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MON-PP058: Randomised Clinical Trial: Casein Glycomacropeptide for Active Distal Ulcerative Colitis – A Pilot Study
Liver and gastrointestinal tract exposure on isolated colonocytes dose-dependently inhibited O2 consumption. Last, we observed that nitric oxide impaired H2 S detoxification by colonocytes. Conclusion: Our data show that H2 S increases the expression of pro-inflammatory genes and reversibly affects mitochondrial metabolism while its detoxification is limited. From those results, it appears that increased colonocytes exposure to H2 S during HPD may be deleterious for gut health. Disclosure of Interest: None declared
MON-PP057 CARNITINE DEFICIENCY AND IMPROVEMENT OF SUBJECTIVE SYMPTOMS BY ADMINISTRATION OF CARNITINE IN HEMODIALYSIS PATIENTS WITH LIVER CIRRHOSIS N. Hotta1 , T. Kurokawa1 . 1 Department of Hepatology, Masuko Memorial Hospital, Nagoya, Japan Rationale: In recent years, there are reports that L-carnitine is useful in improvement of hyperammonemia and cognitive function in patients with liver cirrhosis, and of muscle symptoms in dialysis patients. We measured carnitine levels in patients with liver cirrhosis including dialysis patients, and examined whether administration of L-carnitine improved muscle symptoms. Methods: We measured carnitine levels in 9 patients with liver cirrhosis (Child-pugh classification A/B/C = 5/4/0) who were receiving treatment in our hospital, and administered L-carnitine 900 mg to patients having muscle cramps for approximately one month and examined the presence/absence of the symptom. We measured carnitine concentration before and after dialysis, before dialysis after the administration to nine dialysis patients. In addition, we examined the presence/absence of symptom after the administration of L-carnitine in symptomatic patients. Results: The total carnitine concentration of 6 dialysis patients whose serum carnitine concentrations were measured was a subnormal 42.2 mmol/L before dialysis and 17.7 mmol/L after dialysis, showing a significant decrease (P = 0.011). In 5 patients treated with LC, the levels of serum total carnitine, free carnitine, and acylcarnitine before and after administration increased significantly from 42.0 mmol/L to 155.0 mmol/L, 26.4 mmol/L to 102.9 mmol/L, and from 16.8 mmol/L to 60.8 34.3 mmol/L, respectively. Conclusion: Total carnitine levels were low even before dialysis in the dialysis patients with liver cirrhosis in particular and they further decreased after the dialysis. Administration of L-carnitine increased the total carnitine levels and improved the symptom. Based on these results, we conclude that L-carnitine is useful for carnitine deficiency in hemodialysis patients with liver cirrhosis Disclosure of Interest: None declared
MON-PP058 RANDOMISED CLINICAL TRIAL: CASEIN GLYCOMACROPEPTIDE FOR ACTIVE DISTAL ULCERATIVE COLITIS A PILOT STUDY P.G. Wernlund1 , C.L. Hvas1 , L.A. Christensen1 , J.F. Dahlerup1 , M.B. Rasch1 , A.K. Dige1 , J. Agnholt1 . 1 Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark, Aarhus, Denmark Rationale: In ulcerative colitis (UC), dietary supplements and nutritional strategies may have anti-inflammatory properties
S149 and improve the disease course. We investigated the effects of casein glycomacropeptide (CGMP), a fraction of bovine whey protein, in active UC. Methods: In a randomised open label intervention study, 24 adult patients with active UC involving 10 40 cm of the distal colon, were randomised in a 2:1 ratio to their usual oral mesalazine treatment plus a daily nutritional supplement of CGMP 30 grams or dose escalation to 4,800 mg oral mesalazine daily (standard treatment) for 4 weeks. Acceptance and adherence to CGMP up to 8 weeks were documented. Results: After 4 weeks treatment, 10/16 (63%) who received CGMP had unchanged or decreased Simple Clinical Colitis Activity Index (SCCAI) which was similar to those on standard treatment, 4 of 8 (50%) (p = 0.67). The number of patients where SCCAI fell 3 or more did not differ between the two groups, 9/16 (56%) versus 4/8 (50%) (p = 0.77). Changes in disease extend and severity were similar between the two groups. CGMP was well tolerated and accepted by the patients. Conclusion: The addition of CGMP as nutritional therapy to standard treatment was safe and well accepted by patients with active distal UC. The disease-modifying effect of CGMP was similar to that of mesalazine dose escalation. Disclosure of Interest: None declared
MON-PP059 MORPHOLOGICAL ALTERATIONS OF THE COLON IN CANCER CACHEXIA antara3 , R.G. Figuerˆ edo1 , P. Leme1 , D.C. Cara2 , P.S.M. Alcˆ 3 1 1 3 J.P. Otoch , L.F. Maximiano , M. Seelaender . Department of Cell Biology and Development, University of S˜ ao Paulo, S˜ ao Paulo, 2 Department of Morphology, Federal University of Minas Gerais, Belo Horizonte, 3 Department of Surgery Clinical, University Hospital, S˜ ao Paulo, Brazil Rationale: Cancer cachexia is a syndrome characterised by severe and involuntary loss of skeletal muscle and adipose tissue and is related with poor prognosis and decreased survival. Efforts to improve the understanding of cachexia etiology are very important in order to create treatment strategies. The role of systemic inflammation and the involvement of the gastrointestinal system in this complex syndrome are aspects that rise growing attention. Thus we studied gut inflammation during cachexia. Methods: For that purpose we carried out a morphological analysis of lymphocyte aggregates and the distribution of eosinophils, plasma cells and fibroblasts in the rectosigmoid colon mucosal biopsies obtained from cachectic and noncachectic cancer patients with colon tumors (sponsored by FAPESP-12500790). Results: The area occupied by goblet cells was reduced in the colon mucosa of cachectic cancer patients (CC = 8), compared to non-cachectic cancer patients (CA = 6). The density of lymphocytic aggregates in the submucosa (p = 0.016) and the inflammatory cellular infiltrate in the lamina propria (p < 0.0001) were higher in CC (CA = 6; CC = 6). The number of plasma cells was increased in samples of CA (p = 0.045), while the number of eosinophils (p < 0.0001) and fibroblasts (p < 0.0001) was higher in CC (analysis of 10 fields per slide; CA = 6; CC = 6). The results suggest that there is an increased recruitment of immune cells to the gut mucosa in cachectic patients as compared with non-cachectic counterparts.
MON-PP057 CARNITINE DEFICIENCY AND IMPROVEMENT OF SUBJECTIVE SYMPTOMS BY ADMINISTRATION OF CARNITINE IN HEMODIALYSIS PATIENTS WITH LIVER CIRRHOSIS N. Hotta1 , T. Kurokawa1 . 1 Department of Hepatology, Masuko Memorial Hospital, Nagoya, Japan Rationale: In recent years, there are reports that L-carnitine is useful in improvement of hyperammonemia and cognitive function in patients with liver cirrhosis, and of muscle symptoms in dialysis patients. We measured carnitine levels in patients with liver cirrhosis including dialysis patients, and examined whether administration of L-carnitine improved muscle symptoms. Methods: We measured carnitine levels in 9 patients with liver cirrhosis (Child-pugh classification A/B/C = 5/4/0) who were receiving treatment in our hospital, and administered L-carnitine 900 mg to patients having muscle cramps for approximately one month and examined the presence/absence of the symptom. We measured carnitine concentration before and after dialysis, before dialysis after the administration to nine dialysis patients. In addition, we examined the presence/absence of symptom after the administration of L-carnitine in symptomatic patients. Results: The total carnitine concentration of 6 dialysis patients whose serum carnitine concentrations were measured was a subnormal 42.2 mmol/L before dialysis and 17.7 mmol/L after dialysis, showing a significant decrease (P = 0.011). In 5 patients treated with LC, the levels of serum total carnitine, free carnitine, and acylcarnitine before and after administration increased significantly from 42.0 mmol/L to 155.0 mmol/L, 26.4 mmol/L to 102.9 mmol/L, and from 16.8 mmol/L to 60.8 34.3 mmol/L, respectively. Conclusion: Total carnitine levels were low even before dialysis in the dialysis patients with liver cirrhosis in particular and they further decreased after the dialysis. Administration of L-carnitine increased the total carnitine levels and improved the symptom. Based on these results, we conclude that L-carnitine is useful for carnitine deficiency in hemodialysis patients with liver cirrhosis Disclosure of Interest: None declared
MON-PP058 RANDOMISED CLINICAL TRIAL: CASEIN GLYCOMACROPEPTIDE FOR ACTIVE DISTAL ULCERATIVE COLITIS A PILOT STUDY P.G. Wernlund1 , C.L. Hvas1 , L.A. Christensen1 , J.F. Dahlerup1 , M.B. Rasch1 , A.K. Dige1 , J. Agnholt1 . 1 Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark, Aarhus, Denmark Rationale: In ulcerative colitis (UC), dietary supplements and nutritional strategies may have anti-inflammatory properties
S149 and improve the disease course. We investigated the effects of casein glycomacropeptide (CGMP), a fraction of bovine whey protein, in active UC. Methods: In a randomised open label intervention study, 24 adult patients with active UC involving 10 40 cm of the distal colon, were randomised in a 2:1 ratio to their usual oral mesalazine treatment plus a daily nutritional supplement of CGMP 30 grams or dose escalation to 4,800 mg oral mesalazine daily (standard treatment) for 4 weeks. Acceptance and adherence to CGMP up to 8 weeks were documented. Results: After 4 weeks treatment, 10/16 (63%) who received CGMP had unchanged or decreased Simple Clinical Colitis Activity Index (SCCAI) which was similar to those on standard treatment, 4 of 8 (50%) (p = 0.67). The number of patients where SCCAI fell 3 or more did not differ between the two groups, 9/16 (56%) versus 4/8 (50%) (p = 0.77). Changes in disease extend and severity were similar between the two groups. CGMP was well tolerated and accepted by the patients. Conclusion: The addition of CGMP as nutritional therapy to standard treatment was safe and well accepted by patients with active distal UC. The disease-modifying effect of CGMP was similar to that of mesalazine dose escalation. Disclosure of Interest: None declared
MON-PP059 MORPHOLOGICAL ALTERATIONS OF THE COLON IN CANCER CACHEXIA antara3 , R.G. Figuerˆ edo1 , P. Leme1 , D.C. Cara2 , P.S.M. Alcˆ 3 1 1 3 J.P. Otoch , L.F. Maximiano , M. Seelaender . Department of Cell Biology and Development, University of S˜ ao Paulo, S˜ ao Paulo, 2 Department of Morphology, Federal University of Minas Gerais, Belo Horizonte, 3 Department of Surgery Clinical, University Hospital, S˜ ao Paulo, Brazil Rationale: Cancer cachexia is a syndrome characterised by severe and involuntary loss of skeletal muscle and adipose tissue and is related with poor prognosis and decreased survival. Efforts to improve the understanding of cachexia etiology are very important in order to create treatment strategies. The role of systemic inflammation and the involvement of the gastrointestinal system in this complex syndrome are aspects that rise growing attention. Thus we studied gut inflammation during cachexia. Methods: For that purpose we carried out a morphological analysis of lymphocyte aggregates and the distribution of eosinophils, plasma cells and fibroblasts in the rectosigmoid colon mucosal biopsies obtained from cachectic and noncachectic cancer patients with colon tumors (sponsored by FAPESP-12500790). Results: The area occupied by goblet cells was reduced in the colon mucosa of cachectic cancer patients (CC = 8), compared to non-cachectic cancer patients (CA = 6). The density of lymphocytic aggregates in the submucosa (p = 0.016) and the inflammatory cellular infiltrate in the lamina propria (p < 0.0001) were higher in CC (CA = 6; CC = 6). The number of plasma cells was increased in samples of CA (p = 0.045), while the number of eosinophils (p < 0.0001) and fibroblasts (p < 0.0001) was higher in CC (analysis of 10 fields per slide; CA = 6; CC = 6). The results suggest that there is an increased recruitment of immune cells to the gut mucosa in cachectic patients as compared with non-cachectic counterparts.