The Current and Future Role of Drugs and Probiotics in the Management of Inflammatory Bowel Disease

Inflammatory Bowel Disease (IBD) and other auto-inflammatory disorders are conditions caused by chronic and persistent intestinal inflammation, which is mainly represented by Ulcerative Colitis (UC) or Crohn’s Disease (CD), both of which typically arise as chronic inflammation of the gastrointestinal mucosa. Doctor’s main focus for treating IBD is the decrease on inflammation processes when the disease is active and promotes the maintenance of inflammation at normal levels. However, to deal with these two parameters is not easy, because the drugs usually used are related to several side effects and they are not totally effective to reduce inflammation and to keep the remission. Authors agree that the therapy approach should include drugs, dietary intervention and use of alternative substances as probiotics. The standard treatment approach for patients with CD and UC is traditionally done with the use of anti-inflammatory agents, like corticosteroids, mesalamine, immunomodulators such as azathioprine and methotrexate, and biologic agents such as infliximab and others. Probiotics are known as viable micro-organisms (or live microorganisms or live microbial dietary supplements) that may promote beneficial physiologic or therapeutic properties when used correctly. The interest in the role of these substances in improving human health is the reason of several researches. They may be used to help the immune system, to control gastro-intestinal infections and to prevent several diseases. Prebiotics, symbiotics, and probiotics may be helpful as adjuvants in the treatment of IBD. Probiotics are normally well-tolerated and are associated with few side effects which are undoubtedly important in the treatment of any disease.

Effects of <i>Pereskia aculeata</i>Miller on the Biochemical Profiles and Body Composition of Wistar Rats

Pereskia aculeata Miller commonly known as “ora-pro-nobis” has been used extensively in folclore medicine. Plant belongs to the family Cactacea and it is found in the Brazil (reaching Bahia and Rio Grande do Sul states). The purpose was to evaluate the effects of plant on biochemical and corporal profiles of Wistar rats. The 80 animals were divided randomly into 4 groups by sex (n = 10 females and 10 males per group) as follows: G1 group (water/rat food ad libitum);G2 group (drink A: commercial condensed milk, sugar and water/rat food ad libitum);G3 group (drink B: P. aculeata juice/rat food ad libitum);G4 group (drink C: commercial condensed milk, sugar and P. aculeate juice/rat food ad libitum). After 35 days their biochemical and corporal profiles were analyzed (cholesterol, glycemia, triglycerides, HDL-c, AST, ALT, Lee Index, weight and visceral fat). Intake of the plant caused no changes in the lipid profile of Wistar rats. However, intake in male rats of the same prevented the increase in triglycerides front of a hypercaloric diet. There were significant changes in glycemic index due to the high carbohydrate content of the plant. The plant was effective in reducing the levels of AST and ALT in male rats and ALT only in females. The use of the plant did not cause significant changes in the index of Lee but the Pereskia aculeata Miller may reduce visceral fat gain in female with a regular diet.

COVID-19 and Gestational Diabetes: A Systematic Review

In March 2020, the World Health Organization declared a pandemic state in response to the number of infected and killed by COVID-19. Gestational diabetes (GD) is characterized by physiological changes making pregnant women even more vulnerable to viral respiratory infections, such as SARS-CoV-2. For these reasons and due to the restriction of data related to DMG and the involvement by COVID-19, the importance of raising information about these two conditions is evident. Therefore, this study aimed to perform a literature review about the complications of COVID-19 in patients with GD. MEDLINE-PubMed, EMBASE, and Scielo databases were searched and followed the PRISMA guidelines. Only four studies were included in the systematic review. The complications and mortality are more significant in pregnant women with diabetes since hyperglycemia promotes immune changes in the inflammatory state and worsens insulin resistance. The imbalance in the immune response favors the development of infections, the most likely being viral respiratory infections. On the other hand, other studies show insufficient recent evidence to indicate that pregnant women are more susceptible to infection with severe acute coronavirus respiratory syndrome. There are divergences between studies concerning complications related to COVID-19 in patients with GD. In view of this scenario and from the information obtained, it is noted that the literature is scarce regarding the worsening of COVID-19 in patients with GD. Therefore, it is necessary to continue research on these mechanisms that may justify their correlation.

Evaluation of the neuropharmacological properties of nerol in mice

The search for therapeutic agents that will provide the ground for man and an improvement in their quality of life is ceaseless. The nerol (cis-2,6-dimethyl-2,6-octadien-8-ol) is a monoterpene which can be found in various medicinal plants as Lippia spp and Melissa officinalis L. The objective of this study was to analyze the acute effect of nerol in the central nervous system (CNS) by performing behavioral tests in mice (open field, elevated plus-maze, light/dark and rota rod tests). We used male albino mice (Mus musculus), Swiss variety, adult with 2 month-old. The animals were divided into five groups (n = 8) for each experimental protocol, and they were administered intraperitoneally (i.p.), respectively, Tween 80 0.05% dissolved in saline solution 0.9%, nerol (30, 60 or 90 mg/kg) or diazepam (2 mg/kg). In the open field test, all groups treated with nerol showed a significant decrease in motor activity (number of crossings, rearings and groomings) when compared with vehicle group. In the elevated plus-maze test, nerol groups significantly increased the number of entries and time of permanence in the open arms when compared with vehicle group. In the light-dark test, nerol groups showed a significant increase the time of permanence in the room clear when compared with vehicle group. In the rota rod test, the groups treated with nerol didn’t show modification in time spent and number of falls in the revolving bar when compared with vehicle group. These results indicate a possible anxiolytic effect of nerol in mice.

Severe adverse events during antiviral therapy in hepatitis C virus cirrhotic patients: A systematic review

AIM: To identify severe adverse events (SAEs) leading to treatment discontinuation that occur during antiviral therapy in hepatitis C virus (HCV)-infected cirrhotic patients. METHODS: We identified all the articles published prior to December 2011 in the PubMed, Medline, Lilacs, Scopus, Ovid, EMBASE, Cochrane and Medscape databases that presented these data in cirrhotic patients. These studies evaluated the rate of SAEs leading to discontinuation of standard care treatment: Pegylated interferon (PegIFN) alpha 2a (135-180 μg/wk) or PegIFN alpha 2b (1 or 1.5 μg/kg per week) and ribavirin (800-1200 mg/d). Patients with genotype 1 + 4 underwent treatment for 48 wk, whereas those with genotypes 2 + 3 were treated for 24 wk.RESULTS: We included 17 papers in this review, comprising of 1133 patients. Treatment was discontinued due to SAEs in 14.5% of the patients. The most common SAEs were: severe thrombocytopenia and/or neutropenia (23.2%), psychiatric disorders (15.5%), decompensation of liver cirrhosis (12.1%) and severe anemia (11.2%). The proportion of patients who needed to discontinue their therapy due to SAEs was significantly higher in patients with Child-Pugh class B and Cvs those with Child-Pugh class A: 22%vs 11.4% (P = 0.003). A similar discontinuation rate was found in cirrhotic patients treated with PegIFN alpha 2a and those treated with PegIFN alpha 2b, in combination with ribavirin: 14.2%vs 13.7% (P = 0.96). The overall sustained virological response rate in cirrhotic patients was 37% (95%CI: 33.5-43.1) but was significantly lower in patients with genotype 1 + 4 than in those with genotype 2 + 3: 20.5% (95%CI: 17.9-24.8) vs 56.5% (95%CI: 51.5-63.2), (P < 0.0001). CONCLUSION: Fourteen point five percent of HCV cirrhotic patients treated with PegIFN and ribavirin needed early discontinuation of therapy due to SAEs, the most common cause being hematological disorders.