English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

s we learn more about the importance of our Amicrobiome in inflammatory, metabolic, and functional disorders, we are coming to appreciate the risks of disturbing this with broad-spectrum antibiotics. We have known for many years that as antibiotics have dramatically reduced the risk of infectious diseases, the incidence of other diseases such as inflammatory bowel disease, obesity, and type 2 diabetes mellitus have increased. Although the causes undoubtedly are multifactorial, meta-analysis showed that for Crohn’s disease (CD), antibiotic exposure nearly doubles the risk. The current article provides one possible mechanism where by this might occur. The authors studied 32 patients who provided stool samples before and after taking a range of antibiotics. They found that 8 patients showed a marked increase in fecal protease activity, mostly owing to increased pancreatic proteases. Supernatants from the stools with increased protease activity increased permeability when applied to a polarized monolayer of cultured colonic epithelial cells. This was particularly evident in patients given antibiotics such as levofloxacin and metronidazole, which are known to markedly reduce fecal microbiota, although this was much less obvious after antibiotics such as rifaximin, which have less impact on the microbiota. The pancreas secretes approximately 500 mg of tryptase daily into the gut, yet only approximately 1 mg is excreted and early animal experiments have shown that this degradation largely was prevented by broad-spectrum antibiotics. This article takes these ideas forward by examining the impact of antibiotic-induced increased fecal proteases on gut barrier function using cell lines and animal models. They showed that in mice, broad-spectrum antibiotics (vancomycin and metronidazole) increased fecal proteolytic activity, mostly owing to increases in pancreatic serine proteases such as trypsin and chymotrypsin. This lead to an increase in permeability, which in normal wild-type mice lasted approximately 14 days but did not lead to an inflammatory response. However, in genetically susceptible interleukin 10 knock-out mice, repeated antibiotic courses lead to the development of a chronic colitis, which could be blocked by a specific protease inhibitor. Although CD is important, it also thankfully is rare and the majority of antibiotic courses do not lead to the development of CD. However, irritable bowel syndrome (IBS) is approximately 100 times more common, affecting approximately 1 in 10 of the population. IBS also is associated with antibiotic use, with a 3-fold increase in the risk of developing functional gastrointestinal symptoms in the 4 months after antibiotic consumption. IBS with diarrhea (IBS-D),

Hidden Dangers of Antibiotic Use: Increased Gut Permeability Mediated by Increased Pancreatic Proteases Reaching the Colon