Purinergic signaling in the gastrointestinal tract

Geoffrey Burnstock completed a BSc at King’s College London and a PhD at University College London. He held postdoctoral fellowships with Wilhelm Feldberg(National Institute for Medical Research),Edith Bülbring(University of Oxford) and C. Ladd Prosser(University of Illinois) . He was appointed to a Senior Lectureship in Melbourne University in 1959 and became Professor and Chairman of Zoology in 1964. In 1975 he became Head of Department of Anatomy and Developmental Biology at UCL and Convenor of the Center of Neuroscience. He has been Director of the Autonomic Neuroscience Institute at the Royal Free Hospital School of Medicine since 1997. He was elected to the Australian Academy of Sciences in 1971,the Royal Society in 1986,the Academy of Medical Sciences in 1998 and an Honorary Fellow of the Royal College of Surgeons and the Royal College of Physicians in 1999 and 2000. He was awarded the Royal Society Gold Medal in 2000. He is editor-in-chief of the journals Autonomic Neuroscience and Purinergic Signalling and on the editorial boards of many other journals. Geoffrey Burnstock’s major research interest has been autonomic neurotransmission and he is best known for his seminal discovery of purinergic transmission and receptors,their signaling pathways and functional relevance. He has supervised over 100 PhD and MD studentsand published over 1400 original papers,re-views and books. He was first in the Institute of Scientific Information list of most cited scientists in Pharmacology and Toxicology from 1994-2004 [59.083 citations(March 2011) and an h-index of 109].     

Giant gastrointestinal stromal tumour of rare sarcomatoid epithelioid subtype:Case study and literature review

Gastrointestinal stromal tumours(GISTs) are the most common mesenchymal tumours of the gastrointestinal tract,but they represent less than 3% of all gastrointestinal tract malignancies.This is a detailed case study of a 52-yearold male patient treated for very uncommon histological subtype of gastric GIST with atypical clinical presentation,asymptomatic progress and late diagnosis.The resected tumour,giant in diameters,was confirmed to represent the most rare histopathologic subtype of GISTs- sarcomatoid epithelioid GIST.We report this case and review the literature with a special focus on pathomorphological evaluation,biological aggressiveness and prognostic factors.To our knowledge this is the first report of giant GIST of very uncommon sarcomatoid epithelioid subtype.It is concluded that clinicians should pay attention to the fact that initial diagnosis may be delayed due to mildly asymptomatic and non-specific clinical presentation.Asymptomatic tumours diagnosed at a late stage,which is often the case,can be large on presentation.Prognosis for patients diagnosed with GIST depend on tumour size,mitotic rate,histopathologic subtype and tumour location.That is why early diagnosis and R0 resection,which is usually feasible and safe even in giant gastric sarcomatoid epithelioid subtype of GISTs,are the key factors for further treatment and good prognosis.     

Role of Toll-like receptors in health and diseases of gastrointestinal tract

The human gastrointestinal (GI) tract is colonized by non-pathogenic commensal microflora and frequently exposed to many pathogenic organisms. For the maintenance of GI homeostasis, the host must discriminate between pathogenic and non-pathogenic organisms and initiate effective and appropriate immune and inflammatory responses. Mammalian toll-like receptors (TLRs) are members of the pattern-recognition receptor (PRR) family that plays a central role in the initiation of innate cellular immune responses and the subsequent adaptive immune responses to microbial pathogens. Recent studies have shown that gastrointestinal epithelial cells express almost all TLR subtypes characterized to date and that the expression and activation of TLRs in the GI tract are tightly and coordinately regulated. This review summarizes the current understanding of the crucial dual roles of TLRs in the development of host innate and adaptive immune responses to GI infections and the maintenance of the immune tolerance to commensal bacteria through down-regulation of surface expression of TLRs in intestinal epithelial cells.     

Abdominal tuberculosis of the gastrointestinal tract: Revisited

Abdominal tuberculosis is an increasingly common disease that poses diagnostic challenge, as the nonspecific features of the disease which may lead to diagnostic delays and development of complications. This condition is regarded as a great mimicker of other abdominal pathology. A high index of suspicion is an important factor in early diagnosis. Abdominal involvement may occur in the gastrointestinal tract, peritoneum, lymphnodes or solid viscera. Various investigative methods have been used to aid in the diagnosis of abdominal tuberculosis. Early diagnosis and initiation of antituberculous therapy and surgical treatment are essential to prevent morbidity and mortality. Most of the patients respond very well to standard antitubercular therapy and surgery is required only in a minority of cases. Imaging plays an important role in diagnosis of abdominal tuberculosis because early recognition of this condition is important. We reviewed our experience with the findings on various imaging modalities for diagnosis of this potentially treatable disease.     

糖原合成酶激酶-3在胃肠道肿瘤的作用及其研究进展

糖原合成酶激酶-3(GSK-3)是一种多功能的丝氨酸/苏氨酸蛋白激酶.实验证实,GSK-3通过多种途径在胃肠道肿瘤的生长、增殖及凋亡等方面起重要作用.现就近年来GSK-3在胃肠道肿瘤的研究进展作一综述.     

Optical coherence tomography and Doppler optical coherence tomography in the gastrointestinal tract

Optical coherence tomography(OCT) is a noninvasive,high-resolution,high-potential imaging method that has recently been introduced into medical investigations.A growing number of studies have used this technique in the field of gastroenterology in order to assist classical analyses.Lately,3D-imaging and Doppler capabilities have been developed in different configurations,which make this type of investigation more attractive.This paper reviews the principles and characteristics of OCT and Doppler-OCT in conn...     

IP-10和CXCR3与消化系统肿瘤

干扰素诱导蛋白10(IFN-γ-inducible protein,IP-10)是由干扰素-γ和/或脂多糖诱导产生的一类可以趋化淋巴细胞的蛋白质,又称CXC趋化因子配体10(CXCL10)。趋化因子CXC受体3(CXCR3)是IP-10的受体。近年来趋化因子及其受体在肿瘤免疫中的作用备受重视,本文就IP-10和CXCR3在消化系统肿瘤中的研究进展作一综述。     

胃肠道间质肿瘤伴发消化道癌

目的探讨8例胃肠道间质肿瘤（GIST）伴发消化道癌的临床病理特征及免疫表型。方法收集70例GIST中，8例伴发消化道癌的临床和病理资料，并用免疫组化Envision法标记CD117、CD34、Vimentin等。结果伴发消化道癌的8例GIST(4例良性，3例交界性，1例恶性)中，胃腺癌5例，食管鳞状细胞癌2例，结肠腺癌1例。2种病变位于同一器官者4例，位于消化道不同部位4例；2种肿瘤均不相连，术前内镜活检病理诊断腺癌6例，鳞状细胞癌2例，且临床及组织学均未能同时诊断出2种肿瘤。免疫组化标记结果显示：Vimentin、CD34均为阳性8例；CD117阳性7例，阴性1例；S-100灶性阳性2例；SMA、Desmin只有1例小灶阳性表达。结论GIST与消化道上皮性肿瘤同时发生者并不少见，临床应重视对本病的诊断，内镜活检结合术中探查、术后病检有助于本病的早期诊断，进一步提高其柃出率。     

Morphology and motor function of the gastrointestinal tract examined with endosonography

Endosonography is a useful tool for studying the morphology and motor function of the gastrointestinal tract. Intraluminal ultrasonography is the common denomination of ultrasound examinations using intracorporal transducers which are inserted into the GI tract. Thus, the visceral wall and adjacent structures can be imaged in detail. This review describes the usefulness of endosonography in gastroenterology, in particular with respect to studies of the biomechanical and motor function of the gastrointestinal tract. New techniques such as 3-D EUS, elastography and strain rate imaging are discussed.     

15-羟基前列腺素脱氢酶与胃肠道恶性肿瘤的研究进展

NAD 依赖的15-羟基前列腺素脱氢酶(15-PGDH)是前列腺素降解的关键酶,对环氧合酶-2(COX- 2)有天然的拮抗作用。近年来发现,15-PGDH表达减少、活性减低与胃肠道及其他系统肿瘤的发生发展有密切关系,15-PGDH可以作为肿瘤预防和治疗的新靶点。     

表皮生长因子及其受体与胃肠道疾病

表皮生长因子(EGF)是最重要的促细胞生长因子之一,消化道中EGF含量远远高于血循环中的浓度。近年研究表明,EGF对许多胃肠道良性疾患有治疗作用,同时也发现EGF和EGFR拮抗剂可以影响恶性肿瘤的发生、发展和消退。     

Metastatic breast cancer to the gastrointestinal tract： A case series and review of the literature

INTRODUCTION Breast cancer is the most common neoplasm in women, accounting for approximately 32% of cancers in women, with a lifetime risk of 1 in 10[1]. Prognosis is related to the presence of hormonal receptors, the size and grade of the primary tumour…     

CCL20和CCR6与消化系统肿瘤的相关性研究

CCL20是一种CC亚族趋化因子,在与受体CCR6结合后直接参与树突状细胞、T细胞的定向迁移,在肿瘤免疫、自身免疫等方面发挥一定作用.近年来趋化因子及其受体在肿瘤免疫中的作用备受重视,本文就CCL20和CCR6在消化道肿瘤中的研究进展作一综述.     

Effects of occupational stress on the gastrointestinal tract

The aim of this review is to provide a general overview of the relationship between occupational stress and gastrointestinal alterations. The International Labour Organization suggests occupational health includes psychological aspects to achieve mental well-being. However, the definition of health risks for an occupation includes biological, chemical, physical and ergonomic factors but does not address psychological stress or other affective disorders. Nevertheless, multiple investigations have studied occupational stress and its physiological consequences, focusing on specific risk groups and occupations considered stressful. Among the physiological effects of stress, gastrointestinal tract (GIT) alterations are highly prevalent. The relationship between occupational stress and GIT diseases is evident in everyday clinical practice; however, the usual strategy is to attack the effects but not the root of the problem. That is, in clinics, occupational stress is recognized as a source of GIT problems, but employers do not ascribe it enough importance as a risk factor, in general, and for gastrointestinal health, in particular. The identification, stratification, measurement and evaluation of stress and its associated corrective strategies, particularly for occupational stress, are important topics to address in the near future to establish the basis for considering stress as an important risk factor in occupational health.     

Fluorescence guided intraluminal endoscopy in the gastrointestinal tract: A systematic review

BACKGROUND Conventional endoscopy is based on full spectrum white light. However, different studies have investigated the use of fluorescence based endoscopy systems where the white light has been supplemented by infrared light and the use of relevant fluorophores. Fluorescence endoscopy utilizes the fluorescence emitted from a fluorophore, visualizing what is not visible to the naked eye.AIM To explore the feasibility of fluorescence endoscopy and evaluate its use in diagnosing and evaluating gastrointestinal disease.METHODS We followed the PRISMA guidelines for this systematic review. The research covered five databases; PubMed, Scopus, Web of Science, Embase, and the Cochrane Collection, including only studies in English and Scandinavian languages. Authors screened title and abstract for inclusion, subsequently full-text for inclusion according to eligibility criteria listed in the protocol. The risk of bias was assessed for all studies according to the Newcastle-Ottawa Scale. The authors extracted the data and reported the results in both text and tables.RESULTS We included seven studies in the systematic review after screening a total of 2769 papers. The most prominent fluorophore was indocyanine green(n = 6), and whereas one study(n = 1) used Bevacizumab 800-CW. Three studies investigated fluorescence endoscopy in detecting varices, adenomas in patients with familial adenomatous polyposis and neoplasms in the gastrointestinal tract. Four studies evaluated the usefulness of fluorescence endoscopy in assessing tumor invasion. Three of the four studies reported an exceptional diagnostic accuracy(93%, 89% and 88%) in assessing tumor invasion, thus representing better visualization and more correct diagnosis by fluorescence endoscopy compared with the conventional endoscopy. The relationship between the endoscopic findings, tumor invasion, and tumor vascularity was evaluated in two studies showing a significant correlation(d P 0.05 and b P 0.01).CONCLUSION The use of fluorescence endoscopy is a promising method adding diagnostic value in the detection of neoplasia, adenomas, and assessment of tumor invasion within the gastrointestinal tract. More studies are needed to utilize the feasibility of fluorescence endoscopy compared with other endoscopic methods.     

消化系统症状为首要表现的甲状旁腺功能亢进症3例临床分析

目的探讨以消化系统症状为主要表现的甲状旁腺功能亢进症早期诊治,以降低误诊率。方法回顾性分析3例以消化系统症状为主要表现的甲状旁腺功能亢进症。结果 3例甲状旁腺功能亢进症患者血钙、尿钙、甲状旁腺激素升高,血磷水平降低。CT及放射性核素扫描99mTc-MIBI有助于定位诊断,手术治疗是目前唯一的有效措施。结论以消化系统症状为主要表现的原发性甲状旁腺功能亢进症的诊断,要重视血钙及甲状旁腺激素水平监测,达到早期诊断、早期治疗的目的。     

Klippel-Trenaunay综合征并肠血管畸形致下消化道出血1例

肠道血管畸形引起下消化道出血较为少见,但在下消化道不明原因出血中占有重要地位,本病例肠道血管畸形合并Klippel-Trenaunay综合征(Klipple-Trenaunay syndrome,KTS).针对本病例,应首要解决脉管畸形所致的肠道出血,再联合其他学科进行综合治疗.     

Clinical value of CT three-dimensional imaging in diagnosing gastrointestinal tract diseases

AIM: To discuss the clinical value of CT three-dimensional (3-D) imaging in diagnosing gastrointestinal tract diseases. METHODS: Three-D imaging findings of 52 patients were retrospectively analyzed. Three-D imaging methods included shaded surface display (SSD), volume rendering (VR), virtual endoscopy (VE) and multiplanar reformatting (MPR). The diagnosis results of CT 3-D were evaluated by comparison with those of endoscopy and/or surgical finding. RESULTS: Fifty-two patients with gastrointestinal tract diseases were diagnosed by CT 3-D imaging, of whom 50 cases were correctly diagnosed and 2 were misdiagnosed. There were 33 cases of gastric diseases (27 with carcinoma, 5 with peptic ulcer and 1 with leiomyoma) and 19 large intestinal diseases (10 with colon carcinoma, 2 with carcinoma of the rectum, 5 with colon polypus and 2 with tuberculosis of the ileocecal junction). Twenty-two cases with prominent lesions (9 with subsequent hollow lesions), 20 with stenosis of cavity (8 with concomitant prominent lesions) and 10 with hollow lesions (5 with concomitant prominent lesions) were shown in 3-D images. The minimal lesion shown was 1.0 cm×0.8 cm×0.5 cm. CONCLUSION: CT 3-D imaging, a non-invasive examination without pain, can display clearly and directly the lesions of gastrointestinal tract with accurate location and high diagnosis accuracy. It is an important complementary technique to endoscopy.     

The role of the gastrointestinal tract in the pathogenesis of rheumatic diseases

Dysregulation of the intestinal epithelial barrier in genetically susceptible individuals may lead to both intestinal and extraintestinal autoimmune disorders. There is emerging literature on the role of microbiota changes in the pathogenesis of systemic rheumatic diseases such as rheumatoid arthritis, spondyloarthropathies, and connective tissue diseases. Although the role of the gastrointestinal tract in the pathogenesis of spondyloartropathies is well defined and many studies underline the importance of gastrointestinal inflammation in modulating local and systemic inflammation, the data are inconclusive regarding the effect of dysbiosis on rheumatoid arthritis and connective tissue diseases. This review aims to summarize current data on the role of the gastrointestinal involvement and intestinal microbiota in the pathogenesis of systemic rheumatic disease.