Insights & Discussion
Carrageenan intake can lead to an earlier relapse in patients with ulcerative colitis who are in remission.
In the methods employed, a clinical trial was carried out to determine if ulcerative colitis patients could avoid or defer relapse by following a diet devoid of carrageenan. Participants were educated about the no-carrageenan diet, and then divided into two groups - one receiving capsules containing carrageenan and the other receiving placebo capsules. The amount of carrageenan in the capsules was less than the average daily dietary intake. Relapses were defined by a rise of two or more points on the Simple Clinical Colitis Activity Index and the need for enhanced ulcerative colitis treatment. Over the course of a year, participants were monitored every two weeks via phone calls.
In the research results, it was found that out of twelve patients, those who ingested carrageenan capsules had a higher relapse rate. Notably, none of those who took the placebo experienced a relapse. The group exposed to carrageenan exhibited increased levels of inflammation indicators - the Interleukin-6 and the fecal calprotectin biomarkers - by the end of their participation in the study. There was no such increase observed in the placebo group.
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Acupuncture and moxibustion therapies have shown effectiveness in treating ulcerative colitis according to the summarised-findings of various systematic reviews and meta-analyses.
2024 Heliyon Effects of acupuncture and moxibustion on ulcerative colitis: An overview of systematic reviews Wang D, Wang Q, Wang Y, Li T, Tian M
Systematic Review Acupuncture Moxibustion Ulcerative Colitis
Methodology: This evaluative study used an extensive and systematic methods to search data from seven different databases. The selected data were further refined by using different screening and evaluation frameworks like AMSTAR-2, PRISMA, ROBIS, and GRADE systems. These were used to determine the methodological quality, reporting quality, risk of bias, and the quality of evidence in the selected studies.
Discussion of results: After critical evaluation, the study found ten relevant reviews and analyses that showed potential for acupuncture and moxibustion therapies being effective in ulcerative colitis treatment. However, many the identified studies were reported to have several problems in their overall design and quality of outcomes. The researchers therefore stress caution when interpreting these results due to the lack of high-quality evidence in the existing studies.
Diverse acupuncture therapies, especially moxibustion, emerged as superior methods for alleviating ulcerative colitis symptoms in clinical practice.
2024 SSRN Electronic Journal Efficacy and Safety of Different Acupuncture Therapies for Patients with Ulcerative Colitis：A Systematic Review And Network Meta-Analysis Zhang X, Yang S, Jin Y, Cheng X, Lu H, Wu H, et al.
Meta-Analysis Acupuncture Moxibustion Ulcerative Colitis
Methodology: The researchers carried out a systematic review and network meta-analysis of clinical efficacy of various acupuncture therapies for ulcerative colitis patients. They accomplished this by sourcing for Clinical Randomized Controlled trial articles from databases such as PubMed, Embase, Cochrane Library, and other data knowledge service platforms, all of which were independently reviewed by two researchers. Several quality assessments were made through Review Manager software, and the meta-analysis was conducted with Stata 16 software. Interventions examined in the analysis included acupuncture, moxibustion, acupoint catgut embedding, and combinations of these therapies with Western medicine.
Discussion of results: 52 articles encompassing 3924 patients participated in randomized control trials. The investigation revealed a range of interventions, including different acupuncture therapies and combinations of these therapies with Western medicine. Namely, moxibustion, either on its own or combined with Western medicine, consistently surfaced as top-ranked for overall effectiveness and specific outcomes. Moreover, moxibustion displayed impressive performance in reducing adverse reactions and recurrence rates. Thus, various acupuncture therapies were confirmed as safe and effective for the treatment of ulcerative colitis, with moxibustion emerging as the most effective.
A combined Mediterranean, low-FODMAP diet along with partial enteral nutrition has shown promise in reducing ulcerative colitis activity and improving patients' quality of life.
2024 Scientific Reports Effectiveness of a novel diet in attenuation of clinical activity of disease in patients with ulcerative colitis: a randomized, clinical trial Narimani B, Sadeghi A, Daryani NE, Shahrokh S, Nilghaz M, Ghods M, et al.
Randomised Controlled Trial Low FODMAP Ulcerative Colitis
In the study, fifty patients with active, mild to moderate ulcerative colitis were randomly allotted one of two diets: a combined Mediterranean, low-FODMAP diet supplemented with partial enteral nutrition, or a standard diet. These diets were implemented for a duration of 6 weeks. Before and after the intervention, various indicators of the patients' conditions were measured. These variables included a disease activity index, the patients' quality of life, and concentrations of various inflammatory and oxidative stress factors in the blood. All of these were measured using tested and trustworthy questionnaires, in conjunction with blood sampling.
The combined diet was found to result in significantly decreased disease activity index values, compared to both the control diet and the baseline data. Simultaneously, patients on the combined diet reported greater enhancements in their quality of life, compared to both the control group and the initial data. Lastly, the serum level of a protein called "high sensitive C-reactive protein," known to be a general marker of inflammation within the body, was found to be reduced in the combined diet group. However, changes in the serum total antioxidant capacity were found to be statistically insignificant across both groups.
A polysaccharide from Tremella aurantialba improves ulcerative colitis symptoms by targeting epithelial cell ferroptosis and modulating the gut microbiota.
2024 International Journal of Biological Macromolecules Tremella aurantialba polysaccharides alleviate ulcerative colitis in mice by improving intestinal barrier via modulating gut microbiota and inhibiting ferroptosis Peng G, Wang S, Zhang H, Xie F, Jiao L, Yuan Y, et al.
Animal Study Gut Microbiota Intestinal Barrier Snow Fungus
The methodology used in this research involved isolating TA 2-1, a specific polysaccharide from Tremella Aurantialba, and studying its effects on ulcerative colitis. This was done by introducing it to Caco-2 cells that were undergoing ferroptosis and assessing its impact on cell viability. The influence of TA 2-1 was also examined in mice with artificially induced ulcerative colitis, verifying its ameliorating effects in an in-vivo context. The structure of TA 2-1 and its components were analysed and the polysaccharide's interaction with gut microbiota was explored to understand how it might modulate symptoms or prevent cell death.
The results of this study showed that TA 2-1 does not only decrease the rate of cell death in epithelial cells undergoing ferroptosis, but it also repairs the intestinal barrier by upregulating specific proteins such as claudin-1 and zonula occludens-1. TA 2-1 was also found to suppress lipid peroxidation, thus inhibiting ferroptosis. Further investigation revealed that TA 2-1 may alleviate ulcerative colitis by influencing the composition or metabolites of gut microbiota. This research offers promising insight into the potential of TA 2-1 in treating ulcerative colitis.
Carrageenan, a common food additive, has dual aspects, being both useful in drug delivery and food printing, while potentially harmful via inducing intestinal inflammatory conditions.
2024 Nutrients Carrageenan as a Potential Factor of Inflammatory Bowel Diseases Komisarska P, Pinyosinwat A, Saleem M, Szczuko M
Carrageenan Inflammatory Bowel Diseases
This study investigates the dual roles of carrageenan, a naturally occurring polysaccharide. It is used in creating edible films and encapsulating drugs, and has potential uses in food printing. Moreover, it can regulate the composition of intestinal microflora, including promoting the increase of Bifidobacterium bacteria. The research shines a light on the harmful side of carrageenan as well by focusing on its interactive effects with intestinal microflora, mucous barrier, and proinflammatory pathways.
The study reveals that carrageenan negatively alters intestinal microflora, triggering a breakdown of the mucus barrier, leading to an inflammatory response. This response occurs due to activation of the pro-inflammatory nuclear factor kappa-light-chain-enhancer pathway in the epithelial cells, likely via the mechanism of TLR4 receptor activation, alteration in macrophage activity, production of proinflammatory cytokines, and activation of innate immune pathways. Carrageenan's influence also led to increased levels of Bacteroidetes bacteria, alongside reducing short-chain fatty acid-producing bacteria, ultimately damaging the integrity of the intestinal membrane and reducing the mucin layer. The study finds that those with intestinal inflammation disorders, like Crohn's disease and ulcerative colitis, are particularly vulnerable to these harmful effects.
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