Non-invasive diagnosis of steatosis, inflammatory changes and liver fibrosis in patients with non-alcoholic fatty liver diseases. Pilot study.

INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of abnormal liver enzymes in adult patients consulted by hepatologists. Due to the high prevalence of this disease, most often associated with obesity, it is necessary to assess the risk of NAFLD, monitoring the progression of the disease and the effectiveness of treatment. MATERIAL AND METHODS: We evaluated the intensity of steatosis, inflammatory activity and fibrosis in 36 patients with NAFLD (fatty liver in abdominal ultrasound examination), using non-invasive tests: SteatoTest, ActiTest and FibroTest. We compared the prevalence of metabolic disorders and hypertension between women and men. RESULTS: There were no significant differences in analysed parameters of metabolic disorders between women and men. In both studied groups, the intensity of steatosis and inflammatory changes was similar. However, in the male group, the intensity of liver fibrosis was higher. CONCLUSIONS: The tests helped to detect advanced liver fibrosis in patients who were diagnosed with liver steatosis in ultrasound examination. Non-invasive diagnostics of liver injury may be useful in screening to select groups of patients requiring liver biopsy, as well as in monitoring the course of the disease and assessment of the treatment effectiveness. Early detection of liver disease may improve the prognosis of these patients.

The Role of Intestinal Alkaline Phosphatase in Inflammatory Disorders of Gastrointestinal Tract.

Over the past few years, the role of intestinal alkaline phosphatase (IAP) as a crucial mucosal defence factor essential for maintaining gut homeostasis has been established. IAP is an important apical brush border enzyme expressed throughout the gastrointestinal tract and secreted both into the intestinal lumen and into the bloodstream. IAP exerts its effects through dephosphorylation of proinflammatory molecules including lipopolysaccharide (LPS), flagellin, and adenosine triphosphate (ATP) released from cells during stressful events. Diminished activity of IAP could increase the risk of disease through changes in the microbiome, intestinal inflammation, and intestinal permeability. Exogenous IAP exerts a protective effect against intestinal and systemic inflammation in a variety of diseases and represents a potential therapeutic agent in diseases driven by gut barrier dysfunction such as IBD. The intestinal protective mechanisms are impaired in IBD patients due to lower synthesis and activity of endogenous IAP, but the pathomechanism of this enzyme deficiency remains unclear. IAP has been safely administered to humans and the human recombinant form of IAP has been developed. This review was designed to provide an update in recent research on the involvement of IAP in intestinal inflammatory processes with focus on IBD in experimental animal models and human patients.

Can exercise affect the course of inflammatory bowel disease? Experimental and clinical evidence.

The inflammatory bowel disease (IBD) consisting of Crohn's disease (CD) and ulcerative colitis (UC) are defined as idiopathic, chronic and relapsing intestinal disorders occurring in genetically predisposed individuals exposed to environmental risk factors such as diet and microbiome changes. Since conventional drug therapy is expensive and not fully efficient, there is a need for alternative remedies that can improve the outcome in patients suffering from IBD. Whether exercise, which has been proposed as adjunct therapy in IBD, can be beneficial in patients with IBD remains an intriguing question. In this review, we provide an overview of the effects of exercise on human IBD and experimental colitis in animal models that mimic human disease, although the information on exercise in human IBD are sparse and poorly understood. Moderate exercise can exert a beneficial ameliorating effect on IBD and improve the healing of experimental animal colitis due to the activity of protective myokines such as irisin released from working skeletal muscles. CD patients with higher levels of exercise were significantly less likely to develop active disease at six months. Moreover, voluntary exercise has been shown to exert a positive effect on IBD patients' mood, weight maintenance and osteoporosis. On the other hand, depending on its intensity and duration, exercise can evoke transient mild systemic inflammation and enhances pro-inflammatory cytokine release, thereby exacerbating the gastrointestinal symptoms. We discuss recent advances in the mechanism of voluntary and strenuous exercise affecting the outcome of IBD in patients and experimental animal models.