S100B protein in the gut:The evidence for enteroglial-sustained intestinal inflammation

Glial cells in the gut represent the morphological and functional equivalent of astrocytes and microglia in the central nervous system （CNS）. In recent years, the role of enteric glial cells （EGCs） has extended from that of simple nutritive support for enteric neurons to that of being pivotal participants in the regulation of inflammatory events in the gut. Similar to the CNS astrocytes, the EGCs physiologically express the SIOOB protein that exerts either trophic or toxic effects depending on its concentration in the extracellular milieu. In the CNS, SIOOB overexpression is responsible for the initiation of a gliotic reaction by the release of pro-inflammatory mediators, which may have a deleterious effect on neighboring cells. SlOOB-mediated pro-inflammatory effects are not limited to the brain： SIOOB overexpression is associated with the onset and maintenance of inflammation in the human gut too. In this review we describe the major features of EGCs and SIOOB protein occurring in intestinal inflammation deriving from such.

Leaky gut, dysbiosis, and enteric glia activation: the trilogy behind the intestinal origin of Parkinson’s disease

Early diagnosis of Parkinson’s disease(PD):how we can improve the therapeutic approach:PD is a neurodegenerative disease characterized by motor dysfunctions(tremor,rigidity,bradykinesia and impaired posture/balance)elicited by selective depletion of dopaminergic(DA)neurons in substantia nigra pars compacta.DA neuron loss is associated with neuronal inclusions of the phosphorylatedα-synuclein protein called Lewy body(Shults,2006).Although the underlying neurodegenerative process is not affected,the management of PD patients has been revolutionized with the introduction of levodopa and DA drugs in the routine therapy,which ensures initial symptomatic relief of motor functions through the DA supply in the nigrostriatal circuit.These drugs are currently the best option for treating PD,although their chronic use is associated with progressive dopamine resistance and loss of effectiveness in the recovery of motor dysfunctions.Alternative therapeutic strategies,including agonists of DA receptors,monoamine oxide B inhibitors,and even deep brain stimulation techniques have been developed to overcome these clinical limitations.Unfortunately,these therapeutic approaches cannot restore PD-compromised functions,as irreversible DA neurodegeneration has occurred in substantia nigra pars compacta when first motor symptoms appear.The nigrostriatal system is traditionally considered as the first region affected by neuronal impairment in Parkinsonisms;however,α-synuclein aggregation appears in a pre-motor stage of the disease in the enteric nervous system(ENS).

Large symptomatic gastric diverticula:Two case reports and a brief review of literature

Gastric diverticula are rare and uncommon conditions.Most gastric diverticula are asymptomatic.When symptoms arise,they are most commonly upper abdominal pain,nausea and emesis,while dyspepsia and vomiting are less common.Occasionally,patients with gastric diverticula can have dramatic presentations related to massive bleeding or perforation.The diagnosis may be difficult,as symptoms can be caused by more common gastrointestinal pathologies and only aggravated by diverticula.The appropriate management of diverticula depends mainly on the symptom pattern and as well as diverticulum size.There is no specific therapeutic strategy for an asymptomatic diverticulum.Although some authors support conservative therapy with antacids,this provides only temporary symptom relief since it is not able to resolve the underlying pathology.Surgical resection is the mainstay of treatment when the diverticulum is large,symptomatic or complicated by bleeding,perforation or malignancy,with over two-thirds of patients remaining symptom-free after surgery,while laparoscopic resection,combined with intraoperative endoscopy,is a safe and feasible approach with excellent outcomes.Here,we present two cases of uncommon large symptomatic gastric diverticula with a discussion of the cornerstones in management and report a minimally invasive solution,with a brief review of the literature.