Skip to main content
Erschienen in: European Journal of Nutrition 1/2016

01.02.2016 | Original Contribution

Bifidobacterium pseudocatenulatum CECT7765 promotes a TLR2-dependent anti-inflammatory response in intestinal lymphocytes from mice with cirrhosis

verfasst von: Alba Moratalla, Isabel Gómez-Hurtado, Ángela Moya-Pérez, Pedro Zapater, Gloria Peiró, José M. González-Navajas, Eva Maria Gómez Del Pulgar, José Such, Yolanda Sanz, Rubén Francés

Erschienen in: European Journal of Nutrition | Ausgabe 1/2016

Einloggen, um Zugang zu erhalten

Abstract

Background

Intestinal homeostasis plays an important role in bacteria-derived complications in cirrhosis. Intestinal lymphocytes are responsible for immune effector functions and can be modulated by certain probiotics. We evaluate the interaction between Bifidobacterium pseudocatenulatum CECT7765 and intestinal lymphocytes in mice with cirrhosis.

Animals and methods

Cirrhosis was induced by intragastrical administration of carbon tetrachloride in Balb/C mice. One week prior to laparotomy, animals received B. pseudocatenulatum CECT7765 (107, 109 or 1010 cfu/daily) or placebo. Chemokine receptor and cytokine expression were evaluated in intestinal lymphocytes. Gut permeability was studied by FITC-LPS recovery in vivo. Luminal antigens, inflammation and functional markers were evaluated in liver samples.

Results

Bifidobacterium pseudocatenulatum CECT7765 decreased the expression of pro-inflammatory chemokine receptors CCR6, CCR9, CXCR3 and CXCR6 in intestinal lymphocytes from cirrhotic mice in a concentration-dependent manner. The bifidobacterial strain induced a shift towards an anti-inflammatory cytokine profile in this cell subset. B. pseudocatenulatum CECT7765-induced inflammatory modulation was TLR2-mediated, as in vitro TLR2 blockade inhibited the reduction of TNF-alpha and its receptors and the increase of IL-10 and IL-10 receptor secretion. The recovery rate of administered fluorescence-labelled endotoxin was significantly and dose-dependently lowered with the bifidobacterial strain. The reduced intestinal permeability was associated with a decreased burden of bacterial antigens in the liver of mice treated with B. pseudocatenulatum CECT7765. Liver function and inflammation were improved with the use of the bifidobacterial strain at the highest dose tested (1010 cfu).

Conclusion

Bifidobacterium pseudocatenulatum CECT7765 improves gut homeostasis and prevents gut-derived complications in experimental chronic liver disease.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Berg RD (1992) Bacterial translocation from the gastrointestinal tract. J Med 23:217–244 Berg RD (1992) Bacterial translocation from the gastrointestinal tract. J Med 23:217–244
2.
Zurück zum Zitat Wiest R, Garcia-Tsao G (2005) Bacterial translocation (BT) in cirrhosis. Hepatology 41:422–433CrossRef Wiest R, Garcia-Tsao G (2005) Bacterial translocation (BT) in cirrhosis. Hepatology 41:422–433CrossRef
3.
Zurück zum Zitat Yan AW, Fouts DE, Brandl J, Starkel P, Torralba M, Schott E et al (2011) Enteric dysbiosis associated with a mouse model of alcoholic liver disease. Hepatology 53:96–105CrossRef Yan AW, Fouts DE, Brandl J, Starkel P, Torralba M, Schott E et al (2011) Enteric dysbiosis associated with a mouse model of alcoholic liver disease. Hepatology 53:96–105CrossRef
4.
Zurück zum Zitat Gomez-Hurtado I, Santacruz A, Peiro G, Zapater P, Gutierrez A, Perez-Mateo M et al (2011) Gut microbiota dysbiosis is associated with inflammation and bacterial translocation in mice with CCl4-induced fibrosis. PLoSOne 6:e23037CrossRef Gomez-Hurtado I, Santacruz A, Peiro G, Zapater P, Gutierrez A, Perez-Mateo M et al (2011) Gut microbiota dysbiosis is associated with inflammation and bacterial translocation in mice with CCl4-induced fibrosis. PLoSOne 6:e23037CrossRef
5.
Zurück zum Zitat Kirpich IA, McClain CJ (2012) Probiotics in the treatment of the liver diseases. J Am Coll Nutr 31:14–23CrossRef Kirpich IA, McClain CJ (2012) Probiotics in the treatment of the liver diseases. J Am Coll Nutr 31:14–23CrossRef
6.
Zurück zum Zitat Stadlbauer V, Mookerjee RP, Hodges S, Wright GA, Davies NA, Jalan R (2008) Effect of probiotic treatment on deranged neutrophil function and cytokine responses in patients with compensated alcoholic cirrhosis. J Hepatol 48:945–951CrossRef Stadlbauer V, Mookerjee RP, Hodges S, Wright GA, Davies NA, Jalan R (2008) Effect of probiotic treatment on deranged neutrophil function and cytokine responses in patients with compensated alcoholic cirrhosis. J Hepatol 48:945–951CrossRef
7.
Zurück zum Zitat Pereg D, Kotliroff A, Gadoth N, Hadary R, Lishner M, Kitay-Cohen Y (2011) Probiotics for patients with compensated liver cirrhosis: a double-blind placebo-controlled study. Nutrition 27:177–181CrossRef Pereg D, Kotliroff A, Gadoth N, Hadary R, Lishner M, Kitay-Cohen Y (2011) Probiotics for patients with compensated liver cirrhosis: a double-blind placebo-controlled study. Nutrition 27:177–181CrossRef
8.
Zurück zum Zitat Moratalla A, Gomez-Hurtado I, Santacruz A, Moya A, Peiro G, Zapater P, et al. (2014) Protective effect of Bifidobacterium pseudocatenulatum CECT7765 against induced bacterial antigen translocation in experimental cirrhosis. Liver Int 34:850–858CrossRef Moratalla A, Gomez-Hurtado I, Santacruz A, Moya A, Peiro G, Zapater P, et al. (2014) Protective effect of Bifidobacterium pseudocatenulatum CECT7765 against induced bacterial antigen translocation in experimental cirrhosis. Liver Int 34:850–858CrossRef
9.
Zurück zum Zitat Agace WW (2006) Tissue-tropic effector T cells: generation and targeting opportunities. Nat Rev Immunol 6:682–692CrossRef Agace WW (2006) Tissue-tropic effector T cells: generation and targeting opportunities. Nat Rev Immunol 6:682–692CrossRef
10.
Zurück zum Zitat de Kivit S, Tobin MC, Forsyth CB, Keshavarzian A, Landay AL (2014) Regulation of intestinal immune responses through TLR activation: implications for pro- and prebiotics. Front Immunol 5:60CrossRef de Kivit S, Tobin MC, Forsyth CB, Keshavarzian A, Landay AL (2014) Regulation of intestinal immune responses through TLR activation: implications for pro- and prebiotics. Front Immunol 5:60CrossRef
11.
Zurück zum Zitat Jeon SG, Kayama H, Ueda Y, Takahashi T, Asahara T, Tsuji H et al (2012) Probiotic Bifidobacterium breve induces IL-10-producing Tr1 cells in the colon. PLoS Pathog 8:e1002714CrossRef Jeon SG, Kayama H, Ueda Y, Takahashi T, Asahara T, Tsuji H et al (2012) Probiotic Bifidobacterium breve induces IL-10-producing Tr1 cells in the colon. PLoS Pathog 8:e1002714CrossRef
12.
Zurück zum Zitat Isono A, Katsuno T, Sato T, Nakagawa T, Kato Y, Sato N et al (2007) Clostridium butyricum TO-A culture supernatant downregulates TLR4 in human colonic epithelial cells. Dig Dis Sci 52:2963–2971CrossRef Isono A, Katsuno T, Sato T, Nakagawa T, Kato Y, Sato N et al (2007) Clostridium butyricum TO-A culture supernatant downregulates TLR4 in human colonic epithelial cells. Dig Dis Sci 52:2963–2971CrossRef
13.
Zurück zum Zitat Hayashi A, Sato T, Kamada N, Mikami Y, Matsuoka K, Hisamatsu T et al (2013) A single strain of Clostridium butyricum induces intestinal IL-10-producing macrophages to suppress acute experimental colitis in mice. Cell Host Microbe 13:711–722CrossRef Hayashi A, Sato T, Kamada N, Mikami Y, Matsuoka K, Hisamatsu T et al (2013) A single strain of Clostridium butyricum induces intestinal IL-10-producing macrophages to suppress acute experimental colitis in mice. Cell Host Microbe 13:711–722CrossRef
14.
Zurück zum Zitat Mazmanian SK, Round JL, Kasper DL (2008) A microbial symbiosis factor prevents intestinal inflammatory disease. Nature 453:620–625CrossRef Mazmanian SK, Round JL, Kasper DL (2008) A microbial symbiosis factor prevents intestinal inflammatory disease. Nature 453:620–625CrossRef
15.
Zurück zum Zitat Vizoso Pinto MG, Rodriguez Gomez M, Seifert S, Watzl B, Holzapfel WH, Franz CM (2009) Lactobacilli stimulate the innate immune response and modulate the TLR expression of HT29 intestinal epithelial cells in vitro. Int J Food Microbiol 133:86–93CrossRef Vizoso Pinto MG, Rodriguez Gomez M, Seifert S, Watzl B, Holzapfel WH, Franz CM (2009) Lactobacilli stimulate the innate immune response and modulate the TLR expression of HT29 intestinal epithelial cells in vitro. Int J Food Microbiol 133:86–93CrossRef
16.
Zurück zum Zitat Furrie E, Macfarlane S, Thomson G, Macfarlane GT, Microbiology and Gut Biology Group et al (2005) Toll-like receptors-2, -3 and -4 expression patterns on human colon and their regulation by mucosal-associated bacteria. Immunology 115:565–574CrossRef Furrie E, Macfarlane S, Thomson G, Macfarlane GT, Microbiology and Gut Biology Group et al (2005) Toll-like receptors-2, -3 and -4 expression patterns on human colon and their regulation by mucosal-associated bacteria. Immunology 115:565–574CrossRef
17.
Zurück zum Zitat Kingma SD, Li N, Sun F, Valladares RB, Neu J, Lorca GL (2011) Lactobacillus johnsonii N6.2 stimulates the innate immune response through Toll-like receptor 9 in Caco-2 cells and increases intestinal crypt Paneth cell number in biobreeding diabetes-prone rats. J Nutr 141:1023–1028CrossRef Kingma SD, Li N, Sun F, Valladares RB, Neu J, Lorca GL (2011) Lactobacillus johnsonii N6.2 stimulates the innate immune response through Toll-like receptor 9 in Caco-2 cells and increases intestinal crypt Paneth cell number in biobreeding diabetes-prone rats. J Nutr 141:1023–1028CrossRef
18.
Zurück zum Zitat Such J, Frances R, Munoz C, Zapater P, Casellas JA, Cifuentes A et al (2002) Detection and identification of bacterial DNA in patients with cirrhosis and culture-negative, nonneutrocytic ascites. Hepatology 36:135–141CrossRef Such J, Frances R, Munoz C, Zapater P, Casellas JA, Cifuentes A et al (2002) Detection and identification of bacterial DNA in patients with cirrhosis and culture-negative, nonneutrocytic ascites. Hepatology 36:135–141CrossRef
19.
Zurück zum Zitat Guarner C, Gonzalez-Navajas JM, Sanchez E, Soriano G, Frances R, Chiva M et al (2006) The detection of bacterial DNA in blood of rats with CCl(4)-induced cirrhosis with ascites represents episodes of bacterial translocation. Hepatology 44:633–639CrossRef Guarner C, Gonzalez-Navajas JM, Sanchez E, Soriano G, Frances R, Chiva M et al (2006) The detection of bacterial DNA in blood of rats with CCl(4)-induced cirrhosis with ascites represents episodes of bacterial translocation. Hepatology 44:633–639CrossRef
20.
Zurück zum Zitat Gautreaux MD, Gelder FB, Deitch EA, Berg RD (1995) Adoptive transfer of T lymphocytes to T-cell-depleted mice inhibits Escherichia coli translocation from the gastrointestinal tract. Infect Immun 63:3827–3834 Gautreaux MD, Gelder FB, Deitch EA, Berg RD (1995) Adoptive transfer of T lymphocytes to T-cell-depleted mice inhibits Escherichia coli translocation from the gastrointestinal tract. Infect Immun 63:3827–3834
21.
Zurück zum Zitat Choudhry MA, Fazal N, Goto M, Gamelli RL, Sayeed MM (2002) Gut-associated lymphoid T cell suppression enhances bacterial translocation in alcohol and burn injury. Am J Physiol Gastrointest Liver Physiol 282:G937–G947CrossRef Choudhry MA, Fazal N, Goto M, Gamelli RL, Sayeed MM (2002) Gut-associated lymphoid T cell suppression enhances bacterial translocation in alcohol and burn injury. Am J Physiol Gastrointest Liver Physiol 282:G937–G947CrossRef
22.
Zurück zum Zitat Stenstad H, Ericsson A, Johansson-Lindbom B, Svensson M, Marsal J, Mack M et al (2006) Gut-associated lymphoid tissue-primed CD4 + T cells display CCR9-dependent and -independent homing to the small intestine. Blood 107:3447–3454CrossRef Stenstad H, Ericsson A, Johansson-Lindbom B, Svensson M, Marsal J, Mack M et al (2006) Gut-associated lymphoid tissue-primed CD4 + T cells display CCR9-dependent and -independent homing to the small intestine. Blood 107:3447–3454CrossRef
23.
Zurück zum Zitat Chu PS, Nakamoto N, Ebinuma H, Usui S, Saeki K, Matsumoto A et al (2013) C-C motif chemokine receptor 9 positive macrophages activate hepatic stellate cells and promote liver fibrosis in mice. Hepatology 58:337–350CrossRef Chu PS, Nakamoto N, Ebinuma H, Usui S, Saeki K, Matsumoto A et al (2013) C-C motif chemokine receptor 9 positive macrophages activate hepatic stellate cells and promote liver fibrosis in mice. Hepatology 58:337–350CrossRef
24.
Zurück zum Zitat Hammerich L, Bangen JM, Govaere O, Zimmermann HW, Gassler N, Huss S et al (2014) Chemokine receptor CCR6-dependent accumulation of gammadelta T cells in injured liver restricts hepatic inflammation and fibrosis. Hepatology 59:630–642CrossRef Hammerich L, Bangen JM, Govaere O, Zimmermann HW, Gassler N, Huss S et al (2014) Chemokine receptor CCR6-dependent accumulation of gammadelta T cells in injured liver restricts hepatic inflammation and fibrosis. Hepatology 59:630–642CrossRef
25.
Zurück zum Zitat Helwig U, Lammers KM, Rizzello F, Brigidi P, Rohleder V, Caramelli E et al (2006) Lactobacilli, Bifidobacteria and E. coli nissle induce pro- and anti-inflammatory cytokines in peripheral blood mononuclear cells. World J Gastroenterol 12:5978–5986 Helwig U, Lammers KM, Rizzello F, Brigidi P, Rohleder V, Caramelli E et al (2006) Lactobacilli, Bifidobacteria and E. coli nissle induce pro- and anti-inflammatory cytokines in peripheral blood mononuclear cells. World J Gastroenterol 12:5978–5986
26.
Zurück zum Zitat Medina M, Izquierdo E, Ennahar S, Sanz Y (2007) Differential immunomodulatory properties of Bifidobacterium logum strains: relevance to probiotic selection and clinical applications. Clin Exp Immunol 150:531–538CrossRef Medina M, Izquierdo E, Ennahar S, Sanz Y (2007) Differential immunomodulatory properties of Bifidobacterium logum strains: relevance to probiotic selection and clinical applications. Clin Exp Immunol 150:531–538CrossRef
27.
Zurück zum Zitat Agrawal S, Agrawal A, Doughty B, Gerwitz A, Blenis J, Van Dyke T et al (2003) Cutting edge: different Toll-like receptor agonists instruct dendritic cells to induce distinct Th responses via differential modulation of extracellular signal-regulated kinase-mitogen-activated protein kinase and c-Fos. J Immunol 171:4984–4989CrossRef Agrawal S, Agrawal A, Doughty B, Gerwitz A, Blenis J, Van Dyke T et al (2003) Cutting edge: different Toll-like receptor agonists instruct dendritic cells to induce distinct Th responses via differential modulation of extracellular signal-regulated kinase-mitogen-activated protein kinase and c-Fos. J Immunol 171:4984–4989CrossRef
28.
Zurück zum Zitat Dillon S, Agrawal A, Van Dyke T, Landreth G, McCauley L, Koh A et al (2004) A Toll-like receptor 2 ligand stimulates Th2 responses in vivo, via induction of extracellular signal-regulated kinase mitogen-activated protein kinase and c-Fos in dendritic cells. J Immunol 172:4733–4743CrossRef Dillon S, Agrawal A, Van Dyke T, Landreth G, McCauley L, Koh A et al (2004) A Toll-like receptor 2 ligand stimulates Th2 responses in vivo, via induction of extracellular signal-regulated kinase mitogen-activated protein kinase and c-Fos in dendritic cells. J Immunol 172:4733–4743CrossRef
29.
Zurück zum Zitat Redecke V, Hacker H, Datta SK, Fermin A, Pitha PM, Broide DH et al (2004) Cutting edge: activation of Toll-like receptor 2 induces a Th2 immune response and promotes experimental asthma. J Immunol 172:2739–2743CrossRef Redecke V, Hacker H, Datta SK, Fermin A, Pitha PM, Broide DH et al (2004) Cutting edge: activation of Toll-like receptor 2 induces a Th2 immune response and promotes experimental asthma. J Immunol 172:2739–2743CrossRef
30.
Zurück zum Zitat Plantinga TS, van Maren WW, van Bergenhenegouwen J, Hameetman M, Nierkens S, Jacobs C et al (2011) Differential Toll-like receptor recognition and induction of cytokine profile by Bifidobacterium breve and Lactobacillus strains of probiotics. Clin Vaccine Immunol 18:621–628CrossRef Plantinga TS, van Maren WW, van Bergenhenegouwen J, Hameetman M, Nierkens S, Jacobs C et al (2011) Differential Toll-like receptor recognition and induction of cytokine profile by Bifidobacterium breve and Lactobacillus strains of probiotics. Clin Vaccine Immunol 18:621–628CrossRef
31.
Zurück zum Zitat Hartmann P, Haimerl M, Mazagova M, Brenner DA, Schnabl B (2012) Toll-like receptor 2-mediated intestinal injury and enteric tumor necrosis factor receptor I contribute to liver fibrosis in mice. Gastroenterology 143(1330–1340):e1331 Hartmann P, Haimerl M, Mazagova M, Brenner DA, Schnabl B (2012) Toll-like receptor 2-mediated intestinal injury and enteric tumor necrosis factor receptor I contribute to liver fibrosis in mice. Gastroenterology 143(1330–1340):e1331
32.
Zurück zum Zitat Frances R, Zapater P, Gonzalez-Navajas JM, Munoz C, Cano R, Moreu R et al (2008) Bacterial DNA in patients with cirrhosis and noninfected ascites mimics the soluble immune response established in patients with spontaneous bacterial peritonitis. Hepatology 47:978–985CrossRef Frances R, Zapater P, Gonzalez-Navajas JM, Munoz C, Cano R, Moreu R et al (2008) Bacterial DNA in patients with cirrhosis and noninfected ascites mimics the soluble immune response established in patients with spontaneous bacterial peritonitis. Hepatology 47:978–985CrossRef
33.
Zurück zum Zitat Moorthy G, Murali MR, Devaraj SN (2009) Lactobacilli facilitate maintenance of intestinal membrane integrity during Shigella dysenteriae 1 infection in rats. Nutrition 25:350–358CrossRef Moorthy G, Murali MR, Devaraj SN (2009) Lactobacilli facilitate maintenance of intestinal membrane integrity during Shigella dysenteriae 1 infection in rats. Nutrition 25:350–358CrossRef
34.
Zurück zum Zitat Khailova L, Dvorak K, Arganbright KM, Halpern MD, Kinouchi T, Yajima M et al (2009) Bifidobacterium bifidum improves intestinal integrity in a rat model of necrotizing enterocolitis. Am J Physiol Gastrointest Liver Physiol 297:G940–G949CrossRef Khailova L, Dvorak K, Arganbright KM, Halpern MD, Kinouchi T, Yajima M et al (2009) Bifidobacterium bifidum improves intestinal integrity in a rat model of necrotizing enterocolitis. Am J Physiol Gastrointest Liver Physiol 297:G940–G949CrossRef
35.
Zurück zum Zitat Mennigen R, Nolte K, Rijcken E, Utech M, Loeffler B, Senninger N et al (2009) Probiotic mixture VSL#3 protects the epithelial barrier by maintaining tight junction protein expression and preventing apoptosis in a murine model of colitis. Am J Physiol Gastrointest Liver Physiol 296:G1140–G1149CrossRef Mennigen R, Nolte K, Rijcken E, Utech M, Loeffler B, Senninger N et al (2009) Probiotic mixture VSL#3 protects the epithelial barrier by maintaining tight junction protein expression and preventing apoptosis in a murine model of colitis. Am J Physiol Gastrointest Liver Physiol 296:G1140–G1149CrossRef
36.
Zurück zum Zitat Zhou YK, Qin HL, Zhang M, Shen TY, Chen HQ, Ma YL et al (2012) Effects of Lactobacillus plantarum on gut barrier function in experimental obstructive jaundice. World J Gastroenterol 18:3977–3991CrossRef Zhou YK, Qin HL, Zhang M, Shen TY, Chen HQ, Ma YL et al (2012) Effects of Lactobacillus plantarum on gut barrier function in experimental obstructive jaundice. World J Gastroenterol 18:3977–3991CrossRef
37.
Zurück zum Zitat Sanchez E, Nieto JC, Boullosa A, Vidal S, Sancho FJ, Rossi G, et al. (2014) VSL#3 probiotic treatment decreases bacterial translocation in rats with carbon tetrachloride-induced cirrhosis. Liver Int 34:1504–1512CrossRef Sanchez E, Nieto JC, Boullosa A, Vidal S, Sancho FJ, Rossi G, et al. (2014) VSL#3 probiotic treatment decreases bacterial translocation in rats with carbon tetrachloride-induced cirrhosis. Liver Int 34:1504–1512CrossRef
38.
Zurück zum Zitat Velayudham A, Dolganiuc A, Ellis M, Petrasek J, Kodys K, Mandrekar P et al (2009) VSL#3 probiotic treatment attenuates fibrosis without changes in steatohepatitis in a diet-induced nonalcoholic steatohepatitis model in mice. Hepatology 49:989–997CrossRef Velayudham A, Dolganiuc A, Ellis M, Petrasek J, Kodys K, Mandrekar P et al (2009) VSL#3 probiotic treatment attenuates fibrosis without changes in steatohepatitis in a diet-induced nonalcoholic steatohepatitis model in mice. Hepatology 49:989–997CrossRef
39.
Zurück zum Zitat Li Z, Yang S, Lin H, Huang J, Watkins PA, Moser AB et al (2003) Probiotics and antibodies to TNF inhibit inflammatory activity and improve nonalcoholic fatty liver disease. Hepatology 37:343–350CrossRef Li Z, Yang S, Lin H, Huang J, Watkins PA, Moser AB et al (2003) Probiotics and antibodies to TNF inhibit inflammatory activity and improve nonalcoholic fatty liver disease. Hepatology 37:343–350CrossRef
Metadaten
Titel
Bifidobacterium pseudocatenulatum CECT7765 promotes a TLR2-dependent anti-inflammatory response in intestinal lymphocytes from mice with cirrhosis
verfasst von
Alba Moratalla
Isabel Gómez-Hurtado
Ángela Moya-Pérez
Pedro Zapater
Gloria Peiró
José M. González-Navajas
Eva Maria Gómez Del Pulgar
José Such
Yolanda Sanz
Rubén Francés
Publikationsdatum
01.02.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Nutrition / Ausgabe 1/2016
Print ISSN: 1436-6207
Elektronische ISSN: 1436-6215
DOI
https://doi.org/10.1007/s00394-015-0837-x

Weitere Artikel der Ausgabe 1/2016

European Journal of Nutrition 1/2016 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.