Hypervigilance and symptoms anticipation, visceral hypersensitivity and gastroduodenal sensorimotor abnormalities account for the varied clinical presentation of functional dyspepsia (FD) patients. ...Many patients recognize meals as the main triggering factor; thus, dietary manipulations often represent the first-line management strategy in this cohort of patients. Nonetheless, scarce quality evidence has been produced regarding the relationship between specific foods and/or macronutrients and the onset of FD symptoms, resulting in non-standardized nutritional approaches. Most dietary advises are indeed empirical and often lead to exclusion diets, reinforcing in patients the perception of "being intolerant" to food and self-perpetuating some of the very mechanisms underlying dyspepsia physiopathology (
., hypervigilance and symptom anticipation). Clinicians are often uncertain regarding the contribution of specific foods to dyspepsia physiopathology and dedicated professionals (
., dietitians) are only available in tertiary referral settings. This in turn, can result in nutritionally unbalanced diets and could even encourage restrictive eating behaviors in severe dyspepsia. In this review, we aim at evaluating the relationship between dietary habits, macronutrients and specific foods in determining FD symptoms. We will provide an overview of the evidence-based nutritional approach that should be pursued in these patients, providing clinicians with a valuable tool in standardizing nutritional advises and discouraging patients from engaging into indiscriminate food exclusions.
AIM To evaluate how different levels of adherence to a mediterranean diet(MD) correlate with the onset of functional gastrointestinal disorders.METHODS As many as 1134 subjects(598 M and 536 F;age ...range 17-83 years) were prospectively investigated in relation to their dietary habits and the presence of functional gastrointestinal symptoms.Patients with relevant chronic organic disease were excluded from the study.The Mediterranean Diet Quality index for children and adolescents(KIDMED) and the Short Mediterranean Diet Questionnaire were administered.All subjects were grouped into five categories according to their ages:14-24 years;25-34;35-49;50-64;above 64.RESULTS On the basis of the Rome Ⅲ criteria,our population consisted of 719(63.4%) individuals who did not meet the criteria for any functional disorder and were classified as controls(CNT),172(13.3%) patients meetingcriteria for prevalent irritable bowel syndrome(IBS),and 243(23.3%) meeting criteria for prevalent functional dyspepsia(FD).A significantly lower adherence score in IBS(0.57 ± 0.23,P < 0.001) and FD(0.56 ± 0.24,P < 0.05) was found compared to CNT(0.62 ± 0.21).Females with FD and IBS exhibited significantly lower adherence scores(respectively 0.58 ± 0.24,P < 0.05 and 0.56 ± 0.22,P < 0.05) whereas males were significantly lower only for FD(0.53 ± 0.25,P < 0.05).Age cluster analyses showed a significantly lower score in the 17-24 years and 25-34 year categories for FD(17-24 years:0.44 ± 0.21,P < 0.001;25-34 years:0.48 ± 0.22,P < 0.05) and IBS(17-24 years:0.45 ± 0.20,P < 0.05;24-34 years:0.44 ± 0.21,P < 0.001) compared to CNT(17-24 years:0.56 ± 0.21;25-34 years:0.69 ± 0.20).CONCLUSION Low adherence to MD may trigger functional gastrointestinal symptoms,mainly in younger subjects.Moreover,with increasing age,patients tend to adopt dietary regimens closer to MD.
It has been shown that γδ T cells protect against the formation of squamous cell carcinoma (SCC) in several models. However, the role of γδ T cells in human papillomavirus (HPV)-associated uterine ...cervical SCC, the third-leading cause of death by cancer in women, is unknown. Here, we investigated the impact of γδ T cells in a transgenic mouse model of carcinogenesis induced by HPV16 oncoproteins. Surprisingly, γδ T cells promoted the development of HPV16 oncoprotein-induced lesions. HPV16 oncoproteins induced a decrease in epidermal Skint1 expression and the associated antitumor Vγ5⁺ γδ T cells, which were replaced by γδ T-cell subsets (mainly Vγ6⁺ γδlowCCR2⁺CCR6⁻) actively producing IL-17A. Consistent with a proangiogenic role, γδ T cells promoted the formation of blood vessels in the dermis underlying the HPV-induced lesions. In human cervical biopsies, IL-17A⁺ γδ T cells could only be observed at the cancer stage (SCC), where HPV oncoproteins are highly expressed, supporting the clinical relevance of our observations in mice. Overall, our results suggest that HPV16 oncoproteins induce a reorganization of the local epithelial-associated γδ T-cell subpopulations, thereby promoting angiogenesis and cancer development.
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BFBNIB, NMLJ, NUK, PNG, SAZU, UL, UM, UPUK
Lung macrophages constitute a sophisticated surveillance and defense system that contributes to tissue homeostasis and host defense and allows the host to cope with the myriad of insults and antigens ...to which the lung mucosa is exposed. As opposed to alveolar macrophages, lung interstitial macrophages (IMs) express high levels of Type 2 major histocompatibility complex (MHC-II), a hallmark of antigen-presenting cells. Here, we showed that lung IMs, like dendritic cells, possess the machinery to present soluble antigens in an MHC-II-restricted way. Using
ovalbumin (OVA)-specific T cell proliferation assays, we found that OVA-pulsed IMs could trigger OVA-specific CD4
T cell proliferation and Foxp3 expression through MHC-II-, IL-10-, and transforming growth factor β-dependent mechanisms. Moreover, we showed that IMs efficiently captured locally instilled antigens
, did not migrate to the draining lymph nodes, and enhanced local interactions with CD4
T cells in a model of OVA-induced allergic asthma. These results support that IMs can present antigens to CD4
T cells and trigger regulatory T cells, which might attenuate lung immune responses and have functional consequences for lung immunity and T cell-mediated disorders.
Europeans consume large quantities of bakery products, although these are known as one of the food categories that potentially leads to postprandial symptoms (such as fullness and bloating).
The aim ...of this study was to evaluate the effects of sourdough baked goods on gastric emptying and gastrointestinal fermentation and symptoms in healthy people.
In a double-blind, randomized crossover study, 2 sourdough croissants (SCs) or 2 brewer's yeast croissants (BCs) were served as single meals to 17 healthy adults 9 women; age range: 18–40 y; body mass index range (in kg/m2): 18–24. Gastric volume (GV) was evaluated by magnetic resonance to calculate gastric-emptying rate in the 3-h interval after croissant ingestion. A hydrogen breath test was performed to measure hydrogen production after SC and BC ingestion. Palatability and postprandial gastrointestinal symptoms (discomfort, nausea, fullness, and bloating) over a 4-h period after the meal were evaluated. The area under the curve (AUC) was used to evaluate the overall effects on all variables tested.
The total GV AUC was reduced by 11% during the 3 h after the consumption of SCs compared with BCs (P = 0.02). Hydrogen production during the 4-h interval after ingestion of SCs was 30% lower than after BCs (P = 0.03). SCs were rated as being >2 times as palatable as BCs (P < 0.001). The overall severity of postprandial symptoms was 36% lower during the 4 h after intake of SCs compared with BCs (P = 0.05).
Sourdough bakery products could promote better postprandial gastrointestinal function in healthy adults and be more acceptable than those prepared with brewer's yeast. This trial was registered at www.clinicaltrials.gov as NCT03207516.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Acceptance of the fetal semi-allograft by the mother's immune system has become the focus of intensive research. CD4+ T cells are important actors in the establishment of pregnancy. Th1/Th2 paradigm ...has been expanded to include CD4+ regulatory T (Treg) and T helper 17 (Th17) cells. Pregnancy hormones exert very significant modulatory properties on the maternal immune system. In this review, we describe mechanisms by which the endocrine milieu modulates CD4 T cell polarization during pregnancy. We first focused on Treg and Th17 cells and on their importance for pregnancy. Secondly, we review the effects of pregnancy hormones progesterone (P4) and estradiol (E2) on immune cells previously described, with a particular attention to human chorionic gonadotropin (hCG). The importance of Treg cells for pregnancy is evidenced. They are recruited before implantation and are essential for pregnancy maintenance. Decreased number or less efficient Treg cells are implicated in fertility disorders. As for Th17 cells, the few available studies suggest that they have a negative impact on fertility. Th17 frequency is increased in infertile patients. With the combination of its pro-effects on Th2 and Treg cells and anti-effects on Th1 and Th17 cells, P4 contributes to establishment of a favorable environment for pregnancy. E2 effects are more dependent on the context but it seems that E2 promotes Treg and Th2 cells while it inhibits Th1 cells. hCG positively influences activities of Treg and uterine natural killer cells. This embryo signal is an essential actor for the success of pregnancy, both as the endocrine factor regulating P4 secretion by the ovarian corpus luteum, but also as a paracrine agent during implantation as well as an angiogenic and immunologic mediator during the course of gestation. Luteinizing hormone (LH) immune properties begin to be studied but its positive impact on Treg cells suggests that LH could be a considerable immunomodulator in the mouse.
It has been shown that γδ T cells protect against the formation of squamous cell carcinoma (SCC) in several models. However, the role of γδ T cells in human papillomavirus (HPV)-associated uterine ...cervical SCC, the third-leading cause of death by cancer in women, is unknown. Here, we investigated the impact of γδ T cells in a transgenic mouse model of carcinogenesis induced by HPV16 oncoproteins. Surprisingly, γδ T cells promoted the development of HPV16 oncoprotein-induced lesions. HPV16 oncoproteins induced a decrease in epidermal Skint1 expression and the associated antitumor Vγ5+ γδ T cells, which were replaced by γδ T-cell subsets (mainly Vγ6+ γδlowCCR2+CCR6-) actively producing IL-17A. Consistent with a proangiogenic role, γδ T cells promoted the formation of blood vessels in the dermis underlying the HPV-induced lesions. In human cervical biopsies, IL-17A+ γδ T cells could only be observed at the cancer stage (SCC), where HPV oncoproteins are highly expressed, supporting the clinical relevance of our observations in mice. Overall, our results suggest that HPV16 oncoproteins induce a reorganization of the local epithelial-associated γδ T-cell subpopulations, thereby promoting angiogenesis and cancer development.
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Background
Water balance influences gastrointestinal (GI) activity. Our aim was to evaluate how dehydration and rehydration with different types of water are able to affect GI activity in healthy and ...dyspeptic athletes.
Methods
Twenty non‐competitive athletes, respectively 10 healthy and 10 dyspeptic subjects, were enrolled. All subjects underwent three test sessions (0, A, B) of 6 hours. Dehydration was achieved with a walking/jogging exercise test on a treadmill. After exercising, 500 mL of calcium‐bicarbonate (Test A) or soft water (Test B) were administered, while no rehydration was provided during Test 0; thereafter, all subjects consumed a light lunch. GI symptoms were evaluated during each test and an electrocardiogram (ECG) Holter recording was performed at the end of the exercise.
Key Results
Dyspeptic subjects exhibited higher overall symptoms during Test 0 (VAS: 30.8 ± 0.8 mm) compared to Test A (18.4 ± 1.1, P < 0.001) and Test B (24.4 ± 1.3, P < 0.001). However, analyzing GI symptoms, only subjects receiving calcium‐bicarbonate water (Test A) showed significantly lower symptomatic scores compared to Test 0 or Test B. Moreover, heart rate variability analyses revealed that only in Test A dyspeptic patients exhibit a trend to a decrease in the post‐prandial low/high frequency (LF/HF) ratio, similarly to healthy subjects, while in Test 0 and Test B, post‐prandial LF/HF ratio was increased compared to the pre‐prandial phase.
Conclusions and Inferences
Our results show that mild dehydration in dyspeptic athletes is able to increase GI symptoms but an adequate rehydration, with calcium‐bicarbonate water, is able to improve post‐exercise disturbances restoring sympathovagal imbalance.
Hydration status may influence symptoms onset and severity in dyspeptic patients. However, different types of water may differently affect gastrointestinal activity since calcium‐bicarbonate water seems to improve dyspeptic symptoms, induced by physical stress.
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DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
Interleukin-17 (IL-17)-producing γδ (γδ17) T cells are innate-like lymphocytes that contribute to protective anti-microbial responses but are also implicated in pathogenic inflammation at barrier ...sites. Understanding tissue-specific signals that regulate this subset is important to boost host defense mechanisms, but also to mitigate immunopathology. Here, we demonstrate that prostaglandin E
(PGE
), a cyclooxygenase-dependent member of the eicosanoid family, directly enhances cytokine production by circulating and tissue-specific γδ17 T cells in vitro. Gain- and loss-of-function in vivo approaches further reveal that although provision of PGE
amplifies psoriasiform inflammation, ablation of host mPGES1-dependent PGE
synthesis is dispensable for cutaneous γδ17 T cell activation. By contrast, loss of endogenous PGE
production or depletion of the gut microbiota compromises intestinal γδ17 T cell responses and increases disease severity during experimental colitis. Together, our results demonstrate how a lipid mediator can synergize with tissue-specific signals to enhance innate lymphocyte production of IL-17 during barrier inflammation.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Introduction
Pregnancy is an immune paradox. While the immune system is required for embryo implantation, placental development and progression of gestation, excessive inflammation is associated with ...pregnancy failure. Similarly, the cytokine IL‐17A plays an important role in defence against extracellular pathogens, but its dysregulation can lead to pathogenic inflammation and tissue damage. Although expression of IL‐17 has been reported during pregnancy, the cellular source of this cytokine and its relevance to gestation are not clear.
Objectives
Here we define the kinetics and cellular source of IL‐17A in the uterus during healthy and abortion‐prone murine pregnancy.
Methods
The CBA/J x DBA/2J abortion‐prone mating was used and compared to CBA/J x BALB/c control mating.
Results
We demonstrate that, irrespective of gestational health, the number of IL‐17‐producing cells peaks during midterm pregnancy and is largely derived from the γδ T‐cell lineage. We identify γδ T, Th17, CD8 T and NKT cells as the cellular source of IL‐17A in pregnant mice. Furthermore, we positively identify the Vγ6+ subset of uterine γδ T cells as the main producer of IL‐17A during both healthy pregnancy and abortive pregnancy.
Conclusions
To conclude, the accumulation of uterine IL‐17+ innate‐like T cells appears not to adversely impact the developing foetus. Collectively, our results show that IL‐17+ γδ T cells are present in the uterus throughout the course of normal gestation and therefore may play an important role in healthy pregnancy.
The accumulation of uterine IL‐17+ γδ T cells appears not to adversely impact the developing foetus. Collectively, our results show that IL‐17+ γδ T cells are present in the uterus throughout the course of normal gestation and therefore may play an important role in healthy pregnancy.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
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