| 1. |
- Högberg, Lotta, et al.
(författare)
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Pediatric celiac disease-is a diagnostic biopsy necessary?
- 2012
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Ingår i: Nature Reviews Gastroenterology & Hepatology. - : Nature Publishing Group. - 1759-5045 .- 1759-5053. ; 9:3, s. 127-128
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- A small-bowel biopsy is currently required in the diagnosis of celiac disease in children. The European Society for Pediatric Gastroenterology, Hepatology and Nutrition has now presented new guidelines for the diagnosis of celiac disease, which indicate that small-bowel biopsy could be avoided in certain cases.
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| 2. |
- Johansson, Malin E V, 1971, et al.
(författare)
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The gastrointestinal mucus system in health and disease.
- 2013
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Ingår i: Nature reviews. Gastroenterology & hepatology. - : Springer Science and Business Media LLC. - 1759-5053 .- 1759-5045. ; 10:6, s. 352-61
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Forskningsöversikt (refereegranskat)abstract
- Mucins--large, highly glycosylated proteins--are important for the luminal protection of the gastrointestinal tract. Enterocytes have their apical surface covered by transmembrane mucins and goblet cells produce the secreted gel-forming mucins that form mucus. The small intestine has a single unattached mucus layer, which in cystic fibrosis becomes attached, accounting for the intestinal manifestations of this disease. The stomach and colon have two layers of mucus; the inner layer is attached and the outer layer is less dense and unattached. In the colon, the outer mucus layer is the habitat for commensal bacteria. The inner mucus layer is impervious to bacteria and is renewed every hour by surface goblet cells. The crypt goblet cells have the ability to restitute the mucus layer by secretion, for example after an ischaemic challenge. Proteases of certain parasites and some bacteria can cleave mucins and dissolve the mucus as part of their pathogenicity. The inner mucus layer can, however, also become penetrable to bacteria by several other mechanisms, including aberrations in the immune system. When bacteria reach the epithelial surface, the immune system is activated and inflammation is triggered. This mechanism might occur in some types of ulcerative colitis.
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| 3. |
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| 4. |
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| 5. |
- Öhman, Lena, 1967, et al.
(författare)
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Pathogenesis of IBS: role of inflammation, immunity and neuroimmune interactions.
- 2010
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Ingår i: Nature reviews. Gastroenterology & hepatology. - : Springer Science and Business Media LLC. - 1759-5053 .- 1759-5045. ; 7:3, s. 163-73
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Forskningsöversikt (refereegranskat)abstract
- IBS is one of the most common functional gastrointestinal disorders worldwide and is thought to be the result of disturbed neural function along the brain-gut axis. The mechanisms behind this disturbance are not clear, but important roles for low-grade inflammation and immunological alterations in the development of symptoms compatible with IBS have become evident. The development of long-standing gastrointestinal symptoms after infectious gastroenteritis and patients with IBD in remission frequently having functional gastrointestinal symptoms support this hypothesis. An increased innate immune activity in the intestinal mucosa and in blood is found in subpopulations of patients with IBS. Mast cells and monocytes seem to be particularly important. In addition, studies have demonstrated that IBS may be associated with an activated adaptive immune response. Increased epithelial barrier permeability and an abnormal gut flora might lead to increased activation of the intestinal immune system. Functional and anatomical evidence for abnormal neuroimmune interactions has been found in patients with IBS. The link between immune alterations and severity of gastrointestinal symptoms and the positive effect of anti-inflammatory treatments in IBS further highlight the relevance of neuroimmune interactions in this condition.
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| 6. |
- Clemens, John, et al.
(författare)
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New-generation vaccines against cholera
- 2011
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Ingår i: NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY. - 1759-5045. ; 8:12, s. 701-710
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Forskningsöversikt (refereegranskat)abstract
- Cholera is a major global health problem, causing approximately 100,000 deaths annually, about half of which occur in sub-Saharan Africa. Although early-generation parenteral cholera vaccines were abandoned as public health tools owing to their limited efficacy, newer-generation oral cholera vaccines have attractive safety and protection profiles. Both killed and live oral vaccines have been licensed, although only killed oral vaccines are currently manufactured and available. These killed oral vaccines not only provide direct protection to vaccinated individuals, but also confer herd immunity. The combination of direct vaccine protection and vaccine herd immunity effects makes these vaccines highly cost-effective and, therefore, attractive for use in developing countries. Administration of these oral vaccines does not require qualified medical personnel, which makes their use practical--even in developing countries. Although new-generation oral cholera vaccines should not be considered in isolation from other preventive approaches, especially improved water quality and sanitation, they represent important tools in the public health armamentarium to control both endemic and epidemic cholera.
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