Browsing by Subject "Inflammatory Bowel Diseases"
Now showing 1 - 16 of 16
- Results Per Page
- Sort Options
Item Alexithymia in Adolescents with Inflammatory Bowel Disease(2012-12-20) Crowley, Jaime Dorian; Wetherington, Crista E.Adolescents with inflammatory bowel disease exhibit increased psychosocial problems, such as higher rates of depressive symptoms; however, the relationship between psychological factors and health outcomes remains relatively unstudied in this pediatric population. Both depression and stress have been linked to health outcomes in adults with inflammatory bowel disease. Alexithymia, defined as a personality trait and affective deficit disorder, may represent another psychological variable influencing health outcomes in inflammatory bowel disease populations. While no prior studies have investigated alexithymia in adolescents with inflammatory bowel disease, higher rates of alexithymia have been documented and associated with poorer quality of life in adults with inflammatory bowel disease. This study investigated the prevalence of alexithymia in adolescents with inflammatory bowel disease and examined the relationship between alexithymia and other psychological variables (i.e., depressive symptoms and perceived stress). An additional aim was to determine whether these psychological variables predicted adolescent inflammatory bowel disease patients’ health outcomes. An investigation of 63 participants with inflammatory bowel disease between the ages of 13 to 17 years revealed a significant prevalence of alexithymia compared to a previously reported rate in a normal adolescent population. Higher alexithymia scores were associated with greater depressive symptoms, perceived stress of major life events, perceived stress of daily hassles, and perceived recent stress. None of the psychological variables were significantly related to illness course, and only perceived stress of major life events was significantly correlated with disease severity. In contrast, all of the psychological variables showed significant inverse correlations with disease-specific quality of life. Notably, alexithymia emerged as the strongest predictor of disease-specific quality of life and consistently accounted for more unique variance than depressive symptoms and perceived stress. Taken together, the present results implicate alexithymia as a risk factor for poor illness perception and adjustment in adolescents with inflammatory bowel disease. The potential lifelong repercussions of alexithymia make it an important topic for health outcome research, which may guide the development of psychological interventions for this pediatric chronic illness population.Item Changes in the Gut Metabolic Landscape Drive Inflammation-Associated Dysbiosis and Host Responses(2020-12-01T06:00:00.000Z) Hughes, Elizabeth Rose; Sperandio, Vanessa; Pfeiffer, Julie K.; Alto, Neal; Winter, Sebastian E.Intestinal inflammation is frequently associated with alterations in composition of gut microbial communities, termed dysbiosis. Inflammation-associated dysbiosis is characterized by an expansion of facultative anaerobic bacteria in the Proteobacteria phylum, such as Escherichia coli. A dysbiotic microbiota has been linked to increased disease severity in the context of inflammatory bowel disease. However, the mechanisms responsible for inflammation-associated dysbiosis and its impact on disease are incompletely understood. Utilizing bioinformatic analyses of gut microbiota composition and mechanistic studies with Escherichia coli as a model organism in murine models, we uncovered two metabolic pathways that are unique to intestinal inflammation and responsible for changes in microbiota composition. Aerobic respiration coupled with formate oxidation, and utilization of molecular hydrogen fuel expansion of Escherichia coli populations during intestinal inflammation. The impact of oxygen leakage into the gut lumen on obligate anaerobic bacterial metabolism was additionally investigated. In vitro metabolite measurements and use of bacterial genetics indicated formate production increased in Bacteroides exposed to low oxygen levels. Formate measurements and exogenous delivery of formate in mice suggested that intestinal formate levels increase during inflammation and may exacerbate disease. However, further study is required. In conclusion, we identified key changes that occur during non-infectious inflammation in the gut metabolic landscape, illustrating the importance of understanding bacterial metabolism in order to understand host-microbiota interactions.Item Epithelial Cell Autophagy in Antibacterial Defense of the Small Intestine(2013-10-14) Benjamin, Jamaal Louis; Yarovinsky, Felix; Hooper, Lora V.; Levine, Beth; Sperandio, VanessaThe intestines of all mammals are colonized with a diverse microbiota that provide metabolic benefits to their hosts. However, this symbiotic relationship can break down when resident bacteria opportunistically invade the intestinal barrier, leading to pathologies such as inflammatory bowel disease (IBD), and bacteremia. As a result, epithelial cell innate immune responses play an essential role in preventing bacterial invasion of host tissues and maintaining a symbiotic host-bacterial relationship. Autophagy is emerging as an important component of innate immunity. Mounting evidence suggests that dysregulation of the autophagy-independent function of autophagy genes can lead to inflammatory bowel disease. However, little is known about the role of autophagy-dependent gene function in controlling interactions between intestinal bacteria and the intestinal epithelium in vivo. In this study, I have demonstrated that small intestinal epithelial cell autophagy is essential for protection against tissue invasion by intestinal pathogens and opportunistically invasive commensals. I have shown that small intestinal autophagy is an early innate immune response that functions in an epithelial cell-intrinsic MyD88-dependent, NOD2-independent manner. Utilizing mice deficient in small intestinal epithelial cell autophagy (Atg5∆IEC), I have determined that epithelial cell autophagy is required to limit pathogen dissemination to extraintestinal sites. This study thus shows that autophagy is a critical mechanism of innate immune defense that protects intestinal epithelial surfaces from bacterial invasion. My findings may lead to new insights into how autophagy protects against gastrointestinal infections and maintains homeostasis with the intestinal microbiota.Item Health maintenance and IBD: collaborative approach between PCP and specialist(2014-08-22) Ahmed, TasneemItem Impact of Psychological Variables on Health Status Over Time in Adolescents With Inflammatory Bowel Disease(2014-07-25) Martinez, Dailyn; Donewar, Crista W.; Iteld, Lily; Patel, Ashish; Reed, Gabriela; Stewart, Sunita M.The relationship between psychological factors and health outcomes over time in adolescents with Inflammatory Bowel Disease (IBD) is complex. The pediatric IBD literature with respect to these relationships is limited, yet the broader IBD and health psychology literatures offer clues as to the negative impact of alexithymia, depressive symptoms, and stress on health status and health care utilization. Studies have revealed higher rates of alexithymia in adult IBD populations, which in turn has been associated with worse emotional functioning and lower quality of life (QOL). Depression has been associated with worse disease status in children with IBD, but this relationship requires additional exploration, as it remains equivocal. In the adult IBD literature, stress has been associated with disease relapse and avoidant coping. Our study sought to understand the relationship between these psychological factors, health status as determined by disease severity, and health care utilization (i.e., outpatient GI visits, ED visits, nights hospitalized, and time to medical care) over the course of 3 months and 12 months after baseline. Our study revealed correlations between disease severity and age, race, and ethnicity. However, no associations emerged between disease severity and our psychological factors of interest. Conversely, significant associations emerged between our health care utilization variables and psychological factors. For instance, stress was predictive of nights hospitalized over the course of 3 months post-baseline while both alexithymia and depressive symptoms emerged as significantly predictive of number of nights hospitalized over the course of 12 months. Additionally, increasing depressive symptoms were associated with shorter time to hospitalization post-baseline. These results highlight the complex and important relationship between psychological factors and markers of health outcome, and the importance of continuing research efforts to elucidate the mechanisms underlying these relationships. Ultimately, clearer understanding of these dynamics has important implications for pediatric IBD patients and the providers who treat them.Item Inflammatory bowel diseases(2009-07-10) Swaroop, Prabhakar P.Item Inflammatory bowel diseases: genetics, inflammatory mediators, new treatments(2000-09-21) Westergaard, HenrikItem The microbiome and spondyloarthritis(2015-10-30) Reimold, AndreasItem Optimizing inflammatory bowel disease clinical care and research at UTSW(2016-03-11) Kwon, John H.Item Recent advances in the medical therapy of inflammatory bowel disease(1995-08-24) Spady, David K.Item [Southwestern News](1997-10-22) Steeves, Susan A.Item Understanding and improving inflammatory bowel disease care in 2022: the gut and beyond(2022-06-24) Fudman, DavidItem Update in management of inflammatory bowel disease: new approaches and new therapies(2001-09-06) Cryer, ByronItem [UT Southwestern Medical Center News](2008-12-08) Shear, Kristen HollandItem [UT Southwestern Medical Center News](2011-10-19) Bolles, Debbie; Wormser, DeborahItem [UT Southwestern Medical Center News](2006-08-25) Heinzl, Toni