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16 pages, 907 KB  
Review
Methylsulfonylmethane as a Bioactive Nutraceutical: Molecular Mechanisms, Clinical Evidence, Combination Therapy, Dosing, and Safety
by Yonghyun Yoon, Jihyo Hwang, Jungyoun Kim, Jonghyeok Lee, Seungbeom Kim, Youngmo Kim and King Hei Stanley Lam
Int. J. Mol. Sci. 2026, 27(20), 8967; https://doi.org/10.3390/ijms27208967 - 9 Oct 2026
Viewed by 447
Abstract
Methylsulfonylmethane (MSM; dimethyl sulfone) is an organosulfur nutraceutical used primarily for joint symptoms, although its molecular actions and clinical applicability beyond osteoarthritis remain uncertain. This narrative review integrates pharmacological, preclinical, and human evidence on MSM, with emphasis on musculoskeletal disorders, multi-ingredient formulations, dosing, [...] Read more.
Methylsulfonylmethane (MSM; dimethyl sulfone) is an organosulfur nutraceutical used primarily for joint symptoms, although its molecular actions and clinical applicability beyond osteoarthritis remain uncertain. This narrative review integrates pharmacological, preclinical, and human evidence on MSM, with emphasis on musculoskeletal disorders, multi-ingredient formulations, dosing, safety, toxicology, and clinical monitoring. Experimental studies implicate NF-κB and NLRP3 signaling, redox regulation, sulfur metabolism, and AMPK/mTOR/ULK1-related autophagy; however, most pathway-level evidence remains preclinical. Human clinical evidence is comparatively most developed for knee osteoarthritis, although it remains limited to small, short-term randomized trials reporting modest symptomatic improvement rather than established structural or disease-modifying benefit. Recent evidence syntheses also identify signals for glucosamine–MSM and glucosamine–chondroitin–MSM combinations, although certainty is limited and the independent contribution of MSM cannot be determined. Tendon studies largely evaluate multi-ingredient products, preventing attribution of benefit to MSM alone. Evidence in cardiometabolic disease, gastrointestinal health, exercise recovery, and toxicant exposure is preliminary. MSM is not a direct metal chelator and should not replace established chelation therapy. Short-term studies have used approximately 1–6 g/day with generally mild gastrointestinal adverse effects, whereas long-term safety, formal drug-interaction data, and clinically validated biomarker-guided dosing remain undefined. MSM should therefore be considered an adjunct with indication-dependent evidence rather than a broadly applicable anti-inflammatory or detoxification supplement. Full article
(This article belongs to the Collection Latest Review Papers in Bioactives and Nutraceuticals)
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15 pages, 469 KB  
Article
A Postbiotic Containing Limosilactobacillus fermentum CNCM I-2998 and Lactobacillus delbrueckii subsp. lactis CNCM I-4831 Reduces Bowel Movement Frequency in Healthy Adults with Self-Reported Unusually Frequent and Soft Stools
by Nize Otaru, Erik Eckhardt, Matthew R. Hayward, Tomoya Isaji, Yuki Kamioka, Britt Blokker and Gabriel Vinderola
Microorganisms 2026, 14(9), 1939; https://doi.org/10.3390/microorganisms14091939 - 2 Sep 2026
Viewed by 528
Abstract
Unusually frequent and soft stools may negatively impact the quality of life. A postbiotic containing heat inactivated Limosilactobacillus fermentum CNCM I-2998 and Lactobacillus delbrueckii subsp. lactis CNCM I-4831 has previously been shown to alleviate gastrointestinal symptoms and diarrhea in patients with clinically diagnosed [...] Read more.
Unusually frequent and soft stools may negatively impact the quality of life. A postbiotic containing heat inactivated Limosilactobacillus fermentum CNCM I-2998 and Lactobacillus delbrueckii subsp. lactis CNCM I-4831 has previously been shown to alleviate gastrointestinal symptoms and diarrhea in patients with clinically diagnosed gastrointestinal disorders. This study evaluated whether this postbiotic can support bowel movement frequency in Japanese healthy adults with self-reported frequent and soft stools. In a randomized, double-blind, placebo-controlled clinical trial, participants (n = 100) received the postbiotic (20 billion heat-inactivated cells per day) or placebo for four weeks. The primary endpoint was weekly bowel movement frequency. Secondary endpoints included days with bowel movements per week, sense of relief, stool characteristics (shape, color, odor, water content), gastrointestinal symptoms, and fecal microbiome composition. After four weeks, the postbiotic group showed significantly lower bowel movement frequency and fewer days with bowel movements when compared with the placebo group. Importantly, these reductions were not accompanied by decreased stool volume or increased hard stools or constipation symptoms. Mild changes in microbiome composition were detected across groups, and no adverse events were reported. These findings suggest that the postbiotic is safe and can help reduce bowel movement frequency in healthy individuals experiencing unusually frequent and soft stools. Full article
(This article belongs to the Section Gut Microbiota)
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15 pages, 281 KB  
Article
Comparative Effectiveness of Mebeverine and Otilonium Bromide on Health-Related Quality of Life in Patients with Irritable Bowel Syndrome: A Prospective Cohort Study
by Anh Thi Phuong Luu and Thong Duy Vo
Life 2026, 16(9), 1390; https://doi.org/10.3390/life16091390 - 24 Aug 2026
Viewed by 363
Abstract
Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that significantly impairs patients’ quality of life. Antispasmodics such as mebeverine and otilonium bromide (OB) are commonly used as first-line therapies; however, comparative evidence regarding their effectiveness and safety profile remains limited. This [...] Read more.
Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that significantly impairs patients’ quality of life. Antispasmodics such as mebeverine and otilonium bromide (OB) are commonly used as first-line therapies; however, comparative evidence regarding their effectiveness and safety profile remains limited. This study aimed to compare short-term changes in health-related quality of life and the occurrence of adverse events among IBS patients receiving mebeverine or otilonium bromide. A prospective cohort study was conducted from December 2024 to July 2025 among 110 IBS patients meeting the Rome IV criteria who received either mebeverine 200 mg or OB 40 mg twice daily for 4 weeks. The IBS-specific quality-of-life questionnaire (IBS-QOL) was interviewer-administered at baseline and after treatment (week 4). Adverse drug events were documented and classified according to the Common Terminology Criteria for Adverse Events (CTCAE). After 4 weeks, significant within-group improvements in the overall IBS-QOL score and most domain scores were observed in both treatment groups. In the unadjusted between-group analysis, the mean improvement in the overall IBS-QOL score was greater in the mebeverine group than in the otilonium bromide group (20.31 ± 13.17 vs. 14.62 ± 14.61; p = 0.034). However, treatment group was not independently associated with change in the overall IBS-QOL score after multivariable adjustment (OB vs. mebeverine: B = −4.63, 95% CI −10.28 to 1.02; p = 0.107). Nominal differences in activity interference and health worry did not remain statistically significant after Holm correction for multiple domain-level comparisons. Adverse events occurred in 9 of 110 patients (8.2%), with no significant difference between the mebeverine and otilonium bromide groups (11.7% vs. 4.0%; Fisher’s exact p = 0.178). All reported events were mild. In this prospective observational cohort, both mebeverine and otilonium bromide use was associated with short-term improvement in health-related quality of life and low rates of mild adverse events. Although the unadjusted change in the overall IBS-QOL score favored mebeverine, the adjusted analysis did not establish an independent difference between the two treatments. Full article
15 pages, 480 KB  
Review
Efficacy and Safety of Semaglutide in Patients with Polycystic Ovary Syndrome: A Scoping Review
by Sandro La Vignera and Rosita A. Condorelli
Biomedicines 2026, 14(8), 1845; https://doi.org/10.3390/biomedicines14081845 - 17 Aug 2026
Viewed by 1078
Abstract
Background/Objectives: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, characterised by hyperandrogenism, ovulatory dysfunction, and metabolic disturbances. Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), has emerged as a promising therapeutic option for weight management and [...] Read more.
Background/Objectives: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, characterised by hyperandrogenism, ovulatory dysfunction, and metabolic disturbances. Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), has emerged as a promising therapeutic option for weight management and metabolic optimisation in PCOS. This scoping review evaluates the efficacy and safety of semaglutide in women with PCOS, with pre-specified primary outcomes (weight loss, metabolic parameters) and secondary outcomes (menstrual cyclicity, hormonal regulation, ovarian function, safety). Methods: A systematic literature search was conducted across four electronic databases (SciSpace Deep Search, SciSpace Full Text, Google Scholar, and PubMed) from inception through July 2026. Studies were included if they evaluated semaglutide in women with confirmed PCOS and reported outcomes related to weight loss, hormonal regulation, metabolic parameters, ovarian function, or safety. Two independent reviewers screened 356 unique records; 28 reports were assessed for eligibility, of which full-text access was confirmed for 5, and the remaining 23 were assessed using published abstracts or conference summaries. Two additional records were subsequently excluded due to unverifiable source identification, yielding a final corpus of 25 studies. The review adhered to the PRISMA-ScR reporting guidelines. Results: Twenty-five studies met the inclusion criteria. Semaglutide produced clinically relevant weight reduction (mean 7.6–11.5 kg over 3–6 months; ≥5% weight loss in approximately 80% of patients in responsive cohorts) with concurrent improvements in fasting insulin and HOMA-IR, based predominantly on observational and small-sample study designs. Improvements in menstrual regularity were reported by several studies; however, these data derive largely from conference abstracts or small pilot studies and should be interpreted cautiously. Gastrointestinal adverse events were the most frequent side effects, generally mild-to-moderate and transient. Important safety considerations include gallbladder disease, pancreatitis, and the risk of inadvertent pregnancy exposure following the potential restoration of ovulatory function; semaglutide must be discontinued before planned conception. Conclusions: Based on preliminary evidence from heterogeneous and predominantly low-quality studies, semaglutide shows potentially beneficial effects on weight, metabolic health, and menstrual regularity in women with PCOS. Confirmatory data on ovulation rates, reproductive outcomes, and long-term safety from large-scale RCTs with standardised endpoints are needed before definitive clinical recommendations can be made. Full article
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17 pages, 1369 KB  
Review
Potential Mechanisms of Platelet Dysfunction and Bleeding in Acid Sphingomyelinase Deficiency
by Maksim Sysoev, Dmitri Solovyov, Aleksandr Shestopalov and Sergey Kutsev
Cells 2026, 15(15), 1338; https://doi.org/10.3390/cells15151338 - 26 Jul 2026
Viewed by 524
Abstract
Acid sphingomyelinase deficiency (ASMD) is an autosomal recessive lysosomal storage disorder caused by mutations in the SMPD1 gene, resulting in sphingomyelin accumulation. With a birth prevalence of 0.25–0.6 per 100,000, it is more prevalent in Ashkenazi Jewish and Middle Eastern populations. The disease [...] Read more.
Acid sphingomyelinase deficiency (ASMD) is an autosomal recessive lysosomal storage disorder caused by mutations in the SMPD1 gene, resulting in sphingomyelin accumulation. With a birth prevalence of 0.25–0.6 per 100,000, it is more prevalent in Ashkenazi Jewish and Middle Eastern populations. The disease features a clinical spectrum ranging from severe, early-onset neurodegeneration (infantile neurovisceral ASMD) to chronic, non-neurological visceral involvement (chronic visceral ASMD) and intermediate forms (chronic neurovisceral ASMD). The chronic visceral form is characterized by liver dysfunction, respiratory symptoms, and hepatosplenomegaly, which can lead to secondary thrombocytopenia. The majority of patients exhibit thrombocytopenia and/or mild bleeding manifestations, most commonly easy bruising and epistaxis, whereas clinically significant bleeding events, including gastrointestinal or variceal hemorrhage, occur less frequently. Systematic platelet-function studies in patients with ASMD are currently lacking. Evidence retrieved from biological models indicates that ASMD contributes to platelet dysfunction, including impaired secretion and thrombin generation, mediated by complex pathological mechanisms. These findings underscore the importance of hematological monitoring and further research in patients with this condition and could potentially offer new therapeutic possibilities. Full article
(This article belongs to the Special Issue Molecular and Cellular Insights into Platelet Function, 2nd Edition)
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4 pages, 1032 KB  
Interesting Images
Whipple Disease with Concurrent Mycobacterium szulgai Infection: A Rare Diagnostic and Therapeutic Challenge
by Nándor Giba, Kinga Orsolya Dunkel, Eszter Boros, Judit Csomor, Dóra Paróczai, Tamás Lantos and Anita Sejben
Diagnostics 2026, 16(15), 2315; https://doi.org/10.3390/diagnostics16152315 - 23 Jul 2026
Viewed by 462
Abstract
Whipple disease is a rare systemic infection caused by Tropheryma whipplei that often presents with nonspecific gastrointestinal symptoms and may mimic other disorders. We report the case of a 75-year-old woman with type 2 diabetes mellitus who presented with chronic diarrhoea and a [...] Read more.
Whipple disease is a rare systemic infection caused by Tropheryma whipplei that often presents with nonspecific gastrointestinal symptoms and may mimic other disorders. We report the case of a 75-year-old woman with type 2 diabetes mellitus who presented with chronic diarrhoea and a 15 kg unintentional weight loss over 6 months despite preserved appetite. Laboratory investigations revealed iron-deficiency anaemia, hypoproteinaemia, mild inflammatory and liver function abnormalities, and peripheral eosinophilia. Extensive infectious, autoimmune, and gastrointestinal investigations were unrevealing. Abdominal computed tomography demonstrated mesenteric lymphadenopathy, raising suspicion for lymphoma. Histopathological examination of duodenal biopsies revealed numerous foamy macrophages containing periodic acid–Schiff-positive, diastase-resistant granular material, consistent with Whipple disease. Ziehl–Neelsen staining additionally demonstrated acid-fast bacilli, and subsequent investigations confirmed concomitant Mycobacterium szulgai infection. The significance of this finding remains uncertain, as it may represent either true coinfection or incidental colonisation. A potential explanation is that T. whipplei-induced macrophage dysfunction creates a permissive intracellular niche for nontuberculous mycobacteria, although supporting evidence is lacking. Following antimicrobial therapy, the patient experienced marked clinical improvement with resolution of symptoms and an 8 kg weight gain. This case highlights the diagnostic challenges of Whipple disease and the need to consider concomitant mycobacterial infection when acid-fast organisms are identified. Full article
(This article belongs to the Special Issue Insights into Gastrointestinal Pathology)
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10 pages, 214 KB  
Review
Trastuzumab Emtansine–Associated Porto-Sinusoidal Vascular Disorder: Clinical Features and Outcomes from Published Cases
by Jiazheng Sun, Yanjie Lin and Hong Zhao
J. Clin. Med. 2026, 15(13), 4950; https://doi.org/10.3390/jcm15134950 - 25 Jun 2026
Viewed by 557
Abstract
Introduction: Ado-trastuzumab emtansine (T-DM1) is a targeted agent for human epidermal growth factor receptor 2 (HER2)-positive breast cancer, which combines the anti-tumor activity of trastuzumab with the cytotoxic effect of DM1, a microtubule inhibitor. Although T-DM1 has improved outcomes in patients with [...] Read more.
Introduction: Ado-trastuzumab emtansine (T-DM1) is a targeted agent for human epidermal growth factor receptor 2 (HER2)-positive breast cancer, which combines the anti-tumor activity of trastuzumab with the cytotoxic effect of DM1, a microtubule inhibitor. Although T-DM1 has improved outcomes in patients with HER2-positive breast cancer, portal hypertension may occur during treatment in the absence of overt cirrhosis on liver biopsy. These clinical and pathological features are consistent with porto-sinusoidal vascular disorder (PSVD). This study aimed to summarize the reported clinical, biochemical, imaging, histological, therapeutic, and prognostic features of T-DM1-associated PSVD. Methods: PubMed and Web of Science were searched for published cases of T-DM1-associated PSVD. Given the evolving terminology of PSVD, related terms, including non-cirrhotic portal hypertension and nodular regenerative hyperplasia, were also included in the search strategy. If the patient has a recorded history of T-DM1 exposure and the liver biopsy results meet PSVD criteria, the case is included regardless of whether there is clinical, endoscopic, or imaging evidence of portal hypertension. Cases without liver biopsy or with features suggestive of overt cirrhosis were excluded. Patient-level data were extracted and descriptively summarized, including demographic characteristics, clinical manifestations, biochemical indicators, imaging examination results, liver biopsy results, treatment methods, and prognosis. Unreported data were considered missing values and were not imputed. Results: Seven eligible articles comprising eight patients were identified. All patients were female, with a mean age of 60.38 years and a median age of 62.50 years. The interval from T-DM1 initiation to PSVD diagnosis ranged from 6 to 30 months. When reported, the mean interval from treatment initiation to symptom onset was 18.3 months. Thrombocytopenia and splenomegaly were observed in 7 of 8 patients. Mild elevations in alanine aminotransferase and aspartate aminotransferase were observed in all patients. Liver biopsy showed thinned and disorganized hepatic plates accompanied by nodular regeneration of hepatocytes in six patients. Clinical improvement was observed after discontinuation or modification of T-DM1 in most cases. Conclusions: T-DM1-associated PSVD is a rare but clinically significant complication that may develop months after treatment initiation. It commonly presents with thrombocytopenia, splenomegaly, gastrointestinal bleeding, or mild liver biochemical abnormalities in the absence of overt cirrhosis. Early recognition of unexplained platelet decline, splenic enlargement, or portal hypertension-related findings during T-DM1 therapy may facilitate timely diagnosis and individualized management. Withdrawal or modification of the suspected drug may contribute to clinical improvement, although further studies are needed to clarify the mechanism and optimal management strategy. Full article
(This article belongs to the Section Oncology)
12 pages, 16882 KB  
Article
Familial White–Sutton Syndrome Caused by a Pathogenic POGZ p.Arg508* Variant: Intrafamilial Variability from Childhood to Adulthood
by Massimiliano Chetta, Simone Lattarulo, Michele Stasi, Yevheniia Krylovska, Patrizia Lastella, Nicoletta Resta, Orazio Palumbo, Pietro Palumbo and Nenad Bukvic
Genes 2026, 17(6), 722; https://doi.org/10.3390/genes17060722 - 21 Jun 2026
Viewed by 1451
Abstract
Background/Objectives: White–Sutton syndrome (WHSUS; OMIM 616364) is a rare neurodevelopmental disorder caused by pathogenic variants in the POGZ gene and characterized by developmental delay, intellectual disability, speech impairment, autism spectrum features, and dysmorphic traits. Although most reported cases are sporadic, inherited forms are [...] Read more.
Background/Objectives: White–Sutton syndrome (WHSUS; OMIM 616364) is a rare neurodevelopmental disorder caused by pathogenic variants in the POGZ gene and characterized by developmental delay, intellectual disability, speech impairment, autism spectrum features, and dysmorphic traits. Although most reported cases are sporadic, inherited forms are exceptionally rare. We describe a familial case of WHSUS involving an affected mother and two children carrying a heterozygous POGZ nonsense variant, highlighting marked intra-familial phenotypic variability and expanding the clinical spectrum of the disorder. Methods: Clinical evaluation included multidisciplinary assessments. Genetic testing was performed using clinical exome sequencing (CES) with a virtual neurodevelopmental disorder (NDD) gene panel, followed by Sanger confirmation and segregation analysis in family members. The POGZ transcript reference NM_015100.3 was used for variant nomenclature and verified with the Mutalyzer tool. CNV detection from NGS data was performed using the Alissa CNV caller (Agilent) and visualized via IGV; the Xp11.22 microduplication was confirmed by chromosomal microarray (aCGH) and parental segregation analyses. Results: CES identified the heterozygous pathogenic POGZ variant c.1522C>T (p.Arg508*) in the female proband (III6), an infant presenting with global developmental delay, hypotonia, speech impairment, gait abnormalities, and characteristic dysmorphic features. Segregation analysis demonstrated maternal inheritance and confirmed the presence of the variant in her affected brother (III4), who also carries a de novo 1.79 kb microduplication at Xp11.22, while the maternal grandparents tested negative, indicating a de novo origin in the mother. The mother exhibited an attenuated phenotype, including mild neuropsychiatric and gastrointestinal manifestations. The variant is predicted to undergo nonsense-mediated decay (NMD), consistent with a moderate clinical presentation; however, experimental validation was not performed. Conclusions: This report documents a rare familial occurrence of WHSUS with highly variable expressivity. Our findings broaden the phenotypic and molecular characterization of POGZ-related disorders and emphasize the importance of comprehensive segregation studies and early genomic diagnosis. While experimental data link POGZ deficiency to DNA repair defects, no longitudinal clinical studies have demonstrated increased cancer risk in WHSUS; therefore, formal malignancy screening guidelines cannot be established at present, and this issue deserves future study in larger cohorts or registries. Full article
(This article belongs to the Section Neurogenomics)
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19 pages, 3312 KB  
Article
Impact of Lipid Source on Protein Digestion and Absorption in Skimmed Goat Milk and Associated Intestinal Oxidative Stress Responses in a Caco-2 Cell Model
by Haiyan Xue, Bowei Ding, Baoyuan He, Jun Ma, Yanhui Lian and Wenmin Dong
Foods 2026, 15(7), 1200; https://doi.org/10.3390/foods15071200 - 2 Apr 2026
Viewed by 870
Abstract
Liquid infant formula has garnered increasing attention due to its mild thermal processing and superior retention of bioactive nutrients. Within such matrices, the lipid source is a critical determinant of protein digestion behavior, yet its influence on peptide bioavailability and intestinal homeostasis remains [...] Read more.
Liquid infant formula has garnered increasing attention due to its mild thermal processing and superior retention of bioactive nutrients. Within such matrices, the lipid source is a critical determinant of protein digestion behavior, yet its influence on peptide bioavailability and intestinal homeostasis remains undefined. Given that efficient peptide absorption is vital for the systemic delivery of bioactivity in infants, understanding the lipid–protein synergy is essential for formula optimization. Moreover, excessive oxidative stress is closely associated with impaired intestinal health and developmental disorders in infants, making the regulation of oxidative stress crucial for maintaining intestinal function. The present study evaluated the effects of three distinct lipid sources—soybean oil (SM), bovine milk fat (BM), and goat milk fat (GM)—on the physicochemical stability, proteolytic digestion, peptide release, intestinal absorption, and oxidative stress modulation of goat-milk-based infant formula. An integrated approach combining physicochemical characterization, in vitro simulated infant digestion, and a Caco-2 intestinal epithelial cell model was employed. we demonstrate that all three lipids (3% w/w) formed stable emulsions with uniform spherical structures and mean particle diameters of 117–300 nm, as visualized by laser confocal microscopy. Following in vitro simulation of infant gastrointestinal digestion, the SM group exhibited the most extensive protein hydrolysis, yielding the highest total peptide content (4.28 ± 0.10 mg/mL) and generated the highest number of peptides identified by LC-MS/MS (474 types). Bioinformatic analysis predicted that peptides from all groups possess potential antihypertensive, hypoglycemic, and immunomodulatory activities. The Caco-2 monolayer cell model demonstrated that although the GM group produced fewer identified peptide species than the SM group (365 types), it achieved significantly higher intestinal peptide absorption rate (55.34 ± 1.05%). Furthermore, the GM digests provided superior protection against H2O2-induced oxidative stress in Caco-2 cells, markedly reducing reactive oxygen species levels and suppressing the expression of pro-inflammatory cytokines TNF-α and IL-6. Collectively, these findings reveal that while soybean oil promotes more extensive proteolysis, the use of homologous goat milk lipid enhances peptide bioaccessibility and confers potential cytoprotective effects on intestinal epithelial cells, underscoring its potential as a preferred lipid source in infant formula formulations. Full article
(This article belongs to the Section Nutraceuticals, Functional Foods, and Novel Foods)
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9 pages, 2104 KB  
Case Report
Resolution of Chronic Diarrhoea Following Treatment of Periodontal Disease in a Cat
by Samantha Taylor, Charlie Tewson and Victoria Edmondson
Animals 2026, 16(5), 759; https://doi.org/10.3390/ani16050759 - 1 Mar 2026
Viewed by 5109
Abstract
An association between periodontal disease and comorbid disorders, including gastrointestinal signs, has been reported in cats and investigated in humans, where a bidirectional relationship between oral and gastrointestinal microbiomes exists. A 5-year-old neutered female domestic shorthair cat was presented with a 2-year history [...] Read more.
An association between periodontal disease and comorbid disorders, including gastrointestinal signs, has been reported in cats and investigated in humans, where a bidirectional relationship between oral and gastrointestinal microbiomes exists. A 5-year-old neutered female domestic shorthair cat was presented with a 2-year history of small-bowel diarrhoea. The cat’s appetite was reduced, and coat quality had deteriorated. On examination, the cat was found to have periodontal disease affecting multiple teeth and a matted coat. Biochemistry revealed mild hyperproteinaemia, haematology was unremarkable, cobalamin was normal, folate was elevated, and retroviral testing was negative. Abdominal ultrasound showed diffuse muscularis thickening without other abnormalities, and dental examination and radiography revealed missing teeth, a root remnant, stage 4 periodontal disease, and tooth resorption. Multiple extractions were performed, and multimodal analgesia was provided, including locoregional dental blocks. The cat’s appetite, body condition, energy levels, and coat quality improved after the procedure, and the diarrhoea completely resolved within a month of the procedure without any changes in diet, physical, social environment, or the use of any medications, and did not recur during the following 7 months. This case illustrates the potential role of periodontal disease in the development of gastrointestinal disease and the benefits outside the oral cavity of managing dental disease in cats. Full article
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9 pages, 890 KB  
Case Report
Cowden Syndrome in Childhood: Gastrointestinal Involvement in a Multisystem Genetic Disorder—A Case Report
by Maria Rogalidou, Nikolaos Katzilakis, Kalliopi Stefanaki, Konstantina Dimakou, Dafni Margoni, Iordanis Pelagiadis, Alexandra Papadopoulou and Eftichia Stiakaki
Reports 2026, 9(1), 21; https://doi.org/10.3390/reports9010021 - 9 Jan 2026
Cited by 1 | Viewed by 2159
Abstract
Background and Clinical significance: Cowden syndrome is an autosomal dominant disorder caused by germline loss-of-function mutations in the PTEN tumor suppressor gene. It is characterized by multiple hamartomas and an increased lifetime risk of malignancies affecting the breast, thyroid, endometrium, and gastrointestinal (GI) [...] Read more.
Background and Clinical significance: Cowden syndrome is an autosomal dominant disorder caused by germline loss-of-function mutations in the PTEN tumor suppressor gene. It is characterized by multiple hamartomas and an increased lifetime risk of malignancies affecting the breast, thyroid, endometrium, and gastrointestinal (GI) tract. Pediatric presentations may include macrocephaly, scrotal tongue, and intellectual disability. Gastrointestinal involvement is frequent, with juvenile-like hamartomatous polyps occurring in at least half of patients and distributed throughout the GI tract, posing a risk for malignant transformation. Early diagnosis and surveillance are crucial for improving patient outcomes. Case Presentation: We report a case of a 10-year-old Caucasian female with Cowden syndrome, with a history of a malignant germ cell tumor of the ovary consisting of a yolk sac tumor and low-grade immature teratoma diagnosed at age six, and thyroidectomy at age nine. The patient has mild intellectual disability. Routine radiological surveillance revealed a right colon intraluminal mass, prompting referral for pediatric gastroenterology evaluation. Endoscopy identified multiple polyps throughout the colon, stomach, and small intestine. Polypectomy of larger lesions was performed, and histopathology confirmed juvenile-like hamartomatous polyps without dysplasia or malignancy. This case highlights the necessity of comprehensive gastrointestinal evaluation in pediatric Cowden syndrome patients. Endoscopic surveillance is essential for early detection and management of polyps. Conclusions: Given the multisystem involvement and elevated cancer risk associated with PTEN mutations, a multidisciplinary approach that includes genetic counseling, dermatologic evaluation, and ongoing oncologic monitoring is recommended. Increased awareness of gastrointestinal manifestations enables timely intervention and may reduce morbidity and mortality in this high-risk population. Full article
(This article belongs to the Section Gastroenterology)
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24 pages, 1548 KB  
Article
Fecal Microbiota Transplantation for Autism Spectrum Disorder in Children: Results from a Prospective Open-Label Controlled Observational Study
by Dominykas Varnas, Arnas Kunevičius, Aurelijus Burokas and Vaidotas Urbonas
Medicina 2026, 62(1), 65; https://doi.org/10.3390/medicina62010065 - 28 Dec 2025
Cited by 7 | Viewed by 3704
Abstract
Background and Objectives: Autism spectrum disorder (ASD) is a prevalent neurodevelopmental disorder with an increasing global incidence. Gut microbiota dysbiosis is believed to be playing a role in ASD pathogenesis. Fecal microbiota transplantation (FMT) is emerging as a potential therapeutic strategy to [...] Read more.
Background and Objectives: Autism spectrum disorder (ASD) is a prevalent neurodevelopmental disorder with an increasing global incidence. Gut microbiota dysbiosis is believed to be playing a role in ASD pathogenesis. Fecal microbiota transplantation (FMT) is emerging as a potential therapeutic strategy to alleviate ASD-related and gastrointestinal symptoms, but data in pediatric ASD populations remain limited. Materials and Methods: We conducted a prospective, single-center, open-label controlled study to evaluate the efficacy of colonoscopic FMT in children with ASD. Participants were allocated to two groups: an intervention group that underwent a single FMT procedure and a control group. Gastrointestinal Symptoms Rating Scale (GSRS), Autism Diagnostic Observation Schedule (ADOS), Childhood Autism Rating Scale (CARS), Child Behavior Checklist (CBCL), and Parent Global Impression (PGI-R) scales were assessed for both groups at baseline and at set time points. Results: 30 participants were enrolled, with 15 in each group. At 8 weeks, no significant between-group differences were observed for the prespecified primary endpoint, change in ADOS scores. The intervention group showed significantly greater improvements in CARS (p < 0.001), PGI-R (p < 0.001), CBCL Internalizing Problems (p = 0.001), and GSRS (p = 0.037) compared with controls; CARS and PGI-R improvements persisted at 6 months. Within the intervention group, sustained improvements were noted in CARS, GSRS, and PGI-R up to 18 months. No serious adverse events were observed; three mild, self-limited adverse events were recorded following FMT. Conclusions: Colonoscopic FMT was associated with significant short-term improvements in gastrointestinal and caregiver-reported ASD symptoms (CARS), but not in ADOS scores. Some effects persisted long-term. However, due to a lack of blinding and possible selection bias, these findings should be interpreted as exploratory. Larger randomized controlled trials are needed to confirm efficacy and optimize protocols. Full article
(This article belongs to the Section Pediatrics)
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10 pages, 1171 KB  
Article
Efficacy of Adaptol® 500 mg Tablets in Patients with Anxiety and Somatic Symptoms of Anxiety Disorder: A Noninterventional Study
by Maris Taube, Guna Dansone and Yulia Troshina
J. Clin. Med. 2025, 14(22), 7972; https://doi.org/10.3390/jcm14227972 - 10 Nov 2025
Cited by 3 | Viewed by 3700
Abstract
Background: Anxiety disorders, including panic disorder, agoraphobia, specific phobias, and generalized anxiety disorder, are among the most frequent psychiatric conditions in primary care. They often present with somatic symptoms such as dyspnea, palpitations, chest or gastrointestinal discomfort, sweating, or flushing. Adaptol® [...] Read more.
Background: Anxiety disorders, including panic disorder, agoraphobia, specific phobias, and generalized anxiety disorder, are among the most frequent psychiatric conditions in primary care. They often present with somatic symptoms such as dyspnea, palpitations, chest or gastrointestinal discomfort, sweating, or flushing. Adaptol® is a non-benzodiazepine anxiolytic with nootropic properties that modulates the limbic-reticular system, hypothalamic emotional centers, and multiple neurotransmitter systems. This study aimed to assess the association between Adaptol® use and changes in anxiety symptoms, including somatic manifestations, in routine practice. Methods: A noninterventional observational study was conducted in 100 adults diagnosed with anxiety disorders in primary care. All received Adaptol® 500 mg as prescribed. Patients had to have mild-to-moderate anxiety (5–14 points according GAD-7) to be enrolled. Exclusion criteria ruled out individuals with concomitant psychiatric or severe somatic conditions and those with use of other medications or any interventions that could affect the symptoms. Anxiety severity and somatic symptom burden were assessed at baseline and after treatment. Results: Adaptol® treatment was associated with reduction in anxiety and somatic complaints. Improvements were reported in palpitations, chest discomfort, gastrointestinal disturbances, and autonomic symptoms. Greater benefit was observed in male patients, though without significance testing, and in those with severe baseline anxiety, as demonstrated by correlation between GAD-7 scores at baseline and changes after the treatment (r = 0.5). No unexpected adverse events occurred. Conclusions: In this real-world study, Adaptol® showed anxiolytic efficacy and good tolerability, improving both psychological and somatic manifestations of anxiety disorders. These findings support its use in primary care, especially in severe cases of anxiety. Controlled trials are needed to support these results. Full article
(This article belongs to the Special Issue Innovations in the Treatment for Depression and Anxiety)
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17 pages, 3106 KB  
Article
Hydrogel-Based Finger Foods: Enhancing Nutritional Intake and Swallowing Safety in Older Persons with Dysphagia
by Enrika Lazickaitė, Milda Keršienė, Viktorija Eisinaitė, Ina Jasutienė, Gytė Damulevičienė and Daiva Leskauskaitė
Nutrients 2025, 17(20), 3289; https://doi.org/10.3390/nu17203289 - 20 Oct 2025
Cited by 6 | Viewed by 1844
Abstract
Background: Dysphagia is a common problem in older adults, characterized as a swallowing disorder that prevents food from passing from the mouth to the esophagus. Besides impairing dietary intake and leading to malnutrition, dysphagia also severely restricts water intake. Purpose: This study aimed [...] Read more.
Background: Dysphagia is a common problem in older adults, characterized as a swallowing disorder that prevents food from passing from the mouth to the esophagus. Besides impairing dietary intake and leading to malnutrition, dysphagia also severely restricts water intake. Purpose: This study aimed to develop polysaccharide-based hydrogels as dysphagia-friendly finger foods designed to provide high water content and enable controlled vitamin delivery to older persons with dysphagia. Procedures: Agar–carboxymethylcellulose (Agar-CMC) composite hydrogels with incorporated vitamins C, B9, B, and D3 were developed and tested for their textural and rheological properties, vitamin stability during storage, and vitamin release under simulated gastrointestinal conditions. Finally, a fiberoptic endoscopic swallowing assessment and sensory evaluation were conducted. Main Findings: Increasing the agar concentration in Agar-CMC hydrogels improved their internal structure and handling properties as finger foods, while still being easily breakable during swallowing. Agar-CMC hydrogels’ structure protected vitamins during processing and six weeks of storage. Vitamin release started immediately and remained steady in the gastric phase, with a noticeable increase at the beginning of the intestinal phase, resulting in 70–100% vitamin release by the end of this phase. The Fiberoptic Endoscopic Swallowing Evaluation confirmed their suitability for individuals with mild to moderate oropharyngeal dysphagia, with a low risk of aspiration (1 point on the Penetration-Aspiration Scale out of 8). Principal Conclusions: The developed Agar-CMC hydrogels present a promising dysphagia-friendly finger food alternative with high water content. They effectively deliver essential vitamins throughout the gastrointestinal tract, and notably demonstrate a low aspiration risk, making them suitable for individuals with mild to moderate oropharyngeal dysphagia. Full article
(This article belongs to the Special Issue The Role of Nutrition and Lifecare on Malnutrition)
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13 pages, 957 KB  
Article
Food Safety Concerns: Anisakis spp. in Ready-to-Eat Fish from the Greek Market
by Evangelia N. Papapostolou, Serafeim C. Chaintoutis, Panagiota Gousia, Aggeliki Karpouza, Melania Kachrimanidou and Anastasia Diakou
Pathogens 2025, 14(10), 981; https://doi.org/10.3390/pathogens14100981 - 27 Sep 2025
Cited by 4 | Viewed by 4833
Abstract
Nematode parasites of the family Anisakidae can cause human disease when ingested, at the third larval stage (L3), through infected fish or fish products. While human infection is often asymptomatic, in some cases it may present with symptoms ranging from mild to severe [...] Read more.
Nematode parasites of the family Anisakidae can cause human disease when ingested, at the third larval stage (L3), through infected fish or fish products. While human infection is often asymptomatic, in some cases it may present with symptoms ranging from mild to severe gastrointestinal disorders, skin rash, itching, or even anaphylaxis. Ingestion of destroyed L3 (e.g., following processing, sanitisation, or cooking) may still trigger allergic reactions. In the present study, the occurrence of Anisakidae L3 in ready-to-eat (RTE) fish products was investigated. A total of 108 RTE fish products, representing eight species and five processing methods, were examined using (a) macroscopic inspection, (b) artificial digestion (AD), and (c) molecular analysis of both the AD material (to detect non-visible parasite fragments) and the larvae collected by the first two methods. Nematodes morphologically identified as Anisakidae L3 were detected in 32 of the 108 samples (29.62%). Molecular analysis of the AD product did not reveal additional positive samples and confirmed the identification of the isolated larvae as Anisakis simplex sensu stricto and Anisakis pegreffii. Given the public health importance of anisakidosis, the findings of this study provide valuable insight into the prevalence of contamination in RTE fish products currently available on the Greek market. Full article
(This article belongs to the Section Parasitic Pathogens)
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