Pregnant women with inflammatory bowel disease: the effects of biologicals on pregnancy, outcome of infants, and the developing immune system

: Inflammatory bowel disease (IBD) is a chronic, elusive disorder resulting in relapsing inflammation of intestine with incompletely elucidated etiology, whose two representative forms are ulcerative colitis (UC) and Crohn’s disease (CD). Accumulating researches have revealed that the individual genetic susceptibility, environmental risk elements, intestinal microbial flora, as well as innate and adaptive immune system are implicated in the pathogenesis and development of IBD. Despite remarkable progression of IBD therapy has been achieved by chemical drugs and biological therapies such as aminosalicylates, corticosteroids, antibiotics, anti-tumor necrosis factor (TNF)-α, anti-integrin agents, etc., healing outcome still cannot be obtained, along with inevitable side effects. Consequently, a variety of researches have focused on exploring new therapies, and found that natural products (NPs) isolated from herbs or plants may serve as promising therapeutic agents for IBD through antiinflammatory, anti-oxidant, anti-fibrotic and anti-apoptotic effects, which implicates the modulation on nucleotide- binding domain (NOD) like receptor protein (NLRP) 3 inflammasome, gut microbiota, intestinal microvascular endothelial cells, intestinal epithelia, immune system, etc. In the present review, we will summarize the research development of IBD pathogenesis and current mainstream therapy, as well as the therapeutic potential and intrinsic mechanisms of NPs in IBD.

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Su1184 - Evaluation of Fecal Lactoferrin and Calprotectin Levels in Healthy Pregnant Women as a Reference for Detecting Inflammatory Bowel Disease

Gastroenterology ◽

10.1016/s0016-5085(18)31884-5 ◽

2018 ◽

Vol 154 (6) ◽

pp. S-497 ◽

Cited By ~ 1

Author(s):

James M. Gray ◽

Allison Durica ◽

Kristin Knight ◽

Megan Lord ◽

Lauren Irby ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Pregnant Women ◽

Bowel Disease ◽

Fecal Lactoferrin ◽

Inflammatory Bowel

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Vaginal microbiota in pregnant women with inflammatory rheumatic and inflammatory bowel disease: A matched case‐control study

Mycoses ◽

10.1111/myc.13288 ◽

2021 ◽

Author(s):

Klara Rosta ◽

Antonia Mazzucato‐Puchner ◽

Herbert Kiss ◽

Veronika Malik ◽

Peter Mandl ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Pregnant Women ◽

Bowel Disease ◽

Case Control Study ◽

Case Control ◽

Vaginal Microbiota ◽

Inflammatory Bowel ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

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Pregnancy outcomes in women with inflammatory bowel disease following exposure to thiopurines and antitumor necrosis factor drugs

Human & Experimental Toxicology ◽

10.1177/0960327114550882 ◽

2014 ◽

Vol 34 (5) ◽

pp. 445-459 ◽

Cited By ~ 26

Author(s):

S Mozaffari ◽

AH Abdolghaffari ◽

S Nikfar ◽

M Abdollahi

Keyword(s):

Inflammatory Bowel Disease ◽

Pregnant Women ◽

Bowel Disease ◽

Pregnancy Outcomes ◽

Congenital Abnormalities ◽

Meta Analysis ◽

Adverse Pregnancy Outcomes ◽

Inflammatory Bowel ◽

Adverse Pregnancy ◽

Necrosis Factor

Several studies have indicated the harmful effect of flare-up periods in pregnant women with inflammatory bowel disease (IBD) on their newborns. Therefore, an effective and safe medical treatment during pregnancy is of great concern in IBD patients. The aim of this study was to perform a meta-analysis on the outcomes of thiopurines use and a systematic review of antitumor necrosis factor (anti-TNF) drugs used during pregnancy in women with IBD. The results of cohorts evaluating the safety of anti-TNF drugs during pregnancy up to July 2013 were collected and analyzed. In the meta-analysis, a total of 312 pregnant women with IBD who used thiopurines were compared with 1149 controls (women with IBD who were not treated with any medication and women who were exposed to drugs other than thiopurines) to evaluate the drug effect on different pregnancy outcomes, including prematurity, low birth weight, congenital abnormalities, spontaneous abortion, and neonatal adverse outcomes. Results of statistical analysis demonstrated that congenital abnormalities were increased significantly in thiopurine-exposed group in comparison with control group who did not receive any medicine for IBD treatment. The summary odds ratio was 2.95 with 95% confidence interval = 1.03–8.43 ( p = 0.04). We observed no significant differences in occurrence of other adverse pregnancy outcomes between compared groups. The results of cohorts evaluated the safety of anti-TNF drugs during pregnancy demonstrated no increase in occurrence of adverse pregnancy outcomes in comparison with controls except for the significant decrease in gestational age of newborns of drug-exposed mothers in one trial. In conclusion, a benefit–risk ratio should be considered in prescribing or continuing medicinal therapy during pregnancy of IBD patients.

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Pregnancy outcome in patients with inflammatory bowel disease treated with thiopurines: cohort from the CESAME Study

Yearbook of Medicine ◽

10.1016/s0084-3873(11)00329-4 ◽

2011 ◽

Vol 2011 ◽

pp. 456-457

Author(s):

M.F. Picco

Keyword(s):

Inflammatory Bowel Disease ◽

Pregnancy Outcome ◽

Bowel Disease ◽

Inflammatory Bowel

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Socio-anamnestic and clinical analysis of pregnant women with ulcerative colitis

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2021-25(1)-12 ◽

2021 ◽

Vol 25 (1) ◽

pp. 65-69

Author(s):

I. V. Oleksiienko

Keyword(s):

Ulcerative Colitis ◽

Health Care ◽

Inflammatory Bowel Disease ◽

Pregnant Women ◽

Bowel Disease ◽

Clinical Analysis ◽

Chronic Inflammatory Bowel Disease ◽

Care Providers ◽

History Of ◽

Inflammatory Bowel

Annotation. At the turn of the 21st century, chronic inflammatory bowel disease (CIBD) has become a global disease with accelerating morbidity in industrialized countries with a prevalence exceeding 0.3%. These data underscore the need for research into the prevention of inflammatory bowel disease and innovations in health care systems to manage this complex and costly disease. The information from a personal anamnesis of 40 women patients with ulcerative colitis (clinical group (main). In the second group (control), 30 practically healthy pregnant women with a physiological course of gestation were included, which did not have in their history of inflammatory intestinal diseases. Statistical processing of research results was performed using the software package Statistica 6.0. The arithmetic mean (M) and the standard deviation error (± m) (p<0.05) were determined, as well as the odds ratio (OR), confidence interval (CI) at p=95%. It was found that for women with ulcerative colitis is characterized by the presence of a history of obstetric pathology, such as: spontaneous miscarriage of OR 3.33, 95% CI [1.06-10.53], p=0.04 and blood secretions of OR 3.0, 95% CI [1.00-8.98], p=0.0496; among extragenital pathology in the anamnesis: children's infectious diseases of OR 4.85, 95% CI [1.25-18.85], p=0.02, chronic bronchitis of OR 7.54, 95% CI [1,56-36, 41], p=0.01, varicose veins OR 4.33, 95% CI [1.11-16.95], p=0.035, chronic gastritis OR 6.0, 95% CI [1,23-29, 31], p=0.03, anemia of OR 15.0, 95% CI [4.53-49.68], p<0.0001, allergy history of OR 6.65, 95% CI [1.73-25.60], p=0.006; among gynecological complications – premenstrual syndrome OR 6.0, 95% CI [1.55-23.15], p=0.009, algomenorrhea OR 8.14, 95% CI [2.12-31.24], p=0.002 , salpingo-oophoritis, OR 7.54, 95% CI [1.56-36.41], p=0.01. Because CIBD during pregnancy is associated with an increased risk of adverse effects on the mother and fetus, information on socio-anamnestic and clinical analysis of pregnant women with ulcerative colitis will be useful to health care providers in making decisions about CIBD during pregnancy.

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Potential markers for early diagnostics of Colorectal cancer and Inflammatory bowel disease in humans : intestinal microorganisms and immune system (teammates or rivals)

Canadian Journal of Biotechnology ◽

10.24870/cjb.2017-000109 ◽

2017 ◽

Vol 1 (2) ◽

pp. 59-64

Author(s):

Pavel Horak ◽

Petra Kucerova ◽

Monika Cervinkova

Keyword(s):

Colorectal Cancer ◽

Inflammatory Bowel Disease ◽

Immune System ◽

Bowel Disease ◽

Early Diagnostics ◽

Intestinal Microorganisms ◽

Inflammatory Bowel

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Dynamic Colonization of Microbes and Their Functions after Fecal Microbiota Transplantation for Inflammatory Bowel Disease

mBio ◽

10.1128/mbio.00975-21 ◽

2021 ◽

Author(s):

Nathaniel D. Chu ◽

Jessica W. Crothers ◽

Le T. T. Nguyen ◽

Sean M. Kearney ◽

Mark B. Smith ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Immune System ◽

Bowel Disease ◽

Healthy Donor ◽

Fecal Microbiota Transplantation ◽

Fecal Microbiota ◽

Complex Mixtures ◽

Sick Patient ◽

Inflammatory Bowel ◽

Living Organisms

Fecal microbiota transplantation (FMT)—transferring fecal microbes from a healthy donor to a sick patient—has shown promise for gut diseases such as inflammatory bowel disease. However, unlike pharmaceuticals, fecal transplants are complex mixtures of living organisms, which must then interact with the microbes and immune system of the recipient.

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Microbiota-nourishing Immunity and Its Relevance for Ulcerative Colitis

Inflammatory Bowel Diseases ◽

10.1093/ibd/izz004 ◽

2019 ◽

Vol 25 (5) ◽

pp. 811-815 ◽

Cited By ~ 8

Author(s):

Mariana X Byndloss ◽

Yael Litvak ◽

Andreas J Bäumler

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Immune System ◽

Environmental Exposure ◽

Large Intestine ◽

Bowel Disease ◽

Human Diseases ◽

Colonization Resistance ◽

Inflammatory Bowel ◽

New Hypothesis

An imbalance in our microbiota may contribute to many human diseases, but the mechanistic underpinnings of dysbiosis remain poorly understood. We argue that dysbiosis is secondary to a defect in microbiota-nourishing immunity, a part of our immune system that balances the microbiota to attain colonization resistance against environmental exposure to microorganisms. We discuss this new hypothesis and its implications for ulcerative colitis, an inflammatory bowel disease of the large intestine.

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