Intestinal Research

Original Articles

IBD

One-year clinical efficacy and safety of indigo naturalis for active ulcerative colitis: a real-world prospective study: Yuichi Matsuno, Takehiro Torisu, Junji Umeno, Hiroki Shibata, Atsushi Hirano, Yuta Fuyuno, Yasuharu Okamoto, Shin Fujioka, Keisuke Kawasaki, Tomohiko Moriyama, Tomohiro Nagasue, Keizo Zeze, Yoichiro Hirakawa, Shinichiro Kawatoko, Yutaka Koga, Yoshinao Oda, Motohiro Esaki, Takanari Kitazono; Intest Res 2022;20(2):260-268. Published online April 29, 2022; DOI: https://doi.org/10.5217/ir.2021.00124

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Background/Aims
Recent studies suggested a favorable effect of indigo naturalis (IN) in inducing remission for refractory ulcerative colitis (UC), however, the maintenance effect of IN for patients with UC remains unknown. Therefore, we conducted a prospective uncontrolled open-label study to analyze the efficacy and safety of IN for patients with UC.
Methods
Patients with moderate to severe active UC (clinical activity index [CAI] ≥ 8) took 2 g/day of IN for 52 weeks. CAI at weeks 0, 4, 8, and 52 and Mayo endoscopic subscore (MES) and Geboes score (GS) at weeks 0, 4, and 52 were assessed. Clinical remission (CAI ≤ 4), mucosal healing (MES ≤ 1), and histological healing (GS ≤ 1) rates at each assessment were evaluated. Overall adverse events (AEs) during study period were also evaluated. The impact of IN on mucosal microbial composition was assessed using 16S ribosomal RNA gene sequences.
Results
Thirty-three patients were enrolled. The rates of clinical remission at weeks 4, 8, and 52 were 67%, 76%, and 73%, respectively. The rates of mucosal healing at weeks 4 and 52 were 48% and 70%, respectively. AEs occurred in 17 patients (51.5%) during follow-up. Four patients (12.1%) showed severe AEs, among whom 3 manifested acute colitis. No significant alteration in the mucosal microbial composition was observed with IN treatment.
Conclusions
One-year treatment of moderate to severe UC with IN was effective. IN might be a promising therapeutic option for maintaining remission in UC, although the relatively high rate of AEs should be considered.

Citations

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Indigo naturalis (Qing dai) for inflammatory bowel disease: A systematic review and meta-analysis
Rinkalben Kakdiya, Daya Krishna Jha, Arup Choudhury, Anuraag Jena, Vishal Sharma
Clinics and Research in Hepatology and Gastroenterology.2024; 48(1): 102250. CrossRef
Reply to “Ferroptosis in the colon epithelial cells as a therapeutic target for ulcerative colitis”
Akihito Yokote, Noriyuki Imazu, Junji Umeno, Keisuke Kawasaki, Shin Fujioka, Yuta Fuyuno, Yuichi Matsuno, Tomohiko Moriyama, Kohta Miyawaki, Koichi Akashi, Takanari Kitazono, Takehiro Torisu
Journal of Gastroenterology.2024; 59(1): 77. CrossRef
Risk of Infection in Patients With Inflammatory Bowel Disease Treated With Interleukin-Targeting Agents: A Systematic Review and Meta-Analysis
Konstantinos Ouranos, Hira Saleem, Stephanos Vassilopoulos, Athanasios Vassilopoulos, Evangelia K Mylona, Fadi Shehadeh, Markos Kalligeros, Bincy P Abraham, Eleftherios Mylonakis
Inflammatory Bowel Diseases.2024;[Epub] CrossRef
Herbal Medicines for the Treatment of Active Ulcerative Colitis: A Systematic Review and Meta-Analysis
Preetha Iyengar, Gala Godoy-Brewer, Isha Maniyar, Jacob White, Laura Maas, Alyssa M. Parian, Berkeley Limketkai
Nutrients.2024; 16(7): 934. CrossRef
Clinical Efficacy and Future Application of Indigo Naturalis in the Treatment of Ulcerative colitis
Dianzhen Wu, Qi Huang, Yingbi Xu, Ruiyi Cao, Ming Yang, Jin Xie, Dingkun Zhang
Journal of Ethnopharmacology.2024; : 118782. CrossRef
Ferroptosis in the colon epithelial cells as a therapeutic target for ulcerative colitis
Akihito Yokote, Noriyuki Imazu, Junji Umeno, Keisuke Kawasaki, Shin Fujioka, Yuta Fuyuno, Yuichi Matsuno, Tomohiko Moriyama, Kohta Miyawaki, Koichi Akashi, Takanari Kitazono, Takehiro Torisu
Journal of Gastroenterology.2023; 58(9): 868. CrossRef
Hyaluronic acid/inulin-based nanocrystals with an optimized ratio of indigo and indirubin for combined ulcerative colitis therapy via immune and intestinal flora regulation
Jin Xie, Qi Huang, Huijuan Xie, Jun Liu, Shimin Tian, Ruiyi Cao, Ming Yang, Junzhi Lin, Li Han, Dingkun Zhang
International Journal of Biological Macromolecules.2023; 252: 126502. CrossRef
High-Quality Indigo Naturalis Obtained with Automatic Foam Separation
Xin Yang, Jun Tang, Juan Su, Xin Yang, Ming Yang, Xiangbo Yang, Qisen Ji, Yanan He, Li Han, Dingkun Zhang
ACS Applied Materials & Interfaces.2023; 15(37): 43272. CrossRef

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Colorectal neoplasia

Microvascular density under magnifying narrow-band imaging endoscopy in colorectal epithelial neoplasms: Takahiro Gonai, Keisuke Kawasaki, Shotaro Nakamura, Shunichi Yanai, Risaburo Akasaka, Kunihiko Sato, Yousuke Toya, Kensuke Asakura, Jun Urushikubo, Yasuko Fujita, Makoto Eizuka, Noriyuki Uesugi, Tamotsu Sugai, Takayuki Matsumoto; Intest Res 2020;18(1):107-114. Published online November 4, 2019; DOI: https://doi.org/10.5217/ir.2019.00061

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Background/Aims
Magnifying endoscopic classification systems, such as the Japan narrow-band imaging (NBI) Expert Team (JNET) classification, have been widely used for predicting the histologic diagnosis and invasion depth of colorectal epithelial tumors. However, disagreement exists among observers regarding magnifying endoscopic diagnosis, because these classification systems are subjective. We herein investigated the utility of endoscopic microvascular density (eMVD) calculated from magnifying NBI endoscopic images in colorectal tumors.
Methods
We reviewed magnifying NBI endoscopic images from 169 colorectal epithelial tumors (97 adenomas, 72 carcinomas/high-grade dysplasias) resected endoscopically or surgically. The eMVD on magnifying NBI endoscopic images was evaluated using image-editing software, and relationships between eMVD and clinical, endoscopic, and pathological findings were retrospectively analyzed.
Results
The eMVD in carcinomas (0.152 ± 0.079) was significantly higher than that in adenomas (0.119 ± 0.059, P< 0.05). The best cutoff value for distinguishing carcinoma from adenoma was 0.133. Sensitivity, specificity, and accuracy were 56.9%, 67.0%, and 62.7%, respectively. In addition, JNET type 2B tumors showed significantly higher eMVD (0.162 ± 0.079) compared to type 2A tumors (0.111 ± 0.050, P< 0.05).
Conclusions
The eMVD as determined by magnifying NBI endoscopy is considered to be a possible objective indicator for differentiating colorectal carcinomas from adenomas.

Citations

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Novel physiological analysis using blood flow velocity for colonic polyps: Pilot study
Eiji Kamba, Takashi Murakami, Naoki Tsugawa, Kei Nomura, Keiichi Haga, Yoichi Akazawa, Hirofumi Fukushima, Hiroya Ueyama, Kenshi Matsumoto, Tomoyoshi Shibuya, Takeshi Terai, Takashi Yao, Akihito Nagahara
Endoscopy International Open.2024; 12(06): E781. CrossRef
Feasibility of moxifloxacin and proflavine dual fluorescence imaging for detecting gastrointestinal neoplastic lesions: A prospective study
Kwangwoo Nam, Noseong Park, Seunghun Lee, Suil Jeon, Jungbin Lee, Seung‐Mo Hong, Sung Wook Hwang, Sang Hyoung Park, Dong‐Hoon Yang, Byong Duk Ye, Jeong‐Sik Byeon, Suk‐Kyun Yang, Jeong Hoon Lee, Do Hoon Kim, Ki Hean Kim, Seung‐Jae Myung
Lasers in Surgery and Medicine.2023; 55(4): 378. CrossRef
Application of artificial intelligence in diagnosis and treatment of colorectal cancer: A novel Prospect
Zugang Yin, Chenhui Yao, Limin Zhang, Shaohua Qi
Frontiers in Medicine.2023;[Epub] CrossRef
Chicken skin mucosa surrounding small colorectal cancer could be an endoscopic predictive marker of submucosal invasion
Ying-Jie Zhang, Wu Wen, Fan Li, Yi Jian, Chuan-Ming Zhang, Meng-Xia Yuan, Ye Yang, Feng-Lin Chen
World Journal of Gastrointestinal Oncology.2023; 15(6): 1062. CrossRef
A review on self-healing featured soft robotics
Md. Ariful Islam, Labanya Talukder, Md. Firoj Al, Subrata K. Sarker, S. M. Muyeen, Prangon Das, Md. Mehedi Hasan, Sajal K. Das, Md. Manirul Islam, Md. Robiul Islam, Sumaya Ishrat Moyeen, Faisal R. Badal, Md. Hafiz Ahamed, Sarafat Hussain Abhi
Frontiers in Robotics and AI.2023;[Epub] CrossRef
Emergence of a New Optical Marker for Colorectal Neoplasms: To What Extent Should We Accept It?
Han Hee Lee
Clinical Endoscopy.2022; 55(2): 315. CrossRef
Endoscopic diagnosis and treatment of early colorectal cancer
Seung Wook Hong, Jeong-Sik Byeon
Intestinal Research.2022; 20(3): 281. CrossRef
Colonic Chicken Skin Mucosa Surrounding Colon Polyps Is an Endoscopic Predictive Marker for Colonic Neoplastic Polyps
Yu Mi Lee, Kyung Ho Song, Hoon Sup Koo, Choong-Sik Lee, Inseok Ko, Sang Hyuk Lee, Kyu Chan Huh
Gut and Liver.2022; 16(5): 754. CrossRef
Artificial intelligence-based colorectal polyp histology prediction using narrow-band image-magnifying colonoscopy: a stepping stone for clinical practice
Ji Young Chang
Clinical Endoscopy.2022; 55(5): 699. CrossRef
Response to Artificial intelligence-based colorectal polyp histology prediction using narrow-band image-magnifying colonoscopy: a stepping stone for clinical practice
Istvan Racz, Andras Horvath, Zoltán Horvath
Clinical Endoscopy.2022; 55(5): 701. CrossRef
Photoacoustic endoscopy: A progress review
Heng Guo, Ying Li, Weizhi Qi, Lei Xi
Journal of Biophotonics.2020;[Epub] CrossRef
Diagnostic efficacy of the Japan Narrow-band-imaging Expert Team and Pit pattern classifications for colorectal lesions: A meta-analysis
Yu Zhang, Hui-Yan Chen, Xiao-Lu Zhou, Wen-Sheng Pan, Xin-Xin Zhou, Hang-Hai Pan
World Journal of Gastroenterology.2020; 26(40): 6279. CrossRef

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IBD

Immunohistochemical differentiation between chronic enteropathy associated with SLCO2A1 gene and other inflammatory bowel diseases: Satoko Yamaguchi, Shunichi Yanai, Shotaro Nakamura, Keisuke Kawasaki, Makoto Eizuka, Noriyuki Uesugi, Tamotsu Sugai, Junji Umeno, Motohiro Esaki, Takayuki Matsumoto; Intest Res 2018;16(3):393-399. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.393

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<b>Background/Aims</b><br/>

We recently identified recessive mutations in the solute carrier organic anion transporter family member 2A1 gene (SLCO2A1) as causative variants of chronic enteropathy associated with SLCO2A1 (CEAS). The aim of this study was to evaluate SLCO2A1 protein expression in the intestinal tissues of patients with CEAS, intestinal Behçet's disease (BD), simple ulcer (SU), and Crohn's disease (CD).

Methods

Immunohistochemical staining using a polyclonal anti-SLCO2A1 antibody was performed on the resected intestinal specimens from 13 cases of CD, 9 cases of intestinal BD/SU, and 3 cases of CEAS. The extent of SLCO2A1 expression was determined by counting positively-staining vascular endothelial cells and scored as 0 (no cells), 1 (1%–30% cells), 2 (31%–60%), or 3 (>60%). The intensity of SLCO2A1 expression was scored either as 0 (negative), 1 (intermediate), or 2 (strong). The extent score and intensity score were summed for the final score of 0, 2, 3, 4, or 5.

Results

SLCO2A1 protein expression was observed in 1 of 3 cases of CEAS (33%), all 13 cases of CD (100%), and all 9 cases of BD/SU (100%). The mean final expression scores of CEAS, CD, and BD/SU were 1.6 (range, 0–5), 4.8 (range, 4–5), and 4.3 (range, 4–5), respectively. The final expression score in CEAS was significantly lower than in CD (P=0.03).

Conclusions

Immunohistochemical staining of the SLCO2A1 protein is considered useful to distinguish CEAS from other inflammatory bowel diseases.

Citations

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First case report of dichorionic diamniotic twins with chronic enteropathy associated with the SLCO2A1 gene
Ryutaro Saura, Shin-ichiro Hagiwara, Keinosuke Hizuka, Nobuhiko Okamoto, Yuri Etani
Clinical Journal of Gastroenterology.2024; 17(2): 240. CrossRef
Characteristics of chronic enteropathy associated with SLCO2A1 gene (CEAS) in children, a unique type of monogenic very early-onset inflammatory bowel disease
Jin Gyu Lim, Jae Sung Ko, Jung Min Ko, Hyun Young Kim, Man Jin Kim, Moon Woo Seong, Young Hun Choi, Gyeong Hoon Kang, Jaemoon Koh, Jin Soo Moon
BMC Pediatrics.2024;[Epub] CrossRef
Clinical and genetic characteristics of Chinese patients diagnosed with chronic enteropathy associated with SLCO2A1 gene
Qing Shang, Yimin Dai, Jingyi Huang, Wei Liu, Weixun Zhou, Yaping Liu, Hong Yang, Qiang Wang, Yue Li
Orphanet Journal of Rare Diseases.2024;[Epub] CrossRef
Histopathology underlying environmental enteric dysfunction in a cohort study of undernourished children in Bangladesh, Pakistan, and Zambia compared with United States children
Paul Kelly, Kelley VanBuskirk, David Coomes, Samer Mouksassi, Gerald Smith, Zehra Jamil, Md Shabab Hossain, Sana Syed, Chelsea Marie, Phillip I Tarr, Peter B Sullivan, William A Petri, Donna M Denno, Tahmeed Ahmed, Mustafa Mahfuz, S Asad Ali, Sean R Moore
The American Journal of Clinical Nutrition.2024; 120: S15. CrossRef
Capsule Endoscopy for the Diagnosis of Suspected Small Bowel Bleeding
P. P. Polyakov, A. Ya. Alimetov, A. V. Onopriev, A. V. Avakimyan, A. Kh. Kade, S. A. Zanin, E. S. Zanina, Z. S. Popov, A. I. Trofimenko, Z. T. Jndoyan, A. A. Avagimyan
Innovative Medicine of Kuban.2023; (3): 121. CrossRef
Attenuated Expression of SLCO2A1 Caused by DNA Methylation in Pediatric Inflammatory Bowel Disease
Natsuki Ito, Takahiro Kudo, Hidetaka Eguchi, Keisuke Jimbo, Atsushi Furuhata, Toshiaki Okuno, Ichiro Takeuchi, Katsuhiro Arai, Takashi Ishige, Yasushi Okazaki, Toshiaki Shimizu
Inflammatory Bowel Diseases.2023; 29(12): 1920. CrossRef
Updates on the diagnosis and management of cryptogenic multifocal ulcerative stenosing enteropathy (CMUSE) and non-steroidal enteropathy
Tom G. Moreels, Ayaskanta Singh
Best Practice & Research Clinical Gastroenterology.2023; 64-65: 101847. CrossRef
Chronic Enteropathy Associated with Solute Carrier Organic Anion Transporter Family, Member 2A1 (SLCO2A1) with Positive Immunohistochemistry for SLCO2A1 Protein
Chizuru Ariake, Naoki Hosoe, Hinako Sakurai, Anna Tojo, Yukie Hayashi, Kenji JL Limpias Kamiya, Tomohisa Sujino, Kaoru Takabayashi, Kenjiro Kosaki, Satowa Seki, Tadakazu Hisamatsu, Haruhiko Ogata, Takanori Kanai
Internal Medicine.2022; 61(17): 2607. CrossRef
Epithelial Abnormalities in the Small Intestine of Zambian Children With Stunting
Chola Mulenga, Sanja Sviben, Kanta Chandwe, Beatrice Amadi, Violet Kayamba, James A. J. Fitzpatrick, Victor Mudenda, Paul Kelly
Frontiers in Medicine.2022;[Epub] CrossRef
Functional analysis of mutant SLCO2A1 transporters found in patients with chronic enteropathy associated with SLCO2A1
Satowa Seki, Gen Tanaka, Toru Kimura, Mari Hayashida, Jun Miyoshi, Minoru Matsuura, Hiroyuki Sakurai, Tadakazu Hisamatsu
Journal of Gastroenterology and Hepatology.2022; 37(9): 1776. CrossRef
Clinical and Genetic Characteristics of Korean Patients Diagnosed with Chronic Enteropathy Associated with SLCO2A1 Gene: A KASID Multicenter Study
Hee Seung Hong, Jiwon Baek, Jae Chul Park, Ho-Su Lee, Dohoon Park, A-Ran Yoon, Soo Jung Park, Sung Noh Hong, Seong-Joon Koh, Chang Kyun Lee, Bo-In Lee, Sung Wook Hwang, Sang Hyoung Park, Seung-Jae Myung, Suk-Kyun Yang, Kyuyoung Song, Byong Duk Ye
Gut and Liver.2022; 16(6): 942. CrossRef
Recent advances in studies of SLCO2A1 as a key regulator of the delivery of prostaglandins to their sites of action
Takeo Nakanishi, Yoshinobu Nakamura, Junji Umeno
Pharmacology & Therapeutics.2021; 223: 107803. CrossRef
Meta-Analysis-Assisted Detection of Gravity-Sensitive Genes in Human Vascular Endothelial Cells
Yin Liang, Mengxue Wang, Yun Liu, Chen Wang, Ken Takahashi, Keiji Naruse
Frontiers in Cell and Developmental Biology.2021;[Epub] CrossRef
Chronic Nonspecific Multiple Ulcers of the Small Intestine / Chronic Enteropathy Associated with SLCO2A1 Gene (CEAS)
Junji Umeno, Yuta Fuyuno, Yuichi Matsuno, Takehiro Torisu
Nippon Daicho Komonbyo Gakkai Zasshi.2021; 74(10): 581. CrossRef
Retrospective study of the differential diagnosis between cryptogenic multifocal ulcerous stenosing enteritis and small bowel Crohn’s disease
Dan Chen, Wei Liu, Weixun Zhou, Weiyang Zheng, Dong Wu, Jiaming Qian
BMC Gastroenterology.2020;[Epub] CrossRef
Chronic Enteropathy Associated with SLCO2A1 with Pachydermoperiostosis
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Small bowel ulcers
Martin Keuchel, Niehls Kurniawan, Peter Baltes
Current Opinion in Gastroenterology.2019; 35(3): 213. CrossRef
Measurement of prostaglandin metabolites is useful in diagnosis of small bowel ulcerations
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World Journal of Gastroenterology.2019; 25(14): 1753. CrossRef
Distinction between Chronic Enteropathy Associated with the SLCO2A1 Gene and Crohn's Disease
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Gut and Liver.2019; 13(1): 62. CrossRef
Chronic enteropathy associated with SLCO2A1 gene: A case report and literature review
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Clinics and Research in Hepatology and Gastroenterology.2019; 43(5): e68. CrossRef

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