A patient's viewpoint of the severity of irritable bowel syndrome (IBS) symptoms can be influenced not only by physical symptoms of IBS but broader psychological problems, according to a new study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association. "Clinicians who face pressure to treat patients in a cost-effective manner within tight time constraints and at a satisfactory level are likely to find that patient-reported outcome data can increase their understanding of what patients mean when they describe how they function or feel, " said Jeffrey Lackner, PsyD, of the University at Buffalo School of Medicine and Biomedical Sciences, and lead author of this study. "To maximize the utility of patient-reported outcomes, it is important to know what they measure and what influences patients' perceptions of their symptoms when gastroenterologists ask them about their symptoms.
Certain patients with inflammatory bowel disease (IBD) may have an increased risk of skin cancer, which is intensified by the use of immunosuppressant medications, according to two new studies in Gastroenterology, the official journal of the American Gastroenterological Association. Immunosuppressants are commonly used in the treatment of IBD. In the first study, researchers found that both past and present exposure to thiopurines (a widely used class of immunosuppressants) significantly increased the risk of nonmelanoma skin cancer (NMSC) in patients with IBD, even before the age of 50. Currently, there are no specific recommendations for screening for skin cancers in individuals with IBD. "The increased risk of skin cancer that we found in our study was observed in all patients, even before the age of 50 years.
Working with lab cultures and mice, Johns Hopkins scientists have found that a strain of the common gut pathogen Bacteroides fragilis causes colon inflammation and increases activity of a gene called spermine oxidase (SMO) in the intestine. The effect is to expose the gut to hydrogen peroxide - the caustic, germ-fighting substance found in many medicine cabinets - and cause DNA damage, contributing to the formation of colon tumors, say the scientists. "Our data suggest that the SMO gene and its products may be one of the few good targets we have discovered for chemoprevention, " says Robert Casero, Ph.D., professor of oncology at the Johns Hopkins Kimmel Cancer Center. In a study, Casero and his colleagues introduced B. fragilis to two colon cell lines and measured SMO gene activity.
IMMUNOLOGY: Stopping autoimmunity in the NIK of time Immune cells known as T cells play a key role in ridding the body of dangerous microbes. However, if they are not kept under control properly they can attack the body's own tissues and cells and cause autoimmunity. Working in mice, a team of researchers led by Susan Murray, at Oregon Health and Science University, Portland, has gained new understanding of the molecular mechanisms responsible for keeping T cells under control and preventing autoimmunity. Specifically, Murray and colleagues defined a T cell-intrinsic role for the protein NIK during immune responses and determined that dysregulation of this led to a rapid and fatal autoimmunity. They went on to suggest that therapeutics designed to decrease NIK activity in T cells might ameliorate autoimmunity.
Growing evidence for the effectiveness of fecal microbiota transplants as a treatment for patients with recurrent bouts of Clostridium difficile (C.difficile) associated diarrhea is presented in three studies -- including a long-term follow-up of colonoscopic fecal microbiota transplant (FMT) for recurrent C. difficile Infection that included 77 patients from five different states -- unveiled at the American College of Gastroenterology's (ACG) 76th Annual Scientific meeting in Washington, DC. In a fourth study, investigators from the Centre for Digestive Diseases in Australia explored fecal bacterial transplantation as a treatment for Inflammatory Bowel Disease. While this is a new area of research, results of this study show success in treating IBD when the fecal transplant is done recurrently.