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Zhongguo Ying Yong Sheng Li Xue Za Zhi... Dec 2023A peptic ulcer is a lesion (sore) on the stomach lining, or duodenum. Peptic ulcers are probably a twentieth-century condition. The ulcer disease continues to be a... (Review)
Review
A peptic ulcer is a lesion (sore) on the stomach lining, or duodenum. Peptic ulcers are probably a twentieth-century condition. The ulcer disease continues to be a significant source of worldwide morbidity and mortality. The Gastrointestinal ulcers and duodenal ulcers are considered the two most extreme types of peptic ulcers. Peptic ulcers are found to be caused by an excess of violent factors including Hydrochloric acid (HCL) pepsin, refluxed bile leukotrienes (LT), reactive oxygen species (ROS) and protective factors, these include mucus-bicarbonate barrier functions, prostaglandins (PGs), mucosal blood flow, cell regeneration and migration, non-enzymatic and enzymatic and certain growth factors. The primary cause of peptic ulcer disease is pylori infection and the use of NSAIDs. This review article underscores the importance of a multidisciplinary approach in the management of ulcers to improve patient outcomes and quality of life.
Topics: Humans; Peptic Ulcer
PubMed: 38755116
DOI: 10.62958/j.cjap.2023.006 -
Journal of Autoimmunity Jun 2024Many antibody responses induced by infection, vaccination or autoimmunity show signs of convergence across individuals with epitope-dependent selection of particular...
Many antibody responses induced by infection, vaccination or autoimmunity show signs of convergence across individuals with epitope-dependent selection of particular variable region gene segments and complementarity determining region 3 properties. However, not much is known about the relationship between antigen-specific effector cells and antigen-specific precursors present in the naïve B-cell repertoire. Here, we sought to address this relationship in the context of celiac disease, where there is a stereotyped autoantibody response against the enzyme transglutaminase 2 (TG2). By generating TG2-specific monoclonal antibodies from both duodenal plasma cells and circulating naïve B cells, we demonstrate a discord between the naïve TG2-specific repertoire and the cells that are selected for autoantibody production. Hence, the naïve repertoire does not fully reflect the epitope preference and gene usage observed for memory B cells and plasma cells. Instead, distinct naïve B cells that target particular TG2 epitopes appear to be selectively activated at the expense of TG2-binding B cells targeting other epitopes.
Topics: Celiac Disease; Humans; Autoantibodies; Transglutaminases; Protein Glutamine gamma Glutamyltransferase 2; Epitopes, B-Lymphocyte; GTP-Binding Proteins; Lymphocyte Activation; B-Lymphocytes; Plasma Cells; Female; Antibodies, Monoclonal; Epitopes; Male; Adult; Duodenum
PubMed: 38754235
DOI: 10.1016/j.jaut.2024.103241 -
Heliyon May 2024The reasons for gastrointestinal bleeding among patients with acquired immune deficiency syndrome (AIDS) were complex. Here we present an unusual case of...
BACKGROUND
The reasons for gastrointestinal bleeding among patients with acquired immune deficiency syndrome (AIDS) were complex. Here we present an unusual case of life-threatening gastrointestinal bleeding caused by a cytomegalovirus-induced duodenal ulcer in an AIDS patient.
CASE PRESENTATION
A 31-year-old male with AIDS was admitted on July 18, 2023, complaining of abdominal pain for 38 days and intermittent hematochezia for 12 days. During his hospitalization, gastrointestinal endoscopy attributed gastrointestinal bleeding to a giant duodenal ulcer. Furthermore, cytomegalovirus(CMV) infection was confirmed as the reason for the ulcer through metagenomic next-generation sequencing (mNGs), hematoxylin-eosin(HE) staining, and immunohistochemistry (IHC) staining for the biopsy tissue. The patient's gastrointestinal bleeding was stopped by interventional embolization. Following a 4-week course of anti-CMV treatment, the giant duodenal ulcer was cured.
CONCLUSIONS
For AIDS patients with gastrointestinal bleeding, the CMV-induced gastrointestinal ulcer should be considered. Comprehensive mothods (mNGs, HE staining and IHC staining for biopsy tissue) were benefit for confirmed diagnosis. Beside anti-CMV treatment, the interventional embolization is a choice for hemostasis.
PubMed: 38737287
DOI: 10.1016/j.heliyon.2024.e30112 -
Animals : An Open Access Journal From... Apr 2024ser. Enteritidis () is widely found in chickens and eggs, and it can potentially induce human illness. The investigation in this study centers on the impacts of...
ser. Enteritidis () is widely found in chickens and eggs, and it can potentially induce human illness. The investigation in this study centers on the impacts of long-term dietary supplementation with coated sodium butyrate (CSB) on intestinal well-being and the colonization of cecum in laying hens infected with We segregated a total of 120 Lohmann laying hens aged 51 weeks into four treatment categories: 0 (CON), 300 (CSB1), 500 (CSB2), and 800 (CSB3) mg/kg of CSB, supplemented with CSB from the first day of the experiment. A 24-week observation process was carried out for each laying hen. The was orally administered to all chickens on the morning of the first and third days of week 22 of the trial. After the challenge, egg production decreased the most in the CON group. Compared to the CON group, the three doses of CSB significantly improved egg production after the challenge ( < 0.05). challenge increased plasma DAO activity, but CSB supplementation reduced plasma DAO activity ( < 0.05). The challenge disrupted intestinal villi morphology; compared to the CON group, the three dosages of CSB resulted in an increase in villus height (VH) and the ratio of villus height to crypt depth (V/C) in the duodenum, jejunum, and ileum of infected laying hens ( < 0.05), with a significant increase in jejunal villus height ( < 0.05). A decrease in ileal crypt depth was also observed ( < 0.05). CSB2 and CSB3 markedly increased the content of butyric acid in the cecum ( < 0.05). Additionally, in contrast to those in the CON group, the propionic acid content in the CSB supplementation group increased ( < 0.05). Compared with those in the CON group, mRNA relative expression of the and in jejunum ( < 0.05) and mRNA relative expression of the in ileum ( < 0.05) were significantly lower, and mRNA relative expression of the in ileum ( < 0.05) were significantly higher in the CSB group. In addition, in contrast to the CON group, the CSB supplementation group significantly upregulated mRNA relative expression of the and ( < 0.05). Additionally, CSB supplementation reduced the number of and increased the number of Lactobacilli in the cecum ( < 0.05) and tended to increase the total bacteria count ( = 0.069) and reduce the count ( = 0.081). In conclusion, long-term dietary supplementation with coated sodium butyrate can alleviate intestinal injury and the colonization of cecum in laying hens infected with .
PubMed: 38731359
DOI: 10.3390/ani14091356 -
Scientific Reports May 2024Coccidiosis, an intestinal disease caused by Eimeria parasites, is responsible for major losses in the poultry industry by impacting chicken health. The gut microbiota...
Coccidiosis, an intestinal disease caused by Eimeria parasites, is responsible for major losses in the poultry industry by impacting chicken health. The gut microbiota is associated with health factors, such as nutrient exchange and immune system modulation, requiring understanding on the effects of Eimeria infection on the gut microbiota. This study aimed to determine the effects of Eimeria acervulina infection on the luminal and mucosal microbiota of the cecum (CeL and CeM) and ileum (IlL and IlM) at multiple time points (days 3, 5, 7, 10, and 14) post-infection. E. acervulina infection decreased evenness in CeL microbiota at day 10, increased richness in CeM microbiota at day 3 before decreasing richness at day 14, and decreased richness in IlL microbiota from day 3 to 10. CeL, CeM, and IlL microbiota differed between infected and control birds based on beta diversity at varying time points. Infection reduced relative abundance of bacterial taxa and some predicted metabolic pathways known for short-chain fatty acid production in CeL, CeM, and IlL microbiota, but further understanding of metabolic function is required. Despite E. acervulina primarily targeting the duodenum, our findings demonstrate the infection can impact bacterial diversity and abundance in the cecal and ileal microbiota.
Topics: Animals; Chickens; Cecum; Eimeria; Ileum; Coccidiosis; Gastrointestinal Microbiome; Poultry Diseases; Intestinal Mucosa
PubMed: 38729976
DOI: 10.1038/s41598-024-61299-6 -
JGH Open : An Open Access Journal of... May 2024represents the major pathogen in the pathophysiology of diverse gastrointestinal conditions. This study sought to determine the endoscopic aspect of the gastric mucosa...
Endoscopic mucosal phenotypes and endoscopic Sydney system gastritis assessment in relation to infection and upper digestive clinical signs: A 2-year study among patients with gastroduodenal disorders in Cameroon.
BACKGROUND AND AIM
represents the major pathogen in the pathophysiology of diverse gastrointestinal conditions. This study sought to determine the endoscopic aspect of the gastric mucosa in relation to infection in Cameroon.
METHODS
This study was conducted in three reference health facilities in Cameroon from October 2020 to October 2022. The study enrolled 494 consecutive volunteer dyspeptic patients attending to the gastroenterology department of the selected health facilities. A description of the aspect of gastric mucosa of all participants was performed during endoscopy examination, and biopsies were collected for detection using rapid urease tests.
RESULTS
Gastritis, ulcerated lesions, duodenitis, esophagitis, normal mucosa aspect, bulbitis, and gastric neoplastic lesions were found in 40.1, 22.3, 10.9, 10.3, 9.7, 6.3, and 0.40% of biopsy samples, respectively. Erythematous/exudative (45.9%) and enterogastric reflux (12.2%) were the main gastritis types recorded. was present in 58.1, 46.3, 87.1, 66.7, and 61.8% in gastritis, duodenitis, bulbitis, esophagitis, and ulcerated lesions, respectively. A positive relationship was noticed between the presence of and gastritis (1.037 [0.720-1.493]; = 0.845), bulbitis (4.237 [1.602-11.235]; = 0.004), esophagitis (1.515 [0.822-2.793]; = 0.183), ulcerated lesions (1.233 [0.798-1.904]; = 0.345), erythematous/exudative gastritis (1.354 [0.768-2.389]; = 0.295), and enterogastric reflux gastritis (1.159 [0.492-2.733]; = 0.736).
CONCLUSION
Gastritis and erythematous/exudative gastritis are the most frequent gastrointestinal pathophysiology conditions in dyspeptic patient in our milieu. infection is responsible for 94.8% of the gastrointestinal pathophysiology conditions with bulbitis as the condition is significantly associated with this bacterium infection.
PubMed: 38725943
DOI: 10.1002/jgh3.13060 -
Turkish Journal of Surgery Dec 2023Secondary peritonitis is caused by infection of the peritoneal cavity due to perforation of the alimentary tract. Mannheim's peritonitis ındex (MPI) is a prognostic...
OBJECTIVES
Secondary peritonitis is caused by infection of the peritoneal cavity due to perforation of the alimentary tract. Mannheim's peritonitis ındex (MPI) is a prognostic scoring system that predicts outcomes in peritonitis. Increasing MPI scores correlate with poor outcomes and mortality. The objective of this study is to evaluate the effectiveness of MPI-based prognosis and its impact on Indian patients with secondary peritonitis.
MATERIAL AND METHODS
For understanding the effectiveness of the MPI scoring system, a cross-sectional data analysis of published studies on secondary peritonitis from 10 geographical locations in India was performed. The 10-site study results were compared with unpublished in-house study data for individual MPI parameters to analyze any variations of MPI score-based predictions across a diverse Indian population. Patients were divided into risk groups on the basis of MPI scores: <21 mild, MPI= 21-29 moderate, MPI> 29 severe risk.
RESULTS
We observed a significant correlation between mortality with age and gender as reported worldwide. Site of perforations were prevalent in the upper alimentary tract with the majority being gastro-duodenal for the Indian population as opposed to distal parts in the western population. Higher lethality in India is often associated with evolution time, organ failure, and sepsis due to delayed presentation and poor management.
CONCLUSION
MPI scoring is effective in predicting risk across geographically diverse Indian populations. The sensitivity and specificity of MPI scores are more reliable and a score >29 specifically recommends aggressive resuscitation & monitoring of patients, initiation of broad-spectrum antibiotics, and intensive care support to reduce mortality and morbidity.
PubMed: 38694533
DOI: 10.47717/turkjsurg.2023.6043 -
Frontiers in Immunology 2024Carcinoembryonic antigen-related cell adhesion molecule 5 (CEACAM5), as a typical tumor marker, has been found to exert immunomodulatory effects in many diseases. We...
BACKGROUND
Carcinoembryonic antigen-related cell adhesion molecule 5 (CEACAM5), as a typical tumor marker, has been found to exert immunomodulatory effects in many diseases. We previously reported the clinical and molecular evidences supporting that SARS-Cov-2 infected the gastrointestinal (GI) tract and found a reduction of CEACAM5 in COVID-19 patients' feces which associated with gut dysbiosis. Yet the role of CEACAM5 in GI infection is ill-defined.
METHODS
Mice models were established through intraperitoneally injecting with recombinant viral spike-Fc to mimic the intestinal inflammation. We collected duodenum, jejunum, ileum and colon samples after 6h, 2 days, 4 days and 7 days of spike-Fc or control-Fc injection to perform proteomic analysis. Blood was collected from healthy donors and peripheral blood mononuclear cells (PBMC) were separated by density gradient centrifugation, then CD4+ T cells were isolated with magnetic beads and co-cultured with Caco-2 cells.
RESULTS
In addition to intestinal CEACAM5, the expression of tight junction and the percent of CD4+ T lymphocytes were significantly decreased in spike-Fc group compared to control (p < 0.05), accompanied with increased level of inflammatory factors. The KEGG analysis revealed differentially expressed proteins were mainly enriched in the coronavirus disease (COVID-19), tight junction, focal adhesion, adherens junction and PI3K-Akt signaling pathway. Protein-protein interaction (PPI) network analysis identified the interaction between CEACAM5 and Galectin-9 that was also verified by molecular docking and co-IP assay. We further confirmed a reduction of CEACAM5 in SARS-CoV-2 spike stimulated enterocytes could promote the expression of Galectin-9 protein in CD4+T cells. Then it gave rise to the increasing release of inflammatory factors and increased apoptosis of CD4+T cells by inhibition of PI3K/AKT/mTOR pathway. Ultimately intestinal barrier dysfunction happened.
CONCLUSION
Our results indicated that CEACAM5 overexpression and Galectin-9 knockdown played a protective role in intestinal barrier injury upon spike-Fc stimulation. Collectively, our findings identified firstly that SARS-CoV-2 spike induced intestinal barrier dysfunction through the interaction between CEACAM5 and Galectin-9. The result provides potential therapeutic targets in intestinal barrier dysfunction for treating severe COVID patients.
Topics: Animals; Female; Humans; Male; Mice; Caco-2 Cells; Carcinoembryonic Antigen; CD4-Positive T-Lymphocytes; COVID-19; Disease Models, Animal; Galectins; GPI-Linked Proteins; Intestinal Mucosa; SARS-CoV-2; Signal Transduction; Spike Glycoprotein, Coronavirus
PubMed: 38686388
DOI: 10.3389/fimmu.2024.1303356 -
BMC Surgery Apr 2024The primary duodenal gastrointestinal stromal tumor (GIST) is a rare type of gastrointestinal tract tumor. Limited resection (LR) has been increasingly performed for...
BACKGROUND
The primary duodenal gastrointestinal stromal tumor (GIST) is a rare type of gastrointestinal tract tumor. Limited resection (LR) has been increasingly performed for duodenal GIST. However, only a few studies reported minimally invasive limited resection (MI-LR) for primary duodenal GIST.
METHODS
The clinical data of 33 patients with primary duodenal GIST from December 2014 to February 2024 were retrospectively analyzed including 23 who received MI-LR and 10 who received laparoscopic or robotic pancreaticoduodenectomy (LPD/RPD).
RESULTS
A total of 33 patients with primary duodenal GIST were enrolled and retrospectively reviewed. Patients received MI-LR exhibited less OT (280 vs. 388.5min, P=0.004), EBL (100 vs. 450ml, P<0.001), and lower morbidity of postoperative complications (52.2% vs. 100%, P=0.013) than LPD/RPD. Patients received LPD/RPD burdened more aggressive tumors with larger size (P=0.047), higher classification (P<0.001), and more mitotic count/50 HPF(P=0.005) compared with patients received MI-LR. The oncological outcomes were similar in MI-LR group and LPD/RPD group. All the patients underwent MI-LR with no conversion, including 12 cases of LLR and 11 cases of RLR. All of the clinicopathological data of the patients were similar in both groups. The median OT was 280(210-480) min and 257(180-450) min, and the median EBL was 100(20-1000) mL and 100(20-200) mL in the LLR and the RLR group separately. The postoperative complications mainly included DGE (LLR 4 cases, 33.4% and RLR 4 cases, 36.4%), intestinal fistula (LLR 2 cases, 16.7%, and RLR 0 case), gastrointestinal hemorrhage (LLR 0 case and RLR 1 case, 9.1%), and intra-abdominal infection (LLR 3 cases, 25.0% and RLR 1 case, 9.1%). The median postoperative length of hospitalization was 19.5(7-46) days in the LLR group and 19(9-38) days in the RLR group. No anastomotic stenosis, local recurrence or distant metastasis was observed during the follow-up period in the two groups.
CONCLUSIONS
Minimally invasive limited resection is an optional treatment for primary duodenal GIST with satisfactory short-term and long-term oncological outcomes.
Topics: Humans; Gastrointestinal Stromal Tumors; Retrospective Studies; Male; Female; Middle Aged; Duodenal Neoplasms; Feasibility Studies; Treatment Outcome; Aged; Laparoscopy; Robotic Surgical Procedures; Pancreaticoduodenectomy; Adult; Postoperative Complications; Minimally Invasive Surgical Procedures
PubMed: 38678296
DOI: 10.1186/s12893-024-02417-z -
Translational Animal Science 2024During the bacterial selection, isolate PF9 demonstrated tolerance to low pH and high bile salt and an ability to extend the lifespan of infected with enterotoxigenic...
During the bacterial selection, isolate PF9 demonstrated tolerance to low pH and high bile salt and an ability to extend the lifespan of infected with enterotoxigenic (; < 0.05). Thirty-two weaned piglets susceptible to ETEC F4 were randomly allocated to four treatments as follows: 1) non-challenged negative control group (; basal diet and piglets gavaged with phosphate-buffered saline), 2) negative control group (; basal diet and piglets challenged with ETEC F4, 3 × 10 CFU per pig), 3) positive control (; basal diet + 80 mg·kg of avilamycin and piglets challenged with ETEC F4), and 4) probiotic candidate (PF9; control basal diet + 2.5 × 10 CFU·kg diet of PF9 and piglets challenged with ETEC F4). The infection of ETEC F4 decreased average daily gain and gain:feed in the NC group when compared to the NNC group ( < 0.05). The inoculation of ETEC F4 induced severe diarrhea at 3 h postinoculum (), 36, 40 hpi in the NC group when compared to the NNC group ( < 0.05). The supplementation of PF9 significantly relieved diarrhea severity at 3 hpi when compared to the NC group ( < 0.05). The inoculation of ETEC F4 reduced duodenal, jejunal, and ileal villus height () in the NC group when compared to the NNC group. A significant ( < 0.05) decrease was detected in the duodenal VH in the PC and NNC groups. Moreover, the NNC group had a reduced relative mRNA level of Na-glucose cotransporter 1 () when compared to the NC group ( < 0.05). Compared to the NC and NNC groups, the supplementation of PF9 increased the relative mRNA levels of aminopeptidase N, occludin, zonula occludens-1, and SGLT1 ( < 0.05). The supplementation of PF9 also significantly increased the relative mRNA level of excitatory amino acid transporter 1 when compared to the NC group ( < 0.05). Piglets supplemented with PF9 showed lower relative abundance of Bacteroidetes in the colon than piglets from the NNC group ( < 0.05). The NNC group had a higher relative abundance of Firmicutes in the ileum than all the challenged piglets ( < 0.05); however, a lower relative abundance of Proteobacteria in the ileum and colon was observed in the NC group ( < 0.05). This study provides evidence that PF9 has the potential to improve the gut health of piglets under challenging conditions.
PubMed: 38665217
DOI: 10.1093/tas/txae050