(Poly) phenols nyob rau hauv Inflammatory Bowel Disease Thiab Irritable Bow Syndrome: Kev Ntsuam Xyuas
Mar 24, 2022
Yog xav paub ntxiv. tiv taujtina.xiang@wecistanche.com
Abstract: (Poly) phenols(PPs) tej zaum yuav muaj txiaj ntsig kho mob hauv plab hnyuv (GI), xws li chim siab plob tsis so tswj (IBS) lossisinflammatory plab hnyuv kab mob(IB). Lub hom phiaj ntawm qhov kev tshuaj xyuas no yog los sau cov ntaub ntawv pov thawj hauv qhov no. Kev soj ntsuam cov pov thawj tsis qhia meej tias kev noj PP muaj lub luag haujlwm tiv thaiv IBD lossis IBS, thaum cov kev tshawb fawb cuam tshuam qhia tias cov tshuaj no tuaj yeem ua rau cov tsos mob thiab kev noj qab haus huv ntsig txog kev txhim kho lub neej hauv cov neeg mob paub. Muaj cov txiaj ntsig tsis sib xws rau cov teebmeem ntawm cov cim ntawm qhov mob, tab sis muaj cov lus ceeb toom pheej hmoo ntawm kev txhim kho endoscopic. Ua haujlwm ntawm cov teebmeem ntawm PPs ntawm txoj hnyuv permeability thiab oxidative kev nyuaj siab yog txwv thiab yog li cov lus xaus tsis tuaj yeem tsim. Kev ua haujlwm yav tom ntej ntawm kev siv PPs hauv IBD thiab IBS yuav ntxiv dag zog rau kev nkag siab ntawm kev kho mob thiab kev siv tshuab.
Ntsiab lus: inflammatory bowels disease (IBD); Crohn tus kab mob; ulcerative colitis; chim siab plob tsis so tswj syndrome (IBS); (poly) phenols
1. Taw qhia
(Poly) phenols(PPs, suav nrog cov phenolic tebchaw nrog tsawg kawg ib lub nplhaib nrog ib lossis ntau pawg hydroxyl txuas), yog ib pawg loj heev ntawm cov nroj tsuag theem nrab metabolites uas yog sub-classified li flavonoids thiab non-flavonoids.Flavonoids muaj flavan-3-ols, flavones, isoflavones, flavonols, dihydroflavonols, flavanones, proantho-cyanins, anthocyanins, chalcones, dihydrochalcones, thiab aurones. Non-flavonoids suav nrog phenolic acids (hydroxybenzoic acids thiab hydroxycinnamic acids), stilbenes, lignans, coumarins, curcuminoids, thiab tannins (xws li ellagitannins) [1-3]. Cov khoom noj khoom haus tseem ceeb tshaj plaws suav nrog kas fes, tshuaj yej, txiv hmab txiv ntoo thiab zaub, cocoa, kua txiv hmab txiv ntoo, txiv ntseej, txiv roj roj, cawv liab, cereals, thiab tag nrho cov nplej [2-4]. PPS tau raug lees paub los tiv thaiv kab mob thiab kev tiv thaiv cardio (nrog rau lwm tus) [1,2,5] thiab yog li ntawd nws tau raug pom zoo tias lawv yuav muaj txiaj ntsig zoo hauv plab hnyuv (GI) mob xws li kab mob plab hnyuv (IBD) thiab chim siab. bowel syndrome (IBS) [6,7].
IBD muaj xws li Crohn's disease (CD) thiab ulcerative colitis (UC), uas yog ob qho tib simob inflammatoryCov yam ntxwv ntawm GI ib puag ncig [8] Thoob plaws ntiaj teb, muaj 6.8 lab tus tib neeg nyob nrog IBD (84.3 rau 100,000 cov pej xeem), nrog rau qhov tshaj tawm tshaj tawm hauv North America tom qab United Kingdom [9]. Qhov xwm txheej ntev thiab tsis sib xws ntawm IBD txhais tau hais tias txhua hnub lub cev, kev sib raug zoo, thiab kev ua haujlwm tuaj yeem cuam tshuam loj heev [10]. Mob plab, mob plab thaum lub sij hawm tso zis, thiab ntshav, kua paug, lossis hnoos qeev hauv cov quav yog cov tsos mob tshwm sim [11]. Pharmacological kev kho mob rau induction thiab kev saib xyuas ntawm kev tso tawm hauv IBD muaj xws li aminosalicylates, corticosteroids, immunomodulators, thiab monoclonal antibodies [11]. Pharmacological kev kho mob muaj ntau yam kev phiv xws li mob plab hnyuv, mob taub hau, mob, poob phaus, muaj kev pheej hmoo ntawm kev kis kab mob, ntshav qab zib, thiab pob txha loj, nrog rau lwm tus [12,13]. Cov ntawv nyeem tau txhawb nqa ntau yam kev noj haus los txhawb kev tso tawm hauv IBD, xws li kev noj zaub mov tshwj xeeb carbohydrate (SCD), qis fermentable oligosaccharide, disaccharide, monosaccharide, thiab polyol (FODMAP) noj zaub mov, Palaeolithic noj (Paleo), thiab cov khoom noj tiv thaiv kab mob. (IBD-AID)[14]. Kev noj zaub mov SCD pom zoo kom noj monosaccharides thiab txwv tsis pub disaccharides thiab polysaccharides raws li txoj kev xav tias disaccharides thiab polysaccharides nkag mus rau hauv txoj hnyuv undigested, ua rau mob plab hnyuv [14]. Paleo noj zaub mov qhia pom tias tsis muaj zaub mov tshwm sim thaum tib neeg kev hloov pauv tuaj yeem ua rau muaj kab mob niaj hnub; Yog li ntawd, kev noj zaub mov tsis zoo thiab cov zaub mov muaj fiber ntau tau pom zoo [15]. Kev noj ntau dhau ntawm FODMAPs, uas yog fermentable heev tab sis tsis zoo absorbed luv-chain carbohydrates thiab polyols, tuaj yeem ua rau plab hnyuv permeability [16] ib yam nkaus, ua rau cov tsos mob tseem ceeb hauv plab hnyuv. Kev noj zaub mov qis FODMAP suav nrog tshem tawm cov zaub mov siab hauv FODMAPs rau 6-8 lub lis piam thiab maj mam rov qhia lawv nrog kev txhawb nqa ntawm tus kws noj zaub mov [17]. Cov kev tshawb fawb tsis pom kev thiab kev soj ntsuam pom tau hais tias txo FODMAPs hauv IBD cov neeg mob hauv kev zam txim tuaj yeem ua rau muaj txiaj ntsig zoo rau cov tsos mob zoo li IBS [18]. randomized tswj cov ntaub ntawv mus sib hais tsis muaj; Yog li ntawd, kev pom zoo ntawm cov kws tshaj lij tam sim no tsis pom zoo "IBD noj zaub mov" los txhawb kev tshem tawm hauv cov neeg mob uas muaj tus kab mob nquag [19].
IBS yog ib qho kev ua haujlwm ntawm plab hnyuv siab raum uas txhais tau tias siv Rome IV cov txheej txheem ua ke nrog kev mob plab, tsis zoo ntawm plab hnyuv, thiab tsam plab [20]. Qhov pib ntawm cov tsos mob yuav tsum tshwm sim tsawg kawg 6 lub hlis ua ntej kev kuaj mob thiab tau tshwm sim rau 3 lub hlis dhau los [20]. IBS tuaj yeem muab faib ua plaub hom subtypes raws li cov tsos mob tseem ceeb tshaj plaws: cem quav-predominant (IBS-C), raws plab-predominant (IBS-D), sib xyaw plob tsis so tswj (IBS-M), lossis unsubtyped [21]. Qhov tshwm sim ntawm IBS yog kwv yees li ntawm 5.7 feem pua hauv Tebchaws Meskas, Canada, thiab United Kingdom [22]. Ntau yam tau raug cuam tshuam rau hauv pathogenesis ntawm IBS, suav nrog visceral hypersensitivity, kev sib cuam tshuam ntawm lub paj hlwb, plab hnyuv, tom qab kis kab mob, plab hnyuv o, zaub mov rhiab heev, carbohydrate malabsorption, hloov pauv plab zom mov, cov kab mob overgrowth, thiab kev hloov pauv hauv microflora. Kev hloov pauv ntawm cov kab mob microflora, kev ua xua rau zaub mov, kab mob enteritis, thiab caj ces yuav ua rau muaj kev mob qis, tab sis cov txheej txheem tsis nkag siab [24]. Kev kho mob ntawm IBS feem ntau cuam tshuam nrog kev noj haus thiab kev hloov pauv kev ua neej [25,26]; Txawm li cas los xij, cov tshuaj siv tau los kho tus kheej cov tsos mob ntawm cramping, cem quav, thiab raws plab [27]. Kev pom zoo ntawm kev noj zaub mov thiab kev ua neej nyob yog ua raws li cov pov thawj tsawg heev los ntawm cov pov thawj los ntawm kev sim tshuaj ntsuam xyuas (RCTs) thiab cov kev sim tswj thiab suav nrog cov qauv noj mov tsis tu ncua, hloov kho cov fiber ntau thiab cov kua dej, thiab cov khoom noj FODMAP tsawg [26]. Pharmacological kev pom zoo kev taw qhia kuj tseem ua raws li cov pov thawj qis heev los ntawm RCTs thiab suav nrog cov tshuaj antispasmodic, laxatives rau cem quav, thiab cov tshuaj tiv thaiv kab mob rau raws plab. Tricyclic antidepressants (TCAs) yog suav tias yog kev kho mob thib ob tom qab los ntawm kev xaiv serotonin reuptake inhibitors (SSRI) [26]. Muaj lub cev loj hlob hauv vitro thiab tsiaj cov qauv pov thawj ntawm cov txiaj ntsig ntawm PPs hauv kev tswj cytokine-mediated o, kev tiv thaiv kab mob, thiab kev ua dawb radical uas cuam tshuam hauv IBD thiab IBS pathogenesis [7,28]. Tsis ntev los no, qee cov pov thawj los ntawm tib neeg kev tshawb fawb txog kev ua tau zoo ntawm PPs hauv IBD thiab IBShas tau luam tawm, suav nrog kev tshuaj ntsuam xyuas meta ntawm kev siv curcumin hauv UC thiab CD, uas yog hom (poly) phenol feem ntau tshawb xyuas txog tam sim no [{ {28}}]. Cov kev tshuaj xyuas yav dhau los ntawm lub ncauj lus no tau tsom mus rau ib tus neeg PPs, cov txheej txheem ntawm kev ua, thiab cov pov thawj los ntawm kev tshawb fawb preclinical [732-351, Lub hom phiaj ntawm tsab xov xwm no yog los tshuaj xyuas cov pov thawj uas twb muaj lawm thiab tshwm sim los ntawm tib neeg kev tshawb fawb rau kev siv PPs ntawm Kev tiv thaiv thiab kev tswj hwm ntawm IBD thiab IBS, nrog rau kev tsom mus rau cov txiaj ntsig ntawm tus neeg mob.
2. (Poly) phenols, Kab mob plab hnyuv, thiab mob plab plob tsis so tswj
Tag nrho ntawm 27 txoj kev tshawb fawb txog kev tshawb fawb txog cov txiaj ntsig ntawm PPs hauv IBD thiab IBS suav nrog hauv qhov kev tshuaj xyuas no (Tables 1-3). Ntawm 18 IBD cov kev tshawb fawb, 15 tau randomized tswj kev sim (RCTs), thaum 3 yog cov kev sim tsis tswj, xws li 1 lub lis piam mus rau 6 lub hlis ntawm lub sijhawm, nrog rau 18-83 cov tib neeg cuv npe. Hais txog kev cuam tshuam cov kev tshawb fawb hauv IBS, 8 yog RTCs thiab 1 yog kev sau npe ntxiv txij li 4-12 lub lis piam ntawm lub sijhawm thiab suav nrog 44 txog 241 yam. Tag nrho ntawm 11 txoj kev tshawb fawb tau tshawb xyuas qhov ua tau zoo ntawm curcumin, thaum lwm qhov PP tau kawm suav nrog cov tshuaj dawb huv (resveratrol, epigallocatechin-3-gallate (EGCG), isoflavones, proanthocyanidins, thiab silymarin) thiab PP-nplua nuj zaub mov (liab caw, txiv nkhaus taw). , flaxseeds, qhiav, tshuaj yej ntsuab, bilberry, txiv roj roj, thiab tshuaj yej ntsuab).
Tsuas yog 10 qhov kev soj ntsuam me me tau suav nrog thiab sau cov ntsiab lus hauv Table 4 (6 ntu ntu thiab 4 qhov kev tswj xyuas), nrog 6IBD cov kev tshawb fawb suav nrog 55-256 cov tib neeg thiab 4 IBS cov kev tshawb fawb nrog 297-388 cov ntsiab lus. Cov kev tshawb fawb kwv yees kev noj zaub mov noj ntawm isoflavones, proanthocyanidins, tag nrho cov polyphenols, tshuaj yej, kas fes, lossis chocolate siv cov khoom noj lossis cov lus nug txog kev ua neej.
Ntau yam kev ntsuas tau raug sim hauv cov kev tshawb fawb suav nrog IBD thiab IBS-txog cov tsos mob, cov cim inflammatory, kev noj qab haus huv ntawm lub neej, qhov tshwm sim ntawm IBS thiab IBD, plab hnyuv permeability, endoscopic teb, thiab oxidative stress. Cov kev tshawb pom tseem ceeb thiab cov lus xaus ntawm cov kev tshawb fawb no tau tham hauv Tshooj 21-2.7.
2.1. (Poly) phenols thiab Cov tsos mob hauv Kab mob plab hnyuv thiab kab mob plab hnyuv quav
Tag nrho ntawm 21 txoj kev tshawb fawb tau tshawb xyuas qhov cuam tshuam ntawm PPs ntawm cov tsos mob ntawm IBD (Table 1,2 thiab 4), suav nrog curcumin (n=9), bilberry anthocyanin (n=1), tshuaj yej ntsuab EGCG (n { {6}}), ntxiv virginolive roj (n=1), flaxseed (n=1), qhiav (n=1), silymarin (n{10}}), ntshiab trans -resveratrol (n=1), txiv nkhaus taw (n=1), liab caw (n{14}}), proanthocyanidins (n{15}}), thiab isoflavones (n{16}) }).
Mayo qhab nia, ulcerative colitis kab mob kev ua index (UCDAI, thiab kab mob kev ua index (Dal) yog plaub-criteria kab mob kev ua indexes nyob rau hauv UC uas muaj xws li cov quav zaus, qhov quav los ntshav, qhov tsos ntawm mucosa ntawm sigmoidoscopy, thiab ib tug kws kho mob soj ntsuam ntawm tus kab mob hnyav. [75,76]. Cov qhab nia ib nrab ntawm Mayo suav nrog 3 cov qauv ntawm Mayo cov qhab nia tsis suav nrog cov khoom siv endoscopic [77]. Kev txo qis hauv UCDAI thiab kev kho mob tshem tawm tau txhais tias UCDAI Tsawg dua lossis sib npaug li 3 tau cuam tshuam nrog kev tswj hwm ntawm cov tshuaj yej ntsuab. EGCG [45] thiab curcuminenema [42]. Txawm li cas los xij, kev noj tshuaj curcumin tsawg ntawm qhov ncauj (450 mg rau 8 lub lis piam) tsis tau tsim kev txhim kho hauv UCDAI [41]. Silymarin muaj flavonolignans thiab txhim kho DAI ntawm koob tshuaj 240 mg. / hnub rau 6 hli [49. Bilberry anthocyanins (840 mg / hnub rau 6 lub lis piam) [44], flaxseed, thiab flaxseed roj (30 g / hnub thiab 10g / hnub raws li rau 12 lub lis piam) [46] txo qis Mayo qhab nia; Txawm li cas los xij, ntxiv virgin txiv ntseej roj (50 mL / hnub rau 20 hnub) tsis muaj txiaj ntsig [47]. Curcumin supplementation (3000mg / hnub rau 1 lub hlis) txo qis qhov qhab nia Mayo ib nrab los ntawm Ntau dua lossis sib npaug rau 1 point [38]. Raws li cov indexes tau hais tias siv cov ntsuas ntsuas zoo sib xws, lawv sib sau ua ke txhawb kev siv ntau dua ntawm qhov ncauj curcumin, curcumin enema, ntsuab tshuaj yej EGCG, silymarin, bilberry anthocyanin, flaxseed, thiab flaxseed roj rau txo cov tsos mob hauv UC.
Qhov yooj yim kho mob colitis kev ua index (SSCAl) yog ib qho kev ntsuas tsib yam kab mob kev ua haujlwm nrog rau lub plab zom mov nyob rau nruab hnub thiab hmo ntuj, qhov ceev ntawm kev tso quav, ntshav hauv cov quav, kev noj qab nyob zoo, thiab cov kab mob plab ntxiv [8]. Hauv UC, qhov txo qis hauv SsCAI tau pom zoo nrog kev tswj hwm ntawm 3000 mg curcumin rau 1 lub hlis [38], 240 mg curcuminoids nanomicelles rau 28 hnub [39], ntshiab trans-resveratrol [50,51], txiv nkhaus taw [52], thiab qhiav hmoov [48].Clinical remission txhais tias yog SCCAI<2 was="" significantly="" correlated="" with="" curcumin="" supplementation="" of="" 1500mg-3000mg/day="" in="" uc="" [38,40].="" mango="" administration="" also="" significantly="" reduced="" sscai="" in="" cd52].="" the="" clinical="" activity="" index(ca="" is="" a7="" criteria="" disease="" activity="" index="" including="" the="" number="" of="" stools="" per="" week,="" blood="" in="" stools,="" abdominal="" pain/cramps,="" temperature,="" lab="" findings(erythrocyte="" sedimentation="" rate="" (esr)and="" hemoglobin="" concentration),="" and="" general="" wellbeing="" [79].="" in="" uc,="" cai="" significantly="" reduced="" with="" bilberry="" anthocyanin="" supplementation="" [44]="" and="" both="" curcumin="" alone="" [37]="" and="" curcumin="" administered="" in="" combination="" with="" green="" tea="" [36].="" the="" gastrointestinal="" symptom="" rating="" scale(gsrs)="" is="" a="" 15="" item="" rating="" scale="" used="" to="" assess="" symptoms="" in="" ibd="" and="" peptic="" ulcer="" disease="" [80].="" consumption="" of="" extra="" virgin="" olive="" oil="" significantly="" reduced="" the="" gsrs="" in="" participants="" with="" uc="" [47].="" one="" study="" investigating="" curcumin="" supplementation="" found="" a="" significant="" reduction="" in="" a="" global="" score="" that="" considered="" general="" wellbeing,="" number="" and="" quality="" of="" stool,="" blood="" in="" stool,="" abdominal="" pain,="" rectal="" pain="" urgency,="" medication="" change,="" and="" endoscopy="">
Crohn tus kab mob kev ua index (CDAI) yog xya yam kab mob kev ua ub no suav nrog ntau zaus ntawm cov kua quav, mob plab, kev noj qab haus huv, muaj teeb meem, siv tshuaj rau raws plab, plab plab, hematocrit, thiab sib txawv ntawm tus qauv hnyav [81 ]. Kev tswj hwm ntawm Theracurmin, uas tau nce bioavailability nyob rau hauv kev sib piv nrog tus qauv curcumin, ua rau muaj kev txo qis hauv CDAI [54] piv nrog kev txo qis tsis tseem ceeb nrog tus qauv curcumin [43]. Ib txoj kev tshawb nrhiav pom tsis muaj kev hloov pauv hauv CDAI hauv CD lossis ulcerative colitis kev soj ntsuam kev ua haujlwm Performance index (UCAD) hauv UC nrog cov cawv liab liab [53]. Cov ntaub ntawv kawm no tau xa mus rau UCAI tab sis tsis tau qhia meej tias tus qauv ntsuas twg tau siv, yog li nws nyuaj rau kev sib piv cov txiaj ntsig nrog lwm cov kev tshawb fawb soj ntsuam cov tsos mob hauv UC.
Qhov cuam tshuam ntawm PPs ntawm tus neeg mob plab hnyuv hauv UC kuj tau tshawb nrhiav hauv cov ntaub ntawv, txawm hais tias cov ntaub ntawv tsis tshua muaj thiab cov kev tshawb fawb muaj ntau yam sib txawv ntawm hom PPs, kev cuam tshuam, koob tshuaj, thiab lub sijhawm ntawm kev kawm. Kev txhim kho hauv fecal ceev tau pom nrog curcuminoid nano micelles [39] thiab ntxiv virgin txiv roj roj [47]. Tsis muaj qhov mob plab tau cuam tshuam nrog kev noj zaub mov ntau dua daidzein thiab tag nrho isoflavones; Txawm li cas los xij, tsis muaj qhov sib txawv ntawm qhov mob plab nrog kev noj zaub mov ntau dua proanthocyanidins [66. Tsis muaj cem quav tau cuam tshuam nrog kev noj zaub mov qis glycitein [66] thiab kev noj zaub mov ntau dua proanthocyanidins tau cuam tshuam nrog cem quav [65]. Ntxiv virgin txiv roj roj kev tswj hwm tau ua rau txo qis hauv cov lus ceeb toom ntawm cem quav [47]. Ib txoj kev tshawb fawb tau tshawb xyuas cov tsos mob ntawm tus neeg mob plab hauv CD thiab pom tias muaj cov tshuaj ntxiv nrog Theracurmin txo cov quav ntau zaus thiab pom tau tias muaj kev txo qis hauv plab [54].
Tag nrho ntawm 11 txoj kev tshawb fawb tau tshawb xyuas cov teebmeem ntawm PPs ntawm IBS cov tsos mob (Table 3 thiab 4), suav nrog tshuaj yej (n=2), kas fes (n=2), chocolate (n=1), Pycnogenol (n=1), soy isoflavones (n =1), soy isoflavones ua ke nrog vitamin D (n=1), Crofelemer (n =2), curcumin thiab fennel tseem ceeb roj (n{10}}), qhiav (n=1), polydatin ua ke nrog palmitoylethanolamide (n{12}}), thiab Gelsectan (n=1). Cov kab mob siab plob tsis so tswj qhov hnyav (IBS-SSS) yog ib daim ntawv nug tsib yam uas tshawb nrhiav cov lus nug txog cov tsos mob ntawm plab hnyuv thiab cuam tshuam ntawm IBS nrog lub neej zoo [82]. Plaub caug mg ntawm cov kua isoflavones txhua hnub rau 6 lub lis piam tsis cuam tshuam rau IBS-SSS [59]; Txawm li cas los xij, thaum ua ke nrog vitamin D 50.000 U ob lub lis piam, nws ua rau cov qhab nia qis dua [57,58]. Yim caum-plaub mg curcumin ntxiv nrog rau fennel tseem ceeb roj rau 30 hnub [62] thiab 1000 mg qhiav rau 28 hnub [64] kuj txo IBS-SSS. Txawm hais tias 1000 mg Ginger supplementation txhim kho IBS-SSS, kuj tseem muaj kev txhim kho hauv pawg placebo [64]. Cov ntsiab lus PP ntawm cov qhiav ntxiv tsis muaj, uas txwv tsis pub muaj peev xwm los txhais cov ntaub ntawv. Soy isoflavones supplementation kuj txo cov qhab nia IBS thaum soj ntsuam siv qhov pom kev sib piv (VAS) [59].
Muaj cov txiaj ntsig zoo los ntawm cov kev tshawb fawb qhia tias PPs tuaj yeem txhim kho qhov mob plab thiab tsis hnov tsw hauv IBS, tab sis tsis muaj kev txhim kho ntawm cov quav hauv qhov sib xws, zaus, qhov ceev kom qhib plab hnyuv, thiab pab kom txaus. Pycnogenol yog maritime Pine bark extract ntxiv uas muaj phenolic monomers, condensed flavonoids, thiab phenolic acids [83]. Pycnogenol txo qhov mob ntawm phau ntawv lub plab siab, nce kev ntxhov siab thiab lub plab zom mov, thiab txo qhov kev xav tau ntawm kev siv tshuaj cawm siav, txawm tias tsis muaj kev cuam tshuam rau qhov mob ntau zaus [55]. Mob plab mob hnyav tau txo nrog kev ntxiv ntawm polydatin ua ke palmitoylethanolamide [56]. Soy isoflavones ua ke nrog vitamin D 50, 000 IU ob lub lis piam txo qhov mob plab tab sis tsis hloov plab plab [57]. Crofelemer yog ib qho oligomeric proanthocyanidin muab rho tawm los ntawm cov tawv ntoo ntawm Croton lechleri [84], thiab 500 mg / hnub nce qhov mob thiab tsis xis nyob hauv cov poj niam kawm [60]. Conversely, crofelemer muab nyob rau hauv qis dua koob tshuaj (125 mg thiab 250 mg) thiab nyob rau hauv cov txiv neej cov ntsiab lus tsis qhia qhov txawv ntawm qhov mob thiab tsis xis nyob tsis muaj hnub [60,61]. Tsis muaj qhov sib txawv ntawm cov quav hauv qhov sib xws los yog zaus lossis ceev kom qhib plab hnyuv nrog ntxiv ntawm ib koob tshuaj crofelemer [60,61]. Gelsectan yog ib qho ntxiv uas ua ke tannins nrog xyloglucan, pea protein. Gelsectan supplementation tau pom los ua kom cov quav ntau zaus 3-4 ntawm Bristol quav nplai; Txawm li cas los xij, koob tshuaj tannins hauv Gelsectan tsis tau teev tseg, thiab yog li cov txiaj ntsig yuav tsum tau txhais nrog ceev faj [63]. Cov ntsiab lus ntxiv nrog cov qhiav qhia tsis txawv qhov tsis txaus siab thaum qhib lub plab [64]. Hauv ib qho kev soj ntsuam, 39 feem pua ntawm cov neeg kawm tau tshaj tawm tias kev haus kas fes tau cuam tshuam nrog IBS cov tsos mob, thaum noj cov qhob noom xim kasfes cuam tshuam nrog IBS cov tsos mob hauv 28 feem pua ntawm cov ntsiab lus [74]. Txoj kev tshawb no muaj ib qho piv txwv me me ntawm 330 cov ntsiab lus thiab yuav tsum tau txhais nrog ceev faj, raws li cov tsos mob ntawm tus kheej qhia txog cov khoom noj tau qhia rov qab, siab dua rau cov neeg uas muaj kev ntxhov siab, thiab cov ntsiab lus PP tsis tau tshaj tawm.
Ob peb txoj kev tshawb fawb tau tshawb xyuas cov txiaj ntsig ntawm PPs ntawm IBS piv rau IBD. Soy isoflavones thiab Ginger supplementation tau sib npaug nrog rau IBS-SSS. Curcumin tau kawm ntau zaus thoob plaws IBD thiab IBS, tshwj xeeb hauv UC. Hauv UC qhov ncauj curcumin, curcumin enema, curcumin ua ke nrog cov tshuaj yej ntsuab thiab curcuminoids nanomiclles ua rau txo qis cov kab mob kev ua ub no (CAI, ib feem ntawm Mayo qhab nia, UCDAI, thiab SSCAI) thiab induced remission hauv qee zaus. Cov ntaub ntawv tsis tshua muaj rau kev siv curcumin hauv CD thiab IBS. Los ntawm cov kev tshawb fawb muaj, curcumin tau pom los txo CDAIin CD, thiab ua ke nrog fennel tseem ceeb roj, nws kuj tau tshaj tawm kom txo IBS-SSS. Cov pov thawj qhia tias mob plab yog cov tsos mob tseem ceeb hloov los ntawm PP supplementation, txawm hais tias tsis muaj qhov sib xws nrog rau lwm cov tsos mob ntawm IBS. Crofelemer thiab Pycnogenol, ob qho tib si bark extracts, yog cov lus cog tseg rau kev txhim kho cov tsos mob hauv IBS thiab lav kev tshawb fawb ntxiv. Kev ua haujlwm ntxiv hauv kev ua haujlwm ntawm lwm cov PPs thiab cov tsos mob hauv IBD thiab IBS yog qhov tsim nyog raws li kev tshawb fawb tsawg heev tau ua uas txwv tsis pub muaj peev xwm los tsim cov lus xaus.
2.2. (Poly) phenols thiab Inflammatory Markers nyob rau hauv Inflammatory Bowel Disease thiab Irritable Bow Syndrome
Tag nrho ntawm 10 qhov kev tshawb fawb tau tshawb xyuas qhov cuam tshuam ntawm PPs raumobCov cim hauv IBD (Tables 1,2 thiab 4), suav nrog fecal calprotectin, C-reactive protein (CRP), ESR, transform-ing growth factor-beta(TGF-), qog necrosis factor-alpha(TNF-), interferon- gamma (IFN-), nuclear factor-kappa beta (NF-kB), (interleukin 8) IL-8, kev loj hlob tswj oncogene (GRO), granulocyte-macrophage colony-stimulating factor (GM-CSF), platelet theem , thiab txhais tau tias platelet ntim.
Cov teebmeem ntawm ib qho spectrum ntawm PPs tau raug tshawb fawb txog kev cuam tshuam rau cov cim inflammatory hauv IBD. Qhov feem ntau tshawb xyuas yog ESR, uas tau pom tias muab cov ntaub ntawv txhim khu kev qha ntawm cov kab mob hauv IBD [85]. Kev txo qis hauv ESR tau pom nrog kev tswj hwm ntawm 1500 mg thiab 1650 mg curcumin [40,43], 140 mg silymarin [49], 30 g flaxseed, 10 g flaxseed roj [46], thiab 50 mL ntxiv virgin txiv roj roj [47] ] hauv UC. Ib qho piv txwv ntawm kev txo qis ESR tau pom nrog 1000 mg curcumin ua ke nrog 500 mg tshuaj yej ntsuab [36]. Kedia pom tsis muaj qhov sib txawv hauv ESR nrog kev tswj hwm ntawm 450mg curcumin ib hnub rau 8 lub lis piam hauv UC [41]. Qhov kev txo qis ntawm 10 mm / hr tau tshaj tawm nyob rau hauv tag nrho 4 yam kev kawm nrog CD ntxiv nrog 1650 mg curcumin [43]. Shapira thiab Sadeghi siv cov tshuaj curcumin ntau dua piv rau Kedia, uas tuaj yeem piav qhia qhov txiaj ntsig zoo ntawm ESR cov kev tshawb fawb pom.
CRP yog ib qho mob hnyav heev uas qhia tau hais tias mob o thiab raug kho ntawm kev txhawb nqa ntawm interleukin6 (IL-6), TNF- , thiab interleukin 1-beta (IL-1- )[{{6} }]. CRP tuaj yeem siv los ua qhov taw qhia ntawm cov kab mob hauv CD thiab cuam tshuam nrog CRP cov lus teb muaj zog, qhov UC cuam tshuam nrog cov lus teb me me rau qhov tsis tuaj yeem txawm hais tias muaj kev mob tshwm sim [86]. Ib qho kev txo qis hauv CRP yog tsim los ntawm kev sib txuas ntawm 1000 mg curcumin thiab 500 mg ntsuab tshuaj yej supplementation hauv UC [36]. Ntshiab trans-resveratrol (500 mg) [50] thiab 50 ml ntxiv virgin txiv roj roj [47] ua rau muaj kev txo qis hauv siab CRP (hs-CRP) hauv UC. Txawm li cas los xij, tsis muaj kev hloov pauv tseem ceeb hauv CRP nrog kev tswj hwm ntawm 840 mg bilberry anthocyanins rau 6 lub lis piam hauv UC [44] lossis haus cawv liab nruab nrab (1-3 iav) rau 1 lub lis piam hauv UC lossis CD[53].
NF-KB yog ib qho kev hloov pauv uas ua rau muaj kev tsim cov cytokines pro-inflammatory xws li TNF- thiab IFN-y, enzymes, thiab adhesion molecules [8788]. TGF- yog tus neeg sawv cev tiv thaiv kab mob uas muaj lub luag haujlwm tiv thaiv hauv IBD [89]. Ib qho kev txo qis hauv NF-kB p65 thiab TNF- tau pom nrog kev ntxiv nrog cov ntshiab 500 mg trans-resveratrol hauv UC [51]. Hloov pauv, tsis muaj kev hloov pauv hauv TNF- nrog ntxiv ntawm 1500 mg curcumin [40] lossis 50mLextra virgin txiv roj roj [47] hauv UC thiab 200-400g txiv nkhaus taw noj hauv UC thiab CD[52]. Peb caug g flaxseed thiab 10g flaxseed roj kuj txo qis IFN- thiab nce TGF- 【46】.
Ntshav platelet theem thiab qhov nruab nrab platelet ntim yog qhov qhia txog tus lej platelet thiab qhov loj ntawm platelets feem. Hauv IBD, kev mob ntev ua rau cov ntshav platelet tooj liab thiab platelets loj dua tau nce metabolic thiab enzymatic kev ua si thiab ua lub luag haujlwm hauv o. [90]. Txo cov qib platelet thiab nce qhov nruab nrab platelet ntim tuaj yeem qhia txog kev txo qis hauv cov kab mob hauv IBD91]. Ib txoj kev tshawb fawb txog curcumin supplementation hauv UC tau sau tseg tias platelet nce qib thiab txhais tau tias platelet ntim nrog 1500 mg curcumin supplementation rau 8 lub lis piam [40].
Calprotectin yog ib qho protein uas muaj nyob rau hauv lub cev tiv thaiv kab mob thiab fecal calprotectin yog siv los qhia txog cov kab mob hauv IBD [92]. Fecal calprotectin tau txo qis nrog liab
haus cawv (1-3 iav) hauv cov ntsiab lus nrog UC thiab CD[53]; 840 mg bilberry anthocyanin supplementation kuj txo qis calprotectin hauv cov neeg mob nrog UC, txawm hais tias nws tsis muaj kev cuam tshuam rau cov ntshav cov cim txuam nrog o [44].
Cov kab mob mucosa-associated microbiome yog qhov tsis muaj qhov cuam tshuam ntawm biomarkers rau lub plab o [93] thiab tuaj yeem tiv thaiv tus tswv tsev los ntawm kev tsim cov kab mob luv luv fatty acids [94]. Hauv CD, 200-400 g txiv nkhaus taw noj tau nce fecal butyric acid thiab Lactobacillus ntau ntau, tshwj xeeb tshaj yog Lactobacillus Plantarum, Lactobacillus lactis, thiab Lactobacillus Reuters [52]. Ua ke nrog qis qis ntawm IL-8, GRO, thiab GM-CSF, qhov no qhia tias kev noj txiv nkhaus taw txo qis neutrophilic induced o hauv CD[52]
Kev tshuaj xyuas tsis ntev los no qhia tau hais tias mucosal o thiab neuro-o tuaj yeem koom nrog hauv pathophysiology ntawm IBS [95].Ua raws li kev txwv tab sis kev nkag siab txog kev hloov pauv hauv IBS, tau muaj kev tshawb fawb txog cov lus teb inflammatory hauv IBS tom qab PP cov thawj coj. , tsuas yog ob qho kev tshawb fawb tshawb nrhiav cov cim inflammatory. Kev noj 40 mg kua isoflavones ua rau muaj kev txo qis hauv TNF- thiab qis qis ntawm NF-kB [58], tab sis kev ntxiv ntawm 20 mg polydatin ua ke nrog 200 mg palmitoylethanolamide supplementation tsis cuam tshuam rau mast cell suav dhau sijhawm [56].
ESR yog tus cim inflammatory nrog cov pov thawj zoo tshaj plaws hais txog qhov cuam tshuam ntawm PPs ntawm qhov mob hauv IBD. Curcumin, silymarin, flaxseed thiab flaxseed roj, thiab cov roj txiv roj roj ntxiv ua rau muaj kev txo qis hauv ESR, txawm hais tias qis dua cov tshuaj curcumin thiab curcumin ua ke nrog tshuaj yej ntsuab tsis tsim cov txiaj ntsig zoo ib yam. Qhov xwm txheej ntawm qhov cuam tshuam ntawm PPs ntawm lwm cov cim inflammatory tseem tsis meej thiab xav tau kev ua haujlwm ntxiv los txiav txim siab fecal calprotectin. Nyob rau hauv ob txoj kev tshawb fawb, hs-CRP tau zoo txuam nrog cov ntshiab trans-resveratrol thiab ntxiv virgin txiv roj roj ntxiv UC; Txawm li cas los xij, kev koom tes nrog CRP hauv UC thiab CD tsis sib xws. Kev txwv tsis pub ua haujlwm ntawm cov cim kab mob tau ua tiav hauv IBS (Table 3). Los ntawm ob txoj kev tshawb fawb suav nrog hauv qhov kev tshuaj xyuas no, nws nyuaj rau kev txiav txim siab tab sis lav ua haujlwm ntxiv. Tsuas yog ib txoj kev tshawb fawb tshawb nrhiav mucosa-txuas nrog microbiota thiab neutrophilic induced o nrog mango noj, uas yog ib qho chaw zoo siab rau kev tshawb fawb ntxiv.
2.3. (Poly) phenols thiab Health-Related Quality of Life in Inflammatory bowel Disease and Irritable Bozoel Syndrome
Tag nrho ntawm rau qhov kev tshawb fawb tau tshawb xyuas qhov cuam tshuam ntawm PPs ntawm kev noj qab haus huv ntawm lub neej hauv IBD thiab peb qhov kev tshawb fawb hauv IBS (Tables 1-3). Cov lus nug kab mob plab hnyuv loj (IBDO, IBDO-9), daim ntawv nug tus kab mob plab hnyuv loj (SIBDO). IBS qhov qhab nia zoo ntawm lub neej (IBS-QOL) thiab EQ-5D-3L tau qhab nia yog cov qauv lus nug uas siv los tshawb nrhiav qhov txiaj ntsig ntsuas no.
Daim ntawv nug kab mob inflammatory plob tsis so tswj (IBDQ) yog 32 yam khoom hais txog kev noj qab haus huv ntawm lub neej cov lus nug uas tau lees paub siv rau hauv IBD [96]. Tom qab ntawd IBDQ tau raug txo mus rau 10 yam (cov lus nug luv luv inflammatory plob tsis so tswj kab mob, SIBDQ)[97] thiab 9 yam (IBDQ-9) [98] cov lus nug. IBDQ thiab SIBDQ suav nrog plaub yam hauv qab no ntawm kev ua haujlwm thiab kev noj qab haus huv: cov tsos mob plab, cov tsos mob ntawm lub cev, kev xav, thiab kev ua haujlwm [96,97]. IBDO yog cov cuab yeej siv kev noj qab haus huv zoo tshaj plaws ntawm lub neej hauv IBD thiab ob qho tib si luv SIBDO thiab IBDO-9 sib raug zoo nrog nws [99]. IBDQ, IBDQ-9, thiab SIBDQ tau siv hauv kev tshawb fawb los ntsuas cov txiaj ntsig ntawm PPs ntawm IBD.
Txhua PPs tau tshawb xyuas uas tshawb nrhiav IBDQ thiab IBDQ-9 raws li qhov kev ntsuas tau tshaj tawm tau nce qib hauv UC. Ob leeg 200 mg Ginger hmoov [48] thiab 400-800 mg tshuaj yej ntsuab EGCG [45] nce IBDQin koom nrog UC, thaum 1500 mg cur-cumin [40], 30g flaxseed, 10g flaxseed roj [46], thiab 500 mg ntshiab trans-resveratrol [50,51] ua rau muaj kev nce ntxiv hauv IBDQ-9 hauv cov neeg koom nrog UC. Curcuminoid nano micelles kuj nce kev noj qab haus huv cov qhab nia [39]. Kev noj txiv nkhaus taw (200-400g) tsis cuam tshuam rau SIBDQ hauv UC lossis CD [52].
Cov lus nug txog lub neej tsis zoo ntawm lub plab (IBS-QOL) yog ib qho kev ntsuas kev noj qab haus huv ntawm lub neej tshwj xeeb rau IBS suav nrog 41 yam khoom [100]. Qee qhov kev tshawb fawb tsawg tau tshaj tawm siv IBS-QOL hauv PP kev cuam tshuam. Soy Isoflavones (40 mg)
nce IBS-QOL [57,59], 84 mg curcumin ua ke nrog 50 mg fennel tseem ceeb roj [62], thiab ob lub ntsiav tshuaj ntawm Gelsectan [63] ua rau muaj qhov tsis tseem ceeb hauv IBS-QOL. Gelsectan tseem ua rau muaj kev txhim kho tsis tseem ceeb hauv kev noj qab haus huv ntsig txog lub neej zoo ntsuas EQ{11}}D-3L tau qhab nia [63].
Kev noj qab haus huv ntsig txog lub neej tseem yog ib qho kev tshawb xyuas tsis zoo ntawm cov ntsiab lus ntawm PPs hauv IBD thiab IBS. Cov pov thawj tsawg qhia tau hais tias kev noj qab haus huv ntawm lub neej tuaj yeem txhim kho los ntawm PP ntxiv hauv UC txawm hais tias yuav tsum ua haujlwm ntau ntxiv hauv CD thiab IBS.
2.4. Habitual (Poly) phenol Consumption on Inflammatory Bowel thiab Irritable bowel Syndrome
Tag nrho ntawm peb qhov kev tswj xyuas cov ntaub ntawv tshawb fawb txog kev noj PP ib txwm nyob ntawm qhov tshwm sim ntawm IBD, suav nrog ib qho kev tshawb fawb txog tshuaj yej thiab kas fes, ib qho kev tshawb fawb txog PPs, thiab ib qho kev tshawb fawb ntawm isoflavones (Table4). Cov txiaj ntsig tau nthuav tawm ntawm no yuav tsum tau txhais nrog ceev faj, vim tias cov tib neeg uas muaj IBD tsis tshaj 256. Cov kev tshawb fawb ntawm isoflavones, tshuaj yej, thiab kas fes noj tau rov qab los thiab txoj kev tshawb fawb ntawm PPs yog yav tom ntej.
Siv lub koom haum International ntawm IBD (IOIBD) cov lus nug txog ib puag ncig ib puag ncig, ib txoj kev tshawb fawb nrog 256 tus neeg nrog UC thiab 186 tus neeg uas muaj CD tau pom tias muaj kev sib koom tes tseem ceeb ntawm kev noj tshuaj yej txhua hnub thiab txo qis ntawm kev txhim kho UC thiab CD (0. 630 thiab 0.662 feem)[69]. Tib txoj kev tshawb nrhiav pom qhov tsis sib haum xeeb nrog kev haus kas fes, vim nws tau cuam tshuam nrog kev txo qis ntawm UC (0.630), tab sis tsis muaj qhov sib txawv ntawm CD [69]. Cov lus nug txog zaub mov hauv tebchaws tshwj xeeb tau siv los ntsuas PP cov ntsiab lus ntawm kev noj zaub mov noj ib txwm siv phenol explorer database hloov kho rau txoj kev ua noj [70]. Tsis muaj kev koom tes nrog tag nrho PP thiab qhov sib txawv ntawm UC thiab CD; Txawm li cas los xij, nyob rau hauv peb lub quarter thib peb ntawm kev noj flavonols, muaj qhov sib txawv qis dua ntawm UC [70]. Hloov pauv, ib txoj kev tshawb nrhiav pom muaj qhov txawv ntawm UC, suav nrog qhov txawv ntawm tus kab mob mus txog cecum lossis ileum, nrog kev noj ntau dua ntawm isoflavones tom qab daim ntawv nug txog kev noj zaub mov ntawm isoflavones noj ib hlis thiab ib xyoos ua ntej kuaj mob [67].
Tag nrho ntawm peb qhov kev soj ntsuam kev soj ntsuam tau tshawb pom qhov cuam tshuam ntawm kev siv tshuaj yej thiab kas fes ntawm qhov txawv ntawm kev tsim IBS nrog cov txiaj ntsig tsis sib xws (Table 4). Kev haus peb khob kas fes ib hnub [71] thiab ua ib tus neeg tsis haus kasfes [73] ob leeg tau cuam tshuam nrog kev sib txawv ntau ntxiv rau kev tsim IBS. Kuj tseem muaj pov thawj qhia tias tsis muaj qhov sib txawv ntawm qhov sib txawv ntawm qhov sib txawv [71] thiab nce qhov sib txawv ntawm qhov sib piv [72] nrog tshuaj yej noj rau kev tsim IBS.
Hauv kev tshawb fawb txog kev noj zaub mov, nws tuaj yeem yog ib qho kev sib tw rau kev siv cov kev ntsuas kev noj qab haus huv rov qab los ntawm qhov deb dhau los vim qhov no tsuas yog muaj kev sib raug zoo nrog cov ntaub ntawv thaum lub sijhawm [101]. Nrog rau kev tshawb fawb yav tom ntej piv txwv tias kev noj zaub mov zoo ib yam tom qab kev sau cov ntaub ntawv kuj tseem muaj teeb meem. Txoj kev loj hlob ntawm IBS thiab IBD tseem tsis tau nkag siab tag nrho thiab ntau yam; yog li ntawd, kev sib cuam tshuam ntawm lwm yam yuav tsum tau ua tib zoo mloog [8,23]. Cov ntsiab lus PP ntawm tshuaj yej thiab kas fes tsis tau tshawb pom hauv cov kev tshawb fawb; yog li ntawd, lwm yam khoom noj khoom haus kuj tseem tuaj yeem cuam tshuam qhov kev pheej hmoo ntawm kev tsim tus kab mob. Cov kev tshawb fawb me me tau tshawb fawb txog kev koom tes ntawm PPs thiab kev txhim kho ntawm IBD thiab IBS nrog cov txiaj ntsig tsis sib xws; yog li ntawd, nws yog ib qho nyuaj rau kos cov lus xaus rau lawv cov hauj lwm zoo.
2.5. (Poly) phenols thiab plab hnyuv permeability nyob rau hauv Inflammatory plob tsis so tswj kab mob thiab Irritable bowel Sy/ndr0mee
Tag nrho ntawm ib txoj kev tshawb fawb yav tom ntej thiab ib qho kev tshawb fawb tsis tau tshawb xyuas qhov cuam tshuam ntawm PPs ntawm txoj hnyuv permeability hauv IBD (Tables 1 thiab 2). Ib txoj kev tshawb nrhiav RCT tau tshawb xyuas qhov cuam tshuam ntawm PPs ntawm txoj hnyuv permeability hauv IBS (Table 3).
Txoj hnyuv permeability yog hais txog kev ua haujlwm ntawm txoj hnyuv hauv plab nrog impaired permeability uas ua rau poob ntawm txoj hnyuv homeostasis thiab kev ua haujlwm tsis zoo [102]. IBD thiab IBS yog ob qho tib si cais raws li kab mob ntsig txog plab hnyuv permeability [102]. Qhov sib piv ntawm lactulose / mannitol (L / M) yog ib qho kev sim ntawm lub plab me me permeability [103] thiab urinary sucralose yog ib qho kev sim ntawm tag nrho lub plab permeability [104]. Serine protease kev ua haujlwm tsis ntev los no tau ua
txuam nrog plab hnyuv permeability [105] thiab lipopolysaccharide (LPS) permeability yog txuas nrog plab hnyuv thiab kab mob o [52]. Tsuas yog ob txoj kev tshawb fawb nrog cawv liab thiab txiv nkhaus taw tau tshawb xyuas cov hnyuv permeability hauv IBD. Ib lub lim tiam ntawm kev haus cawv liab nruab nrab (1-3 iav) cuam tshuam txoj hnyuv ua haujlwm hauv IBD[53]. Liab cawu cub tsis txo qis L / M piv hauv UC tab sis ua rau cov zis sucralose ntau ntxiv, tawm tswv yim ntxiv rau tag nrho plab permeability [53]. Hauv CD, liab caw liab tau nce qhov sib piv L / M, qhia txog kev ua kom me me hauv plab permeability [53]; 200-400 g txiv nkhaus taw noj tau ua rau muaj kev cuam tshuam rau kev txo cov ntshav LPS ntau lawm [52]. Hmoov tsis zoo, ob qho ntawm cov kev tshawb fawb no tau tshaj tawm cov ntsiab lus polyphenol; yog li ntawd; cov txiaj ntsig yuav tsum tau txhais nrog ceev faj. Hauv IBS soy isoflavones, supplementation ua rau txo qis hauv serine protease kev ua [58].
Los ntawm cov kev tshawb fawb tau nthuav tawm, kua isoflavones tuaj yeem txo cov plab hnyuv permeability hauv IBS tab sis ua haujlwm hauv IBD yog qhov sib npaug. Muaj nyob rau hauv vitro thiab hauv vivo kev tshawb fawb txog cov txheej txheem thiab cov nyhuv ntawm PPs ntawm txoj hnyuv permeability; Txawm li cas los xij, kev tshawb fawb hauv tib neeg tseem nyob hauv nws cov me nyuam mos [106]. PPs thiab plab hnyuv permeability tau raug txiav txim siab hauv cov neeg laus [107], tab sis lub cev loj ntawm kev ua haujlwm yuav tsum tau ua kom cov ntaub ntawv pov thawj ntxiv rau cov txiaj ntsig ntawm PPs ntawm txoj hnyuv permeability hauv IBD thiab IBS.
2.6. (Poly) phenols thiab Endoscopic teb nyob rau hauv mob plab hnyuv kab mob
Mucosal kho tau dhau los ua qhov kawg tseem ceeb hauv kev kho IBD [108]. Endoscopic nta ntsuam xyuas txog IBD muaj xws li vascular qauv, mucosal erythema, friability thiab los ntshav, ulceration, thiab granulation [76,79]. Cov qhab nia Mavo, UCDAL, thiab DAI tag nrho suav nrog cov kev ntsuas endoscopic subscores, tab sis tsuas yog cuaj txoj kev tshawb fawb tham txog cov txiaj ntsig endoscopic (rau nrog curcumin, ib qho nrog curcumin ua ke nrog ntsuab tshuaj yej, ib qho nrog bilberry anthocyanins, thiab ib qho nrog tshuaj yej ntsuab EGCG). Hauv UC, 2000 mg curcumin supplementation tau txhim kho qhov Rachmilewitz endoscopic Performance index qhab nia [37] thiab endoscopic dis-ease kev ua haujlwm txhais tau tias txo qis los ntawm tsawg kawg yog 1 hauv mucosal tsos qhab nia ntawm UCDAI42] nrog rau kev sib raug zoo nrog kev kho mob raws li endoscopy [ 38] ib. Cur-cumin (1650 mg) kuj txo cov qhab nia ib nrab ntawm qhov endoscopic hauv 2 ntawm 5 yam hauv ib qho kev kawm me me [43]. Curcumin (1000 mg) ua ke nrog 500 mg ntawm tshuaj yej ntsuab extract kuj txo qhov nruab nrab endoscopic Mayo qhab nia los ntawm 0.68 hauv UC, tab sis nws tsis paub meej tias qhov kev cuam tshuam no puas yog ntawm ib qho kev piav qhia (xws li, vascular qauv lossis friability) [36] . Qhov kev txo qis hauv endoscopic Mayo qhab nia hauv cov neeg koom nrog UC tau cuam tshuam nrog bilberry anthocyanin noj J44]. Qhov endoscopic feem ntawm UCDAI cov qhab nia raug txo qis hauv cov ncauj lus nrog UC uas tau pom tias muaj kev txo qis hauv UCDAI tom qab cov tshuaj yej ntsuab EGCG ntxiv [45]. Hauv CD, 360 mg ntawm curcumin (Theracurmin) txo qis cov qhab nia endoscopic yooj yim rau Crohn's kab mob (SESCD) thiab qhov quav qhov quav, txawm hais tias tsis muaj qhov sib txawv ntawm qhov endoscopic remission tus nqi txhais ntawm SESCD.<4>
Los ntawm cov lej tsawg ntawm cov kev tshawb fawb qhia txog cov lus teb endoscopic hauv IBD, muaj qhov qhia tau zoo ib yam tias kev tswj hwm ntawm curcumin ib leeg lossis ua ke nrog cov tshuaj yej ntsuab confers me me, tab sis qhov tseeb endoscopic txhim kho hauv IBD. Ntsuab tshuaj yej EGCG kuj txhim kho cov lus teb endoscopic, uas txhawb kev tshawb pom ntawm curcumin ua ke nrog tshuaj yej ntsuab. Tsuas yog ib qho kev tshawb fawb me me tshawb nrhiav bilberry anthocyanin nrog cov txiaj ntsig zoo, tab sis qhov no yuav tsum tau txhais nrog ceev faj. Cov kev tshawb fawb yav tom ntej yuav tsum txiav txim siab cais qhia txog cov khoom siv endoscopic ntawm cov kab mob kev ua ub no kom nthuav dav cov kev paub thiab cov pov thawj-raws li cov txiaj ntsig ntawm PPs ntawm cov lus teb endoscopic hauv IBD.
2.7. (Poly) phenols thiab Oxidative Stress nyob rau hauv mob plab hnyuv kab mob
Nws tau raug pom zoo tias kev raug mob rau cov ntaub so ntswg ua rau oxidative kev nyuaj siab los ntawm kev tsim cov pa oxygen ntau ntxiv [109]. Txawm li cas los xij, seb qhov muaj peev xwm antioxidant ncaj qha ntawm PPs hauv vivo cuam tshuam rau tib neeg kev noj qab haus huv tsis tau tsim thiab tseem yog qhov teeb meem ntawm kev sib cav sib ceg [110]. Ib RCT tshawb xyuas cov teebmeem antioxidant ntawm cov ntshiab trans-resveratrol hauv UC (Table 1) [51]. Tag nrho cov antioxidant muaj peev xwm (TAC), malondialdehyde (MDA), thiab superoxide dismutase (SOD) tau txo qis tom qab ntxiv.
nrog 500 mg ntshiab trans-resveratrol, qhia tias muaj zog antioxidant thiab txo oxidative kev nyuaj siab [51]. Qhov cuam tshuam ntawm PPs ntawm oxidative kev nyuaj siab yog qhov tshwm sim ntawm kev tshawb fawb hauv IBD; Txawm li cas los xij, tsis muaj pov thawj thiab xav tau ntau ntxiv ntawm cov kev tshawb fawb zoo los muab kev pom ntxiv rau cov txiaj ntsig zoo. Kev ua haujlwm yav tom ntej yuav pab nkag siab txog kev sib txuas ntawm kev raug mob, oxidative kev nyuaj siab, thiab lub luag haujlwm uas PPs ua si.
3. Cov kev txwv thiab qhov muaj zog ntawm cov pov thawj tam sim no
Lub zog ntawm cov kev tshawb fawb suav nrog yog tias ntau qhov kev tshawb fawb cuam tshuam tau ua tau zoo ua ob qhov muag tsis pom RCTs. Cov kev tshawb fawb hla dhau thiab cov qauv kev kawm factorial kuj tau siv los ua kom muaj kev nkag siab zoo thiab ntsuas cov txiaj ntsig tau zoo. Ntau cov tsos mob thiab kev noj qab haus huv ntawm cov lus nug hauv lub neej tau raug lees paub thiab siv dav, yog li tso cai rau kev sib piv ntawm cov kev tshawb fawb.
Cov qauv me me yog qhov kev txwv tseem ceeb rau ntau qhov kev tshawb fawb txog kev cuam tshuam, ua raws li kev cuam tshuam luv luv los tiv thaiv kev tsim cov ntaub ntawv siv tau ntev. Cov txiaj ntsig endoscopic yog qhov tseem ceeb hauv IBD; Txawm li cas los xij, vim nws qhov xwm txheej thiab tus nqi, ntau cov kev tshawb fawb tsis tuaj yeem suav nrog cov qauv endoscopic lossis sau cov ntaub ntawv endoscopic tiav los ntawm cov neeg koom. Tsuas yog ob txoj kev tshawb fawb tau koom nrog kev tshawb nrhiav kev tshawb fawb txog koob tshuaj [45,60], yog li txo qhov peev xwm los muab qhov pom tseeb ntawm cov koob tshuaj zoo tshaj plaws ntawm PPs. Ntawm cov kev tshawb fawb suav nrog, plaub qhov kev tshawb fawb yog qhov kev sim tsis tau tswj xyuas. Ntawm kev txaus siab, ib txoj kev tshawb fawb tau tshem tawm cov fiber ntau ntxiv cov placebo tswj, vim tias cov neeg koom nrog IBD tsis kam ua randomized vim qhov pom kev cuam tshuam ntawm fiber ntau [52]. Ib qho kev txwv tseem ceeb yog tias ntau qhov kev tshawb fawb thiab kev soj ntsuam muaj xws li cov khoom noj uas muaj PP, tab sis ua tsis tau zoo ntawm cov ntsiab lus PP; yog li ntawd, nws yog ib qho nyuaj heev los kos cov lus xaus ntawm lawv. Tsis tas li ntawd, tsis muaj ib qho ntawm cov kev tshawb fawb qhia txog bioavailability ntawm PP hauv cov ntshav lossis zis, thiab kev ua raws cai tsis raug soj ntsuam nrog cov biomarkers txaus. Qhov no yog qhov tseem ceeb tshwj xeeb hauv kev tshawb fawb curcumin, vim nws paub zoo tias tsis muaj bioavailability.
4. Cov txheej txheem
Cov kev tshawb fawb tau txheeb xyuas los ntawm kev tshawb xyuas cov ntaub ntawv hluav taws xob Medline, EMBASE, thiab Cochrane mus txog thiab suav nrog Lub Kaum Ob Hlis 2020. Cov ntsiab lus tshawb fawb cuam tshuam nrog PPs thiab lawv cov txiaj ntsig tau ua ke nrog IBS, CD, UC, thiab lawv cov tsos mob (saib Ntxiv S1 hauv Cov Khoom Siv Ntxiv rau cov Medline, EMBASE, thiab Cochrane nrhiav tswv yim). Kev ntsuam xyuas kev tsim nyog tau ua raws li tus qauv thiab cov ntaub ntawv tau muab tso rau hauv daim ntawv rho tawm cov ntaub ntawv los ntawm ib tus neeg tshuaj xyuas (MH). Kev cuam tshuam thiab kev soj ntsuam kev tshawb fawb ntawm cov neeg laus tau tshaj tawm ua lus Askiv tau suav nrog. Cov txheej txheem cais tawm suav nrog cov txheej txheem kev kawm, cov lus piav qhia yam tsis muaj tag nrho tsab xov xwm, tshuaj xyuas cov ntawv, cov kev tshawb fawb tsis muaj cov ntsiab lus meej ntawm PPs, lossis PP uas muaj cov khoom noj, thiab kev tshawb fawb txog lwm yam kab mob plab tsis zoo ntawm IBS thiab IBD. Tag nrho ntawm 37 cov kev tshawb fawb tau tsim nyog rau kev suav nrog, 13 kev tshawb fawb hauv IBS, thiab 24 cov kev tshawb fawb hauv IBD raws li qhia hauv Cov Lus Qhia Tshaj Lij Tshaj Lij rau Kev Ntsuam Xyuas Txheej Txheem thiab Meta-Analyses (PRISMA) flow diagram (Daim duab 1). Cov ntaub ntawv muab rho tawm los ntawm txhua txoj kev tshawb fawb suav nrog: cov yam ntxwv ntawm cov neeg koom, hom kev cuam tshuam, thiab cov txiaj ntsig.
5. Cov lus xaus
Ntau yam ntawm PPs tau raug tshawb xyuas txog kev mob plab hnyuv. PPS tau siv los ua kev kho mob ntxiv nrog qee qhov txiaj ntsig zoo. Curcumin tau txais kev nyiam tshaj plaws, nrog 11 txoj kev tshawb fawb tshawb nrhiav nws cov txiaj ntsig. Ntawm qhov kev ceeb toom, kev tshuaj xyuas tsis ntev los no ntawm curcumin hauv UC tau faib cov kev tshawb fawb suav nrog qhov tsis zoo vim muaj kev pheej hmoo ntawm kev tsis ncaj ncees, tsis sib xws, thiab tsis raug [111]. Nws yog ib qho nyuaj rau kev txiav txim siab ruaj khov rau cov txiaj ntsig ntawm PPs raws li kev tshawb fawb loj loj yuav tsum tau ua, tshwj xeeb tshaj yog nyob rau hauv IBD, qhov twg cov neeg koom tsis tau tshaj 100. Los ntawm cov pov thawj tam sim no, muaj kev cog lus tias cov tsos mob thiab lub neej zoo. Kev txhim kho tuaj yeem pom los ntawm kev ntxiv nrog PPs. Hauv UC, curcumin qhov ncauj, curcumin enema, curcumin ua ke nrog tshuaj yej ntsuab, tshuaj yej ntsuab EGCG, bilberry anthocyanins, flaxseeds, flaxseed roj, thiab silymarin ua rau muaj kev txhim kho zoo hauv cov kab mob kev ua ub no (UCDAal, Mayo score, DA). Kev ua haujlwm tsawg tau tshawb fawb txog kev noj qab haus huv ntawm lub neej hauv IBD thiab IBS, tab sis muaj kev cog lus ua haujlwm nrog rau IBDQ thiab IBDQ kev noj qab haus huv ntsig txog kev ntsuas lub neej. Kev txhim kho hauv IBDQ thiab IBDQ-9 tau pom nyob rau hauv tag nrho cov kev tshawb fawb PPs uas tau tshaj tawm cov txiaj ntsig no (ginger, curcumin, ntsuab tshuaj yej EGCG, ntshiab trans-resveratrol, flaxseeds, thiab flaxseed roj). Kev koom tes nrog kev noj qab haus huv ntsig txog kev ntsuas lub neej zoo rau hauv kev sim tsim kev tshawb fawb txog kev cuam tshuam yuav muab qhov tseem ceeb ntxiv rau cov pov thawj hauv paus.
Tshaj tawm cov kev tshawb pom endoscopic tsis tu ncua qhia tias cov txiaj ntsig tau pom hauv IBD los ntawm kev ntxiv nrog PPs, tshwj xeeb nrog curcumin supplementation; Yog li ntawd, curcumin supplementation warrants ntxiv loj-scale interventional sim kom paub meej tias nws cov txiaj ntsig. Kev loj hlob ntawm IBD thiab IBS tuaj yeem ua tau ntau yam yog li kev soj ntsuam kev tshawb fawb ntawm qhov txawv ntawm kev tsim IBD thiab IBS raws li kev noj zaub mov noj yuav tsum tau txhais nrog ceev faj. Kev noj zaub mov ntawm PPs zoo li qis dua li cov koob tshuaj PP siv hauv kev tshawb fawb txog kev cuam tshuam; Yog li ntawd, nws tuaj yeem nyuaj rau kev txiav txim siab txog lub luag haujlwm kev noj haus PPs ua si hauv IBD thiab IBS. Txawm li cas los xij, kev tshawb fawb txog kev cuam tshuam tsis tau tshaj tawm txog kev noj zaub mov tsis zoo, uas tuaj yeem cuam tshuam nrog kev cuam tshuam PP ntxiv.
Cov ntaub ntawv pov thawj rau qhov cuam tshuam ntawm PPs ntawm cov cim inflammatory hauv IBD thiab IBS tseem muaj qhov sib npaug thiab xav tau kev tshawb nrhiav ntxiv. Txawm li cas los xij, ESR yog tus cim inflammatory nrog qhov muaj zog tshaj txuas nrog PPs thiab IBD los ntawm cov pov thawj tshuaj xyuas. Kev ua haujlwm tsis ntev los no tau tshawb xyuas cov hnyuv permeability thiab PPs hauv IBD thiab IBS. Soy isoflavones txo serine protease kev ua, qhia txog kev txhim kho hauv plab hnyuv permeability hauv IBS. Hauv IBD, kev haus cawv liab nruab nrab tau nce plab hnyuv permeability thiab mango noj txo cov plab hnyuv permeability. Hauv IBD, ob qho kev tshawb fawb piv rau tag nrho cov khoom noj thiab tsis yog PPs ib leeg; Yog li ntawd, yuav tsum tau ua hauj lwm ntxiv los tsim kom muaj kev sib raug zoo ntawm PPs thiab plab hnyuv permeability. Kev cuam tshuam ntawm PPs ntawm oxidative kev nyuaj siab hauv IBD thiab IBS kuj tseem xav tau kev ua haujlwm ntxiv, raws li ib qho kev tshawb fawb tshawb txog qhov cuam tshuam ntawm cov ntshiab trans-resveratrol tau nthuav tawm cov kev tshawb pom nthuav dav ntawm kev ua kom muaj peev xwm antioxidant hauv UC. Lub plab hnyuv enzymes thiab colonic microflora ua lub luag haujlwm hauv kev nqus ntawm PPs; Yog li ntawd, bioavailability ntawm PPs yuav tsum tau txiav txim siab [112]. Curcuminoids nanomicelles thiab Theracurmin, uas yog kev npaj ntawm curcumin nrog txhim kho bioavailability, ua rau cov txiaj ntsig zoo ntawm cov koob tshuaj qis dua li kev npaj curcumin. Kev txiav txim siab ntawm plab hnyuv enzyme kev ua si thiab microbiome ua ib feem ntawm kev tshawb fawb kev tshawb fawb yuav muab qhov muaj txiaj ntsig zoo rau kev pom hauv vivo.
Hauv kev xaus, kev cog lus ua haujlwm tau ua tiav nrog rau PPs thiab IBD thiab IBS, tab sis kom paub meej txog qhov cuam tshuam ntawm PPs ntxiv, kev sim mus ntev uas suav nrog kev kho mob thiab kev ua haujlwm yuav tsum tau ua.
Cov ntaub ntawv
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