Studies have demonstrated that inflammatory bowel disease (IBD) patients are at an increased risk of developing anxiety and/or depression. IBD patients with depression/anxiety have higher rates of hospitalization and increased disease severity than those without. So far, there is a paucity of data concerning the impact of anxiety/depression on Chinese IBD patients. The aim of this study was to find out the prevalence of symptoms of anxiety/depression in Chinese IBD population and its impact on IBD-related features. This is a cross-sectional study from the southwest China IBD referral center. Eligible participants were divided into those with symptoms of anxiety/depression and those without based on the Hospital Anxiety and Depression Scale (HADS). Demographic data and disease duration, IBD-related surgery, tobacco use, extra-intestinal manifestations, disease activity scores, endoscopic evaluation, laboratory data and current medication use were compared between two groups. A total of 341 IBD patients [221 Crohn’s disease (CD) and 120 ulcerative colitis (UC)] were included. The prevalence of symptoms of anxiety/depression in IBD was 33.1%. CD patients with symptoms of anxiety/depression tended to have higher scores of simple endoscopic scores for Crohn’s disease (SES-CD) (p = 0.0005). UC patients with symptoms of anxiety/depression had a significantly higher Mayo score (p = 0.0017) and ulcerative colitis endoscopic index of severity (UCEIS) (p < 0.0001) than their non-anxiety/depression counterparts. CD-related surgery (p = 0.012) and Crohn's disease activity index (CDAI) (p < 0.0001) were identified as independent risk factors for symptoms of anxiety/depression in CD, while corticosteroid use (p = 0.036) as an independent risk factor for symptoms of anxiety/depression in UC. This study helps our understanding of the prevalence of symptoms of anxiety/depression in IBD patients and its impact on IBD course and reminds us to pay more attention on IBD management with anxiety/depression.

Background and AimsThe effect of antidepressant therapy on Inflammatory Bowel Disease (IBD) remains controversial. This trial aimed to assess whether adding venlafaxine to standard therapy for IBD improved the quality of life (QoL), mental health, and disease activity of patients with IBD with anxious and depressive symptoms.MethodsA prospective, randomized, double-blind, and placebo-controlled clinical trial was conducted. Participants diagnosed with IBD with symptoms of anxiety or depression were randomly assigned to receive either venlafaxine 150 mg daily or equivalent placebo and followed for 6 months. Inflammatory Bowel Disease Questionnaire (IBDQ), Mayo score, Crohn's disease activity index (CDAI), Hospital Anxiety and Depression Scale (HADS), and blood examination were completed before the enrollment, during, and after the follow-up. Mixed linear models and univariate analyses were used to compare groups.ResultsForty-five patients with IBD were included, of whom 25 were randomized to receive venlafaxine. The mean age was 40.00 (SD = 13.12) years old and 25 (55.6%) were male. Venlafaxine showed a significant improvement on QoL (p &lt; 0.001) and disease course (p = 0.035), a greater reduction in HADS (anxiety: p &lt; 0.001, depression: p &lt; 0.001), Mayo scores (p &lt; 0.001), and CDAI (p = 0.006) after 6 months. Venlafaxine had no effect on IL-10 expression, endoscopic scores, relapse rate, and use rate of biologics and corticosteroids, but did reduce serum level of erythrocyte estimation rate (ESR; p = 0.003), C-reactive protein (CRP; p &lt; 0.001) and tumor necrosis factor-α (TNF-α; p = 0.009).ConclusionsVenlafaxine has a significantly beneficial effect on QoL, IBD activity, and mental health in patients with IBD with comorbid anxious or depressive symptoms. (Chinese Clinical Trial Registry, ID: ChiCTR1900021496).

Bacteria-mediated infectious diseases have become a health-care challenge globally since the development of antibiotic resistance. Reactive oxygen species produced by photosensitizers have great potential in fighting bacterial infections, especially against Gram-negative bacteria that are hard to kill by regular methods owing to their formidable defensive membrane structures under the premise of avoiding overuse of antibiotics. In this work, a small molecular photosensitizer, curcumin (CCM), was used as a model and encapsulated into zeolitic imidazolate framework-8 (ZIF-8). Then the ZIF-8 loaded with CCM (CCM@ZIF-8) was decorated with biocompatible polymers hyaluronic acid (HA) and chitosan (CS) by the layer-by-layer self-assembly technique to yeild in an antibacterial CCM@ZIF-8@HA@CS nanoparticle with a high local positive charge density and is capable of binding the surface of bacteria by electrostatic interactions. The CCM drug loading capability of the nanoparticle was found to be as high as 10.89%. Upon exposure to blue light (72 J/cm2) for 10 min, the minimum inhibitory concentration and minimum bactericidal concentration of CCM@ZIF-8@HA@CS against Gram-positive bacteria (G(+)) Staphylococcus aureus (S. aureus) and Gram-negative bacteria (G(−)) Escherichia coli (E. coli) were the same, which were as low as 0.625 and 2.5 μg/mL, respectively, showing highly effective antibacterial activities. After treatment with CCM@ZIF-8@HA@CS under blue-light irradiation, the membranes of S. aureus and E. coli folded and cracked. Importantly, the antibacterial agent showed good biocompatibility in the cytotoxicity test using L929 cells and hemolysis test using rabbit blood cells under blue-light irradiation. Therefore, this CCM@ZIF-8@HA@CS nanocomposite is expected to find application in the treatment of superficial traumatic and refractory chronic infections caused by G(+) and G(−).