0000000001234003

AUTHOR

Provvidenza Damiani

showing 20 related works from this author

HSP10,HSP70 AND HSP90 IMMUNOHISTOCHEMICAL LEVELS CHANGE IN ULCERATIVE COLITIS AFTER THERAPY

2011

Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD) characterized by damage of large bowel mucosa and frequent extra-intestinal autoimmune comorbidities. The role played in IBD pathogenesis by molecular chaperones known to interact with components of the immune system involved in inflammation is unclear. We previously demonstrated that mucosal Hsp60 decreases in UC patients treated with conventional therapies (mesalazine, probiotics), suggesting that this chaperonin could be a reliable biomarker useful for monitoring response to treatment, and that it might play a role in pathogenesis. In the present work we investigated three other heat shock protein/molecular chaperones:…

HistologyBiophysicsDown-RegulationInflammationcomorbidity.Inflammatory bowel diseaseulcerative colitis heat shock proteins Hsp molecular chaperones inflammation comorbidity.Pathogenesischemistry.chemical_compoundMesalazineulcerative colitis heat shock proteins Hsp molecular chaperones inflammation comorbidityHeat shock proteinChaperonin 10MedicineHspHumansHSP70 Heat-Shock ProteinsHSP90 Heat-Shock ProteinsColitisMesalaminelcsh:QH301-705.5ulcerative colitisbusiness.industryBrief Reportmolecular chaperonesAnti-Inflammatory Agents Non-SteroidalCell Biologymedicine.diseaseUlcerative colitisImmunohistochemistrydigestive system diseaseschemistrylcsh:Biology (General)inflammationImmunologyheat shock proteinsBiomarker (medicine)Colitis Ulcerativemedicine.symptombusiness
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Arthritis Associated with Ulcerative Colitis: Our Experience in Palermo

2009

To The Editor: Ulcerative colitis (UC) is one of the inflammatory bowel diseases, which affects the small intestine and colon [1]. The pathophysiology of UC is not known [2, 3]. The association between arthritis and UC is well known. The authors report the frequency of arthritis in 53 Sicilian patients with UC. The diagnosis of UC was made according to criteria described by Schachter and Kirsner [4]. The involvement of sacroilitic joints was assessed radiologically according to Bennett and Burch grade (0=normal joint, 1=suspicious sacroiliitis 2=abnormal joint with sclerosis and/or erosions, 3=unequivocally abnormal with erosions, sclerosis, widening or narrowing or partly ankylosed, 4=tota…

musculoskeletal diseasesmedicine.medical_specialtylcsh:MedicineArthritisLetter to EditorGastroenterologyInternal medicineSettore MED/33 - Malattie Apparato LocomotoremedicineAnkylosisRheumatoid factorSpondylitisHLA-B27Inflammatory bowel diseases Arthritis spondylitis ulcerative colitisbusiness.industryArthritislcsh:RSacroiliitisGeneral MedicineInflammatory Bowel Diseasesmedicine.diseaseUlcerative colitisSurgerymedicine.anatomical_structureUlcerative colitisAnklebusinessSpondylitisLibyan Journal of Medicine
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NUTRITION, OXIDATIVE STRESS AND INTESTINAL DYSBIOSIS: INFLUENCE OF DIET ON GUT MICROBIOTA IN INFLAMMATORY BOWEL DISEASES.

2016

Background: Microbiota refers to the population of microorganisms (bacteria, viruses and fungi) that inhabit the entire gastrointestinal tract, more particularly the colon whose role is to maintain the integrity of the intestinal mucosa and control the proliferation of pathogenic bacteria. Alteration in the composition of the gut microbiota is called dysbiosis. Dysbiosis redisposes to inflammatory bowel diseases such as ulcerative colitis, Crohn disease and indeterminate colitis. Methods: The purpose of this literature review is to elucidate the influence of diet on the composition of the gastrointestinal microbiota in the healthy gut and the role of diet in the development of dysbiosis. Co…

0301 basic medicineSettore MED/09 - Medicina InternaPopulationhealthy dietlcsh:MedicineNutritional Statuscolorectal cancerGut floramedicine.disease_causeintestinal dysbiosisInflammatory bowel diseaseGeneral Biochemistry Genetics and Molecular BiologyMicrobiology03 medical and health sciences0302 clinical medicineIntestinal mucosaInflammatory Bowel diseases colorectal cancer intestinal dysbiosis gut microbiota MALT healthy diet.medicineOily fishHumanseducationeducation.field_of_studybiologygut microbiotabusiness.industrylcsh:RPathogenic bacteriamedicine.diseasebiology.organism_classificationInflammatory Bowel DiseasesUlcerative colitisDietGastrointestinal MicrobiomeOxidative StressSettore MED/18 - Chirurgia Generale030104 developmental biology030220 oncology & carcinogenesisImmunologyDysbiosisbusinessDysbiosis
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A MIXTURE OF VEGETABLE EXTRACTS (CHAMOMILLE, PASSIONFLOWER, CARAWAY, FENNEL), AND ENZYMES (BETA-GALACTOSIDASE) FOR IRRITABLE BOWEL SYNDROME (ibs): AN…

2018

Summary. Aims: Irritable bowel syndrome (IBS) is a functional intestinal disorder. This syndrome may creates psychological disorders in patients who are affected and severely limits daily activities and lifestyle. Methods: We investigated the effect of the natural product consisting of chamomile, fennel, caraway, passionflower and melissa (Spasmicol®), on IBS patients. For the study, 187 patients with IBS, enrolled by primary care doctors, were treated with Spasmicol® (Aristeia Farmaceutici s.r.l.), two tablets/daily, for 30 days. At the end of the study, patients were re-evaluated to analyse the effects of therapy. Results: After 30 days, patients showed a marked reduction of symptoms (abd…

Settore MED/12 - GastroenterologiaSettore MED/18 - Chirurgia GeneraleIrritable Bowel Syndrome supplements alternative supplements colitisSettore BIO/16 - Anatomia Umana
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Antitumoral activity of curcumin: an adjuvant therapeutic strategy

2021

Curcumin, an active substance contained in an Indian spice called turmeric or curcuma, is well known for its anti-inflammatory and antioxidant properties. In recent times, it was taken into account and studied as an antitumoral molecule, by relying on its interference on several biological mechanisms, such as the inhibition of inflammatory mediators, the enhancement of detoxifying enzymes’ action and processes of cell growth and proliferation. Studies show how the high dosage of curcumin in vitro inhibits colorectal tumor cells, pancreatic tumor cells, lung cancer cells and glioblastoma’s cells, interfering in signaling pathways as Wnt/β-catenin, NF-kB and PI3K/Akt and leading to cell cycle…

Curcumincolorectal tumors antioxidants curcumin antinflammatory effects pancratic cancerbusiness.industryBiochemistry (medical)Plant SciencePharmacologyGeneral Biochemistry Genetics and Molecular Biologychemistry.chemical_compoundnutritionSettore MED/03 - Genetica Medicachemistrycolon cancerlcsh:Biology (General)CurcuminMedicinechemopreventionantitumor activity5-fluorouracilbusinesslcsh:QH301-705.5Therapeutic strategyJournal of Biological Research
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Hsp60 and Hsp10 increase in colon mucosa of Crohn's disease and ulcerative colitis.

2010

The purpose of this work was to determine in colon mucosa of Crohn’s disease (CD) and ulcerative colitis (UC) in relapse: a) the levels of the chaperonins Hsp60 and Hsp10; b) the quantity of inflammatory cells; and c) if the levels of chaperonins parallel those of inflammation cells. Twenty cases of CD and UC and twenty normal controls (NC) were studied using immunohistochemistry, Western blotting and immunofluorescence. Immunohistochemically, Hsp60 and Hsp10 were increased in both inflammatory bowel diseases (IBD) compared to NC. These results were confirmed by Western blotting. Hsp60 and Hsp10 occurred in the cytoplasm of epithelial cells in CD and UC but not in NC. Hsp60 and Hsp10 co-loc…

AdultMaleColonConnective tissueInflammationBiologyBiochemistryImmune systemSettore MED/38 - Pediatria Generale E SpecialisticaCrohn DiseaseIntestinal mucosaChaperonin 10LeukocytesmedicineHumansIntestinal MucosaColitisIBD HSP 60 HSP 10AgedOriginal PaperLamina propriaCrohn's diseaseEpithelial CellsChaperonin 60Cell BiologyMiddle Agedmedicine.diseaseUlcerative colitismedicine.anatomical_structureImmunologyColitis UlcerativeFemalemedicine.symptom
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Intestinal dysbiosis and hormonal neuroendocrine secretion in the fibromyalgic patient

2018

Fibromyalgia is a rheumatic syndrome and its pathogenesis is controversial. The recent literature has placed considerable attention on the link between alteration of the intestinal microbiota and fibromyalgia, emphasizing the close connection between the neuroenteric system and the CNS. This study aims to evaluate the probable relationship between intestinal dysbiosis and altered secretion of hormones and vitamins such as cortisol, serotonin, Vitamin D and thyroid hormones in a patient with fibromyalgia.

musculoskeletal diseasesPhysiologylcsh:MedicineIntestinal dysbiosiscortisolGeneral Biochemistry Genetics and Molecular BiologyPathogenesis03 medical and health sciences0302 clinical medicineFibromyalgiaVitamin D and neurologymicrobiotaMedicineSecretion030203 arthritis & rheumatologyhormonesbusiness.industrylcsh:Rvitamin ddysbiosismedicine.diseasehumanitiesserotoninfibromyalgiaSerotoninbusinessDysbiosis030217 neurology & neurosurgeryHormoneBiomedical Papers
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Bone loss in inflammatory Bowel disease: our multicentric study

2011

Patients with inflammatory bowel disease are at increased risk of developing disorder in bone and mineral metabolism The study was aimed to determine if inflammatory bowel disease (IBD) is a risk factor for osteoporosis in 103 adult patients. We included 103 IBD patients, 67 patients with Crohn’s disease (CD) and 36 with ulcerative colitis (UC). Bone mineral density was measured by dual-energy X-ray absorptiometry. We used T score to express bone loss (osteopenia: -2.5 SD 2 years) and active disease would be risk factors of bone mineral loss in IBD.

Bone mineralmedicine.medical_specialtybusiness.industryOsteoporosisDiseasemedicine.diseaseGastroenterologyUlcerative colitisInflammatory bowel diseasedigestive system diseasesOsteopeniaIncreased riskInternal medicinemedicineRisk factorbusinessEndocrinology Studies
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Changes in immunohistochemical levels and subcellular localization after therapy and correlation and colocalization with CD68 suggest a pathogenetic …

2011

In an earlier work, the role of heat shock protein (Hsp60) in the pathogenesis of ulcerative colitis (UC) was suggested by its significant increase in the pathological mucosa parallel with an increase in inflammatory cells. More data in this direction are reported in this work. We analyzed by immunohistochemistry biopsies of colon tissue from 2 groups of patients with UC and treated with either 5-aminosalicylic acid (5-ASA) alone or in combination with a probiotic. We looked for inflammatory markers and Hsp60. Both the treatments were effective in reducing symptoms but the group treated with both 5-ASA and probiotics showed better clinical results. Amelioration of symptoms was associated wi…

Pathologymedicine.medical_specialtyHistologyColonBiopsyAntigens Differentiation MyelomonocyticInflammationBiomarkers PharmacologicalPathology and Forensic MedicinePathogenesisAntigens CDHeat shock proteinmedicineHumansColitisMesalamineInflammationMucous Membranebusiness.industryCD68ProbioticsAnti-Inflammatory Agents Non-SteroidalColocalizationChaperonin 60medicine.diseaseUlcerative colitisImmunohistochemistryMedical Laboratory TechnologyProtein TransportGene Expression RegulationDisease ProgressionImmunohistochemistryColitis Ulcerativemedicine.symptombusinessFollow-Up StudiesApplied immunohistochemistrymolecular morphology : AIMM
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Gut microbiota imbalance and chaperoning system malfunction are central to ulcerative colitis pathogenesis and can be counteracted with specifically …

2013

In this work, we propose that for further studies of the physiopathology and treatment for inflammatory bowel diseases, an integral view of the conditions, including the triad of microbiota-heat shock proteins (HSPs)-probiotics, ought to be considered. Microbiota is the complex microbial flora that resides in the gut, affecting not only gut functions but also the health status of the whole body. Alteration in the microbiota's composition has been implicated in a variety of pathological conditions (e.g., ulcerative colitis, UC), involving both gut and extra-intestinal tissues and organs. Some of these pathologies are also associated with an altered expression of HSPs (chaperones) and this is…

Microbiology (medical)medicine.medical_specialtyImmunologyInflammationBiologyGut floradigestive systemMedical microbiologyFlora (microbiology)Heat shock proteinmedicineHumansImmunology and AllergyColitisCrohn's diseaseMicrobiotaProbioticsGeneral Medicinemedicine.diseasebiology.organism_classificationMicrobiota Probiotics Ulcerative colitis Heat shock proteins Molecular chaperones InflammationUlcerative colitisGastrointestinal TractImmunologyColitis Ulcerativemedicine.symptomMolecular ChaperonesMedical Microbiology and Immunology
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Colorectal Carcinogenesis: Role of Oxidative Stress and Antioxidants

2017

One of the contributory causes of colon cancer is the negative effect of reactive oxygen species on DNA repair mechanisms. Currently, there is a growing support for the concept that oxidative stress may be an important etiological factor for carcinogenesis. The purpose of this review is to elucidate the role of oxidative stress in promoting colorectal carcinogenesis and to highlight the potential protective role of antioxidants. Several studies have documented the importance of antioxidants in countering oxidative stress and preventing colorectal carcinogenesis. However, there are conflicting data in the literature concerning its proper use in humans, since these studies did not yield defin…

0301 basic medicineCancer ResearchCarcinogenesisSettore MED/06 - Oncologia MedicaColorectal cancerDNA repairCellReviewColorectal Neoplasmmedicine.disease_causeAntioxidants03 medical and health sciences0302 clinical medicineAntioxidants; Colorectal cancer; Dysbiosis; Oxidative stress; Review; Animals; Antioxidants; Carcinogenesis; Colorectal Neoplasms; Humans; Reactive Oxygen Species; Oxidative Stress; Oncology; Cancer ResearchAnimalsHumansMedicinecolorectal cancer dysbiosis microbioma oxodative stress carcinogenesiCarcinogenesichemistry.chemical_classificationReactive oxygen speciesAnimalbusiness.industryOxidative StreGeneral MedicineColorectal carcinogenesismedicine.diseaseColorectal cancerDysbiosiOxidative StressSettore MED/18 - Chirurgia Generalecolorectal cancer dysbiosis microbioma oxodative stress carcinogenesis030104 developmental biologymedicine.anatomical_structureOncologyBiochemistrychemistry030220 oncology & carcinogenesisCancer researchAntioxidantColorectal NeoplasmsReactive Oxygen SpeciesReactive Oxygen SpeciebusinessCarcinogenesisDysbiosisOxidative stressHumanAnticancer Research
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Argentum-quarz solution in the treatment of anorectal fistulas: Is it possible a conservative approach?

2012

Patients suffering from chronic intestinal diseases (Crohn's disease, Ulcerative Colitis, Indeterminate Colitis) are prone to the development of pyogenic complications. These complications are most commonly in the form of perianal or intraabdominal abscesses and/or fistulas. The treatment of these complications are managed differently but, after an initial treatment based on medical or minimally invasive management, the solution of the pathological condition is always achieved by a surgical procedure. In the last few years prospective studies have proposed an alternative conservative therapeutic approach based on application of fibrin glue in the healing of patients with fistulas-in-ano. In…

Intestinal bowel diseasemedicine.medical_specialtySilverDiseaseFibrin Tissue AdhesiveModels BiologicalTherapeutic approachmedicineInitial treatmentHumansRectal FistulaProspective cohort studyFibrin gluePathologicalCell ProliferationAnorectal FistulaWound Healingbusiness.industryCell DifferentiationChronic inflammationGeneral MedicineQuartzFibroblastsmedicine.diseaseUlcerative colitisSurgerySolutionsSettore MED/18 - Chirurgia GeneraleAnorectal fustulabusinessIntestinal bowel diseases; Anorectal fustulas; Chronic inflammation
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Serum ionized magnesium in diabetic older persons

2014

Objective. Several alterations of magnesium metabolism have been associated with type 2 diabetes pathophysiology, a condition particularly frequent in older persons. We aimed to evaluate serum total (Mg-tot) and serum ionized magnesium (Mg-ion) in older persons with type 2 diabetes in order to explore clinically applicable methods for the detection of magnesium deficit. Material/Methods: Mg-tot and Mg-ion were measured in 105 fasting subjects with type 2 diabetes (mean age: 71.10.8 years; M/F: 45/60) and in 100 age-matched non-diabetic control persons (mean age: 72.20.8 years; M/F: 42/58). Results: Mg-ion concentrations were significantly lower in diabetic persons compared with controls (…

Blood GlucoseMalemedicine.medical_specialtySettore MED/09 - Medicina InternaEndocrinology Diabetes and Metabolismchemistry.chemical_elementType 2 diabetesEnd stage renal diseaseMagnesium Ionized magnesium Diabetes Hypertension AgingEndocrinologyDiabetes mellitusInternal medicinemedicineHumansMagnesiumAgedSubclinical infectionGlycated HemoglobinChemistryMagnesiummedicine.diseasePathophysiologyBlood pressureEndocrinologyDiabetes Mellitus Type 2Case-Control StudiesFemaleBody mass indexMetabolism
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BENEFICIAL EFFECT OF PROBIOTICS ADMINISTRATION IN INFLAMMATORY BOWEL DISEASE AND RELATED SPONDYLOARTHROPATHY: A PROSPECTIVE STUDY

2015

Background: Therapeutic treatment for inflammatory bowel disease (IBD) may follow different approaches, systemic as well as local, especially when the target is the osteoarticular apparatus. Although some clinical trials have suggested benefits from probiotics administration in IBD, there is still a great deal of controversy on their use. The aim of this study was to further investigate the effects of probiotics in patients with IBD and related spondyloarthropathy. Material/Methods: Fifty-nine patients affected by IBD with extra-intestinal involvement where evaluated from 2006 to 2010. Twenty-eight patients received administration of a standard therapy with mesalazine and 31 where treated w…

medicine.medical_specialtySettore MED/09 - Medicina InternaSpondyloarthropathyBiomedical EngineeringBioengineeringInflammatory bowel diseaseGastroenterologylaw.inventionchemistry.chemical_compoundProbioticMesalazineRandomized controlled triallawInternal medicinemedicineIn patientProspective cohort studyGeneral PsychologyInflammatory Bowel Disease IBD Microbiome Dysbiosis MALTbusiness.industrySettore BIO/16 - Anatomia UmanaGeneral Medicinemedicine.diseaseClinical trialSettore MED/18 - Chirurgia Generalechemistrybusiness
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The long-term effects of probiotics in the therapy of ulcerative colitis: a clinical study

2016

Aim: Intestinal dysbiosis seems to be the leading cause of inflammatory bowel diseases, and probiotics seems to represent the proper support against their occurrence. Actually, probiotic blends and anti-inflammatory drugs represent a weapon against inflammatory bowel diseases. The present study evaluates the long-term (2 years) effects of combination therapy (mesalazine plus a probiotic blend of Lactobacillus salivarius, Lactobacillus acidophilus and Bifidobacterium bifidus strain BGN4) on ulcerative colitis activity. Method: Sixty patients with moderate-to-severe ulcerative colitis were enrolled: 30 of them were treated with a single daily oral administration of mesalazine 1200 mg; 30 pati…

MaleSettore MED/07 - Microbiologia E Microbiologia Clinicaved/biology.organism_classification_rank.specieslcsh:MedicineGastroenterologyInflammatory bowel diseaselaw.inventionProbioticchemistry.chemical_compound0302 clinical medicineLactobacillus acidophiluslawMesalamineBifidobacteriumSettore MED/12 - GastroenterologiabiologyLactobacillus salivariusMicrobiotaMedicine (all)Anti-Inflammatory Agents Non-Steroidalfood and beveragesMiddle AgedUlcerative colitisLactobacillus acidophilusTreatment Outcome030220 oncology & carcinogenesis030211 gastroenterology & hepatologyDrug Therapy CombinationFemaleBifidobacteria; Inflammatory bowel diseases; Lactobacilli; Microbiota; Ulcerative colitis; Medicine (all); Biochemistry Genetics and Molecular Biology (all)Adultmedicine.medical_specialtyCombination therapyinflammatory bowel diseasesGeneral Biochemistry Genetics and Molecular Biology03 medical and health sciencesMesalazineDouble-Blind MethodBifidobacteriaInternal medicinemedicineHumansulcerative colitisAgedAnalysis of VarianceBifidobacterium bifidumUlcerative colitiBiochemistry Genetics and Molecular Biology (all)ved/biologybusiness.industryProbioticslcsh:Rbiology.organism_classificationmedicine.diseaseSettore MED/18 - Chirurgia GeneralechemistryLactobacilliLigilactobacillus salivariusColitis UlcerativeBifidobacterium bifidumbusiness
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Intestinal microbiota mutualism and gastrointestinal diseases

2015

The purpose of this work is to investigate the link between an altered intestinal mcro-biota or dysbiosis and chronic inflammatory disorders, in particular inflammatory bowel disease (IBD). Along with probiotics, faecal microbiota transplantation (FMT) opts to be a promising therapeutic treatment for restoring the bacterial homeostasis of the hu-man intestine and reducing the risk of colorectal carcinogenesis. Microbiota is the com-plex microbial flora that resides in the gut establishing a mutually beneficial relation-ship. Alteration of the microbiota’s composition, termed as dysbiosis, may lead to pathological conditions. Treatment with probiotics can restore the normal commensal flora i…

intestinal microbiota IBD gastrointestinal diseasesSettore MED/18 - Chirurgia Generale
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La valutazione clinica degli anziani

2015

senescenza diagnosi fattori psicologici fattori fisici fattori fisiologici
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POSTURE AND POSTUROLOGY, ANATOMICAL AND PHYSIOLOGICAL PROFILES: OVERVIEW AND CURRENT STATE OF ART

2017

Background and aim of work: posture is the position of the body in the space, and is controlled by a set of anatomical structures. The maintenance and the control of posture are a set of interactions between muscle-skeletal, visual, vestibular, and skin system. Lately there are numerous studies that correlate the muscle-skeletal and the maintenance of posture. In particular, the correction of defects and obstruction of temporomandibular disorders, seem to have an impoact on posture. The aim of this work is to collect information in literature on posture and the influence of the stomatognatich system on postural system. Methods: Comparison of the literature on posture and posturology by cons…

muscle-skeletal systemspinometriaSettore BIO/16 - Anatomia UmanaMusculoskeletal Physiological PhenomenaPostureHumansanatomy posture and posturologyReviewvestibular receptorsProprioceptionStomatognathic Systemposturology
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Validation of a modified model of TNBS-induced colitis in rats. How to induce a chemical colitis in rats

2014

Background: there are no standard practice in the induction of colitis by 2,4,6-trinitrobenzene sulfonic (TNBS) acid. Usually, the repeated administration of TNBS is preferred, because it will result in a local Th1 response that has the characteristics of Crohn's disease. material and Methods: A total of 30 rats were randomized into two groups, consisting of a saline control group of ten rats and a TNBS groups of 20 rats. After the animals were anesthesized, 0,5 ml of either 0,9 % saline 8controls) or TNBS 50 mg/Kg dissolved in 50% ethanol were instilled into the colon through a rubber catheter. The experiment was repeated weekly for four weeks, then, the rats were killed at day 40, and the…

MaleSettore MED/12 - GastroenterologiaSettore MED/09 - Medicina InternaSettore MED/06 - Oncologia MedicaCrohn's disease colitis induced TNBS induction colitis 246-trinitrobenzene sulfonic acid (TNBS)Reproducibility of ResultsSettore MED/08 - Anatomia PatologicaColitisRatsDisease Models AnimalSettore MED/18 - Chirurgia GeneraleInstillation DrugTrinitrobenzenesulfonic AcidAnimalsRats Wistar
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NUTRITION IN IBD PATIENT'S: WHAT ARE THE PROSPECTS?

2015

Summary: Inflammatory Bowel Disease (IBD) is a chronic disorder characterized by a relapsing-remitting course, which alternates between active and quiescent states, ultimately impairing a patients quality of life. The two main types of IBD are Crohn's disease (CD) and Ulcerative Colitis (UC). In physiological conditions the gut is costantly exposed to various antigens, commensal microflora and pathogens and the inflammatory response is finely balanced. It is thought that a vast number of environmental risk factors may be implicated in the development of IBD, including smoking factors, dietary factors, psycological stress, use of non-steroidal anti-inflammatory drugs and oral contraceptives,…

Settore MED/04 - Patologia GeneraleSettore MED/18 - Chirurgia GeneraleSettore MED/09 - Medicina Internainflammatory bowel disease IBD nutrition microbiome dysbiosis
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