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Fungal Microbiota and Inflammatory Bowel Disease
Vančíková, Sabína ; Kostovčíková, Klára (advisor) ; Dobeš, Jan (referee)
Inflammatory bowel disease (IBD) is a term for the gastrointestinal tract's chronic inflammatory disorders, evincing growing worldwide prevalence. Commonly, IBD is divided into two major subgroups, Crohn's disease (CD) and ulcerative colitis (UC). Despite intensive efforts, IBD etiology and development mechanisms are not fully understood. Gut barrier dysfunction, dysbiosis, and overreactive immune response to gut microbiota appear to have a significant impact. While bacteria are the most studied gut inhabitants, research on the role of fungal microbiota (mycobiota) in IBD lags behind. This diploma thesis aimed to study immune responses to gut mycobiota in IBD. Levels of antifungal antibodies against gut residents and biomarkers relevant to gut barrier damage and microbial translocation were measured in the sera of IBD patients and healthy individuals. Sera of individuals diagnosed with UC, CD, and IBD associated with primary sclerosing cholangitis (PSC-IBD) were used. Since continuous intestinal macrophage activation is a feature of IBD, the effect of selected fungal mycobiota species on the reactivity of peripheral blood-derived macrophages from healthy donors was assessed in vitro. The levels of serum antibodies against mycobiota components were higher in IBD patients than in controls, and the...
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The effect of microbiota on pathogenesis of gut diseases
Galanová, Natalie ; Kolařík, Miroslav (advisor) ; Hudcovic, Tomáš (referee)
Gut microbiota is considered an important factor in the development of various diseases including inflammatory bowel disease (IBD, n = 127), Ulcerative colitis, Crohn's disease, and colorectal cancer (CRC, n = 64). A part of this thtesis is to prepare clinical material of different sorts (stool, biopsy) for sequencing on Illumina Miseq platform. This is achieved trough DNA isolation, amplification of 16S and internal transcribed spacer (ITS), normalization and ligation of sequencing adaptors. The aim of this project is to describe the differences between microbiota in healthy and diseased subjects in case of IBD or unimpaired and tumorous tissue for CRC patients. This research is also being based on cultivation, where a fresh stool samples (n = 3) are cultivated in a broad range of conditions, which enables us to obtain ecophysiological and species diversity of these samples by traditional and molecular methods. The cultivable fungi are also assigned reliable taxonomy by amplification of relevant genes (ITS1, β tubulin, second largest subunit of RNA polymerase II, RPB2) followed by both-sided Sanger sequencing. Selected species of fungi are processed into lysates, which are used for stimulation of mice macrofage cell line (RAW). Therefore the impact on immunity response is studied in vitro and...
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Clinical and genetic predictors of drug dependency in inflammatory bowel disease
Ďuricová, Dana ; Lukáš, Milan (advisor) ; Keil, Radan (referee) ; Špičák, Julius (referee)
IN ENGLISH Drug dependency in inflammatory bowel disease (IBD), Crohn's disease (CD) and ulcerative colitis (UC), is a specific disease phenotype which determines disease prognosis and hence may be used as a prognostic marker for treatment management. Drug dependency in IBD has been well described in corticosteroid treatment and recently also in infliximab (IFX) therapy. The aims of this thesis were: 1) to assess the occurrence of IFX dependency in paediatric and adult patients with CD; further to search for clinical and genetic predictors of IFX outcome and to evaluate the impact of IFX dependency on surgical rate; 2) to assess in CD patients the outcome of the first course of 5-ASA monotherapy with emphasis on 5-ASA dependency and to define clinical predictors of 5-ASA treatment outcome. We found that 66% of children and 29% of adults with CD became IFX dependent. The high frequency in paediatrics is in agreement with previously published studies, while the finding in adult patients indicates a lower rate of IFX dependency in the only study to date. Perianal disease and no bowel surgery prior to IFX start were predicative of IFX dependency in paediatric patients. In adult cohort, 2 genetic variants LTA c.207 A>G and CASP9 c.93 C>T were associated with IFX outcome, whereas no relevant clinical...
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Inflammatory Bowel Diseases in pregnancy
Kovářová, Tereza ; Krátká, Zuzana (advisor) ; Hadlová, Petra (referee)
(EN) Inflammatory bowel disease is a chronic autoimmune disease of the intestinal tract including Crohn's disease, ulcerative colitis, and other unspecified colitis. Depending on the type of disease, inflammation affects the small or large intestine or rectum. It is a multifactorial disease in which the intestinal microflora, the immune system status, and genetic predisposition are crucial. IBD is most often diagnosed in late adolescence or early adulthood. Due to the availability of quality treatment, the health status of IBD patients also improves, allowing them to consider starting a family after the disease has calmed down. Patients have fewer children than the general population, but there was no significantly higher risk of infertility. A prerequisite for successful pregnancy and childbirth is a stable condition of the disease and the use of treatment during pregnancy to prevent relapse. A specific problem of patients is voluntary childlessness because of worries about the worsening of IBD during or after pregnancy, about negative effects of treatment on a foetus, but also an occurrence of disease in offspring This work aims to summarize the issue of pregnancy in patients with IBD and to provide information on the current situation in patients with IBD in the Czech Republic. Keywords:...
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Pathophysiology of inflammatory bowel disease. Relation to primary scklerosing cholangitis, liver transplantation and carcinogenesis.
Bajer, Lukáš ; Drastich, Pavel (advisor) ; Živný, Jan (referee) ; Procházka, Vlastimil (referee)
Inflammatory bowel disease (IBD) represents a group of multifactorial illnesses with increasing incidence worldwide. Crohn's disease (CD) and ulcerative colitis (UC) are the two most thoroughly defined phenotypes of IBD. IBD associated with primary sclerosing cholangitis (PSC) - a progressive biliary disease leading to cirrhosis and liver failure - is considered as specific IBD phenotype (also referred to as 'PSC - IBD') due to its clinical and pathophysiological characteristics. The aim of the experimental part of this thesis was to define specific features of PSC - IBD in the key areas of IBD pathogenesis. These are: microbiota composition, gut - barrier failure, genetic predisposition and aberrant cellular and antibody immune response. Furthermore, the other goals were to describe relation of IBD status and activity to liver transplantation (LTx) and carcinogenesis based on thorough analysis of clinical data in patients under surveillance at the liver transplantation unit. Using the next-generation parallel sequencing technology, we discovered specific bacterial and mycobial features of gut microbiota composition in PSC - IBD which significantly differed from UC and healthy controls recruited from Czech general population. Moreover, we identified numerous seral biomarkers distinguishing CD, UC...
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The case study of physiotherapy treatment of a patient after liver transplantation.
Švejdová, Jana ; Stupková, Michaela (advisor) ; Charvát, Robert (referee)
Title: The case study of physiotherapy treatment of a patient after liver transplantation. Author: Jana Švejdová Head of the thesis: Mgr. Michaela Stupková Objectives: The aim of this bachelor thesis is to summarize the facts about liver transplantation including an example of physiotherapeutic treatment on a specific patient after liver transplantation. The thesis is written from a physiotherapeutical point of view. Methods: The bachelor thesis consists of two parts - theoretical part and special part. The theoretical part contains information about anatomy, physiology and pathology of the liver, including liver diseases, description of the transplantation process and physiotherapeutic techniques used after the surgery. All of this information was obtained from scientific literature. The special part of this thesis describes the case study of a specific patient after undergoing liver transplantation including a description of physiotherapeutic care, examinations and therapeutic units. This part was created during my practice in the Institute of Clinical and Experimental Medicine in Prague between 6th and 31st January 2019. Results: The main improvement was in muscle strenght and overal physical condition being noticeable mostly in the gait ability and activities of daily living. Keywords: liver,...
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Microbiota and inflammatory bowel diseases
Gajdárová, Zuzana ; Kostovčíková, Klára (advisor) ; Grobárová, Valéria (referee)
Inflammatory bowel diseases (IBD) are an autoimmune illnesses affecting gastrointestinal tract. The main types include ulcerative colitis and Crohn's disease. Recently, primary sclerosing cholangitis (PSC) has also been associated with IBD. PSC is a chronic liver disease associated with bile duct stenosis. The exact pathogenesis and etiology of these diseases is not clear, despite the great efforts of the scientific community. They are multifactorial diseases that are associated with dysbiosis of intestinal microbiota. Their diagnosis is based on for patients unpleasant endoscopic examinations and therefore the search for new serum biomarkers is needed and appreciated target of scientific interest. In the first part of diploma thesis, we focused on the reactivity of peripheral blood cells of IBD patients to 10 selected representatives of typical intestinal microbiota: Lactobacillus plantarum, Bifidobacterium adolescentis, Blautia coccoides, Roseburia intestinalis, Eubacterium rectale, Faecalibacterium prausnitzii, Ruminococcus flavefaciens, Bacteroides thetaiotaomicron, Prevotella ruminicola and Escherichia coli. Reactivity of CD, UC and PSC- IBD patients was increased after stimulation with Faecalibacterium, Lactobacillus and Prevotella. However, we got low percentage of cytokine-producing cells,...
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Colorectal cancer - from patogenesis to screening. Colorectal carcinogenesis in ulcerative colitis with primary sclerosing cholangitis and the issue of the screening of the colorectal cancer.
Wohl, Pavel ; Špičák, Julius (advisor) ; Škarda, Jozef (referee) ; Gregor, Martin (referee)
Colorectal carcinoma (CRC) ranks high in mortality and morbidity in most developed countries. Following theses focus on specific aspects of colorectal carcinoma pathogenesis including the issue of screening. The goal of the first study was assessment of expression of epithelial markers of colorectal carcinogenesis p53, COX-2, bcl-2. The study included patients with active ulcerative colitis (UCA), ulcerative colitis in remission (UCR), primary sclerosing cholangitis with ulcerative colitis (PSC-UC) (PSC), patients after liver transplantation for PSC (OLT) and a control group (N). We found significantly increased expression of tumour suppressor gene p53 in non-dysplastic mucosae in PSC-UC compared with UCA, UCR, OLT, and N, which may indicate higher neoplastic potential of PSC. Statistically significant correlation was found between PSC incidence and p53 expression. Surprisingly, OLT showed no p53 expression in non-dysplastic mucosa compared with PSC-UC. This indicates that PSC may contribute to increased expression of p53 and p53-induced colorectal carcinogenesis. Furthermore, a correlation between expression of p53 and COX-2 together with the increased expression of bcl-2 in UCA compared to N can support the role of inflammation in colorectal carcinogenesis. The goal of the second study was...
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Influence of education of nutrition specialist on vitamins level at patients with inflammatory bowel diseases.
Palugová, Natália ; Meisnerová, Eva (advisor) ; Šatný, Marek (referee)
In diploma thesis we deal with inflammatory bowel diseases. The theoretical part describes etiology, pathogenesis, clinical symptoms, out-of-body manifestation and drug therapy. Current knowledge about the relationship between nutrition and disease is described. Since inflammatory bowel diseases are incurable, therapy pays attention to keep the patient in remission and preventing relapse. Nutrition therapy plays an important role in achieving these goals. In the practical part, we deal with the level of nutrition awareness of patients, in the form of a questionnaire and a non- standardized interview. We also study the influence of education on vitamin levels in patients. We determine whether they know the importance of eating and eating nutrients in their illnesses. From the background, it can be appreciated that information resources are insufficient for patients. Patients would also welcome more detailed education, and therefore part of the practical part of the educational material for patients with Crohn's disease. Key words: Crohn's disease, ulcerative colitis, nutrition, education, diet
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