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- Spagnuolo, R., et al.
(författare)
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Deregulation of SGK1 in Ulcerative Colitis: A Paradoxical Relationship Between Immune Cells and Colonic Epithelial Cells
- 2018
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Ingår i: Inflammatory Bowel Diseases. - : Oxford University Press (OUP). - 1078-0998 .- 1536-4844. ; 24:9, s. 1967-1977
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Tidskriftsartikel (refereegranskat)abstract
- Background: Inflammatory bowel disease (IBD) is due to the interaction of genetic and environmental factors that trigger an unbalanced immune response ultimately resulting in the peculiar inflammatory reaction. Experimental models of IBD point to a role of T-cell-derived cytokines (Th17) and to SGK1 as mediator of the Th17 switch. We hypothesize that SGK1, a salt inducible kinase, directs lymphocytic behavior and tissue damage. Methods: Eleven controls and 32 ulcerative colitis (UC) patients were randomized according to endoscopic Mayo score. Mucosal biopsies from different intestinal tracts were analyzed by immunohistochemistry and quantitative real-time polymerase chain reaction to check the expression of disease markers including SGK1. Peripheral blood mononuclear cells (PBMCs) from patients and controls were analyzed by fluorescence-activated cell sorting. Finally, an in vitro cell model was developed to test the hypothesis. Results: SGK1 mRNA and protein expression in lesional areas of UC patients were lower than in normal peri-lesional areas of the same patients and in normal tissues of healthy controls. SGK1 expression was increased in PBMCs from UC patients, particularly in the CD4+ cell population, enriched in Th17 cells. IL17/IL13 was increased in patients and correlated with SGK1 expression. Genetically engineered Jurkat cells confirmed the effect of SGK1 overexpression on viability of RKO cells. Conclusions: These observations suggest a pathogenic mechanism whereby SGK1 overexpression in CD4+ T cells induces the secretion of the inflammatory cytokines IL17 and IL13, which downregulate the expression of SGK1 in target tissues. Our data suggest a novel hypothesis in the pathogenesis of UC, integrating colonic epithelial cells and lymphocytes.
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- Spagnuolo, R., et al.
(författare)
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Effects of listening to music in digestive endoscopy: A prospective intervention study led by nursing
- 2020
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 76:11, s. 2993-3002
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Tidskriftsartikel (refereegranskat)abstract
- Aims To explore whether music can reduce anxiety and pain in patients who underwent diagnostic endoscopic examinations in conscious and deep sedation and to assess degree of satisfaction and willingness to repeat the procedure. Design Prospective study led by nursing. Methods Between March 2019-June 2019, consecutive outpatients undergoing endoscopic examinations were simple matched into four groups: Group 1: conscious sedation with music; Group 2: conscious sedation without music; Group 3: deep sedation with music and Group 4: deep sedation without music. Ten minutes before the procedure, two trainee nurses applied music.State-Trait Anxiety Inventorywas used to evaluate anxiety. Results Before and at the end of the procedure, patients who listened to music had a lower level anxiety than those who did not listen and, also, reported lower pain intensity during procedure. Only within Group 1 median anxiety, measured after the procedure, is lower than that measured before. In the bivariate logistic regression model, pain and listening to music were independent factors for satisfaction and willingness to repeat procedure. Conclusion music in digestive endoscopy reduce pain and anxiety in conscious sedation, thus could be used to reduce anxiety in support to conscious sedation leading to lower usage of deep sedation and consequently reduction of costs and adverse events. Impact Anxiety in digestive endoscopy limits patients' satisfaction. Music in digestive endoscopy as a specific nursing intervention could reduce anxiety of patients. This nursing intervention study confirms positive effect of music in digestive endoscopy. As part of nursing management, the addition of music to daily care practice in digestive endoscopy may reduce anxiety and increase the patient's degree of satisfaction. Use of music could limit deep sedation use in digestive endoscopy with consequent reduction of risks for patients, execution times, and costs of procedures.
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- Mancina, Rosellina Margherita, et al.
(författare)
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PNPLA3 148M Carriers with Inflammatory Bowel Diseases Have Higher Susceptibility to Hepatic Steatosis and Higher Liver Enzymes
- 2016
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Ingår i: Inflammatory Bowel Diseases. - : Oxford University Press (OUP). - 1078-0998. ; 22:1, s. 134-140
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Tidskriftsartikel (refereegranskat)abstract
- Background: Inflammatory bowel diseases (IBD) are characterized by chronic relapsing inflammation of the gastrointestinal tract and encompass Crohn's disease and ulcerative colitis. IBD are often associated with extraintestinal manifestations affecting multiple organs including the liver. Increased levels of serum aminotransferases, possibly related to nonalcoholic fatty liver disease, constitute one of the most frequently described IBD-related liver diseases. The PNPLA3 I148M substitution is a major common genetic determinant of hepatic fat content and progression to chronic liver disease. The aim of this study was to investigate whether carriers of PNPLA3 148M allele with IBD have higher risk of liver steatosis and increase in transaminases levels. Methods: The PNPLA3 I148M (rs738409) genotype was performed by Taqman assays in 158 individuals from Southern Italy (namely, Catanzaro cohort) and in 207 individuals from Northern Italy (namely, Milan cohort) with a definite diagnosis of IBD. Demographic and clinical data and also alanine transaminase levels were collected for both cohorts. The Catanzaro cohort underwent liver evaluation by sonography and liver stiffness and controlled attenuation parameter measurements by transient elastography. Results: Here, we show for the first time that carriers of the PNPLA3 148M allele with IBD have a greater risk of hepatic steatosis (odds ratio, 2.9, and confidence interval, 1.1-7.8), higher controlled attenuation parameter values (P = 0.029), and increased circulating alanine transaminase (P = 0.035) in the Catanzaro cohort. We further confirm the higher alanine transaminase levels in the Milan cohort (P < 0.001). Conclusions: Our results show that PNPLA3 148M carriers with IBD have higher susceptibility to hepatic steatosis and liver damage.
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- Mancina, Rosellina Margherita, et al.
(författare)
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Ulcerative Colitis as an Independent Risk Factor for Hepatic Steatosis
- 2020
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Ingår i: Gastroenterology Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 1042-895X. ; 43:4, s. 292-297
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Tidskriftsartikel (refereegranskat)abstract
- Inflammatory bowel disease (IBD) is an inflammatory condition of the gastrointestinal tract encompassing Crohn disease and ulcerative colitis, often associated with extraintestinal manifestations. Nonalcoholic fatty liver disease represents one of the described inflammatory bowel disease-related liver diseases. To understand the IBD contribution to nonalcoholic fatty liver disease onset, we compared liver fat content and fibrosis between IBD patients and healthy controls integrating medical and nursing expertise (integrated nursing approach). A total of 95 patients and 53 healthy volunteers were recruited. Only nondiabetic and nonobese individuals were included in the study. Liver evaluation was performed by an experienced nurse using transient elastography. We found that IBD patients had higher liver fat content than the control group (p= .003). Bonferroni post hoc analyses revealed that patients with Crohn disease or ulcerative colitis had higher liver fat than the control group. We also found that ulcerative colitis was associated with more than a 4-fold increased risk for mild steatosis and 7-fold increased risk for moderate/severe steatosis independently from other risk factors such as glucose and body mass index. In conclusion, we showed for the first time that ulcerative colitis is an independent risk factor for hepatic steatosis measured by transient elastography.
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- Spagnuolo, R., et al.
(författare)
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Beta-glucan, inositol and digestive enzymes improve quality of life of patients with inflammatory bowel disease and irritable bowel syndrome
- 2017
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Ingår i: European Review for Medical and Pharmacological Sciences. - 1128-3602. ; 21, s. 102-107
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the efficacy of a mixture of beta-glucan, inositol and digestive enzymes in improving gastrointestinal symptoms in patients affected by inflammatory bowel disease (IBD)-irritable bowel syndrome (IBS). PATIENTS AND METHODS: The study was conducted at the IBD Unit of the University of Catanzaro. Forty-three IBD patients with IBS symptoms were included in the study. IBD diagnosis was performed by clinical, endoscopic, histological and radiological criteria. Patients were in clinical remission and in treatment only with systemical and topical mesalamine. All study participants fulfilled the Rome III criteria for the diagnosis of IBS. The study participants were randomized into 2 groups: group A (n=23) received conventional treatment (systemical and topical mesalamine) plus a mixture of beta-glucan, inositol and digestive enzymes (one tablet after lunch and dinner) for four consecutive weeks; group B (n=20) received only conventional treatment. The prevalence and intensity of gastrointestinal (GI) symptoms were evaluated both at the enrollment (T-0) and after four weeks of treatment (T-1). RESULTS: Patients who received mesalamine plus the mixture of beta-glucan, inositol and digestive enzymes (group A) reported a reduction in abdominal pain together with reduction in bloating and flatulence after four weeks of treatment. Importantly, an overall improvement in the general well-being has been recorded. Patients who underwent only mesalamine treatment (group B) reported a mild reduction in the evacuative urgency without any other improvements. CONCLUSIONS: We have shown that supplementation with a mixture of beta-glucan, inositol and digestive enzymes reduces bloating, flatulence and abdominal pain, improving the overall clinical condition of IBD-IBS patients.
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- Boldemann, C., et al.
(författare)
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Preschool outdoor play environment may combine promotion of children's physical activity and sun protection. Further evidence from Southern Sweden and North Carolina
- 2011
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Ingår i: Science and Sports. - : Elsevier BV. - 0765-1597. ; 26:2, s. 72-82
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Konferensbidrag (refereegranskat)abstract
- Objective. - To study the impact of preschool outdoor environments on children's physical activity and solar ultraviolet (UV) exposure at different latitudes and countries. Methods. Outdoor environments of 11 preschools (two in Raleigh NC, USA, Lat.36 degrees N, nine in Malmo, Sweden, Lat.55 degrees N) were scored (OPEC) regarding space, vegetation, hilly terrain and level of integration between open spaces, vegetation and play structures. Free sky (%) was determined by imaging. Physical activity was measured by pedometers and solar UV-exposure by polysulphone dosimeters during 5 days in spring 2009, and individual background data gathered by questionnaires and anthropometric measurements. Global UV radiation was measured and available individual UV radiation (%) computed. Results. - In Malmo, mean step count/minute was 21.2 in preschools with high-scored environment vs. 17.6 in low-scored environments, and UV-exposure lower, 26% vs. 43% of available UV during outdoor stay. In Raleigh, step count/minute was 12.3 and UV-exposure of available UV 27% during outdoor stay. Conclusions. - Step count/minute was lower in Raleigh than in Malmo, but in Malmo children at low-scored environments ran a higher risk of sunburn than in Raleigh. Trees and shrubbery integrated in children's playscape trigger both physical activity and sun-protective behaviour in Sweden, and previous measurements in Stockholm were confirmed. Such outdoor environment should be recommended, but the role of season and climate needs to be further explored. (C) 2011 Elsevier Masson SAS. All rights reserved.
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- Spagnuolo, R., et al.
(författare)
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Multifaceted pathogenesis of liver steatosis in inflammatory bowel disease: a systematic review
- 2021
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Ingår i: European Review for Medical and Pharmacological Sciences. - 1128-3602. ; 25:18, s. 5818-5825
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Non-Alcoholic Fatty Liver Disease (NAFLD), as a hepatic manifestation of metabolic syndrome (MET)-related obesity, insulin resistance, dyslipidemia, and hypertension, is the main cause of chronic liver disease. Inflammatory Bowel Diseases (IBD). (Crohn's Disease (CD) and Ulcerative Colitis (UC)). are often associated with extraintestinal manifestations. Of these. NAFLD is one of the most frequently reported. To highlight the etiopathogenesis of NAFLD in IBD, we performed a systematic review emphasizing the relationship between NAFLD genetic alterations, metabolic syndrome, and drugs. MATERIALS AND METHODS: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA) criteria, we performed a systematic literature search on PubMed, Google Scholar, and Web of Science for literature updated from 2010 to 1 March 2021. Inclusion criteria for studies were observational design and Randomized Controlled Trials (RCTs); written in English; primary research only; based on adult patients, and human research only. RESULTS: We identified nine studies on the link between NAFLD and IBD. Among these, two described the genetic predisposition to NAFLD of patients with IBD. Four reported an association between MetS and NAFLD in IBD patients. Regarding medications, none of four studies included. detected a relationship between NAFLD onset and IBD treatment (corticosteroids, immunomodulators, methotrexate, or biologics). However, a retrospective study showed a protective effect of anti-TNF alpha therapies against altered liver enzymes. CONCLUSIONS: In this interplay between genetic, metabolic, drug, and inflammatory factors, the underlying pathogenic mechanisms behind NAFLD in IBD are still far from clear. Further studies are needed to better clarify the role of individual components influencing the development of NAFLD in IBD.
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| 10. |
- Spagnuolo, R., et al.
(författare)
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Satisfaction with Social Roles and Physical Function in Immune-mediated Inflammatory Diseases: A Cross-Sectional Study
- 2022
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Ingår i: Reviews on Recent Clinical Trials. - : Bentham Science Publishers Ltd.. - 1574-8871. ; 17:3, s. 177-186
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although mood disorders have been well characterized by immune-mediated inflammatory diseases, physical function and satisfaction with social roles have not yet been defined as independent domains. Objective: The study aims to assess satisfaction with social roles and physical function alterations in a population with immune-mediated inflammatory diseases and identify associated characteristics. Methods: Physical function and social role satisfaction were evaluated through the Patient-reported Outcomes Measurement System. Besides comparison between groups, univariate and multivariable logistic regression analyses were performed to identify independent predictors. Results: Two hundred sixty-five patients with immune-mediated inflammatory diseases and 206 controls were recruited. Compared to controls, patients with inflammatory bowel diseases had impaired physical function (p<0.001), while patients with inflammatory arthritis reported impairment in both domains (p<0.001, each). In the univariate logistic regression, gender, high school educational level, physical activity, and occupation were positively associated with physical function and social role satisfaction (pp=0.001; pp=0.001 and pp=0.012; p=0.008; p=0.004, respectively). Active disease and steroids were inversely associated with physical function and social roles satisfaction (p=0.033; p=0.022 and p=0.002; p=0.038, respectively). Further associations were found between age and physical function (p=0.002) and biological treatment and ESR with social roles satisfaction (pp=0.043; respectively). In the multivariable regression, gender was found to be associated with physical function (p<0.001) and social roles satisfaction (p=0.003). Negatively associated factors were biological treatment for satisfaction with social roles (p<0.001) and steroids for physical function (p=0.021), and social roles satisfaction (p=0.018). Conclusion: Immune-mediated inflammatory diseases determine alterations in physical function and social life satisfaction. Gender and treatment are independently associated factors. Patient-reported outcomes should be considered in clinical management to define patients' real needs.
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