Genetic and environmental factors are important in the pathogenesis of clinical and experimental chronic intestinal inflammation. We investigated the influence of normal luminal bacteria and several groups of selected bacterial strains on spontaneous gastrointestinal and systemic inflammation in HLA-B27 transgenic rats. Rats maintained germfree for 3-9 mo were compared with littermates conventionalized with specific pathogen-free bacteria. Subsequently, germfree transgenic rats were colonized with groups of five to eight bacteria that were either facultative or strictly anaerobic. Transgenic germfree rats had no gastroduodenitis, colitis, or arthritis, but developed epididymitis and dermatitis to the same degree as conventionalized rats. Colonic proinflammatory cytokine expression was increased in transgenic conventionalized rats but was undetectable in germfree and nontransgenic rats.

Resident bacteria are incriminated in the pathogenesis of experimental colitis and inflammatory bowel diseases. We investigated the relative roles of various enteric bacteria populations in the induction and perpetuation of experimental colitis. HLA-B27 transgenic rats received antibiotics (ciprofloxacin, metronidazole, or vancomycin-imipenem) in drinking water or water alone in either prevention or treatment protocols. Mice were treated similarly with metronidazole or vancomycin-imipenem before or after receiving 5% dextran sodium sulfate (DSS). Germfree transgenic rats were colonized with specific-pathogen-free enteric bacteria grown overnight either in anaerobic or aerobic atmospheres. Nontransgenic rats colonized with anaerobic bacteria served as negative controls. Although preventive metronidazole significantly attenuated colitis in transgenic rats and DSS-treated mice, it had no therapeutic benefit once colitis was established. Ciprofloxacin also partially prevented but did not treat colitis in B27 transgenic rats. In both animal models vancomycinimipenem most effectively prevented and treated colitis. Germfree transgenic rats reconstituted with enteric bacteria grown under anaerobic conditions had more aggressive colitis than those associated with aerobic bacteria. These results suggest that a subset of resident luminal bacteria induces colitis, but that a complex interaction of commensal aerobic and anaerobic bacteria provides the constant antigenic drive for chronic immune-mediated colonic inflammation.Rapidly growing evidence supports the influence of normal enteric bacteria on the pathogenic process of intestinal inflammation and extraintestinal manifestations in experimental colitis and human inflammatory bowel diseases (IBD) (40-43). Both spontaneous and induced inflammation in multiple widely diverse rodent models have been associated with commensal luminal bacteria (1, 11-13, 16, 22, 31, 44, 45, 52, 54). The influence of resident bacteria on the induction and perpetuation of spontaneous colitis and gastritis has been thoroughly studied in HLA-B27/␤ 2 -microglobulin transgenic (B27 TG) rats. Colitis, gastritis, and joint inflammation fail to develop in B27 TG rats raised under germfree (sterile) conditions (36, 49). Moreover, when transferred into a specific-pathogenfree (SPF) environment, B27 TG rats universally develop immune-mediated colitis and gastritis within 1 month of bacterial colonization (36).However, not all luminal bacteria have equal abilities to cause inflammation. Antibiotics with narrow specificities, such as metronidazole, which is selectively active against anaerobic bacteria, are effective in Crohn's colitis and ileocolitis (47) and also attenuate chronic experimental intestinal inflammation induced by indomethacin or carageenan in rats and guinea pigs, respectively (32, 54). In addition, overgrowth of predominantly anaerobic bacteria in bypassed small intestinal segments can lead to systemic inflammation. A jejunal self-filling blind loop induces hepatobiliary inflammation rese...

Background: Experimental studies have shown that luminal antigens are involved in chronic intestinal inflammatory disorders such as Crohn's disease and ulcerative colitis. Alteration of the intestinal microflora by antibiotic or probiotic therapy may induce and maintain remission. The aim of this randomized, placebo-controlled trial was to determine the effect of oral Lactobacillus GG (L. GG) to induce or maintain medically induced remission.

Our preliminary experience with the self-expanding and removable Polyflex plastic stent for the sealing of anastomotic leaks and esophageal perforations suggests that this stent is a feasible treatment option, in particular, for more extensive esophageal defects, patients with co-morbid conditions, and critically ill patients.

Background: The resident flora plays a critical role in initiation and perpetuation of intestinal inflammation, as demonstrated in experimental models of colitis where animals fail to develop disease under germ free conditions. However, the importance of exposure to commensal bacteria before the onset of colitis is unclear. Our aim was to investigate the influence of previous exposure of donor animals to bacterial antigens on colitis development using a transfer model. Methods: Clinical course and histology were evaluated after transfer of CD4