Microscopic Colitis Is Characterized by Intestinal Dysbiosis

Morgan, David M. L.; Cao, Yueming; Miller, Kaia C.; McGoldrick, Jessica; Bellavance, Danielle; Chin, Sang; Halvorsen, Stefan; Maxner, Benjamin; Richter, James M.; Sassi, Slim; Burke, Kristin E.; Yarze, Joseph C.; Ludvigsson, Jonas F.; Staller, Kyle; Chung, Daniel C.; Khalili, Hamed

doi:10.1016/j.cgh.2019.06.035

Cited by 42 publications

(50 citation statements)

References 8 publications

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“…Based on studies such as the one published by Morgan et al in 2020 [34], which demonstrated the important role of the intestinal microbiome in the development of microscopic colitis and the regression of inflammation after reconstructive surgery, we considered that stimulation with probiotics prior to closure of the protective ileostomy would allow the altered autoimmune function to be normalized, restore homeostasis, and reduce mucosal inflammation, achieving the reduction or disappearance of the macroscopic and microscopic changes associated with it. This initial hypothesis seems to correlate with the results we have obtained, achieving a remission in endoscopic and histological findings of DC in SG, as we can see in Figures 2 and 3, where a significant remission in SG was observed compared to CG after stimulation with probiotics prior to closing the protective stoma.…”

Section: Discussionmentioning

confidence: 99%

Diversion Colitis: Macro and Microscopic Findings after Probiotics Stimulation

Rodríguez-Padilla

Morales-Martín

Pérez-Quintero

et al. 2021

Biology

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The use of a loop ileostomy as the defunctioning procedure of choice to protect a distal colonic anastomosis causes histological and endoscopic changes in the intestinal mucosal architecture, which have been related to chronic inflammation and changes in the microflora that consequently impact the intestinal structure and function following fecal stream diversion. The aim of this study was to evaluate the histological and endoscopic changes on the colonic mucosa in patients with diversion colitis after stimulation of the efferent loop with probiotics prior to closure of the protective ileostomy. A prospective, randomized, double-blind, controlled study was designed. All patients who underwent surgery for colorectal carcinoma with protective ileostomy between January 2017 and December 2018 were included. These patients were pending reconstructive surgery and were diagnosed with endoscopic and histological diversion colitis. Divided into two groups, a group stimulated with probiotics (SG) and a control group (CG). 34 cases and 35 controls were included in the study. Histological and endoscopic changes were evaluated after stimulation, after restorative surgery and during the short-term follow-up after surgery. A decrease in endoscopic pathological findings (mucosal friability, mucous erosions, polyps, edema, erythema and stenosis) and in histological findings (follicular hyperplasia, eosinophils, cryptic abscesses, lymphocyte infiltration, plasma cell infiltration and architecture distortion) was observed in SG. These results were statistically significant with a p < 0.001. The stimulation of the efferent loop of the ileostomy in patients with diversion colitis produced a decrease of the endoscopic and histological severity of colitis in the short term.

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Section: Discussionmentioning

confidence: 99%

Diversion Colitis: Macro and Microscopic Findings after Probiotics Stimulation

Rodríguez-Padilla

Morales-Martín

Pérez-Quintero

et al. 2021

Biology

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“…The most studied probiotic bacteria are Bifidobacterium and Lactobacillus spp. These two bacteria produce a decrease of pro-inflammatory molecules and an increase of molecules that inhibit inflammation, also protecting against oxidative stress in humans and demonstrating an important role in intestinal dysbiosis [ 23 , 39 , 40 ]. Currently, the evidence showed that probiotics have a positive effect on systemic and oxidative inflammation, especially at the gastrointestinal level.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, the evidence showed that probiotics have a positive effect on systemic and oxidative inflammation, especially at the gastrointestinal level. L. acidophilus, one of the probiotics administered during our stimulation, has demonstrated its role in inflammatory regulation in multiple experimental studies [ 27 , 28 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ]. A randomized, controlled clinical trial conducted by Jafarnejad et al [ 46 ] described the effect of supplementation with probiotics for 8 weeks, in this case, with VSL3 (a probiotic similar to the one administered in our study), on glycaemic status and inflammatory markers among pregnant women.…”

Section: Discussionmentioning

confidence: 99%

Serological Biomarkers and Diversion Colitis: Changes after Stimulation with Probiotics

et al. 2021

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Diversion colitis is a non-specific inflammation of a defunctionalised segment of the colon after a temporary stoma has been performed. This inflammation is associated with an alteration of certain inflammatory serum markers. The aims of this study were, firstly, to evaluate the modification of inflammatory biomarkers after stimulation with probiotics prior to closure of the protective ileostomy. Secondly, to identify if a relationship could be established between the severity of diversion colitis and the alteration of inflammatory biomarkers in the blood. A prospective, randomized, double-blind, controlled study was conducted. Patients who underwent surgery for colorectal carcinoma with protective ileostomy between January 2017 and December 2018 were included, pending reconstructive surgery and with diversion colitis as diagnosis. The sample was randomly divided into a group stimulated with probiotics (SG) (n = 34) and a control group (CG) (n = 35). Histological and endoscopic changes were evaluated after stimulation, after restorative surgery and during the short-term follow-up after surgery, including the correlation with pro-inflammatory biomarkers in blood. As main findings, a significant decrease in C-reactive protein (CRP), Neutrophil/lymphocyte ratio (NLR ratio), and monocyte/lymphocyte ratio (LMR ratio) was observed in the SG versus the CG with a p < 0.001. A significant increase in transferrin values and in the platelet/lymphocyte ratio (PLR) was observed in the SG versus CG after stimulation with probiotics with a p < 0.001. A normalisation of CRP and transferrin levels was observed in the third month of follow-up after closure ileostomy, and NLR, LMR and PLR ratios were equal in both groups. Decreased modified Glasgow prognostic score was found in SG compared to CG after probiotic stimulation (p < 0.001). The endoscopic and histological severity of diversion colitis is associated with a greater alteration of blood inflammatory biomarkers. The stimulation with probiotics prior to reconstructive surgery promotes an early normalization of these parameters.

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“…16 Moreover, several physiological perturbations implicated in PD pathogenesis, such as autoimmune dysfunction, 17 intestinal dysbiosis, 18 and disruption of epithelial permeability, 19 are also demonstrated in MC, implying a possible connection between MC and PD. 15,[20][21][22] Nevertheless, whether MC is indeed related to PD remains unexplored. Therefore, we aimed at investigating the association between MC and incident PD diagnosis by leveraging a unique nationwide histopathology database and national population registers in Sweden.…”

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confidence: 99%

Association Between Microscopic Colitis and Parkinson's Disease in a Swedish Population

et al. 2021

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A BS TRACT: Background: Gastrointestinal inflammation has been linked with Parkinson's disease (PD). Microscopic colitis (MC) is an intestinal inflammatory disease with unknown relationship with PD.Objective: This study aimed to examine the association of MC with PD risk. Methods: In this nationwide matched cohort study in Sweden, PD incidence was compared between 12,609 patients with histologically confirmed MC and a matched population cohort of 58,879 MC-free individuals and a sibling cohort comprising all unaffected siblings of the MC patients (N MC /N Sibling = 6281/12,351). Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models. Results: During a mean follow-up of $7 years, we identified 449 incident PD diagnoses among the MC patients and the population cohort. Overall, MC was associated with an adjusted HR of 1.76 for PD, but the association attenuated substantially during follow-up. In the time-varying effects model, PD hazard was 3.45-fold (95% CI: 2.42, 4.93) higher during the first 2 years after biopsy and 1.80-fold (95% CI: 1.23, 2.64) higher during the following 3 years among MC versus MC-free individuals but was not different beyond 5 years after biopsy (HR: 1.03; 95% CI: 0.68, 1.54). This temporal pattern of MC-PD associations persisted when comparing MC patients to their siblings. In a post hoc case-control analysis, we also detected a strong association between MC and preexisting PD (odds ratio: 3.46; 95% CI: 2.91, 4.12). Conclusions: Our findings suggest that MC may not be a risk factor for PD; instead, it may co-occur with PD as a comorbidity or develop after a diagnosis of PD.

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Microscopic Colitis Is Characterized by Intestinal Dysbiosis

Cited by 42 publications

References 8 publications

Diversion Colitis: Macro and Microscopic Findings after Probiotics Stimulation

Diversion Colitis: Macro and Microscopic Findings after Probiotics Stimulation

Serological Biomarkers and Diversion Colitis: Changes after Stimulation with Probiotics

Association Between Microscopic Colitis and Parkinson's Disease in a Swedish Population

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