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The aim of the study was evaluation of the correlation between the level of clinical activity of Crohn’s disease (CD) and the number of Faecalibacterium prausnitzii, total number of bacteria and the concentration of selected short chain fatty acids (SCFA) in stool. 34 individuals diagnosed with Crohn’s disease participated in this study in 2011. The disease activity was determined according to the Crohn Disease Activity Index (CDAI). The number of Faecalibacterium prausnitzii and total number of bacteria were monitored by RT-PCR. The concentrations of SCFA were determined by gas chromatography. In CD patients, Faecalibacterium prausnitzii number and percentage of the total number of bacteria were greatly reduced. In patients with CD the percentage of acetate was elevated (70%), while the percentages of propionate and butyrate were significantly reduced (14.9% and 7.99%, respectively).
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Inflammatory bowel diseases and brain-gut axis

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The influence of stress on inflammation in inflammatory bowel disease (IBD) is reviewed. In experimental forms of colitis in rats, stress reactivated the disease. A study of stable IBD patients who were followed for over five years explored the influence of stress on exacerbating the disease. Those patients with high prolonged stressful life events were found to have a 90% recurrence rate of their colitis as compared to only 40% recurrence in low stress patients. Some of the mediators of stress include VIP, TNFalpha, heat shock proteins, glucocorticoid and catecholamines. Stress was shown to increase intestinal permeability to markers such as Cr-EDTA, HRP and dextran 10,000 in rats. In addition, stress increases the permeability of intestinal M-cells. Finally, stress increased the permeability of Paneth cells to HRP. Since Paneth cells synthesize NOD2 mRNA and protein, stress may play a role in the genesis or reactivation of Crohn's disease involving the terminal ileum. Brain-gut interactions via neural, hormonal and cytokine signals can diminish the mucosal protective factors and increase the permeability of luminal antigens into the intestinal epithelial and immune cells. Stress appears to play a key role in exacerbating and accentuating the intestinal inflammation in IBD through brain-gut interactions.
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Platelets and the clinical course of Crohn's disease

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Background. Crohn’s disease (CD) is a chronic, autoimmune, inflammatory bowel disease (IBD) characterised by periods of exacerbations and remissions. Autoimmune disorders caused by undetermined factors lead to inflammation in the intestinal mucosa. Presently, there is a growing interest in the role of platelets in the assessment of inflammatory lesions in CD. Accordingly, the aim of this study was to answer the question of whether routinely measured platelet indices: concentration of platelets (PLT), the mean platelet volume (MPV), plateletcrit (PCT) could become biomarkers for monitoring the course of CD. Material and methods. In the study programme, there were enrolled 100 patients with a diagnosed CD with a different clinical course, disease location and heterogeneous therapy. In all patients, there were collected blood and stool samples for the assessment of CRP, blood count and fecal calprotectin evaluation. The clinical state of each patient was classified using the Harvey-Bradshaw index. Results. The study showed a positive, statistically significant correlation between fecal calprotectin, CRP, WBC, the Harvey-Bradshaw index and the number of platelets and PCT. Furthermore, the analysis showed a statistically significant negative correlation between MPV and the number of WBC, CRP and fecal calprotectin. Conclusions. Our study showed that platelet indices are a valuable, non-invasive and widely accessible method to assess mucosal healing and the clinical status of the patient.
The purpose of our study was to analyze hospitalizations for inflammatory bowel disease noted in the Department of Gastroenterology, Medical University of Lublin. Cases of patients hospitalized in the Department of Gastroenterology, Medical University of Lublin in 1997-2007 were retrospectively analyzed. The material studied included patients’ case histories and medical records that were used to select such patients whose hospitalizations were caused by ulcerative colitis and Crohn’s disease. Analysis distinguished two groups: rural and urban inhabitants. In 1997-2007 there were 1,825 hospitalizations for the inflammatory bowel disease noted at our clinic, which was 12.15% of all hospitalizations: 8.54% patients with ulcerative colitis and 3.61% with Crohn’s disease. Among them, 30.47% were rural inhabitants while 69.53% of patients lived in towns. The observation data demonstrated that there has been a significant increase of patients with inflammatory bowel disease in the last decade, and the patients originating in urban areas were more frequent than those from rural regions. This may be related to environmental differences between these two population groups.
Transforming growth factor β1 (TGF-β1) is a cytokine affecting cell proliferation and development, which also has an immunomodulatory activity. Correlations between polymorphisms of the TGF-β1 gene and clinical parameters of inflammatory bowel disease (IBD) were reported previously in adults. Here, we tested whether such correlations occur in pediatric patients suffering from IBD. One hundred and four pediatric IBD patients were involved in this study. Among them, 36 were diagnosed with Crohn's Disease (CD) and 68 were diagnosed with ulcerative colitis (UC). The control group consisted of 103 children, in which IBD was excluded. TGF-β1 levels were determined in plasma and intestinal mucosa samples. The presence of the TGF β1 protein and the amount of TGF β1 mRNA were estimated in intestinal mucosa by immunohistochemistry and reverse transcription Real-Time PCR, respectively. Four common polymorphisms of the TGF-β1 gene were investigated: -800G/A, -509C/T, 869T/C and 915G/C. No significant correlation between TGF-β1 genotypes and (i) TGF-β1 levels in plasma and tissue samples, (ii) TGF-β1 gene expression efficiency in intestinal mucosa, (iii) IBD clinical parameters and (iv) inflammatory activity could be detected in children suffering from IBD. We conclude that, contrary to previous suggestions, the four common polymorphisms of the TGF-β1 gene do not influence the susceptibility to or clinical parameters of IBD in the tested population of children.
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Clinical usefulness of probiotics in inflammatory bowel diseases

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Probiotics are live nonpathogenic bacteria or bacterial components that may be helpful in the prevention and treatment of acute diarrhoea in adults and children and have some effects on the course of inflammatory bowel diseases (IBD). Many experimental and clinical studies suggest that intestinal bacterial flora plays an important role in the pathogenesis of IBD, and manipulation of the luminal contents with antibiotics or probiotics represents a potentially effective therapeutic option. The beneficial effect of probiotics was demonstrated mainly in the prevention and treatment of pouchitis and in maintaining remission of mild to moderate ulcerative colitis. Probiotics seems to be less effective in patients with Crohn’s disease. Randomized clinical trials are still required to further define the role of probiotics as preventive and therapeutic agents. This review summarizes the current data about probiotics in IBD.
Bacteria of Desulfovibrio desulfuricans species are Gram-negative, anaerobic rods selectively reducing sulphates and colonizing oxygen-free ecosystems. They are ubiquitous in the natural environment and have been also found to reside in the human digestive tract. They are suggested to be involved in the pathogenesis of ulcerative colitis and Crohn's disease. The D. desulfuricans wild strains were isolated from feces and bioptate of patients suffering from various digestive tract disorders. LPSs were isolated from the wild enteric strains and soil type strain La 2226 of D. desulfuricans and analyzed in terms of their 2-keto-3-deoxyoctulosonic acid (Kdo) component content. The obtained spectrophotometric data indicate that Kdo content is characteristic of each of the investigated strains and it ranges from 0.48% to 2.86% (w/w) of the total LPS mass. Statistically significant interstrain differences of Kdo quantity seem to suggest the differences in the O-antigen content. Comparative analysis of Kdo content in LPSs of D. desulfuricans strains in relation to that of the reference endotoxin from Salmonella spp. allows us to suggest that D. desulfuricans bacteria possess O-antigen polysaccharides composed of diverse number of carbohydrate units.
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