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| 1 | Intestinal-borne dermatoses significantly improved by oral application of Escherichia coli Nissle 1917显示文摘AIM: To evaluate the effect of oral Escherichia coli(E. coli) Nissle application on the outcome of intestinalborne dermatoses.METHODS: In a randomized, controlled, non-blinded prospective clinical trial 82 patients with intestinal-borne facial dermatoses characterized by an erythematous papular-pustular rash were screened. At the initiation visit 37 patients entered the experimental arm and 20 patients constituted the control arm. All 57 patients were treated with a vegetarian diet and conventional topical therapy of the dermatoses with ointments containing tetracycline, steroids and retinoids. In the experimental arm patients received a one month therapy with oral E. coli Nissle at a maintenance dose of 2 capsules daily. The experimental group was compared to a non-treatment group only receiving the diet and topical therapy. The primary outcome parameter was improvement of the dermatoses, secondary parameters included life quality and adverse events. In addition the immunological reaction profile(Ig A, interleucin-8 and interferon-a) was determined. Furthermore the changes of stool consistency and the microbiota composition over the time of intervention were recorded.RESULTS: Eighty-nine percent of the patients with acne, papular-pustular rosacea and seborrhoic dermatitis responded to E. coli Nissle therapy with significant amelioration or complete recovery in contrastto 56% in the control arm(P < 0.01). Accordingly, in the E. coli Nissle treated patients life quality improved significantly(P < 0.01), and adverse events were not recorded. The clinical improvement was associated with a significant increase of Ig A levels to normal values in serum as well as suppression of the proinflammatory cytokine IL-8(P < 0.01 for both parameters). In the E. coli Nissle treated group a shift towards a protective microbiota with predominance of bifidobacteria and lactobacteria(> 107 CFU/g stool) was observed in 79% and 63% of the patients, respectively(P < 0.01), compared to no change in the control group without E. coli Nissle. Moreover, the detection rate of a pathogenic flora dropped from 73% to 14 % of the patients in the experimental arm(P < 0.01) with no significant change in the control arm(accounting 80% before and 70% after the observation period, P > 0.05). Accordingly, stool consistency, color and smell normalized in the E. coli Nissle treated patients. CONCLUSION: E. coli Nissle protects the mucus barrier by overgrowth of a favorable gut microbiota with less immunoreactive potential which finally leads to clinical improvement of intestinal borne dermatoses. | Elina Manzhalii Daniel Hornuss Wolfgang Stremmel | 2016 | World Journal of Gastroenterology2016，22，23： | 4 |
| 2 | Pharmacological- and non-pharmacological therapeutic approaches in inflammatory bowel disease in adults显示文摘Inflammatory bowel diseases(IBDs) are a group of chronic inflammatory conditions mainly of the colon and small intestine. Crohn's disease(CD) and ulcerative colitis(UC) are the most frequent types of IBD. IBD is a complex disease which arises as a result of the interaction of environmental, genetic and immunological factors. It is increasingly thought that alterations of immunological reactions of the patients to their own enterable bacteria(microfilm) may contribute to inflammation. It is characterized by mucosal and sub mucosal inflammation, perpetuated by infiltration of activated leukocytes. CD may affect the whole gastrointestinal tract while UC only attacks the large intestine. The therapeutic goal is to achieve a steroidfree long lasting remission in both entities. UC has the possibility to be cured by a total colectomy, while CD never can be cured by any operation. A lifelong intake of drugs is mostly necessary and essential. Medical treatment of IBD has to be individualized to each patient and usually starts with anti-inflammatory drugs. The choice what kind of drugs and what route administered(oral, rectal, intravenous) depends on factors including the type, the localization, and severity of the patient's disease. IBD may require immune-suppression to control symptoms such as prednisolone, thiopurines, calcineurin or sometimes folic acid inhibitors or biologics like TNF-α inhibitors or anti-integrin antibodies. For both types of disease(CD, UC) the same drugs are available but they differ in their preference in efficacy between CD and UC as 5-aminosalicylic acid for UC or budesonide for ileocecal CD. As therapeutic alternative the main mediators of the disease, namely the activated pro-inflammatory cytokine producing leukocytes can be selectively removed via two apheresis systems(Adacolumn and Cellsorba) in steroid-refractory or dependent cases. Extracorporeal photopheresis results in an increase of regulatory B cells, regulatory CD8^+ T cells and T-regs Type 1. Both types of apheresis were able to induce clinical remission and mucosal healing accompanied by tapering of steroids. | Gerda C Leitner Harald Vogelsang | 2016 | World Journal of Gastrointestinal Pharmacology and Therapeutics2016，7，1： | 3 |
| 3 | 肠道菌群调节在消化系统疾病治疗中的应用显示文摘肠道微生态系统对机体正常功能的发挥起至关重要的作用。肠道菌群失调参与人体各系统多种疾病的发病过程,益生菌制剂和粪便菌群移植技术因能有效调节肠道菌群且无明显不良反应而成为当今疾病治疗研究的热点课题。本文就肠道菌群调节在消化系统疾病治疗中的应用情况作一综述。 | 李静 孙剑勇 | 2014 | 胃肠病学2014，19，11： | 3 |
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