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Article ; Online: Editorial: the increasing burden of microscopic colitis.

Guagnozzi, Danila / Tontini, Gian Eugenio / Pastorelli, Luca

2019 Volume 50, Issue 2, Page(s) 228–229

MeSH term(s)	Colitis, Lymphocytic ; Colitis, Microscopic ; Humans
Language	English
Publishing date	2019-07-25
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	639012-2
ISSN	1365-2036 ; 0269-2813 ; 0953-0673
ISSN (online)	1365-2036
ISSN	0269-2813 ; 0953-0673
DOI	10.1111/apt.15363
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Article ; Online: Colonic bacterial diversity and dysbiosis in active microscopic colitis as compared to chronic diarrhoea and healthy controls: effect of polyethylene glycol after bowel lavage for colonoscopy.

Batista, Lissette / Robles, Virginia / Manichanh, Chaysavanh / Ruiz, Laura / Guagnozzi, Danila / Pinsach, Ferran / Guarner, Francisco / Fernández-Bañares, Fernando

BMC gastroenterology

2022 Volume 22, Issue 1, Page(s) 320

Abstract: Background: Most microbiota studies in microscopic colitis patients are performed after diagnostic colonoscopy without considering the potential effect of colonic lavage. Patients may achieve clinical remission after colonoscopy and it is unknown ... ...

Abstract	Background: Most microbiota studies in microscopic colitis patients are performed after diagnostic colonoscopy without considering the potential effect of colonic lavage. Patients may achieve clinical remission after colonoscopy and it is unknown whether lavage-induced changes play a role. Aim: To assess the effect of polyethylene glycol (PEG) colonic lavage on clinical remission rate, microbial diversity, microbial dysbiosis index and specific microbial changes in patients with active microscopic colitis as compared to other diarrhoeal diseases and healthy controls. Methods: Fifty-five consecutive patients presenting chronic watery diarrhoea and 12 healthy controls were included. Faecal samples were collected three days before and 30 days after PEG in patients and controls for microbiome analysis. Results: Clinical remission was observed in 53% of microscopic colitis patients, and in 32% of non-microscopic colitis patients (p = 0.16). Considering patients with persisting diarrhoea after colonoscopy, 71% of non-microscopic colitis patients had bile acid diarrhoea. Baseline Shannon Index was lower in diarrhoea groups than in healthy controls (p = 0.0025); there were no differences between microscopic colitis, bile-acid diarrhoea and functional diarrhoea. The microbial dysbiosis index was significantly higher in microscopic colitis than in bile acid diarrhoea plus functional diarrhoea (p = 0.0095), but no bacterial species showed a significantly different relative abundance among the diarrheal groups. Conclusions: Dysbiosis is a feature in active microscopic colitis, but loss of microbial diversity was similar in all diarrheal groups, suggesting that faecal microbial changes are not due to microscopic colitis itself but associated with stool form. A considerable number of microscopic colitis patients achieved clinical remission after colonoscopy, but we were unable to demonstrate related PEG-induced changes in faecal microbiome.
MeSH term(s)	Bile Acids and Salts ; Colitis, Microscopic ; Colonoscopy ; Diarrhea/complications ; Dysbiosis ; Humans ; Polyethylene Glycols/therapeutic use ; Therapeutic Irrigation
Chemical Substances	Bile Acids and Salts ; Polyethylene Glycols (3WJQ0SDW1A)
Language	English
Publishing date	2022-06-28
Publishing country	England
Document type	Journal Article
ZDB-ID	2041351-8
ISSN	1471-230X ; 1471-230X
ISSN (online)	1471-230X
ISSN	1471-230X
DOI	10.1186/s12876-022-02392-w
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Article ; Online: Acute Stress Regulates Sex-Related Molecular Responses in the Human Jejunal Mucosa: Implications for Irritable Bowel Syndrome.

Rodiño-Janeiro, Bruno K / Pigrau, Marc / Salvo-Romero, Eloísa / Nieto, Adoración / Expósito, Elba / González-Castro, Ana M / Galán, Carmen / de Torres, Inés / Pribic, Teodora / Hernández, Laura / Lobo, Beatriz / Fortea, Marina / Gallart, Milagros / Pardo-Camacho, Cristina / Guagnozzi, Danila / Santos, Javier / Alonso-Cotoner, Carmen

Cells

2023 Volume 12, Issue 3

Abstract: Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder linked to intestinal barrier dysfunction and life stress. We have previously reported that female sex per se determines an increased susceptibility to intestinal barrier dysfunction ... ...

Abstract	Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder linked to intestinal barrier dysfunction and life stress. We have previously reported that female sex per se determines an increased susceptibility to intestinal barrier dysfunction after cold pain stress (CPS). We aimed to identify sex-related molecular differences in response to CPS in healthy subjects to understand the origin of sex bias predominance in IBS. In 13 healthy males and 21 females, two consecutive jejunal biopsies were obtained using Watson's capsule, at baseline, and ninety minutes after CPS. Total mucosal RNA and protein were isolated from jejunal biopsies. Expression of genes related to epithelial barrier (
MeSH term(s)	Male ; Humans ; Female ; Irritable Bowel Syndrome/genetics ; Irritable Bowel Syndrome/metabolism ; Jejunum/metabolism ; Jejunum/pathology ; Intestinal Mucosa/pathology ; Intestines/pathology ; Biopsy
Language	English
Publishing date	2023-01-27
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2661518-6
ISSN	2073-4409 ; 2073-4409
ISSN (online)	2073-4409
ISSN	2073-4409
DOI	10.3390/cells12030423
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Article ; Online: Anemia in inflammatory bowel disease: a neglected issue with relevant effects.

Guagnozzi, Danila / Lucendo, Alfredo J

World journal of gastroenterology

2014 Volume 20, Issue 13, Page(s) 3542–3551

Abstract: Anemia, a common complication associated with inflammatory bowel disease (IBD), is frequently overlooked in the management of IBD patients. Unfortunately, it represents one of the major causes of both decreased quality of life and increased hospital ... ...

Abstract	Anemia, a common complication associated with inflammatory bowel disease (IBD), is frequently overlooked in the management of IBD patients. Unfortunately, it represents one of the major causes of both decreased quality of life and increased hospital admissions among this population. Anemia in IBD is pathogenically complex, with several factors contributing to its development. While iron deficiency is the most common cause, vitamin B12 and folic acid deficiencies, along with the effects of pro-inflammatory cytokines, hemolysis, drug therapies, and myelosuppression, have also been identified as the underlying etiology in a number of patients. Each of these etiological factors thus needs to be identified and corrected in order to effectively manage anemia in IBD. Because the diagnosis of anemia in IBD often presents a challenge, combinations of several hematimetric and biochemical parameters should be used. Recent studies underscore the importance of determining the ferritin index and hepcidin levels in order to distinguish between iron deficiency anemia, anemia due to chronic disease, or mixed anemia in IBD patients. With regard to treatment, the newly introduced intravenous iron formulations have several advantages over orally-administered iron compounds in treating iron deficiency in IBD. In special situations, erythropoietin supplementation and biological therapies should be considered. In conclusion, the management of anemia is a complex aspect of treating IBD patients, one that significantly influences the prognosis of the disease. As a consequence, its correction should be considered a specific, first-line therapeutic goal in the management of these patients.
MeSH term(s)	Anemia/complications ; Anemia, Iron-Deficiency/complications ; Cytokines/metabolism ; Dietary Supplements ; Erythropoietin/therapeutic use ; Ferritins/blood ; Folic Acid Deficiency/complications ; Hemolysis ; Hepcidins/blood ; Humans ; Inflammatory Bowel Diseases/complications ; Iron/administration & dosage ; Prognosis ; Quality of Life ; Vitamin B 12 Deficiency/complications
Chemical Substances	Cytokines ; Hepcidins ; Erythropoietin (11096-26-7) ; Ferritins (9007-73-2) ; Iron (E1UOL152H7)
Language	English
Publishing date	2014-02-24
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2185929-2
ISSN	2219-2840 ; 1007-9327
ISSN (online)	2219-2840
ISSN	1007-9327
DOI	10.3748/wjg.v20.i13.3542
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Article ; Online: Advances in knowledge on microscopic colitis

Danila Guagnozzi / Alfredo J. Lucendo

Revista Espanola de Enfermedades Digestivas, Vol 107, Iss 2, Pp 98-

from bench to bedside

2015 Volume 108

Abstract: Microscopic colitis (MC) is a general term that describes a family of chronic inflammatory bowel diseases, including lymphocytic colitis (LC) and collagenous colitis (CC). The two forms are characterized by chronic watery diarrhea with normal or near ... ...

Abstract	Microscopic colitis (MC) is a general term that describes a family of chronic inflammatory bowel diseases, including lymphocytic colitis (LC) and collagenous colitis (CC). The two forms are characterized by chronic watery diarrhea with normal or near normal endoscopic colonic appearance and specific histopathological abnormalities. Data from recent epidemiological studies reported the diagnosis of MC from several different regions in the world, providing that it can be a worldwide condition. The etiopathogenesis of MC still remains unknown but it is generally accepted that MC is a multifactorial disease, probably secondary to an abnormal immune reaction in predisposed individuals, triggered by different luminal factors (infections, drugs, autoimmunity and/or bile acids). Furthermore, some studies show that the epithelial barrier function in the colonic mucosa of MC patients is also impaired. Several mucosal factors of intestinal inflammation have been studied in MC, postulating that an aberrant T-lymphocyte response may lead to a chronic gut inflammatory condition, with the infiltration of colonic mucosa by different proportion of subset of T-lymphocytes. Little is known about the specific inflammatory mediators in MC pathogenesis, but a predominant Th1 type cytokine profile has been demonstrated. Currently, a number of medical treatments have been studied in MC patients, following mainly an empirical treatment approach. Further studies are needed in order to obtain prospective and more evidence-based data. In the future, it will be possible to develop causal treatment approaches after better understanding the molecular mechanisms behind the origin of the disease.
Keywords	Microscopic colitis ; Lymphocytic colitis ; Collagenous colitis ; Pathogenesis ; Therapeutics ; T-lymphocytes ; Medicine ; R ; Internal medicine ; RC31-1245 ; Specialties of internal medicine ; RC581-951 ; Diseases of the digestive system. Gastroenterology ; RC799-869
Subject code	610
Publishing date	2015-02-01T00:00:00Z
Publisher	The Spanish Society of Digestive Pathology
Document type	Article ; Online
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Article ; Online: Towards a new paradigm of microscopic colitis: Incomplete and variant forms.

Guagnozzi, Danila / Landolfi, Stefania / Vicario, Maria

World journal of gastroenterology

2016 Volume 22, Issue 38, Page(s) 8459–8471

Abstract: Microscopic colitis (MC) is a chronic inflammatory bowel disease that has emerged in the last three decades as a leading cause of chronic watery diarrhoea. MC classically includes two main subtypes: lymphocytic colitis (LC) and collagenous colitis (CC). ... ...

Abstract	Microscopic colitis (MC) is a chronic inflammatory bowel disease that has emerged in the last three decades as a leading cause of chronic watery diarrhoea. MC classically includes two main subtypes: lymphocytic colitis (LC) and collagenous colitis (CC). Other types of histopathological changes in the colonic mucosa have been described in patients with chronic diarrhoea, without fulfilling the conventional histopathological criteria for MC diagnosis. Whereas those unclassified alterations remained orphan for a long time, the use of the term incomplete MC (MCi) is nowadays universally accepted. However, it is still unresolved whether CC, LC and MCi should be considered as one clinical entity or if they represent three related conditions. In contrast to classical MC, the real epidemiological impact of MCi remains unknown, because only few epidemiological studies and case reports have been described. MCi presents clinical characteristics indistinguishable from complete MC with a good response to budesonide and cholestiramine. Although a number of medical treatments have been assayed in MC patients, currently, there is no causal treatment approach for MC and MCi, and only empirical strategies have been performed. Further studies are needed in order to identify their etiopathogenic mechanisms, and to better classify and treat MC.
MeSH term(s)	Biopsy/adverse effects ; Budesonide/therapeutic use ; Cholestyramine Resin/therapeutic use ; Colitis, Collagenous/classification ; Colitis, Collagenous/diagnosis ; Colitis, Collagenous/epidemiology ; Colitis, Lymphocytic/classification ; Colitis, Lymphocytic/diagnosis ; Colitis, Lymphocytic/epidemiology ; Collagen/chemistry ; Colon/pathology ; Diagnosis, Differential ; Diarrhea/diagnosis ; Humans ; Immunohistochemistry ; Inflammatory Bowel Diseases/diagnosis ; Intestinal Mucosa/pathology ; Sex Factors
Chemical Substances	Cholestyramine Resin (11041-12-6) ; Budesonide (51333-22-3) ; Collagen (9007-34-5)
Language	English
Publishing date	2016-10-14
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2185929-2
ISSN	2219-2840 ; 1007-9327
ISSN (online)	2219-2840
ISSN	1007-9327
DOI	10.3748/wjg.v22.i38.8459
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Article ; Online: Colorectal cancer surveillance in patients with inflammatory bowel disease: What is new?

Guagnozzi, Danila / Lucendo, Alfredo J

World journal of gastrointestinal endoscopy

2012 Volume 4, Issue 4, Page(s) 108–116

Abstract: Several studies assessing the incidence of colorectal cancer (CRC) in inflammatory bowel disease (IBD) patients have found an increased risk globally estimated to be 2 to 5 times higher than for the general population of the same age group. The real ... ...

Abstract	Several studies assessing the incidence of colorectal cancer (CRC) in inflammatory bowel disease (IBD) patients have found an increased risk globally estimated to be 2 to 5 times higher than for the general population of the same age group. The real magnitude of this risk, however, is still open to debate. Research is currently being carried out on several risk and protective factors for CRC that have recently been identified in IBD patients. A deeper understanding of these factors could help stratify patient risk and aid specialists in choosing which surveillance program is most efficient. There are several guidelines for choosing the correct surveillance program for IBD patients; many present common characteristics with various distinctions. Current recommendations are far from perfect and have important limitations such as the fact that their efficiency has not been demonstrated through randomized controlled trials, the limited number of biopsies performed in daily endoscopic practice, and the difficulty in establishing the correct time to begin a given surveillance program and maintain a schedule of surveillance. That being said, new endoscopic technologies should help by replacing random biopsy protocols with targeted biopsies in IBD patients, thereby improving the efficiency of surveillance programs. However, further studies are needed to evaluate the cost-effectiveness of introducing these techniques into daily endoscopic practice.
Language	English
Publishing date	2012-01-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573698-X
ISSN	1948-5190 ; 1948-5190
ISSN (online)	1948-5190
ISSN	1948-5190
DOI	10.4253/wjge.v4.i4.108
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Article ; Online: Small bowel video capsule endoscopy in Crohn's disease: What have we learned in the last ten years?

Lucendo, Alfredo J / Guagnozzi, Danila

World journal of gastrointestinal endoscopy

2011 Volume 3, Issue 2, Page(s) 23–29

Abstract: Since its introduction in 2001, capsule endoscopy (CE) has become the most important advance in the study of small bowel disease, including Crohn's disease (CD). This technique has been demonstrated to be superior to all other current forms of ... ...

Abstract	Since its introduction in 2001, capsule endoscopy (CE) has become the most important advance in the study of small bowel disease, including Crohn's disease (CD). This technique has been demonstrated to be superior to all other current forms of radiological investigation in detecting mucosal abnormalities of small bowel nonstricturing CD. CE has proven to be extremely useful in diagnosing CD in patients with inconclusive findings from ileocolonoscopy and x-ray-based studies. Almost half of all patients with CD involving the ileum also present lesions in proximal intestinal segments, with the small bowel being exclusively involved in up to 30% of all CD cases. Despite the widespread use of CE, several questions concerning the utility of this technique remain unanswered. The lack of commonly agreed diagnostic criteria for defining CD lesions with the aid of CE may have had an influence on the variation in diagnostic results for CE reported in the literature. The utility of CE in monitoring CD and in guiding therapy has also been proposed. Furthermore, CE could be a useful second-line technique for patients with an established diagnosis of CD and unexplained symptoms. Finally, as no threshold for CD diagnosis has been agreed upon, a severity scale of mucosal disease activity has not been universally followed. None of the available activity indexes based on CE findings has been independently validated. This article discusses several cutting-edge aspects of the usefulness of CE in CD 10 years after its introduction as a sensible method to study the small intestine.
Language	English
Publishing date	2011-02-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573698-X
ISSN	1948-5190 ; 1948-5190
ISSN (online)	1948-5190
ISSN	1948-5190
DOI	10.4253/wjge.v3.i2.23
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Article ; Online: Editorial: tissue findings fail to predict disease activity or prognosis in microscopic colitis-an opportunity to look at the molecular level-authors' reply.

Olsen, Laerke Müller / Engel, Peter Johan Heiberg / Goudkade, Danny / Villanacci, Vincenzo / Thagaard, Jeppe / Walbech, Julie Sparholt / Bohr, Johan / Kupcinskas, Juozas / Verhaegh, Bas / Münch, Andreas / Guagnozzi, Danila / Fernández-Bañares, Fernando / Munck, Lars Kristian / Fiehn, Anne-Marie Kanstrup

Alimentary pharmacology & therapeutics

2021 Volume 54, Issue 2, Page(s) 194–195

MeSH term(s)	Colitis ; Colitis, Microscopic/diagnosis ; Colitis, Microscopic/epidemiology ; Humans ; Prognosis
Language	English
Publishing date	2021-06-25
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	639012-2
ISSN	1365-2036 ; 0269-2813 ; 0953-0673
ISSN (online)	1365-2036
ISSN	0269-2813 ; 0953-0673
DOI	10.1111/apt.16409
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Article: Present and Future Therapeutic Approaches to Barrier Dysfunction.

Fortea, Marina / Albert-Bayo, Mercé / Abril-Gil, Mar / Ganda Mall, John-Peter / Serra-Ruiz, Xavier / Henao-Paez, Alejandro / Expósito, Elba / González-Castro, Ana María / Guagnozzi, Danila / Lobo, Beatriz / Alonso-Cotoner, Carmen / Santos, Javier

Frontiers in nutrition

2021 Volume 8, Page(s) 718093

Abstract: There is converging and increasing evidence, but also uncertainty, for the role of abnormal intestinal epithelial barrier function in the origin and development of a growing number of human gastrointestinal and extraintestinal inflammatory disorders, and ...

Abstract	There is converging and increasing evidence, but also uncertainty, for the role of abnormal intestinal epithelial barrier function in the origin and development of a growing number of human gastrointestinal and extraintestinal inflammatory disorders, and their related complaints. Despite a vast literature addressing factors and mechanisms underlying changes in intestinal permeability in humans, and its connection to the appearance and severity of clinical symptoms, the ultimate link remains to be established in many cases. Accordingly, there are no directives or clinical guidelines related to the therapeutic management of intestinal permeability disorders that allow health professionals involved in the management of these patients to carry out a consensus treatment based on clinical evidence. Instead, there are multiple pseudoscientific approaches and commercial propaganda scattered on the internet that confuse those affected and health professionals and that often lack scientific rigor. Therefore, in this review we aim to shed light on the different therapeutic options, which include, among others, dietary management, nutraceuticals and medical devices, microbiota and drugs, and epigenetic and exosomes-manipulation, through an objective evaluation of the scientific publications in this field. Advances in the knowledge and management of intestinal permeability will sure enable better options of dealing with this group of common disorders to enhance quality of life of those affected.
Language	English
Publishing date	2021-10-28
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2776676-7
ISSN	2296-861X
ISSN	2296-861X
DOI	10.3389/fnut.2021.718093
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