A Vicious Cycle of Osteosarcopenia in Inflammatory Bowel Diseases—Aetiology,Clinical Implications and Therapeutic Perspectives

Sarcopenia is a disorder characterized by a loss of muscle mass which leads to the reduction of muscle strength and a decrease in the quality and quantity of muscle. It was previously thought that sarcopenia was specific to ageing. However, sarcopenia may affect patients suffering from chronic diseases throughout their entire lives. A decreased mass of muscle and bone is common among patients with inflammatory bowel disease (IBD). Since sarcopenia and osteoporosis are closely linked, they should be diagnosed as mutual consequences of IBD. Additionally, multidirectional treatment of sarcopenia and osteoporosis including nutrition, physical activity, and pharmacotherapy should include both disorders, referred to as osteosarcopenia.     

Associations of Lifestyle Factors with Osteopenia and Osteoporosis in Polish Patients with Inflammatory Bowel Disease

Reduced physical activity (PA), smoking, and coffee and alcohol drinking constitute risk factors of osteoporosis in patients with inflammatory bowel disease (IBD). The aim of the study was to measure the bone mineral density (BMD) and frequency of osteopenia and osteoporosis in patients with IBD and their correlation with PA, smoking, coffee, and alcohol. The study group consisted of 208 patients with IBD-103 with Crohn’s disease (CD), 105 suffering from ulcerative colitis (UC). Densitometric measurements were performed using the DXA. All patients completed a questionnaire concerning PA, smoking, and coffee and alcohol consumption. The prevalence of osteopenia and osteoporosis (L2–L4) in the IBD group was 48.1%; in the CD group, it amounted to 48.6%, and in the UC group, the prevalence was equal to 33.3%. Patients with CD who were diagnosed with osteopenia and osteoporosis demonstrated reduced PA compared to patients with a normal BMD who exercised regularly (p = 0.0335). A similar observation was made in the group of women with IBD. Women with a normal BMD exercised significantly more often than women suffering from osteopenia and osteoporosis (p = 0.0146). However, no differences in BMD were observed with regard to coffee use, alcohol consumption, or smoking. Thus, since the incidence of osteoporosis in IBD patients is high, it may be dependent on PA.     

生长抑素对溃疡性结肠炎患者炎症反应及氧化应激的调节作用

目的探讨生长抑素对溃疡性结肠炎(UC)患者炎症因子和氧化应激的改善作用。方法收集2019年1-12月法库县卫生健康服务中心收治的活动期UC患者40例,随机分为对照组和观察组各20例。对照组采用常规治疗方案,观察组在其基础上加用生长抑素,0.1mg/次,1次/8h,两组均治疗14d。比较两组治疗后炎症水平和氧化应激状态改善情况。结果两组治疗后各炎症和氧化应激指标差异均有统计学意义(P<0.05)。结论生长抑素能够进一.步改善活动期UC患者的炎症和氧化应激水平,值得推荐使用。     

乙状结肠镜直视下给药治疗溃疡性直肠乙状结肠炎疗效观察

目的 :研究乙状结肠镜下直接给药治疗溃疡性结肠炎 (UC)的疗效和安全性。方法 :用随机对照方法对 12 4例溃疡性直肠乙状结肠炎患者分为治疗组 6 4例与对照组 6 0例 ,治疗组给予乙状结肠直视下给药 ,对照组给予局部灌肠治疗 ,疗程 4周。观察临床症状、结肠镜下组织学炎症及疾病活动指数 (DAI)和改善情况。结果 :两种治疗方法症状改善率分别为 87 5 0 %和6 8 33% (P <0 0 5 ) ;结肠镜下炎症改善率分别为 82 81%和 6 5 0 0 % (P <0 0 5 ) ;组织学改善率分别为 85 75 %和 6 1 6 7% (P <0 0 5 ) ;两组的DAI均有明显下降 ,无严重副作用。结论 :乙状结肠镜直视下给药为一有效、简便、安全的治疗溃疡性直肠乙状结肠炎的方法。     

溃疡性结肠炎患者的心理健康状况及个性特征

目的 了解溃疡性结肠炎（UC）患者的心理健康状况及个性特征。方法 采用症状自评量表（SCL－90）、Zung焦虑自评量表（SAS）、抑郁自评量表（SDS）及卡特尔16项人格测评问卷（16－PF）调查了46例UC患者并与健康者对照。结果 UC患者SCL－90总分、阳性项目数,阳性症状均分、躯体化、焦虑、恐怖以及SAS、SDS得分均升高。16PF结果：O、Q4因子分及次级人格因子中X1分升高而C、F、Y1分均下降。UC病人抑郁发生率32．6％明显高于健康者。结论 UC病人存在明显的心理健康障碍,主要表现为躯体化、焦虑、抑郁、恐怖。同时UC患者存在不良的人格特征：表现为个性同倾、敏感、固执、情绪稳定性差。     

Clinical significance and assessment of cytokines in various stages of ulcerative colitis

Summary In order to study the clinical significance and change of interleukin (IL)-1β and IL-10 concentration in intestinal mucosal tissues in various stage of ulcerative colitis (UC), IL-1β and IL10 levels were measured by enzyme linked immunosorbent assays (ELISA). Our results showed that IL-β level caused by spontaneous secretion in the intestinal mucous tissues in active stage of ulcerative colitis was significantly higher than that in normal controls and in remission stage of ulcerative colitis (P <0. 01,P<0. 001). IL-10 level in various stage of UC was relatively lower in controls, but there was no significantly difference between the two groups. Our study suggested that higher IL-1β level in active might play an important role in pathogenesis of UC, and IL-10, as an anti-inflammatory cytokine, was low in active UC, suggesting that it may be a important factor contributing to the development of higher IL-1β level. This project was supported by the grant of the Scientific Research Fund of the Ministry of Health (No. 98-2-387).     

基于NF-κB相关信号通路探讨常用中药治疗溃疡性结肠炎研究进展

核转录因子-κB(NF-κB)相关信号通路在溃疡性结肠炎的形成与发展中起到很大的作用。研究显示中药单体及单药可以通过NF-κB信号通路介导减少黏膜炎症反应、抑制肠道上皮细胞凋亡、增强肠道黏膜屏障、调节肠道内菌群丰度等抑制溃疡性结肠炎的发展,但具体的作用机制尚不明确。可能与调节TLR4/NF-κB信号通路、JAK2/STAT3/NF-κB信号通路、PI3K/AKT/NF-κB信号通路、NF-κB/NLRP3信号通路等有关。涉及到的常用药物包括黄连、干姜、鸦胆子、黄芪、肉桂、青黛、雷公藤、黄芩、蒲公英、马齿苋、苦参、青蒿等及其提取物小檗碱、6-姜烯酚、鸦胆子苦醇、黄芪多糖、肉桂醛、雷公藤多苷、黄芩苷、苦参总碱、双氢青蒿素等。故围绕NF-κB相关信号通路对常用治疗UC的中药及其单体作一综述,旨在为进一步深入研究提供思路和参考。     

Screening for Escherichia coli O157:H7 in Illinois

Objective: To determine the incidence of infection with Escherichia coli O157:H7 in a tertiary referral center in Chicago, where a similar study had been performed in 1984, to evaluate cases of disease reported to the Illinois Department of Public Health (IDPH) in 1993, and to determine laboratory practices used to detect this infection throughout the state.
Methods: During a 6-month period in 1993, all stool specimens at Rush-Presbyterian-St Luke's Medical Center (RPSLMC) were tested for E. coli O157:H7. Reports of diagnosed E. coli O157:H7 cases investigated by IDPH were also reviewed. A survey of 73 hospitals in the Chicago area was performed to determine routine culturing practices, specifically, the selection of stool specimens for evaluation for this pathogen.
Results: In the RPSLMC survey, two cases were identified among 1985 samples (incidence 0.1%), similar to the 0.08% incidence detected in a similar study conducted at the same institution in 1984. Through passive surveillance, the IDPH received 44 reports of E. coli O157:H7 in 1993. The hospital survey revealed that, in the seven labs testing all stool specimens for E. coli O157:H7, an incidence of 16/8137 specimens (0.2%) was determined.
Conclusions: These data suggest that sporadic E. coli O157:H7 remains uncommon in Illinois and that the incidence may not have changed over a 9-year period. The low yield and substantial cost of culturing all stools suggest that only specimens from patients with bloody diarrhea should be evaluated routinely in areas of low endemicity.     

Efficacy of recombinant granulocyte colony-stimulating factor (rhG-CSF) in experimental colitis

Inflammatory bowel disease is associated with mucosal neutrophil recruitment and activatation, mediated in part by arachidonic acid metabolites. G-CSF attenuates the immune response to sepsis and ameliorates glycogen storage disease Ib-related colitis. These actions may be effected through the shedding of neutrophil adhesion molecules, or inhibition of proinflammatory mediator synthesis. Immune complex colitis was used to evaluate the effect of rhG-CSF on colonic mucosal inflammation, neutrophil recruitment and the generation of eicosanoids. Immune complex colitis was induced in White New Zealand rabbits. Animals were pretreated with rhG-CSF either 24 h before induction, or at induction, with dosages of 50 and 200 μg/kg. rhG-CSF caused a time- and dose-dependent neutrophilia in all animals. Pretreatment with rhG-CSF resulted in increased tissue myeloperoxidase levels, despite a histologically similar mucosal polymorphonuclear cell infiltrate between treated and control colitis groups. Leukotriene B₄ (LTB₄) and thromboxane B₂ (TXB₂) dialysis fluid levels were lower in treated animals, in particular in the groups receiving two doses (LTB₄: both P < 0.01; TXB₂: both P < 0.01. Prostaglandin E₂ (PGE₂) levels in dialysis fluid of the rhG-CSF-treated animals showed no difference from controls. In this model of experimental colitis, high-dose therapy with G-CSF resulted in a marked decrease of proinflammatory mediators, but mucosal generation of the protective PGE₂ was preserved. These results suggest that prolonged high-dose therapy with G-CSF may have anti-inflammatory effects in colitis.