scholarly journals Study of the role of soluble transferrin receptor/ferritin index in the assessment of anemia in inflammatory bowel disease patients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
E A Awad ◽  
M L Soliman ◽  
T M A George ◽  
S G F Elshabasy
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Transferrin Receptor ◽  
Inactive Disease ◽  
Deficiency Anemia ◽  
Soluble Transferrin Receptor ◽  
Significant Difference ◽  
Inflammatory Bowel

Abstract Background Idiopathic inflammatory bowel disease (IBD) includes those conditions characterized by a tendency for chronic or relapsing immune activation and inflammation within the gastrointestinal tract, Crohn’s disease (CD) and ulcerative colitis (UC) are the two major forms of idiopathic IBD. Aim of the Work The aim of this study is to evaluate the clinical usefulness of the soluble transferrin receptor-Ferritin index in the evaluation of anemia in patients with IBD and especially for differentiation between iron deficiency anemia and anemia of chronic disease. Patients and Methods This study included fifty patients with established diagnosis of IBD either Ulcerative Colitis or Crohn’s disease. They were collected at Internal Medicine and Gastroenterology outpatient clinics and inpatient wards at Ain Shams University hospitals as well at New Cairo hospital in the period from March 2017 to September 2017. They were classified into 2 groups: group I 25 patients with Crohn’s disease and anemia with active or inactive disease, group II 25 patients with ulcerative colitis and anemia with active or inactive disease, group III 25 healthy controls with no significant medical or family history of IBD. Results In the current study there was no significant difference between the different study groups regarding the demographic data except for the disease localization as there was significant difference between ulcerative and crohn’s disease. Conclusion The results of the current study stated that the sTfR and sTfR-F index seems to be very efficient in the detection and diagnosis of IDA, among patients with IBD. Its detection rate is higher using sTfR/F index than sTfR alone and of course higher than the other existing markers. It is essential to mention that the clinical use of this sTfR/F index rather adds to the value of other established markers, such as ferritin, transferrin and Tsat, than replaces them in the diagnosis of IDA. Therefore, sTfR-F index could be proposed as an additional parameter, which can improve the diagnosis of iron deficiency anemia in patients with IBD. This remains to be confirmed with other larger studies.

scholarly journals Anemia in inflammatory bowel disease: prevalence, differential diagnosis and association with clinical and laboratory variables

2014 ◽  
Vol 132 (3) ◽  
pp. 140-146 ◽  
Author(s):  
Rodrigo Andrade Alves ◽  
Sender Jankiel Miszputen ◽  
Maria Stella Figueiredo
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Iron Deficiency ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Activity Index ◽  
Deficiency Anemia ◽  
Inflammatory Bowel

CONTEXT AND OBJECTIVES:Anemia is the most frequent extraintestinal complication of inflammatory bowel disease. This study aimed to: 1) determine the prevalence of anemia among patients with inflammatory bowel disease; 2) investigate whether routine laboratory markers are useful for diagnosing anemia; and 3) evaluate whether any association exists between anemia and clinical/laboratory variables.DESIGN AND SETTING:Cross-sectional at a federal university.METHODS:44 outpatients with Crohn's disease and 55 with ulcerative colitis were evaluated. Clinical variables (disease activity index, location of disease and pharmacological treatment) and laboratory variables (blood count, iron laboratory, vitamin B12 and folic acid) were investigated.RESULTS:Anemia and/or iron laboratory disorders were present in 75% of the patients with Crohn's disease and in 78.2% with ulcerative colitis. Anemia was observed in 20.5% of the patients with Crohn's disease and in 23.6% with ulcerative colitis. Iron-deficiency anemia was highly prevalent in patients with Crohn's disease (69.6%) and ulcerative colitis (76.7%). Anemia of chronic disease in combination with iron deficiency anemia was present in 3% of the patients with Crohn's disease and in 7% of the patients with ulcerative colitis. There was no association between anemia and disease location. In ulcerative colitis, anemia was associated with the disease activity index.CONCLUSIONS:Most patients present iron laboratory disorders, with or without anemia, mainly due to iron deficiency. The differential diagnosis between the two most prevalent types of anemia was made based on clinical data and routine laboratory tests. In ulcerative colitis, anemia was associated with the disease activity index.

scholarly journals Assessment of quality of life of patients with inflammatory bowel disease residing in Southern Brazil

2010 ◽  
Vol 47 (3) ◽  
pp. 285-289 ◽  
Author(s):  
Danielle Cohen ◽  
Ceres Maltz Bin ◽  
Ana Paula Trussardi Fayh
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Significant Difference ◽  
Inflammatory Bowel

CONTEXT: Chronic diseases have an impact on the quality of life of the individuals. OBJECTIVE: To evaluate the quality of life of adults with inflammatory bowel disease by the inflammatory bowel disease questionnaire certified for Portuguese language. METHODS: We interviewed 50 individuals from both genders aged from 18 to 60 years old, with Crohn's disease and ulcerative colitis, regardless of disease activity. RESULTS: The average age of the sample was 42.2 ± 13.6 years old, the disease length was 98.8 ± 74.3 months, and 72% of patients had Crohn's disease and 14% presented disease activity. There was no significant difference in questionnaire scores of patients with different inflammatory bowel disease when they are in the remission phase (172.0 ± 42.4 and 173.6 ± 28.2 for ulcerative colitis and Crohn's disease, respectively, P = 0.886). When compared to scores of patients who were in crisis, it was found that they have a lower quality of life that patients in remission (123.8 ± 44.5 and 173.3 ± 31.5 for patients in crisis and remission, respectively, P = 0.001). CONCLUSION: It was noticed that the quality of life of patients with inflammatory bowel disease did not differ among patients with Crohn's disease or ulcerative colitis, when patients are in remission. The main aspect which determines the loss of quality of life would be being at the stage of disease activity.

scholarly journals Visualising E-selectin in the detection and evaluation of inflammatory bowel disease

Gut ◽  
1998 ◽  
Vol 43 (1) ◽  
pp. 40-47 ◽  
Author(s):  
M Bhatti ◽  
P Chapman ◽  
M Peters ◽  
D Haskard ◽  
H J F Hodgson
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Tissue Expression ◽  
Inactive Disease ◽  
Similar Disease ◽  
Inflammatory Bowel ◽  
Active Inflammation

Background—Vascular endothelial E- selectin expression is induced by proinflammatory cytokines and contributes to accumulation of leucocytes in tissues.Aims—To investigate the role of E-selectin in inflammatory bowel disease (IBD).Methods—E-selectin expression was assessed in patients with ulcerative colitis and Crohn’s disease by measuring the concentration of circulating soluble E-selectin (sE-selectin) using ELISA, by immunohistochemistry of colonic biopsy specimens, and by abdominal immunoscintigraphy after injecting radiolabelled F(ab′)2 fragment of a monoclonal anti-E-selectin antibody. The value of scintigraphy using anti-E-selectin was judged by a prospective comparative study of autologous leucocyte scanning and E-selectin antibody scanning in 17 patients with IBD.Results—Circulating sE-selectin was elevated in patients with clinically active disease. Tissue expression of E-selectin was enhanced in patients with active inflammation, with weak or absent expression in inactive disease and healthy controls. In-111 labelled anti-E-selectin scintiscans were compared with Tc-99m labelled leucocyte scans performed 24 hours earlier. Twelve patients had areas of active inflammation on leucocyte scan while 11 patients had positive E-selectin scans. The results of the two scans were concordant in 14 patients, with those positive for both (10/17) showing similar disease localisation and extent.Conclusions—Tissue E-selectin and circulating sE-selectin are increased during active inflammatory bowel disease. Anti-E-selectin imaging with radiolabelled monoclonal antibody identified areas of inflammation in Crohn’s disease and ulcerative colitis. The technique should prove useful clinically for identifying the site and extent of disease.

Prebiotics and Probiotics in Inflammatory Bowel Disease: Where are we now and where are we going?

2020 ◽  
Vol 15 (3) ◽  
pp. 216-233 ◽  
Author(s):  
Maliha Naseer ◽  
Shiva Poola ◽  
Syed Ali ◽  
Sami Samiullah ◽  
Veysel Tahan
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Clinical Trials ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Adverse Effects ◽  
Bowel Disease ◽  
Relapse Prevention ◽  
Remission Induction ◽  
Inflammatory Bowel

The incidence, prevalence, and cost of care associated with diagnosis and management of inflammatory bowel disease are on the rise. The role of gut microbiota in the causation of Crohn's disease and ulcerative colitis has not been established yet. Nevertheless, several animal models and human studies point towards the association. Targeting intestinal dysbiosis for remission induction, maintenance, and relapse prevention is an attractive treatment approach with minimal adverse effects. However, the data is still conflicting. The purpose of this article is to provide the most comprehensive and updated review on the utility of prebiotics and probiotics in the management of active Crohn’s disease and ulcerative colitis/pouchitis and their role in the remission induction, maintenance, and relapse prevention. A thorough literature review was performed on PubMed, Ovid Medline, and EMBASE using the terms “prebiotics AND ulcerative colitis”, “probiotics AND ulcerative colitis”, “prebiotics AND Crohn's disease”, “probiotics AND Crohn's disease”, “probiotics AND acute pouchitis”, “probiotics AND chronic pouchitis” and “prebiotics AND pouchitis”. Observational studies and clinical trials conducted on humans and published in the English language were included. A total of 71 clinical trials evaluating the utility of prebiotics and probiotics in the management of inflammatory bowel disease were reviewed and the findings were summarized. Most of these studies on probiotics evaluated lactobacillus, De Simone Formulation or Escherichia coli Nissle 1917 and there is some evidence supporting these agents for induction and maintenance of remission in ulcerative colitis and prevention of pouchitis relapse with minimal adverse effects. The efficacy of prebiotics such as fructooligosaccharides and Plantago ovata seeds in ulcerative colitis are inconclusive and the data regarding the utility of prebiotics in pouchitis is limited. The results of the clinical trials for remission induction and maintenance in active Crohn's disease or post-operative relapse with probiotics and prebiotics are inadequate and not very convincing. Prebiotics and probiotics are safe, effective and have great therapeutic potential. However, better designed clinical trials in the multicenter setting with a large sample and long duration of intervention are needed to identify the specific strain or combination of probiotics and prebiotics which will be more beneficial and effective in patients with inflammatory bowel disease.

scholarly journals The Changing Prognosis of Ulcerative Colitis and Crohn’s Disease by Decades

2021 ◽  
Author(s):  
Burton I Korelitz ◽  
Judy Schneider
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Medical Therapy ◽  
Bowel Disease ◽  
Surgical Intervention ◽  
Inflammatory Bowel

Abstract We present a bird’s eye view of the prognosis for both ulcerative colitis and Crohn’s disease as contained in the database of an Inflammatory Bowel Disease gastroenterologist covering the period from 1950 until the present utilizing the variables of medical therapy, surgical intervention, complications and deaths by decades.

scholarly journals Targeted 1H NMR metabolomics and immunological phenotyping of human fresh blood and serum samples discriminate between healthy individuals and inflammatory bowel disease patients treated with anti-TNF

2021 ◽  
Author(s):  
Sara Notararigo ◽  
Manuel Martín-Pastor ◽  
Juan E. Viñuela Roldán ◽  
Adriano Quiroga ◽  
J. Enrique Dominguez-Munoz ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Clinical Practice ◽  
Crohn's Disease ◽  
T Lymphocyte ◽  
Fresh Blood ◽  
Serum Samples ◽  
Nmr Metabolomics ◽  
Inflammatory Bowel

Abstract Inflammatory bowel disease is a multifactorial etiology, associated with environmental factors that can trigger both debut and relapses. A high level of tumor necrosis factor-α in the gut is the main consequence of immune system imbalance. The aim of treatment is to restore gut homeostasis. In this study, fresh blood and serum samples were used to identify biomarkers and to discriminate between Crohn’s disease and ulcerative colitis patients under remission treated with anti-TNF. Metabolomics based on Nuclear Magnetic Resonance spectroscopy (NMR) was used to detect unique biomarkers for each class of patients. Blood T lymphocyte repertories were characterized, as well as cytokine and transcription factor profiling, to complement the metabolomics data. Higher levels of homoserine-methionine and isobutyrate were identified as biomarkers of Crohn’s disease with ileocolic localization. For ulcerative colitis, lower levels of creatine-creatinine, proline, and tryptophan were found that reflect a deficit in the absorption of essential amino acids in the gut. T lymphocyte phenotyping and its functional profiling revealed that the overall inflammation was lower in Crohn’s disease patients than in those with ulcerative colitis. These results demonstrated that NMR metabolomics could be introduced as a high-throughput evaluation method in routine clinical practice to stratify both types of patients related to their pathology. Key messages NMR metabolomics is a non-invasive tool that could be implemented in the normal clinical practice for IBD to assess beneficial effect of the treatment. NMR metabolomics is a useful tool for precision medicine, in order to sew a specific treatment to a specific group of patients. Finding predictors of response to IFX would be desirable to select patients affected by IBD. Immunological status of inflammations correlates with NMR metabolomics biomarkers.

Physiological Basis for Novel Drug Therapies Used to Treat the Inflammatory Bowel Diseases I. Immunology and therapeutic potential of antiadhesion molecule therapy in inflammatory bowel disease

2005 ◽  
Vol 288 (2) ◽  
pp. G169-G174 ◽  
Author(s):  
Gert Van Assche ◽  
Paul Rutgeerts
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Adhesion Molecules ◽  
Bowel Disease ◽  
Intestinal Inflammation ◽  
Therapeutic Potential ◽  
Physiological Basis ◽  
Inflammatory Bowel

Adhesion molecules regulate the influx of leukocytes in normal and inflamed gut. They are also involved in local lymphocyte stimulation and antigen presentation within the intestinal mucosa. In intestinal inflammation, many adhesion molecules are upregulated, but α4-integrins most likely hold a key position in directing leukocytes into the inflamed bowel wall. Therapeutic compounds directed against trafficking of leukocytes have been designed and are being developed as a novel class of drugs in the treatment of Crohn's disease and ulcerative colitis. This review deals with the immunological aspects of leukocyte trafficking focused on gut homing of T cells. Second, the changes in adhesion molecules and T cell trafficking during intestinal inflammation are discussed. Finally, we review the clinical data that have been gathered with respect to the therapeutic potential and the safety of antiadhesion molecule treatment. Antegren, or natalizumab, a humanized anti-α4 integrin IgG4 antibody, has been most extensively evaluated and may be close to registration. A more specific humanized α4β7-integrin MLN-02 has shown preliminary clinical efficacy in ulcerative colitis, and both antergren and MLN-02 appear to be very safe. Trials with the anti-ICAM-1 antisense oligonucleotide ISIS-2302 in steroid refractory Crohn's disease have provided conflicting efficacy data. In the near future, some of these novel biological agents may prove valuable therapeutic tools in the management of refractory inflammatory bowel disease, although it is too early to define the patient population that will benefit most from these agents.

The Incidence of Deep Venous Thrombosis and Pulmonary Embolism among Patients with Inflammatory Bowel Disease: A Population-based Cohort Study

2001 ◽  
Vol 85 (03) ◽  
pp. 430-434 ◽  
Author(s):  
James Blanchard ◽  
Donald Houston ◽  
Andre Wajda ◽  
Charles Bernstein
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Pulmonary Embolism ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Population Based ◽  
Incidence Rates ◽  
Increased Risk ◽  
Inflammatory Bowel

Summary Background: There is an impression mostly from specialty clinics that patients with inflammatory bowel disease (IBD) have an increased risk of venous thromboembolic disorders. Our aim was to determine the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) from a population-based database of IBD patients and, to compare the incidence rates to that of an age, gender and geographically matched population control group. Methods: IBD patients identified from the administrative claims data of the universal provincial insurance plan of Manitoba were matched 1:10 to randomly selected members of the general population without IBD by year, age, gender, and postal area of residence using Manitoba Health’s population registry. The incidence of hospitalization for DVT and PE was calculated from hospital discharge abstracts using ICD-9-CM codes 451.1, 453.x for DVT and 415.1x for PE. Rates were calculated based on person-years of follow-up for 1984-1997. Comparisons to the population cohort yielded age-adjusted incidence rate ratios (IRR). Rates were calculated based on person-years of follow-up (Crohn’s disease = 21,340, ulcerative colitis = 19,665) for 1984-1997. Results: In Crohn’s disease the incidence rate of DVT was 31.4/10,000 person-years and of PE was 10.3/10,000 person-years. In ulcerative colitis the incidence rates were 30.0/10,000 person-years for DVT and 19.8/10,000 person-years for PE. The IRR was 4.7 (95% CI, 3.5-6.3) for DVT and 2.9 (1.8-4.7) for PE in Crohn’s disease and 2.8 (2.1-3.7) for DVT and 3.6 (2.5-5.2) for PE, in ulcerative colitis. There were no gender differences for IRR. The highest rates of DVT and PE were seen among patients over 60 years old; however the highest IRR for these events were among patients less than 40 years. Conclusion: IBD patients have a threefold increased risk of developing DVT or PE.

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