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Hospital de Órbigo, Spain

de los Reyes-Gavilan C.G.,Institute Productos Lacteos Of Asturias | Suarez A.,Seccion de Aparato Digestivo | Fernandez-Garcia M.,Institute Productos Lacteos Of Asturias | Margolles A.,Institute Productos Lacteos Of Asturias | And 2 more authors.
Research in Microbiology | Year: 2011

According to the FAO/WHO, in vitro criteria for selection of probiotics for food application consist of testing survival when confronted with gastrointestinal tract (GIT) challenge and the ability to colonize the colon. We used a model that simulated GIT transit using sequential immersion in gastric and duodenal juices of human origin to evaluate survival of bile-adapted Bifidobacterium strains. Bifidobacterium animalis tolerated gastric juice, whereas Bifidobacterium longum showed poor survival under these conditions. In contrast, B. animalis strains were more sensitive to duodenal juice than B. longum. The percentage of survival after GIT transit simulation (GITTS), determined both by plate counts and fluorescent probes, was significantly higher for bile-adapted strains than for corresponding parental ones. This suggests that use of bile-adapted strains is a suitable approach for increasing survival of bifidobacteria under the harsh conditions of the upper GIT. However, the bile resistance phenotype was not related to improvement of adhesion capacity, after GITTS, of the intestinal cell line HT29-MTX which constitutively produces mucus. This work shows that sequential GITTS with human juices modified the in vitro adhesion properties of the strains challenged with colonocyte-like cells. © 2011 Institut Pasteur.


Filmann N.,Institute of Biostatistics and Mathematical Modeling | Filmann N.,Goethe University Frankfurt | Rey J.,Institute of Biostatistics and Mathematical Modeling | Schneeweiss S.,Goethe University Frankfurt | And 11 more authors.
Inflammatory Bowel Diseases | Year: 2014

Background: The main objective is to determine the overall prevalence of anemia in inflammatory bowel diseases (IBD) in Europe. Methods: A systematic literature search in PubMed and Embase was performed for studies published between January 2007 and May 2012. Eligible studies were included if they were original full-paper publications originated from Europe and if the authors agreed to provide their data. An overall prevalence of anemia in IBD, disease specific, and age-gender stratified basis prevalences were estimated. The influence of disease entity (Crohn's disease/ulcerative colitis), gender, age, disease activity (remission/active disease), and IBD-specific treatment strategies on the prevalence of anemia was analyzed by a mixed logistic regression model. Thereby, the factor country of origin was included as a random effect. Results: Data were available for 2192 patients, mainly treated in tertiary referral centers. The overall prevalence of anemia in IBD patients was 24% (95% confidence interval, 18-31). Age-gender stratified prevalences were estimated for the age strata 18 to 29, 30 to 39, 40 to 49, 50 to 64, 65 to 74, >74 years and ranged from 18% to 35%. Patients receiving IBD-specific medication (P = 0.0002, odds ratio 1.54), and patients with active disease status (P < 0.0001, odds ratio 2.72) were significantly more likely to have anemia compared with patients not receiving IBD-specific medication or being in remission. Patients with ulcerative colitis tended to have anemia less likely than patients with Crohn's disease (P = 0.01, odds ratio 0.77). Conclusions: The overall prevalence of anemia in patients with Crohn's disease was 27% (95% confidence interval, 19-35) and 21% (95% confidence interval, 15-27) in patients with ulcerative colitis. Thereby, 57% of the anemic patients were iron deficient. Copyright © 2014 Crohn's & Colitis Foundation of America, Inc.


Legido J.,Seccion de Aparato Digestivo | Gisbert J.P.,Hospital Universitario Of La Princesa | Mate J.,Hospital Universitario Of La Princesa
Gastroenterologia y Hepatologia | Year: 2011

Objectives: To evaluate the prevalence of osteopenia and osteoporosis in patients with inflammatory bowel disease (IBD) and to study the factors involved in their pathogenesis. Methods: One hundred consecutive patients with IBD (57 women, mean age 41 years) were included in this study. Data were collected about their life habits, disease characteristics of medication use (mainly corticosteroids). Bone turnover markers were analyzed and the presence of osteoporosis or osteopenia was assessed with total hip and lumbar spine bone densitometry (DXA). Results: Osteopenia percentages ranged from 37% (t-score measured by lumbar spine DXA) to 39% (hip DXA t-score). The prevalence of osteoporosis ranged from 2% (t-score measured by hip DXA) to 15% (lumbar spine DXA t-score). In the multivariate analysis, diagnosis of Crohn's disease (vs. ulcerative colitis; odds ratio 2.9, 95% CI 1-8.7) and the number of flares controlled by the cumulative dose of steroids (number of flares ≥3: odds ratio 8.7; 95%CI 1.6-45) were associated with a higher risk of osteopenia/osteoporosis. None of the analytical parameters significantly correlated with bone mineral density values. Conclusions: The prevalence of osteopenia/osteoporosis is higher in patients with IBD (mainly those with Crohn's disease) than in the general population. Changes in bone metabolism seem to be more closely related to the inflammatory activity of IBD than to the steroid dose per se. Bone turnover markers did not correlate with the presence of osteopenia and osteoporosis. © 2011 Elsevier España, S.L.


Sanchez Cazalilla M.,Seccion de Aparato Digestivo | Lucendo A.J.,Seccion de Aparato Digestivo
Medicine | Year: 2012

Dysphagia is a symptom common to many inflammatory processes affecting the oesophagus. Infectious aetiologies are often accompanied by odinophagia, symptoms have a continuous course and presents predominantly in immunosuppressed patients, mainly due to HIV infection, immunosuppressive therapy or chemotherapy. Oesophageal candidiasis is the most common infection in immunocompetent as well. Its diagnosis requires endoscopy and biopsies, the later being essential for the characterization of other viral esophagitis, such as those caused by herpes simplex virus, cytomegalovirus and varicella-zoster virus, which require specific treatments. Eosinophilic esophagitis constitutes the 2 nd cause of chronic esophagitis, is immunologically mediated and predominantly affects males between childhood and the 5 th decade of life. It presents with chronic or intermittent dysphagia and food impaction. Endoscopic features are diverse, but the diagnosis requires biopsies, after which the treatment may be based on avoidance of food allergens, topical steroids or oesophageal endoscopic dilation in case of strictures.


Barr J.,OWL | Caballeria J.,Institute dInvestigacions Biomediques August Pi Sunyer IDIBAPS | Martinez-Arranz I.,OWL | Dominguez-Diez A.,University of Cantabria | And 27 more authors.
Journal of Proteome Research | Year: 2012

Our understanding of the mechanisms by which nonalcoholic fatty liver disease (NAFLD) progresses from simple steatosis to steatohepatitis (NASH) is still very limited. Despite the growing number of studies linking the disease with altered serum metabolite levels, an obstacle to the development of metabolome-based NAFLD predictors has been the lack of large cohort data from biopsy-proven patients matched for key metabolic features such as obesity. We studied 467 biopsied individuals with normal liver histology (n = 90) or diagnosed with NAFLD (steatosis, n = 246; NASH, n = 131), randomly divided into estimation (80% of all patients) and validation (20% of all patients) groups. Qualitative determinations of 540 serum metabolite variables were performed using ultraperformance liquid chromatography coupled to mass spectrometry (UPLC-MS). The metabolic profile was dependent on patient body-mass index (BMI), suggesting that the NAFLD pathogenesis mechanism may be quite different depending on an individuals level of obesity. A BMI-stratified multivariate model based on the NAFLD serum metabolic profile was used to separate patients with and without NASH. The area under the receiver operating characteristic curve was 0.87 in the estimation and 0.85 in the validation group. The cutoff (0.54) corresponding to maximum average diagnostic accuracy (0.82) predicted NASH with a sensitivity of 0.71 and a specificity of 0.92 (negative/positive predictive values = 0.82/0.84). The present data, indicating that a BMI-dependent serum metabolic profile may be able to reliably distinguish NASH from steatosis patients, have significant implications for the development of NASH biomarkers and potential novel targets for therapeutic intervention. © 2012 American Chemical Society.

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