Although synthesized nanotherapeutics (NTs) are attractive for the oral treatment of colon diseases, their clinical translations are constrained by the unsatisfactory therapeutic outcomes, potential ...adverse effects, and high cost of mass production. Here, we report the development of tea leaf-derived natural NTs with desirable particle sizes (140.0 nm) and negative surface charge (−14.6 mV). These natural exosome-like NTs were found to contain large amounts of lipids, some functional proteins, and many bioactive small molecules. Specifically, galactose groups on the surface of NTs could mediate their specific internalization by macrophages via galactose receptor-mediated endocytosis. Moreover, these NTs were able to reduce the production of reactive oxygen species, inhibit the expression of pro-inflammatory cytokines, and increase the amount of anti-inflammatory IL-10 secreted by macrophages. Orally administered NTs could efficiently inhibit the inflammatory bowel responses, restore disrupted colonic barriers and enhance the diversity and overall abundance of gut microbiota, thereby preventing or alleviating inflammatory bowel disease and colitis-associated colon cancer. The present study brings new insights to the facile application of a versatile and robust natural nanoplatform for the prevention and treatment of colon diseases.
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Computer-aided diagnosis systems developed by computer vision researchers have helped doctors to recognize several endoscopic colorectal diseases more rapidly, which allows appropriate treatment and ...increases the patient's survival ratio. Herein, we present a robust architecture for endoscopic image classification using an efficient dilation in Convolutional Neural Network (CNNs). It has a high receptive field of view at the deep layers in increasing and decreasing dilation factor to preserve spatial details. We argue that dimensionality reduction in CNN can cause the loss of spatial information, resulting in miss of polyps and confusion in similar-looking images. Additionally, we use a regularization technique called DropBlock to reduce overfitting and deal with noise and artifacts. We compare and evaluate our method using various metrics: accuracy, recall, precision, and F1-score. Our experiments demonstrate that the proposed method provides the F1-score of 0.93 for Colorectal dataset and F1-score of 0.88 for KVASIR dataset. Experiments show higher accuracy of the proposed method over traditional methods when classifying endoscopic colon diseases.
Targeting the drug delivery system is very tough nowadays due to premature drug release at the upper GIT tract and altered pH conditions. Colon-specific drug delivery systems can overcome that ...problem using different polymer combinations. A nanoparticulate drug delivery system is the prominent dosage form that impacts the bioavailability and requires a low dose to excrete the therapeutic efficacy. All nanoscience and nanotechnology are applications of Nanometrology, the science of measurements at the nanoscale. NPDDSs were primarily developed to combine the colloidal stability of solid particle suspensions in biological fluids and the solubilizing properties of liquids. An ideal drug-delivery system possesses two elements: the ability to target and control the drug release. Colloidal drug carriers offer a number of potential advantages as delivery systems, such as better bioavailability for poorly soluble drugs. Researchers have created various sophisticated and multifunctional nanocarrier systems that can transport pharmaceuticals in a targeted, sustained, and regulated manner to provide therapeutic medications that are safer and more effective, particularly to ulcerative colitis. These innovative technologies are improving the pharmacokinetic profile of pharmaceuticals, increasing their systemic circulation, and decreasing the frequency of pharmacological side effects. The review focuses on the current trend and future perspectives of natural polymer-based-loaded nanoparticle-based drug delivery systems for the management of inflammatory bowel disease.
Symptomatic uncomplicated diverticular colon disease (SUDCD) is a highly prevalent disease in our setting, which significantly affects the quality of life of patients. Recent changes in understanding ...the natural history of this disease and technological and pharmacological advances have increased the available options for both diagnosis and treatment. However, consensus regarding the use of these options is scarce and sometimes lacks scientific evidence. The objective of this systematic review is to clarify the existing scientific evidence and analyse the use of the different diagnostic and therapeutic options for SUDCD, comparing their advantages and disadvantages, to finally suggest a diagnostic-therapeutic algorithm for this pathology and, at the same time, propose new research questions.
The OBJECTIVE was to study the informative value of ultrasound examination in patients with paracolar abscess, to evaluate the therapeutic and diagnostic effectiveness of minimally invasive treatment ...of abdominal and pelvic abscesses in this pathology.METHODS AND MATERIALS. In the period from 2016 to 2021, 85 patients who underwent minimally invasive drainage of paracolar abscesses were treated under ultrasound and RTV guidance. In 72 (84.7%) patients, the diagnosis was confirmed on MSCT. Transvaginal ultrasound was performed in 12 (14.1%) patients, and transrectal ultrasound was performed in 25 (29.4%) patients. In 18 (21.1%) cases, the diagnosis was determined on pelvic MRI.RESULTS. Diverticulitis in 65 (76.4 %) patients led to the development of paracolitis, with the formation of intraperitoneal and retroperitoneal inflammatory infiltrates in 40 (47 %) patients and in 25 (29.4 %) patients. Percutaneous drainage was performed in 85 cases. By volume, the abscesses were divided as follows: in 19 (22.3 %) patients, dimensions were 8–10 cm; in 42 (49.4 %) patients, dimensions were 5–8 cm; in 24 (28.2 %) patients, dimensions were up to 5 cm. The most severe group consisted of patients with an abscess volume of 8 to 10 cm. The duration of standing drains in patients with sizes 8–10 cm was 16–18 days, with sizes 5–8 cm–10–14 days, with sizes up to 5 cm – no more than 10 days. Rdical surgical treatment was performed in 15 (17.6 %) patients.CONCLUSION. A paracolar abscess is an indication for its minimally invasive drainage. We considered the technique of minimally invasive drainage as a possible «bridge» to elective surgery for diverticular disease of the colon. Ultrasound examination has a high sensitivity and specificity in diverticular disease of the colon. This makes it possible to use it not only as a method of primary examination and minimally invasive drainage of the abscess, but also as a way to objectify the dynamics of the affected area of the colon.
La enfermedad diverticular de colon (EDC) no complicada sintomática (EDCNCS) es una patología con elevada prevalencia en nuestro medio que afecta de manera importante la calidad de vida de los ...pacientes que la padecen. Los cambios recientes en la comprensión de la historia natural de esta enfermedad y los avances tecnológicos y farmacológicos han incrementado sustancialmente las opciones disponibles tanto para su diagnóstico como para el tratamiento. Sin embargo, el consenso que existe en cuanto al uso de estas opciones es pobre y en algunas ocasiones carente de evidencia científica. El objetivo de esta revisión sistemática es esclarecer la evidencia científica existente y fundamentar la utilización de las diferentes opciones diagnósticas y terapéuticas en la EDCNCS, comparando las ventajas y desventajas entre estas, para sugerir finalmente un algoritmo diagnóstico-terapéutico para esta patología y al mismo tiempo proponer nuevas preguntas de investigación.
Symptomatic uncomplicated diverticular colon disease (SUDCD) is a highly prevalent disease in our setting, which significantly affects the quality of life of patients. Recent changes in understanding the natural history of this disease and technological and pharmacological advances have increased the available options for both diagnosis and treatment. However, consensus regarding the use of these options is scarce and sometimes lacks scientific evidence. The objective of this systematic review is to clarify the existing scientific evidence and analyse the use of the different diagnostic and therapeutic options for SUDCD, comparing their advantages and disadvantages, to finally suggest a diagnostic-therapeutic algorithm for this pathology and, at the same time, propose new research questions.
Colon-Targeted Drug Delivery System (CTDDS) is able to improve local therapeutic effects in the treatment of colon-specific diseases, such as Crohn’s disease, Ulcerative Colitis (UC), and Irritable ...Bowel Syndrome (IBS). A colon can also be a suitable site for systemic delivery of drugs susceptible to extreme gastric pH, such as peptides and protein therapeutics. The physiological conditions of the gastrointestinal tract and the physicochemical properties of drugs are being considered to develop strategies and approaches to overcome emerging challenges. This review will discuss factors, challenges, strategies, and approaches to developing a colon-targeted drug delivery system.
Oral treatment of colon diseases with the CRISPR/Cas9 system has been hampered by the lack of a safe and efficient delivery platform. Overexpressed CD98 plays a crucial role in the progression of ...ulcerative colitis (UC) and colitis‐associated colorectal cancer (CAC). In this study, lipid nanoparticles (LNPs) derived from mulberry leaves are functionalized with Pluronic copolymers and optimized to deliver the CRISPR/Cas gene editing machinery for CD98 knockdown. The obtained LNPs possessed a hydrodynamic diameter of 267.2 nm, a narrow size distribution, and a negative surface charge (−25.6 mV). Incorporating Pluronic F127 into LNPs improved their stability in the gastrointestinal tract and facilitated their penetration through the colonic mucus barrier. The galactose end groups promoted endocytosis of the LNPs by macrophages via asialoglycoprotein receptor‐mediated endocytosis, with a transfection efficiency of 2.2‐fold higher than Lipofectamine 6000. The LNPs significantly decreased CD98 expression, down‐regulated pro‐inflammatory cytokines (TNF‐α and IL‐6), up‐regulated anti‐inflammatory factors (IL‐10), and polarized macrophages to M2 phenotype. Oral administration of LNPs mitigated UC and CAC by alleviating inflammation, restoring the colonic barrier, and modulating intestinal microbiota. As the first oral CRISPR/Cas9 delivery LNP, this system offers a precise and efficient platform for the oral treatment of colon diseases.
Mulberry leaf‐based lipid nanoparticles (LNPs) are facilely fabricated for overcoming the harsh intestinal environment, colonic mucus barrier, non‐specific cellular uptake, and lysosomal degradation of CRISPR/Cas machinery against CD98. Oral LNPs can down‐regulate inflammatory responses, reconstruct the mucus barrier, repair the disrupted colonic epithelial layer, and restore microbiota balance, achieving synergistic treatment outcomes of ulcerative colitis and colitis‐associated colorectal cancer.
The automatic and dependable identification of colonic disease subtypes by colonoscopy is crucial. Once successful, it will facilitate clinically more in-depth disease staging analysis and the ...formulation of more tailored treatment plans. However, inter-class confusion and brightness imbalance are major obstacles to colon disease subtyping. Notably, the Fourier-based image spectrum, with its distinctive frequency features and brightness insensitivity, offers a potential solution. To effectively leverage its advantages to address the existing challenges, this article proposes a framework capable of thorough learning in the frequency domain based on four core designs: the position consistency module, the high-frequency self-supervised module, the complex number arithmetic model, and the feature anti-aliasing module. The position consistency module enables the generation of spectra that preserve local and positional information while compressing the spectral data range to improve training stability. Through band masking and supervision, the high-frequency autoencoder module guides the network to learn useful frequency features selectively. The proposed complex number arithmetic model allows direct spectral training while avoiding the loss of phase information caused by current general-purpose real-valued operations. The feature anti-aliasing module embeds filters in the model to prevent spectral aliasing caused by down-sampling and improve performance. Experiments are performed on the collected five-class dataset, which contains 4591 colorectal endoscopic images. The outcomes show that our proposed method produces state-of-the-art results with an accuracy rate of 89.82%. The source code is released at https://github.com/soleilssss/AFACNet .
Symptomatic uncomplicated diverticular colon disease (SUDCD) is a highly prevalent disease in our setting, which significantly affects the quality of life of patients. Recent changes in understanding ...the natural history of this disease and technological and pharmacological advances have increased the available options for both diagnosis and treatment. However, consensus regarding the use of these options is scarce and sometimes lacks scientific evidence. The objective of this systematic review is to clarify the existing scientific evidence and analyse the use of the different diagnostic and therapeutic options for SUDCD, comparing their advantages and disadvantages, to finally suggest a diagnostic–therapeutic algorithm for this pathology and, at the same time, propose new research questions.
La enfermedad diverticular de colon (EDC) no complicada sintomática (EDCNCS) es una patología con elevada prevalencia en nuestro medio, que afecta de manera importante la calidad de vida de los pacientes que la padecen. Los cambios recientes en la comprensión de la historia natural de esta enfermedad y los avances tecnológicos y farmacológicos han incrementado sustancialmente las opciones disponibles tanto para su diagnóstico, como para el tratamiento. Sin embargo, el consenso que existe en cuanto al uso de estas opciones es pobre y en algunas ocasiones carente de evidencia científica. El objetivo de esta revisión sistemática es esclarecer la evidencia científica existente y fundamentar la utilización de las diferentes opciones diagnósticas y terapéuticas en la EDCNCS, comparando las ventajas y desventajas entre estas, para sugerir finalmente un algoritmo diagnostico-terapéutico para esta patología y al mismo tiempo proponer nuevas preguntas de investigación.
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