Intestinal epithelial cells in inflammatory bowel diseases

The pathogenesis of inflammatory bowel diseases (IBDs) seems to involve a primary defect in one or more of the elements responsible for the maintenance of intestinal homeostasis and oral tolerance. The most important element is represented by the intestinal barrier, a complex system formed mostly by intestinal epithelial cells (IECs). IECs have an active role in producing mucus and regulating its composition; they provide a physical barrier capable of controlling antigen traffic through the intestinal mucosa. At the same time, they are able to play the role of non-professional antigen presenting cells, by processing and presenting antigens directly to the cells of the intestinal immune system. On the other hand, immune cells regulate epithelial growth and differentiation, producing a continuous bi-directional cross-talk within the barrier. Several alterations of the barrier function have been identified in IBD, starting from mucus features up to its components, from epithelial junctions up to the Toll-like receptors, and altered immune responses. It remains to be understood whether these defects are primary causes of epithelial damage or secondary effects. We review the possible role of the epithelial barrier and particularly describe the role of IECs in the pathogenesis of IBD

Multiple abdominal nodules in a patient with ulcerative proctitis: a case of peritoneal splenosis

A 40-year old gardener was referred for ulcerative proctitis treated with topical mesalamine with rapid improvement of symptoms. Eighteen years before he had had a splenectomy for traumatic splenic rupture. At the end of 2010, he was admitted to another hospital because of abdominal pain. Computerized tomography (CT) scan and magnetic resonance imaging revealed multiple abdominal nodules but a definite diagnosis was not made. While being examined for the proctitis, the patient was admitted to our unit due to worsening of the abdominal pain. After another CT scan, a laparoscopy was performed: several reddish-blue nodules on the peritoneal wall were observed and biopsies were performed. Histological examination was consistent with splenosis. After the procedure, we observed an improvement in the abdominal pain. Splenosis is an acquired condition defined as autotransplantation of viable splenic tissue throughout different sites of the body. It occurs after splenic rupture via trauma or surgery. Splenosis is a benign condition that is usually found incidentally unless symptomatic. Since on radiographic examination it can mimic a neoplasia, extensive workup is usually needed. The diagnostic method of choice is nuclear scintigraphy. Splenosis usually occurs in the abdominal and pelvic cavities but patients have been described with splenosis in other intrathoracic, hepatic and subcutaneous sites. Splenosis is usually asymptomatic and treatment is not necessary. Most patients who have an exploratory laparotomy or laparoscopy for abdominal pain, such as in our patient, experience no more pain after the procedure, regardless of whether the splenic nodules have been completely removed or not. The reason for this spontaneous improvement is not known

Role of metabolic, atherogenic and psychological factors in patients with colorectal adenomas

Some metabolic, atherogenic, and psychological risk factors are related to the growth of colorectal adenoma

Role of Reflux in the Pathogenesis of Eosinophilic Esophagitis: Comprehensive Appraisal With Off- and On PPI Impedance-pH Monitoring

Role of reflux and mechanisms of response to proton pump inhibitor (PPI) therapy in eosinophilic esophagitis (EoE) have not yet been fully elucidated. Comprehensive assessment by impedance-pH monitoring could clarify these issues

<em>Curcuma longa</em> Extract Exerts a Myorelaxant Effect on the Ileum and Colon in a Mouse Experimental Colitis Model, Independent of the Anti-Inflammatory Effect

<div><h3>Background</h3><p>Curcuma has long been used as an anti-inflammatory agent in inflammatory bowel disease. Since gastrointestinal motility is impaired in inflammatory states, the aim of this work was to evaluate if <em>Curcuma Longa</em> had any effect on intestinal motility.</p> <h3>Methods</h3><p>The biological activity of Curcuma extract was evaluated against Carbachol induced contraction in isolated mice intestine. Acute and chronic colitis were induced in Balb/c mice by Dextran Sulphate Sodium administration (5% and 2.5% respectively) and either Curcuma extract (200 mg/kg/day) or placebo was thereafter administered for 7 and 21 days respectively. Spontaneous contractions and the response to Carbachol and Atropine of ileum and colon were studied after colitis induction and Curcuma administration.</p> <h3>Results</h3><p>Curcuma extract reduced the spontaneous contractions in the ileum and colon; the maximal response to Carbachol was inhibited in a non-competitive and reversible manner. Similar results were obtained in ileum and colon from Curcuma fed mice. DSS administration decreased the motility, mainly in the colon and Curcuma almost restored both the spontaneous contractions and the response to Carbachol after 14 days assumption, compared to standard diet, but a prolonged assumption of Curcuma decreased the spontaneous and Carbachol-induced contractions.</p> <h3>Conclusions</h3><p>Curcuma extract has a direct and indirect myorelaxant effect on mouse ileum and colon, independent of the anti-inflammatory effect. The indirect effect is reversible and non-competitive with the cholinergic agent. These results suggest the use of curcuma extract as a spasmolytic agent.</p> </div

Effect of curcuma extract on carbachol-induced contraction in isolated mouse ileum (A) and distal colon (B).

<p><b>a)</b> Cumulative concentration-response curves were obtained before and after exposure to curcuma extract for 30 min. Each point is the mean ± SEM (<i>n</i>  = 3–5). <b>b)</b> Time course of curcuma extract effect on Carbachol-induced contraction in isolated mouse ileum (<b>A</b>) or distal colon (<b>B</b>) (100%). Cumulative concentration-response curves were obtained before and after exposure to curcuma extract (0.05 mg/mL) for 5, 30 and 45 min. Each point is the mean ± SEM (<i>n</i>  = 3–5). <b>c)</b> Time course of curcuma extract (0.05 mg/mL) on carbachol-induced contraction in isolated mouse ileum (<b>A</b>) and distal colon (<b>B</b>). Cumulative concentration-response curves were obtained before and after exposure to curcuma extract (0.05 mg/mL) and following 5, 30 and 60 min washing. Data are the mean ± SEM (<i>n</i>  = 3–5). Where error bars are not shown, these are covered with the point itself.</p

Potency of CCh (pEC₅₀) (dark blu) and atropine (pA₂) (light blu) on ileum (a) and on distal colon (red) and (pink) respectively.

<p>(1): control mice. (2): mice with acute DSS induced colitis; (3): acute colitis mice fed the usual diet over 7 days after stopping DSS; (4): acute colitis mice fed curcuma over 7 days after stopping DSS. The dashed line shows the control values for CCh pEC₅₀. The dotted line shows the control values for Atropine pA₂. When error bar are not shown these are covered by the point itself. The contraction induced by Carbachol and the antagonistic effects of Atropine were used as reference. In healthy animals Carbachol is by 3.55 times more potent on the ileum than on the colon. Atropine presents similar antagonistic activity on both tissues: these data have been used as a comparison with the effect of Carbachol and Atropine on tissues from acute colitis animals. Carbachol pEC₅₀ decreased by 3.80 times in the ileum and 1.58 times in the colon and Atropine p<i>A</i>₂ was reduced by 1.86 and 1.12 times respectively in the ileum and the colon, compared with the corresponding intestinal segments of control mice. Curcuma administration improved the response to Carbachol in the colon, but not in the ileum, also if it did not completely restore the normal values.</p