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Oral nanotechnological approaches for colon-specific drug delivery
Published in Ana Rute Neves, Salette Reis, Nanoparticles in Life Sciences and Biomedicine, 2018
Rute Nunes, Bruno Sarmento, Salette Reis, Pedro Fonte
In the last two decades, several attempts have been made to improve the delivery of drugs to the colon for the management of IBD. Briefly, IBD is the generic name for a group of chronic GI diseases, among which the most prevailing are Crohn’s disease and ulcerative colitis [70]. The common feature is the chronic inflammation of the GI tract, characterized by periods of relapse and remission. Currently, there is no cure for IBD and current therapies are intended to control the disease progress and treat symptoms. They include anti- inflammatory and immunosuppressive agents [71]. Despite relevant progress in colon-specific drug delivery with the development of prodrugs or the use of dosage forms such as delayed or controlled release systems, these conventional strategies are far from ideal [72]. One main challenge in the treatment of IBD relates with the fact that the biological environment and physiological processes are altered (Table 6.2), leading to unspecific and unpredictable performance of these systems since their design is usually based on normal physiological parameters [73]. Consequently, they may have some problems, such as systemic toxicity, poor tissue retention and distribution, insufficient drug accumulation within affected tissue, delivery of drug at undesirable sites of the GI tract, and incomplete drug release. These drawbacks lead to adverse effects, lower drug concentrations at the inflammation site, inconsistent efficacy, and patient intervariability [74].
Microbiota Transplantation, Health Implications, and the Way Forward
Published in Nwadiuto (Diuto) Esiobu, James Chukwuma Ogbonna, Charles Oluwaseun Adetunji, Olawole O. Obembe, Ifeoma Maureen Ezeonu, Abdulrazak B. Ibrahim, Benjamin Ewa Ubi, Microbiomes and Emerging Applications, 2022
Olugbenga Samuel Michael, Olufemi Idowu Oluranti, Ayomide Michael Oshinjo, Charles Oluwaseun Adetunji, Juliana Bunmi Adetunji, Nwadiuto (Diuto) Esiobu
IBD is a disorder of the gut that is associated with protracted inflammation of the gut such as Crohn’s disease and ulcerative colitis. IBD has a repetitive attribute of infection advancement and decrease (Gupta et al., 2016). IBD is postulated to take place because of incessant unsuitable antigen activation of gut mucosa lymphatic system (Zhang and Li, 2014). Anderson et al. (2012) reported that FMT therapy for IBD patients showed that 63% of ulcerative colitis patients were relieved, 76% could stop taking drugs for IBD, and 76% had reduced gut inflammations and other associated signs (Figure 5.1).
Targeted Intestinal Delivery of Probiotics
Published in Emmanuel Opara, Controlled Drug Delivery Systems, 2020
Kevin Enck, Emmanuel Opara, Alec Jost
Inflammatory Bowel Disease (IBD) is a gastrointestinal disorder that affects 100–200 patients per 100,000 people in North America and Northern Europe.43 As the name suggests, IBD involves a chronic inflammatory response in gut that can lead to diarrhea, ulceration, intestinal obstruction, and even perforation of the GIT. Two of the most common phenotypes are Crohn’s Disease (CD) and Ulcerative Colitis (UC) and both have been characterized with dysbiosis of the microbiota.2,44,45 While these are two unique diseases that affect patients differently, the pathogenesis and how it relates to the microbiome is believed to be fairly similar. It is well established that environmental factors play a role in rapid progression of IBD as the rate of development is different for industrialized western nations compared with their Asian or less developed counterparts.46 The relevant factors are still being determined, but a reduction in complexity of the gut microbiome appears to be the result. With a reduction in immune modulating and anti-inflammatory bacteria such as F. prausnitzii and Butyricoccus pullicaecorum and an increase in proinflammatory strains such as Escherichia coli, there is an inflammatory response that proliferates throughout the gut.46 An example of this response starts with E. coli stimulating the release of proinflammatory cytokines such as Interferon-γ (IFN-γ) and IL-6 which activates Matrix Metallopeptidase (MMPs) that trigger matrix degradation, epithelial cell detachment, and ulceration.46,47 There is evidence that demonstrates that the reintroduction of bacteria such as F. prausnitzii8 and B. pullicaecorum44 back into the gut attenuates some of the inflammation and has led to extended remission periods in patients. Both oral delivery of specific probiotics and FMT have been used with varying degrees of success to repopulate the microbiome of patients with IBD.36,38
Synthesis of carboxmethyl chitosan and its effect on budesonide colon sensitive nano release system
Published in Journal of Dispersion Science and Technology, 2023
Inflammatory bowel disease (IBD) comprises idiopathic, chronic, inflammatory diseases: Ulcerative colitis, intermediate colitis and Crohn’s disease. The disease is often characterized by the influence of immunological factors accompanied by genetic factors in the capability of the gastrointestinal tract to distinguish self-antigen from extraneous substances. In some patients distinguishing the particular form of bowel disease becomes challenging and even more difficult to diagnose and treat because of the overlapping clinical, epidemiological, and therapeutic physiognomies. Ulcerative colitis typically, continuously affects the mucosa. Pathologically, crypt abscesses and granulomas are detected in Crohn’s disease only. Crohn’s disease also features transmural engrossment, and mucosal discontinuity whereas these are not found in Ulcerative colitis patients. In Crohn’s disease swelling is detected all the way from mucosa to serosa through the walls of the intestine.[1]
The perinatal period, the developing intestinal microbiome and inflammatory bowel diseases: What links early life events with later life disease?
Published in Journal of the Royal Society of New Zealand, 2020
Fathalla Ali, Kei Lui, Alex Wang, Andrew S. Day, Steven T. Leach
IBD is a group of chronic intestinal inflammatory disorders consisting of Crohn’s disease, ulcerative colitis and inflammatory bowel disease unclassified. They are characterised by lifelong relapsing-remitting diarrhoea, rectal bleeding and abdominal pain that is associated with significant morbidity and excess mortality requiring specialised medical therapies, hospitalisation and surgery. Furthermore, approximately 25% of people diagnosed with IBD will present in childhood or adolescence (Baldassano and Piccoli 1999) and will subsequently suffer from disease throughout their life. While the underlying pathogenic mechanism of IBD is still not fully resolved, the current accepted hypothesis is that some combination of genetics and environmental factors drives an inappropriate host response to the intestinal microbiota, which results in disease.
Guided dietary fibre intake as a means of directing short-chain fatty acid production by the gut microbiota
Published in Journal of the Royal Society of New Zealand, 2020
The best, current nutrition-based treatment for IBD (mainly paediatric CD) is exclusive enteral nutrition (EEN) in which patients consume a liquid diet that provides all of their energy and nutrient needs (Heuschkel et al. 2000; Lewis and Abreu 2017; MacLellan et al. 2017). Although there is sometimes poor compliance by patients, clinical improvement has been reported with reduced symptoms of disease, which may be due to improved mucosal healing (Borrelli et al. 2006). Ironically, EEN results in lower butyrate production by the gut microbiota because the diet does not contain dietary fibre (Gerasimidis et al. 2014). As indicated previously, the Hadza people have lower concentrations of butyrate (Clostridium clusters IV and XIVa less abundant) in the faeces than Italian counterparts. It is possible, therefore, that the importance of butyrate in gut health has been over-stated, but further research may show that smaller quantities can still be therapeutic. It should be noted moreover that SCFAs, in general, may mitigate colorectal cancer through anti-inflammatory effects (Louis et al. 2014).