<i>Actinomyces</i> in Crohn’s‐like appendicitis

Horváth, Béla; Maryamchik, Elena; Miller, Gregory; Brown, Ian; Setia, Namrata; Mattia, Anthony R.; Lamps, Laura W.; Lauwers, Gregory Y.; Rosenberg, Eric S.; Misdraji, Joseph

doi:10.1111/his.13929

Cited by 10 publications

(8 citation statements)

References 16 publications

(56 reference statements)

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“…Sally A Cross reported that Desulfovibrio can cause bacteremia ( 41 ). Besides, Actinomyces are normal members in human gut and can cause endogenous infection, which is a well-recognized cause of chronic appendicitis, and histologically mimicking Crohn’s disease ( 42 ).…”

Section: Discussionmentioning

confidence: 99%

Clostridium butyricum potentially improves inflammation and immunity through alteration of the microbiota and metabolism of gastric cancer patients after gastrectomy

Cao

Zheng

et al. 2022

Front. Immunol.

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BackgroundGastrectomy is the most effective treatment to improve the clinical survival rate of patients with gastric cancer. However, the pathophysiological changes caused by gastrectomy have seriously affected the postoperative recovery.MethodsIn the present trial, Ataining (containing C. butyricum, CGMCC0313.1) was applied in patients after gastrectomy to investigate the effect of C. butyricum on the early postoperative recovery by monitoring the inflammatory immune response with blood indicators, detecting the gut microbiota with high-throughput sequencing, and analyzing the short-chain fatty acids (SCFAs) with targeted metabolomics. This study is registered with the number ChiCTR2000040915.ResultsOur outcomes revealed that C. butyricum had significantly reduced the number of Leucocyte (P < 0.001), the percentage of Neutrophil (P < 0.001), the expression of IL-1β (P < 0.01), IL-6 (P < 0.05), and TNF-α (P < 0.01), while markedly enhanced the immunity indexes (immunoglobulin and lymphocyte) (P < 0.05) and nutrition indexes (albumin and total protein) (P < 0.05). In addition, the use of the C. butyricum greatly enriched the relative abundance of beneficial bacteria Bacteroides, Faecalibacterium and Gemmiger, while the abundance of pathogenic Streptococcus, Desulfovibrio and Actinomyces were markedly decreased at genus level. We also observed significant up-regulation of SCFAs, including acetic acid, propionic acid, butyric acid and isobutyric acid, after C. butyricum administration in patients receiving gastrectomy.ConclusionTherefore, evidence supported that oral administration of C. butyricum after gastrectomy can reduce early postoperative inflammation, enhance immune ability, restore intestinal microbiota eubiosis, increase intestinal SCFAs, reduce the occurrence of postoperative complications, and ultimately promote the early recovery of the patient.Clinical trial registrationhttp://www.chictr.org.cn/, identifier (ChiCTR2000040915).

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Section: Discussionmentioning

confidence: 99%

Clostridium butyricum potentially improves inflammation and immunity through alteration of the microbiota and metabolism of gastric cancer patients after gastrectomy

Cao

Zheng

et al. 2022

Front. Immunol.

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“…10 A few subsequent studies have reported additional features that could be seen in IA, including Actinomyces infection, pulse granulomas and postinflammatory mucosal hyperplasia. [11][12][13] Whereas, in the past, most appendectomy specimens in our practice demonstrated AA, we have noted an increase in IA in recent years. We often receive appendectomy specimens with a provided clinical history of acute appendicitis on the requisition form, without specific information regarding prior supportive therapy, and sometimes additional information is not readily available in the patient's medical record.…”

Section: Introductionmentioning

confidence: 52%

“…(Interestingly, a recent study in a paediatric cohort primarily observed serosal granulomas in IA 19 20 such as with Enterobius vermicularis 21 or Actinomyces spp., 11 both of which can be observed in the appendiceal lumen. The most common infectious organism causing granulomatous appendicitis is Yersinia spp 22 …”

Section: Discussionmentioning

confidence: 96%

“…This was first described by Guo and colleagues in 2003, who analysed 22 cases of IA and reported that granulomas, xanthogranulomatous inflammation, mural fibrosis/thickening and transmural Crohn‐like chronic inflammation were more common in IA than in their comparison group of 44 AA samples 10 . A few subsequent studies have reported additional features that could be seen in IA, including Actinomyces infection, pulse granulomas and postinflammatory mucosal hyperplasia 11–13 …”

Section: Introductionmentioning

confidence: 99%

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Interval appendicitis shows histological differences from acute appendicitis and may mimic Crohn disease and other forms of granulomatous appendicitis

2022

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Interval appendicitis shows histological differences from acute appendicitis and may mimic Crohn disease and other forms of granulomatous appendicitis Aims: While patients presenting with clinical signs and symptoms of acute appendicitis (AA) often receive surgical intervention shortly after presentation, certain patients may instead receive nonoperative management initially, with appendectomy later. The histology of such interval appendicitis (IA) has only been described in small series. Also, we have noticed a recent increase in the incidence of IA specimens at our institution. Methods and results: We identified appendectomy specimens in our department during 2018 with available haematoxylin and eosin slides and electronic clinical data, and evaluated multiple histological findings. Cases were then divided into AA and IA, based on clinical history (AA if the patient presented to the hospital within 1 week of symptom onset and underwent appendectomy within 48 h; IA if appendectomy was delayed at least 1 week). Changes between groups were compared. The cohort included 165 cases (125 AA, 40 IA). Findings significantly more common in AA included mucosal acute inflammation, mural acute inflammation and acute serositis. Findings significantly more common in IA included Crohn-like mural inflammation, mural fibrosis, goblet cell hyperplasia, granulomas, xanthogranulomatous inflammation, haemosiderinladen macrophages and granulation tissue. The rate of IA in 2018 (24%) was noticeably higher than in previous years. Conclusion: Acute inflammatory changes are more common in AA but can remain present in IA. Mural fibrosis, serosal adhesions, haemosiderin-laden macrophages and granulation tissue suggest IA. Granulomas and xanthogranulomatous inflammation can also be seen in IA, and Crohn-like mural inflammation is not uncommon. These histological patterns can guide signout and prevent diagnostic errors, particularly when clinical information is unavailable.

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“…Actinomycetes are recognized to be a cause of chronic appendicitis. Actinomycetes are also associated with Crohn-like appendicitis with significant fibrosis, transmural inflammation, lymphoid hyperplasia, and granuloma[ 29 ]. TM7x is a saccharifying bacteria, which is a parasitic bacterium that interacts with core members of Actinomycetes.…”

Section: Discussionmentioning

confidence: 99%

Mucosal bacterial dysbiosis in patients with nodular lymphoid hyperplasia in the terminal ileum

Jiang¹,

Lü²,

Zhang³

et al. 2022

WJG

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BACKGROUND Nodular lymphoid hyperplasia (NLH) in the small intestine is a rare benign lesion characterized by multiple small nodules on the intestinal surface. Patients with terminal ileal NLH may experience long-term abdominal pain, diarrhea, and abdominal distension, among other symptoms. Supplementation with probiotics could mitigate these symptoms. NLH is linked to the immune system, and it may result from accumulation of plasma-cell precursors due to a maturational defect during the development of B lymphocytes. The intestinal microbiome plays an essential role in the immune system. Thus, we speculate that the gut flora plays a key role in terminal ileal NLH. AIM To explore the correlation between intestinal flora and terminal ileal NLH. METHODS We collected mucosal biopsy samples that were obtained via colonoscopy from 15 patients with terminal ileal NLH (the test group) and 15 normal subjects (the control group). We subsequently performed 16S-rRNA gene amplicon sequencing of these samples, and the results were evaluated using alpha diversity, beta diversity and microbial composition analyses. The Phylogenetic Investigation of Communities by Reconstruction of Unobserved States was used to predict the metabolic pathways and orthologous groups according to the Kyoto Encyclopedia of Genes and Genomes database. RESULTS Compared with the control group, the terminal ileal NLH group showed an increased alpha diversity ( P < 0.05). The overall intestinal microbiota in the NLH group was significantly different from that of the control group ( P < 0.05), implying that there was the dysbiosis in the terminal ileal NLH patients. The relative abundance of phylum Bacteroidetes was significantly lower in the NLH group, while that of Patescibacteria and Campilobacterota was significantly higher. The genus Bacteroides was the dominant gut microbiota in both groups, but its abundance was significantly lower in the test group than it was in the control group. Conversely, the relative abundances of Haemophilus, Streptococcus, Pseudomonas, Actinomyces, TM7X, Fusobacterium nucleatum, Parvimonas, Granulicatella, Helicobacter , and the [ Eubacterium ] nodatum group were significantly higher in the test group than they were in the control group. In addition, several altered metabolic pathways, orthologous groups, and modules were found. For example, the Peptidoglycan biosynthesis and Aminoacyl tRNA biosynthesis were both increased in the test group. CONCLUSION Maintaining the microbial balance and supplementing targeted protective bacteria could improve symptoms and potentially reduce the risk of lymphoma transformation in patients with terminal ileal NLH.

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Actinomyces in Crohn’s‐like appendicitis

Cited by 10 publications

References 16 publications

Clostridium butyricum potentially improves inflammation and immunity through alteration of the microbiota and metabolism of gastric cancer patients after gastrectomy

Clostridium butyricum potentially improves inflammation and immunity through alteration of the microbiota and metabolism of gastric cancer patients after gastrectomy

Interval appendicitis shows histological differences from acute appendicitis and may mimic Crohn disease and other forms of granulomatous appendicitis

Mucosal bacterial dysbiosis in patients with nodular lymphoid hyperplasia in the terminal ileum

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