure of disease activity. These indexes distinguished active CD or UC patients from each remission patients with ROC AUCs of 0.894 (95%CI: 0.853–0.935) and 0.849 (95%CI: 0.770–0.928), and correlated with clinical disease activity indexes for CD (r_s = 0.592, 95%CI: 0.385–0.742, p<0.001) or UC (r_s = 0.598, 95%CI: 0.452–0.713, p<0.001), respectively.

Conclusions and Significance

In this study, we demonstrated that established multivariate indexes composed of plasma amino acid profiles can serve as novel, non-invasive, objective biomarkers for the diagnosis and monitoring of IBD, providing us with new insights into the pathophysiology of the disease.     

双歧杆菌三联活菌散联合葡萄糖酸锌对 儿童厌食症患者的疗效及其肠道菌群的影响

目的探讨双歧杆菌三联活菌散联合葡萄糖酸锌对儿童厌食症患者的疗效及其肠道菌群的影响。方法选取儿科门诊就诊的儿童厌食症患者80例,随机分为观察组和对照组各40例。两组患儿均予以调整饮食习惯及健胃消食药治疗。对照组患儿加用葡萄糖酸锌口服液10 mL/次,1次/d,口服。观察组患儿在对照组基础上加用双歧杆菌三联活菌散1.0～2.0 g/次,3次/d,温开水冲服。两组患儿均连用8周。观察并比较两组患儿治疗前后微量元素(铁和锌)及肠道菌群(乳杆菌、双歧杆菌和肠杆菌)的变化,并评估其临床效果。结果治疗8周后,两组患儿血清铁和锌含量均不同程度上升(P0.05),且观察组上升幅度较对照组更显著(P0.05)。治疗后观察组患儿肠道乳杆菌和双歧杆菌数量明显上升,肠杆菌数量明显下降(P0.05),而对照组患儿治疗前后肠道菌群数量变化无统计学意义(P0.05)。治疗后观察组患儿肠道乳杆菌和双歧杆菌数量高于对照组,肠杆菌数量低于对照组(P0.05),同时观察组患儿临床总有效率(95.00%)高于对照组(80.00%)。结论双歧杆菌三联活菌散联合葡萄糖酸锌对儿童厌食症患者的疗效确切,能增进患儿食欲和食量,其机制可能与其能能调节肠道菌群紊乱,改善患儿肠道微生态环境,促进肠道对铁和锌等微量元素的吸收和利用密切相关。