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Role and mechanisms of action of escherichia coli nissle 1917 in the maintenance of remission in ulcerative colitis patients: an update 认领 引用 被引量：29
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作者 Franco Scaldaferri Viviana Gerardi +8 位作者 Francesca Mangiola Loris Riccardo Lopetuso Marco Pizzoferrato Valentina Petito Alfredo Papa Jovana Stojanovic Andrea Poscia Giovanni Cammarota Antonio Gasbarrini 《World Journal of Gastroenterology》 SCIE CAS 2016年第24期5505-5511,共7页
Ulcerative colitis (UC) is a chronic inflammatory disease, whose etiology is still unclear. Its pathogenesis involves an interaction between genetic factors, immune response and the &#x0201c;forgotten organ&#x... Ulcerative colitis (UC) is a chronic inflammatory disease, whose etiology is still unclear. Its pathogenesis involves an interaction between genetic factors, immune response and the &#x0201c;forgotten organ&#x0201d;, Gut Microbiota. Several studies have been conducted to assess the role of antibiotics and probiotics as additional or alternative therapies for Ulcerative Colitis. Escherichia coli Nissle (EcN) is a nonpathogenic Gram-negative strain isolated in 1917 by Alfred Nissle and it is the active component of microbial drug Mutaflor&#x000ae; (Ardeypharm GmbH, Herdecke, Germany and EcN, Cadigroup, In Italy) used in many gastrointestinal disorder including diarrhea, uncomplicated diverticular disease and UC. It is the only probiotic recommended in ECCO guidelines as effective alternative to mesalazine in maintenance of remission in UC patients. In this review we propose an update on the role of EcN 1917 in maintenance of remission in UC patients, including data about efficacy and safety. Further studies may be helpful for this subject to further the full use of potential of EcN. 展开更多
关键词 Ulcerative colitis Escherichia coli Nissle Metanalysis Probiotic Randomized trial Inflammatory bowel disease
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Haemostatic system in inflammatory bowel diseases:New players in gut inflammation 认领 引用 被引量：20
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作者 Franco Scaldaferri Stefano Lancellotti +1 位作者 Marco Pizzoferrato Raimondo De Cristofaro 《World Journal of Gastroenterology》 SCIE CAS CSCD 2011年第5期594-608,共15页
Inflammation and coagulation constantly influence each other and are constantly in balance.Emerging evidence supports this statement in acute inflammatory diseases,such as sepsis,but it also seems to be very important... Inflammation and coagulation constantly influence each other and are constantly in balance.Emerging evidence supports this statement in acute inflammatory diseases,such as sepsis,but it also seems to be very important in chronic inflammatory settings,such as inflammatory bowel disease(IBD).Patients with Crohn's disease and ulcerative colitis have an increased risk of thromboembolic events,and several abnormalities concerning coagulation components occur in the endothelial cells of intestinal vessels,where most severe inflammatory abnormalities occur.The aims of this review are to update and classify the type of coagulation system abnormalities in IBD,and analyze the strict and delicate balance between coagulation and inflammation at the mucosal level.Recent studies on possible therapeutic applications arising from investigations on coagulation abnormalities associated with IBD pathogenesis will also be briefly presented and critically reviewed. 展开更多
关键词 Activated protein C Coagulation Crohn＇sdisease Inflammation Inflammatory bowel disease Platelets Ulcerative colitis
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Extraintestinal manifestations in inflammatory bowel disease 认领 引用 被引量：34
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作者 Silvio Danese Stefano Semeraro +5 位作者 Alfredo Papa Italia Roberto Franco Scaldaferri Giuseppe Fedeli Giovanni Gasbarrini Antonio Gasbarrini 《World Journal of Gastroenterology》 SCIE CAS 2005年第46期7227-7236,共10页
Inflammatory bowel diseases (IBD) can be really considered to be systemic diseases since they are often associated with extraintestinal manifestations,complications, and other autoimmune disorders. Indeed,physicians w... Inflammatory bowel diseases (IBD) can be really considered to be systemic diseases since they are often associated with extraintestinal manifestations,complications, and other autoimmune disorders. Indeed,physicians who care for patients with ulcerative colitis and Crohn's disease, the two major forms of IBD, face a new clinical challenge every day, worsened by the very frequent rate of extraintestinal complications. The goal of this review is to provide an overview and an update on the extraintestinal complications occurring in IBD.Indeed, this paper highlights how virtually almost every organ system can be involved, principally eyes, skin,joints, kidneys, liver and biliary tracts, and vasculature (or vascular system) are the most common sites of systemic IBD and their involvement is dependent on different mechanisms. 展开更多
关键词 Crohn＇s disease Ulcerative colitis Inflammatory bowel disease
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Anti-tumor necrosis factorαtherapy associates to type 17 helper T lymphocytes immunological shift and significant microbial changes in dextran sodium sulphate colitis 认领 引用 被引量：2
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作者 Valentina Petito Cristina Graziani +13 位作者 Loris R Lopetuso Marco Fossati Alessandra Battaglia Vincenzo Arena Domenico Scannone Gianluca Quaranta Andrea Quagliariello Federica Del Chierico Lorenza Putignani Luca Masucci Maurizio Sanguinetti Alessandro Sgambato Antonio Gasbarrini Franco Scaldaferri 《World Journal of Gastroenterology》 SCIE CAS 2019年第12期1465-1477,共13页
BACKGROUND Anti-tumor necrosis factorα(TNFα)represents the best therapeutic option to induce mucosal healing and clinical remission in patients with moderate-severe ulcerative colitis.On the other side gut microbiot... BACKGROUND Anti-tumor necrosis factorα(TNFα)represents the best therapeutic option to induce mucosal healing and clinical remission in patients with moderate-severe ulcerative colitis.On the other side gut microbiota plays a crucial role in pathogenesis of ulcerative colitis but few information exists on how microbiota changes following anti-TNFαtherapy and on microbiota role in mucosal healing.AIM To elucidate whether gut microbiota and immune system changes appear following anti TNFαtherapy during dextran sulfate sodium(DSS)colitis.METHODS Eighty C57 BL/6 mice were divided into four groups:"No DSS","No DSS+antiTNFα","DSS"and"DSS+anti-TNFα"."DSS"and"DSS+anti-TNFα"were treated for 5 d with 3%DSS.At day 3,mice whithin"No DSS+anti-TNFα"and"DSS+anti-TNFα"group received 5 mg/kg of an anti-TNFαagent.Forty mice were sacrificed at day 5,forty at day 12,after one week of recovery post DSS.The severity of colitis was assessed by a clinical score(Disease Activity Index),colon length and histology.Bacteria such as Bacteroides,Clostridiaceae,Enterococcaceae and Fecalibacterium prausnitzii(F.prausnitzii)were evaluated by quantitative PCR.Type 1 helper T lymphocytes(Th1),type 17 helper T lymphocytes(Th17)and CD4+regulatory T lymphocytes(Treg)distributions in the mesenteric lymph node(MLN)were studied by flow cytometry.RESULTS Bacteria associated with a healthy state(i.e.,such as Bacteroides,Clostridiaceae and F.prausnitzii)decreased during colitis and increased in course of anti-TNFαtreatment.Conversely,microorganisms belonging to Enterococcaceae genera,which are linked to inflammatory processes,showed an opposite trend.Furthermore,in colitic mice treated with anti-TNFαmicrobial changes were associated with an initial increase(day 5 of the colitis)in Treg cells and a consequent decrease(day 12 post DSS)in Th1 and Th17 frequency cells.Healthy mice treated with anti-TNFαshowed the same histological,microbial and immune features of untreated colitic mice."No DSS+anti-TNFα"group showed a lymphomononuclear infiltrate both at 5 th and 12 th d at hematoxylin and eosin staining,an increase of in Th1 and Th17 frequency at day 12,an increase of Enterococcaceae at day 5,a decrease of Bacteroides and Clostridiaceae at day 12.CONCLUSION Anti-TNFαtreatment in experimental model of colitis improves disease activity but it is associated to an increase in Th17 pathway together with gut microbiota alteration. 展开更多
关键词 Gut microbiota Dextran sodium sulphate colitis Immune system T cells Mesenchymal lymphnode Tumor necrosis factorα
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Propionyl-L-carnitine hydrochloride for treatment of mild to moderate colonic inflammatory bowel diseases 认领 引用 被引量：1
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作者 Giuseppe Merra Giovanni Gasbarrini +9 位作者 Lucrezia Laterza Marco Pizzoferrato Andrea Poscia Franco Scaldaferri Vincenzo Arena Francesca Fiore Achille Cittadini Alessandro Sgambato Francesco Franceschi Antonio Gasbarrini 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第36期5065-5071,共7页
AIM:To assess clinical and endoscopic response to propionyl-L-carnitine hydrochloride(PLC) in colonic inflammatory bowel disease.METHODS:Patients suffering from mild to moderate ulcerative colitis(UC) or Crohn's d... AIM:To assess clinical and endoscopic response to propionyl-L-carnitine hydrochloride(PLC) in colonic inflammatory bowel disease.METHODS:Patients suffering from mild to moderate ulcerative colitis(UC) or Crohn's disease(CD) colitis,with disease activity index(DAI) between 3 and 10 and under stable therapy with oral aminosalicylates,mercaptopurine or azathioprine,for at least 8 wk prior to baseline assessments,were considered suitable for enrollment.Fourteen patients were enrolled to assume PLC 2 g/d(two active tablets twice daily) orally.Clinical-endoscopic and histological activity were assessed by DAI and histological index(HI),respectively,following a colonoscopy performed immediately before and after 4 wk treatment.Clinical response was defined as a lowering of at least 3 points in DAI and clinical remission as a DAI score ≤ 2.Histological response was defined as an improvement of HI of at least 1 point.We used median values for the analysis.Differences pre-and post-treatment were analyzed by Wilcoxon signed rank test.RESULTS:All patients enrolled completed the study.One patient,despite medical advice,took deflazacort 5 d before follow-up colonoscopy examination.No side effects were reported by patients during the trial.After treatment,71%(SE 12%) of patients achieved clinical response,while 64%(SE 13%) obtained remission.Separating UC from CD patients,we observed a clinical response in 60%(SE 16%) and 100%,respectively.Furthermore 60%(SE 16%) of UC patients and 75%(SE 25%) of CD patients were in clinical remission after therapy.The median DAI was 7 [interquartile range(IQR):4-8] before treatment and decreased to 2(IQR:1-3)(P < 0.01) after treatment.Only patients with UC showed a significant reduction of DAI,from a median 6.5(IQR:4-9) before treatment to 2(IQR:1-3) after treatment(P < 0.01).Conversely,in CD patients,although displaying a clear reduction of DAI from 7(IQR:5.5-7.5) before therapy to 1.5(IQR:0.5-2.5) after therapy,differences observed were not significant(P = 0.06).Seventy-nine percent(SE 11%) of patients showed improvement of HI of at least 1 point,while only one CD and two UC patients showed HI stability;none showed HI worsening.Median HI decreased from 1(IQR:1-2),to 0.5(IQR:0-1) at the endoscopic control in the whole population(P < 0.01),while it changed from 1(IQR:1-2) to 0.5(IQR:0-1) in UC patients(P < 0.01) and from 1.5(IQR:1-2) to 0.5(IQR:0-1) in CD patients(P = not significant).The two sample tests of proportions showed no significant differences in clinical and histological response or in clinical remission between UC and CD patients.No side effects were reported during treatment or at 4 wk follow-up visit.CONCLUSION:PLC improves endoscopic and histological activity of mild to moderate UC.Further studies are required to evaluate PLC efficacy in colonic CD patients. 展开更多
关键词 PropionyI-L-carnitine Ulcerative colitis Crohn＇s disease Inflammatory bowel disease therapy PropionyI-L-carnitine hydrochloride
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Origin of celiac disease:How old are predisposing haplotypes? 认领 引用
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作者 Giovanni Gasbarrini Olga Rickards +6 位作者 Cristina Martínez-Labarga Elsa Pacciani Filiberto Chilleri Lucrezia Laterza Giuseppe Marangi Franco Scaldaferri Antonio Gasbarrini 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第37期5300-5304,共5页
We recently presented the case of a first century AD young woman, found in the archaeological site of Cosa, showing clinical signs of malnutrition, such as short height, osteoporosis, dental enamel hypoplasia and crib... We recently presented the case of a first century AD young woman, found in the archaeological site of Cosa, showing clinical signs of malnutrition, such as short height, osteoporosis, dental enamel hypoplasia and cribra orbitalia, indirect sign of anemia, all strongly suggestive for celiac disease (CD). However, whether these findings were actually associated to CD was not shown based on genetic parameters. To investigate her human leukocyte antigen (HLA) class Ⅱ polymorphism, we extracted DNA from a bone sample and a tooth and genotyped HLA using three HLA-tagging single nucleotide polymorphisms for DQ8, DQ2.2 and DQ2.5, specifically associated to CD. She displayed HLA DQ 2.5, the haplotype associated to the highest risk of CD. This isthe first report showing the presence of a HLA haplotype compatible for CD in archaeological specimens. 展开更多
关键词 Celiac disease Human leukocyte antigen hap-Iotype Ancient DNA Single nucleotide polymorphisms Malabsorption
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Infliximab does not increase colonic cancer risk associated to murine chronic colitis 认领 引用
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作者 Loris R Lopetuso Valentina Petito +11 位作者 Tiziano Zinicola Cristina Graziani Viviana Gerardi Vincenzo Arena Maria Emiliana Caristo Andrea Poscia Giovanni Cammarota Alfredo Papa Valerio Cufino Alessandro Sgambato Antonio Gasbarrini Franco Scaldaferri 《World Journal of Gastroenterology》 SCIE CAS 2016年第44期9727-9733,共7页
AIM To explore the influence of Infliximab(IFX) on cancer progression in a murine model of colonic cancer associated to chronic colitis.METHODS AOM/DSS model was induced in C57BL/6 mice. Mice were injected with IFX(5 ... AIM To explore the influence of Infliximab(IFX) on cancer progression in a murine model of colonic cancer associated to chronic colitis.METHODS AOM/DSS model was induced in C57BL/6 mice. Mice were injected with IFX(5 mg/kg) during each DSS cycle while control mice received saline. Body weight, occult blood test and stool consistency were measured to calculate the disease activity index(DAI). Mice were sacrificed at week 10 and colons were analyzed macroscopically and microscopically for number of cancers and degree of inflammation. MTT assay was performed on CT26 to evaluate the potential IFX role on metabolic activity and proliferation. Cells were incubated with TNF-α or IFX or TNF-α plus IFX, and cell vitality was evaluated after 6, 24 and 48 h. The same setting was used after pre-incubation with TNF-α for 24 h.RESULTS IFX significantly reduced DAI and body weight loss in mice compared with controls, preserving also colon length at sacrifice. Histological score was also reduced in treated mice. At macroscopic analysis, IFX treated mice showed a lower number of tumor lesions compared to controls. This was confirmed at microscopic analysis, although differences were not statistically significant. In vitro, IFX treated CT26 maintained similar proliferation ability at MTT test, both when exposed to IFX alone and when associated to TNF-α.CONCLUSION IFX did not increase colonic cancer risk in AOM-DSS model of cancer on chronic colitis nor influence directly the proliferation of murine colon cancer epithelial cells. 展开更多
关键词 Inflammatory bowel disease Ulcerative colitis Colorectal cancer Infliximab AOM-DSS model Cancer on chronic colitis
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Orphan patients with inflammatory bowel disease-when we treat beyond evidence 认领 引用
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作者 Giuseppe Privitera Daniela Pugliese +5 位作者 Loris Riccardo Lopetuso Franco Scaldaferri Alfredo Papa GianLodovico Rapaccini Antonio Gasbarrini Alessandro Armuzzi 《World Journal of Gastroenterology》 SCIE CAS 2021年第47期8047-8057,共11页
Inflammatory bowel disease(IBD)is a chronic condition that requires continuous medical treatment.To date,the medical management of patients with moderatelyto-severely active IBD who develop dependence or resistance to... Inflammatory bowel disease(IBD)is a chronic condition that requires continuous medical treatment.To date,the medical management of patients with moderatelyto-severely active IBD who develop dependence or resistance to corticosteroids is based on immunomodulator drugs.Such therapies are licenced after passing through three phases of randomized controlled trials(RCTs),and are subsequently adopted in clinical practice.However,the real-life population of IBD patients who require these therapies can significantly differ from those included in RCTs.As a matter of fact,there is a number of exclusion criteria–nearly ubiquitous in all RCTs–that prevent the enrolment of specific patients:Chronic refractory pouchitis or isolated proctitis in ulcerative colitis,short-bowel syndrome and stomas in Crohn’s disease,ileorectal anastomosis in both ulcerative colitis and Crohn’s disease,and elderly age are some representative examples.In this frontier article,we aim to give an overview of current literature on this topic,in order to address the main knowledge gaps that need to be filled in the upcoming years. 展开更多
关键词 Pouchitis Proctitis Stoma Short-bowel Ileo-rectal anastomosis Biologics
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