Gastrointestinal Diseases

胃肠道疾病
  • 文章类型: Journal Article
    背景:犬细小病毒2型(CPV-2)是感染犬的最常见的肠道病毒。CPV是主要由狗的临床胃肠道体征定义的传染病的病原体。在1970年代后期,CPV-2是一种能够感染家犬并在世界各地生长的新病毒。VP2基因是致病性的关键决定因素,抗原性,和CPV-2的宿主相互作用。
    目的:VP2基因的分子特征对于了解CPV进化和流行病学至关重要。
    方法:对编码VP2蛋白的基因进行测序并与全世界的参考菌株进行比较。最大似然法用于使用CPVVP2基因核苷酸序列构建系统发育树。
    结果:我们对VP2基因的系统发育分析显示,5个菌株非常相似,并且聚集在一起,三个菌株在2b进化枝中,而其他两个在2a/2b进化枝。
    结论:本文报道了两种新型CPV-2a/2b亚型在有胃肠道症状的犬中的分子特征。在包含编码结构蛋白VP2的开放阅读框(ORF)之一的CPV基因组区域上进行遗传分析。序列分析表明新的和未报告的序列变化,主要影响VP2基因,其中包括突变Ser297Ala和Leu87Met。这项研究代表了Türkiye中新的CPV-2a/2b亚型的第一个证据。由于VP2在编码CPV-2的衣壳蛋白中的关键作用及其在宿主-病毒相互作用中的重要参与,密切监测其进化变化并在寻找新的或预先存在的亚型时保持谨慎至关重要.
    结论:这项研究强调了连续分子研究对于获得有关新型CPV突变体循环的更多见解的重要性。
    BACKGROUND: Canine parvovirus type 2 (CPV-2) is the most common enteric virus that infects canids. CPV is the causative agent of a contagious disease defined mostly by clinical gastrointestinal signs in dogs. During the late 1970s, CPV-2 emerged as a new virus capable of infecting domestic dogs and growing across the world. The VP2 gene stands out as a key determinant in the pathogenicity, antigenicity, and host interactions of CPV-2.
    OBJECTIVE: The molecular characterization of the VP2 gene is crucial for understanding CPV evolution and epidemiology.
    METHODS: Genes encoding the VP2 protein were sequenced and compared to reference strains worldwide. The maximum likelihood method was used to build a phylogenetic tree using CPV VP2 gene nucleotide sequences.
    RESULTS: Our phylogenetic analysis of the VP2 gene revealed that five strains were very similar and clustered together, and three strains were in the 2b clade, whereas the other two were in the 2a/2b clade.
    CONCLUSIONS: This paper reports the molecular characterization of two novel CPV-2a/2b subtypes in dogs with gastrointestinal symptoms. Genetic analysis was conducted on a CPV genomic region encompassing one of the open reading frames (ORFs) encoding the structural protein VP2. Sequence analysis indicates new and unreported sequence changes, mainly affecting the VP2 gene, which includes the mutations Ser297Ala and Leu87Met. This study represents the first evidence of a new CPV-2a/2b subtype in Türkiye. Due to VP2\'s crucial role in encoding the capsid protein of CPV-2 and its significant involvement in the host-virus interaction, it is critical to closely monitor its evolutionary changes and be cautious while searching for novel or pre-existing subtypes.
    CONCLUSIONS: This study highlights the significance of continuous molecular research for acquiring more insights on the circulation of novel CPV mutants.
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  • 文章类型: Journal Article
    肠神经胶质细胞(EGCs)是肠神经系统(ENS)的重要组成部分,在胃肠道发育中起着关键作用。稳态,和疾病。来源于神经嵴细胞,EGC经历由各种信号通路调节的复杂分化过程。作为消化系统中最具活力的细胞之一,EGC对其周围微环境中的线索作出反应,并与肠道内的各种细胞类型和系统进行通信。形态学研究和最近的单细胞RNA测序研究揭示了EGC群体之间的异质性,对疾病中的区域功能和作用有影响。在胃肠道疾病中,包括炎症性肠病(IBD),感染和癌症,EGCs调节神经可塑性,免疫反应和肿瘤发生。最近的证据表明,EGCs对微环境线索有塑性反应,在疾病状态下调整其表型和功能并发挥关键作用。它们表现出分子异常并改变与其他肠道细胞类型的通讯,强调他们作为目标的治疗潜力。这篇综述深入探讨了EGC的多方面作用,特别强调它们与肠道中各种细胞类型的相互作用以及它们对胃肠道疾病的重要贡献。了解EGC在胃肠道生理学和病理学中的复杂作用对于开发胃肠道疾病的新型治疗策略至关重要。
    Enteric glial cells (EGCs) are an essential component of the enteric nervous system (ENS) and play key roles in gastrointestinal development, homeostasis, and disease. Derived from neural crest cells, EGCs undergo complex differentiation processes regulated by various signalling pathways. Being among the most dynamic cells of the digestive system, EGCs react to cues in their surrounding microenvironment and communicate with various cell types and systems within the gut. Morphological studies and recent single cell RNA sequencing studies have unveiled heterogeneity among EGC populations with implications for regional functions and roles in diseases. In gastrointestinal disorders, including inflammatory bowel disease (IBD), infections and cancer, EGCs modulate neuroplasticity, immune responses and tumorigenesis. Recent evidence suggests that EGCs respond plastically to the microenvironmental cues, adapting their phenotype and functions in disease states and taking on a crucial role. They exhibit molecular abnormalities and alter communication with other intestinal cell types, underscoring their therapeutic potential as targets. This review delves into the multifaceted roles of EGCs, particularly emphasizing their interactions with various cell types in the gut and their significant contributions to gastrointestinal disorders. Understanding the complex roles of EGCs in gastrointestinal physiology and pathology will be crucial for the development of novel therapeutic strategies for gastrointestinal disorders.
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  • 文章类型: Journal Article
    背景:急性健康急性护理中的种族不平等尚未得到很好的研究。我们研究了参与者种族如何影响未选择的胃肠道(GI)疾病患者的急诊治疗结果。
    方法:描述性,莱斯特大学医院急诊科参与者匿名患者水平数据的回顾性队列分析,从2018年1月1日至2021年12月31日,我们接受了胃肠道疾病诊断.感兴趣的主要接触是自我报告的种族,研究的两个结局是入院和患者是否接受了临床调查.混杂变量,包括性别和年龄,在分析中调整了剥夺指数和疾病敏锐度.卡方检验和Kruskal-Wallis检验用于检查结果指标和协变量之间的种族差异。多变量逻辑回归用于检查种族和结果测量之间的关联。
    结果:在34,337人中,中位年龄43岁,被确定为患有胃肠道疾病的急诊室,68.6%是白人。少数民族患者明显比白人患者年轻。所有种族的多急诊科出勤率相似(总体为18.3%)。白人患者的调查中位数最高(6,IQR3-7),而来自混合族裔的人最低(2,IQR0-6)。调整后的年龄,性别,出席年,多重剥夺和疾病敏锐度指数,与白种人患者相比,所有少数族裔患者接受现症调查的可能性仍然显著较低(亚裔:aOR0.80,95%CI0.74~0.87;黑人:0.67,95%CI0.58~0.79;混合:0.71,95%CI0.59~0.86;其他:0.79,95%CI0.67~0.93;全部p<0.0001).同样,调整后,少数族裔患者入院的可能性也明显较小(亚裔:aOR0.63,95%CI0.60-0.67;黑人:0.60,95%CI0.54-0.68;混合:0.60,95%CI0.51-0.71;其他:0.61,95%CI0.54-0.69;全部p<0.0001).
    结论:本研究观察到不同种族胃肠道疾病患者在使用模式和急性护理结果方面的显著差异。在对混杂因素以及剥夺和疾病敏锐度的测量进行调整后,这些差异仍然存在,并且表明与白人患者相比,少数民族个体不太可能接受调查或入院。
    BACKGROUND: Ethnic inequalities in acute health acute care are not well researched. We examined how attendee ethnicity influenced outcomes of emergency care in unselected patients presenting with a gastrointestinal (GI) disorder.
    METHODS: A descriptive, retrospective cohort analysis of anonymised patient level data for University Hospitals of Leicester emergency department attendees, from 1 January 2018 to 31 December 2021, receiving a diagnosis of a GI disorder was performed. The primary exposure of interest was self-reported ethnicity, and the two outcomes studied were admission to hospital and whether patients underwent clinical investigations. Confounding variables including sex and age, deprivation index and illness acuity were adjusted for in the analysis. Chi-squared and Kruskal-Wallis tests were used to examine ethnic differences across outcome measures and covariates. Multivariable logistic regression was used to examine associations between ethnicity and outcome measures.
    RESULTS: Of 34,337 individuals, median age 43 years, identified as attending the ED with a GI disorder, 68.6% were White. Minority ethnic patients were significantly younger than White patients. Multiple emergency department attendance rates were similar for all ethnicities (overall 18.3%). White patients had the highest median number of investigations (6, IQR 3-7), whereas those from mixed ethnic groups had the lowest (2, IQR 0-6). After adjustment for age, sex, year of attendance, index of multiple deprivation and illness acuity, all ethnic minority groups remained significantly less likely to be investigated for their presenting illness compared to White patients (Asian: aOR 0.80, 95% CI 0.74-0.87; Black: 0.67, 95% CI 0.58-0.79; mixed: 0.71, 95% CI 0.59-0.86; other: 0.79, 95% CI 0.67-0.93; p < 0.0001 for all). Similarly, after adjustment, minority ethnic attendees were also significantly less likely to be admitted to hospital (Asian: aOR 0.63, 95% CI 0.60-0.67; Black: 0.60, 95% CI 0.54-0.68; mixed: 0.60, 95% CI 0.51-0.71; other: 0.61, 95% CI 0.54-0.69; p < 0.0001 for all).
    CONCLUSIONS: Significant differences in usage patterns and disparities in acute care outcomes for patients of different ethnicities with GI disorders were observed in this study. These differences persisted after adjustment both for confounders and for measures of deprivation and illness acuity and indicate that minority ethnic individuals are less likely to be investigated or admitted to hospital than White patients.
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  • 文章类型: Journal Article
    2024年欧洲和北美儿科胃肠、肝病和营养学会发布了“儿童非食管嗜酸粒细胞性胃肠道疾病国际联合指南”,详细阐述了疾病的定义、流行病学、临床特征、诊治方法,为该病的临床实践提供了决策依据。本文对指南的主要内容进行解读。.
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  • 文章类型: Journal Article
    目的:确定具有不同化疗引起的呕吐(CIV)特征的患者亚组;确定这些亚组在几个人口统计学上的差异,临床,和症状特征;并评估与化疗引起的恶心和CIV概况相关的因素。
    接受癌症化疗的成年患者(N=1,338)。
    收集了人口统计数据,临床,和症状特征。使用参数和非参数检验评估具有不同CIV特征的患者亚组之间的差异。
    结果:ThreeCIV配置文件(无,减少,和增加)被确定。与None类相比,减少和增加的阶层更有可能有较低的家庭收入和较高的合并症负担,以及报告更高的口干率,恶心,腹泻,抑郁症,焦虑,睡眠障碍,早晨疲劳,和疼痛干扰。
    结论:临床医生需要评估CIV和化疗引起的恶心的常见和不同的危险因素。
    OBJECTIVE: To identify subgroups of patients with distinct chemotherapy-induced vomiting (CIV) profiles; determine how these subgroups differ on several demographic, clinical, and symptom characteristics; and evaluate factors associated with chemotherapy-induced nausea and CIV profiles.
    UNASSIGNED: Adult patients (N = 1,338) receiving cancer chemotherapy.
    UNASSIGNED: Data were collected on demographic, clinical, and symptom characteristics. Differences among subgroups of patients with distinct CIV profiles were evaluated using parametric and nonparametric tests.
    RESULTS: Three CIV profiles (None, Decreasing, and Increasing) were identified. Compared with the None class, Decreasing and Increasing classes were more likely to have lower household income and a higher comorbidity burden, as well as to report higher rates of dry mouth, nausea, diarrhea, depression, anxiety, sleep disturbance, morning fatigue, and pain interference.
    CONCLUSIONS: Clinicians need to assess common and distinct risk factors for CIV and chemotherapy-induced nausea.
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  • 文章类型: Journal Article
    功能性胃肠病(FGIDs),以腹痛为特征的慢性疾病,改变肠道运动,或它们的组合,在全球范围内的患病率超过40%,并造成很高的社会经济负担,生活质量显着下降。最近,FGID已被重新分类为肠-脑相互作用障碍(DGBI),反映了肠-脑双向交流在这些疾病中的关键作用及其对心理合并症的影响。虽然,在过去的几十年里,DGBIs领域取得了显著进步,DGBIs发病机制和病理生理学的分子机制,而肠道微生物组在这些过程中的作用还没有被完全理解。本文旨在讨论有关复杂的微生物群-肠-脑相互作用及其在DGBIs发病机理中的最新文献。更好地了解肠道微生物组和大脑之间的现有交流途径有望为DGBI开发有效的治疗干预措施。
    Functional gastrointestinal disorders (FGIDs), chronic disorders characterized by either abdominal pain, altered intestinal motility, or their combination, have a worldwide prevalence of more than 40% and impose a high socioeconomic burden with a significant decline in quality of life. Recently, FGIDs have been reclassified as disorders of gut-brain interaction (DGBI), reflecting the key role of the gut-brain bidirectional communication in these disorders and their impact on psychological comorbidities. Although, during the past decades, the field of DGBIs has advanced significantly, the molecular mechanisms underlying DGBIs pathogenesis and pathophysiology, and the role of the gut microbiome in these processes are not fully understood. This review aims to discuss the latest body of literature on the complex microbiota-gut-brain interactions and their implications in the pathogenesis of DGBIs. A better understanding of the existing communication pathways between the gut microbiome and the brain holds promise in developing effective therapeutic interventions for DGBIs.
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  • 文章类型: Journal Article
    胃肠道(GI)疾病的病因是复杂和多因素的,包括遗传易感性和肠道微生物群之间复杂的相互作用。细胞命运的改变,免疫功能调节,患病组织中的微环境组成由微生物和突变基因独立或通过协同相互作用控制。全面了解胃肠道疾病的病因对于制定精确的预防和治疗策略至关重要。然而,用于研究胃肠道疾病微环境的现有模型-无论是癌细胞系还是小鼠模型-都表现出明显的局限性。这导致类器官模型的繁荣。这篇综述首先描述了类器官模型的发展历史,随后详细演示了从实验室到临床的类器官应用。至于工作台的使用,我们提出了一种逐层阐明的宿主-微生物相互作用的类器官模拟,以及在分子机理分析中的应用。至于临床抑制,我们提供了从炎症性疾病到恶性肿瘤疾病的胃肠道疾病模拟中的类器官应用的广义解释。以及胃肠道疾病治疗,包括药物筛选,免疫疗法,以及微生物靶向和筛选治疗。这篇综述对类器官模型进行了全面而系统的描述,为从实验室到临床的类器官模型的利用提供了新的见解。
    The etiology of gastrointestinal (GI) diseases is intricate and multifactorial, encompassing complex interactions between genetic predisposition and gut microbiota. The cell fate change, immune function regulation, and microenvironment composition in diseased tissues are governed by microorganisms and mutated genes either independently or through synergistic interactions. A comprehensive understanding of GI disease etiology is imperative for developing precise prevention and treatment strategies. However, the existing models used for studying the microenvironment in GI diseases-whether cancer cell lines or mouse models-exhibit significant limitations, which leads to the prosperity of organoids models. This review first describes the development history of organoids models, followed by a detailed demonstration of organoids application from bench to clinic. As for bench utilization, we present a layer-by-layer elucidation of organoid simulation on host-microbial interactions, as well as the application in molecular mechanism analysis. As for clinical adhibition, we provide a generalized interpretation of organoid application in GI disease simulation from inflammatory disorders to malignancy diseases, as well as in GI disease treatment including drug screening, immunotherapy, and microbial-targeting and screening treatment. This review draws a comprehensive and systematical depiction of organoids models, providing a novel insight into the utilization of organoids models from bench to clinic.
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  • 文章类型: Editorial
    糖尿病,以其代谢作用而闻名,也严重影响肠神经系统(ENS),这对调节胃肠(GI)运动至关重要,分泌,和吸收。糖尿病引起的肠神经病的发展可导致各种胃肠道功能障碍,如胃轻瘫和不规则的排便习惯,主要是由于ENS内神经元和神经胶质细胞功能的破坏,以及氧化应激和炎症。这篇社论探讨了糖尿病患者肠神经病变发展的病理生理机制。此外,它讨论了诊断方法的最新进展,强调需要早期发现和干预,以减轻糖尿病患者的胃肠道并发症。社论还回顾了当前和新兴的治疗策略,专注于药物治疗,饮食管理,和潜在的神经调节干预措施。最终,这篇社论强调了多学科方法在治疗糖尿病肠神经病中的必要性,旨在提高患者的生活质量,并解决这种广泛疾病经常被忽视的并发症。
    Diabetes, commonly known for its metabolic effects, also critically affects the enteric nervous system (ENS), which is essential in regulating gastrointestinal (GI) motility, secretion, and absorption. The development of diabetes-induced enteric neuropathy can lead to various GI dysfunctions, such as gastroparesis and irregular bowel habits, primarily due to disruptions in the function of neuronal and glial cells within the ENS, as well as oxidative stress and inflammation. This editorial explores the pathophysiological mechanisms underlying the development of enteric neuropathy in diabetic patients. Additionally, it discusses the latest advances in diagnostic approaches, emphasizing the need for early detection and intervention to mitigate GI complications in diabetic individuals. The editorial also reviews current and emerging therapeutic strategies, focusing on pharmacological treatments, dietary management, and potential neuromodulatory interventions. Ultimately, this editorial highlights the necessity of a multidisciplinary approach in managing enteric neuropathy in diabetes, aiming to enhance patient quality of life and address a frequently overlooked complication of this widespread disease.
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  • 文章类型: Editorial
    在这篇社论中,我们评论了一篇题为“胃肠道疾病中与自噬相关的形态学和生化特征”的文章,发表在最近一期的《世界胃肠病学杂志》上。我们专注于“自噬与消化密切相关,分泌,和胃肠细胞的再生。“随着研究的推进,自噬,尤其是巨自噬在维持胃肠系统细胞平衡和应激反应中的关键作用,已经得到了广泛的研究。然而,有丝分裂的意义,具有泛素依赖性和非依赖性变体的独特选择性自噬途径,不应该被忽视。近几十年来,线粒体自噬已被证明与胃肠道疾病的发生发展密切相关,尤其是炎症性肠病,胃癌,还有结直肠癌.线粒体自噬和线粒体质量控制之间的相互作用对于阐明疾病机制至关重要。以及开发新的治疗策略。探索胃肠道疾病背后的发病机制,为患者提供个体化、高效的治疗是我们一直在探索的课题。本文就线粒体自噬在胃肠道疾病中的潜在作用机制进行综述,以期为胃肠道疾病的诊断和治疗提供新的思路。
    In this editorial, we comment on an article titled \"Morphological and biochemical characteristics associated with autophagy in gastrointestinal diseases\", which was published in a recent issue of the World Journal of Gastroenterology. We focused on the statement that \"autophagy is closely related to the digestion, secretion, and regeneration of gastrointestinal cells\". With advancing research, autophagy, and particularly the pivotal role of the macroautophagy in maintaining cellular equilibrium and stress response in the gastrointestinal system, has garnered extensive study. However, the significance of mitophagy, a unique selective autophagy pathway with ubiquitin-dependent and independent variants, should not be overlooked. In recent decades, mitophagy has been shown to be closely related to the occurrence and development of gastrointestinal diseases, especially inflammatory bowel disease, gastric cancer, and colorectal cancer. The interplay between mitophagy and mitochondrial quality control is crucial for elucidating disease mechanisms, as well as for the development of novel treatment strategies. Exploring the pathogenesis behind gastrointestinal diseases and providing individualized and efficient treatment for patients are subjects we have been exploring. This article reviews the potential mechanism of mitophagy in gastrointestinal diseases with the hope of providing new ideas for diagnosis and treatment.
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  • 文章类型: Letter
    暂无摘要。
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