Author Interviews, Gastrointestinal Disease, JAMA, Lymphoma / 08.11.2017

MedicalResearch.com Interview with: ANSMRosemary Dray-Spira, MD, PhD Department of Epidemiology French National Agency for Medicines and Health Products Safety (ANSM) Saint-Denis, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: Anti-tumor necrosis factor (anti-TNF) agents are increasingly used for the management of inflammatory bowel diseases (IBD), either alone or in combination with thiopurines. Their clinical benefits have been largely assessed, however they may expose to potentially serious adverse effects. While an increased risk of lymphoma has been established with thiopurines, up to now such a risk of lymphoma remained uncertain with anti-TNF agents. In this study based upon a large, nationwide cohort of 189,289 patients with IBD, the use of anti-TNF agents alone was found associated with a 2 to 3 fold increase in the risk of lymphoma, similarly to thiopurines alone. In addition, the combination of these two treatments was associated with a 6 fold increase in the risk of lymphoma, ie a higher risk than with each treatment used alone. Although these differences are statistically significant, the risk of lymphoma among patients exposed to anti-TNF agents is less than 1 case per 1000 person-years.
Author Interviews, Gastrointestinal Disease / 06.11.2017

MedicalResearch.com Interview with: [caption id="attachment_38003" align="alignleft" width="133"]Eamonn M.M. Quigley, M.D. Director, Lynda K. and David M. Underwood Center for Digestive Disorders Houston Methodist Hospital Dr. Quigley[/caption] Eamonn M.M. Quigley, M.D. Director, Lynda K. and David M. Underwood Center for Digestive Disorders Houston Methodist Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: The BURDEN IBS-C (Better Understanding and Recognition of the Disconnects, Experiences, and Needs of Patients with Irritable Bowel Syndrome with Constipation) Study was designed to develop a better understanding of the experiences and attitudes associated with IBS-C. This study consisted of more than 1,300 individuals who met IBS-C criteria (mean age 46 years; 73 percent of respondents were female) and completed the author-developed, IRB-approved online questionnaire. The study also evaluated, through an approximately 45-minute long questionnaire, more than 325 healthcare providers who treat patients with IBS-C. Notably, the study found many patients experienced stress, lost productivity and described a feeling of frustration with their condition. HCPs recognize this frustration, yet underestimate how many patients have “accepted” their condition. Both patients and healthcare providers (HCPs) also noted a lack of satisfaction in currently available prescription treatments for IBS-C. Detailed findings can be found here.
Author Interviews, Gastrointestinal Disease, Kidney Disease / 06.11.2017

MedicalResearch.com Interview with: Charat Thongprayoon, MD Bassett Medical Center Cooperstown, NY 13326 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We conducted a meta-analysis including 5 observational studies with 536,902 patients to assess the risks of chronic kidney disease (CKD) and/or end-stage kidney disease (ESRD) in patients who are taking proton pump inhibitors (PPIs) and/or H2 receptor antagonists (H2RAs). We found a statistically significant association between the use of PPI and 1.3-fold increased risk of CKD or ESRD development. Compared with H2Ras, the use of proton pump inhibitors was significantly associated with 1.3-fold higher risk for CKD development. Conversely, there was no significant association between the use of H2RAs and chronic kidney disease.
Author Interviews, Gastrointestinal Disease, Pharmaceutical Companies, University of Michigan / 23.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37675" align="alignleft" width="106"]William D. Chey Dr. Chey[/caption] William D. Chey, M.D., F.A.C.G. Timothy T. Nostrant Professor of Gastroenterology & Nutrition Director, Digestive Disorders Nutrition & Lifestyle Program Michigan Medicine Ann Arbor, Michigan  MedicalResearch.com: What is the background for this study? Response: Functional Dyspepsia (FD) has been characterized as recurring indigestion with no known organic cause and is an area of high unmet medical need. This medical condition, which is non-life threatening, can have a significant impact on an individual’s quality of life. It remains poorly recognized and presents a significant management challenge for providers and patients. Gastrointestinal symptoms can include epigastric pain or discomfort, inability to finish a normal-sized meal, heaviness, pressure, nausea, bloating and belching. Currently, there are no FDA-approved drugs for FD. Off-label medications are used to treat the condition and patient dissatisfaction remains high.[1] In a real-world, observational study, called FDACT™ (Functional Dyspepsia Adherence and Compliance Trial), we analyzed information on the frequency of FD symptoms, daily consumption of capsules, onset of action, improvement in FD symptoms, quality of life and patient satisfaction among 600 patients who took FDgard®, a nonprescription medical food specially formulated for the dietary management of FD.
Author Interviews, Gastrointestinal Disease, Kidney Disease, Microbiome, Supplements / 19.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37590" align="alignleft" width="150"]Ron Walborn Jr. Prebiotin CEO Ron Walborn Jr.[/caption] Ron Walborn Jr. Prebiotin CEO  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The product Prebiotin™ Prebiotic Fiber was brought to market in 2007 by Dr. Frank Jackson, a gastroenterologist out of Harrisburg, PA. He found through 40 years of experience with his patients that a variety of digestive issues benefitted from daily supplementation with a soluble prebiotic fiber, specifically, oligofructose-enriched inulin (OEI) derived from chicory root. In the late summer of 2012, Prebiotin caught the attention of Dr. Dominic Raj at the Internal Medicine Department of George Washington University. Dr. Raj’s laboratory showed that patients with kidney disease may have a higher level of release of endotoxins like p-Cresol sulfate and indole from the bacteria in the gut, which can move into the bloodstream and promote inflammation. This early work was the basis of a successful grant application. Researchers were interested in investigating the therapeutic potential of altering the composition and/or function of the gut microbiome in this patient population, based on the understanding that by building up the levels of healthy bacteria in the gut, undesirable bacteria is eventually crowded out, thereby reducing the release of harmful endotoxins into the system.
Author Interviews, Gastrointestinal Disease, Global Health, Lancet / 18.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37559" align="alignleft" width="150"]Gilaad Kaplan, MD, MPH, FRCPC Associate Professor  CIHR New Investigator & AI-HS Population Health Investigator Co-Director, Environmental Health Research Group Snyder Institute for Chronic Diseases & Institute of Public Health Departments of Medicine & Community Health Sciences University of Calgary Dr. Kaplan[/caption] Gilaad Kaplan, MD, MPH, FRCPC Associate Professor CIHR New Investigator & AI-HS Population Health Investigator Co-Director, Environmental Health Research Group Snyder Institute for Chronic Diseases & Institute of Public Health Departments of Medicine & Community Health Sciences University of Calgary MedicalResearch.com: What is the background for this study? What are the main findings? Response: The aim of the study was to provide a global perspective on the epidemiology of the inflammatory bowel diseases in the 21st century. During the 20th century IBD was considered a disease of the Western world. At the turn of the 21st century, IBD has become a global disease with accelerating number of cases in the developing world as it transition towards a westernized society.
Aging, Author Interviews, Gastrointestinal Disease, Microbiome / 18.10.2017

MedicalResearch.com Interview with: Greg Gloor, PhD Principal investigator Professor at Western's Schulich School of Medicine & Dentistry and Scientist at Lawson Health Research Institute. MedicalResearch.com: What is the background for this study? What are the main findings? Response: We sampled the bacteria in the gut (stool) in over 1000 members of a super healthy population in China across the age ranges of 3 to over 100. Exclusion criteria included a history of genetic or chronic disease (intergenerational in the case of people younger than 30), no smoking, drinking or drug use (including no prescription drugs). Our goal was to identify what, if any changes in the makeup of the gut microbiota occurred in this population so that we could define "what is associated with health". We found three things.
  • First, that the expected differences between the very young and everyone else were found in this population. This indicates that we could observe the standards signatures of a maturing gut microbiota.
  • Second, that the gut microbiota of very healthy very elderly group (over 95 yo) was very similar to that of any very healthy person over the age of 30.
  • Third, we found that the gut microbiota of 20yo people (in three distinct groups) was different from all other age groups. The reason for the differences observed in the 20 yo groups from all the others is unknown, but is not methodological in origin.
Author Interviews, Gastrointestinal Disease, Pharmacology / 15.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37464" align="alignleft" width="139"]Brooks D. Cash, M.D., A.G.A.F., F.A.C.G., F.A.S.G.E. Professor of Medicine and Chief of the USA Gastroenterology Division Director, Motility and Physiology Service University of South Alabama Mobile, Alabama Dr. Cash[/caption] Brooks D. Cash, M.D., A.G.A.F., F.A.C.G., F.A.S.G.E. Professor of Medicine and Chief of the USA Gastroenterology Division Director, Motility and Physiology Service University of South Alabama Mobile, Alabama  MedicalResearch.com: What is the background for this study? Response: Irritable Bowel Syndrome (IBS) among patients with IBS-M (mixed diarrhea and constipation) is a challenging and difficult to diagnose and treat sub-type of IBS. Patients with IBS-M represent a dissatisfied group of IBS patients due to the lack of proven therapies. It is an area of high unmet medical need. Among adult patients with IBS, a sizeable proportion suffers from IBS-M with prevalence rates estimated to be between 44 to 66 percent of IBS sufferers[1],[2],[3]. IBS-M patients carry a heavy burden, characterized by bouts of constipation interrupted by diarrhea and vice versa. Physicians find IBS-M challenging to manage because of the difficulty in avoiding ‘overshoots’ when diarrhea management can turn into constipation and vice versa.[4] 
Author Interviews, Gastrointestinal Disease, JAMA, Surgical Research / 04.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37370" align="alignleft" width="132"]Marc D. Basson, MD, PhD, MBA Professor of Surgery, Pathology, and Biomedical Science Senior Associate Dean for Medicine and Research University of North Dakota School of Medicine & Health Sciences Grand Forks, ND 58202 Dr. Basson[/caption] Marc D. Basson, MD, PhD, MBA Professor of Surgery, Pathology, and Biomedical Science Senior Associate Dean for Medicine and Research University of North Dakota School of Medicine & Health Sciences Grand Forks, ND 58202  MedicalResearch.com: What is the background for this study? What are the main findings? Response: I and other surgeons have previously had the experience of caring for patients with appendicitis who had recently undergone colonoscopy, and wondered if there might be a connection.  However, colonoscopy and appendicitis are both common events, and so it would be difficult to tell whether they are linked or just coincidences from scattered occurrences. After obtaining appropriate regulatory approvals, we identified almost 400,000 veterans from the US Department of Veterans Affairs database who had undergone screening colonoscopy and compared their rates of appendectomy and acute appendicitis in the week following colonoscopy to rates of appendectomy and appendicitis over each of the following 51 weeks.  We asked the question in several different ways and verified our results by examining surgical and pathology reports.  Depending on how the question was asked and appendicitis or appendectomy defined, rates of appendectomy and appendicitis were clearly 4-9 times higher in the first week after diagnostic colonoscopy.  This wasn’t true when we asked whether appendectomy was more common after several other procedures that also required sedation and contact with the medical system.
Author Interviews, Coffee, Gastrointestinal Disease, Hepatitis - Liver Disease / 03.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37320" align="alignleft" width="200"]Coffee Wikipedia image Coffee
Wikipedia image[/caption] Patrizia Carrieri PhD INSERM U912 - ORS PACA IHU - Faculté de Médecine Marseille, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study is based on the longitudinal data of the French  ANRS HEPAVIH cohort of patients with HIV and Hepatitis C co-infection. This cohort was set up thanks to a collaboration between INSERM (National Institute of health and medical research) UMR912 in Marseille, the ISPED (public health and epidemiology institute) in Bordeaux and several hospital/university sites. Our INSERM team in Marseille is specialized in the study of the impact of behaviors on HIV and HCV outcomes, including mortality. We could think that HCV cure was enough to reduce mortality in HIV-HCV patients as the mortality risk was 80% lower in those who were cured of (i.e. who “cleared”) Hepatitis C thanks to treatment. However, our study showed that, even after HCV cure, sociobehavioral factors still matter: drinking at least 3 cups of coffee a day was associated with a 50% reduction in mortality risk as well as not smoking which was also associated with a reduced mortality risk. This association between elevated coffee intake and reduced mortality risk is probably due to the properties of polyphenols contained in coffee which can protect the liver and also reduce inflammation.
Author Interviews, Diabetes, Gastrointestinal Disease, Lancet, Mayo Clinic, Weight Research / 29.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37242" align="alignleft" width="125"]Prof Michael Camilleri, MD Gastroenterologist, Professor of Medicine, Pharmacology and Physiology at Mayo Clinic Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Mayo Clinic, Rochester, MN Prof. Camilleri[/caption] Prof Michael Camilleri, MD Gastroenterologist, Professor of Medicine, Pharmacology and Physiology at Mayo Clinic Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Mayo Clinic, Rochester, MN MedicalResearch.com: What is the background for this study? What are the main findings? Response: Liraglutide is approved for treatment of obesity; the precise mechanisms for the beneficial weight loss are unclear. We are interested to learn whether it is possible to identify people who are more likely to benefit from this treatment.
Author Interviews, Cancer Research, Gastrointestinal Disease, Infections, Nature, Stem Cells / 20.08.2017

MedicalResearch.com Interview with: Michael Sigal PhD Clinical scientist of the Charité -- Universitätsmedizin Berlin Investigator at the Max Planck Institute for Infection Biology  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have previously found that H. pylori can colonize gastric glands and that in colonized glands the epithelial turnover was increased. We wanted to characterize the mechanisms that control the gland turnover in the stomach. We found that Axin2, a classic Wnt target gene, marks two different subpopulations of cells with stem cell properties, one of which is Lgr5-positive and the other one Lgr5-negative. Both populations are affected by Rspondin 3, that is produced in myofibroblasts right beneath the stem cell compartment. Rspondin is crucial for stem cell signaling and knockout of Rspondin 3 in myofibroblasts results in loss of Lgr5 and Axin2 expression. Once we increased the bioavailability of Rspondin, that now could also interact with cells outside of the stem cell compartment, we noticed that the number of Axin2 positive stem cells dramatically increased. Of interest, only Lgr5-negative cells expanded in number and proliferate more, while the Lgr5-positive cells remained silenced. Infection with Helicobacter pylori leads to an expansion of Axin2-positive cells which is driven by increased expression of Rspondin3. Expansion of the long lived stem cell pool could be an explanation for how H. pylori infection increases the risk for gastric cancer.
Author Interviews, Gastrointestinal Disease, JAMA / 15.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36440" align="alignleft" width="200"]Maureen Leonard, MD MMSc Clinical Director, Center for Celiac Research and Treatment Instructor in Pediatrics, Harvard Medical School Associate Investigator, Nutrition Obesity Research Center, Harvard Medical School MassGeneral Hospital for Children | Pediatric Gastroenterology & Nutrition Dr. Leonard[/caption] Maureen Leonard, MD MMSc Clinical Director, Center for Celiac Research and Treatment Instructor in Pediatrics Associate Investigator, Nutrition Obesity Research Center Harvard Medical School Pediatric Gastroenterology & Nutrition MassGeneral Hospital for Children   MedicalResearch.com: What is the background for this study? What are the main findings? Response: In this systematic review, we discuss the clinical approach to celiac disease and nonceliac gluten sensitivity, highlighting how to distinguish between these two conditions and their management. These disorders cannot be distinguished based on symptoms. A single elevated serology test is not diagnostic for celiac disease, and patients with abnormal serologic testing must be referred to a gastroenterologist for further testing and remain on a gluten-containing diet until their diagnostic evaluation is completed. While the treatment for both conditions is a gluten-free diet, the possibility of long-term complications differs.
Author Interviews, Gastrointestinal Disease, Microbiome / 28.07.2017

MedicalResearch.com Interview with: [caption id="attachment_36197" align="alignleft" width="126"]Eric I. Benchimol, MD, PhD, FRCPC Associate Professor of Pediatrics and Epidemiology, University of Ottawa Division of Gastroenterology, Hepatology and Nutrition Children's Hospital of Eastern Ontario Ottawa, ON Canada Dr. Benchimol[/caption] Eric I. Benchimol, MD, PhD, FRCPC Associate Professor of Pediatrics and Epidemiology, University of Ottawa Division of Gastroenterology, Hepatology and Nutrition Children's Hospital of Eastern Ontario Ottawa, ON Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: We found that living in a rural household (compared to urban households) was protective against developing inflammatory bowel disease (IBD). People living in a rural household were around 10% less likely to get IBD (Crohn’s disease and ulcerative colitis). While our finding that IBD was more common in people living in urban households was similar to other studies from around the world, there were a number of new, interesting findings:
  1. Living in a rural household was most protective against pediatric-onset IBD. In fact, it was not protective in IBD with onset between ages 18-39, 40-64, or 65 and older at diagnosis.
  2. Living in a rural household in the first 5 years of life was highly protective against IBD later in life.
These findings indicate the importance of early life environmental exposures in the subsequent development of IBD. This effect has been seen in the inflammatory bowel disease literature when examining other environmental risk factors, particularly early-life antibiotic use and air pollution. These risk factors seem to have the strongest effect of increasing the risk of childhood-onset IBD, and not adult-onset disease.
Author Interviews, Autism, Gastrointestinal Disease, Nutrition / 14.07.2017

MedicalResearch.com Interview with: [caption id="attachment_35911" align="alignleft" width="200"]Bradley James Ferguson, PhD University of Missouri School of Medicine Dr. Ferguson[/caption] Bradley James Ferguson, PhD University of Missouri School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many individuals with autism spectrum disorder (ASD) have gastrointestinal problems, such as constipation, irritable bowel syndrome and abdominal pain, but the cause of these GI issues is not currently known. Previous research from our laboratory showed a significant positive relationship between cortisol levels and GI problems, especially for constipation. However, it is possible that other factors such as diet may affect GI functioning, especially since many children have altered diets. This study examined 32 different nutrients in the children’s diets, as assessed by a food frequency questionnaire that assessed the participant’s diet over the past month, and how each nutrient was related to upper and lower GI tract symptom scores over the past month created from the Questionnaire on Pediatric Gastrointestinal Symptoms – Rome III. The results showed no significant relationships between any of the nutrients and GI symptoms, suggesting that diet was not associated with GI symptoms in this sample.
Author Interviews, BMJ, Gastrointestinal Disease / 09.07.2017

MedicalResearch.com Interview with: [caption id="attachment_35797" align="alignleft" width="145"]Ziyad Al-Aly MD FASN Assistant Professor of Medicine Co-director for Clinical Epidemiology Center Department of Medicine, Washington University School of Medicine Saint Louis, Missouri Dr. Ziyad Al-Aly[/caption] Ziyad Al-Aly MD FASN Assistant Professor of Medicine Co-director for Clinical Epidemiology Center Department of Medicine, Washington University School of Medicine Saint Louis, Missouri Associate Chief of Staff for Research and Education Veterans Affairs Saint Louis Health Care System MedicalResearch.com: What is the background for this study? What are the main findings? Response: Proton Pump Inhibitors (PPI) are commonly used, and they are associated with adverse events including kidney disease, dementia, fractures, cardiovascular disease, and pneumonia. We asked the question of whether this translates to increased risk of death. We conducted this large cohort study to specifically examine the association between PPI use and risk of death. The results consistently showed an association between use of PPI and increased mortality risk. Moreover, there was a graded relationship between duration of PPI use and risk of death in that longer duration of use was associated with incrementally higher risk of death.
Author Interviews, Gastrointestinal Disease, Pediatrics, Weight Research / 10.06.2017

MedicalResearch.com Interview with: [caption id="attachment_35183" align="alignleft" width="150"]Raylene Reimer, PhD, RD Professor, Faculty of Kinesiology University of Calgary Department of Biochemistry & Molecular Biology Cumming School of Medicine Full Scientist Alberta Children's Hospital Research Institute Dr. Reimer[/caption] Raylene Reimer, PhD, RD Professor, Faculty of Kinesiology University of Calgary Department of Biochemistry & Molecular Biology Cumming School of Medicine Full Scientist Alberta Children's Hospital Research Institute MedicalResearch.com: What is the background for this study? Response: The human gut microbiota is a complex and dynamic population of microorganisms that benefit the human host through a variety of microbial activities (e.g. production of vitamins, immune regulation, utilization of dietary fiber). Despite these benefits however, it is now recognized that disruption of the microbiota (dysbiosis) can upset homeostasis and contribute to diseases such as obesity and type 2 diabetes. Manipulation of the gut microbiota to prevent or treat chronic disease is now an area of intense scientific and clinical interest. Dietary prebiotics, such as inulin and oligofructose, are used selectively by host microorganisms to confer a health benefit. Prebiotics have previously been shown to reduce body fat, improve appetite control and reduce blood glucose in adults with overweight or obesity.
Author Interviews, Gastrointestinal Disease, Lancet, Vaccine Studies / 13.05.2017

MedicalResearch.com Interview with: Leslie Williams, BS, RN, MBA Director, Founder, President and Chief Executive Officer and Dr Robert P Anderson MBChB BMedSc PhD FRACP Chief Scientific Officer ImmusanT, Cambridge, MA MedicalResearch.com: What is the background for this study? Response: The 2 Phase 1 trials were randomized, double-blind, placebo-controlled, multi-center studies evaluating the safety, tolerability, and relevant bioactivity of Nexvax2 in HLA-DQ2.5+ patients with celiac disease. In one study, patients received three fixed doses of Nexvax2 or placebo once per week over a three-week period. In the other study, patients received 16 fixed doses of Nexvax2 or placebo twice per week over an eight-week period. Both studies evaluated a range of fixed, intradermal dose administrations in a series of ascending dose cohorts, which included a crossover, double-blind, placebo-controlled oral gluten challenge in the screening and post-treatment periods. The primary outcome measures were the number and percentage of adverse events in the treatment period.
Author Interviews, Gastrointestinal Disease / 13.05.2017

MedicalResearch.com Interview with: [caption id="attachment_34529" align="alignleft" width="200"]Brooks D. Cash, MD</strong> Chief, Gastroenterology Division Professor of Medicine University of South Alabama Mobile, AL 36688 Dr. Cash[/caption] Brooks D. Cash, MD Chief, Gastroenterology Division Professor of Medicine University of South Alabama Mobile, AL 36688 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Irritable bowel syndrome (IBS) is a chronic functional disorder characterized by multiple symptoms including, but not limited to, abdominal pain or discomfort, constipation, diarrhea, urgency of bowel movement (BM), a sensation of incomplete evacuation, pain at evacuation, abdominal bloating, and passage of gas or mucus. IBS can be classified into four primary subtypes: mixed IBS (IBS-M), diarrhea-predominant IBS (IBS-D), constipation-predominant IBS (IBS-C), and unsubtyped IBS (IBS-U). Among adult patients with IBS, a sizeable proportion suffers from IBS-M, with prevalence rates among IBS patients estimated to be between 44% to 66%. Because of the variability in symptoms associated with IBS-M and the lack of effective or approved therapies, clinicians often face challenges in managing this common IBS subtype. PO and its active ingredient, l-Menthol, are kappa opioid agonists, possess smooth muscle calcium channel antagonist and serotonergic (5HT3) antagonist properties, and exert anti-inflammatory, anti-infective, and carminative effect. A recent meta-analysis of medical therapies for IBS found that PO had the lowest number needed to treat among the various options evaluated. The previously published IBS Reduction Evaluation and Safety Trial (IBSREST) showed that PO-SST, a novel formulation of PO using solid-state microspheres to target delivery to the small intestine, was an effective IBS therapy at 24 hours, with improved efficacy at 4 weeks in a combined group of IBS-M and IBS-D patients. In view of the unmet need in IBS-M, we performed a post hoc analysis of the effects of PO-SST among only the IBS-M patients from the IBSREST trial.
Author Interviews, Gastrointestinal Disease, Hepatitis - Liver Disease / 10.05.2017

MedicalResearch.com Interview with: [caption id="attachment_34426" align="alignleft" width="150"]Dr. Winston Dunn, MD Assistant Professor The University of Kansas Medical Center Dr. Dunn[/caption] Dr. Winston Dunn, MD Assistant Professor The University of Kansas Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is widely believed that everyone with HCV can be cured with the medications now a day. But sadly, about 5% of the patients already have very bad damage done to the liver. We call this decompensated cirrhosis. Our medication is still very effective in curing the virus, but in decompensated cirrhosis, curing the virus is not always enough. Only about half to two-thirds of patients with decompensated cirrhosis clinically gets better, but the remaining struggles along or even gets worse after the cure. That is the problem. So, our research was to understand why that was. We used genetic factor to predict which patient would get better and which patient would not. We found that a gene previous found to be predictive of fatty liver and fibrosis is also predictive of recovery in this setting.
Author Interviews, Gastrointestinal Disease, Immunotherapy, NEJM, UCSD / 04.05.2017

MedicalResearch.com Interview with: [caption id="attachment_34246" align="alignleft" width="133"]William J. Sandborn, MD Professor of Medicine and Adjunct Professor of Surgery Chief, Division of Gastroenterology Vice Chair for Clinical Operations, Department of Medicine Director, UCSD IBD Center University of California San Diego and UC San Diego Health System Dr. Sandborn[/caption] William J. Sandborn, MD Professor of Medicine and Adjunct Professor of Surgery Chief, Division of Gastroenterology Vice Chair for Clinical Operations, Department of Medicine Director, UCSD IBD Center University of California San Diego and UC San Diego Health System MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is still a substantial unmet need for new treatments for patients with ulcerative colitis. A previous Phase II study had suggested that tofacitinib might be effective for short term therapy of ulcerative colitis. The patients in that study for the most part had not failed anti-TNF therapy. Now we report the findings from 3 large Phase III trials, two short term trials and one long term trial, demonstrating that tofacitinib 10 mg twice daily is effective for short term therapy, and that both 5 mg and 10 mg twice daily is effective for long term therapy. We also demonstrated that tofacitinib is effective both in patients who have not failed anti-TNF therapy and patients who have failed anti-TNF therapy. The study demonstrated induction of clinical remission, clinical response and mucosal healing (flexible sigmoidoscopy improvement) over the short term, and maintenance of clinical remission, clinical response, and mucosal healing over the long term.
Author Interviews, Gastrointestinal Disease, Karolinski Institute, Parkinson's / 29.04.2017

MedicalResearch.com Interview with: [caption id="attachment_34221" align="alignleft" width="150"]Karin Wirdefeldt, MD, PhD</strong> Associate professor Karolinska Institutet Stockholm, Sweden Dr. Wirdefeldt[/caption] Karin Wirdefeldt, MD, PhD Associate professor Karolinska Institutet Stockholm, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: It has been hypothesized that Parkinson's disease may start in the gut and spread to the brain via the vagal nerve. We found that people who had a truncal vagotomy (ie, the nerve trunk fully resected) at least 5 years earlier were less likely to develop Parkinson's disease compared to people without vagotomy or people who had a selective vagotomy (ie, only branches of the nerve resected).
Author Interviews, Gastrointestinal Disease, Hepatitis - Liver Disease, Transplantation / 24.04.2017

MedicalResearch.com Interview with: [caption id="attachment_34124" align="alignleft" width="128"]Jasmohan S. Bajaj, M.D. Virginia Commonwealth University Associate Professor Department of Internal Medicine Division of Gastroenterology Dr. Bajaj[/caption] Jasmohan S. Bajaj, M.D. Virginia Commonwealth University Associate Professor Department of Internal Medicine Division of Gastroenterology MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hepatic encephalopathy is a devastating complication of cirrhosis, which often recurs despite standard of care therapy with lactulose and rifaximin. This has a basis in an altered gut milieu therefore we need to change that in a more meaningful way to help patients. This was an FDA-monitored Phase I safety study of Fecal microbiome transfer (FMT) using a rationally-derived donor compared to standard of care. We found that FMT was safe and was associated with lower all-cause and hepatic encephalopathy-related hospitalizations over 5 months compared to standard of care.
Author Interviews, Exercise - Fitness, Gastrointestinal Disease, Microbiome / 10.04.2017

MedicalResearch.com Interview with: Dr. Orla O’Sullivan Computational Biologist, Teagasc Food Research Centre, Moorepark, Co. Cork, Ireland  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previously we had demonstrated that professional rugby players had significantly increased microbial diversity compared to both low and high BMI controls. This microbial diversity correlated with creatine kinase levels in the blood (which we had used as a proxy for exercise) and protein intake. In this present study we went a step further and demonstrated that these same athletes had distinct functional potential in their gut microbes compared to controls and furthermore both the host derived ( urine) and bacterial derived ( faecal water) metabolites were also distinct in the athlete group. In particular we found that the athlete’s microbiome is primed for tissue repair and to harness energy from the diet, reflecting the significant energy demands and high cell-turnover evident in elite sport. Thus, the state of physical fitness is not limited to the host alone; it appears to also include conditioning of the microbiota.
Author Interviews, Gastrointestinal Disease, Pediatrics, PLoS, Vitamin D / 10.04.2017

MedicalResearch.com Interview with: [caption id="attachment_33775" align="alignleft" width="120"]Benjamin Udoka Nwosu, MD, FAAP Associate Professor of Pediatrics Division of Endocrinology University of Massachusetts Medical School Worcester, Massachusetts Dr. Nwosu[/caption] Benjamin Udoka Nwosu, MD, FAAP Associate Professor of Pediatrics Division of Endocrinology University of Massachusetts Medical School Worcester, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: Vitamin D deficiency has been reported in various gastrointestinal disorders but the vitamin D status of children and adolescents with irritable bowel syndrome (IBS) has not been previously characterized. Secondly, the vitamin D status in IBS has not been compared to those of other malabsorption syndromes such as irritable bowel syndrome, lactose intolerance, and celiac disease.
Author Interviews, Gastrointestinal Disease, JAMA / 04.04.2017

MedicalResearch.com Interview with: [caption id="attachment_30723" align="alignleft" width="200"]Ann Kurth, Ph.D., C.N.M., R.N. Dr. Ann Kurth[/caption] Dr. Ann Kurth, Task Force member Dean of the Yale School of Nursing Adjunct professor New York University College of Nursing and the College of Global Public Health. MedicalResearch.com: What is the background for this study? Response: Celiac disease, an immune disorder where people should not eat food with gluten, is fairly prevalent. When people with celiac disease eat foods containing gluten, which is found in wheat, rye and barley, their body responds by inflaming or destroying villi—the tiny, fingerlike projections on the inner lining of the small intestine–which prevents the body from absorbing the necessary nutrients from food.
Author Interviews, C. difficile, Gastrointestinal Disease, JAMA, Mayo Clinic / 29.03.2017

MedicalResearch.com Interview with: [caption id="attachment_33270" align="alignleft" width="166"]Sahil Khanna, Dr. Sahil Khanna[/caption] Sahil Khanna, M.B.B.S. MS Division of Gastroenterology and Hepatology Mayo Clinic, Rochester, Minnesota MedicalResearch.com: What is the background for this study? What are the main findings? Response: Clostridium difficile infection (CDI) is the most common cause of hospital-acquired diarrhea and has recently shown increasing incidence especially in the community. Novel risk factors for CDI development include the use of gastric acid suppression medication, presence of systemic comorbid conditions, C difficile carriage in water and food sources, amongst others. Gastric acid suppression medications such as proton-pump inhibitors (PPIs) and histamine-2 receptor blockers (H2Bs) are commonly prescribed and consumed over the counter for gastroesophageal reflux disease, peptic ulcer disease, or functional dyspepsia, but they are also sometimes prescribed for unnecessary indications, which leads to overuse of these medications. Recurrent CDI after a primary infection is a major problem, with the risk being as high as 50% to 60% after 3 or more Clostridium difficile infections. Data on the association between acid suppression and recurrent CDI are conflicting and therefore we performed a systematic review and meta-analysis to study the association between the use of gastric acid suppression medications and the risk of recurrent CDI.
Author Interviews, Gastrointestinal Disease, Microbiome / 28.03.2017

MedicalResearch.com Interview with: [caption id="attachment_33446" align="alignleft" width="200"]Dr Pauline Scanlan Royal Society-Science Foundation Ireland University Research Fellow/APC Faculty, APC Microbiome Institute, Biosciences, University College Cork, Éire Dr. Scanlan[/caption] Dr Pauline Scanlan Royal Society-Science Foundation Ireland University Research Fellow/APC Faculty, APC Microbiome Institute, Biosciences, University College Cork, Éire MedicalResearch.com: What is the background for this study? Response: The human gut is host to an incredible diversity of microbes collectively known as the gut microbiome. Each of us has a unique collection of bacterial strains that form part of the gut microbiome. This uniqueness is of potentially crucial importance with respect to host health as we know that differences in bacterial strain diversity within species could have a range of positive or negative consequences for the human host. For example, some strains of a given bacteria are harmless whilst another strain of the same bacterial species could kill you. A classic example of such a difference in strain functionality is exemplified by the gut bacterium Escherichia coli – one strain called E. coli Nissle 1917 is used as a probiotic and another, E. coli O157:H7, has been responsible for a number of deadly food-borne pathogen outbreaks. Therefore a better understanding of what drives bacterial strain diversity is not just fundamental to our understanding of the ecology and evolution of microbes but is also highly relevant for improvements in human health and disease prevention.
Author Interviews, Gastrointestinal Disease, Inflammation, Microbiome, Nature / 19.03.2017

MedicalResearch.com Interview with: Justin E. Wilson, Ph.D On behalf of the authors Research Assistant Professor - Laboratory of Jenny Ting Department of Genetics Lineberger Comprehensive Cancer Center The University of North Carolina at Chapel Hill Chapel Hill, NC 27599 MedicalResearch.com: Could you provide me with some background on this project? Why did you decide to do this research project? What prior work led up to this latest paper? Response: Previous work from our lab and others discovered two major points about NLRP12: a) NLRP12 suppresses inflammation in response to bacterial components b) NLRP12 provides protection against the inflammatory bowel disease colitis and colitis-associated colon cancer (i.e., Nlrp12-defcient mice have greater colon inflammation and inflammation-driven colon cancer). Therefore, we wanted to know if Nlrp12 was regulating inflammation in the colon by responding to the trillions of intestinal microbes collective referred to as the microbiome. Mounting evidence also indicates that the immune system both responds to and influences the composition of the intestinal microbiome during intestinal health and disease, and we hypothesized that NLRP12 could be one of the important immune components during this process. Moreover, we were also interested in this topic because targeting the microbiome to treat inflammatory disorders and other diseases is an attractive method that has many advantages over immune suppression.
Author Interviews, C. difficile, Gastrointestinal Disease, Microbiome, Transplantation / 14.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32899" align="alignleft" width="100"]Dr. H. L. DuPont MD Director, Center for Infectious Diseases, UTHealth School of Public Health Mary W. Kelsey Chair in the Medical Sciences, McGovern Medical School at UTHealth Professor, Department of Epidemiology, Human Genetics and Environmental Sciences UTHealth School of Public Health Houston, TX 77030 Dr. DuPont[/caption] Dr. H. L. DuPont MD Director, Center for Infectious Diseases, UTHealth School of Public Health Mary W. Kelsey Chair in the Medical Sciences, McGovern Medical School at UTHealth Professor, Department of Epidemiology, Human Genetics and Environmental Sciences UTHealth School of Public Health Houston, TX 77030 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many diseases and disorders are associated with “dysbiosis,” where the intestinal microbiota diversity is reduced. This contributes to disease and to the acquisition of antibiotic resistance. Fecal microbiota transplantation (FMT) is successful in conditions with pure dysbiosis (e.g. C diff infection) and a single dose of FMT is curative in most cases.