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Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
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Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
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Related Experiment Video

Updated: Jul 23, 2025

Analysis of Fecal Microbiota Dynamics in Lupus-Prone Mice Using a Simple, Cost-Effective DNA Isolation Method
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Intestinal Microbiota Reduction Followed by Fasting Discloses Microbial Triggering of Inflammation in Rheumatoid

Thomas Häupl1,2,3, Till Sörensen1, Biljana Smiljanovic1

  • 1Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Berlin, 10117 Berlin, Germany.

Journal of Clinical Medicine
|July 14, 2023
PubMed
Summary

Fasting and bowel cleansing reduced gut microbes in rheumatoid arthritis (RA) patients, improving disease activity and reducing inflammatory markers. This suggests a link between gut dysbiosis and RA, supporting nutritional interventions.

Keywords:
cytometric profilingdysbiosisfastingintestinal microbiotamonocytesmucosal barrierrheumatoid arthritis

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Area of Science:

  • Immunology
  • Microbiome research
  • Gastroenterology

Background:

  • Rheumatoid arthritis (RA) synovitis involves monocytes/macrophages with inflammatory patterns similar to microbial stimulation.
  • The intestinal microbiome's role in RA pathogenesis is under investigation.

Purpose of the Study:

  • To investigate the impact of intestinal microbiota reduction through fasting and bowel cleansing on RA disease activity and immune parameters.
  • To explore the relationship between gut dysbiosis and RA-specific inflammation.

Main Methods:

  • An open-label study involving 20 RA patients undergoing bowel cleansing and a 7-day fast (≤250 kcal/day).
  • Immune monitoring, microbiome sequencing, and measurement of disease activity scores (DAS28/SDAI), IL-6, zonulin, and cortisol levels.
  • A control group of 10 patients with metabolic syndrome was included.

Main Results:

  • Disease activity scores (DAS28/SDAI) significantly declined within days, with 19 of 20 RA patients showing improvement after fasting.
  • Remission was achieved in 6 patients (DAS28 < 2.6) and 3 patients (SDAI < 3.3).
  • Fasting reduced monocyte turnover, serum IL-6, and zonulin levels, while increasing endogenous cortisol. Microbiome sequencing revealed reduced potentially arthritogenic bacteria and an increase in eukaryotic, predominantly fungal, colonizers.

Conclusions:

  • A direct link exists between the intestinal microbiota and RA-specific inflammation.
  • Gut dysbiosis may be etiologically relevant in RA.
  • Targeted nutritional interventions addressing gut dysbiosis represent a potential causal therapeutic approach for RA.