Expressão De E-Caderina E Claudina-3 No Epitélio Cólico Após Terapia Com Infliximabe: Modelo Experimental De Colite De Exclusão

Junior, A.J.T. Alves; Goto, Eduardo Felipe Kim; Pereira, José Aires; Domingues, Fernanda Aparecida; Ávila, Mariane Grandi de; Coy, Cláudio Saddy Rodrigues

doi:10.1590/0102-672020210002e1639

Cited by 1 publication

(3 citation statements)

References 28 publications

(245 reference statements)

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Section: Discussionmentioning

confidence: 99%

“…However, studies in recent years has shown that DC is common in patients after terminal ileostomy. DC is also clinically known as disuse colitis (12). DC was first mentioned by Basil Morson et al (13) in 1974, when it was described as a segmental nonspecific inflammation confined to the colonic mucosa.…”

Section: Discussionmentioning

confidence: 99%

“…Metabolites in feces are an important source of energy for the body, and disruption of fecal flow may lead to colitis, but direct evidence is still few (19). Glotzer et al (12) speculated in a clinical report about 10 DC patients that DC might be the result of factors such as excessive proliferation of pathogenic bacteria, nutritional deficiencies, toxins, or disturbance of the symbiotic relationship between bacteria and the mucosal layer in gut. In an in vivo study (20), it was shown that the changes in gut microbiota were dominated by the increase of Bacteroides and Clostridium.…”

Section: Discussionmentioning

confidence: 99%

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Interaction between the intestinal flora and the severity of diversion colitis after low anterior resection of rectal cancer

Sun

Yunjie²,

Liang³

et al. 2023

Front. Oncol.

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BackgroundDiversion colitis (DC) is nonspecific inflammation of the distal intestinal mucosa following disruption of colonic continuity with colonic dysfunction. The colonscopic score is a good tool for differentiating the severity of patients with DC. At present, no studies have analyzed the pathogenesis of DC from the perspective of the diversity and and differences of intestinal flora.MethodsRetrospective study: Clinical information were collected from patients with low rectal cancer admitted to the Department of Anorectal Surgery, Changzheng Hospital, from April 2017 to April 2019. These patients underwent laparoscopic low anterior resection (LAR) combined with terminal ileum enterostomy (dual-chamber). We used chi-square test to comparethe clinical baseline information, clinical symptoms, and colonscopic characteristics between different severity of DC. Propsective oberservational study: We recruited 40 patients with laparoscopic anterior low resection combined with terminal ileum enterostomy and they were further classified into mild group and severe group according to the scores of colonscopic examinations for DC. 16s-rDNA sequencing was carried out to analyze the diversity and and differences of intestinal flora in the intestinal lavage fluid of the two groups.ResultsIn retrospective study, we found that age, BMI, history of diabetes, and symptoms associated with the stoma state were the independent risk factors that affect DC severity (P<0.05). Meanwhile, age, BMI, history of diabetes and colonscopic score were found to be independent risk factors affecting the severity of diarrhea after ileostomy closure surgery(P<0.05), which was consistent with our results of differentiating the severity of DC under endoscopy; In propsective oberservational study, 40 patients with low rectal cancer recruited by sample size calculation, 23 were in the mild group and 17 in the severe group. The results of 16s-rDNA sequencing showed that intestinal flora with high enrichment values primarily consisted of Bifidobacteriales and Prevotella in mild group, whereas that in the severe group consisted of Providencia and Dorea. The functional predictions on such two types of intestinal flora were mainly focused on lipid synthesis, glycan synthesis, metabolism, and amino acid metabolism pathways.ConclusionAfter ileostomy closure surgery, a series of severe clinical symptoms might appear in DC patients. There are significant differences in local and systemic inflammatory responses, composition of intestinal flora between DC patients with different colonscopic scores, which provide a basis for the clinical interventional treatment for DC in patients with permanent stoma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%