GIT

[Jo Bowyer]

Fiber-rich diet may reduce lung disease

http://www.sciencedaily.com/releases...0122145457.htm

Analyzing data from the National Health and Nutrition Examination Surveys, researchers report in "The Relationship between Dietary Fiber Intake and Lung Function in NHANES," that among adults in the top quartile of fiber intake:

• 68.3 percent had normal lung function, compared to 50.1 percent in the bottom quartile.

• 14. 8 percent had airway restriction, compared to 29.8 percent in the bottom quartile.

In two important breathing tests, those with the highest fiber intake also performed significantly better than those with the lowest intake. Those in the top quartile had a greater lung capacity (FVC) and could exhale more air in one second (FEV1) than those in the lowest quartile.

"Lung disease is an important public health problem, so it's important to identify modifiable risk factors for prevention," said lead author Corrine Hanson PhD, RD, an associate professor of medical nutrition at the University of Nebraska Medical Center. "However, beyond smoking very few preventative strategies have been identified. Increasing fiber intake may be a practical and effective way for people to have an impact on their risk of lung disease."

Researchers adjusted for a number of demographic and health factors, including smoking, weight and socioeconomic status, and found an independent association between fiber and lung function. They did not adjust for physical activity, nor did the NHANES data allow them to analyze fiber intake and lung function over time -- limitations acknowledged by the authors.

Authors cited previous research that may explain the beneficial effects of fiber they observed. Other studies have shown that fiber reduces inflammation in the body, and the authors noted that inflammation underlies many lung diseases. Other studies have also shown that fiber changes the composition of the gut microbiome, and the authors said this may in turn reduce infections and release natural lung-protective chemicals to the body.

If further studies confirm the findings of this report, Hanson believes that public health campaigns may one day "target diet and fiber as safe and inexpensive ways of preventing lung disease."

[Jo Bowyer]

Screening gets top marks for picking up bowel cancer early

http://www.sciencedaily.com/releases...0122083443.htm

Of the cases picked up by bowel screening (where the stage at diagnosis was known), more than one third (37 per cent) were caught at the earliest stage (stage one) while fewer than one in ten (8 per cent) were advanced (stage four).

This compares to four in ten (40 per cent) of bowel cancers diagnosed as an emergency being stage four for those cases with known stage. The figures also show that more than a fifth (22 per cent) of bowel cancers were advanced (stage four) by the time people go to the doctor and are then diagnosed.

More than half (58 per cent) of all cancers diagnosed as an emergency were diagnosed at stage four compared to around a tenth (11 per cent) at stage one.

[Jo Bowyer]

Leafy green vegetables could hold the key to explaining how 'good' bacteria protect our gut and promote health

https://www.sciencedaily.com/release...0215114005.htm

A critical discovery about how bacteria feed on an unusual sugar molecule found in leafy green vegetables could hold the key to explaining how 'good' bacteria protect our gut and promote health. The finding suggests that leafy greens are essential for feeding good gut bacteria, limiting the ability of bad bacteria to colonize the gut by shutting them out of the prime 'real estate.'

[Jo Bowyer]

Hidden musculoskeletal involvement in inflammatory bowel disease: a multicenter ultrasound study

http://bmcmusculoskeletdisord.biomed...891-016-0932-z

Abstract

Background
Inflammatory bowel diseases are associated with a variety of extra-intestinal manifestations. The most frequent of these is joint involvement, which affects 16–33 % of IBD patients. Our aim was to evaluate the ultrasound prevalence of sub-clinical joint and entheseal involvement in patients with IBD without musculoskeletal symptoms, and to correlate the US findings with clinical and laboratory variables.

Methods
We recorded the clinical and laboratory data of 76 patients with IBD, 20 patients with spondyloarthritis (SpA) and 45 healthy controls at three rheumatology centers. All of the IBD patients and healthy controls were clinically examined by a rheumatologist in order to confirm the absence of musculoskeletal symptoms, and all of the subjects underwent grey-scale (GS) and power Doppler (PD) US examinations of the second and third metacarpophalangeal joints, knees and lower limbs in order to detect joint or entheseal abnormalities.

Results
A total of 1410 entheseal sites and 1410 joints were evaluated by US. Of the 76 patients with IBD, 64 (84.1 %) had at least one GS entheseal abnormality, and 11 (13.9 %) had more than one PD-positive entheseal site; 32 (42.1 %) showed sub-clinical joint involvement.

There was a significant difference between the IBD patients and healthy controls in terms of global entheseal, PD-positive entheseal, and joint involvement (p < 0.0001), but no difference between the IBD and SpA patients. Anti-neutrophil cytoplasmic antibodies predicted entheseal involvement in patients with IBD (OR 6.031; p = 0.015).

Conclusions
The prevalence of sub-clinical joint and entheseal involvement was higher in IBD patients than healthy controls, but there was no difference between the IBD and SpA patients.

Keywords

Inflammatory bowel disease Spondyloarthritis Ultrasound Enthesis Joint
Background

[Jo Bowyer]

Gut Microbiome of Coexisting BaAka Pygmies and Bantu Reflects Gradients of Traditional Subsistence Patterns

http://www.cell.com/cell-reports/abs...showall%3Dtrue

Highlights
•BaAka hunter-gatherers and Bantu agriculturalists have distinct gut microbiomes
•Microbiome profiles follow a gradient that reflects the degree of traditional lifestyle
•Comparisons with US Americans show western-like microbiome patterns in the Bantu
•Westernization drives sugar/xenobiotic processing and loss of traditional microbes

Summary
To understand how the gut microbiome is impacted by human adaptation to varying environments, we explored gut bacterial communities in the BaAka rainforest hunter-gatherers and their agriculturalist Bantu neighbors in the Central African Republic. Although the microbiome of both groups is compositionally similar, hunter-gatherers harbor increased abundance of Prevotellaceae, Treponema, and Clostridiaceae, while the Bantu gut microbiome is dominated by Firmicutes. Comparisons with US Americans reveal microbiome differences between Africans and westerners but show western-like features in the Bantu, including an increased abundance of predictive carbohydrate and xenobiotic metabolic pathways. In contrast, the hunter-gatherer gut shows increased abundance of predicted virulence, amino acid, and vitamin metabolism functions, as well as dominance of lipid and amino-acid-derived metabolites, as determined through metabolomics. Our results demonstrate gradients of traditional subsistence patterns in two neighboring African groups and highlight the adaptability of the microbiome in response to host ecology.

[Jo Bowyer]

Bread and other edible agents of mental disease

http://journal.frontiersin.org/artic...00130/abstract

Perhaps because gastroenterology, immunology, toxicology, and the nutrition and agricultural sciences are outside of their competence and responsibility, psychologists and psychiatrists typically fail to appreciate the impact that food can have on their patients’ condition. Here we attempt to help correct this situation by reviewing, in non-technical, plain English, how cereal grains—the world’s most abundant food source—can affect human behavior and mental health. We present the implications for the psychological sciences of the findings that, in all of us, bread (1) makes the gut more permeable and can thus encourage the migration of food particles to sites where they are not expected, prompting the immune system to attack both these particles and brain-relevant substances that resemble them; and (2) releases opioid-like compounds, capable of causing mental derangement if they make it to the brain. A grain-free diet, although difficult to maintain (especially for those that need it the most), could improve the mental health of many and be a complete cure for others.

[Jo Bowyer]

Risk of Gastrointestinal Cancers among Patients with Appendectomy: A Large-Scale Swedish Register-Based Cohort Study during 1970-2009

http://journals.plos.org/plosone/art...l.pone.0151262

Abstract

Background

Removal of the appendix might induce physiological changes in the gastrointestinal tract, and subsequently play a role in carcinogenesis. Therefore, we conducted a nationwide register-based cohort study in Sweden to investigate whether appendectomy is associated with altered risks of gastrointestinal cancers.

Methods

A population-based cohort study was conducted using the Swedish national registries, including 480,382 eligible patients followed during the period of 1970–2009 for the occurrence of site-specific gastrointestinal cancer (esophageal/gastric/colon/rectal cancer). Outcome and censoring information was collected by linkage to health and demography registers. We examined the incidence of appendectomy in Sweden using data from 1987–2009. We also calculated standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) to estimate the relative gastrointestinal cancer risk through comparison to the general population.

Results

We noted an overall decrease in the age-standardized incidence of appendectomy among the entire Swedish population from 189.3 to 105.6 per 100,000 individuals between 1987 and 2009. Grouped by different discharge diagnosis, acute appendicitis, incidental appendectomy, and entirely negative appendectomy continuously decreased over the study period, while the perforation ratio (18%–23%) stayed relatively constant. Compared to the general population, no excess cancer risk was observed for gastrointestinal cancers under study with the exception of a marginally elevated risk for esophageal adenocarcinoma (SIR 1.32, 95% CI 1.09–1.58).

Conclusions

In Sweden, the incidence of appendectomy and acute appendicitis has decreased during 1987–2009. No excess gastrointestinal cancer risks were observed among these appendectomized patients, with the possible exception of esophageal adenocarcinoma.

[Jo Bowyer]

Reduction in dietary diversity impacts richness of human gut microbiota

https://www.sciencedaily.com/release...0315104210.htm

Heiman and Greenway describe how the reduction in dietary diversity has changed the richness of human gut microbiota, the community of microorganisms living in the gut. The researchers point out that healthy individuals have diverse gut microbiota and many of the common pathologies of the 21st century, including type 2 diabetes, obesity and inflammatory bowel disease, are associated with reduced microbiotic richness.

Gut microbiota function as an endocrine organ, metabolizing specific nutrients from the diet and producing specific substances that act as metabolic signals in the host. It follows then that highly specialized diets will change the landscape of the gut microbiome over time. In fact, it takes only a few days of changing diet to alter the micro biotic makeup of the human gut. And if the dietary change involves elimination of one or more macronutrients (think Atkins or Paleo or vegan), humans are essentially selecting for some micro biotic species over others.

[Jo Bowyer]

Mom's microbes influence her offspring's immune system, mice study shows

https://www.sciencedaily.com/release...0317150002.htm

During gestation, a mother's microbiome shapes the immune system of her offspring, a new study in mice suggests. While it's known that a newborn's gut microbiota can affect its own immune system, the impact of a mother's microbiota on her offspring has largely been unexplored.

Here, Mercedes Gomez de Agüero et al. infected the guts of pregnant mice with E.coli engineered to dwindle over time, allowing the mothers to become germ-free again around the time they gave birth.

This temporary colonization of E.coli in the mother affected the immune system of her offspring; after birth, the offspring harbored more innate lymphoid and mononuclear cells in their intestines compared to mice born to microbe-free pregnant mothers. Similar results were seen when pregnant mothers were temporarily colonized with a cocktail of eight other microbes.

An RNA analysis of offspring born to gestation-only colonized mothers compared with controls revealed greater expression of numerous genes, including those that influence cell division and differentiation, mucus and ion channels, and metabolism and immune function.

By transferring serum from bacteria-colonized pregnant mice to non-colonized pregnant mice, the researchers found that maternal antibodies likely facilitate the transmission and retention of microbial molecules from a mother to her offspring.

The results of this study add another surprising chapter to the growing body of literature surrounding the

[Jo Bowyer]

Our gut microbiome is always changing; it's also remarkably stable

https://www.sciencedaily.com/release...0317145845.htm

Turnover is to be expected in the gut--as soon as one bacterium leaves, another is ready to divide and take its place. The question, explored in a Review published March 17 in Trends in Microbiology, part of a special issue on microbial endurance, is how our gut remains healthy under this constantly enacted succession plan. A growing body of research indicates that different species of microbes fulfil the same functions in the gut, ensuring stability in the face of constant disturbance.

Humans and their microbes are part of an ancient symbiotic relationship. We provide our gut bacteria with a place to live and nutrients to grow, while they help us break down food and fight off more pathogenic invaders. Daily changes such as meals or exercise may cause some of our intestinal tenants to die off, but these populations have evolved to hold steady, regrow, or be replaced with similarly acting bacteria. Even with a revolving door of bacterial species, our bodies continue to function normally.

But this is not always the case. At least 50 disorders are associated with gut microbes that have been knocked out of balance, and many potential treatments--from probiotics to fecal transplants--depend on the idea that a person's microbiota can be changed for the better. The problem is that even with the improvements associated with these therapies, they are not long lasting. There's something that brings an organism's microbiome back to a base point.

"You and I will have different microbes in our bodies, so there are some kind of genetic factors in the human host that make individuals more susceptible to harboring particular bacteria," says Review coauthor Andrés Moya, a geneticist with an interest in evolutionary biology at FISABIO-Universitat de València in Spain. "We don't understand these differences yet, and it's an area that needs to be better studied."

Moya and second coauthor Manuel Ferrer of the Consejo Superior de Investigaciones Científicas, also in Spain, say that most of our research focus on gut microbes is on looking at their individual functions and the diversity of gut microbes in different populations. For example, we know that lean (under antibiotic treatment) and obese individuals have interchangable types of bacteria related to breaking down sugar or processing carbohydrates. What we don't know is what role these bacteria play in the larger microbiome community.

The researchers make the case for studying the human microbiota as an intestinal ecosystem, by concentrating more on how the various species work with one another and our own cells. Recent work has shown tremendous genetic transfer between the bacteria of the gut, indicating that they have evolved specialized core functions. This top-down approach could help us understand the role these bacteria play in the human body and what leads to clinical symptoms when they are in dysbiosis.

"When we are born, we are not alone. We already have different bacterial species that are interacting with our human cells--they are not independent, trying to survive in our gut, they are forming something like a superspecies," says Moya, also a researcher from the Genomics and Health Area of the FISABIO Foundation. "The microbiome may be the last human organ to be studied."

No need to feel lonely when you have millions hitching a ride on and inside you

[Jo Bowyer]

Rye-Based Evening Meals Favorably Affected Glucose Regulation and Appetite Variables at the Following Breakfast; A Randomized Controlled Study in Healthy Subjects

http://journals.plos.org/plosone/art...l.pone.0151985

Abstract

Background

Whole grain has shown potential to prevent obesity, cardiovascular disease and type 2 diabetes. Possible mechanism could be related to colonic fermentation of specific indigestible carbohydrates, i.e. dietary fiber (DF). The aim of this study was to investigate effects on cardiometabolic risk factors and appetite regulation the next day when ingesting rye kernel bread rich in DF as an evening meal.

Method

Whole grain rye kernel test bread (RKB) or a white wheat flour based bread (reference product, WWB) was provided as late evening meals to healthy young adults in a randomized cross-over design. The test products RKB and WWB were provided in two priming settings: as a single evening meal or as three consecutive evening meals prior to the experimental days. Test variables were measured in the morning, 10.5–13.5 hours after ingestion of RKB or WWB. The postprandial phase was analyzed for measures of glucose metabolism, inflammatory markers, appetite regulating hormones and short chain fatty acids (SCFA) in blood, hydrogen excretion in breath and subjective appetite ratings.

Results

With the exception of serum CRP, no significant differences in test variables were observed depending on length of priming (P>0.05). The RKB evening meal increased plasma concentrations of PYY (0–120 min, P<0.001), GLP-1 (0–90 min, P<0.05) and fasting SCFA (acetate and butyrate, P<0.05, propionate, P = 0.05), compared to WWB. Moreover, RKB decreased blood glucose (0–120 min, P = 0.001), serum insulin response (0–120 min, P<0.05) and fasting FFA concentrations (P<0.05). Additionally, RKB improved subjective appetite ratings during the whole experimental period (P<0.05), and increased breath hydrogen excretion (P<0.001), indicating increased colonic fermentation activity.

Conclusion

The results indicate that RKB evening meal has an anti-diabetic potential and that the increased release of satiety hormones and improvements of appetite sensation could be beneficial in preventing obesity. These effects could possibly be mediated through colonic fermentation.

[Jo Bowyer]

Antibiotics for appendicitis: Yes and no

https://www.sciencedaily.com/release...0318090430.htm

Using antibiotics as the primary treatment for mild appendicitis does not increase the risk for complications at least in the first year. But other considerations must also be taken into account, say researchers.

[Jo Bowyer]

Healthy gut could help prevent deadly side effect of bone marrow transplant

https://www.sciencedaily.com/release...0321123541.htm

Could playing better defense make bone marrow transplants more successful?

With this question in mind, researchers began looking at whether the trillions of little bugs and bacteria living in our gastrointestinal tract could be the key to playing defense.

Up to half of patients who receive a bone marrow transplant from a donor will develop severe gastrointestinal damage from graft vs. host disease, a condition in which the donor cells attack the host's body. It's the reason why transplants -- which can be very successful at eliminating cancers such as leukemia or lymphoma -- are so risky.

In a new study, published in Nature Immunology, researchers searched for alterations in the gut microbiome to see whether their metabolites could impact outcomes after BMT.

They found that a metabolite called butyrate was significantly reduced in the intestinal tract of experimental mice that received bone marrow transplant. When the researchers increased butyrate in these mouse models, they saw a decrease in the incidence and severity of graft vs. host disease.

"Our findings suggest we can prevent graft vs. host disease by bolstering the amount of the microbiome-derived metabolite butyrate," says study lead author Pavan Reddy, M.D., the Moshe Talpaz Professor of Translational Pathology and interim division chief of hematology/oncology at the University of Michigan.

"If the GI gut lining can remain healthy and strong, it can resist the attack by the donor immune system and hopefully prevent graft vs. host disease," he adds.

I have written before about my experience as a junior physiotherapist on a pioneering bone marrow transplant unit in the 1970s when we were losing all our patients to graft vs host disease and I finally told my senior that I thought that I was going to have to stop being a physiotherapist.

My senior re jigged the work load so that I covered paediatric orthopaedics and she focussed on the medical and surgical wards. I also got a visit from the Prof running the unit who spent time I suspect he needed for much more important tasks, talking me through it and making me a promise that within the next five years, patients in the UK and elsewhere would survive the treatment.

I haven't worked in paediatric oncology since, but it was thanks to those two remarkable individuals that one very young broken physiotherapist didn't give up on a profession barely started.

[Jo Bowyer]

Is there a ‘gut–brain–skin axis’?

http://onlinelibrary.wiley.com/doi/1...9.01060.x/full

Viewpoint

There is a rapidly growing interest in the characterisation of the human intestinal microbiome, the composition of which remains largely uncharacterised (1). Associated with this has risen the knowledge and conviction that, in addition to local intestinal effects, there is a continually functioning interaction between the gut, its microbiome and the brain (‘gut–brain axis’) (2,3). For example, visual cues of food as well as food intake interact with this axis at the level of the hypothalamus, while gut peptides, in turn, are involved in the regulation of central processes such as satiety and feeding behaviour. Gut peptides also regulate numerous other processes including glucose regulation, insulin secretion and insulin sensitivity (2,3). In addition, gut peptides also impact on distant tissue functions, including possibly bone metabolism (3,4). Metabolic abnormalities and gastrointestinal infection impact on this axis, as shown in patients with type 2 diabetes (5) or in mice with chronic Helicobacter pylori infection (6).

Thus, the ‘gut–brain axis’ is now thought to contribute to the regulation of a multitude of metabolic, immune, endocrine and even nervous system processes, whose full scope is only slowly emerging (2,3,5,7). Also, the ‘gut–brain axis’ has increasingly become a target for therapeutic intervention in gastrointestinal diseases, obesity and metabolic syndrome (8,9). Furthermore, immense interest has recently been raised by the possible use of ingested commensal organisms for treating inflammatory and allergic conditions (10,11). While the potential clinical benefit of such probiotic strategies is generally acknowledged, its actual efficacy in clinical practice, the profound strain-specific effects of, e.g. different Lactobacilli in ameliorating inflammation and pain (12), and the underlying mechanisms of action through which these effects may be exerted in vivo all remain hotly debated (13,14).

Although clinicians have long felt this to be evident, it has only relatively recently become clear that, besides the ‘gut–brain axis’, there is also a ‘brain–skin axis’, whose molecular key players are increasingly understood (15–18). Interestingly, a number of gastrointestinal peptides (e.g., calcitonin gene-related peptide (CGRP), vasoactive intestinal peptide) have also been detected in intra-cutaneous nerve fibres (19).

A great deal of understanding mediators involved in the brain–skin axis came from studies in mice, where perceived stress-induced major neurogenic inflammation in mammalian skin (20,21) and even alters epidermal barrier function (17). For example, sound stress causes substantial substance P-, nerve growth factor- and mast cell-dependent neurogenic inflammation in mouse skin and even impacts on neuropeptide production by dorsal root ganglia sensory neurons (19,21,22). Interestingly, formation of functional associations between nerve fibres and mast cells appear to be very similar in the skin and gut (23,24). In the skin, perceived stress, at least in part via neurogenic inflammation, subsequently inhibits hair growth by premature induction of hair follicle (HF) regression (catagen), reduction in HF keratinocyte proliferation and stimulation of HF keratinocyte apoptosis, e.g. via activation of mast cells, macrophages and dendritic cells (20,23).

Here, we introduce our viewpoint that the ‘gut–brain axis’ and this more recently documented ‘gut–skin axis’ are intimately linked with each other. The large number of shared signals and cellular protagonists, the intricate innervation of both skin and gut, and the prominence of neurogenic inflammation in several gastrointestinal and dermatological diseases all make this an intuitively persuasive hypothesis (25,26).

[Jo Bowyer]

Commensal microbiota affects ischemic stroke outcome by regulating intestinal γδ T cells

http://neurosciencenews.com/microbio...eurology-3928/

Abstract

Commensal gut bacteria impact the host immune system and can influence disease processes in several organs, including the brain. However, it remains unclear whether the microbiota has an impact on the outcome of acute brain injury. Here we show that antibiotic-induced alterations in the intestinal flora reduce ischemic brain injury in mice, an effect transmissible by fecal transplants. Intestinal dysbiosis alters immune homeostasis in the small intestine, leading to an increase in regulatory T cells and a reduction in interleukin (IL)-17–positive γδ T cells through altered dendritic cell activity. Dysbiosis suppresses trafficking of effector T cells from the gut to the leptomeninges after stroke. Additionally, IL-10 and IL-17 are required for the neuroprotection afforded by intestinal dysbiosis. The findings reveal a previously unrecognized gut-brain axis and an impact of the intestinal flora and meningeal IL-17+ γδ T cells on ischemic injury.

“Commensal microbiota affects ischemic stroke outcome by regulating intestinal γδ T cells” by Corinne Benakis, David Brea, Silvia Caballero, Giuseppe Faraco, Jamie Moore, Michelle Murphy, Giulia Sita, Gianfranco Racchumi, Lilan Ling, Eric G Pamer, Costantino Iadecola and Josef Anrather in Nature Communications. Published online March 28 2016 doi:10.1038/nm.4068