Serum Elabela level is related to endoscopic activity index in patients with active ulcerative colitis

Abstract Objectives Data on diet and physical activity in ulcerative colitis patients are scarce and frequently mixed with data of patients with Crohn's disease. Therefore, the objective of this study is to investigate habitual diet and physical activity of ulcerative colitis patients and to determine whether there is an association with disease activity. Methods In this cross-sectional study, data of 172 subjects were collected via an online questionnaire that consisted of several validated questionnaires: the Patient Simple Clinical Colitis Activity Index (P-SCCAI) to assess disease activity, a Food Frequency Questionnaire (FFQ) to assess habitual nutrient intake and the Short QUestionnaire to ASsess Health-enhancing physical activity (SQUASH) to assess habitual physical activity. Nutrient intake was used to calculate the Adjusted Dietary Inflammatory Index (ADII). Physical activity data were used to calculate intensity levels (light, moderate or vigorous intensity) and duration of activity (min/week). These were used combined with age to calculate activity scores. Correlations between the ADII and physical activity with disease activity were investigated. Results The ADII ranged from −5.45 to 3.79 with a mean (±SD) of 0.00 (±1.55). The mean ADII was anti-inflammatory (−0.08) in subjects in remission, while it was pro-inflammatory in subjects with mild and moderately active ulcerative colitis (0.06 and 0.42, respectively), although the correlation between ADII and disease activity was not significant. With regard to physical activity, most minutes per week were spent on light to moderate activity at work or school (median [IQR] of 1375 [825]). The activity with the highest activity score was heavy activity at work or school (median [IQR] of 2160 [6480]). Subjects mostly performed activities of light intensity (median [IQR] of 840 [1575]). No significant differences in intensity levels, duration and activity score between subjects in remission and mild or moderately active ulcerative colitis were found. Also, no correlations were found between intensity levels, duration and activity score with disease activity. Conclusions We found no associations of diet and physical activity with disease activity in patients with ulcerative colitis. Funding Sources N.A.

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Colon Mucosa Exhibits Loss of Ectopic MUC5AC Expression in Patients with Ulcerative Colitis Treated with Oral Tacrolimus

ISRN Gastroenterology ◽

10.1155/2013/304894 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 11

Author(s):

Tsutomu Mizoshita ◽

Satoshi Tanida ◽

Hironobu Tsukamoto ◽

Keiji Ozeki ◽

Takahito Katano ◽

...

Keyword(s):

Ulcerative Colitis ◽

Activity Index ◽

Statistical Significance ◽

Complete Response ◽

Mayo Score ◽

Tacrolimus Therapy ◽

Clinicopathologic Findings ◽

Endoscopic Activity Index ◽

The Relationship ◽

Free Status

Background. Tacrolimus (FK506) is effective for patients with ulcerative colitis (UC). However, there are few reports on tacrolimus therapy (TT) with respect to the relationship with endoscopic and clinicopathologic findings. Methods. Thirty patients with moderate/severe active UC refractory to or dependent on corticosteroid were treated with oral tacrolimus. The expression of ectopic MUC5AC in the colon was pathologically analyzed before and at 12 weeks after TT, evaluating the Mayo score and steroid-sparing effects. Results. Both mean disease and endoscopic activity index scores were reduced at levels of statistical significance in 26 UC patients receiving more than one month of TT (). The dose of prednisolone was reduced by a statistically significant amount (), and 14 of the 26 patients (53.8%) had steroid-free status 12 weeks after TT. The decrease in ectopic MUC5AC expression in the mucous cells of the colon was significantly associated with endoscopic improvement of inflammation in the UC patients with TT (). Loss of ectopic MUC5AC expression was detected in all patients who had complete response. Conclusions. Tacrolimus appears to be effective for the treatment of moderate/severe UC patients. Loss of ectopic MUC5AC expression may be important for pathologic remission in the colon of UC patients.

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Sympathetic overactivity in active ulcerative colitis: effects of clonidine

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00442.2005 ◽

2006 ◽

Vol 290 (1) ◽

pp. R224-R232 ◽

Cited By ~ 61

Author(s):

Raffaello Furlan ◽

Sandro Ardizzone ◽

Laura Palazzolo ◽

Alexandra Rimoldi ◽

Francesca Perego ◽

...

Keyword(s):

Ulcerative Colitis ◽

Sympathetic Activity ◽

Activity Index ◽

Muscle Sympathetic Nerve Activity ◽

Systolic Pressure ◽

Disease Activity Index ◽

Systolic Arterial Pressure ◽

Plasma Catecholamine ◽

Active Ulcerative Colitis ◽

Normalized Units

Previous reports suggest that inflammatory bowel diseases may be accompanied by abnormalities in the neural autonomic profile. We tested the hypotheses that 1) an exaggerated sympathetic activity characterizes active ulcerative colitis (UC) and 2) a reduction of sympathetic activity by clonidine would be associated with clinical changes of UC. In 23 patients with UC and 20 controls, muscle sympathetic nerve activity (MSNA), ECG, blood pressure, and respiration were continuously recorded, and plasma catecholamine was evaluated both at rest and during a 75° head-up tilt. Autonomic profile was assessed by MSNA, norepinephrine, epinephrine, spectral markers of low-frequency (LF) cardiac sympathetic (LFRR; normalized units) and high-frequency (HF) parasympathetic (HFRR; normalized units) modulation and sympathetic vasomotor control (LF systolic arterial pressure; LFSAP), obtained by spectrum analysis of the R-R interval and systolic pressure variability. Among UC patients, 16 agreed to be randomly assigned to 8-wk transdermal clonidine (15 mg/wk, 9 subjects), or placebo (7 patients). An autonomic profile, Disease Activity Index (DAI), and endoscopic pattern were compared before and after clonidine/placebo. At rest, MSNA, heart rate (HR), LFRR, LF/HF, and LFSAP were higher and HFRR was lower in patients than in controls. Tilt decreased HFRR and increased MSNA and LFRR less in patients than in controls. Clonidine decreased HR, MSNA, epinephrine, LFRR, and increased HFRR, whereas placebo had no effects. Changes of the autonomic profile after clonidine were associated with reduction of DAI score. An overall increase of sympathetic activity characterized active UC. Normalization of the autonomic profile by clonidine was accompanied by an improvement of the disease.

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How disease extent can be included in the endoscopic activity index of ulcerative colitis: the panMayo score, a promising scoring system

BMC Gastroenterology ◽

10.1186/s12876-017-0725-3 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 4

Author(s):

Anita Bálint ◽

Klaudia Farkas ◽

Zoltán Szepes ◽

Ferenc Nagy ◽

Mónika Szűcs ◽

...

Keyword(s):

Ulcerative Colitis ◽

Scoring System ◽

Activity Index ◽

Disease Extent ◽

Endoscopic Activity Index

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Therapeutic Efficacy of pH-Dependent Release Formulation of Mesalazine on Active Ulcerative Colitis Resistant to Time-Dependent Release Formulation: Analysis of Fecal Calprotectin Concentration

BioMed Research International ◽

10.1155/2014/342751 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Kousaku Kawashima ◽

Shunji Ishihara ◽

Takafumi Yuki ◽

Koji Onishi ◽

Yoshinori Kushiyama ◽

...

Keyword(s):

Ulcerative Colitis ◽

Clinical Efficacy ◽

Activity Index ◽

Fecal Calprotectin ◽

Mucosal Healing ◽

Time Dependent ◽

Clinical Activity ◽

Active Ulcerative Colitis ◽

Release Formulation ◽

Ph Dependent

Purpose. Few reports have compared the clinical efficacy of a pH-dependent release formulation of mesalazine (pH-5-ASA) with a time-dependent release formulation (time-5-ASA). We examined whether pH-5-ASA is effective for active ulcerative colitis (UC) in patients resistant to time-5-ASA.Methods. We retrospectively and prospectively analyzed the efficacy of pH-5-ASA in mildly to moderately active UC patients in whom time-5-ASA did not successfully induce or maintain remission. The clinical efficacy of pH-5-ASA was assessed by clinical activity index (CAI) before and after switching from time-5-ASA. In addition, the efficacy of pH-5-ASA on mucosal healing (MH) was evaluated in a prospective manner by measuring fecal calprotectin concentration.Results. Thirty patients were analyzed in a retrospective manner. CAI was significantly reduced at both 4 and 8 weeks after switching to pH-5-ASA. In the prospective study (n=14), administration of pH-5-ASA also significantly reduced CAI scores at 4 and 8 weeks in these patients who were resistant to time-5-ASA. In addition, fecal calprotectin concentration was significantly decreased along with improvement in CAI after switching to pH-5-ASA.Conclusions. Our results suggest that pH-5-ASA has clinical efficacy for mildly to moderately active patients with UC in whom time-5-ASA did not successfully induce or maintain remission.

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Fecal Calprotectin: A Reliable Predictor of Mucosal Healing after Treatment for Active Ulcerative Colitis

Gastroenterology Research and Practice ◽

10.1155/2017/2098293 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 9

Author(s):

Vendel Kristensen ◽

Arne Røseth ◽

Tahir Ahmad ◽

Viggo Skar ◽

Bjørn Moum

Keyword(s):

Ulcerative Colitis ◽

Medical Treatment ◽

Flexible Sigmoidoscopy ◽

Activity Index ◽

Fecal Calprotectin ◽

Mucosal Healing ◽

Mucosal Inflammation ◽

Active Ulcerative Colitis ◽

Reliable Marker

Objectives. Mucosal healing has become the new goal of treatment in ulcerative colitis. Fecal calprotectin has been demonstrated to differentiate between mucosal inflammation and mucosal healing. With this project, we investigated whether a reduction in f-calprotectin to <250 μg/g after medical treatment for active ulcerative colitis could predict mucosal healing. Material and Methods. After a baseline colonoscopy, 20 patients with active ulcerative colitis were followed with consecutive fecal calprotectin monthly until two measurements of fecal calprotectin < 250 μg/g or a maximum follow-up of 12 months. A flexible sigmoidoscopy was then performed and Mayo endoscopic subscore was used to evaluate degree of inflammation. Simple Clinical Colitis Activity Index was used for evaluation of clinical disease activity. Results. A total of 16 patients achieved fecal calprotectin < 250 μg/g during follow-up, and all 16 patients had endoscopic mucosal healing (Mayo endoscopic subscore of ≤1) on the second endoscopy. The remaining four patients had persistently high f-calprotectin levels before the second endoscopy with Mayo endoscopic subscore corresponding to endoscopic mucosal healing in three out of four patients. Conclusions. Fecal calprotectin <250 μg/g after medical treatment for active ulcerative colitis is a reliable marker of endoscopic mucosal healing.

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