SP22 689 Weekly Wall 2 by Sara Police https://padlet.com/sarapolice/jqybh6y1ujquz58r Identify a research paper relevant to this week’s topic. Post the citation along with answers to these questions in a padlet post to The Weekly Wall. Your post should be at least 150 words (not counting the citation). Respond to a classmate’s padlet with a question, comment or link to a related study. Address the following questions: 1) Why is this study important 2) Identify one key finding of this study and describe how it relates to nutritional sciences. 3) What are the clinical implications of this study? en-us 2022-01-03 18:19:59 UTC 2023-01-20 02:40:53 UTC hello@padlet.com sarapolice https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/1972726567 Click the pink plus sign at the lower right-hand side of the screen to get started!  Please email me with any questions about this exercise. -Dr. Police]]> 2022-01-03 18:26:27 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/1972726567 https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2000913500 The research paper I selected for this week is titled Prevalence of Celiac Diseases in 52,721 Youth With Type 1 Diabetes: International Comparison Across Three Continents. As it can be assumed from the title, this study was performed to examine the prevalence of Celiac Disease (CD) and type 1 diabetes (T1D), but it mostly examined the differences between the youth who had both CD and T1D versus the youth who only had T1D. This study is important because it looks into the relationship of two common chronic diseases. It is also important because it attempts to account for differences worldwide, possibly uncovering more differences than they would have found by only examining one place. There are two key findings from this study that I want to mention. The first is that very few of the youth with CD and T1D were deemed overweight. This ties in with nutritional science through our learnings that CD (and other inflammatory bowel diseases) are associated with symptoms of weight loss, which helps explain why most of the youth with CD and T1D were at a lower weight than the youth who only had T1D. The other finding I wanted to mention is that youth with CD were typically diagnosed with T1D at an earlier age (avg. of 5.4 yrs. old) than youth only being diagnosed with T1D (avg. of 7 yrs. old). This relates to nutritional sciences as well because it shows that there could be a common denominator for diseases like CD and other chronic conditions like diabetes, provided that more research is done between the relation of the two diseases. A clinical implication from this trial is that more patients with T1D should be tested for CD as well, since the study found that many of the patients with CD and T1D had asymptomatic CD, meaning it could be under-detected/under-diagnosed in patients that are currently only diagnosed with T1D.
 
Craig, M. E., Prinz, N., Boyle, C. T., Campbell, F. M., Jones, T. W., Hofer, S. E., Simmons, J. H., Holman, N., Tham, E., Fröhlich-Reiterer, E., DuBose, S., Thornton, H., King, B., Maahs, D. M., Holl, R. W., & Warner, J. T. (2017). Prevalence of celiac disease in 52,721 youth with type 1 diabetes: International comparison across three continents. Diabetes Care, 40(8), 1034–1040. https://doi.org/10.2337/dc16-2508 
 
]]> 2022-01-19 16:44:22 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2000913500 Cole Zetter's post colezetter https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2006261847 The research paper that I selected this week for the module was titled Accuracy of Serologic Tests and HLA-DQ Typing for Diagnosing Celiac Disease. I found this paper to be quite an important read because it directly related to my line of work. (Which is testing for HLA DQ2/DQ8 genotype from whole blood specimens in the laboratory). This is to report a positive or negative resort to be reviewed by pathologists and physicians. The study brought to light a whole lot of what goes on behind the scenes of DQ2/DQ8 testing, which happens to be small-bowel biopsies from patients. This study even included small-bowel histologic findings (photographs) which were very neat to look at. This report related directly to nutritional sciences because it brought up how patients were to be biopsied and seen before they started their gluten free diet and then biopsied once again months and months later to report the difference the diet makes in the lining of the bowel. The clinical implications of this study were that they reported that there is an association with HLA DQ2/DQ8 with celiac disease and the sensitivity could vary with the patient. The study suggested that the absence of HLA DQ2/DQ8 excludes the diagnoses of celiac disease although a positive result for this genotype is not enough to confirm the disease either.



Citation: 
  Hadithi, M et al. “Accuracy of Serologic Tests and HLA-DQ Typing for Diagnosing Celiac Disease.” Annals of internal medicine 147.5 (2007): 294–302. Web.

]]> 2022-01-22 10:49:05 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2006261847 Crohn's Disease Exclusion Diet rwpr222 https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2006511609 2022-01-22 16:47:29 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2006511609 Circadian Rhythm's Involvement in Irritable Bowel Diseases anwa238 https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2006700621 The reason this article first grabbed my attention was the connection between melatonin and inflammatory bowel diseases. Melatonin supplements is something that I take periodically to help with sleep. However, I didn't realize the beneficial properties of melatonin. This study is important because it points to a potential cause of these irritable bowel diseases and could become a potential therapeutic for treating patients. One of the most prominent negative symptoms associated with IBD is poor quality of asleep. Poor quality of asleep can exacerbate inflammatory cytokines thus negatively impacting the GI function which in turn can result in a positive feedback loop maintaining perpetual inflammation. One key finding that I would like to mention from this study is that they looked at a DSS mice model with colitis and they disrupted the circadian rhythm in one group and kept it consistent in the other. They found that that the group with the disrupted circadian rhythm had a more severe form of colitis, significant weight loss and a higher mortality. This just emphasizes the significant role that the circadian rhythm may play in IBD. This information relates to nutritional sciences because we can get melatonin from our food (bananas, tomatoes, and strawberries). Melatonin can help to regulate our circadian cycle and potentially help alleviate these symptoms. As I alluded to earlier, there is still a lot of research to be completed on this to see if it would be a viable therapeutic for individuals who have IBD.  However, if it is seen as a viable therapeutic, we could use it to treat patients and help modulate their inflammation keeping their flare ups to a minimum.

-By Ashley Wahlman

Citation:
Swanson, G. R., Burgess, H. J., & Keshavarzian, A. (2011). Sleep disturbances and inflammatory bowel disease: a potential trigger for disease flare?. Expert review of clinical immunology, 7(1), 29–36. https://doi.org/10.1586/eci.10.83]]> 2022-01-22 21:55:56 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2006700621 Duration of Breast-Feeding and Celiac Disease Development Ellen_Reusch https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2006777170 (Ellen Reusch) For this week's wall, I found an article from the World Journal of Gastroenterology discussing the effect the timing of gluten introduction might have on the development of celiac disease. This paper analyzed results from several other, some older, studies on the duration of breastfeeding and whether it had an impact on the development or timing of celiac disease occurring in children. Several studies had previously documented a negative correlation between the duration of breastfeeding and the development of celiac disease, and this review concluded that there are still plenty of questions regarding breastfeeding's relationship with celiac disease development. This epidemiological data, however, was used by the ESPGHAN (European Society for Paediatric Gastroenterology, Hepatology and Nutrition) to recommend that parents introduce their children to gluten between the ages of 4 months and 7 months, and in small amounts gradually while still supplementing with breastfeeding. I think this article relates to our week 2 required readings as those focused on not only celiac's disease, but also some of the predispositions nutrition may play in a person's likelihood to develop the autoimmune condition. Additionally, this paper directly relates to nutrition as it discusses how early nutritional sources play a role in a child's future gastrointestinal health.  Some of this data could be used to change how new mothers decide between breastfeeding and formula-feeding their newborn babies, when they have a choice. ]]> 2022-01-23 01:36:27 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2006777170 Katelyn Spain: Cancer in IBD https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2007660669 I found an article about the risk of colorectal cancer for inflammatory bowel disease patients. This article is important because IBD patients have an increased risk in developing colorectal cancer, due to the increase of colitis. Colorectal cancers are caused by longer durations of colitis, which is the inflammation of the colon. This occurs frequently in patients with IBD. Due to cancer being a risk for these patients, biopsies are needed to monitor the presence of disease in IBD patients. It has also been found that IBD patients that also have been diagnosed with Cronh's disease are at an even higher risk for these cancers. A key finding found in this article, was that chronic IBD patients typically have a folate deficiency. This is due to lack of folate in their nutritional intake. Colorectal cancers are associated with low folate intake. It was determined that folate supplementation for IBD patients can decrease the risk of these cancers. The clinical implications from this study are that patients with IBD should be tested for cancers to monitor the increased risk of colorectal cancers through rectal biopsies and stool samples. IBD patients can also talk with their primary care physicians to talk about nutritional supplementation, such as folate supplements, to reduce the risk of developing these cancers.

Xie, J., & Itzkowitz, S. H. (2008). Cancer in inflammatory bowel disease. World journal of gastroenterology, 14(3), 378–389. https://doi.org/10.3748/wjg.14.378]]> 2022-01-23 23:59:18 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2007660669 Seonwook Kim: Self-tunable engineered yeast probiotics for the treatment of inflammatory bowel disease ski224 https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2008008604 My selected article demonstrates how self-tunable engineered yeast probiotics treat inflammatory bowel disease (IBD). The study is important because this new approach provides a new therapeutic platform advantage over most available IBD therapies that suppress the immune system systemically and possibly increase the risk of infections and some cancers. One of the key findings is that CRISPR-Cas9 engineered yeast delivers a probiotic-based dynamic anti-inflammatory response in the inflamed tissue microenvironment through P2Y2-RROP1 gene circuit responsive to extracellular ATP(eATP). eATP signals upregulate pro-inflammatory cytokine production and effector T-cell activation, suppress regulatory T cell responses in IBD. These yeast probiotics suppressed intestinal inflammation in mouse models of IBD, reducing intestinal fibrosis and dysbiosis with high efficacy. As a nutritional science approach, it uses Saccharomyces yeast species which have long been known for use in foods and its anti-inflammatory response may help IBD patients to absorb more nutrients through GI tract. As a clinical implication, the modulation of intestinal pro-inflammatory and anti-inflammatory balance with engineered yeast probiotics may provide generalizable therapeutic approach for intestinal inflammation. 

Scott, B.M., Gutiérrez-Vázquez, C., Sanmarco, L.M. et al. Self-tunable engineered yeast probiotics for the treatment of inflammatory bowel disease. Nat Med 27, 1212–1222 (2021). https://doi.org/10.1038/s41591-021-01390-x
Full article available at uky library. 

]]> 2022-01-24 05:11:02 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2008008604 Anxiety and depression in adult patients with celiac disease on a gluten-free diet https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2009040303 The article I will be discussing for this week looked further into individuals who have celiac disease and it’s correlation with anxiety and depression within the adult population. I was interested in looking deeper into this because one of my family members was recently diagnosed with celiac disease not by her physical symptoms; but by her high levels of anxiety and panic attacks she was experiencing. She has mentioned that those feelings of anxiety and panic attacks have subsided drastically since she has started a gluten free diet. This is important to note because there could be symptoms of these diseases that aren’t just physical for some patients, but also psychological. This also could be important if simply changing one’s diet could impact their mental health. 
 
The study looked at individuals diagnosed with celiac disease, inflammatory bowel disease in remission or slight disease activity, and a general population group (used as their control group). To assess depression and anxiety within these groups they used the Hospital Anxiety and Depression Scale, this assessment focuses on individuals who have anxiety or depression but also takes into account the individual has a physical illness as well. Overall the study found that the individuals diagnosed with both celiac disease and inflammatory bowel disease had a higher rate of anxiety compared to the general population group. The celiac group had a higher rate of anxiety compared to the inflammatory bowel disease patients. 
 
This raises a few questions for me, should treatment for celiac be different in patients who have anxiety or depression? How does treatment for anxiety and depression differ in celiac patients, are they less effective due to decreased absorption?
]]> 2022-01-24 15:22:35 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2009040303 Gluten-Free Diet: How Strict Should It Be? https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2009620627 The article for this week evaluates the safe threshold of ingestion of contaminating gluten for patients with celiac disease. Current guidelines suggest a life long gluten free diet with patients with celiac disease. This has been shown to restore the mucosal abnormalities resulting from an autoimmune reaction to patients that ingest gliadin(gluten). But can research confirm that these diet's were 100% gluten free? There is evidence that many gluten free products actually contain gluten from either contamination or because it's allowed by the FDA to be categorized as “gluten-free” if it contains less than 20ppm. Several studies have established a safe threshold of daily gluten intake. One study found that patients who had received 100 mg gliadin/day (= about 200 mg of gluten) displayed minimal morphometric changes in the histology of the small intestine. Changes were not significant until a dose of 500mg gliadin/day. This is important because the hardship on celiac patients to stay gluten-free can end up in relapse of symptoms and strain their mental health. Clinical implications include case-by-case diagnosing and treatment plans for celiac patients. Some patients will be able to tolerate daily intake of gluten without an immune response.


Itzlinger, A., Branchi, F., Elli, L., & Schumann, M. (2018). Gluten-Free Diet in Celiac Disease-Forever and for All?. Nutrients, 10(11), 1796. https://doi.org/10.3390/nu10111796
]]> 2022-01-24 19:18:36 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2009620627 A randomized phase I study of etrolizumab in moderate to severe ulcerative colitis https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2009871171 This study is important because it will help discover new ways to help reduce problems regarding moderate to severe ulcerative colitis. Etrolizumab is supposed to inhibit the migration of lymphocytes to the gut. Lymphocytes to the gut is the main cause for inflammations in inflammatory bowel disease and using selective antimigration therapies are aimed to protect the gut. A finding of this study says how effective this pharmacological drug is compared to changing a persons diet as a whole. Clinical implications state that a therapy developed to block migration of harmful cells to the gut and instead recruiting effective cells it would become an effective/ more improved therapy. While migration blockers are considered tolerable, there still needs to be further research done to truly understand its impact. 

Citation:
Rutgeerts, Fedorak, R. N., Hommes, D. W., Sturm, A., Baumgart, D. C., Bressler, B., Schreiber, S., Mansfield, J. C., Williams, M., Tang, M., Visich, J., Wei, X., Keir, M., Luca, D., Danilenko, D., Egen, J., & O’Byrne, S. (2013). A randomised phase I study of etrolizumab (rhuMAb β7) in moderate to severe ulcerative colitis. Gut, 62(8), 1122–1130. https://doi.org/10.1136/gutjnl-2011-301769]]> 2022-01-24 21:46:02 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2009871171 Rhoda Inimgba https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2010229947 The study I selected for this module talks about how important a nutrition education program that is carried out by a registered dietician could improve the nutritional status of pediatric patients with celiac disease. This program will focus on having a balanced GFD and improving the physical activity levels of patients to further ensure an improved quality of diet. This is important because it could be difficult for celiac disease patients to adjust to a new diet and this program can enable them maintain a healthy lifestyle. One finding from the study was that after patients participated in the nutrition intervention program, their diet changed from just being rich in fats and protein and deficient in carbohydrate to eating foods that are mainly plant based and a decreased amount of meat, diary and processed food in their diets. These results show the role nutritional sciences can play in helping patients with celiac disease adjust to their new diets and ensure they are still getting all the form of nutrition they need. The clinical implication of this study is ensuring that in the treatment plans of children with celiac disease, a nutritional education should be part of the treatment to bring about healthy eating habits and improve the quality of the children’s diet.
Citation
Suárez‐González, M., Bousoño García, C., Jiménez Treviño, S., Iglesias Cabo, T., & Díaz Martín, J. J. (2020). Influence of Nutrition Education in Paediatric coeliac disease: Impact of the role of the registered dietitian: A prospective, single‐arm intervention study. Journal of Human Nutrition and Dietetics, 33(6), 775–785. https://doi.org/10.1111/jhn.12800.]]> 2022-01-25 03:20:53 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2010229947 Dietary patterns, beliefs and behaviors among individuals with inflammatory bowel disease: a cross-sectional study. emaleehaynes https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2011150621 https://doi.org/10.1111/jhn.12786 
 
1)This study is important because it evaluated the beliefs of patients and what they thought worked, versus using recommendations from health professionals to decide for the patients what works. Seems to give more actual patient results, which could be helpful for other IBD patients to read and make changes from. Specifically, the study found that, “Eighty-three percent believed that modifying their diet could reduce IBD symptoms.” Regarding nutrition suggestions, there can be patient resistance when there are large lifestyle changes discussed with healthcare providers, not always but it can definitely happen. This is likely because making big changes, especially with what you eat, can be intimidating and feel really difficult. Additionally, you cannot guarantee you will be satisfied, or see the symptoms improvement, etc. So, when you can hear more personal stories or results from fellow patients it can lead to changes being made which can impact your health and wellbeing. 
2)One key finding from this study was, “Both men and women with IBD struggle to meet the national guidelines for intake of fiber, whole grains, fruits and vegetables. The majority reported modifying their dietary intake as a result of IBD and expressed belief that diet could reduce symptoms.” This relates to nutritional sciences because it broke down each of the requirements for dietary intake, like calcium, fruits, dairy, etc., and evaluated the intake amongst participants with the diet modifications they made to show where they found some relief of symptoms later from making changes. 
3) The clinical implications of this study were support for national guidelines of dietary intake recommendations that if followed showed relief of symptoms for IBD patients. Dietary modifications have been identified as a difficult topic and process for patients, but once done have provided more overall relief. IBD is not a disease that can be cured but can be managed through medications and lifestyle modifications. This study works to highlight the impact nutrition can make on a disease symptomology and patient wellness. 

Kamp, K.J, and B Pennings. “Dietary Patterns, Beliefs and Behaviors among Individuals with Inflammatory Bowel Disease: a Cross-Sectional Study.” Wiley Online Library, 14 June 2020, https://doi.org/10.1111/jhn.12786. 
]]> 2022-01-25 13:29:57 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2011150621 How changes to the American Diet affects Crohn's Disease models in mice tccjrr https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2011662102 Inflammatory Bowel Diseases such as Crohn’s disease have a much higher prevalence in developed countries.  It has long been understood that diet plays a role in inflammation levels of the intestines.  However, which dietary component plays the largest role was still in question. Researchers looked evaluated the three main macronutrients found in the typical American diet (AD) based on a 2011-2012 NHANES report.  These American diet macronutrients were animal protein, refined carbohydrates, and high ω-3: ω-6 fat ratios.  Each macronutrient was evaluated.  The mice that are chow with plant-based protein instead of animal protein showed significantly less intestinal inflammation and reduced weight loss.  Additionally, changes were seen in the microbiome composition of the Crohn’s mice on the plant-based protein diet as opposed to those on the animal protein.  This study supports the idea that changing from animal to plant-based protein sources could greatly improve intestinal inflammation in Crohn’s patients.  With the availability of products like Impossible, patients may see symptom improvement without making major dietary changes.

Raffner Basson, Gomez-Nguyen, A., LaSalla, A., Buttó, L., Kulpins, D., Warner, A., Di Martino, L., Ponzani, G., Osme, A., Rodriguez-Palacios, A., & Cominelli, F. (2021). Replacing Animal Protein with Soy-Pea Protein in an “American Diet” Controls Murine Crohn Disease-Like Ileitis Regardless of Firmicutes: Bacteroidetes Ratio. The Journal of Nutrition, 151(3), 579–590. https://doi.org/10.1093/jn/nxaa386]]> 2022-01-25 16:43:24 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2011662102 Stress and IBD--Ivana Djuricic https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012216361 Sun Y, Li L, Xie R, Wang B, Jiang K
and Cao H (2019) Stress Triggers
Flare of Inflammatory Bowel Disease
in Children and Adults.
Front. Pediatr. 7:432.
doi: 10.3389/fped.2019.00432
This is a review of many different studies, but it is important because of the toll that stress can take on our bodies and immune system. Perceived chronic stress has the ability to ramp up the inflammatory process so it is very important to look at it as a mitigating factor in IBD  
 
One key finding of a study reviewed in the paper is that stress affects IBD by disturbing the gut microbiota. They reviewed a study done based on a dextran sulfate sodium (DSS)-induced colitis mouse model. The results were that chronic stress increases sensitivity to colitis by way of dysbiosis and immune system dysfunction. This relates to nutritional sciences because, based on other studies reviewed, there are nutritional supplements like pre or probiotics which can help prevent stress-induced flare ups of types of IBD. 
 
Clinical implications of the microbiota study reviewed in the paper is that there are therapies that can be prescribed that target the microbiome to treat IBD. Some mentioned are antibiotics, probiotics, fecal transplants that can be helpful not only physically, but for mental recovery of IBD. 
]]> 2022-01-25 20:54:13 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012216361 COVID-19 and Outcomes in Patients with Inflammatory Bowel Disease tonyeinimgba99 https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012401691 I found an article about the clinical outcomes of COVID-19 in IBD patients. I was interested in looking into this because I had read elsewhere that a possible implication of the Covid virus was an onset of autoimmune diseases. The study is important in order to determine the impact of COVID-19 in patients with IBD.  They observed that patients with IBD are at an increased risk of COVID-19 infection, most specifically when they have active disease and are taking immunosuppressive therapy.  However, the prevalence of COVID-19 in IBD patients was low. The use of corticosteroids or mesalamine was associated with worse outcomes, whereas anti-TNFs was associated with more favorable outcomes. Since flares in active IBD patients who have COVID are increased, it relates to nutritional sciences as these patients need to be more cautious of what they intake in order not to worsen this terrible situation. Patients reported that during flare ups, avoiding foods high in fiber reduced symptoms. The clinical implications of the study was to clarify and identify risk factors and coping mechanisms for patients with IBD, who have been infected with COVID-19. Nutrition is obviously linked to immunity and infections and patients with chronic inflammatory diseases must be mindful of their nutritional status as this puts them at a greater risk of infections including COVID-19.

Tripathi, Kartikeya, et al. “COVID-19 and Outcomes in Patients with Inflammatory Bowel Disease: Systematic Review and Meta-Analysis.” Inflammatory Bowel Diseases, 2021, https://doi.org/10.1093/ibd/izab236.

]]> 2022-01-25 23:54:23 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012401691 Nutritional Regimes Enriched with Antioxidants as an Efficient Adjuvant for IBD Patients under Infliximab Administration, a Pilot Study Cassie_Craig https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012404122 This study is important because it evaluates the potential impact of incorporating a nutritional supplement, more specifically antioxidants, along with an Infliximab (IFX) treatment. The treatment is geared towards both Crohn’s disease (CD) patients and Ulcerative colitis (UC) patients and blocks TNF-alpha, which is a inflammatory cytokine. In this study, when an antioxidant rich supplement (purple corn extract) was administered with the IFX treatment, it enhanced the results of the treatment in both CD and UC patients. This relates to nutritional sciences because it highlights the possibility of diet impacting the effectiveness of IBD treatments that are currently being used. As we know, IBD is different for every patient and treatment has to be very individualized. This study shifts the focus from new treatments and medications to the potential of nutritional adjuvants that can be paired with treatments that are already being used. This could potentially enhance the impact of these treatments, making it less individualized to the patient. 
 
Liso M, Sila A, Verna G, Scarano A, Donghia R, Castellana F, Cavalcanti E, Pesole PL, Sommella EM, Lippolis A, Armentano R, Giudetti AM, Vergara D, Campiglia P, Sardone R, Curlo M, Mastronardi M, Petroni K, Tonelli C, Santino A, Chieppa M. Nutritional Regimes Enriched with Antioxidants as an Efficient Adjuvant for IBD Patients under Infliximab Administration, a Pilot Study. Antioxidants. 2022; 11(1):138. https://doi.org/10.3390/antiox11010138
 
]]> 2022-01-25 23:57:20 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012404122 Probiotic Supplementation in Celiac Patients With Persistent IBS-type Symptoms - Mitchell Watts MitchellWatts https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012464196 1) I found this study interesting and potentially important, because even if a patient has strict adherence to a gluten-free diet, IBS type symptoms can still occur. According to the authors, in another metanalysis this persistence of symptoms could be related to motor dysfunction, gut inflammation, small intestinal disease, visceral hypersensitivity, and altered gut microbiota. This altered gut microbiome can persist even if a patient follows a strict gluten free diet. This could be related to the adherence to the diet due to decreased intake of polysaccharides that serve as prebiotics for gut microbes. The objective of this study was to evaluate whether probiotic supplementation was able to improve GI symptoms, specifically using a mixture of probiotic strains that were found to be deficient per microbiological data (three bifidobacteria and two lactobacilli). This potentially important, because it could be beneficial for patients with celiac disease to not only adhere to a strict gluten-free diet, but also start probiotic supplementation as well.
 
2) According to the results, the intervention led to decreased severity of IBS type symptoms. They believe this effect could be due to modification of the microbiome with an increase in bifidobacteria in fecal samples. One result I found interesting is that the IBS-SSS and GSRS scores decreased significantly in the intervention, even though these values were originally higher in the intervention group compared to placebo. This additionally could support the role of probiotic supplementation. As I allude to in the clinical implications, I could imagine increasing intake of food sources of bifidobacterial and lactobacilli could result in similar findings.
 
3) The implications of this study could support probiotic supplementation for patients with celiac disease with persistent IBS type symptoms. Additionally, I would postulate that consuming food sources of bifidobacterial and lactobacilli, including yogurt, kefir, kimchi, and other gluten-free fermented foods would potentially be beneficial. I would also think it is important to increase intake of prebiotic foods, including gluten-free whole grains, onions, garlic, bananas, berries, etc.
 
Francavilla, R., Piccolo, M., Francavilla, A., Polimeno, L., Semeraro, F., Cristofori, F., Castellaneta, S., Barone, M., Indrio, F., Gobbetti, M., & De Angelis, M. (2019). Clinical and Microbiological Effect of a Multispecies Probiotic Supplementation in Celiac Patients With Persistent IBS-type Symptoms: A Randomized, Double-Blind, Placebo-controlled, Multicenter Trial. Journal of clinical gastroenterology, 53(3), e117–e125. https://doi.org/10.1097/MCG.0000000000001023
]]> 2022-01-26 00:55:18 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012464196 Andrea Ballinger: Treating children with inflammatory bowel disease https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012511760 When treating inflammatory bowel disease in children, it is important to establish remission early, as to encourage normal growth and development. Although, achieving normal growth and development is the goal, this can be hindered by undiagnosed inflammatory bowel disease and poor response to current treatment options. This study is important because it looks at how to alter standardized treatments to better suit children with IBD to net a better treatment response. Additionally, the study looks at how clinicians could use biomarkers to better predict IBD outcomes for pediatric patients. The use of biomarkers would allow for more personalized treatment for patients with high risk of severe IBD versus patients with a milder prognosis, yielding better treatment responses. In addition to biomarker therapy, the study confirmed the use of exclusive enteral nutrition (elimination/reduction of animal fat, dairy, gluten) as a beneficial first line of therapy in children with IBD. Dietary interventions like Exclusive Enteral Nutrition can have a positive effect on the intestinal microbiome and serve as a more nutritionally beneficial alternative to steroids. The use of new, individualized biomarker therapy in addition to standardized dietary changes gives a positive outlook on treatment for children with IBD. As disease onset can be more aggressive in children than adults, having new and more potent treatment options ensures they can continue to develop properly and reach early remission. Clinicians will also have more options on how best to treat patients on an individual basis. ]]> 2022-01-26 01:31:44 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012511760 Dietary Inflammatory Potential and Risk of Crohn’s Disease and Ulcerative Colitis ezamzamiez https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012544613 The study I chose is important because it is critical to identify and understand the effect of diet and modifying a diet on the potential risk of Inflammatory bowel diseases (IBD). This study identifies specific dietary patterns and sorts them on a scale from pro-inflammatory to anti-inflammatory by measuring the influence of food groups on inflammatory biomarkers (CRP, IL-6, TNF-α).

The participants who consumed diets higher in pro-inflammatory food groups had a higher risk of developing Crohn’s disease but not ulcerative colitis. While participants that consumed diets lower in pro-inflammatory food groups and higher anti-inflammatory food groups had a significantly lower risk of Crohn’s disease. However, participants who followed a high anti-inflammatory and low pro-inflammatory diet reduced their risk of developing the disease and vice versa; participants who followed a low anti-inflammatory and high pro-inflammatory diet had an increased risk of developing the disease. This strongly relates to nutritional science because it studies the effect of different dietary patterns on disease risk.

Recognizing the influence diet has on IBD risk encourages us to adapt to a high anti-inflammatory and low pro-inflammatory diet, especially those at high risk.

Lo, C. H., Lochhead, P., Khalili, H., Song, M., Tabung, F. K., Burke, K. E., Richter, J. M., Giovannucci, E. L., Chan, A. T., & Ananthakrishnan, A. N. (2020). Dietary Inflammatory Potential and Risk of Crohn's Disease and Ulcerative Colitis. Gastroenterology, 159(3), 873–883.e1. https://doi.org/10.1053/j.gastro.2020.05.011


]]> 2022-01-26 01:54:58 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012544613 Impact of Cigarette Smoking on the Gastrointestinal Tract Inflammation: Opposing Effects in Crohn’s Disease and Ulcerative Colitis https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012622030 Joe Devine

This study highlights the reasons behind cigarette smoking being damaging to the GI tract. It shows that nicotine levels in the gastric fluid are significantly higher than in venous and arterial blood. The study also proposes that due to impaired mucosal cell function bacteria infections are more common, which paves the way for more tissue aggravation. Nicotine also acts as a vasoconstrictor, this property alone accounting for reduced blood flow to tissues is a promising avenue of research that would shed light on the inflammatory response of the tissue lining directly linked to smoking.



Berkowitz, L., Schultz, B. M., Salazar, G. A., Pardo-Roa, C., Sebastián, V. P., Álvarez-Lobos, M. M., & Bueno, S. M. (2018). Impact of cigarette smoking on the gastrointestinal tract inflammation: Opposing effects in crohn’s disease and ulcerative colitis. Frontiers in Immunology, 9. https://doi.org/10.3389/fimmu.2018.00074 ]]> 2022-01-26 02:55:26 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012622030 Tumor necrosis factor and Crohn's disease smayer2247 https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012654575 During inflammatory bowel disease (IBD), the production of pro-inflammatory cytokines are increased. Tumor necrosis factor-a (TNF-a) is a particular pro-inflammatory cytokine released during Crohn’s Disease states and it is involved in thrombosis, fibrinolysis, metabolism, inflammation, and apoptotic cell death. The study I attached highlights the benefits of using anti-tnf-a treatment to reverse the disease in patients. In Crohn's disease, TNF-a positive cells can be detected throughout the mucosa, extending into the deep lamina propria. 
 
In this study, TNF-a antibody (cA2) was administered twice to 9 patients and major clinical implications were observed, complete remission. They even saw healing of damaged mucosal layers. They are unsure if this is due to the anti-inflammatory action or immune modulating. This is major as it relates to nutritional sciences because many use nutrition to manage their Crohn’s Disease symptoms and must avoid certain foods.

Van Deventer S. J. (1997). Tumour necrosis factor and Crohn's disease. Gut, 40(4), 443–448. https://doi.org/10.1136/gut.40.4.443
]]> 2022-01-26 03:21:45 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012654575 Dramatic Increase in Incidence of Ulcerative Colitis and Crohn's Disease https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012728935 This study's purpose was to describe the changes in incidence of pediatric inflammatory bowel disease.  Pediatric onset inflammatory disease patients were tracked over 24 years in a population-based study. This study was completed in France between 1988 and 2011. The subjects included different age groups and different digestive locations. There were 1,350 cases followed. The cases included crohn's disease, ulcerative colitis, and inflammatory bowel disease unclassified. This study is important because pediatric-onset IBD can be more aggressive and can lead to pubertal delays and nutritional impairment. The results showed that Crohn's disease and ulcerative colitis incidences increased dramatically in adolescents across the 24 year span. The incidence of inflammatory bowel disease unclassified remained stable until 2000 then the incidence rate dramatically increased. The possible factors listed for the increase of pediatric onset IDC include environmental factors, dietary habits (high protein diet) and antibiotic consumption.

Armengol-Debeir, Laura et al. “Dramatic Increase in Incidence of Ulcerative Colitis and Crohn’s Disease (1988-2011): A Population-Based Study of French Adolescents.” The American journal of gastroenterology 113.2 (2018): 265–272. Web.

Dierra Doaks]]> 2022-01-26 04:26:43 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012728935 Environmental Particulate Matter Induces Murine Intestinal Inflammatory Responses and Alters the Gut Microbiome https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012759859 As we become more conscious of the influence our daily activities have on the environment, it is equally important to assess the impact it can have on our physiology. Particulate matter contains microscopic particles that come from vehicle exhaust, industrial emissions, road dust, cooking, and combustion activities (candles). Particulate matter exposure is associated with an increased risk of Crohn’s disease and hospitalization in patients with inflammatory bowel disease. This study addresses the effects of particulate matter on the gut microbiome, increasing gut permeability. The researchers found that short term exposure of the gut to high levels of particulate matter resulted in increased gut permeability. An individual can develop digestive symptoms such as diarrhea and bloating with a leaky gut. Increased gut permeability will require a change in diet to reduce the symptoms. This study can be used to better understand a patients treatment plan to reduce the onset of gastrointestinal disease by controlling the exposure to airborne particulate matter. 

Kish, L., Hotte, N., Kaplan, G. G., Vincent, R., Tso, R., Gänzle, M., Rioux, K. P., Thiesen, A., Barkema, H. W., Wine, E., & Madsen, K. L. (2013). Environmental Particulate Matter Induces Murine Intestinal Inflammatory Responses and Alters the Gut Microbiome. PLoS ONE, 8(4), 1–15. 

Clarisa Williams


]]> 2022-01-26 04:56:00 UTC https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2012759859 Dietary Practices and Beliefs in Patients with Inflammatory Bowel Disease richardadefioye https://padlet.com/sarapolice/jqybh6y1ujquz58r/wish/2021834668 The goal of this study was to examine the dietary practices and beliefs of IBD patients. And I just felt this was important because although we have generally accepted dietary recommendations for IBD patients, we don't really talk much about what the patients themselves actually believe about the disease and how much attention they pay to their dietary choices in practice.  

This study was conducted by administering a questionnaire that examined the demographics, dietary beliefs, and eating habits in IBD 400 patients. The mean age of the patients was 48.4 years, with 39% having Crohn's disease and 51% having ulcerative colitis.

The most striking part of the findings for me was that almost 50% of the patients had never "received any formal dietary advice, and two-thirds requested for further dietary advice." And I think this is a big deal because if these many patients are not well educated regarding the role of diet in the management of their condition, then it might be more difficult for them to recover because they'll keep making wrong dietary choices. And this ultimately can reduce their quality of life in the long run.

Limdi JK, Aggarwal D, McLaughlin JT. Dietary Practices and Beliefs in Patients with Inflammatory Bowel Disease. Inflamm Bowel Dis. 2016 Jan;22(1):164-70. doi: 10.1097/MIB.0000000000000585. PMID: 26383912.


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