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Archives of Disease in Childhood Aug 2016Environmental enteric dysfunction (EED) has been recognised as an important contributing factor to physical and cognitive stunting, poor response to oral vaccines,... (Review)
Review
Environmental enteric dysfunction (EED) has been recognised as an important contributing factor to physical and cognitive stunting, poor response to oral vaccines, limited resilience to acute infections and ultimately global childhood mortality. The aetiology of EED remains poorly defined but the epidemiology suggests a multifactorial combination of prenatal and early-life undernutrition and repeated infectious and/or toxic environmental insults due to unsanitary and unhygienic environments. Previous attempts at medical interventions to ameliorate EED have been unsatisfying. However, a new generation of imaging and '-omics' technologies hold promise for developing a new understanding of the pathophysiology of EED. A series of trials designed to decrease EED and stunting are taking novel approaches, including improvements in sanitation, hygiene and nutritional interventions. Although many challenges remain in defeating EED, the global child health community must redouble their efforts to reduce EED in order to make substantive improvements in morbidity and mortality worldwide.
Topics: Child; Duodenitis; Endoscopy, Gastrointestinal; Enteritis; Environment; Gastrointestinal Microbiome; Global Health; Growth Disorders; Health Status; Humans; Intestinal Mucosa; Jejunal Diseases; Microscopy, Confocal
PubMed: 26933151
DOI: 10.1136/archdischild-2015-309534 -
BMC Gastroenterology Feb 2022The purpose of this study was to investigate the diagnosis and treatment experience of traumatic duodenal ruptures in children.
BACKGROUND
The purpose of this study was to investigate the diagnosis and treatment experience of traumatic duodenal ruptures in children.
METHODS
Clinical data were collected from four children suffering from a traumatic duodenal rupture who were admitted to and treated by our hospital from January 2012 to December 2020. The early diagnosis and treatment, surgical plan, postoperative management, complications, and prognosis of each child were analyzed. The key points and difficulties of the diagnosis and treatment for this type of injury are summarized.
RESULTS
One child had an extreme infection caused by drug-resistant bacteria, which resulted in severe complications, including wound infection, dehiscence, and an intestinal fistula. One child developed an anastomotic stenosis after the duodenostomy, which improved following an endoscopic balloon dilatation. The other two children had no relevant complications after their operations. All four patients were cured and discharged from hospital. The average hospital stay was 48.25 ± 26.89 days. The follow-up period was 0.5 to 1 year. No other complications occurred, and all children had a positive prognosis.
CONCLUSIONS
The early identification of a duodenal rupture is essential, and surgical exploration should be carried out proactively. The principles of damage-control surgery should be followed as much as possible during the operation. Multidisciplinary cooperation and management are both important to reduce the occurrence of postoperative complications and improve cure rates.
Topics: Anastomosis, Surgical; Child; Dilatation; Duodenal Diseases; Duodenum; Humans; Postoperative Complications; Retrospective Studies
PubMed: 35151250
DOI: 10.1186/s12876-022-02136-w -
Nihon Rinsho. Japanese Journal of... Sep 2015
Topics: Anti-Bacterial Agents; Biopsy; Duodenum; Humans; Macrophages; Magnetic Resonance Imaging; Prognosis; Whipple Disease
PubMed: 26480785
DOI: No ID Found -
Indian Journal of Pathology &... 2021Strongyloides stercoralis is an intestinal nematode that infects humans, percutaneously and has a complex life cycle. We report a case of a thirty year old male...
Strongyloides stercoralis is an intestinal nematode that infects humans, percutaneously and has a complex life cycle. We report a case of a thirty year old male presenting with chief complaints of profuse watery diarrhoea, abdominal fullness, loss of appetite, creepy abdominal pain and low-grade fever for the last one month. He was on corticosteroids for systemic sclerosis. Endoscopy showed thickened and oedematous duodenal folds with pinpoint areas of bleeding and multiple ulcerations on the duodenal mucosa. Histopathologial examination of duodenal biopsy revealed infestation by Strongyloides stercoralis in the duodenum, the duodenal mucosal glands were occupied by various parts of parasite. The patient was successfully treated and had uneventful recovery.
Topics: Abdominal Pain; Adult; Animals; Anthelmintics; Biopsy; Duodenum; Endoscopy; Histological Techniques; Humans; Intestinal Mucosa; Male; Strongyloides stercoralis; Strongyloidiasis
PubMed: 33433432
DOI: 10.4103/IJPM.IJPM_359_19 -
Nature May 2019The intestinal immune system has the challenging task of tolerating foreign nutrients and the commensal microbiome, while excluding or eliminating ingested pathogens....
The intestinal immune system has the challenging task of tolerating foreign nutrients and the commensal microbiome, while excluding or eliminating ingested pathogens. Failure of this balance leads to conditions such as inflammatory bowel diseases, food allergies and invasive gastrointestinal infections. Multiple immune mechanisms are therefore in place to maintain tissue integrity, including balanced generation of effector T (T) cells and FOXP3 regulatory T (pT) cells, which mediate resistance to pathogens and regulate excessive immune activation, respectively. The gut-draining lymph nodes (gLNs) are key sites for orchestrating adaptive immunity to luminal perturbations. However, it is unclear how they simultaneously support tolerogenic and inflammatory reactions. Here we show that gLNs are immunologically specific to the functional gut segment that they drain. Stromal and dendritic cell gene signatures and polarization of T cells against the same luminal antigen differ between gLNs, with the proximal small intestine-draining gLNs preferentially giving rise to tolerogenic responses and the distal gLNs to pro-inflammatory T cell responses. This segregation permitted the targeting of distal gLNs for vaccination and the maintenance of duodenal pT cell induction during colonic infection. Conversely, the compartmentalized dichotomy was perturbed by surgical removal of select distal gLNs and duodenal infection, with effects on both lymphoid organ and tissue immune responses. Our findings reveal that the conflict between tolerogenic and inflammatory intestinal responses is in part resolved by discrete gLN drainage, and encourage antigen targeting to specific gut segments for therapeutic immune modulation.
Topics: Animals; CD4 Antigens; Cell Differentiation; Cell Movement; Cell Polarity; Dendritic Cells; Duodenum; Female; Lymph Nodes; Male; Mice; Mice, Inbred C57BL; Mouth; Rats; Rats, Wistar; Stromal Cells; T-Lymphocytes
PubMed: 30988509
DOI: 10.1038/s41586-019-1125-3 -
Gastrointestinal Endoscopy Feb 2019
Topics: Aged; Albendazole; Animals; Anticestodal Agents; Asthenia; Double-Balloon Enteroscopy; Duodenum; Female; Humans; Jejunum; Melena; Taenia saginata; Taeniasis
PubMed: 30172654
DOI: 10.1016/j.gie.2018.08.037 -
BMC Microbiology Jan 2022The bioactivities of commensal duodenal microbiota greatly influence the biofunction of hosts. We investigated the role of Helicobacter pylori infection in...
BACKGROUND
The bioactivities of commensal duodenal microbiota greatly influence the biofunction of hosts. We investigated the role of Helicobacter pylori infection in extra-gastroduodenal diseases by determining the impact of H. pylori infection on the duodenal microbiota. We sequenced 16 S rRNA genes in samples aspirated from the descending duodenum of 47 (male, 20; female, 27) individuals who were screened for gastric cancer. Samples were analysed using 16 S rRNA gene amplicon sequencing, and the LEFSe and Kyoto Encyclopaedia of Genes and Genomes methods were used to determine whether the duodenal microflora and microbial biofunctions were affected using H. pylori infection.
RESULTS
Thirteen and 34 participants tested positive and negative for H. pylori, respectively. We identified 1,404 bacterial operational taxonomic units from 23 phyla and 253 genera. H. pylori infection changed the relative mean abundance of three phyla (Proteobacteria, Actinobacteria, and TM7) and ten genera (Neisseria, Rothia, TM7-3, Leptotrichia, Lachnospiraceae, Megasphaera, F16, Moryella, Filifactor, and Paludibacter). Microbiota features were significantly influenced in H. pylori-positive participants by 12 taxa mostly classified as Gammaproteobacteria. Microbial functional annotation revealed that H. pylori significantly affected 12 microbial metabolic pathways.
CONCLUSIONS
H. pylori disrupted normal bacterial communities in the duodenum and changed the biofunctions of commensal microbiota primarily by upregulating specific metabolic pathways. Such upregulation may be involved in the onset of diseases associated with H. pylori infection.
Topics: Aged; Bacteroidetes; Duodenum; Dysbiosis; Female; Gastric Mucosa; Gastrointestinal Microbiome; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metabolic Networks and Pathways; Microbiota; Middle Aged; Proteobacteria; RNA, Ribosomal, 16S
PubMed: 35033024
DOI: 10.1186/s12866-022-02437-w -
BMC Microbiology Aug 2018The pathogenesis of Helicobacter pylori (H. pylori) infection-induced duodenal ulcer remains to be elucidated. Duodenal mucosal bicarbonate secretion is the most...
BACKGROUND
The pathogenesis of Helicobacter pylori (H. pylori) infection-induced duodenal ulcer remains to be elucidated. Duodenal mucosal bicarbonate secretion is the most important protective factor against acid-induced mucosal injury. We previously revealed that H. pylori infection downregulated the expression and functional activity of duodenal mucosal cystic fibrosis transmembrane conductance regulator (CFTR) and solute linked carrier 26 gene family A6 (SLC26A6) which are the two key duodenal mucosal epithelial cellular bicarbonate transporters to mediate duodenal bicarbonate secretion. In this study, we investigated the mechanism of H. pylori infection-induced duodenal CFTR and SLC26A6 expression downregulation.
RESULTS
We found that H. pylori infection induced the increase of serum transforming growth factor β (TGFβ) level and duodenal mucosal TGFβ expression and the decrease of duodenal mucosal CFTR and SLC26A6 expressions in C57 BL/6 mice. The results from the experiments of human duodenal epithelial cells (SCBN) showed that H. pylori increased TGFβ production and decreased CFTR and SLC26A6 expressions in SCBN cells. TGFβ inhibitor SB431542 reversed the H. pylori-induced CFTR and SLC26A6 expression decreases. The further results showed that TGFβ directly decreased CFTR and SLC26A6 expressions in SCBN cells. TGFβ induced the phosphorylation of p38 mitogen-activated protein kinase (MAPK) and P38 MAPK inhibitor SB203580 reversed the TGFβ-induced CFTR and SLC26A6 expression decreases.
CONCLUSIONS
H. pylori infection downregulates duodenal epithelial cellular CFTR and SLC26A6 expressions through TGFβ-mediated P38 MAPK signaling pathway, which contributes to further elucidating the pathogenesis of H. pylori-associated duodenal ulcer.
Topics: Animals; Antiporters; Bicarbonates; Cystic Fibrosis Transmembrane Conductance Regulator; Down-Regulation; Duodenum; Epithelial Cells; Helicobacter Infections; Helicobacter pylori; Imidazoles; Intestinal Mucosa; Male; Mice; Mice, Inbred C57BL; Pyridines; Sulfate Transporters; Transforming Growth Factor beta; p38 Mitogen-Activated Protein Kinases
PubMed: 30119655
DOI: 10.1186/s12866-018-1230-8 -
World Journal of Gastroenterology Mar 2022Research on celiac disease (CD) in northwest China is still in its infancy. At present, large-sample data on the epidemiological, clinical, and pathological...
BACKGROUND
Research on celiac disease (CD) in northwest China is still in its infancy. At present, large-sample data on the epidemiological, clinical, and pathological characteristics of CD are limited.
AIM
To investigate the epidemiological, clinical, and pathological characteristics of CD in northwest China.
METHODS
The clinical data of 2884 patients with gastrointestinal (GI) symptoms were retrospectively analyzed. Total immunoglobulin A (IgA) and anti-tissue transglutaminase (tTG) IgA levels were examined in all patients. Gastroscopy and colonoscopy were performed in patients with positive anti-tTG IgA and deficient total IgA levels. Atrophy of the duodenal and ileal villi was examined and histopathological examinations were performed. The modified Marsh-Oberhuber classification system was used to grade villous atrophy in the duodenum or distal ileum. The patients' () infection status was compared in terms of clinical presentation and Marsh grade. Statistical analyses were performed using the t-test or chi-square test.
RESULTS
Among the 2884 patients, 73 were positive for serum anti-tTG IgA, and 50 were diagnosed with CD. The CD detection rate was significantly higher in Kazakhs (4.39%) than in Uyghurs (2.19%), Huis (0.71%), and Hans (0.55%). The main symptoms of CD were chronic diarrhea, anorexia, anemia, fatigue, weight loss, sleep disorders, osteopenia, and osteoporosis. The body mass index of patients with CD was significantly lower than that of patients without CD. A total of 69 patients with positive serum anti-tTG IgA and two patients with deficient total IgA levels underwent GI endoscopy. Endoscopy revealed crypt hyperplasia and/or duodenal villous atrophy, mainly manifested as nodular mucosal atrophy, grooves, and fissures. The difference in infection rates was not statistically significant between CD and non-CD patients but was significantly different among CD patients with different Marsh grades.
CONCLUSION
Among the patients with GI symptoms in northwestern China, the prevalence of CD was more in the Uyghur and Kazakh populations. infection may be associated with CD severity.
Topics: Atrophy; Autoantibodies; Celiac Disease; Duodenum; Helicobacter Infections; Humans; Immunoglobulin A; Retrospective Studies; Transglutaminases
PubMed: 35431514
DOI: 10.3748/wjg.v28.i12.1272 -
Frontiers in Cellular and Infection... 2021The human salivary microbiota includes hundreds of bacterial species. Alterations in gut microbiota have been explored in Celiac Disease (CD), but fewer studies... (Review)
Review
The human salivary microbiota includes hundreds of bacterial species. Alterations in gut microbiota have been explored in Celiac Disease (CD), but fewer studies investigated the characteristics of salivary microbiome in these patients, despite the potential implications in its pathogenesis. Indeed, some recent studies suggested that the partial digestion of gluten proteins by some bacteria may affect the array of gluten peptides reaching the gut and the way by which those are presented to the intestinal immune system. The available clinical studies investigating the salivary microbiota in children and adults, are insufficient to make any reliable conclusion, even though some bacterial species/phyla differences have been reported between celiac patients and controls. However, the salivary microbiome could correlate better with the duodenal microbiota, than the fecal one. Therefore, further clinical studies on salivary microbiome by different and independent research groups and including different populations, are advisable in order to explore the usefulness of the salivary microbiome analysis and understand some aspects of CD pathogenesis with potential clinical and practical implications.
Topics: Adult; Celiac Disease; Child; Duodenum; Gastrointestinal Microbiome; Glutens; Humans; Microbiota
PubMed: 33680992
DOI: 10.3389/fcimb.2021.625162