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Curcumin, an active substance contained in an Indian spice called turmeric or curcuma, is well known for its anti-inflammatory and antioxidant properties. In recent times, it was taken into account and studied as an antitumoral molecule, by relying on its interference on several biological mechanisms, such as the inhibition of inflammatory mediators, the enhancement of detoxifying enzymes’ action and processes of cell growth and proliferation. Studies show how the high dosage of curcumin in vitro inhibits colorectal tumor cells, pancreatic tumor cells, lung cancer cells and glioblastoma’s cells, interfering in signaling pathways as Wnt/β-catenin, NF-kB and PI3K/Akt and leading to cell cycle arrest and apoptosis. Furthermore, the association between curcumin and chemotherapeutic agents such as 5-fluorouracil strengthens the drug’s cytotoxicity and cells’ susceptibility towards the chemotherapeutic agent.

Summary. Aims: Irritable bowel syndrome (IBS) is a functional intestinal disorder. This syndrome may creates psychological disorders in patients who are affected and severely limits daily activities and lifestyle. Methods: We investigated the effect of the natural product consisting of chamomile, fennel, caraway, passionflower and melissa (Spasmicol®), on IBS patients. For the study, 187 patients with IBS, enrolled by primary care doctors, were treated with Spasmicol® (Aristeia Farmaceutici s.r.l.), two tablets/daily, for 30 days. At the end of the study, patients were re-evaluated to analyse the effects of therapy. Results: After 30 days, patients showed a marked reduction of symptoms (abdominal pain, abdominal distention, stool habit changes). Conclusions: Due to to the combination of chamomile, fennel, caraway, melissa, passionflower and beta-galactosidase, the product Spasmicol® turned out to be remarkedly effective in treating IBS symptoms.

Fibromyalgia is a rheumatic syndrome and its pathogenesis is controversial. The recent literature has placed considerable attention on the link between alteration of the intestinal microbiota and fibromyalgia, emphasizing the close connection between the neuroenteric system and the CNS. This study aims to evaluate the probable relationship between intestinal dysbiosis and altered secretion of hormones and vitamins such as cortisol, serotonin, Vitamin D and thyroid hormones in a patient with fibromyalgia.

One of the contributory causes of colon cancer is the negative effect of reactive oxygen species on DNA repair mechanisms. Currently, there is a growing support for the concept that oxidative stress may be an important etiological factor for carcinogenesis. The purpose of this review is to elucidate the role of oxidative stress in promoting colorectal carcinogenesis and to highlight the potential protective role of antioxidants. Several studies have documented the importance of antioxidants in countering oxidative stress and preventing colorectal carcinogenesis. However, there are conflicting data in the literature concerning its proper use in humans, since these studies did not yield definitive results and were performed mostly in vitro on cell populations, or in vivo in experimental animal models.

Objective. Several alterations of magnesium metabolism have been associated with type 2 diabetes pathophysiology, a condition particularly frequent in older persons. We aimed to evaluate serum total (Mg-tot) and serum ionized magnesium (Mg-ion) in older persons with type 2 diabetes in order to explore clinically applicable methods for the detection of magnesium deficit. Material/Methods: Mg-tot and Mg-ion were measured in 105 fasting subjects with type 2 diabetes (mean age: 71.10.8 years; M/F: 45/60) and in 100 age-matched non-diabetic control persons (mean age: 72.20.8 years; M/F: 42/58). Results: Mg-ion concentrations were significantly lower in diabetic persons compared with controls (0.490.05 mmol/L vs. 0.550.05 mmol/L; p

In this work, we propose that for further studies of the physiopathology and treatment for inflammatory bowel diseases, an integral view of the conditions, including the triad of microbiota-heat shock proteins (HSPs)-probiotics, ought to be considered. Microbiota is the complex microbial flora that resides in the gut, affecting not only gut functions but also the health status of the whole body. Alteration in the microbiota's composition has been implicated in a variety of pathological conditions (e.g., ulcerative colitis, UC), involving both gut and extra-intestinal tissues and organs. Some of these pathologies are also associated with an altered expression of HSPs (chaperones) and this is the reason why they may be considered chaperonopathies. Probiotics, which are live microorganisms able to restore the correct, healthy equilibrium of microbiota composition, can ameliorate symptoms in patients suffering from UC and modulate expression levels of HSPs. However, currently probiotic therapy follows ex-adiuvantibus criteria, i.e., treatments with beneficial effects but whose mechanism of action is unknown, which should be changed so the probiotics needed in each case are predetermined on the basis of the patient's microbiota. Consequently, efforts are necessary to develop diagnostic tools for elucidating levels and distribution of HSPs and the microbiota composition (microbiota fingerprint) of each subject and, thus, guide specific probiotic therapy, tailored to meet the needs of the patient. Microbiota fingerprinting ought to include molecular biology techniques for sequencing highly conserved DNA, e.g., genes encoding 16S RNA, for species identification and, in addition, quantification of each relevant microbe.

Background: Microbiota refers to the population of microorganisms (bacteria, viruses and fungi) that inhabit the entire gastrointestinal tract, more particularly the colon whose role is to maintain the integrity of the intestinal mucosa and control the proliferation of pathogenic bacteria. Alteration in the composition of the gut microbiota is called dysbiosis. Dysbiosis redisposes to inflammatory bowel diseases such as ulcerative colitis, Crohn disease and indeterminate colitis. Methods: The purpose of this literature review is to elucidate the influence of diet on the composition of the gastrointestinal microbiota in the healthy gut and the role of diet in the development of dysbiosis. Conclusion: The "Western diet", in particular a low - fiber high fat/high carbohydrate diet is one factor that can lead to severe dysbiosis. In contrast, "mediterranean" and vegetarian diets that includes abundant fruits, vegetables, olive oil and oily fish are known for their anti-inflammatory effects and could prevent dysbiosis and subsequent inflammatory bowel disease.

Endotracheal intubation in the rat is difficult because of the extremely small size of anatomical structures (oral cavity, epiglottis and vocal cords), small inlet for an endotracheal tube and the lack of proper technical instruments.In this study we used seventy rats weighting 400-500 g. The equipment needed for the intubation was an operating table, a longish of cotton, a cotton tip, orotracheal tube, neonatal laryngoscope blades, KTR4 small animal ventilator and isoflurane for inhalation anaesthesia. Premedication was carried out by medetomidine hydrochloride 1 mg/mL; then, thanks to a closed glass chamber, a mixture of oxygen and isoflurane was administered. By means of a neonatal laryngoscope the orotracheal tube was advanced into the oral cavity until the wire guide was visualized trough the vocal cords; then it was passed through them. The tube was introduced directly into the larynx over the wire guide; successively, the guide was removed and the tube placed into the trachea. Breathing was confirmed using a glove, cut at the end of a finger, simulating a small balloon.We achieved a fast and simple orotracheal intubation in all animals employed.We believe that our procedure is easier and faster than those previously reported in scientific literature.

Background: Therapeutic treatment for inflammatory bowel disease (IBD) may follow different approaches, systemic as well as local, especially when the target is the osteoarticular apparatus. Although some clinical trials have suggested benefits from probiotics administration in IBD, there is still a great deal of controversy on their use. The aim of this study was to further investigate the effects of probiotics in patients with IBD and related spondyloarthropathy. Material/Methods: Fifty-nine patients affected by IBD with extra-intestinal involvement where evaluated from 2006 to 2010. Twenty-eight patients received administration of a standard therapy with mesalazine and 31 where treated with the same therapy plus probiotic supplement. Results: Comparative analysis performed between the 2 groups showed a better clinical response and a reduction of occasional corticosteroids administration in patients receiving probiotic administration. Conclusions: This prospective study supports the beneficial effects of probiotic administration in improving the clinical response to standard therapy and in reducing the need for corticosteroids use. Large randomized trials would provide reliable and conclusive results in this field.

Patients with inflammatory bowel disease (IBD) have an increased risk of 10%-15% developing colorectal cancer (CRC) that is a common disease of high economic costs in developed countries. The CRC has been increasing in recent years and its mortality rates are very high. Multiple biological and biochemical factors are responsible for the onset and progression of this pathology. Moreover, it appears absolutely necessary to investigate the environmental factors favoring the onset of CRC and the promotion of colonic health. The gut microflora, or microbiota, has an extensive diversity both quantitatively and qualitatively. In utero, the intestine of the mammalian fetus is sterile. At birth, the intestinal microbiota is acquired by ingesting maternal anal or vaginal organisms, ultimately developing into a stable community, with marked variations in microbial composition between individuals. The development of IBD is often associated with qualitative and quantitative disorders of the intestinal microbial flora (dysbiosis). The healthy human gut harbours about 10 different bacterial species distributed in colony forming units which colonize the gastrointestinal tract. The intestinal microbiota plays a fundamental role in health and in the progression of diseases such as IBD and CRC. In healthy subjects, the main control of intestinal bacterial colonization occurs through gastric acidity but other factors such as endoluminal temperature, competition between different bacterial strains, peristalsis and drugs can influence the intestinal microenvironment. The microbiota exerts diverse physiological functions to include: growth inhibition of pathogenic microorganisms, synthesis of compounds useful for the trophism of colonic mucosa, regulation of intestinal lymphoid tissue and synthesis of amino acids. Furthermore, mucus seems to play an important role in protecting the intestinal mucosa and maintaining its integrity. Changes in the microbiota composition are mainly influenced by diet and age, as well as genetic factors. Increasing evidence indicates that dysbiosis favors the production of genotoxins and metabolites associated with carcinogenesis and induces dysregulation of the immune response which promotes and sustains inflammation in IBD leading to carcinogenesis. A disequilibrium in gut microflora composition leads to the specific activation of gut associated lymphoid tissue. The associated chronic inflammatory process associated increases the risk of developing CRC. Ulcerative colitis and Crohn’s disease are the two major IBDs characterized by an early onset and extraintestinal manifestations, such as rheumatoid arthritis. The pathogenesis of both diseases is complex and not yet fully known. However, it is widely accepted that an inappropriate immune response to microbial flora can play a pivotal role in IBD pathogenesis.

Patients suffering from chronic intestinal diseases (Crohn's disease, Ulcerative Colitis, Indeterminate Colitis) are prone to the development of pyogenic complications. These complications are most commonly in the form of perianal or intraabdominal abscesses and/or fistulas. The treatment of these complications are managed differently but, after an initial treatment based on medical or minimally invasive management, the solution of the pathological condition is always achieved by a surgical procedure. In the last few years prospective studies have proposed an alternative conservative therapeutic approach based on application of fibrin glue in the healing of patients with fistulas-in-ano. In this paper we suggest and discuss the therapeutic potential of silver and quarz in the conservative treatment of anorectal fistulas pointing out their role in modulating particular steps of the pathogenetic process which characterizes this pathological condition.

In an earlier work, the role of heat shock protein (Hsp60) in the pathogenesis of ulcerative colitis (UC) was suggested by its significant increase in the pathological mucosa parallel with an increase in inflammatory cells. More data in this direction are reported in this work. We analyzed by immunohistochemistry biopsies of colon tissue from 2 groups of patients with UC and treated with either 5-aminosalicylic acid (5-ASA) alone or in combination with a probiotic. We looked for inflammatory markers and Hsp60. Both the treatments were effective in reducing symptoms but the group treated with both 5-ASA and probiotics showed better clinical results. Amelioration of symptoms was associated with reduction of both inflammation and Hsp60, a reduction that was most marked in the group treated with 5-ASA and probiotics. The levels of Hsp60 positively correlated with those of CD68-positive cells, and double immunofluorescence showed a high index of colocalization of the chaperonin and CD68 in lamina propria. Immunoelectron microscopy showed that Hsp60-classically a mitochondrial protein-was abundantly also present in cytosol in biopsies taken at the time of diagnosis, but not after the treatment. Our data suggest that Hsp60 is an active player in pathogenesis of UC and it can be hypothesized that the chaperonin is responsible, at least in part, for initiation and maintenance of disease.

Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD) characterized by damage of large bowel mucosa and frequent extra-intestinal autoimmune comorbidities. The role played in IBD pathogenesis by molecular chaperones known to interact with components of the immune system involved in inflammation is unclear. We previously demonstrated that mucosal Hsp60 decreases in UC patients treated with conventional therapies (mesalazine, probiotics), suggesting that this chaperonin could be a reliable biomarker useful for monitoring response to treatment, and that it might play a role in pathogenesis. In the present work we investigated three other heat shock protein/molecular chaperones: Hsp10, Hsp70, and Hsp90. We found that the levels of these proteins are increased in UC patients at the time of diagnosis and decrease after therapy, supporting the notion that these proteins deserve attention in the study of the mechanisms that promote the development and maintenance of IBD, and as biomarkers of this disease (e.g., to monitor response to treatment at the histological level).

To The Editor: Ulcerative colitis (UC) is one of the inflammatory bowel diseases, which affects the small intestine and colon [1]. The pathophysiology of UC is not known [2, 3]. The association between arthritis and UC is well known. The authors report the frequency of arthritis in 53 Sicilian patients with UC. The diagnosis of UC was made according to criteria described by Schachter and Kirsner [4]. The involvement of sacroilitic joints was assessed radiologically according to Bennett and Burch grade (0=normal joint, 1=suspicious sacroiliitis 2=abnormal joint with sclerosis and/or erosions, 3=unequivocally abnormal with erosions, sclerosis, widening or narrowing or partly ankylosed, 4=total ankylosis) [5]. All patients were screened for the presence of the antigen HLA B27. Arthritis occurred in 11 patients (20.7%). Patients with arthritis had high erythrocyte sedimentation rate (>20) and high C-reactive protein (mean value 14mg/L) at presentation. Latex fixation test rheumatoid factor (RF) was negative in all except one patient who had monoarticular knee involvement (RF = 45 IU/ml). Peripheral arthritis was found in 9 patients (17%). Only three patients had polyarticular involvement. The joints involved in peripheral arthritis were most frequently the knee joint (4 patients), followed by the ankle (3 patients), elbow (2 patients), wrist (2 patients), proximal interphalangeal (2 patients), shoulder (1 patient), and the hip (1 patient). Spondylitis was diagnosed in 2 patients (3.8%), one with sacroilitis grade 2 and the other with grade 3. Both patients with sacroilitiis showed positive HLA B27. In conclusion, our observation of the association between UC and arthritis is in line with previous reports in the literature [6, 7]. The basis of this association is unknown. A better understanding of the role of genetics and environmental factors may improve the treatments and prevention of the disease.

Patients with inflammatory bowel disease are at increased risk of developing disorder in bone and mineral metabolism The study was aimed to determine if inflammatory bowel disease (IBD) is a risk factor for osteoporosis in 103 adult patients. We included 103 IBD patients, 67 patients with Crohn’s disease (CD) and 36 with ulcerative colitis (UC). Bone mineral density was measured by dual-energy X-ray absorptiometry. We used T score to express bone loss (osteopenia: -2.5 SD 2 years) and active disease would be risk factors of bone mineral loss in IBD.

Dysbiosis has been linked to IBD. The intestinal microbiota plays a fundamental role in health and the progression of diseases such as IBD and CRC. Many cancers arise from sites of infection and chronic inflammation. Patients with inflammatory Bowel Disease (IBD) have an increased risk of 10%-15% developing colorectal cancer. Therefore, a complete understanding of the composition and function of the gut microbiota is critical.