CLINICAL AND THERAPEUTIC ASPECTS OF DIVERTICULITIS: A NARRATIVE REVIEW

Diverticulitis is a gastrointestinal condition in which diverticula (small sacs or pouches) in the colon become inamed or infected. This article is a review of the current understanding of diverticulitis and covers its causes, symptoms, diagnosis, and treatment. Epidemiological studies have shown that diverticulitis mainly affects older adults and the incidence increases with age. The Western diet, which is high in fat and low in ber, has been implicated in the development of diverticulitis. The most common presenting symptom is abdominal pain, often localized to the left lower quadrant, and other symptoms include fever, nausea, vomiting, and changes in bowel habits. The diagnosis of diverticulitis is based on a combination of clinical, radiologic, and laboratory ndings. The preferred imaging modality is computed tomography (CT) with intravenous contrast. Mild cases can often be managed with conservative measures, such as bowel rest, antibiotics, and pain management. More severe cases may require hospitalization, intravenous antibiotics, and, in some cases, surgical intervention. Surgery may be required in cases of complicated diverticulitis, such as perforation, abscess formation, or stula formation, and in patients with recurrent diverticulitis. In conclusion, further research is needed to better understand the epidemiology of diverticulitis and its risk factors, especially in developing countries where the incidence of diverticulitis is believed to be lower.

Intestinal microbiome characterization of adult Brazilian men with psoriasis compared to omnivore and vegetarian controls

Abstract Background Psoriasis is a chronic inflammatory disease associated with systemic inflammation and comorbidities. Changes in the composition of the intestinal microbiome are involved in the pathogenesis of inflammatory diseases and metabolic syndrome. Characterizing the intestinal microbiome of patients with psoriasis may be relevant for the understanding of its clinical course and comorbidity prevention. Objective To characterize the intestinal microbiome of men with psoriasis compared to omnivore and vegetarian controls (without psoriasis). Method Cross-sectional study of 42 adult males: 21 omnivores with psoriasis; and controls: 14 omnivores and 7 vegetarian individuals. The characterization of the intestinal microbiome was performed by metagenomic analysis. Serum levels of lipopolysaccharide-binding protein (LPB) and C-reactive protein (CRP) were evaluated. Results The groups differed from each other regarding nutritional aspects and microbiome; individuals with psoriasis had a higher consumption of protein and lower consumption of fibers. Levels of LPB, CRP, and the Firmicutes/Bacteroidetes ratio were higher in the group with psoriasis than in the vegetarian group (p < 0.05). The genera Prevotella, Mogibacterium, Dorea, Bifidobacterium and Coprococcus, differed in the group with psoriasis compared to vegetarians; the genera Mogibacterium, Collinsella and Desulfovibrio differed from omnivores. A microbiome pattern linked to psoriasis (plsPSO) was identified, which was associated with higher LPB levels (rho = 0.39; p = 0.02), and lower dietary fiber intake (rho = −0.71; p < 0.01). Study limitations Only adult men were evaluated. Conclusion A difference was identified in the intestinal microbiome of adult men with psoriasis when compared to healthy omnivores and vegetarian controls. The identified microbiome pattern was correlated with dietary fiber intake and serum levels of LPB.

Influência da vitamina C na lipoperoxidação hepática e muscular de camundongos C57BL/6 submetidos à dieta de cafeteria / Influence of vitamin C on hepatic and muscular lipoperoxidation of C57BL / 6 mice conducted on the cafeteria diet

Analisar o efeito do tratamento com vitamina C sobre a lipoperoxidação hepática e muscular, assim como sobre parâmetros bioquímicos de camundongos C57BL/6 submetidos à dieta de cafeteria durante nove semanas. Dezessete camundongos da linhagem C57BL/6, com dois meses de idade foram alocados em três grupos: 1) Controle, 2) Cafeteria e 3) Cafeteria + Vitamina C. O ensaio biológico foi conduzido por nove semanas, os animais foram mantidos em jejum de doze horas, e depois de sacrificados, o sangue e os tecidos foram coletados para dosagens bioquímicas. A partir de amostras de fígado e músculo sóleo, foram quantificados os teores de espécies reativas ao ácido tiobarbitúrico (TBARS) e de lipídeos totais. Os fígados dos camundongos alimentados com dieta de cafeteria tratados ou não com vitamina C apresentaram maiores teores de TBARS comparados aos controles (p<0,05). Já o teor de TBARS muscular foi maior nos camundongos do grupo Cafeteria + Vitamina C comparado àquele encontrado para os animais Cafeteria e Controle (p<0,05). As concentrações de colesterol hepático e muscular foram mais elevadas no grupo Cafeteria + Vitamina C comparadas às dos grupos Controle e Cafeteria (p<0,05). O tratamento com vitamina C aumentou a lipoperoxidação muscular, mas não influenciou esse parâmetro no fígado de camundongos C57BL/6 alimentados com dieta de cafeteria. Além disso, a vitamina C elevou a concentração de colesterol nos tecidos hepático e muscular, mas não alterou a glicemia e os lipídeos séricos dos animais após nove semanas de tratamento.(AU)

To analyze the effect of vitamin C treatment on hepatic and muscular lipoperoxidation, as well as on biochemical parameters of C57BL / 6 mice submitted to the cafeteria diet for nine weeks. Seventeen mice of the C57BL / 6 lineage, two months old, were allocated to three groups: 1) Control, 2) Cafeteria and 3) Cafeteria + Vitamin C. The biological assay was conducted for nine weeks, the animals were kept in fasting for 12 hours and after being sacrificed, blood and tissues were collected for biochemical dosages. From the samples of liver and muscle, the contents of thiobarbituric acid reactive species (TBARS) and total lipids were quantified. The livers of mice fed with a diet of coffee or not treated with vitamin C showed higher levels of TBARS compared to controls (p <0.05). The muscle TBARS content was higher in the mice of the Cafeteria + Vitamin C group compared to that found for the Cafeteria and Control animals (p <0.05). The concentrations of hepatic and muscular cholesterol were higher in the Cafeteria + Vitamin C group compared to the Control and Cafeteria groups (p <0.05). Treatment with vitamin C increased muscle lipoperoxidation, but did not influence this parameter in the liver of C57BL 6 mice fed with cafeteria diet. In addition, vitamin C increased cholesterol concentration in liver and muscle tissues, but did not change serum glycemia and serum lipids after nine weeks of treatment.(AU)

Establishment of non-alcoholic steatohepatitis mouse model induced by Western diet combined with low-dose carbon tetrachloride / 上海交通大学学报（医学版）

Objective • To construct a non-alcoholic steatohepatitis (NASH) mouse model by the combination of Western diet (WD) and low-dose carbon tetrachloride (CCl4), and explore the time nodes of typical NASH pathological changes. Methods • Male 8-week C57BL/6 mice were fed WD and intraperitoneally injected with CCl4 at a dose of 2 μL/g of body weight per week to construct NASH models. At different time points, the fasting blood glucose, and the levels of triacylglyceride, glutamic-pyruvic transaminase and glutamic-oxaloacetic transaminase were tested; glucose tolerance was tested at the 24th week. Besides, the liver index was calculated and oil red O staining, Sirius red staining, hematoxylin-eosin staining and TUNEL test were conducted to evaluate liver pathological changes after liver sampling. Results • Between the control group and model group, there was no significant difference in fasting blood glucose and glucose tolerance test result, while the significant differences of liver index were observed at the 8th, 12th and 24th week (P<0.05). And at the 24th week, the levels of triacylglyceride, glutamic-pyruvic transaminase and glutamic-oxaloacetic transaminase were higher in the model group than those in the control group (P<0.05). According to the results of oil red O staining, Sirius red staining, hematoxylin-eosin staining and TUNEL test, in the model group, a large amount of small lipid droplets accumulation in the liver tissues was detected and hepatocytes were mainly in apoptotic state at the 8th week; large lipid droplets, hepatocellular ballooning and spot-like necrosis were observed, and hepatocyte apoptosis persisted at the 16th week; stage 3 fibrosis of liver was observed, and the number of spot-like necrosis increased but lipid droplets decreased, while hepatocytes were mainly in a proliferative state at the 24th week. Conclusion • The mouse model of NASH can be established successfully by WD combined with low-dose CCl4, which can simulate the pathologic features of NASH in a short time.

Caloric Substitution of Diets with Apple Pomace was Determined to be Safe for Renal and Bone Health Using a Growing Rat Model

Aims: To determine the safety of caloric substitution with 10% (g/kg) apple pomace to a healthy or Western diet. Study Design: Growing (age 22-29 days) female Sprague-Dawley rats were randomly assigned (n=8 rats/group) to consume a purified standard rodent diet (AIN-93G), AIN-93G/10% g/kg apple pomace (AIN/AP), Western diet, or Western/10% g/kg apple pomace (Western/AP) diets for 8 weeks. Results: Histological evaluation showed renal interstitial hypercellularity in rats fed AIN/AP, Western, and Western/AP diets. However, there were no effects on renal expression of oxidative stress and inflammatory genes or serum measures of kidney damage and function among diet groups. Apple pomace was also high in calcium which can affect calcium balance. Dietary calcium consumption was highest (P < .001) in rats consuming Western/AP. However, there were no significant differences in calcium absorption and retention among diet groups. Further, there was no evidence of renal calcification. There were also no impacts on femoral calcium, total mineral content, size or strength. Conclusions: Based on the results, apple pomace consumption was safe for renal and bone health in a rodent model, regardless of diet quality. Future preclinical studies should be conducted to further determine the efficacy and safety of apple pomace.

Frutanos tipo inulina associados à dieta de cafeteria: efeito no perfil cardiometabólico de ratos Wistar / Inulin-type fructan associated with cafeteria diet: effect on the cardiometabolic profile of Wistar rats

A dieta de cafeteria foi desenvolvida a fim de mimetizar a dieta ocidentalizada, uma vez que esta associa-se a desordens no perfil cardiovascular, como dislipidemias, hiperglicemia, acúmulo de gordura corporal, entre outros. Os frutanos tipo inulina (FTI) são fibras solúveis categorizados como prebióticos. O presente estudo objetivou avaliar os efeitos da dieta de cafeteria associadas aos FTI sobre o perfil cardiometabólico em ratos Wistar. Para tanto, utilizou-se 30 animais. Os FTI purificados, bem como, provenientes da matriz alimentar (yacon em pó), foram adicionados a seus respectivos grupos experimentais na dose de 6%, durante 30 dias. As variáveis analisadas foram: composição centesimal e conteúdo de FTI, ganho de peso (GP), peso relativo do ceco (PRC), peso relativo do fígado (PRF), consumo alimentar, glicemia, triglicerídeos, colesterol total, HDL-c, LDL-c, tecido adiposo subcutâneo e visceral (epididimal, retroperitoneal e mesentérica). Todas as análises seguiram os protocolos padronizados. A análise estatística foi realizada no software Sigma Stat 4.0 e teste de normalidade de Shapiro-Wilk, testes descritivos, ANOVA ou teste de Kruskal-Wallis seguidos dos testes de comparação de médias de Duncan ou Dunn's. O nível de significância adotado foi de p<0,05. A variável PRC foi estatisticamente maior nos grupos submetidos aos FTI. O grupo que recebeu dieta de cafeteria apresentou valores superiores no GP, VLDL, triglicerídeos, tecido adiposo subcutâneo e epididimal. Não houve diferença estatística nos parâmetros PRF, colesterol total, LDL-c, HDL-c e glicemia. Portanto, através deste trabalho, verificou-se efeitos sistêmicos benéficos dos FTI em parâmetros como: PRC, GP, VLDL, triglicerídeos, tecido adiposo(AU)

The cafeteria diet was developed in order to mimic the western diet, since it is associated with disorders in the cardiovascular profile, such as dyslipidemia, hyperglycemia, accumulation of body fat, among others. Inulin-type fructan (ITF) are soluble fibers categorized as prebiotics. The present study aimed to evaluate the effects of ITF associated with cafeteria diet on the cardiometabolic profile in Wistar rats. For this, 30 animals were used. The purified ITFs, as well as from the food matrix (yacon powder), were added to their respective experimental groups at a dose of 6% for 30 days. The analyzed variables were: centesimal composition and ITF content, weight gain (WG), relative weight of cecum (RWC), relative liver weight (RLW), dietary intake, glycemia, triglycerides, total cholesterol, HDL-c, LDL -c, subcutaneous and visceral adipose tissue (epididimal, retroperitoneal and mesenteric). All analyzes followed the standardized protocols. Statistical analysis was performed using the Sigma Stat 4.0 software and a Shapiro-Wilk normality test, descriptive tests, ANOVA or Kruskal-Wallis test followed by the Duncan or Dunn's averages comparison tests were performed. The level of significance was set at p <0.05. The RWC variable was statistically higher in the groups submitted to FTI. The group that received a cafeteria diet presented higher values in WG, VLDL, triglycerides, subcutaneous and epididimal adipose tissue. There was no statistical difference in the parameters RLW, total cholesterol, LDL-c, HDL-c and glycemia. Therefore, through this work, beneficial systemic effects of ITF were observed in parameters such as: RWC, WG, VLDL, triglycerides and adipose tissue(AU)

Research Progress on Relationship Between Western Diet and Inflammatory Bowel Disease / 胃肠病学

Inflammatory bowel disease (IBD), mainly including ulcerative colitis (UC) and Crohn's disease (CD), is a gastroenterological tract inflammatory disease with unknown etiology. In recent years, the morbidity of IBD is gradually increased. Epidemiological survey has indicated that IBD is associated with Western diet. Western diet increases IBD susceptibility via affecting the composition of intestinal microflora, injuring intestinal barrier and activating the inherent immunity. This article reviewed the relationship between Western diet and the incidence rate and pathogenesis of IBD, and the diet intervention of IBD.

Ethanol extract of Allium fistulosum inhibits development of non-alcoholic fatty liver disease

BACKGROUND/OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease and is closely associated with metabolic syndrome. In the present study, we observed the effect of ethanol extract of Allium fistulosum (EAF) on NAFLD and have suggested the possibility of using EAF as a natural product for application in the development of a treatment for NAFLD. MATERIALS/METHODS: The preventive effect on hepatic lipid accumulation was estimated by using an oleic acid (OA)-induced NAFLD model in vitro and a Western diet (high-fat high-sucrose; WD)-induced obese mouse model. Animals were divided into three groups (n = 7): normal diet group (ND), WD group, and WD plus 1% EAF group. RESULTS: EAF reduced OA-stimulated lipid accumulation in HepG2 cells in the absence of cellular cytotoxicity and significantly blocked transcriptional activation of sterol regulatory element-binding protein 1 and fatty acid synthase genes. Subsequently, we investigated these effects in vivo in mice fed either ND or WD in the presence or absence of EAF supplementation. In comparison to the ND controls, the WD-fed mice exhibited increases in body weight, liver weight, epididymal fat weight, and accumulation of fat in hepatocytes, and these effects were significantly attenuated by EAF supplementation. CONCLUSIONS: Allium fistulosum attenuates the development of NAFLD, and EAF elicits anti-lipogenic activity in liver. Therefore, EAF represents a promising candidate for use in the development of novel therapeutic drugs or drug combinations for the prevention and treatment of NAFLD.