Routine clinical administration of 4-week alverine citrate and simeticone combination relief global IBS symptoms

Introduction: The primary treatment aim for irritable bowel syndrome (IBS) is to relieve overall symptoms which can significantly impair the patient’s quality of life (QOL);however, it generally requires a high pill burden that may be improved by administration of combinatorial formulations. Thus, the effectiveness of alverine citrate and simeticone combination (ACS) for global symptom relief for IBS was investigated in this non-interventional study. Patients and Methods: ROME III IBS patients (n = 640;52.3% male: mean age: 43.6 ± 12.5 years) with abdominal pain and discomfort ≥60 of 0-100 visual analogue scale (VAS) were included in a prospective, multicenter, non-interventional study at 26 Chinese sites from December 2010 to January 2012. Patients received alverine citrate (60 mg) with simeticone (300 mg) (ACS) 3× daily for 4 weeks. Pain/discomfort and bloating/distension were assessed by VAS. Global symptoms and QOL were assessed by 7-point and 5-point Likert scales, respectively. Post-treatment bowel function was assessed by Bristol Stool Form Scale (BSFS) and treatment-related adverse events (AEs) were recorded. Results: Of 640 patients, 540 (84.4%) completed the study, and 100 (15.6%) withdrew. In total, 87.5% reported bloating at baseline. After 4-week ACS treatment, 89.1% reported global symptom improvement. Furthermore, 4-week ACS treatment reduced pain and bloated VAS scores significantly from 78.4 ± 9.9 to 32.1 ± 21.0 and from 63.2 ± 27.2 to 22.6 ± 20.9, respectively (both p < 0.001), decreased diarrhea or constipation occurrence from 67.2% to 10.2% (p < 0.001), and reduced IBS impact on QOL with only 2 treatment-related AEs. Conclusion: Routine clinical administration of ACS for IBS over a 4-week period provides effective relief of IBS symptoms and improves QOL in IBS patients.

Epithelial cells mimic immune cells: a novel path toward tumor immunotherapy

Recently,we have shown that FOXP3,a critical transcription factor in regulatory T cells(Tregs),is expressed in pancreatic epithelial cells,and restrain the activity of CD8+T cells by upregulating PD-L1,which in turn regulates immune escape in pancreatic ductal adenocarcinoma(PDAC)^(1).On the basis of a series of studies of our laboratory,we hypothesize that a subset of pancreatic epithelial cells mimics the phenotype and function of Tregs(named quasi-Tregs or qTregs);this concept has been supported by a peer-reviewed commentary^(2).Moreover,evidence suggests that tumor epithelial cells can mimic other types of immune cells and participate in the formation of a tumor immunosuppressive microenvironment(TIM).

Sarcopenia and sarcopenic obesity in patients awaiting liver transplantation

To the Editor,Sarcopenia includes the presence of both low skeletal muscle mass and low skeletal muscle function(strength and/or physical performance).A consensus definition of sarcopenia in cirrhosis patients is the phenotypic manifestation of the loss of muscle mass.1 On the basis of body composition analyses,sarcopenic obesity(SO)is defined as a combination of obesity and sarcopenia.2 Sarcopenia and SO have been detected associating with poor prognosis,including frailty,poor survival,infec-tion,and a greater length of hospital stay,physical impairment,and mortality.