Browsing by Author "Mitrović, Miloš (56979859800)"

Introduction/Aim. Anemia is a common extraintestinal manifestation of inflammatory bowel diseases (IBDs). Recognizing and treating anemia in patients with IBD is vital for improving the quality of life and reducing complications. The aim of this study was to assess the effectiveness and safety of the liposomal iron formulation in the treatment of anemia in patients with Crohn's disease and ulcerative colitis. Method. Among 447 patients in the state of clinical remission of ucerative colitis and Crohn's disease treated with biological therapy, there were 37 patients with confirmed sideropenic anemia (Hb 10 g/dl – 12 g/l, ferritin less than 100) who received a liposomal iron pyrophosphate preparation at the dose of 30 mg daily for one month. Parameters such as hemoglobin level, hematocrit, ferritin, and mean corpuscular volume (MCV) were monitored, along with anemia symptoms, and correlated with the onset of therapy; quality of life was also assessed. Statistical analysis was performed using the SPSS program.Results. The application of liposomal iron over one month resulted in a statistically significant increase in hemoglobin levels, averaging 3 g/dL (p = 0.021). A significant increase in hemoglobin was observed in patients in endoscopic remission, almost 10 g/dL (p = 0.008). Additionally, there was an average increase in ferritin levels by almost 2 ng/mL (p = 0.514) and hematocrit by 0.006% (p = 0.126), although these increases did not reach statistical significance. Analyzing the results based on the type of IBD, greater efficacy was observed in patients with ulcerative colitis, showing a significant increase in hemoglobin of 8 g/dL (p = 0.012) compared to patients with Crohn's disease. Two patients reported abdominal discomfort and diarrhea (5.4%) as adverse effects.Conclusion. Our results suggest that 8.3% of IBD patients in clinical remission have anemia and liposomal iron is an effective and safe option for treating anemia in patients. Further research is needed to evaluate the long-term effectiveness and safety of liposomal iron in this patient population. © 2024 University of Nis, Faculty of Medicine. All rights reserved.

INTRODUCTION: Metabolic Dysfunction-associated Liver Disease (MASLD) represents a spectrum of conditions from simple fat accumulation to non-alcoholic steatohepatitis. The possible role of the intestinal microbiome on MASLD development has been in focus. Our study aimed to examine the effects of synbiotics on the liver steatosis, inflammation, and stool microbiome. METHODS: A double-blind, placebo-controlled study was conducted involving 84 MASLD patients, defined by an elastometric attenuation coefficient (ATT) greater than 0.63 dB/cm/MHz with an alanine aminotransferase level above 40 U/L for men and 35 U/L for women. The patients were divided into an intervention group treated with a synbiotic with 64x109 CFU of Lactobacillus and Bifidobacterium and 6.4g of inulin and a control group treated with a placebo. RESULTS: Using synbiotics for 12 weeks significantly decreased liver steatosis (ΔATT -0.006±0.023 vs -0.016±0.021 dB/cm/MHz, p=0.046). The group of patients treated with synbiotics showed a significant decrease in the level of high-sensitive C-reactive protein (Δhs-CRP 0 vs -0.7 mg/L, p≤0.001). Synbiotics enriched the microbiome of patients in the intervention group with the genera Lactobacillus, Bifidobacterium, Faecalibacterium, and Streptococcus, by 81%, 55%, 51%, and 40%, respectively, with a reduction of Ruminococcus and Enterobacterium by 35% and 40%. Synbiotic treatment significantly shortened the gut transition time (ΔGTT -5h vs. -10h, p=0.031). CONCLUSION: Synbiotics could be an effective and safe option that could have place in MASLD treatment. © 2024 Miloš Mitrović et al., published by Sciendo.

Objective: Altering dysbiotic gut flora through synbiotic supplementation has recently been recognized as a potential treatment strategy to reduce the levels of gut-derived uremic toxins and decrease inflammation. Assessing its efficacy and safety has been the main goal of our randomized, double-blind, placebo-controlled study. Methods: A total of 34 nondialyzed chronic kidney disease patients, aged ≥18 years, with an estimated glomerular filtration rate between 15 and 45 mL/minute, were randomized either to an intervention group (n = 17), receiving synbiotic (Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium lactis, 32 billion colony forming units per day plus 3.2 g of inulin), or control group (n = 17), receiving placebo during 12 weeks. The impact of treatment on the dynamic of serum levels of gut-derived uremic toxins, total serum indoxyl sulfate, p-cresyl sulfate, and trimethylamine N-oxide, was defined as the primary outcome of the study. Secondary outcomes included changes in the stool microbiome, serum interleukin-6 levels, high-sensitivity C-reactive protein, estimated glomerular filtration rate, albuminuria, diet, gastrointestinal symptom dynamics, and safety. Serum levels of uremic toxins were determined using ultraperformance liquid chromatography. The stool microbiome analysis was performed using the 16S ribosomal ribonucleic acid gene sequencing approach. Results: Synbiotic treatment significantly modified gut microbiome with Bifidobacteria, Lactobacillus, and Subdoligranulum genera enrichment and consequently reduced serum level of indoxyl sulfate (ΔIS –21.5% vs. 5.3%, P < .001), improved estimated glomerular filtration rate (ΔeGFR 12% vs. 8%, P = .029), and decreased level of high-sensitivity C-reactive protein (–39.5 vs. –8.5%, P < .001) in treated patients. Two patients of the intervention arm complained of increased flatulence. No other safety issues were noted. Conclusion: Synbiotics could be available, safe, and an effective therapeutic strategy we could use in daily practice in order to decrease levels of uremic toxins and microinflammation in chronic kidney disease patients. © 2022 The Authors

Objective: Altering dysbiotic gut flora through synbiotic supplementation has recently been recognized as a potential treatment strategy to reduce the levels of gut-derived uremic toxins and decrease inflammation. Assessing its efficacy and safety has been the main goal of our randomized, double-blind, placebo-controlled study. Methods: A total of 34 nondialyzed chronic kidney disease patients, aged ≥18 years, with an estimated glomerular filtration rate between 15 and 45 mL/minute, were randomized either to an intervention group (n = 17), receiving synbiotic (Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium lactis, 32 billion colony forming units per day plus 3.2 g of inulin), or control group (n = 17), receiving placebo during 12 weeks. The impact of treatment on the dynamic of serum levels of gut-derived uremic toxins, total serum indoxyl sulfate, p-cresyl sulfate, and trimethylamine N-oxide, was defined as the primary outcome of the study. Secondary outcomes included changes in the stool microbiome, serum interleukin-6 levels, high-sensitivity C-reactive protein, estimated glomerular filtration rate, albuminuria, diet, gastrointestinal symptom dynamics, and safety. Serum levels of uremic toxins were determined using ultraperformance liquid chromatography. The stool microbiome analysis was performed using the 16S ribosomal ribonucleic acid gene sequencing approach. Results: Synbiotic treatment significantly modified gut microbiome with Bifidobacteria, Lactobacillus, and Subdoligranulum genera enrichment and consequently reduced serum level of indoxyl sulfate (ΔIS –21.5% vs. 5.3%, P < .001), improved estimated glomerular filtration rate (ΔeGFR 12% vs. 8%, P = .029), and decreased level of high-sensitivity C-reactive protein (–39.5 vs. –8.5%, P < .001) in treated patients. Two patients of the intervention arm complained of increased flatulence. No other safety issues were noted. Conclusion: Synbiotics could be available, safe, and an effective therapeutic strategy we could use in daily practice in order to decrease levels of uremic toxins and microinflammation in chronic kidney disease patients. © 2022 The Authors