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Du D, Qin J, Gao L, Hu X, Liu S, Wu Y, Li X, Luo F, Shen Y. Linking Chronic Obstructive Pulmonary Disease and Asthma with Gallstones: Evidence from a Cross-Sectional Study and Mendelian Randomization. COPD 2025; 22:2502118. [PMID: 40376761 DOI: 10.1080/15412555.2025.2502118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2025] [Revised: 04/18/2025] [Accepted: 04/30/2025] [Indexed: 05/18/2025]
Abstract
OBJECTIVE To investigate whether chronic obstructive pulmonary disease (COPD) and asthma increase the risk of gallstones based on the National Health and Nutrition Examination Survey (NHANES) and Mendelian randomization (MR). METHODS Data from the NHANES 2017-2023 were included in the cross-sectional study. Diagnoses of COPD, asthma and gallstones were obtained from self-report questionnaires. Multivariate logistic regression, subgroup analyses and interaction tests were applied to explore these associations. Data for MR analysis were obtained from the Finnish cohort and the Integrative Epidemiology Unit (IEU). The inverse variance weighting (IVW) estimate was applied as the main approach to determine the causality of associations. RESULTS A total of 8,728 participants were enrolled in the cross-sectional study. Both COPD (OR 1,842, 95% CI 1.144, 2.968, p = 0.015) and asthma (OR 1.434, 95% CI 1.093, 1.883, p = 0.012) were associated with increased gallstone risk before and after covariate adjustments, and diabetes history may interact with the COPD-gallstone association (p = 0.020). In MR analysis, although a causal association was observed between COPD and gallstones (OR 1.216, 95% CI 1.023, 1.445; p = 0.026), leave-one-out analysis suggested that the causal association disappeared without serpin family A member 1 (SERPINA1). No causal association was observed between asthma and gallstones (OR 1.016, 95% CI 0.932, 1.108; p = 0.718). CONCLUSIONS Although both COPD and asthma were positively associated with gallstones based on NHANES, the COPD-gallstone association was largely driven by SERPINA1, and no causality was observed in asthma-gallstone association. The available evidence provided limited support for causal associations between obstructive lung diseases and gallstones.
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Affiliation(s)
- Dongru Du
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, Sichuan University, Chengdu, China
- High Altitude Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Jiangyue Qin
- Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
| | - Lijuan Gao
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China
- Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu, China
| | - Xueru Hu
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China
| | - Suli Liu
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China
| | - Yanqiu Wu
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China
- Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu, China
| | - Xiaohua Li
- Department of Respiratory and Critical Care Medicine, Sixth People's Hospital of Chengdu, Chengdu, China
| | - Fengming Luo
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, Sichuan University, Chengdu, China
- High Altitude Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Yongchun Shen
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China
- Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu, China
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Zhang KR, Nair RM, Chen Y, Jin F, Dunaief J, VanderBeek BL. Association of Age-Related Macular Degeneration with Cholelithiasis. OPHTHALMOLOGY SCIENCE 2025; 5:100771. [PMID: 40291395 PMCID: PMC12022688 DOI: 10.1016/j.xops.2025.100771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2025] [Revised: 02/27/2025] [Accepted: 03/12/2025] [Indexed: 04/30/2025]
Abstract
Purpose Dysregulated lipid metabolism likely contributes to the pathogenesis of age-related macular degeneration (AMD). There is an overlap in risk factors between AMD and diseases of lipid metabolism, such as cholelithiasis, suggesting that an association between these diseases could provide insight into AMD pathogenesis. This study sought to determine if there is an association between cholelithiasis and AMD. Design A cohort study was conducted using patients in the Optum deidentified Clinformatics Data Mart database from January 1, 2000, to June 30, 2022. Participants Patients over the age of 55 with ≥2 years of data and no prior history of AMD were included. The exposed cohort included patients who had a history of cholelithiasis, cholecystitis, or cholecystectomy. The control cohort included patients with gastroesophageal reflux disease (GERD), matched for age ±3 years, sex, race, and year of index date. Methods Propensity scores were created using multivariable logistic regression and applied to inverse probability of treatment weighting (IPTW). Cox proportional hazard regression modeling with IPTW was used to compare progression to AMD in each cohort. Main Outcome Measures Progression to AMD for patients with cholelithiasis, cholecystitis, or a history of cholecystectomy. Results A total of 332 536 patients with cholelithiasis and 776 591 matched GERD controls were analyzed. After IPTW, the mean age (±standard deviation) was 66.6 ± 9.4 years in the cholelithiasis cohort and 67.5 (±10.3) years in the GERD cohort. Women comprised 58% of the cholelithiasis cohort and 57% of the GERD cohort. In the cholelithiasis cohort, 3511.7 (1.14%) were diagnosed with AMD, compared with 23 367.1 (2.92%) in the GERD cohort and corresponding to a significantly decreased hazard of AMD (adjusted hazard ratio [aHR] = 0.72, 95% confidence interval [CI]: 0.69-0.75, P < 0.0001). In the subanalysis, before IPTW weighting, AMD developed in 3809 of 275 897 (1.4%) patients with only cholelithiasis (aHR = 0.76, 95% CI: 0.73-0.80, P < 0.0001), 335 of 47 166 (0.71%) patients with cholecystitis (aHR = 0.54, 95% CI: 0.47-0.61, P < 0.0001), and 114 of 9473 (1.20%) patients who underwent cholecystectomy (aHR = 0.50, 95% CI: 0.41-0.63, P < 0.0001). Conclusions Cholelithiasis was associated with a 28% hazard reduction in AMD. More severe gallbladder disease conferred greater protection. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Kevin R. Zhang
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Rohini M. Nair
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Yineng Chen
- Center for Preventative Ophthalmology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Fangming Jin
- Center for Preventative Ophthalmology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Joshua Dunaief
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Brian L. VanderBeek
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Center for Pharmacoepidemiology Research and Training, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Leonard Davis Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Shi W, Huang Y, Xu Z, Huang X, Tong G, Lin J, Zhou Y, Yang Q, Chen C. Application effect of standardized nursing process of abdominal drainage tube in cholelithiasis: a single-center retrospective cohort study. BMC Gastroenterol 2025; 25:253. [PMID: 40229721 PMCID: PMC11995659 DOI: 10.1186/s12876-025-03854-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2025] [Accepted: 04/04/2025] [Indexed: 04/16/2025] Open
Abstract
BACKGROUND and aims: Although abdominal drainage tubes have been widely used to treat cholelithiasis, complications still affect patients' prognoses. There is no Standardized Nursing Process (SNP) for abdominal drainage tubes after Laparoscopic cholecystectomy (LC). This study aims to observe the clinical efficacy and explore the feasibility of SNP intervention for abdominal drainage tubes in cholelithiasis patients after LC. METHODS This retrospective study included the patients with cholelithiasis admitted to Xishan People's Hospital of Wuxi City between Jan 2023 and Aug 2024. Patients were separated into Standardized Nursing Process (SNP) group and non-Standardized Nursing Process (non-SNP) group. The outcomes were compared between the two groups, and Univariate and multivariate analyses were performed to analyze the factors associated with SNP. P values less than 0.05 were considered statistically significant. RESULTS Among a total of 264 patients with cholelithiasis who were included in the study, 147 patients were treated with SNP, and the other 117 patients were treated without SNP. Compared with non-SNP, multivariate analysis suggested that SNP was an independent factor linked to alleviation of postoperative pain (OR = 0.22, 95%CI: 0.13-0.36) (P < 0.001), strongly associated with the activity rate of getting out of bed within 24 h (OR = 2.28, 95%CI:1.33-3.91), effectively associated with a lower incidence of drainage tube outlet leakage and post-extubation leakage. Importantly, SNP management correlated with higher patient satisfaction (p < 0.001). CONCLUSIONS SNP implementation correlated with improved activity rate of getting out of bed within 24 h after LC, fewer occurrence of post-extubation leakage, reduced postoperative pain and higher satisfaction rates.
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Affiliation(s)
- Wenhui Shi
- Department of General Surgery, Xishan People's Hospital of Wuxi City, Wuxi, 214105, China
| | - Yan Huang
- Department of General Surgery, Xishan People's Hospital of Wuxi City, Wuxi, 214105, China
| | - Zipeng Xu
- Department of General Surgery, Xishan People's Hospital of Wuxi City, Wuxi, 214105, China
| | - Xinyi Huang
- Department of General Surgery, Xishan People's Hospital of Wuxi City, Wuxi, 214105, China
| | - Genxi Tong
- Department of General Surgery, Xishan People's Hospital of Wuxi City, Wuxi, 214105, China
| | - Jiamei Lin
- Department of General Surgery, Xishan People's Hospital of Wuxi City, Wuxi, 214105, China
| | - Yanan Zhou
- Department of General Surgery, Xishan People's Hospital of Wuxi City, Wuxi, 214105, China
| | - Qinyan Yang
- Department of General Surgery, Xishan People's Hospital of Wuxi City, Wuxi, 214105, China.
| | - Chaobo Chen
- Department of General Surgery, Xishan People's Hospital of Wuxi City, Wuxi, 214105, China.
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Zhang R, Chen C, Zheng S, Zhang J, Chen W, Chen Z. Preliminary study of biliary microbiota and identification of bacterial species associated with pigmented gallstone formation. Front Cell Infect Microbiol 2025; 15:1532512. [PMID: 40182770 PMCID: PMC11966056 DOI: 10.3389/fcimb.2025.1532512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2024] [Accepted: 02/10/2025] [Indexed: 04/05/2025] Open
Abstract
Background Pigmented gallstone disease (PGS) is prevalent in China. Biliary microbiota is certified to be related to the PGS formation. Methods We performed 16S sequencing on both bile and gallstone samples in 16 patients with gallstone disease. We analyzed the microbial composition of the biliary tract and identified crucial bacteria related to the formation of PGS. Results Biliary tract bacterial composition analysis showed heterogeneity of dominated genus among individuals and correlation in bacterial composition between bile and gallstones. We screened 10 prevalent genera with significant abundance in the bile and gallstones. Actinomyces, Streptococcus, and Achromobacter had a significantly higher abundance in gallstones than in bile (P < 0.05). Furthermore, we identified 32 species that harbored uidA, pldA, and plc genes that encoded β-glucuronidase or phospholipase. Finally, we observed an enriched membrane transport for bile resistance through biliary microbiota. Conclusion β-glucuronidase-producing Streptococcus spp., including Streptococcus dysgalactiae and Streptococcus agalactiae, and Parabacteroides merdae, harbored both uidA and pldA genes and were found to be crucial bacterial species in PGS formation.
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Affiliation(s)
| | | | | | | | | | - Zhimin Chen
- Department of Hepatobiliary and Pancreatic Surgery, Pingyang Hospital of Wenzhou
Medical University, Wenzhou, Zhejiang, China
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Sadeghi N, Salari N, Jalali R. Effect of multimedia education on anxiety and pain in patients undergoing laparoscopic cholecystectomy: a Solomon four-group randomized controlled trial. Sci Rep 2025; 15:9357. [PMID: 40102443 PMCID: PMC11920361 DOI: 10.1038/s41598-024-77207-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 10/21/2024] [Indexed: 03/20/2025] Open
Abstract
Preoperative anxiety and postoperative pain pose significant challenges in surgical settings, often leading to various physical and psychological complications. This study aimed to assess the impact of multimedia education on anxiety levels and pain among candidates undergoing laparoscopic cholecystectomy. In a clinical trial employing Solomon's four-group design, 80 candidates for laparoscopic cholecystectomy were enrolled. They were selected through convenience sampling and randomly allocated to four groups: intervention group with pre-test (E1), intervention group without pre-test (E2), control group with pre-test (C1), and control group without pre-test (C2). Multimedia education was administered to the intervention groups. Data were collected using the State-Trait Anxiety Inventory (STAI) for anxiety assessment and the Visual Analog Scale (VAS) for pain measurement, then analyzed using SPSS-22 software. Preoperative state anxiety levels in groups E1 and E2 were significantly lower compared to C1 and C2 (38.6 ± 7.32, 38.1 ± 8.83, 46.3 ± 11.57, and 45.8 ± 9.57, respectively; p = 0.006). However, there was no significant difference in state anxiety levels 24 h post-surgery nor in trait anxiety levels before and 24 h after surgery. Moreover, there was no significant difference in mean pain scores 24 h post-surgery among the groups. The findings indicate that multimedia education can effectively reduce preoperative anxiety in patients undergoing surgery. However, it did not significantly impact anxiety and pain levels post-surgery. Multimedia education may be considered as a supplementary approach to standard preoperative care protocols.
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Affiliation(s)
- Narges Sadeghi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Rostam Jalali
- Social Development and Health Promotion Research Center, Health Policy and Promotion Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Kazakos E, Kountouras J. Helicobacter pylori Infection and Cholelithiasis. J Gastroenterol Hepatol 2025; 40:548-550. [PMID: 39558474 DOI: 10.1111/jgh.16820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Accepted: 11/06/2024] [Indexed: 11/20/2024]
Affiliation(s)
- Evangelos Kazakos
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Jannis Kountouras
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
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Banerjee T, Goswami AG, Basu S. Biliary microbiome and gallstones: A silent friendship. World J Gastrointest Surg 2024; 16:3395-3399. [PMID: 39649211 PMCID: PMC11622098 DOI: 10.4240/wjgs.v16.i11.3395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 07/18/2024] [Accepted: 07/22/2024] [Indexed: 10/30/2024] Open
Abstract
With increasing evidence, the biliary tract and the gallbladder mucosa are no longer considered sterile environments devoid of bacteria. Rather a profound biofilm of resident bacterial flora is associated with the mucosal surface. The bile too harbors a resident flora. It is when a dysbiotic process ensues, that this bacterial flora either becomes opportunist or is replaced by a pathogenic one that has a strong ability to survive the challenges of the biliary environment. Although once believed a metabolic problem, recent evidence indicates a complex interaction between different species of bacteria and gallbladder mucosa and bile which may culminate in calculus formation. The resident microbiota and its several enzymes dictate the type of gallstone by the mere interplay of the constituting type of bacteria in the biofilm, even without any evidence of infection. Dysbiosis is often mediated by either intestinal dysbiosis or less probably by oral dysbiosis. The gallstones, in turn, provide a haven for the resident microbiota in which they can form their own defined niche enriched with the biofilm that can resist the biliary defense mechanisms and survive the hostile biliary environment in the background of biliary stasis and local infection. However, this process of silent friendship is more complex than said, and further research is needed to define the relationship between the two.
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Affiliation(s)
- Tuhina Banerjee
- Microbiology, Institute of Medical Sciences, Banaras Hindu University, Uttar Pradesh, Varanasi 221005, India
| | - Aakansha Giri Goswami
- Department of General Surgery, All India Institute of Medical Sciences, Uttarakhand, Rishikesh 249203, India
| | - Somprakas Basu
- Department of General Surgery, All India Institute of Medical Sciences, Uttarakhand, Rishikesh 249203, India
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Yang Z, Song C, Lu C. Investigation of the causal relationship between cholelithiasis and Parkinson's disease: A bidirectional Mendelian randomization study. Health Sci Rep 2024; 7:e70126. [PMID: 39377023 PMCID: PMC11457209 DOI: 10.1002/hsr2.70126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 09/19/2024] [Accepted: 09/23/2024] [Indexed: 10/09/2024] Open
Abstract
Background Parkinson's disease (PD) and cholelithiasis are a huge public health burden. Although observational studies have suggested a potential link between PD and cholelithiasis, the causal relationship between the two remains uncertain. To address this gap, we performed a two-sample bidirectional Mendelian randomization analysis using genetic tools. Method Genome-wide association study summary statistics for all traits were obtained from publicly available databases. We used strict control steps in instrumental variable selection to screen for single nucleotide polymorphisms (SNPs) from summary-level genome-wide association studies. In addition, all F-statistics were >10, indicating no weak instrumental bias. The inverse variance weighting (IVW) method was the primary method used to assess causal associations. Four other MR methods (MR-Egger, Weighted Median, Simple mode, and Weighted mode) were also used to complement IVW. Various sensitivity tests were also performed to assess reliability: (1) Cochrane's Q test for assessing heterogeneity, (2) MR-Egger intercept test and MR-PRESSO global test for assessing horizontal multiplicity, and (3) leave-one-out sensitivity test for determining stability. Results We selected a total of 30 SNPs as instrumental variables. It was demonstrated that cholelithiasis had a causal effect on the risk of PD (OR = 1.146, 95% CI: 1.062-1.236, p < 0.001) in IVW method. Conclusion The results of our analysis revealed an increased risk effect of cholelithiasis against PD, which may give light on new approaches to PD prevention and therapy.
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Affiliation(s)
- Zijiao Yang
- Department of Geriatrics, Yangpu Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Chengfu Song
- Department of Geriatrics, Yangpu Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Chong Lu
- Department of GynecologyObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
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Komorniak N, Pawlus J, Gaweł K, Hawryłkowicz V, Stachowska E. Cholelithiasis, Gut Microbiota and Bile Acids after Bariatric Surgery-Can Cholelithiasis Be Prevented by Modulating the Microbiota? A Literature Review. Nutrients 2024; 16:2551. [PMID: 39125429 PMCID: PMC11314327 DOI: 10.3390/nu16152551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 07/28/2024] [Accepted: 07/31/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Cholelithiasis is one of the more common complications following bariatric surgery. This may be related to the rapid weight loss during this period, although the exact mechanism of gallstone formation after bariatric surgery has not been fully elucidated. METHODS The present literature review focuses on risk factors, prevention options and the impact of the gut microbiota on the development of gallbladder stones after bariatric surgery. RESULTS A potential risk factor for the development of cholelithiasis after bariatric surgery may be changes in the composition of the intestinal microbiota and bile acids. One of the bile acids-ursodeoxycholic acid-is considered to reduce the concentration of mucin proteins and thus contribute to reducing the formation of cholesterol crystals in patients with cholelithiasis. Additionally, it reduces the risk of both asymptomatic and symptomatic gallstones after bariatric surgery. Patients who developed gallstones after bariatric surgery had a higher abundance of Ruminococcus gnavus and those who did not develop cholelithiasis had a higher abundance of Lactobacillaceae and Enterobacteriaceae. CONCLUSION The exact mechanism of gallstone formation after bariatric surgery has not yet been clarified. Research suggests that the intestinal microbiota and bile acids may have an important role in this.
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Affiliation(s)
- Natalia Komorniak
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland; (V.H.); (E.S.)
| | - Jan Pawlus
- Department of General Mini-Invasive and Gastroenterological Surgery, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland;
| | - Katarzyna Gaweł
- Department of Gastroenterology, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland;
| | - Viktoria Hawryłkowicz
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland; (V.H.); (E.S.)
| | - Ewa Stachowska
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland; (V.H.); (E.S.)
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Georgescu D, Lighezan DF, Ionita I, Hadaruga N, Buzas R, Rosca CI, Ionita M, Suceava I, Mitu DA, Ancusa OE. Cholesterol Gallstones and Long-Term Use of Statins: Is Gut Microbiota Dysbiosis Bridging over Uncertainties? Diagnostics (Basel) 2024; 14:1234. [PMID: 38928650 PMCID: PMC11202934 DOI: 10.3390/diagnostics14121234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/21/2024] [Accepted: 05/25/2024] [Indexed: 06/28/2024] Open
Abstract
A total of 300 research participants-200 consecutive patients diagnosed with dyslipidemia (100 statin (+), treated for at least five years, and 100 statin (-)) and 100 healthy controls-were included in this observational study. The aim of the study was to deliver insights into the relationship between the long-term use of statins for dyslipidemia and gallstone disease (GSD), as well as insights into the background particularities of the gut microbiota. All study participants underwent clinical examination, laboratory workups, stool microbiology/stool 16S r RNA, next-generation sequencing, and abdominal ultrasound/CT exams. Results: The research participants presented with similarities related to age, gender, and location. Patients displayed comparable heredity for GSs, metabolic issues, and related co-morbidities. Gut dysbiosis (DB) was present in 54% of the statin (-) patients vs. 35% of the statin (+) patients (p = 0.0070). GSs were present in 14% of patients in the statin (-) group vs. 5% of patients in the statin (+) group (p = 0.0304). Severe dysbiosis, with a significant reduction in biodiversity, an increase in LPS (+) bacteria, and a notable decrease in mucin-degrading bacteria, mucosa-protective bacteria, and butyrate-producing bacteria were observed in the statin (-) group. Strong positive correlations between GSD and diabetes/impaired glucose tolerance (r = 0.3368, p = 0.0006), obesity (r = 0.3923, p < 0.0001), nonalcoholic fatty liver disease (r = 0.3219, p = 0.0011), and DB (r = 0.7343, p < 0.0001), as well as significant negative correlations between GSD and alcohol use (r = -0.2305, p = 0.0211), were observed. The multiple regression equation demonstrated that only DB (95% CI: 0.3163 to 0.5670; p < 0.0001) and obesity (95% CI: 0.01431 to 0.2578; p = 0.0289) were independent risk factors predicting GSD in the group of patients treated with statins. Conclusion: The long-term use of statins in dyslipidemic patients was associated with a low risk of developing GSs. The gut microbiota associated with a long-term use of statins in dyslipidemic patients was characterized by a low risk of developing an imbalance of various functional bacteria and alterations in the metabolic microbiota. DB and obesity were found to be independent risk factors predicting GSD in statin (+) patients.
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Affiliation(s)
- Doina Georgescu
- Department V of Internal Medicine I, “V Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.G.); (D.-F.L.); (R.B.); (C.-I.R.); (M.I.); (I.S.); (D.-A.M.); (O.-E.A.)
| | - Daniel-Florin Lighezan
- Department V of Internal Medicine I, “V Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.G.); (D.-F.L.); (R.B.); (C.-I.R.); (M.I.); (I.S.); (D.-A.M.); (O.-E.A.)
| | - Ioana Ionita
- Department V of Internal Medicine I, “V Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.G.); (D.-F.L.); (R.B.); (C.-I.R.); (M.I.); (I.S.); (D.-A.M.); (O.-E.A.)
| | - Nicoleta Hadaruga
- Department of Food Science, University of Life Sciences “King Michael I”, 300041 Timisoara, Romania;
| | - Roxana Buzas
- Department V of Internal Medicine I, “V Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.G.); (D.-F.L.); (R.B.); (C.-I.R.); (M.I.); (I.S.); (D.-A.M.); (O.-E.A.)
| | - Ciprian-Ilie Rosca
- Department V of Internal Medicine I, “V Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.G.); (D.-F.L.); (R.B.); (C.-I.R.); (M.I.); (I.S.); (D.-A.M.); (O.-E.A.)
| | - Mihai Ionita
- Department V of Internal Medicine I, “V Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.G.); (D.-F.L.); (R.B.); (C.-I.R.); (M.I.); (I.S.); (D.-A.M.); (O.-E.A.)
| | - Ioana Suceava
- Department V of Internal Medicine I, “V Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.G.); (D.-F.L.); (R.B.); (C.-I.R.); (M.I.); (I.S.); (D.-A.M.); (O.-E.A.)
| | - Diana-Alexandra Mitu
- Department V of Internal Medicine I, “V Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.G.); (D.-F.L.); (R.B.); (C.-I.R.); (M.I.); (I.S.); (D.-A.M.); (O.-E.A.)
| | - Oana-Elena Ancusa
- Department V of Internal Medicine I, “V Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.G.); (D.-F.L.); (R.B.); (C.-I.R.); (M.I.); (I.S.); (D.-A.M.); (O.-E.A.)
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Ozturk D, Sivaslioglu A, Bulus H, Ozturk B. TyG index is positively associated with HOMA-IR in cholelithiasis patients with insulin resistance: Based on a retrospective observational study. Asian J Surg 2024; 47:2579-2583. [PMID: 38508891 DOI: 10.1016/j.asjsur.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/24/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND/OBJECTIVE Cholelithiasis is a common disease but pose significant global health and financial burdens. Mechanisms of the disease are associated with insulin resistance (IR), obesity, metabolic syndrome, and type 2 diabetes. Insulin resistance is commonly observed in cholelithiasis patients. More recently, the triglyceride-glucose (TyG) index has been proposed as an alternative marker of insulin resistance. In our study we aimed to understand whether the TyG index is correlated with HOMA-IR in cholelithiasis patients. And also we aimed the predict a cutoff value for determining insulin resistance in cholelithiasis patients. METHODS A total of 184 cholelithiasis patients were matched in terms of age, gender, and BMI. They were divided into two groups based on their Homa IR levels (IR and Non-IR group). This study was a retrospective, observational study and clinical data was obtained from electronic medical records. Cutoff value for Tyg index was established through ROC Analysis. Binary Logistic Regression was used to identify factors affecting insulin resistance. RESULTS A significant cutoff value was found for the TyG index in determining the presence of insulin resistance. Having a TyG index of ≥8.71 indicates the presence of insulin resistance. The sensitivity was 68.48%, the specificity was 58.70%. Binary Logistic Regression analyses showed that an increase in Tyg Index, waist circumference and waist-to-height ratio values increases the risk of insulin resistance by 2.705 (p = 0.001), 1.032 (p = 0.029), and 334.057 (p = 0.012) times respectively. CONCLUSION Our study indicated that TyG index is positively correlated with HOMA-IR. TyG index was found as a risk factor for insulin resistance.
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Affiliation(s)
- Dogan Ozturk
- University of Health Sciences, Ankara Ataturk Sanatoryum Training and Research Hospital, Department of General Surgery, Ankara, Turkiye
| | - Aysegul Sivaslioglu
- Hacettepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Ankara, Turkiye.
| | - Hakan Bulus
- University of Health Sciences, Ankara Ataturk Sanatoryum Training and Research Hospital, Department of General Surgery, Ankara, Turkiye
| | - Bulent Ozturk
- University of Health Sciences, Ankara Ataturk Sanatoryum Training and Research Hospital, Department of General Surgery, Ankara, Turkiye
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Zhang B, Nie P, Lin Y, Ma Z, Ma G, Wang Y, Ma Y, Zhao J, Zhang J, Yue P, Jiang N, Zhang X, Tian L, Lu L, Yuan J, Meng W. High incidence of gallstones after Roux-en-Y reconstruction gastrectomy in gastric cancer: a multicenter, long-term cohort study. Int J Surg 2024; 110:2253-2262. [PMID: 38320088 PMCID: PMC11020035 DOI: 10.1097/js9.0000000000001136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/24/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Roux-en-Y reconstruction is a common anastomosis technique during gastrectomy in gastric cancer. There is a lack of studies on gallstones after Roux-en-Y reconstruction gastrectomy. This study investigated the incidence and potential risk factors associated with gallstones after Roux-en-Y reconstructive gastrectomy in gastric cancer. METHODS The study analyzed data from gastric cancer who underwent radical gastrectomy and Roux-en-Y reconstruction at two hospitals between January 2014 and December 2020. The patients fall into distal and total gastrectomy groups based on the extent of gastrectomy. The cumulative event probability curve was plotted using the Kaplan-Meier, and differences in gallstone between groups were evaluated using the Log-Rank. Propensity score matching was applied to construct a balanced total versus distal gastrectomies cohort. A Cox regression was employed to analyze the risk factors for gallstones after Roux-en-Y reconstructive gastrectomy in gastric cancer. Further subgroup analysis was performed. RESULTS Five hundred thirty-one patients were included in this study, 201 in the distal gastrectomy group and 330 in the total gastrectomy. During the follow-up, gallstones occurred in 170 cases after gastrectomy, of which 145 cases accounted for 85.29% of all stones in the first two years after surgery. Then, to reduce the impact of bias, a 1:1 propensity score matching analysis was performed on the two groups of patients. A total of 344 patients were evaluated, with each subgroup comprising 172 patients. In the matched population, the Cox regression analysis revealed that females, BMI ≥23 kg/m 2 , total gastrectomy, No.12 lymph node dissection, and adjuvant chemotherapy were risk factors for gallstones after Roux-en-Y reconstructive gastrectomy. Subgroup analysis showed that open surgery further increased the risk of gallstones after total gastrectomy. CONCLUSION The incidence of gallstones increased significantly within 2years after Roux-en-Y reconstructive gastrectomy for gastric cancer. Patients with these risk factors should be followed closely after gastrectomy to avoid symptomatic gallstones.
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Affiliation(s)
- Baoping Zhang
- The First Clinical Medical College, Lanzhou University
| | | | - Yanyan Lin
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou
| | - Zelong Ma
- The First Clinical Medical College, Lanzhou University
| | | | | | - Yuhu Ma
- Department of Anesthesiology
| | - Jinyu Zhao
- The First Clinical Medical College, Lanzhou University
| | - Jinduo Zhang
- The First Clinical Medical College, Lanzhou University
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou
| | - Ping Yue
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou
| | - Ningzu Jiang
- The First Clinical Medical College, Lanzhou University
| | | | - Liang Tian
- The First Clinical Medical College, Lanzhou University
| | - Linzhi Lu
- Department of Gastroenterology, Gansu Wuwei Tumor Hospital, Wuwei, Gansu
| | - Jinqiu Yuan
- Clinical Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, People’s Republic of China
| | - Wenbo Meng
- The First Clinical Medical College, Lanzhou University
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou
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13
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Tanabe MB, Caravedo MA, Clinton White A, Cabada MM. An Update on the Pathogenesis of Fascioliasis: What Do We Know? Res Rep Trop Med 2024; 15:13-24. [PMID: 38371362 PMCID: PMC10874186 DOI: 10.2147/rrtm.s397138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/27/2024] [Indexed: 02/20/2024] Open
Abstract
Fasciola hepatica is a trematode parasite distributed worldwide. It is known to cause disease in mammals, producing significant economic loses to livestock industry and burden to human health. After ingestion, the parasites migrate through the liver and mature in the bile ducts. A better understanding of the parasite's immunopathogenesis would help to develop efficacious therapeutics and vaccines. Currently, much of our knowledge comes from in vitro and in vivo studies in animal models. Relatively little is known about the host-parasite interactions in humans. Here, we provide a narrative review of what is currently know about the pathogenesis and host immune responses to F. hepatica summarizing the evidence available from the multiple hosts that this parasite infects.
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Affiliation(s)
- Melinda B Tanabe
- Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Maria A Caravedo
- Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - A Clinton White
- Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
- Cusco Branch – Alexander von Humboldt Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Miguel M Cabada
- Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
- Cusco Branch – Alexander von Humboldt Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco, Peru
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14
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Su DQ, Tian XF. Causal associations of cytokines and growth factors with cholelithiasis: a bidirectional Mendelian randomization study. Postgrad Med J 2024; 100:84-90. [PMID: 37857513 DOI: 10.1093/postmj/qgad101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/18/2023] [Accepted: 09/28/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND It has been reported that patients with cholelithiasis may have changes in levels of cytokines and growth factors, while their causal relationships were still unclear. METHODS This study was a bidirectional Mendelian randomization (MR) study. Datasets of 41 circulation cytokines and growth factors and the data on cholelithiasis were obtained. Six steps of strict instrumental variable filtration were set, and inverse-variance weighted analysis, MR-Egger regression, and weighted median test were used to identify the causal relationships. Benjamini-Hochberg method was used to adjust the P-values. RESULTS After adjustments of P-values, four cytokines and growth factors were still causally associated with cholelithiasis significantly: interleukin 2 receptor alpha (adjusted P: 4.59E-02), interleukin 8 (adjusted P: 1.09E-02), monocyte-specific chemokine 3 (adjusted P: 2.73E-04), and stem cell factor (adjusted P: 2.73E-04). In the reverse MR analysis, no significant causal relationship was detected after adjustment. CONCLUSIONS Four cytokines and growth factors, including interleukin 2 receptor alpha, interleukin 8, monocyte-specific chemokine 3, and stem cell factor, were proven to relate to cholelithiasis causally and unidirectionally.
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Affiliation(s)
- De-Qiang Su
- Department of Hepatopancreatobiliary Surgery, China-Japan Union Hospital of Jilin University, Changchun, 132000, China
| | - Xiao-Feng Tian
- Department of Hepatopancreatobiliary Surgery, China-Japan Union Hospital of Jilin University, Changchun, 132000, China
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15
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Pal SC, Castillo-Castañeda SM, Díaz-Orozco LE, Ramírez-Mejía MM, Dorantes-Heredia R, Alonso-Morales R, Eslam M, Lammert F, Méndez-Sánchez N. Molecular Mechanisms Involved in MAFLD in Cholecystectomized Patients: A Cohort Study. Genes (Basel) 2023; 14:1935. [PMID: 37895284 PMCID: PMC10606482 DOI: 10.3390/genes14101935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/05/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Gallstone disease and metabolic dysfunction-associated fatty liver disease (MAFLD) share numerous common risk factors and progression determinants in that they both manifest as organ-specific consequences of metabolic dysfunction. Nevertheless, the precise molecular mechanisms underlying fibrosis development in cholecystectomized MAFLD patients remain inadequately defined. This study aimed to investigate the involvement of farnesoid X receptor 1 (FXR1) and fibroblast growth factor receptor 4 (FGFR4) in the progression of fibrosis in cholecystectomized MAFLD patients. A meticulously characterized cohort of 12 patients diagnosed with MAFLD, who had undergone liver biopsies during programmed cholecystectomies, participated in this study. All enrolled patients underwent a follow-up regimen at 1, 3, and 6 months post-cholecystectomy, during which metabolic biochemical markers were assessed, along with elastography, which served as indirect indicators of fibrosis. Additionally, the hepatic expression levels of FGFR4 and FXR1 were quantified using quantitative polymerase chain reaction (qPCR). Our findings revealed a robust correlation between hepatic FGFR4 expression and various histological features, including the steatosis degree (r = 0.779, p = 0.023), ballooning degeneration (r = 0.764, p = 0.027), interphase inflammation (r = 0.756, p = 0.030), and steatosis activity score (SAS) (r = 0.779, p = 0.023). Conversely, hepatic FXR1 expression did not exhibit any significant correlations with these histological features. In conclusion, our study highlights a substantial correlation between FGFR4 expression and histological liver damage, emphasizing its potential role in lipid and glucose metabolism. These findings suggest that FGFR4 may play a crucial role in the progression of fibrosis in cholecystectomized MAFLD patients. Further research is warranted to elucidate the exact mechanisms through which FGFR4 influences metabolic dysfunction and fibrosis in this patient population.
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Affiliation(s)
- Shreya C. Pal
- Faculty of Medicine, National Autonomous University of Mexico, Tlalpan, Mexico City 04510, Mexico; (S.C.P.); (L.E.D.-O.)
| | - Stephany M. Castillo-Castañeda
- Medical, Dental and Health Sciences Master and Doctorate Program, National Autonomous University of Mexico, Tlalpan, Mexico City 04510, Mexico;
- Liver Research Unit, Medica Sur Clinic & Foundation, Tlalpan, Mexico City 14050, Mexico; (M.M.R.-M.); (R.D.-H.)
| | - Luis E. Díaz-Orozco
- Faculty of Medicine, National Autonomous University of Mexico, Tlalpan, Mexico City 04510, Mexico; (S.C.P.); (L.E.D.-O.)
| | - Mariana M. Ramírez-Mejía
- Liver Research Unit, Medica Sur Clinic & Foundation, Tlalpan, Mexico City 14050, Mexico; (M.M.R.-M.); (R.D.-H.)
- Plan of Combined Studies in Medicine, Faculty of Medicine, National Autonomous University of Mexico, Tlalpan, Mexico City 04510, Mexico
| | - Rita Dorantes-Heredia
- Liver Research Unit, Medica Sur Clinic & Foundation, Tlalpan, Mexico City 14050, Mexico; (M.M.R.-M.); (R.D.-H.)
| | - Rogelio Alonso-Morales
- Genetic and Molecular Biology Laboratory, Faculty of Veterinary, National Autonomous University of Mexico, Tlalpan, Mexico City 04510, Mexico;
| | - Mohammed Eslam
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, University of Sydney, Sydney, NSW 2145, Australia;
| | - Frank Lammert
- Health Sciences, Hannover Medical School (MHH), 30625 Hannover, Germany;
| | - Nahum Méndez-Sánchez
- Faculty of Medicine, National Autonomous University of Mexico, Tlalpan, Mexico City 04510, Mexico; (S.C.P.); (L.E.D.-O.)
- Liver Research Unit, Medica Sur Clinic & Foundation, Tlalpan, Mexico City 14050, Mexico; (M.M.R.-M.); (R.D.-H.)
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Mancha Chahuara M, Lopez Tufino LDM, Mugruza-Vassallo CA. Gastrointestinal microbiome and cholelithiasis: Prospect in the nervous system. World J Gastroenterol 2023; 29:5091-5093. [PMID: 37753368 PMCID: PMC10518737 DOI: 10.3748/wjg.v29.i34.5091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/25/2023] [Accepted: 08/29/2023] [Indexed: 09/08/2023] Open
Abstract
Dan and colleagues recently published research suggesting that the gastrointestinal microbiome (microorganisms and metabolites) in cholelithiasis. They reviewed gallbladder stones, choledocholithiasis, and asymptomatic gallstones. Finally, their discussion was on the gastrointestinal. We focused on complementing the effect of the S1 protein and neuroinflammatory changes caused by severe acute respiratory syndrome coronavirus 2. Our contribution was about to involve the microbiota and the nervous system. They can have similar functions because they have similar pathways and advantages, bearing in mind γ-aminobutyric acid in schizophrenia and serotonin in Parkinson's disease. Therefore in the next few years, more research should be encouraged on the microbiota consequences for development, and mobility.
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Affiliation(s)
- Mirella Mancha Chahuara
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima Chorrillos 15067, Lima, Peru
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Priyamvada S, Akhtar S. Editorial: Gut physiology-microbes and inflammatory diseases. Front Physiol 2023; 14:1254228. [PMID: 37546537 PMCID: PMC10401830 DOI: 10.3389/fphys.2023.1254228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 08/08/2023] Open
Affiliation(s)
- Shubha Priyamvada
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Suhail Akhtar
- Department of Biochemistry, A.T. Still University, Kirksville, MO, United States
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