Pathophysiology of Diarrhea and Its Clinical Implications

Sheikh, Irshad Ali; Ammoury, Rana

doi:10.1016/b978-0-12-809954-4.00068-2

Cited by 6 publications

(6 citation statements)

References 175 publications

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“…The colon has a different histological structure and physiological role than the ileum [92]. The microbiota in the colon are composed of highly abundant anaerobes, and a lower proportion of lactobacilli and other aerotolerant bacteria compared to the ileum [76,93].…”

Section: Discussionmentioning

confidence: 99%

High Mobility Group Box 1 and TLR4 Signaling Pathway in Gnotobiotic Piglets Colonized/Infected with L. amylovorus, L. mucosae, E. coli Nissle 1917 and S. Typhimurium

Šplı́chal

Donovan

Jenistova

et al. 2019

IJMS

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High mobility group box 1 (HMGB1) is a DNA-binding nuclear protein that can be actively secreted by immune cells after different immune stimuli or passively released from cells undergoing necrosis. HMGB1 amplifies inflammation, and its hypersecretion contributes to multiple organ dysfunction syndrome and death. We tested possible immunomodulatory effect of commensal Lactobacillus amylovorus (LA), Lactobacillus mucosae (LM) or probiotic Escherichia coli Nissle 1917 (EcN) in infection of gnotobiotic piglets with Salmonella Typhimurium (ST). Transcription of HMGB1 and Toll-like receptors (TLR) 2, 4, and 9 and receptor for advanced glycation end products (RAGE), TLR4-related molecules (MD-2, CD14, and LBP), and adaptor proteins (MyD88 and TRIF) in the ileum and colon were measured by RT-qPCR. Expression of TLR4 and its related molecules were highly upregulated in the ST-infected intestine, which was suppressed by EcN, but not LA nor LM. In contrast, HMGB1 expression was unaffected by ST infection or commensal/probiotic administration. HMGB1 protein levels in the intestine measured by ELISA were increased in ST-infected piglets, but they were decreased by previous colonization with E. coli Nissle 1917 only. We conclude that the stability of HMGB1 mRNA expression in all piglet groups could show its importance for DNA transcription and physiological cell functions. The presence of HMGB1 protein in the intestinal lumen probably indicates cellular damage.

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Section: Discussionmentioning

confidence: 99%

High Mobility Group Box 1 and TLR4 Signaling Pathway in Gnotobiotic Piglets Colonized/Infected with L. amylovorus, L. mucosae, E. coli Nissle 1917 and S. Typhimurium

Šplı́chal

Donovan

Jenistova

et al. 2019

IJMS

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“…This is because diarrhea results from abnormalities in intestinal electrolyte transport (Singh et al, 2014;Das et al, 2018) which contributes to fluid and electrolyte homeostasis (Das et al, 2018). Intestinal ion transport mechanisms play a significant role in diarrhea (Sheikh et al, 2018). Therefore, the possible novel target for diarrhea therapy is the intestinal ion transporters.…”

Section: Change Of Glycerophospholipid Metabolismmentioning

confidence: 99%

Pulsatilla Decoction Can Treat the Dampness-Heat Diarrhea Rat Model by Regulating Glycerinphospholipid Metabolism Based Lipidomics Approach

Hua

Ma²,

Zhang

et al. 2020

Front. Pharmacol.

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Ethnopharmacological Relevance: Diarrhea is a major medical problem in clinical practice. According to the theory of traditional Chinese medicine (TCM), different types of diarrhea should be treated with different TCM formulations based on the targeted medical condition. Dampness-heat diarrhea (DHD) is a serious diarrheal disease and Pulsatilla decoction (PD), a TCM, has been found effective against DHD. Objective: The aim of this study was to clarify the mechanism of action of PD in DHD using an untargeted lipidomics strategy. Materials and Methods: Wistar rats were randomized to four groups, including the control group, model group, PD groups and self-healing group. The PD groups were given a daily intragastric gavage of PD at doses of 3.76 g/kg. The rat model of DHD established by such complex factors as high-sugar and high-fat diet, improper diet, high temperature and humidity environment, drinking and intraperitoneal injection of Escherichia coli., which imitated the inducing conditions of DHD. Then the clinical symptoms and signs, blood routine, serum inflammatory cytokines levels and the histopathological changes of main organs were detected and observed to evaluate DHD model and therapeutic effect of PD. Lipid biomarkers of DHD were selected by comparing the control and model groups with the colon lipidomics technology and an ultra-high performance liquid chromatography (UHPLC) coupled with Q Exactive plus mass analyzer. Multivariate statistical analysis and pattern recognition were employed to examine different lipids within the colon of PD-treated rats. Results: The clinical symptoms and signs of the model rats were consistent with the diagnostic criteria of DHD. After treatment with PD, the clinical symptoms and signs of the rats with DHD were improved; the indexes of blood routine and inflammatory cytokines levels tended to be normal. The lipidomics profile of the model group were

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“…20 Sodium being a primary stool solute is lost during diarrhoeal disease and replacement of the diarrhoeal losses with hypotonic fluids leads to hyponatremia. 21 Varied prevalence rates have been documented for hyponatraemia in acute diarrhoea in children by some authors. 13,16,19,[22][23][24][25][26] The prevalence of 31.3% in this study is however higher than the findings of Gauchan et al in Nepal, 24 respectively than the index study.…”

Section: Discussionmentioning

confidence: 99%

Dyselectrolytemia in under-five children with acute diarrhoea-induced dehydration: a cross-sectional study in a South-East Nigerian hospital

Ezuruike

Ibeneme

Uwaezuoke

2022

Int J Contemp Pediatr

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Background: Diarrhoeal disease contributes significantly to preventable deaths among under-fives globally. Associated dyselectrolytemia is a major contributor to morbidity and mortality in these children. The aim of the study was to determine the prevalence and pattern of serum electrolyte derangement among under-fives with dehydration due to acute diarrhoea.Methods: It was a hospital-based descriptive cross-sectional study conducted at the Federal Medical Centre, Umuahia involving 150 under-five children with dehydration due to acute diarrhoea from October 2018 to January, 2020. Clinical detail and degree of dehydration were recorded. The serum electrolytes were estimated using Ion selective electrode method.Results: The overall prevalence of electrolyte derangement was 62.6%. Hyponatraemia was the commonest electrolyte derangement, accounting for 31.3% of cases. Hypokalaemia and metabolic acidosis occurred in 24% and 12.7% of cases respectively. Across the different degrees of dehydration hyponatremia was 5 times more likely to develop in the severely dehydrated (OR 5.25, p=0.001) compared to the mildly dehydrated. The odds of developing hypokalaemia were 17 times more likely in the moderately dehydrated (OR 17.21, p=0.007) and 38 times more likely in the severely dehydrated Subjects (OR 38.50, p≤0.001).Conclusions: The frequency of electrolyte derangements was high and increased with the increasing severity of dehydration. Routine estimation of serum electrolytes is advocated for under-five children with acute diarrhoea, especially with moderate and severe dehydration. Also, the use of sodium and potassium-containing fluids can be instituted as choice fluids in resource-poor settings without laboratory support.Background: Diarrhoeal disease contributes significantly to preventable deaths among under-fives globally. Associated dyselectrolytemia is a major contributor to morbidity and mortality in these children. The aim of the study was to determine the prevalence and pattern of serum electrolyte derangement among under-fives with dehydration due to acute diarrhoea.Methods: It was a hospital-based descriptive cross-sectional study conducted at the Federal Medical Centre, Umuahia involving 150 under-five children with dehydration due to acute diarrhoea from October 2018 to January, 2020. Clinical detail and degree of dehydration were recorded. The serum electrolytes were estimated using Ion selective electrode method.Results: The overall prevalence of electrolyte derangement was 62.6%. Hyponatraemia was the commonest electrolyte derangement, accounting for 31.3% of cases. Hypokalaemia and metabolic acidosis occurred in 24% and 12.7% of cases respectively. Across the different degrees of dehydration hyponatremia was 5 times more likely to develop in the severely dehydrated (OR 5.25, p=0.001) compared to the mildly dehydrated. The odds of developing hypokalaemia were 17 times more likely in the moderately dehydrated (OR 17.21, p=0.007) and 38 times more likely in the severely dehydrated Subjects (OR 38.50, p≤0.001).Conclusions: The frequency of electrolyte derangements was high and increased with the increasing severity of dehydration. Routine estimation of serum electrolytes is advocated for under-five children with acute diarrhoea, especially with moderate and severe dehydration. Also, the use of sodium and potassium-containing fluids can be instituted as choice fluids in resource-poor settings without laboratory support.

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Pathophysiology of Diarrhea and Its Clinical Implications

Cited by 6 publications

References 175 publications

High Mobility Group Box 1 and TLR4 Signaling Pathway in Gnotobiotic Piglets Colonized/Infected with L. amylovorus, L. mucosae, E. coli Nissle 1917 and S. Typhimurium

High Mobility Group Box 1 and TLR4 Signaling Pathway in Gnotobiotic Piglets Colonized/Infected with L. amylovorus, L. mucosae, E. coli Nissle 1917 and S. Typhimurium

Pulsatilla Decoction Can Treat the Dampness-Heat Diarrhea Rat Model by Regulating Glycerinphospholipid Metabolism Based Lipidomics Approach

Dyselectrolytemia in under-five children with acute diarrhoea-induced dehydration: a cross-sectional study in a South-East Nigerian hospital

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