Ileítis en la COVID-19 complicada: ¿causa o efecto?
Texto completo:
PDFResumen
Introducción: la comprensión histomorfológica y biomolecular del íleon terminal; sitio clave en el control de la absorción nutricional, del metabolismo, sistema inmunitario, microbiota intestinal, y función de órganos extradigestivos; justifica su participación en los procesos inflamatorios intestinales, como pudiera ser en la infección por el SARS-CoV2.
Objetivos: describir las evidencias biomoleculares de los componentes tisulares del íleon que justifican su función en el eje hepático-intestinal, y citar hallazgos histomorfológicos del íleon en fallecidos de la COVID-19.
Adquisición de información: se realizó una revisión sistemática, crítica de los estudios biomoleculares sobre los enterocitos, la barrera epitelial intestinal, microbiota y permeabilidad intestinal del íleon que fundamentan su función de barrera epitelial, reportados en sitios Web (PubMed, Scielos, Lilacs, y Elservier), entre 2000 a 2021, y se citan hallazgos preliminares de cortes histomorfológicos del íleon en fallecidos de la COVID-19.
Desarrollo: se describen las evidencias biomoleculares del íleon normal, y la repercusión de su pérdida, disbiosis e hiperpermeabilidad en los procesos inflamatorios intestinales; también se citan hallazgos histomorfológicos preliminares de ileítis en fallecidos de la COVID-19, que pudiera fundamentar la importancia de la intuición biomolecular del íleon en el equilibrio salud-enfermedad, cuya pérdida justificaría el progreso clínico de la COVID-19.
Conclusiones: la revisión integral del íleon y la cita de los hallazgos histomorfológicos preliminares de ileítis en fallecidos de la COVID-19, motiva realizar estudios amplios, que infieran su papel en el progreso clínico de la COVID-19 y justifique el futuro de nuevas intervenciones terapéuticas para su integridad.
Palabras clave
Referencias
Tang SJ, Wu R. Ileocecum: A Comprehensive Review. Can J Gastroenterol Hepatol. [Internet] 2019 [Consultado Abr 4];2019:1451835. Disponible en: www.https://doi.org/10.1155/2019/1451835.
Jahnel J, Fickert P, Hauer AC, Högenauer C, Avian A, Trauner M. Inflammatory bowel disease alters intestinal bile acid transporter expression. Drug Metab Dispos [Internet] 2014 [Consultado Abr 4];42(9):1423-31. Disponible en: www.https://doi.org/10.1124/dmd.114.058065.
Martinez-Guryn K, Hubert N, Frazier K, Urlass S, Musch MW, Ojeda P, Pierre JF, et al. Small intestine microbiota regulate host digestive and absorptive adaptive responses to dietary lipids. Cell Host Microbe. [Internet] 2018 [Consultado Abr 4];23(4):458-469.e5. Disponible en: www.https://doi.org/10.1016/j.chom.2018.03.011.
Ko CW, Qu J, Black DD, Tso P. Regulation of intestinal lipid metabolism: current concepts and relevance to disease. Nat Rev Gastroenterol Hepatol. [Internet] 2020 [Consultado Abr 4];17(3):169-183. Disponible en: www.https://doi.org/10.1038/s41575-019-0250-7.
Weiss GA, Hennet T. Mechanisms and consequences of intestinal dysbiosis. Cell Mol Life Sci. [Internet] 2017 [Consultado Abr 4];74(16):2959-2977. Disponible en: www.https://doi.org/10.1007/s00018-017-2509-x.
Moszak M, Szulińska M, Bogdański P. You Are What You Eat-The Relationship between Diet, Microbiota, and Metabolic Disorders-A Review. Nutrients. [Internet] 2020 [Consultado Abr 4];12(4):1096. Disponible en: www.https://doi.org/10.3390/nu12041096.
Vijayvargiya P, Camilleri M. Update on Bile Acid Malabsorption: Finally Ready for Prime Time? Curr Gastroenterol Rep. [Internet] 2018 [Consultado Abr 4];20(3):10. Disponible en: www.https://doi.org/10.1007/s11894-018-0615-z.
Karl JP, Margolis LM, Madslien EH, Murphy NE, Castellani JW, Gundersen Y, Hoke AV, et al. Changes in intestinal microbiota composition and metabolism coincide with increased intestinal permeability in young adults under prolonged physiological stress. Am J Physiol Gastrointest Liver Physiol. [Internet] 2017 [Consultado Abr 4];312(6):G559-G571. Disponible en: www.https://doi.org/10.1152/ajpgi.00066.2017.
He J, Zhang P, Shen L, Niu L, Tan Y, Chen L, Zhao Y, et al. Short-Chain Fatty Acids and Their Association with Signaling Pathways in Inflammation, Glucose and Lipid Metabolism. Int J Mol Sci. [Internet] 2020 [Consultado Abr 4];21(17):6356. Disponible en: www.https://doi.org/10.3390/ijms21176356.
Meral M, Bengi G, Kayahan H, Akarsu M, Soytürk M, Topalak Ö, et al. Is ileocecal valve intubation essential for routine colonoscopic examination? Eur J Gastroenterol Hepatol. [Internet] 2018 [Consultado Abr 4];30(4):432-37. Disponible en: www.https://doi.org/10.1097/MEG.0000000000001065.
Volk N, Lacy B. Anatomy and physiology of the small bowel. Gastrointest Endosc Clin N Am. [Internet] 2017 [Consultado Abr 4];27(1):1-13. Disponible en: www.https://doi.org/10.1016/j.giec.2016.08.001.
Lin R, Lu H, Zhou G, Wei Q, Liu Z. Clinicopathological and ileocolonoscopic characteristics in patients with nodular lymphoid hyperplasia in the terminal ileum. Int J Med Sci. [Internet] 2017 [Consultado Abr 4];14(8):750-757. Disponible en: www.https://doi.org/10.7150/ijms.19480.
De Melo MM, Gomes Netinho J. Aspectos endoscópicos no diagnóstico de doenças que acometem o íleo terminal [Endoscopic aspects in the diagnosis of terminal ileum diseases]. Rev Col Bras Cir. [Internet] 2010 [Consultado Abr 4];37(3):234-9. Portuguese. Disponible en: www.https://doi.org/10.1590/s0100-69912010000300012.
Xie C, Huang W, Young RL, Jones KL, Horowitz M, Rayner CK, Wu T. Role of Bile Acids in the Regulation of Food Intake, and Their Dysregulation in Metabolic Disease. Nutrients. [Internet] 2021 [Consultado Abr 4];13(4):1104. Disponible en: www.https://doi.org/10.3390/nu13041104.
Xie C, Jones KL, Rayner CK, Wu T. Enteroendocrine Hormone Secretion and Metabolic Control: Importance of the Region of the Gut Stimulation. Pharmaceutics. [Internet] 2020 [Consultado Abr 4];12(9):790. Disponible en: www.https://doi.org/10.3390/pharmaceutics12090790.
Chen ML, Takeda K, Sundrud MS. Emerging roles of bile acids in mucosal immunity and inflammation. Mucosal Immunol. [Internet] 2019 [Consultado Abr 4];12(4):851-61. Disponible en: www.https://doi.org/10.1038/s41385-019-0162-4.
Adak A, Khan MR. An insight into gut microbiota and its functionalities. Cell Mol Life Sci. [Internet] 2019 [Consultado Abr 4];76(3):473-493. Disponible en: www.https://doi.org/10.1007/s00018-018-2943-4.
Barros GG, Tannuri ACA, Rotondo ÍG, Vaisberg VV, Sarmento LS, Neto CM, Serafini S, et al. Is maintenance of the ileocecal valve important to the intestinal adaptation mechanisms in a weaning rat model of short bowel? Pediatr Surg Int. [Internet] 2018 [Consultado Abr 4];34(11):1215-1224. Disponible en: www.https://doi.org/10.1007/s00383-018-4333-2.
Pastrian-Soto Gabriel. Presencia y Expresión del Receptor ACE2 (Target de SARS-CoV-2) en Tejidos Humanos y Cavidad Oral. Posibles Rutas de Infección en Órganos Orales. Int. J. Odontostomat. [Internet]. 2020 [Consultado Abr 4];14( 4 ): 501-7. Disponible en: http://dx.doi.org/10.4067/S0718-381X2020000400501.
Hamming I, Timens W, Bulthuis ML, Lely AT, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. [Internet] 2004 [Consultado Abr 4];203(2):631-7. Disponible en: www.https://doi.org/10.1002/path.1570.
Burris TP, Solt LA, Wang Y, Crumbley C, Banerjee S, Griffett K, Lundasen T, et al. Nuclear receptors and their selective pharmacologic modulators. Pharmacol Rev. [Internet] 2013 [Consultado Abr 4];65(2):710-78. Disponible en: www.https://doi.org/10.1124/pr.112.006833.
Slijepcevic D, van de Graaf SF. Bile Acid Uptake Transporters as Targets for Therapy. Dig Dis. [Internet] 2017[Consultado Abr 4];35(3):251-258. Disponible en: www.https://doi.org/10.1159/000450983.
Chiang JYL, Ferrell JM. Bile Acid Metabolism in Liver Pathobiology. Gene Expr. [Internet] 2018 [Consultado Abr 4];18(2):71-87. Disponible en: www.https://doi.org/10.3727/105221618X15156018385515.
Pathak P, Xie C, Nichols RG, Ferrell JM, Boehme S, Krausz KW, Patterson AD, Gonzalez FJ, Chiang JYL. Intestine farnesoid X receptor agonist and the gut microbiota activate G-protein bile acid receptor-1 signaling to improve metabolism. Hepatology. [Internet] 2018 [Consultado Abr 4];68(4):1574-1588. Disponible en: www.https://doi.org/10.1002/hep.29857.
Copple BL, Li T. Pharmacology of bile acid receptors: Evolution of bile acids from simple detergents to complex signaling molecules. Pharmacol Res. [Internet] 2016 [Consultado Abr 4];104:9-21. Disponible en: www.https://doi.org/10.1016/j.phrs.2015.12.007.
De Aguiar Vallim TQ, Tarling EJ, Edwards PA. Pleiotropic roles of bile acids in metabolism. Cell Metab. [Internet] 2013 [Consultado Abr 4];17(5):657-69. Disponible en: www.https://doi.org/10.1016/j.cmet.2013.03.013.
Su KC, Wu YC, Chen CS, Hung MH, Hsiao YH, Tseng CM, et al. Bile acids increase alveolar epithelial permeability via mitogen-activated protein kinase, cytosolic phospholipase A2, cyclooxygenase-2, prostaglandin E2 and junctional proteins. Respirology. [Internet]. 2013. [Consultado Abr 4];18:848-56. Disponible en: www.https://doi.org/10.1111/resp.12086.
Khurana S, Raufman JP, Pallone TL. Bile acids regulate cardiovascular function. Clin Trans Sci. [Internte] 2011[Consultado Abr 4];4: 210–18. Disponible en: www.htpps//doi.org/10.1111/j.1752-8062.2011.00272.x
Krones E, Pollheimer MJ, Rosenkranz AR, Fickert P. Cholemic nephropathy - Historical notes and novel perspectives. Biochim Biophys Acta Mol Basis Dis. [Internte] 2018 [Consultado Abr 4];1864(4PtB):1356-66. Disponible en: www.htpps//doi.org/10.1016/j.bbadis.2017.08.028.
Xie C, Huang W, Young RL, Jones KL, Horowitz M, Rayner CK, Wu T. Role of Bile Acids in the Regulation of Food Intake, and Their Dysregulation in Metabolic Disease. Nutrients. [Internet] 2021 [Consultado Abr 4];13(4):1104. Disponible en: www.https://doi.org/10.3390/nu13041104.
Fukui H. Increased Intestinal Permeability and Decreased Barrier Function: Does It Really Influence the Risk of Inflammation? Inflamm Intest Dis. [Internet] 2016 [Consultado Abr 4];1(3):135-45. Disponible en: www.https://doi.org/10.1159/000447252.
Peterson LW, Artis D. Intestinal epithelial cells: regulators of barrier function and immune homeostasis. Nat Rev Immunol. [Internet] 2014 [Consultado Abr 4];14(3):141-53. Disponible en: www.https://doi.org/10.1038/nri3608.
Julio-Pieper M, Bravo JA. Intestinal Barrier and Behavior. Int Rev Neurobiol. [Internet] 2016 [Consultado Abr 4];131:127-141. Disponible en: www.https://doi.org/10.1016/bs.irn.2016.08.006.
Suzuki T. Regulation of the intestinal barrier by nutrients: The role of tight junctions. Anim Sci J. [Internet] 2020 [Consultado Abr 4];91(1):e13357. Disponible en: www.https://doi.org/10.1111/asj.13357.
Camilleri M, Madsen K, Spiller R, Greenwood-Van Meerveld B, Verne GN. Intestinal barrier function in health and gastrointestinal disease. Neurogastroenterol Motil. [Internet] 2012 [Consultado Abr 4];24(6):503-12. Disponible en: www.https://doi.org/10.1111/j.1365-2982.2012.01921.x.
Ahmad R, Sorrell MF, Batra SK, Dhawan P, Singh AB. Gut permeability and mucosal inflammation: bad, good or context dependent. Mucosal Immunol. [Internet] 2017 [Consultado Abr 4];10(2):307-317. Disponible en: www.https://doi.org/10.1038/mi.2016.128.
Vancamelbeke M, Vermeire S. The intestinal barrier: a fundamental role in health and disease. Expert Rev Gastroenterol Hepatol. [Internet] 2017 [Consultado Abr 4];11(9):821-834. Disponible en: www.https://doi.org/10.1080/17474124.2017.1343143.
Camilleri M, Vijayvargiya P. The Role of Bile Acids in Chronic Diarrhea. Am J Gastroenterol. [Internet] 2020 [Consultado Abr 4];115(10):1596-1603. Disponible en: www.https://doi.org/10.14309/ajg.0000000000000696.
Sagar NM, Duboc H, Kay GL, Alam MT, Wicaksono AN, Covington JA, Quince C, et al. The pathophysiology of bile acid diarrhoea: differences in the colonic microbiome, metabolome and bile acids. Sci Rep. [Internet] 2020 [Consultado Abr 4];10(1):20436. Disponible en: www.https://doi.org/10.1038/s41598-020-77374-7.
Fan HN, Zhu P, Lu YM, Guo JH, Zhang J, Qu GQ, Zhu JS. Mild changes in the mucosal microbiome during terminal ileum inflammation. Microb Pathog. [Internet] 2020 [Consultado Abr 4];142:104104. Disponible en: www.https://doi.org/10.1016/j.micpath.2020.104104.
Wang YH. Current progress of research on intestinal bacterial translocation. Microb Pathog. [Internet] 2021 [Consultado Abr 4];152:104652. Disponible en: www.https://doi.org/10.1016/j.micpath.2020.104652.
Fasano A. All disease begins in the (leaky) gut: role of zonulin-mediated gut permeability in the pathogenesis of some chronic inflammatory diseases. F1000Res. [Internet] 2020 [Consultado Abr 4];9:F1000 Faculty Rev-69. Disponible en: www.https://doi.org/10.12688/f1000research.20510.1.
Suzuki T. Regulation of the intestinal barrier by nutrients: The role of tight junctions. Anim Sci J. [Internet] 2020 [Consultado Abr 4];91(1):e13357. Disponible en: www.https://doi.org/10.1111/asj.13357.
Chakaroun RM, Massier L, Kovacs P. Gut Microbiome, Intestinal Permeability, and Tissue Bacteria in Metabolic Disease: Perpetrators or Bystanders? Nutrients. [Internet] 2020 [Consultado Abr 4];12(4):1082. Disponible en: www.https://doi.org/10.3390/nu12041082.
Ticho AL, Malhotra P, Dudeja PK, Gill RK, Alrefai WA. Intestinal Absorption of Bile Acids in Health and Disease. Compr Physiol. [Internet] 2019 [Consultado Abr 4];10(1):21-56. Disponible en: www.https://doi.org/10.1002/cphy.c190007.
Yoo JY, Groer M, Dutra SVO, Sarkar A, McSkimming DI. Gut Microbiota and Immune System Interactions. Microorganisms. [Internet] 2020 [Consultado Abr 4];8(10):1587. Disponible en: www.https://doi.org/10.3390/microorganisms8101587.
Dang AT, Marsland BJ. Microbes, metabolites, and the gut-lung axis. Mucosal Immunol. [Internet] 2019 [Consultado Abr 4];12(4):843-50. Disponible en: www.https://doi.org/10.1038/s41385-019-0160-6.
Chen J, Vitetta L. Gut Microbiota Metabolites in NAFLD Pathogenesis and Therapeutic Implications. Int J Mol Sci. [Internet] 2020 [Consultado Abr 4];21(15):5214. www.https://doi.org/10.3390/ijms21155214.
Allam-Ndoul B, Castonguay-Paradis S, Veilleux A. Gut Microbiota and Intestinal Trans-Epithelial Permeability. Int J Mol Sci. [Internet] 2020 [Consultado Abr 4];21(17):6402. Disponible en: www.https://doi.org/10.3390/ijms21176402.
Meng X, Zhang G, Cao H, Yu D, Fang X, de Vos WM, Wu H. Gut dysbacteriosis and intestinal disease: mechanism and treatment. J Appl Microbiol. [Internet] 2020 [Consultado Abr 4];129(4):787-805. Disponible en: www.https://doi.org/10.1111/jam.14661.
Rizzetto L, Fava F, Tuohy KM, Selmi C. Connecting the immune system, systemic chronic inflammation and the gut microbiome: The role of sex. J Autoimmun. [Internet] 2018 [Consultado Abr 4];92:12-34. Disponible en: www.https://doi.org/10.1016/j.jaut.2018.05.008.
Brunet E, Casabella A, Calzado S, Villoria A. Ileitis as the exclusive manifestation of COVID-19. The first reported case. Gastroenterol Hepatol. [Internet] 2020 [Consultado Abr 4];S0210-5705(20)30372-1. Disponible en: www.https://doi.org/10.1016/j.gastrohep.2020.10.001.
Musa S. Hepatic and gastrointestinal involvement in coronavirus disease 2019 (COVID-19): What do we know till now? Arab J Gastroenterol. [Internet] 2020 [Consultado Abr 4];21(1):3-8. Disponible en: www.https://doi.org/10.1016/j.ajg.2020.03.002.
Cheong J, Bartell N, Peeraphatdit T, Mosli M, Al-Judaibi B. Gastrointestinal and liver manifestations of COVID-19. Saudi J Gastroenterol. [Internet] 2020 [Consultado Abr 4];26(5):226-232. Disponible en: www.https://doi.org/10.4103/sjg.SJG_147_20.
Hunt RH, East JE, Lanas A, Malfertheiner P, Satsangi J, Scarpignato C, Webb GJ. COVID-19 and Gastrointestinal Disease: Implications for the Gastroenterologist. Dig Dis. [Internet] 2021 [Consultado Abr 4];39(2):119-139. Disponible en: www.https://doi.org/10.1159/000512152.
Lee IC, Huo TI, Huang YH. Gastrointestinal and liver manifestations in patients with COVID-19. J Chin Med Assoc. [Internet] 2020 [Consultado Abr 4];83(6):521-523. Disponible en: www.https://doi.org/10.1097/JCMA.0000000000000319.
Wong SH, Lui RN, Sung JJ. Covid-19 and the digestive system. J Gastroenterol Hepatol. [Internet] 2020 [Consultado Abr 4];35(5):744-748. Disponible en: www.https://doi.org/10.1111/jgh.15047.
Sultan, Shahnaz et al. “AGA Institute Rapid Review of the Gastrointestinal and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19.” Gastroenterology. [Internet] 2020[Consultado Abr 4];159,1:320-34.e27. Disponible en: www.https://doi.org/10.1053/j.gastro.2020.05.001
Villapol S. Gastrointestinal symptoms associated with COVID-19: impact on the gut microbiome. Transl Res. [Internet] 2020 [Consultado Abr 4];226:57-69. Disponible en: www.https://doi.org/10.1016/j.trsl.2020.08.004.
Rathore V, Galhotra A, Pal R, Sahu KK. COVID-19 Pandemic and Children: A Review. J Pediatr Pharmacol Ther. [Internet] 2020 [Consultado Abr 4];25(7):574-85. Disponible en: www.https://doi.org/10.5863/1551-6776-25.7.574.
Puoti MG, Rybak A, Kiparissi F, Gaynor E, Borrelli O. SARS-CoV-2 and the Gastrointestinal Tract in Children. Front Pediatr. [Internet] 2021 [Consultado Abr 4];9:617980. Disponible en: www.https://doi.org/10.3389/fped.2021.617980.
Mamishi S, Movahedi Z, Mohammadi M, Ziaee V, Khodabandeh M, Abdolsalehi MR, Navaeian A, et al. Multisystem inflammatory syndrome associated with SARS-CoV-2 infection in 45 children: a first report from Iran. Epidemiol Infect. [Internet] 2020 [Consultado Abr 4];148:e196. Disponible en: www.https://doi.org/10.1017/S095026882000196X.
Chen B, Cai HR, Xue S, You WJ, Liu B, Jiang HD. Bile acids induce activation of alveolar epithelial cells and lung fibroblasts through farnesoid X receptor-dependent and independent pathways. Respirology. [Internet] 2016 [Consultado Abr 4];21(6):1075-80. Disponible en: www.https://doi.org/10.1111/resp.12815.
Vasavan T, Ferraro E, Ibrahim E, Dixon P, Gorelik J, Williamson C. Heart and bile acids - Clinical consequences of altered bile acid metabolism. Biochim Biophys Acta Mol Basis Dis. [Internet] 2018 [Consultado Abr 4];1864(4 Pt B):1345-1355. Disponible en: www.https://doi.org/10.1016/j.bbadis.2017.12.039.
Herman-Edelstein M, Weinstein T, Levi M. Bile acid receptors and the kidney. Curr Opin Nephrol Hypertens. [Internet] 2018 [Consultado Abr 4];27(1):56-62. Disponible en: www.https://doi.org/10.1097/MNH.0000000000000374.
Wang XX, Edelstein MH, Gafter U, Qiu L, Luo Y, Dobrinskikh E, Lucia S, et al. G Protein-Coupled Bile Acid Receptor TGR5 Activation Inhibits Kidney Disease in Obesity and Diabetes. J Am Soc Nephrol. [Internet] 2016 [Consultado Abr 4];27(5):1362-78. Disponible en: www.https://doi.org/10.1681/ASN.2014121271.
Grant SM, DeMorrow S. Bile Acid Signaling in Neurodegenerative and Neurological Disorders. Int J Mol Sci. [Internet] 2020 [Consultado Abr 4];21(17):5982. Disponible en: www.https://doi.org/10.3390/ijms21175982.
Klindt C, Reich M, Hellwig B, Stindt J, Rahnenführer J, Hengstler JG, Köhrer K, et al. The G Protein-Coupled Bile Acid Receptor TGR5 (Gpbar1) Modulates Endothelin-1 Signaling in Liver. Cells. [Internet] 2019 [Consultado Abr 4];8(11):1467. Disponible en: www.https://doi.org/10.3390/cells8111467.
Bottari B, Castellone V, Neviani E. Probiotics and Covid-19. Int J Food Sci Nutr. [Internet] 2021 [Consultado Abr 4];72(3):293-99. Disponible en: www.https://doi.org/10.1080/09637486.2020.1807475.
Grüner N, Mattner J. Bile Acids and Microbiota: Multifaceted and Versatile Regulators of the Liver-Gut Axis. Int J Mol Sci. [Internet] 2021 [Consultado Abr 4];22(3):1397. Disponible en: www.https://doi.org/10.3390/ijms22031397.
Chamrah N, Déchelotte P, Coëffier M. Glutamine and the regulation of intestinal permeability: from bench to bedside. Curr Opin Clin Nutr Metab Care. [Internet] 2017 [Consultado Abr 4];20(1):86-91. Disponible en: www.https://doi.org/10.1097/MCO.0000000000000339.
Shariatpanahi ZV, Eslamian G, Ardehali SH, Baghestani AR. Effects of Early Enteral Glutamine Supplementation on Intestinal Permeability in Critically Ill Patients. Indian J Crit Care Med. 2019 [Consultado Abr 4];23(8):356-62. Disponible en: www.https://doi.org/10.5005/jp-journals-10071-23218.
Çelik S, Guve H, Çalışkan C, Çelik S. The Role of Melatonin, IL-8 and IL-10 in Intrahepatic Cholestasis of Pregnancy. Z Geburtshilfe Neonatol. [Internet] 2020 [Consultado Abr 4]; Disponible en: www.https://doi.org/10.1055/a-1233-9084.
Mannino G, Caradonna F, Cruciata I, Lauria A, Perrone A, Gentile C. Melatonin reduces inflammatory response in human intestinal epithelial cells stimulated by interleukin-1β. J Pineal Res. [Internet] 2019 [Consultado Abr 4];67(3):e12598. Disponible en: www.https://doi.org/10.1111/jpi.12598.
Di Caro V, Alcamo AM, Cummings JL, Clark RSB, Novak EA, Mollen KP, Morowitz MJ, Aneja RK. Effect of dietary cellulose supplementation on gut barrier function and apoptosis in a murine model of endotoxemia. PLoS One. [Internet] 2019 Dec 2;14(12):e0224838. Disponible en: www.https://doi.org/10.1371/journal.pone.0224838.
Chen HL, Lin YM, Wang YC. Comparative effects of cellulose and soluble fibers (pectin, konjac glucomannan, inulin) on fecal water toxicity toward Caco-2 cells, fecal bacteria enzymes, bile acid, and short-chain fatty acids. J Agric Food Chem. [Internet] 2010 [Consultado Abr 4];58(18):10277-81. Disponible en: www.https://doi.org/10.1021/jf102127k.
Abdulrab S, Al-Maweri S, Halboub E. Ursodeoxycholic acid as a candidate therapeutic to alleviate and/or prevent COVID-19-associated cytokine storm. Med Hypotheses. [Internet]. 2020 [Consultado Abr 4];143:109897. Disponible en: https://doi.org/10.1016/j.mehy.2020.109897
Xiong X, Ren Y, Cui Y, Li R, Wang C, Zhang Y. Obeticholic acid protects mice against lipopolysaccharide-induced liver injury and inflammation. Biomed Pharmacother. [Internet] 2017 [Consultado Abr 4];96:1292-1298. Disponible en: www.https://doi.org/10.1016/j.biopha.2017.11.083.
Hvas CL, Ott P, Paine P, Lal S, Jørgensen SP, Dahlerup JF. Obeticholic acid for severe bile acid diarrhea with intestinal failure: A case report and review of the literature. World J Gastroenterol. [Internet] 2018 [Consultado Abr 4];24(21):2320-2326. Disponible en: www.https://doi.org/10.3748/wjg.v24.i21.2320.
Brevini T, Maes M, Webb GJ, Gelson WTH, Forrest S, Mlcochova P, et al. FXR inhibition reduces ACE2 expression, SARS-CoV-2 infection and may improve COVID-19 outcome. BioRxiv. [Internet] 2021[Consultado Abr 4]; preprint. Disponible en: https://doi.org/10.1101/2021.06.06.446781
Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial 4.0 Internacional.