Abstract These days, a wide range of diseases are thought to be primarily caused by chronic inflammation. Anti‐inflammatory medications are therefore frequently used in conventional therapy for inflammatory conditions; however, several drugs have undesirable side effects. Natural products are viable substitutes that may yield novel bioactive chemicals that could serve as lead molecules for novel anti‐inflammatory drugs. An abundant supply of new chemicals can be found in marine environments due to their vast biological and chemical diversity. Some of the major chemical components from marine species, including sesquiterpenoids, diterpenes, steroids, polysaccharides, alkaloids, fatty acids, and proteins, have been extracted and reported to be anti‐inflammatory. An emphasis on previous and recent pre‐clinical and clinical research updates on marine natural communities and their synthetic congeners with possible anti‐inflammatory properties is compiled in this review.
Achalasia is a rare esophageal motility disorder causing dysphagia, chest pain, vomiting, and weight loss, significantly impairing quality of life. Peroral endoscopic myotomy (POEM) has emerged as a minimally invasive and effective treatment. However, limited data compare the outcomes of POEM between type I and type II achalasia based on the Chicago Classification. This single-center retrospective study included patients diagnosed with achalasia (Eckardt score >= 4) who underwent POEM at Kaohsiung Chang Gung Memorial Hospital from December 2016 to May 2023. The Eckardt score was assessed 6 months after the POEM procedure, while the High-Resolution Manometry had an average median follow-up of 30.5 months. Primary outcomes included changes in Eckardt score, lower esophageal sphincter (LES) pressure, upper esophageal sphincter (UES) pressure, and integrated relaxation pressure. Secondary outcomes included hospital stay, operation time, weight gain, and adverse event rates. A total of 39 patients (17 with type I and 22 with type II achalasia) were analyzed, with a median follow-up of 30.5 months. Both subtypes showed significant improvements in Eckardt scores (p < .001) and weight gain (type I: p = .023; type II: p = .03). No significant differences were observed between subtypes in Eckardt score reduction (p = .458) or weight gain (p = .693). Type II patients had shorter hospital stays (p = .017). While LES pressure decreased significantly in type I patients after POEM (p = .007), it did not reach statistical significance in type II patients (p = .051). Our study demonstrated that POEM therapy effectively improves symptoms and facilitates weight gain in both type I and type II achalasia, with no significant differences in primary outcomes.
Coronavirus disease 2019 (COVID-19) vaccines are effective in preventing severe disease in patients with inflammatory bowel disease (IBD), but the risk of infection following vaccination in ulcerative colitis (UC) versus Crohn's disease (CD) patients remains unclear. This study compares the risk of COVID-19 infection between UC and CD patients postvaccination. A retrospective cohort study was conducted on IBD patients who received at least two doses of the COVID-19 vaccine at China Medical University Hospital between January 1, 2020, and October 31, 2024. The study included 169 IBD patients (96 UC, 73 CD). Demographic data, vaccination history, and medical records were analyzed. Logistic regression assessed the odds of COVID-19 infection, adjusting for potential confounders. UC patients were significantly older than CD patients (44.92 +/- 13.72 years vs. 37.27 +/- 15.27 years, p = .0008). The overall prevalence of COVID-19 infection was 49.11%, with UC patients having a significantly higher infection rate (56.25%) compared to CD patients (39.73%, p = .0333). Logistic regression showed UC patients had an odds ratio of 1.95 (95% confidence interval [CI] = 1.05-3.62) and an adjusted odds ratio of 2.78 (95% CI = 1.20-6.44), indicating a 1.95- to 2.78-fold higher risk of infection. A trend toward reduced infection risk with more vaccine doses was observed, with medication use not significantly affecting infection risk. Our study showed that vaccinated UC patients had a significantly higher risk of COVID-19 infection compared to CD patients, highlighting the need for tailored monitoring and care strategies for UC patients, even postvaccination.
Intestinal ultrasound (IUS) is a non-invasive imaging method used to evaluate bowel wall inflammation and monitor disease activity in inflammatory bowel disease (IBD) patients. Both the European Crohn's and Colitis Organization and the American Gastroenterological Association endorse IUS for monitoring disease activity and identifying complications at the point of care. However, to date, no published data are available regarding the use of IUS for IBD management in Taiwan. Similar to the specificity of IUS in visualizing gut inflammation, immunoglobulin A (IgA) is a key immunoglobulin central to gut mucosal immunity. Recent studies have explored the involvement of IgA in IBD, but the relationship between IgA levels and bowel wall inflammation was unknown. We enrolled 28 IBD patients, including 19 with ulcerative colitis (UC) and 9 with Crohn's disease (CD), from the outpatient clinic of China Medical University Medical Center. All patients underwent IUS between July 2023 and August 2024. Ultrasound scores were based on the Milan ultrasound criteria (MUC) for UC and the bowel ultrasound score (BUSS) for CD. Plasma levels of erythrocyte sedimentation rate, C-reactive protein (CRP), albumin, IgA, partial Mayo score, and Crohn's disease activity index (CDAI) were collected at baseline, during treatment, and after 52 weeks of advanced therapy (Adalimumab, Vedolizumab, or Tofacitinib). IUS findings were closely correlated with disease activity. In UC, the MUC score was positively correlated with CRP (R-2 = 0.4888, p < .0001), partial Mayo score (R-2 = 0.3652, p = .0002), and negatively with albumin levels (R-2 = 0.3747, p = .0002). In CD, the BUSS score showed a positive correlation with CDAI (R-2 = 0.2694, p = .0394). Plasma IgA levels were significantly associated with bowel wall thickness (BWT) in both UC and CD (R-2 = 0.1759, p = .0041). Furthermore, plasma IgA was strongly correlated with the BUSS score (R-2 = 0.6585, p = .0001) in CD patients. Notably, when BWT exceeded 3.5 mm, plasma IgA levels increased significantly (p = .0025). These results demonstrate that IUS is an effective tool for monitoring disease activity and evaluating therapeutic responses in IBD patients. Besides, plasma IgA reflects the bowel wall inflammation, particularly in conjunction with IUS.
