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Original Articles
- Impact of Portulaca oleracea L. extract in patients with irritable bowel syndrome
- Kwangwoo Nam, Jung Ho Choi, Yong Sung Kim, Seong Lee, Jee Hun Park, Hyeongjoo Kim, Sangyun Lee, Yerin Lee, Doohyuck Lee, Sunghyeok Ryou, Jeong Eun Shin
- Received August 31, 2025 Accepted December 28, 2025 Published online April 20, 2026
- DOI: https://doi.org/10.5217/ir.2025.00200 [Epub ahead of print]
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Abstract
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Supplementary Material
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ePub - Background/Aims
Portulaca oleracea is known to have anti-inflammatory and immunoregulatory effects, and also showed positive effect on complete spontaneous bowel movement and bowel symptoms in patients with chronic constipation in a previous study. Thus, we aimed to investigate the impact of P. oleracea in patients with irritable bowel syndrome (IBS).
Methods
Patients with IBS defined by ROME IV criteria were enrolled between July 2022 and April 2023. Patients were randomly assigned to P. oleracea or placebo group and took drugs for 8 weeks. Clinical data including gastrointestinal and IBS symptoms, laboratory tests including inflammatory and immunologic laboratory markers, and stool tests including fecal calprotectin and stool microbial analysis were evaluated at the baseline, week 4, and week 8.
Results
A total of 108 patients were initially enrolled and 101 patients were finally included in the analysis. There was significant improvement during 8 weeks in P. oleracea group compared to placebo group in the aspect of gastrointestinal and IBS-related bowel symptoms (Gastrointestinal Symptom Rating Scale total score: from 44.1 to 31.7 vs. from 41.4 to 39.9; IBS-Symptom Severity Score total score: from 232.0 to 120.6 vs. from 202.7 to 178.2), especially in the aspect of abdominal pain. Interleukin-6 (IL-6) was significantly decreased during 8 weeks in P. oleracea group, although there was no significant difference between 2 groups. In addition, increase in IL-6 during study period was significantly associated with dysbiosis in stool microbial analysis. There was no significant adverse event.
Conclusions
P. oleracea has positive impact in patients with IBS showing improvement of immunologic cytokine and stool microbiome.
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- 19 Download
- IBD
- Cross-ethnic evaluation of gut microbial signatures reveal increased colonization with oral pathobionts in the north Indian inflammatory bowel disease cohort
- Arshdeep Singh, Garima Juyal, Ranko Gacesa, Mohan C. Joshi, Vandana Midha, B. K. Thelma, Rinse K Weersma, Ajit Sood
- Intest Res 2026;24(2):255-269. Published online July 14, 2025
- DOI: https://doi.org/10.5217/ir.2024.00216
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Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
Inflammatory bowel disease (IBD) has become a global health concern. With the growing evidence of the gut microbiota’s role in IBD, studying microbial compositions across ethnic cohorts is essential to identify unique, populationspecific microbial signatures.
Methods
We analyzed stool samples and clinical data from 254 IBD patients (226 ulcerative colitis, 28 Crohn’s disease) and 66 controls in northern India using metagenomic shotgun sequencing to assess microbiota diversity, composition, and function. Results were replicated in 436 IBD patients and 903 controls from the Netherlands using identical workflows. Using machine learning, we evaluated the generalizability of Indian IBD signals to the Dutch cohort, and vice versa.
Results
Indian IBD patients exhibited reduced bacterial diversity and an abundance of opportunistic pathogens, including Clostridium, Streptococcus, and oral bacteria like Streptococcus oralis and Bifidobacterium dentium. There was a significant loss of energy metabolic pathways and distinct co-occurrence patterns among microbial species. Notably, 39% of these signals replicated in the Dutch cohort. Unique to the Indian cohort were oral pathobionts such as Scardovia, Oribacterium, Actinomyces dentalis, and Klebsiella pneumoniae. Both Indian and Dutch IBD patients shared reduced butyrate producers. Machine-learning diagnostic models trained on the Indian cohort achieved high predictive accuracy (sensitivity 0.84, specificity 0.95) and moderately generalized to the Dutch cohort (sensitivity 0.77, specificity 0.69).
Conclusions
IBD patients across populations exhibit shared and unique microbial signatures, suggesting a role for the oral-gut microbiome axis in IBD. Crossethnic diagnostic models show promise for broader applications in identifying IBD. -
Citations
Citations to this article as recorded by
- Rhamnocitrin Ameliorates the Intestinal Fibrosis in DSS-Induced Colitis Mice by Modulating Host-Metabolites and Remodeling the Gut Microbiome
Ming-Yu Zhang, Zhi-Zhu Ke, Pei-Lin Deng, Yi-Yan Qin, Shu-Lan Mo, Lin-Ting Qiu, Jie-Jing Xu, Chen-Xi Tong, Jia-Le Song
Antioxidants.2026; 15(5): 639. CrossRef
- Rhamnocitrin Ameliorates the Intestinal Fibrosis in DSS-Induced Colitis Mice by Modulating Host-Metabolites and Remodeling the Gut Microbiome
- 2,529 View
- 289 Download
- 1 Crossref
Review
- IBD
- Cardiovascular disease: extraintestinal manifestation of inflammatory bowel disease
- Samridhi Lakhanpal, Kanishk Aggarwal, Harmanjit Kaur, Kunal Kanwar, Vasu Gupta, Jill Bhavsar, Rohit Jain
- Intest Res 2025;23(1):23-36. Published online May 7, 2024
- DOI: https://doi.org/10.5217/ir.2023.00104
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Abstract
PDFPubReaderePub
- Inflammatory bowel disease (IBD) is a spectrum of diseases characterized by the interplay of the aberrant immune system, genetic factors, environmental factors, and intestinal microbiota, resulting in relapsing inflammation of the gastrointestinal tract. Underlying pro-inflammatory state and immune dysregulation act as a catalyst for increasing the likelihood of developing extraintestinal manifestations, including cardiovascular diseases (CVD) like atherosclerosis, pericarditis, myocarditis, venous and arterial thromboembolism, arrhythmias, despite a lower prevalence of classic CVD risk factors, like high body mass index or dyslipidemia compared to the general population. Chronic inflammation damages endothelium resulting in the recruitment of inflammatory cells, which induce cytotoxicity, lipoprotein oxidation, and matrix degradation, which increases the risk of atherosclerosis. Additionally, intestinal dysbiosis disrupts the intestinal mucosal barrier, releasing endotoxins and lipopolysaccharides into circulation, further exaggerating the atherosclerotic process. Abnormal collagen metabolism and alteration of nitric oxide-mediated vasodilation lead to blood pressure dysregulation in patients with IBD. Therefore, it is essential to make lifestyle modifications like smoking cessation, dietary changes, and increasing physical activity with adherence to medication to mitigate the risk of developing CVD in patients with IBD. This article reviews the potential links between IBD and the increased risk of CVD in such individuals.
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Citations
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Yanfeng Lin, Xiaohui Qin, Haiyan Zhang, Jinke Huang, Xingshun Qi
Canadian Journal of Gastroenterology and Hepatology.2026;[Epub] CrossRef - Therapeutic Potential of Fecal Microbiota Transplantation for Male Sexual Dysfunction: Evidence and Clinical Perspectives
Junyi Chen, Chenfeng Bu, Xia Li, Lei Wu, Xingxiang He
Microbiota Medicine Research.2026; 1(1): 12. CrossRef - Immuno-inflammatory-metabolic interactions in cardiovascular diseases: a review from basic mechanisms to clinical translation
Xingshun Zhu, Fengmei Zhang, Yuxin Wei, Yan Zhao, Jiawei Guo
Frontiers in Immunology.2026;[Epub] CrossRef - Percutaneous Coronary Intervention Outcomes in Patients With Inflammatory Bowel Disease: A Comprehensive Review of Pathophysiology, Clinical Prognosis, and Management Strategies
Faiza Aman Jajja, Vikash Fnu, Omar Alkasabrah, Jaishkar Ramesh, Muhammad Qasim Chaudhry, Rutvij Patel, Ridham Patel, William H. Frishman, Wilbert S. Aronow
Cardiology in Review.2026;[Epub] CrossRef - Metabolic Disorders and Inflammatory Bowel Diseases
Hye Kyung Hyun, Jae Hee Cheon
Gut and Liver.2025; 19(3): 307. CrossRef - Carnitine: Its Crucial Role in Metabolic Health and Cardiovascular Function
Fremita Fredrick, Kanishk Aggarwal, Anish Kumar Reddy Meda, Fnu Anamika, Amishi Singla, Pranjal Jain, Rohit Jain
Journal of Dietary Supplements.2025; 22(5): 664. CrossRef - The gut-heart axis: a correlation between Paneth cells’ dysfunction, microbiome dysbiosis, and cardiovascular diseases
Aysa Rezabakhsh, Solomon Habtemariam, Rezayat Parvizi, Anne Meddahi-Pellé, Violeta Rodriguez Ruiz, Graciela Pavon-Djavid, Abolfazl Barzgari
Cell Communication and Signaling.2025;[Epub] CrossRef - Study design of ‘PASIBO’ - co-creation and development of a physical activity intervention to patients with inflammatory bowel disease
Tanja Thomsen, Marie Villumsen, Anja Poulsen, Anders B. G. Hansen, Bente A. Esbensen, Tine Jess, Mette Aadahl
BMC Health Services Research.2025;[Epub] CrossRef - From Gut Inflammation to Cardiovascular Conflagration: Mapping IBD’s Cardiometabolic Risks
Oscar Noble, Dayoung Jeon, Megan Lewis, Christopher Fan, Khurram Nasir, Bincy P. Abraham
Current Atherosclerosis Reports.2025;[Epub] CrossRef - Cardiovascular Complications Are Increased in Inflammatory Bowel Disease: A Path Toward Achievement of a Personalized Risk Estimation
Vito Annese, Maria Laura Annunziata, Guglielmo Albertini Petroni, Emanuele Orlando, Sofia Cinque, Marzio Parisi, Paolo Biamonte, Giuseppe Dell’Anna, Anna Latiano, Serenella Castelvecchio
Journal of Personalized Medicine.2025; 15(9): 418. CrossRef - Coagulopathy and platelet abnormalities in patients with inflammatory bowel disease
Dae Sung Kim, Won Moon
The Korean Journal of Internal Medicine.2025; 40(6): 866. CrossRef - Clinical Outcomes of Venous Thromboembolism in Patients with Ankylosing Spondylitis vs. Other Immune-mediated Inflammatory Diseases: Insights from the RIETE Registry
Romain Chopard, Gregory Piazza, Laurent Bertoletti, Nicolas Meneveau, Leticia Guirado, José Antonio Porras, Francisco Rivera-Cívico, José Felipe Varona Arche, Manuel Monreal, Clément Prati
Thrombosis and Haemostasis.2025;[Epub] CrossRef
- Association Between Inflammatory Bowel Disease and Venous Leg Ulcers: Insight From Mendelian Randomization Analyses
- 11,700 View
- 299 Download
- 12 Web of Science
- 12 Crossref
Original Article
- Inflammatory bowel diseases
- 5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis
- Shinta Mizuno, Keiko Ono, Yohei Mikami, Makoto Naganuma, Tomohiro Fukuda, Kazuhiro Minami, Tatsuhiro Masaoka, Soichiro Terada, Takeshi Yoshida, Keiichiro Saigusa, Norimichi Hirahara, Hiroaki Miyata, Wataru Suda, Masahira Hattori, Takanori Kanai
- Intest Res 2020;18(1):69-78. Published online January 30, 2020
- DOI: https://doi.org/10.5217/ir.2019.00084
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Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
5-Aminosalicylic acid (ASA) causes intolerance reactions in some patients. This study was performed to examine the prognosis of patients with ulcerative colitis (UC) and 5-ASA intolerance, and to evaluate the potential interaction between 5-ASA intolerance and the intestinal microbiota.
Methods
We performed a retrospective cohort study of patients with UC who visited participating hospitals. The primary endpoint was to compare the incidence of hospitalization within 12 months between the 5-ASA intolerance group and the 5-ASA tolerance group. The secondary endpoint was to compare the risk of adverse clinical outcomes after the start of biologics between the 2 groups. We also assessed the correlation between 5-ASA intolerance and microbial change in an independently recruited cohort of patients with UC.
Results
Of 793 patients, 59 (7.4%) were assigned to the 5-ASA intolerance group and 734 (92.5%) were assigned to the 5-ASA tolerance group. The admission rate and incidence of corticosteroid use were significantly higher in the intolerance than tolerance group (P< 0.001). In 108 patients undergoing treatment with anti-tumor necrosis factor biologics, 5-ASA intolerance increased the incidence of additional induction therapy after starting biologics (P< 0.001). The 5-ASA intolerance group had a greater abundance of bacteria in the genera Faecalibacterium, Streptococcus, and Clostridium than the 5-ASA tolerance group (P< 0.05).
Conclusions
In patients with UC, 5-ASA intolerance is associated with a risk of adverse clinical outcomes and dysbiosis. Bacterial therapeutic optimization of 5-ASA administration may be important for improving the prognosis of patients with UC. -
Citations
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Journal of Allergy and Clinical Immunology: Global.2026; 5(2): 100625. CrossRef - 5-Aminosalicylic Acid-Induced Colitis in a Patient with Rheumatoid Arthritis Without Inflammatory Bowel Disease: A Case Report
Ryosuke Izumi, Issei Hirata, Yuta Hattori, Yuki Shirane, Hirosato Tamari, Teruo Mori, Makoto Higashiyama, Yoshio Kuga, Takashi Moriya
Internal Medicine.2026;[Epub] CrossRef - Tacrolimus therapy for ulcerative colitis: a retrospective study of factors associated with inducing and maintaining remission
Ayumi Ito, Shun Murasugi, Miki Koroku, Maria Yonezawa, Teppei Omori, Shinichi Nakamura, Katsutoshi Tokushige, Yousuke Nakai
BMC Gastroenterology.2026;[Epub] CrossRef - Association of Proton Pump Inhibitor and Potassium‐Competitive Acid Blocker Use With Discontinuation and Intolerance of Oral 5‐Aminosalicylic Acid in Patients With Ulcerative Colitis
Shinsuke Otagiri, Takahiro Ito, Keiji Yagisawa, Ayumu Sugitani, Atsuo Maemoto
JGH Open.2026;[Epub] CrossRef - The Gut-Brain Axis in Comorbidity of Inflammatory Bowel Disease and Anxiety/Depression: Mechanisms, Controversies, and Future Directions
Yuheng Cui, Yangfeng Huang
International Journal of General Medicine.2026; Volume 19: 1. CrossRef - Gut Microbiome Dysbiosis and Inflammatory Bowel Disease Complement Each Other
Huan Zhang, Jingrong Xiang, Jie Feng, Mengting Zhang, Qinhua Xi
Digestive Diseases.2025; 43(3): 345. CrossRef - Inactivated Cells and Metabolites of Saccharomyces boulardii Alleviate Inflammation Damage in Caco-2 Monolayer Cells and Mice with Ulcerative Colitis
Yuxin Jin, Zehui Niu, Menglin Feng, Huilian Che, Zhihong Liang
Antioxidants.2025; 14(6): 737. CrossRef - Increasing age at diagnosis raises malignancy risk and aminosalicylate intolerance influences therapeutic strategies in ulcerative colitis: a multicenter I‑BRITE cohort study
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Journal of Gastroenterology.2025; 60(10): 1259. CrossRef - Gut microbial healing in IBD: visionary approach or evidence-based reality?
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Yusuke Yoshimatsu, Yohei Mikami, Takanori Kanai
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You Sun Kim
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Ji Young Chang, Jae Hee Cheon
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Satohiro Matsumoto, Hirosato Mashima
Scientific Reports.2020;[Epub] CrossRef
- Hemp seed mitigates colonic inflammation through macrophage polarization and microbiota-barrier axis restoration
- 12,665 View
- 397 Download
- 39 Web of Science
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Focused Review: Colorectal Cancer
- Colorectal neoplasia
- Impact of microbiota in colorectal carcinogenesis: lessons from experimental models
- Linda Chia-Hui Yu, Shu-Chen Wei, Yen-Hsuan Ni
- Intest Res 2018;16(3):346-357. Published online July 27, 2018
- DOI: https://doi.org/10.5217/ir.2018.16.3.346
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Abstract
PDFPubReaderePub
A role of gut microbiota in colorectal cancer (CRC) growth was first suggested in germ-free rats almost 50 years ago, and the existence of disease-associated bacteria (termed pathobionts) had becoming increasingly evident from experimental data of fecal transplantation, and microbial gavage or monoassociation. Altered bacterial compositions in fecal and mucosal specimens were observed in CRC patients compared to healthy subjects. Microbial fluctuations were found at various cancer stages; an increase of bacterial diversity was noted in the adenoma specimens, while a reduction of bacterial richness was documented in CRC samples. The bacterial species enriched in the human cancerous tissues included
Escherichia coli ,Fusobacterium nucleatum , and enterotoxigenicBacteroides fragilis . The causal relationship of gut bacteria in tumorigenesis was established by introducing particular bacterial strains inin situ mouse CRC models. Detailed experimental protocols of bacterial gavage and the advantages and caveats of different experimental models are summarized in this review. The microbial genotoxins, enterotoxins, and virulence factors implicated in the mechanisms of bacteria-driven tumorigenesis are described. In conclusion, intestinal microbiota is involved in colon tumorigenesis. Bacteria-targeting intervention would be the next challenge for CRC.-
Citations
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Archives of Microbiology.2025;[Epub] CrossRef - Gut microbiome and gastric cancer: microbial interactions and therapeutic potential
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International Journal of Molecular Sciences.2024; 25(5): 3061. CrossRef - Association of gut microbiome with immune microenvironment in surgically treated colorectal cancer patients
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Case Report
- Fecal microbiota transplantation for refractory Crohn's disease
- Seon Ho Bak, Hyun Ho Choi, Jinhee Lee, Mi Hee Kim, Youn Hee Lee, Jin Su Kim, Young-Seok Cho
- Intest Res 2017;15(2):244-248. Published online April 27, 2017
- DOI: https://doi.org/10.5217/ir.2017.15.2.244
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Abstract
PDFPubReaderePub
Approximately one-third of patients with Crohn's disease do not respond to conventional treatments, and some experience significant adverse effects, such as serious infections and lymphoma, and many patients require surgery due to complications. Increasing evidence suggests that specific changes in the composition of gut microbiota, termed as dysbiosis, are a common feature in patients with inflammatory bowel disease (IBD). Dysbiosis can lead to activation of the mucosal immune system, resulting in chronic inflammation and the development of mucosal lesions. Recently, fecal microbiota transplantation, aimed at modifying the composition of gut microbiota to overcome dysbiosis, has become a potential alternative therapeutic option for IBD. Herein, we present a patient with Crohn's colitis in whom biologic therapy failed previously, but clinical remission and endoscopic improvement was achieved after a single fecal microbiota transplantation infusion.
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Original Article
- Single fecal microbiota transplantation failed to change intestinal microbiota and had limited effectiveness against ulcerative colitis in Japanese patients
- Shinta Mizuno, Kosaku Nanki, Katsuyoshi Matsuoka, Keiichiro Saigusa, Keiko Ono, Mari Arai, Shinya Sugimoto, Hiroki Kiyohara, Moeko Nakashima, Kozue Takeshita, Makoto Naganuma, Wataru Suda, Masahira Hattori, Takanori Kanai
- Intest Res 2017;15(1):68-74. Published online January 31, 2017
- DOI: https://doi.org/10.5217/ir.2017.15.1.68
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Abstract
PDFSupplementary MaterialPubReaderePub
<b>Background/Aims</b><br/> Recent developments in analytical techniques including next-generation sequencing have clarified the correlation between intestinal microbiota and inflammatory bowel disease. Fecal microbiota transplantation (FMT) for patients with ulcerative colitis (UC) is proposed as a potential approach to resolving their dysbiosis; however, its safety and efficacy have not been confirmed. This single-arm, open-label, non-randomized study aimed to evaluate the safety and efficacy of FMT for Japanese patients with UC as the first registered clinical trial in Japan.
Methods We enrolled 10 patients with active UC despite medical therapy. The donors were the patients' relatives and were carefully screened for infectious diseases. Fecal material was administered via colonoscopy, and the primary endpoint was the presence or absence of serious adverse events related to FMT. The secondary endpoint was a change in partial Mayo score at 12 weeks post-FMT. Scores ≤2 were considered a clinical response. Fecal samples were collected to follow changes in gut microbiota, while extracted complementary DNA were analyzed by a next-generation sequencer. We obtained written informed consent from all patients and donors. This study was approved by our Institutional Review Board and is registered in the University hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN 000012814).
Results Five patients with moderate disease and five with severe disease were enrolled. No severe adverse effects were observed. One patient achieved clinical response; however, none of the patients' microbiota diversity recovered to the donor levels.
Conclusions The use of single FMT for UC was safe; however, we failed to show its clinical efficacy and potential to change the intestinal microbiota.
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Review
- Pathogenic role of the gut microbiota in gastrointestinal diseases
- Hiroko Nagao-Kitamoto, Sho Kitamoto, Peter Kuffa, Nobuhiko Kamada
- Intest Res 2016;14(2):127-138. Published online April 27, 2016
- DOI: https://doi.org/10.5217/ir.2016.14.2.127
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Abstract
PDFPubReaderePub
The gastrointestinal (GI) tract is colonized by a dense community of commensal microorganisms referred to as the gut microbiota. The gut microbiota and the host have co-evolved, and they engage in a myriad of immunogenic and metabolic interactions. The gut microbiota contributes to the maintenance of host health. However, when healthy microbial structure is perturbed, a condition termed dysbiosis, the altered gut microbiota can trigger the development of various GI diseases including inflammatory bowel disease, colon cancer, celiac disease, and irritable bowel syndrome. There is a growing body of evidence suggesting that multiple intrinsic and extrinsic factors, such as genetic variations, diet, stress, and medication, can dramatically affect the balance of the gut microbiota. Therefore, these factors regulate the development and progression of GI diseases by inducing dysbiosis. Herein, we will review the recent advances in the field, focusing on the mechanisms through which intrinsic and extrinsic factors induce dysbiosis and the role a dysbiotic microbiota plays in the pathogenesis of GI diseases.
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