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The Journal of Biological Chemistry May 2022Although capsaicin has been studied extensively as an activator of the transient receptor potential vanilloid cation channel subtype 1 (TRPV1) channels in sensory...
Although capsaicin has been studied extensively as an activator of the transient receptor potential vanilloid cation channel subtype 1 (TRPV1) channels in sensory neurons, little is known about its TRPV1-independent actions in gastrointestinal health and disease. Here, we aimed to investigate the pharmacological actions of capsaicin as a food additive and medication on intestinal ion transporters in mouse models of ulcerative colitis (UC). The short-circuit current (I) of the intestine from WT, TRPV1-, and TRPV4-KO mice were measured in Ussing chambers, and Ca imaging was performed on small intestinal epithelial cells. We also performed Western blots, immunohistochemistry, and immunofluorescence on intestinal epithelial cells and on intestinal tissues following UC induction with dextran sodium sulfate. We found that capsaicin did not affect basal intestinal I but significantly inhibited carbachol- and caffeine-induced intestinal I in WT mice. Capsaicin similarly inhibited the intestinal I in TRPV1 KO mice, but this inhibition was absent in TRPV4 KO mice. We also determined that Ca influx via TRPV4 was required for cholinergic signaling-mediated intestinal anion secretion, which was inhibited by capsaicin. Moreover, the glucose-induced jejunal Ivia Na/glucose cotransporter was suppressed by TRPV4 activation, which could be relieved by capsaicin. Capsaicin also stimulated ouabain- and amiloride-sensitive colonic I. Finally, we found that dietary capsaicin ameliorated the UC phenotype, suppressed hyperaction of TRPV4 channels, and rescued the reduced ouabain- and amiloride-sensitive I. We therefore conclude that capsaicin inhibits intestinal Cl secretion and promotes Na absorption predominantly by blocking TRPV4 channels to exert its beneficial anti-colitic action.
Topics: Amiloride; Animals; Capsaicin; Chlorides; Colitis; Colon; Glucose; Mice; Mice, Knockout; Ouabain; Sodium; TRPV Cation Channels
PubMed: 35314195
DOI: 10.1016/j.jbc.2022.101847 -
Medicine Jan 2023Endoscopic injection sclerotherapy (EIS) is a common treatment for patients with liver cirrhosis and esophageal varices. It can effectively treat variceal rupture and...
RATIONALE
Endoscopic injection sclerotherapy (EIS) is a common treatment for patients with liver cirrhosis and esophageal varices. It can effectively treat variceal rupture and bleeding caused by liver cirrhosis. However, EIS has many complications, including postoperative bleeding, retrosternal pain, esophageal ulcers, esophageal stenosis, and ectopic embolism. Intramural hematoma of the esophagus (IHE) is a rare complication of EIS that can lead to chest tightness, chest pain, and dysphagia.
PATIENTS CONCERNS
A 55-year-old man developed severe nausea and vomiting accompanied by chest pain after EIS.
DIAGNOSIS
Comprehensive imaging features, the patient was diagnosed as IHE.
INTERVENTIONS
A vascular clamp was used for hemostasia, and a feeding tube was placed in the patient's jejunum.
OUTCOMES
After the removal of the jejunal feeding tube and the intake of a semiliquid diet, the patient had no episodes of chest pain, chest tightness, or dysphagia and was discharged after 2 days of observation.
LESSONS
Although IHE rarely occurs after EIS, we should not overlook its risk. The occurrence of IHE is not directly related to the number of EISs received or the degree of liver cirrhosis but is more likely related to postoperative nausea and vomiting. Therefore, timely medication and observation are particularly important for patients with nausea and vomiting after endoscopic treatment.
Topics: Male; Humans; Middle Aged; Sclerotherapy; Deglutition Disorders; Esophageal and Gastric Varices; Liver Cirrhosis; Hematoma; Chest Pain; Vomiting; Gastrointestinal Hemorrhage
PubMed: 36705374
DOI: 10.1097/MD.0000000000032752 -
Revista Espanola de Enfermedades... May 2023A 61-year-old woman admitted for epigastric abdominal pain, three months of evolution, worsens after ingestion, associating abdominal distension and constipation....
A 61-year-old woman admitted for epigastric abdominal pain, three months of evolution, worsens after ingestion, associating abdominal distension and constipation. Physical examination: abdominal pain and distension in the mesogastric zone. Blood tests: slight increase in C-reactive protein; abdominal X-ray: the small bowel dilatation; computed tomography scan: small bowel obstruction due to intussusception. An exploratory laparotomy was performed, confirming a mechanical intestinal occlusion secondary to 5 centimeters jejunal intussusception (image 3); It was execute an intestinal resection with adequate margins and an anisoperistaltic mechanical side-to-side anastomosis. Correct postoperative evolution; hospital discharge on the sixth day. Pathology report: polypoid intussusception, 4.3x3.3 centimeters, superficial ulceration, edema, chronic inflammation; resection margins without alterations.
PubMed: 37204085
DOI: 10.17235/reed.2023.9698/2023 -
Clinical Immunology (Orlando, Fla.) Feb 2023Glycoprotein 2 (GP2) is an autoantigen in Crohn's (CD) and coeliac disease (CeD). We assessed GP2-isoform (GP2)-expression in intestinal biopsies of paediatric patients...
Glycoprotein 2 (GP2) is an autoantigen in Crohn's (CD) and coeliac disease (CeD). We assessed GP2-isoform (GP2)-expression in intestinal biopsies of paediatric patients with CD, CeD, ulcerative colitis (UC), and healthy children (HC). Transcription of GP2 was elevated in proximal small intestine in CeD and CD patients (only GP2) compared to jejunum (CeD/CD) and large bowel (CD). CeD patients demonstrated higher duodenal GP2-mRNA levels compared to HC/UC patients whereas CD patients showed higher GP2-mRNA levels compared to UC patients. Duodenal synthesis of only small GP2 isoforms (GP2) was demonstrated in epithelial cells in patients/HC and in Brunner glands (also large isoforms) with a more frequent apical location in CD/CeD patients. All four GP2 isoforms interacted with gliadin and phosphopeptidomannan. Gliadin digestion improved binding to GP2 isoforms. GP2 binding to CeD/CD-related antigens, elevated duodenal GP2-mRNA transcription, and GP2-protein secretion in Brunner glands of CeD/CD patients suggest an autoimmune CeD/CD link.
Topics: Humans; Child; Celiac Disease; Brunner Glands; Gliadin; GPI-Linked Proteins; Autoantibodies; Crohn Disease; Colitis, Ulcerative; Protein Isoforms; RNA, Messenger
PubMed: 36608744
DOI: 10.1016/j.clim.2022.109214 -
International Journal of Surgery Case... 2020Small intestinal telangiectasia is a clinically rare disease, which is mainly characterized by gastrointestinal bleeding. There is a lack of specific and effective...
INTRODUCTION
Small intestinal telangiectasia is a clinically rare disease, which is mainly characterized by gastrointestinal bleeding. There is a lack of specific and effective diagnostic methods in clinical practice due to its unknown etiology and difficult localization, it is often difficult to find the location of the lesion even through observation, touch, endoscope or intestinal incision.
CASE PRESENTATION
A 39-year-old female patient, who had black stool twice without obvious inducement 3 days ago, and came to our hospital for treatment and was hospitalized with gastrointestinal bleeding. the main manifestation of this patient was repeated black stool, sometimes dark red. Initially, we considered other diseases of the digestive tract (gastric ulcers, duodenal ulcers and intestinal tumors). However, no abnormalities were found by CT, gastroscopy and enteroscopy. Later, we considered that there was a greater possibility of intestinal vascular disease, and then blood clots was found in the upper and middle segment of the jejunum through capsule endoscopy, but no bleeding site was found. Therefore, we decided to open the abdomen for further intraoperative enteroscopy exploration, finally found the bleeding point, and then stopped the bleeding by suture. Later, through further follow-up, no rebleeding was found in the patient.
CONCLUSION
Jejunal telangiectasia with bleeding is a very rare intestinal vascular disease, which is difficult to identify and diagnose clinically. Therefore, the possibility of this disease should be considered in patients with negative results through some examinations such as gastroscopy, enteroscopy, gastrointestinal barium meal radiography, etc. In order to treat in time and prevent bleeding.
PubMed: 32066112
DOI: 10.1016/j.ijscr.2020.01.062 -
BMC Surgery Jan 2021Impaction of jujube pits in the upper gastrointestinal (GI) tract is a special clinical condition in the northern Chinese population. Endoscopic removal is the preferred...
BACKGROUND
Impaction of jujube pits in the upper gastrointestinal (GI) tract is a special clinical condition in the northern Chinese population. Endoscopic removal is the preferred therapy, but there is no consensus on the management strategies. We reported our individualized endoscopic strategies on the jujube pits impacted in the upper GI tract.
METHODS
In this retrospective study, we included 191 patients (male: 57; female: 134) who presented to our hospital with ingestion of jujube pits between January 2015 and December 2017. Demographic information, times of hospital visiting, locations of jujube pits, endoscopic procedures, post-extraction endoscopic characteristics were analyzed. Management strategies including sufficient suction, repeated irrigation, jejunal nutrition and gastrointestinal decompression were given based on post-extraction endoscopic characteristics and impacted locations.
RESULTS
Peak incidence was in the second quarter of each year (85/191 cases, 44.5%). Among the 191 cases, 169 (88.5%) showed pits impaction in the esophagus, 20 (10.5%) in the prepyloric region and 2 (1.0%) in the duodenal bulb. A total of 185 patients (96.9%) had pits removed with alligator jaw forceps, and 6 (3.1%) underwent suction removal with transparent caps placed over the end of the endoscope to prevent injury on removal of these pits with two sharp painted edges. Post-extraction endoscopic manifestations included mucosal erosion (26.7%), mucosa laceration (24.6%), ulceration with a white coating (18.9%) and penetrating trauma with pus cavity formation (29.8%). All patients received individualized endoscopic and subsequent management strategies and showed good outcomes.
CONCLUSIONS
Individualized endoscopic management for impacted jujube pits in the upper GI tract based on post-extraction endoscopic characteristics and impacted locations was safe, effective, and minimally invasive.
Topics: China; Female; Foreign Bodies; Humans; Male; Middle Aged; Retrospective Studies; Upper Gastrointestinal Tract; Ziziphus
PubMed: 33407359
DOI: 10.1186/s12893-020-01008-y -
Acta Veterinaria Scandinavica Jul 2023Post-weaning diarrhoea (PWD) is a multifactorial condition and the most well documented infectious cause is enterotoxigenic Escherichia coli. The objective of the study...
BACKGROUND
Post-weaning diarrhoea (PWD) is a multifactorial condition and the most well documented infectious cause is enterotoxigenic Escherichia coli. The objective of the study was to investigate possible associations between pathological manifestations and pathogens in pigs with and without PWD. The study was conducted as a case-control study and included a total of 173 pigs from 9 different commercial intensive indoor production herds in eastern Denmark.
RESULTS
Based on clinical examination, a total of 89 piglets with PWD (cases) and 84 piglets without PWD (controls) were included. Most of the pigs (n = 105/173) presented gastric lesions, which were more frequently observed in the control group. The odds of gastric ulcers were lower among pigs with PWD compared to pigs without PWD with an odds ratio (OR) of 0.2 (0.0; 0.7). Abnormal content in the colon was associated with PWD, with an OR of 6.5 (3.2; 14.3). No apparent association was found between lesions and the various pathogens or a combination of these. The odds of neutrophilic granulocyte infiltration were lower in the jejunum among pigs with PWD (OR 0.3 [0.1; 0.6]) compared to pigs without PWD. The association between neutrophilic granulocyte infiltration in jejunum and PWD differed between the herds (P = 0.03). Furthermore, the associations between PWD and hyperleukocytosis (P = 0.04) or infiltration of eosinophilic granulocytes (P = 0.04) in ileum were also herd dependent. Histopathology revealed several lesions not relatable to PWD.
CONCLUSION
The association between lesions and specific pathogens or PWD is more complex than anticipated.
Topics: Animals; Swine; Escherichia coli Infections; Case-Control Studies; Diarrhea; Gastrointestinal Tract; Jejunum; Swine Diseases
PubMed: 37400879
DOI: 10.1186/s13028-023-00693-y -
International Journal of Surgery... Sep 2019Mini-One Anastomosis Gastric Bypass is a new operation that provides comparable outcomes to the common bariatric procedures. Revisional surgery is still needed after a...
BACKGROUND
Mini-One Anastomosis Gastric Bypass is a new operation that provides comparable outcomes to the common bariatric procedures. Revisional surgery is still needed after a number of MGB-OAGB procedures. The aim of this study is to report the causes and management of these revisions.
METHODS
From 2010 to 2018, 925 MGB-OAGB operations were performed at 7 bariatric units across the United Kingdom and included in this retrospective cohort study. The data was retrospectively collected and analysed. The primary end point was the identification of the causes and management of revisions. Follow up ranged from 6 months to 3 years.
RESULTS
Twenty-two patients [2.3%] required revisional surgery after MGB-OAGB. Five patients [0.5%] developed severe diarrhoea managed by shortening the bilio-pancreatic limb to 150 cm. Four patients [0.4%] developed afferent loop syndrome and bile reflux was reported in another 3 [0.3%] cases; all were managed by either conversion to Roux en Y Gastric Bypass or a Braun anastomosis. Postoperative bleeding was controlled laparoscopically in 3 patients [0.3%]. Liver decompensation that was reported in 2 patients [0.2%] was treated by shortening the BPL in one patient and a reversal to normal anatomy in another. The liver failure resolved in both patients. Other indications for revision included two gastro-jejunal stenosis [0.2%], one perforated ulcer [0.1%], one patient [0.1%] with excessive weight loss and one case [0.1%] of protein malnutrition. None of the 22 patients undergoing revisional surgery after MGB-OAGB died. Lost to follow up rate was 0.2%.
CONCLUSION
Complications requiring revisional surgery after MGB-OAGB are uncommon [2.3%] and the majority can be managed by bilio-pancreatic limb shortening, the addition of a Braun side-to-side anastomosis or conversion to RYGB. Bilio-pancreatic limb length of 200 cm or more resulted in serious complications of liver failure, protein malnutrition, excessive weight loss and diarrhoea.
Topics: Adult; Aged; Anastomosis, Surgical; Female; Gastric Bypass; Humans; Laparoscopy; Male; Middle Aged; Retrospective Studies; Weight Loss
PubMed: 31299430
DOI: 10.1016/j.ijsu.2019.07.003 -
Annals of Gastroenterology 2021Thrombotic microangiopathy (TMA) is a serious complication following kidney transplantation. Although intestinal TMA is a major organ injury and causes abdominal pain,...
Thrombotic microangiopathy (TMA) is a serious complication following kidney transplantation. Although intestinal TMA is a major organ injury and causes abdominal pain, diarrhea and bloody stools, the clinical and endoscopic characteristics of small intestinal TMA remain unclear. Here, we report a drug-induced small intestinal TMA, which did not meet the laboratory-defined TMA criteria but was diagnosed by balloon-assisted enteroscopy (BAE). A 32-year-old woman who underwent kidney transplantation at the age of 10 years complained of abdominal pain, diarrhea and bloody stools one month after starting everolimus (EVE) as an immunosuppressant. Although she did not meet the diagnostic criteria for TMA serologically, BAE revealed a circumferential ulcer in the jejunum, and the pathological findings of a biopsy specimen showed microvascular thrombi, compatible with intestinal TMA. Her symptoms improved upon the discontinuation of EVE, demonstrating that EVE can cause drug-induced intestinal TMA. The present case suggests that BAE should be performed when abdominal pain, diarrhea, and bloody stools occur in patients receiving immunosuppressive medication following kidney transplantation, even if there is no evidence of TMA according to the laboratory definition.
PubMed: 33414631
DOI: 10.20524/aog.2020.0561 -
Revista Espanola de Enfermedades... Sep 2019the relationship between small bowel transit time (SBTT) of the capsule endoscopy (CE) and the diagnosis of small bowel bleeding (SBB) is controversial. (Observational Study)
Observational Study
BACKGROUND
the relationship between small bowel transit time (SBTT) of the capsule endoscopy (CE) and the diagnosis of small bowel bleeding (SBB) is controversial.
OBJECTIVE
to evaluate the relationship between SBTT and CE and the identification of SBB.
MATERIAL AND METHODS
CE was divided according to SBTT into < 4 hours and ≥ 4 hours.
RESULTS
CE with SBTT ≥ 4 hours identified more angioectasias (p = 0.023), single lesions (p = 0.029) and jejunal lesions (p = 0.001) with an OR of 3.13 (95% CI, 1.61-6.10, p = 0.001) to identify the cause of SBB.
CONCLUSIONS
CE SBTT of ≥ 4 hours increases the diagnosis of SBB.
Topics: Adult; Aged; Angiodysplasia; Capsule Endoscopy; Cross-Sectional Studies; Duodenal Diseases; Female; Gastrointestinal Hemorrhage; Gastrointestinal Transit; Humans; Ileal Diseases; Jejunal Diseases; Logistic Models; Male; Middle Aged; Retrospective Studies; Time Factors; Ulcer
PubMed: 31333041
DOI: 10.17235/reed.2019.5943/2018