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31 pages, 8657 KiB  
Review
Exploring Gut Microbiota Imbalance in Irritable Bowel Syndrome: Potential Therapeutic Effects of Probiotics and Their Metabolites
by María José García Mansilla, María Jesús Rodríguez Sojo, Andrea Roxana Lista, Ciskey Vanessa Ayala Mosqueda, Antonio Jesús Ruiz Malagón, Julio Gálvez, Alba Rodríguez Nogales and María José Rodríguez Sánchez
Nutrients 2025, 17(1), 155; https://doi.org/10.3390/nu17010155 - 31 Dec 2024
Cited by 7 | Viewed by 5370
Abstract
Irritable bowel syndrome is a common functional gastrointestinal disorder characterized by recurrent abdominal discomfort, bloating, cramping, flatulence, and changes in bowel movements. The pathophysiology of IBS involves a complex interaction between motor, sensory, microbiological, immunological, and psychological factors. Diversity, stability, and metabolic activity [...] Read more.
Irritable bowel syndrome is a common functional gastrointestinal disorder characterized by recurrent abdominal discomfort, bloating, cramping, flatulence, and changes in bowel movements. The pathophysiology of IBS involves a complex interaction between motor, sensory, microbiological, immunological, and psychological factors. Diversity, stability, and metabolic activity of the gut microbiota are frequently altered in IBS, thus leading to a situation of gut dysbiosis. Therefore, the use of probiotics and probiotic-derived metabolites may be helpful in balancing the gut microbiota and alleviating irritable bowel syndrome symptoms. This review aimed to report and consolidate recent progress in understanding the role of gut dysbiosis in the pathophysiology of IBS, as well as the current studies that have focused on the use of probiotics and their metabolites, providing a foundation for their potential beneficial effects as a complementary and alternative therapeutic strategy for this condition due to the current absence of effective and safe treatments. Full article
(This article belongs to the Special Issue Probiotics and Their Metabolites in Human Health)
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16 pages, 1156 KiB  
Review
Multiple Aspects of Irritable Bowel Syndrome and the Role of the Immune System: An Overview of Systematic Reviews with a Focus on Polyphenols
by Lucia Carmela Passacatini, Sara Ilari, Saverio Nucera, Federica Scarano, Roberta Macrì, Rosamaria Caminiti, Maria Serra, Francesca Oppedisano, Jessica Maiuolo, Ernesto Palma, Valentina Malafoglia, Carlo Tomino, Massimo Fini, Vincenzo Mollace and Carolina Muscoli
Int. J. Mol. Sci. 2024, 25(22), 11993; https://doi.org/10.3390/ijms252211993 - 8 Nov 2024
Cited by 2 | Viewed by 2625
Abstract
Irritable bowel syndrome (IBS) is a complex and often debilitating condition that significantly impacts the gastrointestinal system and the overall quality of life of those affected. IBS is characterized by a variety of distressing symptoms, including cramping, abdominal pain, and irregular bowel movements, [...] Read more.
Irritable bowel syndrome (IBS) is a complex and often debilitating condition that significantly impacts the gastrointestinal system and the overall quality of life of those affected. IBS is characterized by a variety of distressing symptoms, including cramping, abdominal pain, and irregular bowel movements, underlined by an intricate interplay of immune system dysfunction in its pathology. Numerous studies highlight an increased cellular immune response, with elevated levels of proinflammatory cytokines, mucosal alterations due to immune imbalance, and visceral hypersensitivity. Notably, studies indicate increased levels of proinflammatory cytokines, immune imbalances that lead to mucosal changes, and heightened visceral sensitivity. The roles of effector and regulatory T cells are particularly intriguing, as their modification appears to amplify inflammation and may even contribute to autoimmune disorders. This overview of systematic reviews explores the connections between IBS and immune responses, with a focus on immune cell alterations and proliferation of lymphocytes and mast cells in affected individuals. Furthermore, we explore various aspects of IBS management, including its pharmacological approaches. A systematic search of PubMed and Web of Science yielded 676 articles, which were ultimately narrowed down to 9 key studies that met our inclusion criteria. These studies collectively underscore the activation of the immune system with the degranulation of the mast cells in patients with IBS, where the release of inflammatory mediators can compromise intestinal permeability, exacerbating symptoms further. Additionally, we examine the multifaceted management strategies for IBS, emphasizing the potential therapeutic benefits of dietary polyphenols as antioxidants. The present study aims to enhance our understanding of IBS and offer insights into more effective treatment strategies for this challenging condition. Full article
(This article belongs to the Special Issue Synthetic and Natural Drugs for Pain Treatment)
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25 pages, 6602 KiB  
Article
Spasmolytic Activity and Anti-Inflammatory Effect of Novel Mebeverine Derivatives
by Mihaela Stoyanova, Miglena Milusheva, Vera Gledacheva, Iliyana Stefanova, Mina Todorova, Nikoleta Kircheva, Silvia Angelova, Mina Pencheva, Kirila Stojnova, Slava Tsoneva and Stoyanka Nikolova
Biomedicines 2024, 12(10), 2321; https://doi.org/10.3390/biomedicines12102321 - 12 Oct 2024
Cited by 3 | Viewed by 2427
Abstract
Background: Irritable bowel syndrome (IBS) has a major negative influence on quality of life, causing cramps, stomach pain, bloating, constipation, etc. Antispasmodics have varying degrees of efficacy. Mebeverine, for example, works by controlling bowel movements and relaxing the muscles of the intestines [...] Read more.
Background: Irritable bowel syndrome (IBS) has a major negative influence on quality of life, causing cramps, stomach pain, bloating, constipation, etc. Antispasmodics have varying degrees of efficacy. Mebeverine, for example, works by controlling bowel movements and relaxing the muscles of the intestines but has side effects. Therefore, more efficient medication is required. Methods: In the current study, we investigated the synthesis of novel mebeverine analogs and determined ex vivo their spasmolytic and in vitro and ex vivo anti-inflammatory properties. The ability to influence both contractility and inflammation provides a dual-action approach, offering a comprehensive solution for the prevention and treatment of both conditions. Results: The results showed that all the compounds have better spasmolytic activity than mebeverine and good anti-inflammatory potential. Among the tested compounds, 3, 4a, and 4b have been pointed out as the most active in all the studies conducted. To understand their mechanism of activity, molecular docking simulation was investigated. The docking analysis explained the biological activities with their calculated Gibbs energies and possibilities for binding both centers of albumin. Moreover, the calculations showed that molecules can bind also the two muscarinic receptors and interleukin-β, hence these structures would exert a positive therapeutic effect owed to interaction with these specific receptors/cytokine. Conclusions: Three of the tested compounds have emerged as the most active and effective in all the studies conducted. Future in vivo and preclinical experiments will contribute to the establishment of these novel mebeverine derivatives as potential drug candidates against inflammatory diseases in the gastrointestinal tract. Full article
(This article belongs to the Special Issue Recent Advances in Drug Synthesis and Drug Discovery)
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11 pages, 1759 KiB  
Article
Antispasmodic Activity of Light-Roasted Coffee Extract and Its Potential Use in Gastrointestinal Motility Disorders
by Acharaporn Duangjai, Anchalee Rawangkan, Atchariya Yosboonruang, Atcharaporn Ontawong, Surasak Saokaew, Bey-Hing Goh, Masami Suganuma and Pochamana Phisalprapa
Foods 2024, 13(15), 2307; https://doi.org/10.3390/foods13152307 - 23 Jul 2024
Cited by 1 | Viewed by 2095
Abstract
Antispasmodic agents are crucial in managing gastrointestinal motility disorders by modulating muscle contractions and reducing symptoms like cramping and diarrhea. This study investigated the antispasmodic potential of different coffee bean extracts, including light coffee (LC), medium coffee (MC), and dark coffee (DC), on [...] Read more.
Antispasmodic agents are crucial in managing gastrointestinal motility disorders by modulating muscle contractions and reducing symptoms like cramping and diarrhea. This study investigated the antispasmodic potential of different coffee bean extracts, including light coffee (LC), medium coffee (MC), and dark coffee (DC), on ileum contractions induced by potassium chloride (KCl), and elucidated their mechanisms of action using in vitro isolated tissue techniques. The results demonstrated that all coffee extracts reduced spontaneous contractions of rat ileum tissue in a dose-dependent manner. Among these, LC showed the most significant reduction in ileum contractions, particularly at higher concentrations. The key findings reveal that LC at 5 mg/mL significantly reduced CaCl2-induced contractions in isolated rat ileum tissue, indicating that LC may inhibit calcium influx or interfere with calcium signaling pathways. The presence of nifedipine, propranolol, and N-nitro-L-arginine methyl ester (L-NAME) have been confirmed in their involvement; they block calcium influx and calcium channels and activate β-adrenergic pathways as part of LC’s mechanism of action. The presence of their active compounds, particularly chlorogenic acid and caffeine, likely contributes to the observed antispasmodic effects. These findings suggest that LC exerts its antispasmodic effects by targeting key mechanisms involved in muscle spasms and intestinal motility, providing a potential for managing such conditions. Full article
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19 pages, 1211 KiB  
Review
Sports-Related Gastrointestinal Disorders: From the Microbiota to the Possible Role of Nutraceuticals, a Narrative Analysis
by Alexander Bertuccioli, Giordano Bruno Zonzini, Massimiliano Cazzaniga, Marco Cardinali, Francesco Di Pierro, Aurora Gregoretti, Nicola Zerbinati, Luigina Guasti, Maria Rosaria Matera, Ilaria Cavecchia and Chiara Maria Palazzi
Microorganisms 2024, 12(4), 804; https://doi.org/10.3390/microorganisms12040804 - 16 Apr 2024
Cited by 6 | Viewed by 3445
Abstract
Intense physical exercise can be related to a significant incidence of gastrointestinal symptoms, with a prevalence documented in the literature above 80%, especially for more intense forms such as running. This is in an initial phase due to the distancing of the flow [...] Read more.
Intense physical exercise can be related to a significant incidence of gastrointestinal symptoms, with a prevalence documented in the literature above 80%, especially for more intense forms such as running. This is in an initial phase due to the distancing of the flow of blood from the digestive system to the skeletal muscle and thermoregulatory systems, and secondarily to sympathetic nervous activation and hormonal response with alteration of intestinal motility, transit, and nutrient absorption capacity. The sum of these effects results in a localized inflammatory process with disruption of the intestinal microbiota and, in the long term, systemic inflammation. The most frequent early symptoms include abdominal cramps, flatulence, the urge to defecate, rectal bleeding, diarrhea, nausea, vomiting, regurgitation, chest pain, heartburn, and belching. Promoting the stability of the microbiota can contribute to the maintenance of correct intestinal permeability and functionality, with better control of these symptoms. The literature documents various acute and chronic alterations of the microbiota following the practice of different types of activities. Several nutraceuticals can have functional effects on the control of inflammatory dynamics and the stability of the microbiota, exerting both nutraceutical and prebiotic effects. In particular, curcumin, green tea catechins, boswellia, berberine, and cranberry PACs can show functional characteristics in the management of these situations. This narrative review will describe its application potential. Full article
(This article belongs to the Section Gut Microbiota)
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6 pages, 3116 KiB  
Case Report
Colitis as the Main Presentation of COVID-19: A Case Report
by Vlasta Oršić Frič, Vladimir Borzan, Andrej Borzan, Izabela Kiš, Branko Dmitrović and Ivana Roksandić-Križan
Medicina 2023, 59(3), 576; https://doi.org/10.3390/medicina59030576 - 15 Mar 2023
Viewed by 3330
Abstract
The main symptoms of coronavirus disease (COVID-19) are fever, cough, tiredness, and loss of smell and taste. Gastrointestinal symptoms are less common. A 38-year-old female patient, previously healthy, presented with a history of hematochezia up to 8 times per day, followed by abdominal [...] Read more.
The main symptoms of coronavirus disease (COVID-19) are fever, cough, tiredness, and loss of smell and taste. Gastrointestinal symptoms are less common. A 38-year-old female patient, previously healthy, presented with a history of hematochezia up to 8 times per day, followed by abdominal cramps, urgency, and chills for two days. She did not have any respiratory symptoms and was previously vaccinated for COVID-19. She was afebrile, with normal vital signs. Blood samples showed normal complete blood count and increased C-reactive protein (CRP), fibrinogen, and D-dimer levels (66 mg/L, 4.1 g/L, and 2302 μ/L FEU, respectively). Stool samples for stool culture, C. difficile, and viral examination came back negative. On day 3, she reported a mild cough, fever and loss of smell and taste. Nasopharyngeal swab for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) PCR test came back positive. On day 6, the patient still had hematochezia accompanied by abdominal cramps, but fever and respiratory symptoms withdrew. CRP, fibrinogen, and D-dimers were still elevated, as well as liver enzyme levels. Sigmoidoscopy was performed with biopsies taken from sigmoid and rectum for histology and PCR SARS-CoV-2 testing. CT angiography showed no signs of thrombosis in mesenteric veins or arteries. PCR test for SARS-CoV-2 virus from rectal biopsy sample was positive. Patient was treated with methylprednisolone iv for two days and peroral prednisone afterwards, with mesalamine, metronidazole and enoxaparin. Sigmoidoscopy was repeated after two weeks showing only mild hyperemia. At that time, the patient had normal stool, normal CRP, liver enzyme, fibrinogen, and D-dimer levels, and normocytic anemia (hemoglobin level of 103 g/L). We wanted to show that severe gastrointestinal symptoms, such as hemorrhagic colitis, can be the main presentation of COVID-19, even in young patients with no prior comorbidities. In such a case, PCR test in biopsy samples can be performed to prove SARS-CoV-2 infection of bowel mucosa. Full article
(This article belongs to the Special Issue The Digestive System in the Era of COVID-19)
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26 pages, 52380 KiB  
Review
Recent Advances on Chemically Functionalized Cellulose-Based Materials for Arsenic Removal in Wastewater: A Review
by Mary T. Motloung, Sifiso I. Magagula, Andiswa Kaleni, Tlholohelo S. Sikhosana, Kgomotso Lebelo and Mokgaotsa J. Mochane
Water 2023, 15(4), 793; https://doi.org/10.3390/w15040793 - 17 Feb 2023
Cited by 11 | Viewed by 5406
Abstract
Clean water is very important for the good health of society. In South Africa, it is estimated that people need 20 to 50 litres of safe water daily for basic hygiene, drinking, and cooking. In recent times, water bodies have harboured harmful pollutants, [...] Read more.
Clean water is very important for the good health of society. In South Africa, it is estimated that people need 20 to 50 litres of safe water daily for basic hygiene, drinking, and cooking. In recent times, water bodies have harboured harmful pollutants, including oil, heavy metal ions, and dyes. As a result, this has become a major global concern. Societies with limited clean water are often forced to utilise contaminated water or buy filtered water, which might be a problem for poor residents. The health consequences that are related to contaminated water include Guinea worm disease, dysentery, cholera, etc. The side effects associated with the utilisation of unclean water are gastrointestinal diseases such as cramps, vomiting, and diarrhoea. The wastewater disposed of by chemical industries contains toxic elements such as arsenic. Wastewater that is released directly without treatment causes serious damage to the environment. Chronic arsenic poisoning can lead to keratinisation of the skin and even cancer. Cellulose biomass materials have the potential to become the greatest bio-based materials used in wastewater treatment applications. There are two major reasons that validate this statement: firstly, cellulose is a low-cost material that is abundant in nature, and, secondly, cellulose is an environmentally friendly material. However, these are not the only reasons that validate cellulose as a good candidate for wastewater treatment applications. Cellulose has a unique structure a large surface area, good mechanical properties and is degradable, renewable, and biocompatible. Cellulose also has an abundance of hydroxyl groups on its surface. These hydroxyl functional groups allow cellulose to be chemically modified in various ways, which results in the fabrication of nanocomposites with tunable characteristics. Since arsenic pollution has become a serious global concern, this review uniquely provides a broad discussion of the work that has been accomplished recently on the fabrication of functionalised cellulose-based materials designed specifically for the removal of arsenic heavy metal species from wastewater treatment facilities. Furthermore, the functionalised cellulose materials’ arsenic adsorption capacities are also discussed. These adsorption capacities can reach up to a maximum of 350 mg/g, depending on the system used. Factors such as pH and temperature are discussed in relation to the adsorption of arsenic in wastewater. The removal of As(V) was found to be effective in the pH range of 3.0–8.8, with a removal efficiency of 95%. Moreover, the removal efficiency of As(III) was reported to be effective in the pH range of 6–9. However, the effective pH range also depends on the system used. The selective extraction of cellulose from various sources is also discussed in order to verify the percentage of cellulose in each source. Future work should be focused on how the chemical modification of cellulose affects the toxicity, efficiency, selectivity, and mechanical stability of cellulose materials. The use of cheaper and environmentally friendly chemicals during cellulose functionalisation should be considered. Full article
(This article belongs to the Section Wastewater Treatment and Reuse)
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11 pages, 639 KiB  
Article
Self-Medication for the Treatment of Abdominal Cramps and Pain—A Real-Life Comparison of Three Frequently Used Preparations
by Martin Storr, Harald Weigmann, Sabine Landes and Martin C. Michel
J. Clin. Med. 2022, 11(21), 6361; https://doi.org/10.3390/jcm11216361 - 28 Oct 2022
Cited by 6 | Viewed by 9367
Abstract
Functional gastrointestinal disorders (FGIDs), including irritable bowel syndrome (IBS), are frequently handled by self-management with over-the-counter (OTC) products such as hyoscine butylbromide (HBB), alone or in combination with paracetamol, and natural products such as peppermint oil. To obtain real-world information, we have performed [...] Read more.
Functional gastrointestinal disorders (FGIDs), including irritable bowel syndrome (IBS), are frequently handled by self-management with over-the-counter (OTC) products such as hyoscine butylbromide (HBB), alone or in combination with paracetamol, and natural products such as peppermint oil. To obtain real-world information, we have performed an anonymous pharmacy-based patient survey among 1686 users of HBB, HBB + paracetamol, and peppermint oil. Based on the distinct but overlapping indications for the three OTC products, multiple logistic regression was applied to compare them in users reporting gastrointestinal cramps and pain, bloating, flatulence, or IBS as cardinal symptoms. All three treatments reduced symptoms and associated impairments of work/daily chores, leisure activities, and sleep by approximately 50%. Based on the four cardinal symptoms and the four dependent continuous variables of interest (change in intensity of symptoms and of the three impairment domains) a total of 16 logistic regression models were applied. HBB, HBB + paracetamol, and peppermint oil had similar reported overall effectiveness in those models. Gender, age, baseline symptom severity, and impairment in one of three domains had small and inconsistent effects on perceived treatment success. We provide evidence that HBB, HBB + paracetamol, and peppermint oil have comparable effectiveness in their approved indications under real-world conditions in an OTC setting. Full article
(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)
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6 pages, 1544 KiB  
Case Report
Gastroparesis, Thymoma, and Asymptomatic Myasthenia: A Rare Clinical Scenario
by Consuelo Tamburella, Silvana Parisi, Sara Lillo, Giacomo Ferrantelli, Paola Critelli, Anna Viola, Angelo Platania, Maria Santoro, Alberto Cacciola, Anna Santacaterina and Gianluca Ferini
Gastroenterol. Insights 2022, 13(1), 27-32; https://doi.org/10.3390/gastroent13010004 - 15 Jan 2022
Cited by 2 | Viewed by 5629
Abstract
Background: Paraneoplastic gastroparesis is a gastrointestinal syndrome that rarely precedes a tumor diagnosis. To increase awareness of this rare clinical entity, we present a case of severe gastroparesis, which was later proven to be associated with a thymoma. Case report: A 55-year old [...] Read more.
Background: Paraneoplastic gastroparesis is a gastrointestinal syndrome that rarely precedes a tumor diagnosis. To increase awareness of this rare clinical entity, we present a case of severe gastroparesis, which was later proven to be associated with a thymoma. Case report: A 55-year old man had the sudden onset of severe abdominal cramps and abdominal distension, early satiety with postprandial nausea, acid regurgitation, belching, and flatulence. He lost about 20 pounds. The physical and imaging examination revealed stomach distension, gastroparesis, and the presence of a solid mass in the anterior mediastinum. Radical surgery was performed to remove the thymoma and, given the high value of Mib-1, the patient was submitted to postoperative chest radiation therapy. After thymectomy, a diagnosis of paraneoplastic myasthenia gravis with subacute autonomic failure was made. Conclusion: Autoimmune gastroparesis should be considered as a potential paraneoplastic syndrome in patients with thymoma, myasthenia gravis, and delayed gastric emptying in the absence of mechanical obstruction. Full article
(This article belongs to the Special Issue Novel Therapeutics and Prognostications in Gastrointestinal Cancer)
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13 pages, 1116 KiB  
Article
The Impact of Gastrointestinal Symptoms on Patients’ Well-Being: Best–Worst Scaling (BWS) to Prioritize Symptoms of the Gastrointestinal Symptom Score (GIS)
by Axel Christian Mühlbacher and Anika Kaczynski
Int. J. Environ. Res. Public Health 2021, 18(21), 11715; https://doi.org/10.3390/ijerph182111715 - 8 Nov 2021
Cited by 2 | Viewed by 3108
Abstract
Background: The gastrointestinal symptom score (GIS) is used in a standardized form to ascertain dyspeptic symptoms in patients with functional dyspepsia in clinical practice. As a criterion for evaluating the effectiveness of a treatment, the change in the summed total point value is [...] Read more.
Background: The gastrointestinal symptom score (GIS) is used in a standardized form to ascertain dyspeptic symptoms in patients with functional dyspepsia in clinical practice. As a criterion for evaluating the effectiveness of a treatment, the change in the summed total point value is used. The total score ranges from 0 to 40 points, in which a higher score represents a more serious manifestation of the disease. Each symptom is included with equal importance in the overall evaluation. The objective of this study was to test this assumption from a patients’ perspective. Our aim was to measure the priorities of patients for the ten gastrointestinal symptoms by using best–worst scaling. Method: A best–worst scaling (BWS) object scaling (Case 1) was applied. Therefore, the symptoms of the GIS were included in a questionnaire using a fractional factorial design (BIBD—balanced incomplete block design). In each choice set, the patients selected the component that had the most and the least impact on their well-being. The BIB design generated a total of 15 choice sets, which each included four attributes. Results: In this study, 1096 affected patients were asked for their priorities regarding a treatment of functional dyspepsia and motility disorder. Based on the data analysis, the symptoms abdominal cramps (SQRT (B/W): −1.27), vomiting (SQRT (B/W): −1.07) and epigastric pain (SQRT (B/W): −0.76) were most important and thus have the greatest influence on the well-being of patients with functional dyspepsia and motility disorders. In the middle range are the symptoms nausea (SQRT (B/W): −0.69), acid reflux/indigestion (SQRT (B/W): −0.29), sickness (SQRT (B/W): −0.26) and retrosternal discomfort (SQRT (B/W): 0.26), whereas the symptoms causing the least impact are the feeling of fullness (SQRT (B/W): 0.80), early satiety (SQRT (B/W): 1.54) and loss of appetite (SQRT(B/W): 1.95). Discussion: Unlike the underlying assumption of the GIS, the BWS indicated that patients did not weight the 10 symptoms equally. The results of the survey show that the three symptoms of vomiting, abdominal cramps and epigastric pain are weighted considerably higher than symptoms such as early satiety, loss of appetite and the feeling of fullness. The evaluation of the BWS data has illustrated, however, that the restrictive assumption of GIS does not reflect the reality of dyspeptic patients. Conclusions: In conclusion, a preference-based GIS is necessary to make valid information about the real burden of illness and to improve the burden of symptoms in the indication of gastrointestinal conditions. The findings of the BWS demonstrate that the common GIS is not applicable to represent the real burden of disease. The results suggest the potential modification of the established GIS by future research using a stated preference study. Full article
(This article belongs to the Section Health Care Sciences & Services)
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17 pages, 2726 KiB  
Article
Influence of Catheter–Incision Congruency in Epidural Analgesia on Postcesarean Pain Management: A Single-Blinded Randomized Controlled Trial
by Ying-Hsi Chen, Wei-Han Chou, Jr-Chi Yie, Hsiao-Chun Teng, Yi-Luen Wu and Chun-Yu Wu
J. Pers. Med. 2021, 11(11), 1099; https://doi.org/10.3390/jpm11111099 - 27 Oct 2021
Cited by 3 | Viewed by 2025
Abstract
Patient-controlled epidural analgesia (PCEA) or epidural morphine may alleviate postcesarean pain; however, conventional lumbar epidural insertion is catheter–incision incongruent for cesarean delivery. Methods: In total, 189 women who underwent cesarean delivery were randomly divided into four groups (low thoracic PCEA, lumbar PCEA, low [...] Read more.
Patient-controlled epidural analgesia (PCEA) or epidural morphine may alleviate postcesarean pain; however, conventional lumbar epidural insertion is catheter–incision incongruent for cesarean delivery. Methods: In total, 189 women who underwent cesarean delivery were randomly divided into four groups (low thoracic PCEA, lumbar PCEA, low thoracic morphine, and lumbar morphine groups) for postcesarean pain management. Pain intensities, including static pain, dynamic pain, and uterine cramp, were measured using a 100 mm visual analog scale (VAS). The proportion of participants who experienced dynamic wound pain with a VAS score of >33 mm was evaluated as the primary outcome. Adverse effects, including lower extremity blockade, pruritus, postoperative nausea and vomiting, sedation, and time of first passage of flatulence, were evaluated. Results: The low thoracic PCEA group had the lowest proportion of participants reporting dynamic pain at 6 h after spinal anesthesia (low thoracic PCEA, 28.8%; lumbar PCEA, 69.4%; low thoracic morphine, 67.3%; lumbar morphine group, 73.9%; p < 0.001). The aforementioned group also reported the most favorable VAS scores for static, dynamic, and uterine cramp pain during the first 24 h after surgery. Adverse effect profiles were similar among the four groups, but a higher proportion of participants in the lumbar PCEA group (approximately 20% more than in the other three groups) reported prolonged postoperative lower extremity motor blockade (p = 0.005). In addition, the first passage of flatulence after surgery reported by the low thoracic PCEA group was approximately 8 h earlier than that of the two morphine groups (p < 0.001). Conclusions: Epidural congruency is essential to PCEA for postcesarean pain. Low thoracic PCEA achieves favorable analgesic effects and may promote postoperative gastrointestinal recovery without additional adverse effects. Full article
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11 pages, 488 KiB  
Review
Gut Dysbiosis during COVID-19 and Potential Effect of Probiotics
by Yuan-Pin Hung, Ching-Chi Lee, Jen-Chieh Lee, Pei-Jane Tsai and Wen-Chien Ko
Microorganisms 2021, 9(8), 1605; https://doi.org/10.3390/microorganisms9081605 - 28 Jul 2021
Cited by 36 | Viewed by 6555
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an RNA virus of the family Coronaviridae, causes coronavirus disease 2019 (COVID-19), an influenza-like disease that chiefly infects the lungs through respiratory transmission. The spike protein of SARS-CoV-2, a transmembrane protein in its outer portion, [...] Read more.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an RNA virus of the family Coronaviridae, causes coronavirus disease 2019 (COVID-19), an influenza-like disease that chiefly infects the lungs through respiratory transmission. The spike protein of SARS-CoV-2, a transmembrane protein in its outer portion, targets angiotensin-converting enzyme 2 (ACE2) as the binding receptor for the cell entry. As ACE2 is highly expressed in the gut and pulmonary tissues, SARS-CoV-2 infections frequently result in gastrointestinal inflammation, with presentations ordinarily ranging from intestinal cramps to complications with intestinal perforations. However, the evidence detailing successful therapy for gastrointestinal involvement in COVID-19 patients is currently limited. A significant change in fecal microbiomes, namely dysbiosis, was characterized by the enrichment of opportunistic pathogens and the depletion of beneficial commensals and their crucial association to COVID-19 severity has been evidenced. Oral probiotics had been evidenced to improve gut health in achieving homeostasis by exhibiting their antiviral effects via the gut–lung axis. Although numerous commercial probiotics have been effective against coronavirus, their efficacies in treating COVID-19 patients remain debated. In ClinicalTrials.gov, 19 clinical trials regarding the dietary supplement of probiotics, in terms of Lactobacillus and mixtures of Bifidobacteria and Lactobacillus, for treating COVID-19 cases are ongoing. Accordingly, the preventive or therapeutic role of probiotics for COVID-19 patients can be elucidated in the near future. Full article
(This article belongs to the Special Issue Probiotics and Antimicrobial Effect)
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14 pages, 2419 KiB  
Article
An Outer Membrane Vesicle-Adjuvanted Oral Vaccine Protects Against Lethal, Oral Salmonella Infection
by Jaikin E. Harrell, Jonathan R. Kurtz, David L. Bauer, J. Timothy Prior, Patrick S. Gellings, Lisa A. Morici and James B. McLachlan
Pathogens 2021, 10(5), 616; https://doi.org/10.3390/pathogens10050616 - 18 May 2021
Cited by 11 | Viewed by 4574
Abstract
Non-typhoidal salmonellosis, caused by Salmonella enterica serovar Typhimurium is a common fecal-oral disease characterized by mild gastrointestinal distress resulting in diarrhea, chills, fever, abdominal cramps, head and body aches, nausea, and vomiting. Increasing incidences of antibiotic resistant invasive non-typhoidal Salmonella infections makes this [...] Read more.
Non-typhoidal salmonellosis, caused by Salmonella enterica serovar Typhimurium is a common fecal-oral disease characterized by mild gastrointestinal distress resulting in diarrhea, chills, fever, abdominal cramps, head and body aches, nausea, and vomiting. Increasing incidences of antibiotic resistant invasive non-typhoidal Salmonella infections makes this a global threat requiring novel treatment strategies including next-generation vaccines. The goal of the current study was to formulate a novel vaccine platform against Salmonella infection that could be delivered orally. To accomplish this, we created a Salmonella-specific vaccine adjuvanted with Burkholderia pseudomallei outer membrane vesicles (OMVs). We show that adding OMVs to a heat-killed oral Salmonella vaccine (HKST + OMVs) protects against a lethal, oral challenge with Salmonella. Further, we show that opsonizing anti-Salmonella antibodies are induced in response to immunization and that CD4 T cells and B cells can be induced when OMVs are used as the oral adjuvant. This study represents a novel oral vaccine approach to combatting the increasing problem of invasive Salmonella infections. Full article
(This article belongs to the Special Issue Novel Vaccine Strategies against Intracellular Bacteria)
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16 pages, 342 KiB  
Review
Salmonella, Food Safety and Food Handling Practices
by Olugbenga Ehuwa, Amit K. Jaiswal and Swarna Jaiswal
Foods 2021, 10(5), 907; https://doi.org/10.3390/foods10050907 - 21 Apr 2021
Cited by 347 | Viewed by 60224
Abstract
Salmonellosis is the second most reported gastrointestinal disorder in the EU resulting from the consumption of Salmonella-contaminated foods. Symptoms include gastroenteritis, abdominal cramps, bloody diarrhoea, fever, myalgia, headache, nausea and vomiting. In 2018, Salmonella accounted for more than half of the numbers [...] Read more.
Salmonellosis is the second most reported gastrointestinal disorder in the EU resulting from the consumption of Salmonella-contaminated foods. Symptoms include gastroenteritis, abdominal cramps, bloody diarrhoea, fever, myalgia, headache, nausea and vomiting. In 2018, Salmonella accounted for more than half of the numbers of foodborne outbreak illnesses reported in the EU. Salmonella contamination is mostly associated with produce such as poultry, cattle and their feeds but other products such as dried foods, infant formula, fruit and vegetable products and pets have become important. Efforts aimed at controlling Salmonella are being made. For example, legislation and measures put in place reduced the number of hospitalizations between 2014 and 2015. However, the number of hospitalizations started to increase in 2016. This calls for more stringent controls at the level of government and the private sector. Food handlers of “meat processing” and “Ready to Eat” foods play a crucial role in the spread of Salmonella. This review presents an updated overview of the global epidemiology, the relevance of official control, the disease associated with food handlers and the importance of food safety concerning salmonellosis. Full article
(This article belongs to the Special Issue Foodborne Pathogens and Food Safety)
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17 pages, 7747 KiB  
Article
Indol-3-Carbinol and Quercetin Ameliorate Chronic DSS-Induced Colitis in C57BL/6 Mice by AhR-Mediated Anti-Inflammatory Mechanisms
by Sina Riemschneider, Maximilian Hoffmann, Ulla Slanina, Klaus Weber, Sunna Hauschildt and Jörg Lehmann
Int. J. Environ. Res. Public Health 2021, 18(5), 2262; https://doi.org/10.3390/ijerph18052262 - 25 Feb 2021
Cited by 72 | Viewed by 7732
Abstract
Inflammatory bowel diseases (IBD), such as Crohn’s disease and ulcerative colitis, are multifactorial inflammatory disorders of the gastrointestinal tract, characterised by abdominal cramps, bloody diarrhoea, and anaemia. Standard therapies, including corticosteroids or biologicals, often induce severe side effects, or patients may develop resistance [...] Read more.
Inflammatory bowel diseases (IBD), such as Crohn’s disease and ulcerative colitis, are multifactorial inflammatory disorders of the gastrointestinal tract, characterised by abdominal cramps, bloody diarrhoea, and anaemia. Standard therapies, including corticosteroids or biologicals, often induce severe side effects, or patients may develop resistance to those therapies. Thus, new therapeutic options for IBD are urgently needed. This study investigates the therapeutic efficacy and safety of two plant-derived ligands of the aryl hydrocarbon receptor (AhR), quercetin (Q), and indol-3-carbinol (I3C), using a translationally relevant mouse model of IBD. Q and I3C are administered by gavage to C57BL/6 wild-type or C57BL/6 Ahr-/- mice suffering from chronic colitis, induced by dextran sulphate sodium (DSS). The course of the disease, intestinal histopathological changes, and in-situ immunological phenotype are scored over 25 days. Our results show that both Q and I3C improved significantly clinical symptoms in moderate DSS colitis, which coincides with a significantly reduced histopathological score. Even in severe DSS colitis I3C, neither Q nor the therapy control 6-thioguanine (6-TG) can prevent a fatal outcome. Moreover, treatment with Q or I3C restored in part DSS-induced loss of epithelial integrity by induction of tight-junction proteins and reduced significantly gut inflammation, as demonstrated by colonoscopy, as well as by immunohistochemistry revealing lower numbers of neutrophils and macrophages. Moreover, the number of Th17 cells is significantly reduced, while the number of Treg cells is significantly increased by treatment with Q or I3C, as well as 6-TG. Q- or I3C-induced amelioration of colitis is not observed in Ahr-/- mice suggesting the requirement of AhR ligation and signalling. Based on the results of this study, plant-derived non-toxic AhR agonists can be considered promising therapeutics in IBD therapy in humans. However, they may differ in terms of efficacy; therefore, it is indispensable to study the dose-response relationship of each individual AhR agonist also with regard to potential adverse effects, since they may also exert AhR-independent effects. Full article
(This article belongs to the Special Issue Toxicity of Medicinal Plants and Herbal Supplements)
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