Search Results (422)

Background/Objectives: Chronic inflammation and Western-style diets elevate colorectal cancer (CRC) risk, particularly in individuals with colitis, a feature of inflammatory bowel disease (IBD). Diets rich in polyphenol-containing functional foods, such as cocoa, may reduce gut inflammation and modulate the gut microbiome. This study investigated the impact of cocoa polyphenol (CP) supplementation on inflammation and microbiome composition in mice with colitis, fed either a healthy or Western diet, before, during, and after the onset of disease. We hypothesized that CPs would attenuate inflammation and promote distinct shifts in the microbiome, especially in the context of a Western diet. Methods: A 2 × 2 factorial design tested the effects of the basal diet (AIN93G vs. total Western diet [TWD]) and CP supplementation (2.6% w/w CocoaVia™ Cardio Health Powder). Inflammation was induced using the AOM/DSS model of colitis. Results: CP supplementation did not reduce the severity of colitis, as measured by disease activity index or histopathology. CPs did not alter gene expression in healthy tissue or suppress the colitis-associated pro-inflammatory transcriptional profile in either of the two diet groups. However, fecal microbiome composition shifted significantly with CPs before colitis induction, with persistent effects on several rare taxa during colitis and recovery. Conclusions: CP supplementation did not mitigate inflammation or mucosal injury at the tissue level, nor did it affect the expression of immune-related genes. While CPs altered microbiome composition, most notably in healthy mice before colitis, these shifts did not correspond to changes in inflammatory signaling. Basal diet remained the primary determinant of inflammation, mucosal damage, and colitis severity in this model. Full article

Patients with Inflammatory Bowel Disease (IBD) exhibit a dysregulated immune response that may be further exacerbated by bioactive compounds, such as histamine. Current dietary guidelines for IBD primarily focus on symptom management and flare-up prevention, yet targeted nutritional strategies addressing histamine metabolism remain largely unexplored. This narrative review aims to summarize the existing literature on the complex interplay between IBD and histamine metabolism and propose a novel dietary framework for managing IBD progression in patients with histamine intolerance (HIT). Relevant studies were identified through a comprehensive literature search of PubMed/MEDLINE, Google Scholar, ScienceDirect, Scopus, and Web of Science. The proposed low-histamine diet (LHD) aims to reduce the overall histamine burden in the body through two primary strategies: (1) minimizing exogenous intake by limiting high-histamine and histamine-releasing foods and (2) reducing endogenous histamine production by modulating gut microbiota composition, specifically targeting histamine-producing bacteria. In parallel, identifying individuals who are histamine-intolerant and understanding the role of histamine-degrading enzymes, such as diamine oxidase (DAO) and histamine-N-methyltransferase (HNMT), are emerging as important areas of focus. Despite growing interest in the role of histamine and mast cell activation in gut inflammation, no clinical trials have investigated the effects of a low-histamine diet in IBD populations. Therefore, future research should prioritize the implementation of LHD interventions in IBD patients to evaluate their generalizability and clinical applicability. Full article

Objective: Gut dysbiosis has been implicated in the pathology of inflammatory bowel disease (IBD). There is some evidence to suggest that the use of antibiotic treatment can incite an early clinical response or remission when used in conjunction with standard-of-care (SOC) therapy to treat IBD-related flares. Furthermore, antibiotics have been historically investigated for use as a bridge when initiating biologic therapy while waiting for peak biologic treatment effect to occur. This study investigated and compared the time to clinical response when treated with combination antibiotics, metronidazole monotherapy, or SOC therapy in pediatric patients with an active IBD flare. Methods: This study was a retrospective, Institution Review Board-approved, single-centered cohort study which included patients who were less than 18 years of age with a confirmed diagnosis of IBD who received conventional treatment alone or with either combination antibiotic therapy or metronidazole monotherapy to treat an active IBD flare between March 2013 and January 2024. Patients were excluded if they received antibiotic therapy to treat an active infection, had positive stool cultures or enteric pathogen polymerase chain reaction panel, or had colonic disease limited to the rectum. Results: Fifty-nine patients were included and divided into metronidazole monotherapy (n = 18), SOC therapy (n = 20), and combination antibiotics (n = 21). The primary outcome of days to clinical response was not significantly different across all groups; however, patients who received combination antibiotics achieved the fastest time to clinical response (median (IRQ))—4 days (1, 65), compared to 7.5 days (1, 119) for the SOC group and 9 days (2, 217) for the metronidazole group. Secondary outcomes of achievement of clinical response, remission, or failure were determined to be non-significant between all groups. Conclusions: There is no significant difference in time to clinical response, attaining clinical response or remission, or treatment failure rate for patients treated with combination antibiotics, metronidazole monotherapy, or SOC. However, results of this study suggest that the use of combination antibiotics plus SOC may lead to a faster time to clinical response and remission compared to SOC therapy alone. Further studies are warranted to elucidate the role of antimicrobial therapy in management of pediatric IBD. Full article

Objective: Intestinal ultrasound (IUS) is increasingly valued as a noninvasive tool for inflammatory bowel disease (IBD) management, offering real-time, radiation-free assessment of bowel wall thickness, vascularity, and complications. While IUS is widely adopted in Europe, data on its use in Turkey is scarce. This study aims to address this gap. Methods: A nationwide, cross-sectional survey was conducted targeting 817 adult and 150 pediatric gastroenterologists in Turkey. The survey included 26 structured questions on demographics, familiarity with and use of IUS, and barriers to implementation. Results: A total of 191 gastroenterologists participated in this survey, with 56% being adult gastroenterologists (n = 107) and 44% pediatric gastroenterologists (n = 84). Regarding whether they participated in IUS training, 73% (n = 140) of the 191 respondents stated they had not received training. There were notable differences in how IUS was utilized among gastroenterologists: 29% (n = 31) of adult gastroenterologists performed IUS independently, compared to just 2% (n = 2) of pediatric gastroenterologists (p < 0.001). In total, 63% (n = 67) of adult gastroenterologists and 46% (n = 39) of pediatric gastroenterologists reported not using IUS. Altogether, 94% (n = 179) emphasized the necessity of educational opportunities, and 86% (n = 165) favored national guidelines. Conclusions: Our findings reveal that the current application of IUS in Turkey fails to correspond with its expected advantages in managing IBD. Limited educational opportunities are a major challenge, emphasizing the necessity for coordinated educational programs and national guidelines. The expanded adoption of the IUS might significantly improve Turkey’s management of IBD. What is known: Intestinal ultrasound (IUS) is a non-invasive, cost-effective, and reliable imaging method increasingly recognized for its utility in diagnosing and monitoring inflammatory bowel disease (IBD). What is new: This is the first national survey assessing the awareness, usage patterns, and barriers to the adoption of IUS among gastroenterologists in Turkey. The study highlights significant gaps in training opportunities while also identifying strategies to promote IUS integration into routine clinical practice. The findings may encourage similar efforts in other regions where IUS remains underutilized, ultimately improving IBD management and patient outcomes globally. Full article

Cardiovascular disease remains the leading global cause of mortality, with inflammation now recognized as a central driver of atherosclerosis and other cardiometabolic conditions. Recent advances have repositioned perivascular adipose tissue from a passive structural element to an active endocrine and immunomodulatory organ, now a key focus in cardiovascular and metabolic research. Among the most promising tools for assessing perivascular adipose tissue inflammation is the fat attenuation index, a non-invasive imaging biomarker derived from coronary computed tomography angiography. This review explores the translational potential of the fat attenuation index for cardiovascular risk stratification and treatment monitoring in both coronary artery disease and systemic inflammatory or metabolic conditions (psoriasis, systemic lupus erythematosus, inflammatory bowel disease, obesity, type 2 diabetes, and non-obstructive coronary syndromes). We summarize evidence linking perivascular adipose tissue dysfunction to vascular inflammation and adverse cardiovascular outcomes. Clinical studies reviewing the fat attenuation index highlight its ability to detect subclinical inflammation and monitor treatment response. As research advances, standardization of measurement protocols and imaging thresholds will be essential for routine clinical implementation. Full article

Background & Aims: treat-to-target approach is essential for improving outcomes in inflammatory bowel disease (IBD). This study aimed to assess real-world achievement in objective monitoring (clinical, biomarker, and endoscopic assessments) and the correlation between patient-reported outcomes (PROs) and treatment targets. Methods: This retrospective study included consecutive IBD patients from January 2020 to December 2024. Disease activity was assessed using the Harvey-Bradshaw Index (HBI), partial Mayo score, PRO2, and PRO3, along with C-reactive protein (CRP) levels and endoscopic scores (SES-CD, MES). Clinical outcomes were evaluated at baseline, 1 year, and 2 years. Results: Among 112 IBD patients (55% with CD, median age at diagnosis: 45.2 years), clinical remission rates at baseline, 1 year, and 2 years were; CD: 75.8%, 70.0%, and 55.8%; UC: 84.0%, 79.5%, and 81.4%. CRP normalization rates at the same time points were; CD: 54.8%, 41.7%, and 63.8% UC: 78.0%, 70.5%, and 81.8%. Endoscopic remission rates were; CD: 58.1%, 50.0%, and 50.0%, UC: 71.4%, 64.5%, and 51.7% Flare-ups were more frequent in CD than in UC (32% vs. 20%), with an 8.1% rate of IBD-related surgery. In CD, PRO2 and PRO3 strongly correlated with clinical remission (AUC = 0.885 and 0.881), moderately with biomarkers (AUC = 0.737 and 0.755), and modestly with endoscopic remission (AUC = 0.695 and 0.685). In UC, PRO2 showed a strong correlation with clinical remission (AUC = 0.972) and moderate correlations with biomarkers (AUC = 0.653) and endoscopy (AUC = 0.783). Conclusions: Clinical remission was more frequent in UC than in CD. PROs showed a strong correlation with clinical remission but only moderate associations with biomarkers and endoscopic remission in both CD and UC. Full article

Repairing and regenerating tissue barriers is a key challenge in regenerative medicine. Stem cells play a crucial role in restoring the structural and functional integrity of key epithelial barrier surfaces, including the skin and mucosa. This review analyzes the role of dental pulp stem cells (DPSCs) and their derivatives, including extracellular vesicles, conditioned medium, and intracellular factors, in accelerating skin wound healing. The key mechanisms include: (1) DPSCs regulating inflammatory microenvironments by promoting anti-inflammatory M2 macrophage polarization; (2) DPSCs activating vascular endothelial growth factor (VEGF) to drive angiogenesis; (3) DPSCs optimizing extracellular matrix (ECM) spatial structure through matrix metalloproteinase/tissue inhibitor of metalloproteinase (MMP/TIMP) balance; and (4) DPSCs enhancing transforming growth factor-β (TGF-β) secretion to accelerate granulation tissue formation. Collectively, these processes promote wound healing. In addition, we explored potential factors that accelerate wound healing in DPSCs, such as oxidative stress, mechanical stimulation, hypertension, electrical stimulation, and organoid modeling. In addition to demonstrating the great potential of DPSCs for skin repair, this review explores their translational prospects in mucosal regenerative medicine. It covers the oral cavity, esophagus, colon, and fallopian tube. Some studies have found that combining DPSCs and their derivatives with drugs can significantly enhance their biological effects. By integrating insights from skin and mucosal models, this review offers novel ideas and strategies for treating chronic wounds, inflammatory bowel disease, and mucosal injuries. It also lays the foundation for connecting basic research results with clinical practice. This represents a significant step forward in tackling these complex medical challenges and lays a solid scientific foundation for developing more targeted and efficient regenerative therapies. Full article

Background: Postbiotics are bioactive compounds derived from inactivated probiotic microorganisms that show potential for preventing and treating inflammatory diseases. This review aimed to evaluate the evidence on their therapeutic effects in inflammatory conditions. Methods: A search of PubMed, Scopus, and Web of Science databases from 2014 to 2024 identified 39 eligible studies. Article selection was conducted using the Rayyan platform, risk of bias was assessed with the Cochrane ROB 2 tool, and results were visualized with ROBVIS. Bibliometric networks were constructed using VOSviewer. Due to data heterogeneity, a meta-analysis was not performed; therefore, results were described and presented graphically. Results: The most commonly used microorganisms belonged to the Lactobacillaceae and Bifidobacteriaceae families, with heat inactivation as the predominant method. Postbiotics exert multifaceted anti-inflammatory effects by modulating cytokine expression, influencing immune cell signaling pathways, and strengthening epithelial barrier integrity. They regulate immune mechanisms such as the Th1/Th2 and Treg/Th17 balance, indicating their potential in treating inflammatory bowel diseases, autoimmune diseases, and metabolic syndrome. However, the heterogeneity of studies, their limitations, and risk of bias require cautious interpretation. Conclusions: Future research should focus on standardizing postbiotic preparations, conducting long-term clinical trials, and analyzing synergistic effects of different strains. Postbiotics offer a promising approach to managing inflammation, with potential applications in functional foods and nutraceuticals. Full article

(1) Background and Aims: Patients with inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC) face a significantly increased risk of malignancies, including a 10-fold higher risk for colorectal cancer (CRC) and a lifetime risk for cholangiocarcinoma (CCA) exceeding 20%. The mechanisms underlying this elevated risk remain elusive. This review consolidates recent findings on cancer risk in PSC-IBD patients, focusing on molecular pathways, diagnostic innovations, and prevention strategies. (2) Methods: A comprehensive PubMed search was performed to identify studies published through to March 2025 on oncogenic processes, molecular mechanisms, and advancements in diagnostic and preventive strategies for CRC and CCA in PSC-IBD patients. (3) Results: Surveillance guidelines recommend an annual colonoscopy for CRC and imaging combined with CA 19-9 monitoring for CCA. Recent studies highlight the role of molecular alterations, including epigenetic modifications, in tumorigenesis. Advances in molecular diagnostics, imaging, and endoscopic technologies are improving the accuracy and timeliness of cancer detection. (4) Conclusions: PSC-IBD patients remain at high risk for CRC and CCA, emphasizing the need for vigilant surveillance and advanced prevention strategies. Advances in early detection and precision diagnostics offer new opportunities to reduce the cancer burden in this high-risk population. Full article

Background/Objectives: Patients with inflammatory bowel disease (IBD), whether affected by Crohn’s disease (CD) or ulcerative colitis (UC), are burdened by disability and a reduced quality of life. The individual’s regular participation in daily working life is a key factor among its determinants. This work aims to quantify work absenteeism in patients with IBD, profiling it concerning specific demographic variables, the degree of disease activity, and the level of self-reported anxious symptoms. Methods: A cross-sectional observational study targeted patients with a known diagnosis of IBD with disease activity no greater than moderate who were either employed or engaged in regular student activities. Participants were administered the Beck Anxiety Inventory (BAI) for the assessment of anxious symptoms, the Patient-Reported Outcome 2 (PRO-2) for evaluating IBD disease activity, and the Health and Work Performance Questionnaire (HPQ) short form for the analysis of work absenteeism, measured both as absolute and relative over two time frames (the last 7 days and the last 4 weeks). Within the HPQ, Likert scale (0–10) questions were administered to assess self-perceived work productivity. Results: A total of 300 patients were included [median age 43.5 years, IBD (UC 55.7%, CD 44.3%, sex (males 54%, females 46%)], recording absolute absenteeism of 56 (36–76) and 2 (−8–20) hours lost over 4 weeks and 7 days, respectively. The factors associated with worse absolute and relative absenteeism (both at 7-days and 4-weeks) were having CD (p < 0.001), having previous surgery (p < 0.05), and, exclusively in the 4-week assessment, being female (p < 0.05) and a smoker (p < 0.05). The BAI demonstrated a moderate correlation with 4-week absolute absenteeism (ρ = 0.374, p < 0.001), progressively increasing with anxiety severity. Additionally, the BAI was an independent predictor of a 25% work productivity loss over 4 weeks (aOR: 1.1, 95% CI 1.06–1.142, β = 0.096, p < 0.001). Disease activity measured based on PRO-2 strongly correlated with 4-week (ρ = 0.53, p < 0.001) and 7-day (ρ = 0.47, p < 0.001) absolute absenteeism. Conclusions: In conclusion, work absenteeism in IBD patients may be driven by the IBD phenotype, sex, anxiety, and disease activity. Improving these parameters could enhance productivity. Full article

The gut serves as the main site for nutrient digestion and absorption. Simultaneously, it functions as the body’s largest immune organ, playing a dual role in sustaining physiological equilibrium and offering immunological defense against intestinal ailments. Maintaining the structural and functional integrity of the intestine is paramount for ensuring animal health and productivity. Puerarin, a naturally derived isoflavonoid from the Pueraria species, exhibits multifaceted bioactivities, such as antioxidant, anti-inflammatory, antimicrobial, and immunomodulatory properties. Emerging evidence highlights puerarin’s capacity to enhance gut health in farm animals through four pivotal mechanisms: (1) optimization of intestinal morphology via crypt-villus architecture remodeling, (2) augmentation of systemic and mucosal antioxidant defenses through Nrf2/ARE pathway activation, and (3) reinforcement of intestinal barrier function by regulating tight junction proteins (e.g., ZO-1, occludin), mucin secretion, intestinal mucosal immune barrier, the composition of microbiota, and the derived beneficial metabolites; (4) regulating the function of the intestinal nervous system via reshaping the distribution of intestinal neurons and neurotransmitter secretion function. This review synthesizes current knowledge on puerarin’s protective effects on intestinal physiology in farm animals, systematically elucidates its underlying molecular targets (including TLR4/NF-κB, MAPK, and PI3K/Akt signaling pathways), and critically evaluates its translational potential in mitigating enteric disorders such as post-weaning diarrhea and inflammatory bowel disease in agricultural practices. Full article

Inflammatory bowel diseases (IBDs), including Crohn’s disease (CD), ulcerative colitis (UC), and IBD-unclassified (IBD-U), are chronic inflammatory disorders of the gastrointestinal tract. Chronic inflammation in the course of IBD is an important initiating factor of fibrosis of the intestinal wall. Intestinal fibrosis is one of the most common and important complications of IBD and, due to the irreversibility of the process and the need for surgical treatment, currently poses a major clinical challenge. In this review, we presented in detail the process of intestinal wall fibrosis at the molecular, immunological, and clinical levels. We characterized the mediators, including transforming growth factor β (TGF-β), tumor necrosis factor-α (TNF-α), and others participating in this process. We also described the type 2 epithelial–mesenchymal transition (EMT) process closely associated with chronic inflammation, leading to excessive development of connective tissue in the intestinal wall in the course of IBD. Full article

Inflammatory bowel diseases (IBDs) are complex immune-mediated disorders characterised by an unpredictable direction and commonly associated metabolic comorbidities along with obesity and type 2 diabetes mellitus (T2DM). Recent evidence has highlighted the therapeutic capacity of glucagon-like peptide 1 receptor agonists (GLP-1 RAs), already employed in treating T2DM and obesity, in modulating systemic and intestinal inflammatory responses. This narrative review examines the general organic traits of GLP-1, with a specific awareness of its primary gastrointestinal actions and the efficacy of GLP-1 RAs in promoting weight loss and dealing with glycaemic control, mainly in sufferers with IBD. Furthermore, the effects of those agonists on the progression of IBD, their protection profile, their impact on bowel preparation for endoscopic procedures, and their therapeutic capacity, supported through preclinical and early clinical studies, are discussed. GLP-1 RAs appear to lessen the intestinal inflammatory burden by enhancing intestinal epithelial barrier features and modulating the gut microbiota. However, further clinical research will be necessary to verify whether GLP-1 RAs could play a position in IBD treatment. Full article

Background: Constipation is one of the most common gastrointestinal complaints among women, with a variety of contributing factors. We aimed to assess the role of colonoscopy in evaluating young women with constipation. Methods: A multi-center, large cohort, retrospective study included all data from colonoscopies performed between 2016 and 2023 in seven endoscopy departments. The indications and findings of the procedures were collected, and findings of young women aged ≤40 y with constipation as an indication were compared to older women and men of the same age groups. Results: The cohort comprised 377,795 patients, including 198,629 (52.6%) females and 179,166 (47.4%) males. In total, 7872 females underwent colonoscopy for constipation and other indications (Cohort 1). In addition, 6852 women were referred for a colonoscopy for constipation only (Cohort 2). In sum, 75% of colonoscopies in women <40 y were normal in both cohorts. In Cohort 1, inflammatory bowel diseases (IBD) were significantly higher in women <40 y with Ulcerative Colitis (UC) (1.2%) and Crohn’s disease (CD) (0.7%), p < 0.001). The rate of IBD was lower but still significant in Cohort 2. In both cohorts, diverticulosis and polyp rates exponentially increased with age >40 y, p < 0.001. Higher rates of diverticulosis and polyps were found among males <40 y in Cohort 1. One case (0.1%) of Colorectal cancer (CRC) was found in <40 y women. Similar IBD and CRC rates were found in males and females of all ages, p > 0.05. Conclusions: The diagnostic yield of colonoscopy for investigating isolated constipation in young females is not significant. Diagnostic work-up should be guided by accurate clinical understanding. Full article

Background/Objectives: Ileitis, or inflammation of the terminal ileum, is often linked to inflammatory bowel disease (IBD), especially Crohn’s disease, but may also arise from non-steroidal anti-inflammatory drug (NSAID) use. While NSAIDs are known to cause gastrointestinal injury, their role in ileitis and downstream metabolic consequences remains unclear. This study evaluated the relationship between NSAID use, biopsy-confirmed ileitis, and glucose metabolism abnormalities in patients with and without IBD. Methods: We conducted a retrospective cohort study of 3725 adults who underwent ileal biopsy between 2009 and 2022 at a tertiary care center. Patients were stratified based on histologic evidence of ileitis. Collected data included demographics, IBD status, NSAID and steroid use, hemoglobin A1C, fasting glucose, and diagnoses of abnormal glucose metabolism. Multivariable logistic and linear regression models adjusted for age, BMI, sex, steroid use, and IBD. Results: Of 3725 patients, 876 had biopsy-confirmed ileitis. NSAID use—categorized as current, historical, or inpatient—was not significantly associated with ileitis after adjustment. In contrast, IBD was the strongest independent predictor (p < 0.05). Although unadjusted analyses showed lower A1C in the ileitis group (p = 0.003), this was not significant after controlling for confounders (p = 0.084). No significant associations were found between ileitis and fasting glucose or abnormal glucose metabolism. Age and BMI were the dominant predictors of glycemic abnormalities. Conclusions: NSAID use was not associated with biopsy-confirmed ileitis or impaired glucose metabolism. Traditional metabolic risk factors were stronger predictors of glycemic abnormalities than localized ileal inflammation. Full article