Prostaglandin EP Receptors and Their Roles in Mucosal Protection and Ulcer Healing in the Gastrointestinal Tract

Huang-Qi-Jian-Zhong-Tang (HQJZT) is a well-known traditional Chinese herbal formulation. This study aimed to investigate the duodenoprotective properties of HQJZT against Indomethacin (IND)-induced duodenal ulceration in rats, and the mechanisms involved, particularly through NF-κB and STAT signaling pathways. Our results showed that HQJZT completely protected the duodenal mucosa from ulceration caused by IND, as indicated by improved macroscopic and histological appearances. There was a significant decrease in ulcer index and microscopic score, an increase in villus height and crypt depth, and a normalization of the tissue architecture of the duodenum in rats following HQJZT treatment. Blood flow into the duodenal mucosa was significantly increased after HQJZT administration. HQJZT significantly increased PGE₂ and NO levels in the duodenal mucosa. A significant reduction in the production of pro-inflammatory cytokines IL-1β, IL-6, and TNF-α was observed in the duodenal mucosa under treatment with HQJZT. Mechanistically, the administration of HQJZT significantly lowered the duodenal protein expression of inflammation-related genes, including p-NF-κB and p-IκBβ, compared with the ulcer control group. Furthermore, the STAT signaling pathway-related protein markers p-JAK and p-STAT were significantly reduced in the HQJZT (1.30 and 2.60 g/kg) groups. As a result of these findings, HQJZT alleviates duodenal mucosal ulcers caused by IND. A protective effect of HQJZT on duodenal ulcers is attributed to its ability to improve mucosal blood flow, stimulate the production of cytoprotective mediators, minimize proinflammatory cytokines, and block the activation of NF-κB and STAT signaling pathways.

Gastric cancer (GC) is the fifth most common type of cancer and the third leading cause of death due to cancer worldwide. The gastric mucosa often undergoes many years of precancerous lesions of gastric cancer (PLGC) stages before progressing to gastric malignancy. Unfortunately, there are no effective Western drugs for patients with PLGC. In recent years, traditional Chinese medicine (TCM) has been proven effective in treating PLGC. Classical TCM formulas and chemical components isolated from some Chinese herbal medicines have been administered to treat PLGC, and the main advantage is their comprehensive intervention with multiple approaches and multiple targets. In this review, we focus on recent studies using TCM treatment for PLGC, including clinical observations and experimental research, with a focus on targets and mechanisms of drugs. This review provides some ideas and a theoretical basis for applying TCM to treat PLGC and prevent GC.

Clostridioides difficile is one of the leading causes of nosocomial infections worldwide. Increases in incidence, severity, and healthcare cost associated with C. difficile infection (CDI) have made this pathogen an urgent public health threat worldwide. The factors shaping the evolving epidemiology of CDI and impacting clinical outcomes of infection are not well understood, but involve tripartite interactions between the host, microbiota, and C. difficile. In addition to this, emerging data suggests an underappreciated role for environmental factors, such as diet and pharmaceutical drugs, in CDI. In this review, we discuss the role of nonsteroidal anti-inflammatory drugs (NSAIDs) and eicosanoids in CDI.

It is essential that safe and effective treatment options be available to patients suffering from chronic pain. The emergence of an opioid epidemic has shaped public opinions and created stigmas surrounding the use of opioids for the management of pain. This reality, coupled with high risk of adverse effects from chronic opioid use, has led chronic pain patients and their healthcare providers to utilize nonopioid treatment approaches. In this review, we will explore a number of cellular reorganizations that are associated with the development and progression of chronic pain. We will also discuss the safety and efficacy of opioid and nonopioid treatment options for chronic pain. Finally, we will review the evidence for adenylyl cyclase type 1 (AC1) as a novel target for the treatment of chronic pain.

Prostaglandin E₂ (PGE₂) is found throughout the gastrointestinal tract in a diverse variety of functions and roles. The recent discovery of four PGE₂ receptor subtypes in intestinal muscle layers as well as in the enteric plexus has led to much interest in the study of their roles in gut motility. Gut dysmotility has been implicated in functional disease processes including irritable bowel syndrome (IBS) and slow transit constipation, and lubiprostone, a PGE₂ derivative, has recently been licensed to treat both conditions.

The diversity of actions of PGE₂ in the intestinal tract is attributed to its differing effects on its downstream receptor types, as well as their varied distribution in the gut, in both health and disease. This review aims to identify the role and distribution of PGE₂ receptors in the intestinal tract, and aims to elucidate their distinct role in gut motor function, with a specific focus on functional intestinal pathologies.

L’alimentation à l’hôpital est soumise à de multiples contraintes de fabrication, organisationnelle, sanitaire, écologique, qui influent sur le plateau repas proposé au patient. L’addition d’un ou plusieurs régimes peut ajouter à la complexité et contribuer à sa non-consommation et augmente les risques de dénutrition. L’élaboration de recommandations sur l’alimentation et les régimes à l’hôpital est d’un enjeu majeur.

Un groupe de pilotage constitué à parité par des médecins et diététiciens de l’Association Française des Diététiciens Nutritionnistes (AFDN) et de la Société Francophone de Nutrition Clinique et Métabolisme (SFNCM) a été constitué pour élaborer des propositions de recommandations, basées sur les résultats d’une enquête nationale sur les régimes à l’hôpital et sur les données de la littérature. Vingt-trois propositions de recommandations ont alors été soumises à 50 experts nationaux, selon la méthode DELPHI définie par la Haute Autorité de Santé d’élaboration de consensus formalisé d’experts.

Ces vingt-trois recommandations ont été jugées appropriées et validées par un accord fort après trois tours de vote, après modifications et argumentations. Elles visent à définir chez l’adulte : 1-le vocabulaire lié aux alimentations/régimes à l’hôpital, 2-l’offre alimentaire (quantitative et qualitative), 3-la prescription nutritionnelle, 4-les modes alimentaires et adaptations aux patients, 5-délimiter les alimentations restreintes afin de réduire les régimes inutiles et sans preuve scientifique, 6-montrer l’importance de la place d’une alimentation spécifiquement adaptée aux patients dénutris et à risque de dénutrition.

Ces recommandations devraient permettre à toutes les équipes de restauration et de soin, de rationnaliser l’offre alimentaire et les prescriptions d’alimentations thérapeutiques et de focaliser leur objectif sur la qualité d’une offre alimentaire adaptée aux besoins et au plaisir du patient.

Hospital food is subject to multiple constraints (meal production, organisation, health safety, environmental respect) that influence the meal tray offered to the patient. Multiple diets can add complexity and contribute to non-consumption of the meal. To avoid undernutrition, it appeared necessary to propose guidelines for foods and diets in hospitals.

These guidelines were developed using the Delphi method, as recommended by the HAS (French Authority of Health), based on a formal consensus of experts and led by a group of practitioners and dietitians from AFDN (French dietitian association) and SFNCM (French Society of Clinical Nutrition and Metabolism).

Twenty-three recommendations were considered appropriate and validated by a panel of 50 national experts, following 3 rounds of consultation, modifications and arguments. Recommendations aim to define in adults: 1/vocabulary related to food and diets in hospitals, 2/quantitative and qualitative food propositions, 3/nutritional prescription, 4/diet patterns and patient adaptations, 5/limiting restrictions to reduce unnecessary diets and without scientific evidence, 6/emphasizing the place of enriched and adapted diet for at risk and malnourished patients.

These guidelines will enable catering services and health-care teams, to rationalise hospital food and therapeutic food prescriptions, in order to focus on individual needs and tasty foods.