Metz inventory | digest the top ten heavy studies in 2021

The top 10 inventory in the 2021 annual digestion field is coming!

2021 is coming to an end. This year' COVID-19 pandemic has risen and fallen, and many industries are still suffering from large and small blows. But scientists in the field of medical research have not stopped exploring the mysteries of life. This year, a lot of heavy research has been published in the field of digestion, so let Mace take you back to these research progress!

1. Lancet Sub-Journal: Probiotics can effectively treat functional dyspepsia!

There are data showing that the incidence of functional dyspepsia in the domestic population is about 20%, about 300 million people . However, current treatments for functional dyspepsia have limited efficacy or safety concerns. A study published in the journal Lancet Gastroenterol & Hepatol evaluated the efficacy and safety of spore-forming probiotics in functional dyspepsia as a monotherapy or as an add-on therapy for long-term treatment with proton pump inhibitors.

In this single-centered, randomized, double-blind, placebo-controlled flight trial, a total of 68 patients with functional dyspepsia were included, and there were 32 and 36 patients in the probiotic and placebo groups, respectively. The results showed that Bacillus coagulans MY01 and Bacillus subtilis MY02 were effective and safe in the treatment of functional dyspepsia. Subjects have potentially beneficial immune and microbial changes, or may provide potential mechanistic interpretation for future prediction or therapeutic targets.

2.Am J Clin Nutr: An uncontrolled diet increases the risk of digestive cancer!

Uncontrolled eating behaviors, including dietary frequency, timing, and caloric intake, may be a credible risk factor for digestive cancers, but there is currently insufficient epidemiological evidence. A prospective study published in the journal Am J Clin Nutr evaluated the correlation between uncontrolled eating behavior and the risk of digestive cancer. Participants in nurse health studies who were cancer-free in 1994 and had dietary information reported were included, with a maximum follow-up of 18 years.

Studies have shown that women without dietary time and food type restrictions have a higher risk of overall digestive cancer (HR 1.22), overall gastrointestinal cancer (1.33), oral and pharyngeal cancer (1.50), esophageal cancer (1.62), small bowel cancer (1.92), and colorectal cancer (1.20) compared with women with dietary moderation. Thus, uncontrolled eating behavior is independently associated with an increased risk of gastrointestinal cancer. Changing uncontrolled eating behaviors or having a preventive effect on gastrointestinal cancers.

3. Stroke: Efficacy analysis of non-vitamin K antagonists orally anticoagulants in patients with atrial fibrillation who have previous gastrointestinal bleeding

Data supporting the protective effect of nonvitamin K oral anticoagulants (NOACs) in patients with atrial fibrillation who have a previous history of gastrointestinal bleeding (GIB) are limited. Recently, a research paper was published in Stroke, an authoritative journal in the field of cardiovascular disease, in which researchers aimed to evaluate the efficacy and safety of NOACs in patients with a history of atrial fibrillation who had a history of GIB and compared them with warfarin.

A total of 42,048 patients (24,781 in the NOAC group and 17,267 in the warfarin group) were included in the study. The average time interval from previous GIBs to initiation of oral anticoagulants was 3.1±2.6 years. The use of NOAC reduced the risk of ischemic stroke, major bleeding and overall prognosis compared with warfarin, with risk ratios of 0.731 and 0.661 for all secondary outcomes, and NOACs reduced the risk to a greater extent compared with warfarin.

4.Science: Intestinal inflammation causes changes in the structure of the brain barrier, inducing psychiatric symptoms!

Inflammatory bowel disease (IBD) is a chronic, nonspecific inflammatory bowel disease of unknown etiology, mainly crohn's disease and ulcerative colitis. Epidemiological data show that in recent years, the incidence of IBD in China has shown a rapid upward trend, and the number of patients has reached 3.44/100,000, ranking first in Asia.

Instead of simply attributing anxiety and depressive symptoms in IBD patients to the pain of the disease at the level of public perception, scientists have set their sights on the gut-brain connection. A recent study published in Science started with the gut-cerebrovascular axis and revealed the key mechanism by which intestinal inflammation causes psychiatric symptoms. The study found that in mice in the acute enteritis state, the structure of the cerebrovascular barrier changed, although the permeability of the cerebrovascular barrier in the initial choroid plexus area was transiently enhanced, and then the cerebrovascular barrier closed rapidly until the enteritis was restored.

The injection of bacterial endotoxin - lipolysaccharide LPS into the abdominal cavity of mice can also observe changes similar to those occurring in acute colitis in the brain of mice - choroid plexus - cerebrospinal fluid barrier closure, indicating that the presence of bacterial endotoxins affects the structural changes of the cerebrovascular barrier.

5. Gut: Chinese scholars have found that intestinal microbial metabolites can help colorectal cancer early warning

The occurrence of tumors is also accompanied by a comprehensive change in metabolic state, affecting the tumor tissue and the surrounding microenvironment and the large environment. Recently, researchers from the Cancer Hospital of the Chinese Academy of Medical Sciences conducted an inquiry to dissect the metabolites associated with gut microbes in the serum and investigate whether these metabolites can distinguish colorectal cancer (CRC) or adenoma patients from normal healthy people.

The researchers performed a comprehensive analysis of non-target serum metabolomics by liquid chromatography-mass spectrometry and metagenomic sequencing of paired stool samples to identify gut microbiome-associated metabolites with significantly altered abundances in patients with CRC and adenoma. Using targeted metabolomics analysis, the researchers examined the ability of these metabolites to distinguish between CRC and colorectal adenomas and built a model based on gut microbial-associated metabolites, which were then evaluated in an independent validation cohort.

The study found a total of 885 serum metabolites with significant alterations in CRC and adenoma, including 8 gut microbial-associated serum metabolites (GMSM panel), which were repeated in both targeted and non-targeted metabolomics analyses and were able to accurately distinguish CRC and adenoma from normal samples. Therefore, gut microbiome reprogramming in patients with CRC is associated with changes in the serum metabolome, and GMSMs have the potential to be applied to the detection of CRC and adenomas.

6.Nature: How is the gut flora of centenarians different from ordinary people?

Through its role in controlling digestive function, bone density, neuronal activity, immunity, and resistance to pathogen infection, the microbiome has long been recognized as a key player in determining the health of older adults. The researchers found that centenarians have a unique gut microbiota in their bodies, rich in microbes capable of producing unique secondary bile acids (BAs), including ISO-, 3-oxo-, allo-, 3-oxoallo-, and isoallo-lithocholic acid (LCA).

Among these BAs, isoalloLCA's biosynthetic pathway has not been previously described. By sifting through 68 bacterial isolates in a centenarian's fecal microbiome, the researchers found that the Odoribacteraceae strain was an effective producer of isoalloLCA both in vitro and in vivo.

In addition, the researchers found that 5α-reductase (5AR) and 3β-hydroxysteroid dehydrogenase (3βHSDH) are responsible for the production of IsolloLCA. IsoalloLCA can exert a powerful antimicrobial effect on Gram-positive (but not Gram-negative) multidrug-resistant pathogens, including Clostridium difficile and Enterococcus faecalis.

Taken together, these findings suggest that specific bile acid metabolism may be involved in reducing the risk of pathogen infection, which may help maintain balance in the gut.

7.Nature : The mechanism of milk tea gaining weight has been found! Fructose increases intestinal villi by 40% and promotes nutrient absorption

A study published in the journal Nature found that consuming fructose increased the survival of intestinal epithelial cells, thereby increasing the length of the intestinal villi, allowing them to absorb more nutrients. Studies have shown that the main metabolite of fructose promotes the elongation of villi. Mice fed a fructose diet had 25 to 40 percent longer villi than mice fed unfucose, resulting in increased mouse weight.

The researchers divided the mice into 3 groups: a control diet without fructose, a standard high-fat diet containing glucose without fructose (45 percent of calories come from fat), and an equal-calorie, high-fat diet (glucose is replaced by sucrose, half glucose in sucrose, half fructose). The study found that although each group consumed the same amount of energy, mice fed fructose in the form of sucrose increased significantly more weight and fat than the mice on a high-fat diet without fructose, and had longer villi in the small intestine.

Immediately afterward, the researchers carefully studied metabolic changes in the fructose group of mice and found that a specific metabolite of fructose, called fructose 1-phosphate, accumulates at high levels in the cells. In hypoxic intestinal cells, fructose 1-phosphate increases the survival of intestinal epithelial cells by inhibiting the M2 isomer of pyruvate kinase (PK), thereby increasing the length of intestinal villi. In addition, previous animal studies have shown that this fructose metabolite also helps tumors.

8. Clinical Nutrition: Dietary pattern interventions improve blood lipids by influencing the structure and function of the gut microbiota

Diet is one of the important factors affecting the structure and composition of the intestinal flora, and the intestinal flora can affect the digestion, absorption and metabolism of nutrients, and the relationship between the two is more complicated. A study published in the journal Clinical Nutrition shows an important role in improving blood lipids with changes in the structure and function of the gut microbiota associated with dietary patterns.

Specifically, in overweight or obese Chinese women, changes in the structure of the microbiota caused by dietary pattern intervention contributed more to the improvement of blood lipids than changes in host fatty acid-related metabolism. The study provides new evidence for revealing changes in intestinal microbiota and human metabolites caused by dietary pattern interventions, as well as their links with metabolic marker changes, and a reference for interpreting the complex interactions between dietary-microbiota-host.

9.Eur Radiol: A boon for patients with acute lower gastrointestinal bleeding!

A study published in the journal European Radiology evaluated the overall feasibility, safety, and possible side effects of CBCT-guided embolism in patients with CTA-positive and DSA-negative acute LGIB, providing theoretical support and technical guidance for further clinical applications of CBCT.

The study retrospectively examined patients with CTA-positive CTA from January 2008 to July 2019 who underwent DSA tests within 24 hours. Patients who were DSA positive received targeted embolism (TE group). Patients with a negative DSA undergo empirical CBCT-mediated hypothetical luminal rupture embolization (EE group) or nonembolization (NE group). Fisher's precise tests compared recurrent bleeding, major ischemic complications, and nosocomial mortality. Further subgroup analyses were carried out based on hemodynamic instabilities.

For patients with CTA-positive, DSA-negative, and hemodynamically unstable acute LGIB, embolization techniques guided by empiric cone beam CT (CBCT) are a viable, effective, and safe treatment strategy that reduces the incidence of rebleeding and improves clinical success, providing a new and reliable technique for early diagnosis and treatment of acute LGIB.

10.International Journal of Epidemiology: A 500,000-person study shows that eating spicy reduces the risk of cancer in the digestive tract

The China Large Prospective Cohort (CKB) recruited > 512 000 adults aged 30-79 years from 10 regions in China between 2004 and 2008, and as of 1 January 2017, 2350 cases of esophageal cancer, 3350 cases of stomach cancer and 3061 cases of colorectal cancer occurred during the 10-year follow-up period. The findings were published in the Journal of Epidemiology.

In CKB, eating spicy refers to eating fresh chili peppers directly; adding fresh/dried chili peppers, chili oil/sauce/paste, curry when cooking; or adding chili oil/sauce/paste when eating. Respondents were asked how often they had eaten spicy in the past month (never/almost never, occasionally, 1-2 days a week, 3-5 days a week, or 6-7 days a week), as well as how old they had started eating spicy regularly, the intensity of their preferred spiciness (weak, medium, strong), and the types of spicy they had eaten regularly (fresh chili, dried chili, chili paste, chili oil).

Overall, 30 percent of participants reported eating spicy foods daily at baseline. Eating spicy was inversely proportional to the risk of esophageal cancer, and the adjusted risk ratios were 0.88, 0.76, 0.84, and 0.81 for those who ate spicy food per month, 1-2 days/week, 3-5 days/week, and 6-7 days/week, respectively, compared with those who never/rarely ate spicy. The association was stronger in people who did not smoke or did not drink alcohol regularly. The corresponding risk ratios for stomach cancer were 0.97, 0.95, 0.92, and 0.89, respectively, and the risk ratios for colorectal cancer were 1.00, 0.95, 0.87, and 0.90, respectively, and the inverse association appeared to be limited to rectal cancer rather than colon cancer. The type of spicy food eaten and the intensity of the spiciness have little effect on these associations.