Roles of intestinal epithelial cells in the maintenance of gut homeostasis

The intestine is a unique organ inhabited by a tremendous number of microorganisms. Intestinal epithelial cells greatly contribute to the maintenance of the symbiotic relationship between gut microbiota and the host by constructing mucosal barriers, secreting various immunological mediators and delivering bacterial antigens. Mucosal barriers, including physical barriers and chemical barriers, spatially segregate gut microbiota and the host immune system to avoid unnecessary immune responses to gut microbes, leading to the intestinal inflammation. In addition, various immunological mediators, including cytokines and chemokines, secreted from intestinal epithelial cells stimulated by gut microbiota modulate host immune responses, maintaining a well-balanced relationship between gut microbes and the host immune system. Therefore, impairment of the innate immune functions of intestinal epithelial cells is associated with intestinal inflammation.

Attitudes of medical students toward acupuncture and moxibustion after lectures and practical instruction in clinical clerkships / 医学教育

Background: Complementary medicine and alternative medicine have been included in the curricula of many medical schools and colleges; however, teaching methods have not been standardized. We gave lectures and practical instruction on acupuncture and moxibustion medicine to medical students during their clinical clerkship in anesthesiology. We used a questionnaire to evaluate the usefulness of small-group teaching.<br>Methods: The subjects were 93 fifth-year medical students doing clinical clerkships in anesthesiology. The clinical clerkship consists of small-group learning with 2 or 3 students per group. After a lecture and practical instruction on acupuncture and moxibustion were given, students were asked to fill out a questionnaire about their interest in and basic knowledge of acupuncture and moxibustion and whether they would like to master the technique.<br>Results: All 93 students answered the questionnaire （response rate, 100%）. After the small-group teaching, students became more interested in acupuncture and moxibustion and learned that the costs of treatment were covered by health insurance. Most students were interested mastering acupuncture and moxibustion in the future.<br>Discussion: Our results suggest that lectures and practical instruction during clinical clerkship are useful for getting medical students interested in acupuncture and moxibustion medicine.

Regulation of Intestinal Homeostasis by Innate Immune Cells

The intestinal immune system has an ability to distinguish between the microbiota and pathogenic bacteria, and then activate pro-inflammatory pathways against pathogens for host defense while remaining unresponsive to the microbiota and dietary antigens. In the intestine, abnormal activation of innate immunity causes development of several inflammatory disorders such as inflammatory bowel diseases (IBD). Thus, activity of innate immunity is finely regulated in the intestine. To date, multiple innate immune cells have been shown to maintain gut homeostasis by preventing inadequate adaptive immune responses in the murine intestine. Additionally, several innate immune subsets, which promote Th1 and Th17 responses and are implicated in the pathogenesis of IBD, have recently been identified in the human intestinal mucosa. The demonstration of both murine and human intestinal innate immune subsets contributing to regulation of adaptive immunity emphasizes the conserved innate immune functions across species and might promote development of the intestinal innate immunity-based clinical therapy.

Evaluation of acupuncture treatment for chronic pain patients by PainVision / 全日本鍼灸学会雑誌

[Objective]Esthesia and algesthia quantitative analyzers (PainVision®) are instruments that enables us to objectively assess the pain intensity. By applying an electrical current we can measure the intensity of pre-existing pain (pain equivalent current) and the minimum electrical stimulation that can be sensed by the patient (minimum perceptible current). In this study, we used PainVision®to evaluate the effectiveness of acupuncture treatment in patients with chronic pain and compared pain-related parameters with the Visual analogue scale (VAS). <BR>[Methods]Twenty-three patients (4 males, 19 females;median age of 68) with chronic pain were studied. Pain degree was evaluated by the following equation;<BR>Pain degree = 100 x (pain equivalent current -minimum perceptible current)/minimum perceptible current. <BR>Pain degree was compared with VAS at pre-and post-acupuncture treatment.<BR>[Results]VAS, pain degree and pain equivalent current by PainVision®decreased significantly after acupuncture treatment (p < 0.0001, p < 0.0001 and p < 0.01, respectively). Minimum perceptible current did not change significantly (p > 0.05). Pain degree and VAS had relatively high correlation coefficients at pre-and post-treatment (r = 0.52, p < 0.05 and 0.47, p < 0.05;respectively). Changes in VAS and pain degree agreed in 87%of the cases.<BR>[Conclusions]PainVision®is a useful tool to assess pain intensity objectively, and parameters derived from it correlated well with VAS. In patients with chronic pain, acupuncture treatment can be evaluated by PainVision®.