LDL-Receptor Related Protein Five Controls Bone Formation by Inhibiting Serotonin Synthesis in the Duodenum

Abstract

Hysteroscopic sterilization is a minimally invasive, nonincisional method of permanent sterilization that is a valid alternative to laparoscopic sterilization, the conventional method of female sterilization. Under hysteroscopic guidance, an expanding microinsert is introduced into the proximal portion of each fallopian tube; local fibrosis and, ultimately, complete tubal occlusion occurs within 3 months. This retrospective study examined trends in sterilization in women at an outpatient surgery center and university teaching hospitals following the introduction of Essure hysteroscopic sterilization in 2002. A chart review was conducted on women undergoing interval sterilization procedures and postpartum sterilization procedures between 2002 and 2007. Interventions evaluated included minilaparotomy tubal ligation, laparoscopic sterilization, Essure hysteroscopic sterilization, and postpartum tubal ligation performed after vaginal delivery or at the time of cesarean section.Of the 5509 permanent sterilization procedures examined, 2484 were interval sterilization procedures and 3025 were postpartum tubal ligations. For all interval sterilizations performed during the 6-year-study period, a shift toward Essure hysteroscopic sterilizations from 0.0% to 51.3% corresponded significantly with a decrease in laparoscopic sterilizations from 97.9% to 48.5% (P Ͻ 0.001). During the study period, the number of postpartum tubal ligations performed after vaginal delivery decreased significantly from 7.9% to 3.3% of all vaginal deliveries (P Ͻ 0.001), whereas the number of tubal ligations performed at the time of cesarean section did not change significantly (P ϭ 0.51).These findings suggest the high likelihood that Essure hysteroscopic sterilization will replace the laparoscopic approach as the method of choice for permanent sterilization. ABSTRACTIt is becoming increasingly common to enable a woman to see her ambulatory hysteroscopy procedure on a monitor. However, there is only limited evidence on the potential impact of seeing or not seeing the procedure on patient mood, perception of pain, and patient-physician interaction. This randomized controlled trial compared the effects of seeing or not seeing the screen during an outpatient hysteroscopy procedure on patient's experience. At two outpatient clinics, 157 women scheduled for a hysteroscopy procedure were randomized either to see the screen (n ϭ 81) or not to see the screen (n ϭ 76). Before and after the procedure, the patients completed questionnaires to evaluate various parameters of their experience (mood, pain perception, illness cognitions, and communication with the health professional). After 232Obstetrical and Gynecological Survey Office Gynecology 233ABSTRACT Some investigators have reported that presence of the inner border may be a colposcopic sign for the presence of high-grade cervical neoplasia. The inner border can be defined as a sharp acetowhite demarcation or transformation zone within a less opaque acetowhite area. The association of the colposcopic si...

The bridge of the gut–joint axis: Gut microbial metabolites in rheumatoid arthritis

“…In addition, a small fraction of tryptophan (1–2%) can produce serotonin in enterochromaffin cells via tryptophan hydroxylase 1 (TPH1), the expression of which is also regulated by SCFAs. The relevance of gut-derived serotonin in RA remains to be investigated, but serotonin may play a role in the control of bone remodelling, indicating the presence of a gut-bone axis ( 163 , 164 ).…”

“…Acts as an intestinal FXR and TGR5 agonist or antagonist to reduce proinflammatory cytokine production (80) -Protects tight junction proteins (104) -Maintains immune homeostasis -Regulates the balance of Treg/Th17 by both downregulating Th17 cells and upregulating Treg cells (43, 44, 64, 65) -Ameliorates bone destruction -Increases bone-mineral density via vitamin D intake promotion (69-71).-Inhibits the production of proinflammatory cytokines, such as TNF-a, IL-1b, and IL-6 (79) -Activate FXR, increase alkaline phosphatase activity and extracellular matrix calcification, and stimulate the expression of osteoblast marker genes BSP, OC, OPN and ALP and the DNA-binding activity of the bone transcription factor Runx2 (84) Induces the production of antimicrobial peptides and mucin in epithelial cells (108) -Reduces inflammasome activation (61) -Increases intestinal permeability by affecting the tight junctions (103, 104) -Maintains immune homeostasis Enhances the antibacterial activity of macrophages (117) -Suppresses NF-kB activation by HDAC pathway and PPARg pathway (113, 114) -Blocks DC differentiation (119) -Regulates the balance of Treg/Th17 or B cells (131, 133) -Ameliorates bone destruction -Downregulate osteoclast-specific gene expression in bone, like TRAF6 and NFATc1, and inhibits osteoclast differentiation Performs dynamic remodelling of junctional complexes (150) -Reduces the production of TNF-a and IL-6 (150-152) -Increases IL22 expression (154) -Maintains immune homeostasis -Regulates the balance of Treg/Th17 by both Downregulates Th17 cells and upregulates Treg cells (157)-Ameliorates bone destruction -Reduced intra-articular IL-17A, IFN g, IL-6, and TNF-a expression levels (126) -Regulates the bone remodelling(163,164) Bas, bile acids; SCFA, Short-chain Fatty Acid; TRP, Tryptophane; FXR, farnesoid X receptor; TGR5, G protein-coupled bile acid receptor 1; GPR, G protein-coupled receptor; AhR, Aryl Hydrocarbon Receptor; BSP, bone sialoprotein; OC, osteocalcin; OPN, osteopontin; ALP, alkaline phosphatase; TNF-a, Tumor necrosis factor-a; IL-1b, interleukin-1b; IL-6, interleukin-6; HDAC, histone deacetylase; PPARg, peroxisome proliferator-activated receptor g; DC, Dendritic cell; TRAF6, TNF receptor associated factor 6; NFATc1, Recombinant Nuclear Factor Of Activated T-Cells Cytoplasmic 1; IL22, interleukin-22; Th17, T helper 17; Treg, Regulatery T; IL-17A, interleukin-17A; IFN g, interferon-g.…”

Intestinal Microbial Metabolites in Ankylosing Spondylitis

“…Finally, a small portion of Trp (1–2%) can give rise to the serotonin production pathway in enterochromaffin cells via Trp hydroxylase 1 (TpH1), the expression of which is also regulated by SCFA. The intestinal-derived serotonin’s relevance in SpA is still under-investigated but may be relevant for the emerging role of serotonin in controlling bone remodeling and the existence of an entero-bone axis [ 121 , 122 ].…”