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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).
The treatment of inflammatory bowel disease (IBD) possesses numerous difficulties owing to the unclear etiology of the disease. This article overviews the drugs used in the treatment of IBD depending on the intensity of clinical symptoms (Canine Inflammatory Bowel Disease Activity Index and Canine Chronic Enterophaty Clinical Activity Index). Patients demonstrating mild symptoms of the disease are usually placed on an appropriate diet which may be combined with immunomodulative or probiotic treatment. In moderate progression of IBD, 5-aminosalicylic acid (mesalazine or olsalazine) derivatives may be administered. Patients showing severe symptoms of the disease are usually treated with immunosuppressive drugs, antibiotics and elimination diet. Since the immune system plays an important role in the pathogenesis of the disease, the advancements in biological therapy research will contribute to the progress in the treatment of canine and feline IBD in the coming years.
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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.
The aim of the study was to analyze the differences in the activity of β-glucuronidase and β-glucosidase in stool specimens of children with Inflammatory Bowel Diseases (IBD) and healthy subjects. The disease activity was determined according to the PCDAI scale (Crohn disease) and Truelove-Witts scale (Ulcerative colitis). Enzyme activity was determined by spectrophotometry. There was a correlation between the level of β - glucosidase activity in stool and patient’s age in the group of healthy controls, but not in the IBD group. β-glucosidase activity in IBD and healthy subjects stool specimens did not differ significantly. The activity of β-glucuronidase in children with IBD was two times lower than in the healthy group and was correlated with age in children with IBD, but not in the group of healthy ones.
Inflammatory bowel disease (IBD), which includes mainly ulcerative colitis (UC) and Crohn’s disease (Lesniowski-Crohn’s, ChL-C, CD), is a chronic and recurrent inflammatory condition of the gastrointestinal tract with multifactorial causes. Both types of IBD are characterized by chronic inflammation with periods of remission and exacerbation. An increasing number of studies have recently shown that chronic inflammation plays an important role in the carcinogenesis of colorectal cancer (CRC), generating suitable microenvironments for the formation and progression of the disease. The main factors are chronic inflammation as well as the scope and duration of the disease. The pro-inflammatory interleukins IL-13, IL-8 and TNF-α play an important role in tumorigenesis. It is further emphasized that reactive oxygen species (ROS) and reactive nitrogen species produced by inflammatory cells may interact with key genes involved in carcinogenic pathways, such as TP53. Carcinogenesis in IBD involves proteins determined by the genes DLG5, OCTN and NOD2. Immunosuppressive drugs, such as thiopurines and methotrexate, may play a role in extra-intestinal tumour development by impairing the immune system and surveillance of tumour cells or by inducing DNA damage. Recognition of neoplastic changes associated with IBD is difficult due to the heterogeneity of the endoscopic image and variation in the diagnosis depending on the observer. Therefore surveillance of IBD patients by a multidisciplinary team is essential for early detection of the neoplastic process.
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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.
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Inflammatory bowel disease - Polish contribution

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The term "inflammatory bowel disease" includes ulcerative colitis, Lesniowski-Crohn’s disease and indeterminate colitis. The history of these diseases in Poland began with Antoni Lesniowski, who in 1904 described an inflammatory tumour of the small intestine with a fistula to ascending colon. The first contemporary clinical descriptions of the main forms of inflammatory bowel disease emerged after 1960, and were made by Warsaw groups and a surgical group from Poznan. The major contributions of Polish investigators to the development of knowledge about ulcerative colitis and Lesniowski-Crohn’s disease were made in the fields of immunology and genetics and in studies on kallikrein-kinin and haemostasis systems. The investigators of pathogenetic mechanisms in these diseases come from departments of gastroenterology in Warsaw, Lublin, Gdansk and Sosnowiec.
Cysteinyl leukotrienes play a part in inflammatory processes such as inflammatory bowel diseases. The present study aimed to evaluate the effects of the cys-LT-1 receptor antagonist montelukast on a mild colitis model in rats. Colitis was induced by administrating 4% dextran sulphate sodium (DSS, MW 45 000) in drinking water for 9 days. Montelukast (10 mg/kg/day) or vehicle was given by gastric gavage once daily simultaneously with DSS administration. A healthy control group receiving water as drinking fluid and vehicle by gastric gavage was included. Body weight loss, consistency of faeces (loose/diarrhoea) and occult blood in the faeces/ gross bleeding were assessed on days 6 - 9. After sacrifice, the following were assessed: colonic histology, the expression of inducible nitric oxide synthase, macrophage/monocyte marker ED1, cyclooxygenase-1 and cyclooxygenase-2, as well as the production of leukotriene B4 and E4, prostaglandin E2, its metabolite bicyclic-prostaglandin E2 and thromboxane B2 in the colonic tissue incubation in vitro. Rats receiving DSS exhibited bloody diarrhoea from day 6 onwards. Montelukast significantly reduced the occult blood in the faeces/ gross bleeding, maintained normal body weight gain and tended to decrease the ratio of leukotriene B4/ prostaglandin E2 production in the colon in vitro. The results indicate that montelukast has some potential to ameliorate mild experimental colitis induced by DSS.
The usefulness of endoscopic examination for the diagnosis and treatment of chronic enteritis in dogs was determined in this study. It was demonstrated, based on a clinical case, that endoscopy is essential for IBD diagnosis in dogs. Endoscopy also helps to estimate the efficiency of the treatment strategy applied. Nonspecific clinical examination results as well as a predominating lack of deviation in laboratory parameters make endoscopy the basic examination technique in mild and moderately advanced forms of chronic enteritis in the dog.
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