scholarly journals Lactose Intolerance Assessed by Analysis of Genetic Polymorphism, Breath Test and Symptoms in Patients with Inflammatory Bowel Disease

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1290
Author(s):  
Olga Maria Nardone ◽  
Francesco Manfellotto ◽  
Caterina D’Onofrio ◽  
Alba Rocco ◽  
Giovanni Annona ◽  
...  

Many patients with inflammatory bowel disease (IBD) restrict dairy products to control their symptoms. The aim of the study was to investigate the prevalence of lactose intolerance assessed with hydrogen breath test (H-BT) in IBD patients in clinical remission compared to a sex, age and BMI matched control population. We further detected the prevalence of three single nucleotide polymorphisms of the lactase (LCT) gene: the lactase non persistence LCT-13910 CC (wildtype) and the intermediate phenotype LCT-22018 CT and LCT-13910 AG; finally, we assess the correlation between genotype and H-BT. A total of 54 IBD patients and 69 control who underwent clinical evaluation, H-BT and genetic test were enrolled. H-BT was positive in 64.8% IBD patients and 62.3% control (p = 0.3). The wild-type genotype was found in 85.2% IBD patients while CT-22018, AG-13910 and CT-22018/AG-13910 polymorphisms were found in 9.3%, 1.8% and 3.7%. In the control group, the wild-type genotype, CT-22018, AG-13910 and CT-22018/AG-13910 polymorphisms were found in 87%, 5.8%, 5.8% and 1.4% of cases, respectively. Therefore, the wild-type and polymorphisms’ prevalence did not differ between IBD population and control group (85.2% vs. 87%, p = 0.1) (14.8% vs. 13%, p = 0.7). The correlation between positive H-BT and genetic analysis showed that the wild-type genotype was associated with higher rate of lactose intolerance in the total population (OR 5.31, 95%CI 1.73–16.29, p = 0.003) and in the IBD (OR 7.61, 95%CI 1.36–42.7, p = 0.02). The prevalence of lactose intolerance in IBD patients did not differ from that of control. Despite suggestive symptoms, about 1/3 of IBD patients are not lactose intolerant, thus not needing “a priori” elimination diet. This may encourage a rationale and balanced dietary management in IBD.

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S561-S562
Author(s):  
O M Nardone ◽  
F Manfellotto ◽  
C D’Onofrio ◽  
A Rocco ◽  
G Annona ◽  
...  

Abstract Background Many patients with inflammatory bowel disease (IBD) make restriction of dairy products to control their symptoms. We aimed to investigate the prevalence of lactose intolerance assessed with hydrogen breath test (H-BT) in IBD patients in clinical remission with symptoms suggestive for lactose intolerance, compared to a sex- age- and BMI-matched control population. We further detected the prevalence of three single nucleotide polymorphisms of the lactase (LCT) gene: the lactase non persistence LCT-13910CC (genetic wildtype) and the intermediate phenotype LCT-22018AG, LCT-13910CT and we assess the correlation between genotype and H-BT Methods We performed a prospective study enrolling IBD patients in clinical remission: Crohn disease (CD) activity index CDAI<150 for CD and pMayo score≤1 for ulcerative colitis (UC) and controls. All of them underwent clinical evaluation, H-BT and genetic test analysing lactase gene polymorphisms located on chromosome 2. Statistical analysis was performed using chi-square, Student’s t-test and ANOVA. Results A total of 54 IBD patients and 69 matched controls were enrolled. H-BT was positive in 35(64.8%) IBD patients and 43 (62.3%) controls (p=0.3). No significant difference in lactose intolerance rate, assessed by H-BT and symptoms,was found between CD and UC patients (p =0.8). The wild-type genotype was found in 46 (85.2%) IBD patients , CT22018, AG13910 and CT22018/AG13910 polymorphisms were found in 9.3%, 1.8% and 3.7% respectively. While in the control group, the wild-type genotype, CT22018, AG13910 and CT22018/AG13910 polymorphisms were found in 87%, 5.8%, 5.8% and 1.4% of cases, respectively. The wild type and polymorphisms’ prevalence did not differ between IBD population and control group (85.2%vs 87%, p=0.1) (14.8% vs 13%, p=0.7) [Fig.1] and between CD and UC (p>0.05) [Fig.2]. The correlation between positive H-BT and genetic analysis showed that the wild-type genotype was associated with higher rate of lactose intolerance in the total population (OR 5.31, 95%CI 1.73–16.29, p=0.003) and in the IBD population (OR 7.61, 95%CI 1.36–42.7, p=0.02), even thought not in the control group (OR 4, 95%CI 0.90–17.68, p=0.07) Fig.1 Fig.2 Conclusion The prevalence of lactose intolerance in IBD is high but not dissimilar from that of the general population. The prevalence of the wild-type genotype in patients with IBD does not differ from the general population and it correlates with higher rate of lactose intolerance assessed with H-BT. Despite suggestive symptoms, about 1/3 of IBD patients is not lactose intolerant, not needing elimination diet. These can lead to promote a rationale and balanced dietary management in IBD and thereby preventing the occurrence of calcium phosphate metabolism disorders.


2004 ◽  
Vol 50 (2) ◽  
pp. 288-295 ◽  
Author(s):  
Sofie Haglund ◽  
Malin Lindqvist ◽  
Sven Almer ◽  
Curt Peterson ◽  
Jan Taipalensuu

Abstract Background: Interindividual differences in therapeutic efficacy in patients treated with thiopurines might be explained by the presence of thiopurine S-methyltransferase (TPMT) alleles that encode for reduced TPMT enzymatic activity. It is therefore of value to know an individual’s inherent capacity to express TPMT. Method: We developed a pyrosequencing method to detect 10 single-nucleotide polymorphisms (SNPs) in TPMT. A Swedish population (n = 800) was examined for TPMT*3A, TPMT*3B, TPMT*3C, and TPMT*2. Patients with inflammatory bowel disease (n = 24) and healthy volunteers (n = 6), selected on the basis of TPMT enzymatic activity, were investigated for all 10 SNPs to determine the relationship between TPMT genotype and phenotype. Results: In the general population we identified the following genotypes with nonfunctional alleles: TPMT*1/*3A (*3A allelic frequency, 3.75%), TPMT*1/*3C (*3C allelic frequency, 0.44%), TPMT*1/*3B (*3B allelic frequency, 0.13%), and TPMT*1/*2 (*2 allelic frequency, 0.06%). All nine individuals with normal enzymatic activity were wild-type TPMT*1/*1. Thirteen individuals with intermediate activity were either TPMT*1/*3A (n = 12) or TPMT*1/*2 (n = 1). Eight individuals with low enzymatic activity were TPMT*3A/*3A (n = 4), TPMT*3A/*3C (n = 2), or TPMT*1/*3A (n = 2). Conclusion: Next to wild type, the most frequent alleles in Sweden are TPMT*3A and TPMT*3C. A previously established phenotypic cutoff for distinguishing normal from intermediate metabolizers was confirmed. To identify the majority of cases (90%) with low or intermediate TPMT activity, it was sufficient to analyze individuals for only 3 of the 10 SNPs investigated. Nevertheless, this investigation indicates that other mutations might be of relevance for decreased enzymatic activity.


Author(s):  
Christopher X. W. Tan ◽  
Henk S. Brand ◽  
Bilgin Kalender ◽  
Nanne K. H. De Boer ◽  
Tymour Forouzanfar ◽  
...  

Abstract Objectives Although bowel symptoms are often predominant, inflammatory bowel disease (IBD) patients can have several oral manifestations. The aim of this study was to investigate the prevalence of dental caries and periodontal disease in patients with Crohn’s disease (CD) and ulcerative colitis (UC) compared to an age and gender-matched control group of patients without IBD. Material and methods The DMFT (Decayed, Missing, Filled Teeth) scores and the DPSI (Dutch Periodontal Screening Index) of 229 IBD patients were retrieved from the electronic health record patient database axiUm at the Academic Centre for Dentistry Amsterdam (ACTA) and were compared to the DMFT scores and DPSI from age and gender-matched non-IBD patients from the same database. Results The total DMFT index was significantly higher in the IBD group compared to the control group. When CD and UC were analyzed separately, a statistically significant increased DMFT index was observed in CD patients but not in UC patients. The DPSI did not differ significantly between the IBD and non-IBD groups for each of the sextants. However, in every sextant, IBD patients were more frequently edentulous compared to the control patients. Conclusion CD patients have significantly more dental health problems compared to a control group. Periodontal disease did not differ significantly between IBD and non-IBD groups as determined by the DPSI. Clinical relevance It is important that IBD patients and physicians are instructed about the correlation between their disease and oral health problems. Strict oral hygiene and preventive dental care such as more frequent checkups should be emphasized by dental clinicians.


2016 ◽  
Vol 88 (6) ◽  
Author(s):  
Jerzy Mrowicki ◽  
Małgorzata Mrowicka ◽  
Ireneusz Majsterek ◽  
Michał Mik ◽  
Adam Dziki ◽  
...  

AbstractInflammatory bowel disease (IBD) are a heterogeneous group of disorders in the course dominated by chronic, recurrent gastrointestinal inflammation. It is believed that the activation of IBD occurs in patients with a genetic predisposition to their development. Chronic inflammation develops as a result of an excessive reaction of the immune system principally under the influence of environmental risk factors. Among them, it has been shown that the mechanism of oxidative stress is associated with the pathophysiology of inflammatory bowel disease, responsible for the commencement and progress of these diseases.was the relationship between single nucleotide polymorphisms (SNPs) of individual antioxidant enzymes, and the prevalence of inflammatory bowel disease that may be associated with increased levels of oxidative stress.A total of 111 IBD patients, including 65 patients with ulcerative colitis (UC) and 46 with Crohn’s disease (CD) and 125 healthy controls recruited from the Polish population, were genotyped forThe performed analysis of genetic polymorphisms of antioxidant enzymes showed that polymorphic variant of the CAT -262 C / T may have protective effects in patients with ulcerative colitis in the range of genotype C / T; OR = 0.49 (0.25-0.99), p = 0.044. Trend protective, but statistically unrelated, it was also observed for genotype T / T and T allele of the same polymorphism and genotypes and allelesIt has been shown that the polymorphism of antioxidant enzymes


2021 ◽  
Vol 162 (12) ◽  
pp. 443-448
Author(s):  
Gábor Xantus ◽  
V. Anna Gyarmathy

Összefoglaló. Gyulladásos bélbetegségben (IBD) a fájdalomérzés komplex szomatikus és pszichés jelenség. Ez utóbbi komponens pontosabb megértése segíthet a megfelelő kezelési stratégia megállapításában. A szorongásos hangulati zavarok és egyes maladaptív viselkedési minták (dohányzás és alkoholfogyasztás) előfordulási gyakorisága jól dokumentált IBD-ben, a kannabiszhasználat hatása ugyanakkor kevésbé ismert. A szerzők szisztematikus áttekintést végeztek annak megértéséhez, hogy vajon magasabb-e a marihuánahasználat gyakorisága felnőtt IBD-s betegek között egészséges kontrollpopulációhoz viszonyítva, és ha igen, akkor melyek a szerhasználat legfontosabb jellemzői. A kutatási periódust szándékosan az elmúlt 7 évre korlátoztuk, ugyanis 2013-tól jelentős változások álltak be a kannabinoidok jogi és orvosi megítélésében az USA-ban. Öt elsődleges és több másodlagos adatbázisban kutattunk előre meghatározott kulcsszavak segítségével 2013 óta teljes szöveggel megjelent, angol nyelvű felnőtt IBD-s populációt vizsgáló epidemiológiai tanulmányok vonatkozásában. 143 rekord közül 7 cikk felelt meg a beválogatási kritériumoknak. Eredményeink szerint a kannabiszhasználat gyakorisága IBD-ben szenvedő felnőtt betegek körében valószínűleg magasabb, mint a kontrollpopulációban: a „valaha, bármikor” használók aránya 54–70% között változott (szemben a 46–60% gyakorisággal a kontrollcsoportban), míg az „aktív használók” esetén a gyakoriság 6,8–25% között változott (vs. a kontrollcsoportban tapasztalt 8,6–14%-kal). A prevalenciaadatok széles variabilitása arra utal, hogy a beválogatott epidemiológiai tanulmányok valószínűleg vagy nem voltak megfelelően tervezve, vagy jelentős heterogenitással bírtak. A pszichés tényezők ellentmondásos mintája azt sugallja, hogy a kannabinoidok egyes esetekben ronthatták, más esetben valószínűleg javították bizonyos prominens tünetek megélését. Javasoljuk ezért, hogy a valós prevalencia megállapítása érdekében a keresztmetszeti vizsgálatok mellé ismételt pszichometriai vizsgálatokon alapuló vizsgálatok is bekerüljenek a további kutatásba. Orv Hetil. 2021; 162(12): 443–448. Summary. Pain perception in inflammatory bowel disease (IBD) is beyond a purely somatic process. In-depth understanding of psychologic elements might enable more effective management in this patient group. Anxiety disorders and certain maladaptive coping strategies like smoking and alcohol consumption are well-documented in IBD, unlike the scarcely researched cannabis use. The authors designed a systematic review, to investigate if the prevalence of cannabis use is higher in IBD that in unselected controls. The research window was intentionally set to cover for the past 7 years, as in 2013 major legislative changes took place in the cannabis decriminalisation process in the United States. 5 primary and several secondary databases were researched with a pre-formulated algorithm registered at PROSPERO for full text epidemiological studies published in English language involving adult IBD patients. Out of 143 records, 7 articles met the in/exclusion criteria. Our results suggest that cannabis use among adult patients with IBD is likely to be higher than in the unselected control population. The proportion of “ever” users varied from 54% to 70% (vs. 46–60% in the control group); and for ‘active users’, the prevalence ranged between 6.8% to 25% (vs. 8.6–14% in the control group). The wide variability in prevalence data suggests that the selected epidemiological studies were either inappropriately designed or were too heterogeneous (or both). The contradictory pattern of psychological factors suggests that cannabinoids might improve or worsen IBD depending on case by case basis. We therefore opine that in addition to cross-sectional papers, studies based on repeated psychometric analysis are needed to establish the real prevalence and inform cannabinoid prescription and holistic management in inflammatory bowel disease. Orv Hetil. 2021; 162(12): 443–448.


2020 ◽  
Vol 36 (7) ◽  
pp. 799-807
Author(s):  
Shigeki Ishioka ◽  
Takashi Hosokawa ◽  
Taro Ikeda ◽  
Noriyoshi Konuma ◽  
Hide Kaneda ◽  
...  

Abstract Purpose Our previous studies demonstrated that mature adipocyte-derived dedifferentiated fat (DFAT) cells possess similar multipotency as mesenchymal stem cells. Here, we examined the immunoregulatory potential of DFAT cells in vitro and the therapeutic effect of DFAT cell transplantation in a mouse inflammatory bowel disease (IBD) model. Methods The effect of DFAT cell co-culture on T cell proliferation and expression of immunosuppression-related genes in DFAT cells were evaluated. To create IBD, CD4+CD45RBhigh T cells were intraperitoneally injected into SCID mice. One week later, DFAT cells (1 × 105, DFAT group) or saline (Control group) were intraperitoneally injected. Subsequently bodyweight was measured every week and IBD clinical and histological scores were evaluated at 5 weeks after T cell administration. Results The T cell proliferation was inhibited by co-cultured DFAT cells in a cell density-dependent manner. Gene expression of TRAIL, IDO1, and NOS2 in DFAT cells was upregulated by TNFα stimulation. DFAT group improved IBD-associated weight loss, IBD clinical and histological scores compared to Control group. Conclusion DFAT cells possess immunoregulatory potential and the cell transplantation promoted recovery from colon damage and improved clinical symptoms in the IBD model. DFAT cells could play an important role in the treatment of IBD.


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Ewa Dudzińska ◽  
Magdalena Gryzinska ◽  
Janusz Kocki

Introduction. Inflammatory bowel disease (IBD) is a complicated, multifunctional disorder characterized by chronic, recurring inflammation of the digestive tract. The two main types of IBD are ulcerative colitis (UC) and Crohn’s disease (CD). The aim of the study was to determine single nucleotide polymorphism in fragments of the genes CARD15/NOD2 and DLG5 in patients from the Lublin Voivodeship. Patients and Methods. The study was carried out in Lublin (Poland) in 2016. 27 individuals participated in the research. The research group comprised 9 patients with a diagnosis of Crohn’s disease and 9 with ulcerative colitis, aged 20 to 48, and 9 healthy volunteers. Results. No SNPs were confirmed for the CARD15/NOD2 gene fragment, but a substitution (T>C) was found in the DLG5 gene in a Crohn’s disease patient. Conclusion. Absence of extraintestinal symptoms in patients with Crohn’s disease may be associated with the absence of CARD15/NOD2 SNPs. The study suggests that SNPs (T>C substitution) affect the function of the DLG5 protein and thus play a role in the development of IBD, in particular Crohn’s disease. The analysis presented is a pilot study due to the small number of samples.


2020 ◽  
Vol 52 ◽  
pp. S132
Author(s):  
N. Imperatore ◽  
A. Rocco ◽  
F. Manfellotto ◽  
F. Sasso ◽  
A. Testa ◽  
...  

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