P682. Clinical characteristics of Crohn’s disease or ulcerative colitis patients who initiated vedolizumab or an anti-TNF-α as first biologic therapy

AbstractRates of anastomotic leak following intestinal resections in the setting of inflammatory bowel disease are significantly influenced by clinical characteristics. While the literature can be contradictory due to significant heterogeneity in the published data, several common themes appear to consistently arise. With respect to Crohn's disease, low serum albumin, preoperative abscess, reoperative abdominal surgery, and steroid use are associated with an increased risk of postoperative intra-abdominal septic complications. On the contrary, biologic therapy, immunomodulator use, and method of anastomosis appear not to confer increased anastomotic-related complications. Undoubtedly, a low rate of anastomotic leakage is inherent to procedures within colorectal surgery but diligent attention must be paid to identify, optimize, and, therefore, reduce known risks.

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Mo1069 Do Patients' and Gastroenterologists' Views Differ Regarding Openness to Receiving Biologic Therapy Among Biologic Naïve Patients With Ulcerative Colitis or Crohn's Disease?

Gastroenterology ◽

10.1016/s0016-5085(15)32014-x ◽

2015 ◽

Vol 148 (4) ◽

pp. S-596

Author(s):

Amir Goren ◽

Amanda M. Teeple ◽

Michael Ingham

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Biologic Therapy

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P556 Female Crohn's disease patients and ulcerative colitis patients on biologic therapy are most disabled

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjx002.680 ◽

2017 ◽

Vol 11 (suppl_1) ◽

pp. S363-S363

Author(s):

P. Spizzo

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Biologic Therapy

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Anti-inflammatory effects ofSaccharomyces boulardiimediated by myeloid dendritic cells from patients with Crohn's disease and ulcerative colitis

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00217.2011 ◽

2011 ◽

Vol 301 (6) ◽

pp. G1083-G1092 ◽

Cited By ~ 22

Author(s):

Saskia Thomas ◽

Diana Metzke ◽

Jürgen Schmitz ◽

Yvonne Dörffel ◽

Daniel C. Baumgart

Keyword(s):

Ulcerative Colitis ◽

Dendritic Cells ◽

Crohn’S Disease ◽

T Cell ◽

Crohn's Disease ◽

Transforming Growth Factor ◽

Mucosal Healing ◽

Cell Phenotype ◽

Myeloid Dendritic Cells ◽

Tnf Α

Saccharomyces boulardii ( Sb) is a probiotic yeast that has demonstrated efficacy in pilot studies in patients with inflammatory bowel disease (IBD). Microbial antigen handling by dendritic cells (DC) is believed to be of critical importance for immunity and tolerance in IBD. The aim was to characterize the effects of Sb on DC from IBD patients. Highly purified (>95%), lipopolysaccharide-stimulated CD1c+CD11c+CD123−myeloid DC (mDC) from patients with ulcerative colitis (UC; n = 36), Crohn's disease (CD; n = 26), or infectious controls (IC; n = 4) were cultured in the presence or absence of fungal supernatant from Sb ( SbS). Phenotype and cytokine production and/or secretion of IBD mDC were measured by flow cytometry and cytometric bead arrays, respectively. T cell phenotype and proliferation were assessed in a mixed lymphocyte reaction (MLR) with allogenic CD4+CD45RA+naïve T cells from healthy donors. Mucosal healing was investigated in epithelial wounding and migration assays with IEC-6 cells. SbS significantly decreased the frequency of CD40-, CD80-, and CD197 (CCR7; chemokine receptor-7)-expressing IBD mDC and reduced their secretion of tumor necrosis factor (TNF)-α and interleukin (IL)-6 while increasing IL-8. In the MLR, SbS significantly inhibited T cell proliferation induced by IBD mDC. Moreover, SbS inhibited TH1 (TNF-α and interferon-γ) polarization induced by UC mDC and promoted IL-8 and transforming growth factor-β-dependent mucosal healing. In summary, we provide novel evidence of synergistic mechanisms how Sb controls inflammation (inhibition of T cell costimulation and inflammation-associated migration and mobilization of DC) and promotes epithelial restitution relevant in IBD.

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The role of TNF-alpha gene (-238G/A and -308G/A) polymorphisms in the etiology and pathogenesis of inflammatory bowel diseases in various ethnic groups

Almanac of Clinical Medicine ◽

10.18786/2072-0505-2019-47-067 ◽

2019 ◽

Vol 47 (6) ◽

pp. 548-558

Author(s):

I. V. Zhilin ◽

E. Yu. Chashkova ◽

A. A. Zhilina ◽

B. S. Pushkarev ◽

N. S. Korotaeva

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Gene Polymorphism ◽

Ethnic Groups ◽

Small Sample ◽

Tnf Α ◽

Study Results ◽

Inflammatory Bowel

This literature review deals with specifics of the natural course of inflammatory bowel disease (IBD) in patients from various ethnic groups and -308G/A and -238G/A promoter polymorphisms in tumor necrosis factor-alpha (TNF-α) gene. The search in PubMed, Medline, Еlibrary.ru databases has led to identify in total 20 studies, including 2 meta-analyses, on the role of TNF-α-308G/A and -238G/A gene polymorphism in the etiology and pathophysiology of IBD. The TNF-α-308G/A polymorphism is associated with increased secretion of this proinflammatory cytokine, whereas the TNF-α-238G/A genotype is characterized by reduced TNF-α secretion. A number of studies have shown an association between TNF-α-308G/A gene polymorphism and severe course of IBD, requiring more active treatment of patients (cytostatics, corticosteroids, biological agents). Some investigators have found that the patients carriers of TNF-α-308G/A had a higher probability of surgical interventions. The association between TNF-α-308G/A and the phenotypic characteristics of IBD has been identified in studies performed in Europe, Asia, and Russia. The association of this polymorphism with the prevalence of ulcerative colitis has been proven in some studies, in particular, in the Asian population. Similar associations have been noted in few publications originating from Europe and North America, while some studies have found no links between TNF-α-308G/A, -238G/A, and the course of IBD. TNF-α-238G/A gene polymorphism has not shown any significance for the prevalence and course of ulcerative colitis and Crohn's disease. One can assume that the differences in the study results arising from one and the same geographical area are related to genetic heterogeneity of the study groups, phenotypic variances between the study subjects, as well as relatively small sample sizes. Currently, the search for genetic, biochemical and other prognostic criteria for IBD course is in progress. There are studies in progress to investigate the mechanisms of transformation of the genetic information into the particulars of ulcerative colitis and Crohn's disease manifestations, with consideration of ethnicity.

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