scholarly journals Five-Aminosalicylic Acid: An Update for the Reappraisal of an Old Drug

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Cristiana Perrotta ◽  
Paolo Pellegrino ◽  
Eliana Moroni ◽  
Clara De Palma ◽  
Davide Cervia ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Immune Response ◽  
Crohn’S Disease ◽  
Mechanism Of Action ◽  
Bowel Disease ◽  
Therapeutic Option ◽  
Aminosalicylic Acid ◽  
Safety And Efficacy ◽  
Inflammatory Bowel

Inflammatory bowel disease (IBD) comprises several conditions with chronic or recurring immune response and inflammation of the gastrointestinal apparatus, of which ulcerative colitis and Crohn’s disease are the commonest forms. This disease has a significant prevalence and it is of an unknown aethiology. Five-aminosalicylic acid (5-ASA) and its derivatives are among the oldest drugs approved for the treatment of the IBD. In this review we reapprise aspects of 5-ASA mechanism of action, safety, and efficacy that in our opinion make it a valuable drug that can be fruitfully tailored in personalised treatments as a therapeutic option alongside other immune-modifying agents.

scholarly journals Cyclosporine and inflammatory bowel disease: buying time

1998 ◽  
Vol 7 (3) ◽  
pp. 145-147 ◽  
Author(s):  
M. A. C. Meijssen
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Therapeutic Option ◽  
Short Term ◽  
Disease Remission ◽  
Acute Exacerbations ◽  
Inflammatory Bowel

Cyclosporine is an effective drug in acute exacerbations of corticosteroid resistant ulcerative colitis, but its efficacy to maintain disease remission is not clear. Cyclosporine may not be as effective in Crohn's disease. However, being a rapidly acting immunosuppressant, cyclosporine may be a valuable therapeutic option in the short-term to treat corticosteroid resistant Crohn's disease and ulcerative colitis.

scholarly journals Detection of anti-colon antibodies in inflammatory bowel disease using human cultured colonic cells

Gut ◽  
1999 ◽  
Vol 44 (2) ◽  
pp. 196-202 ◽  
Author(s):  
J C W Lee ◽  
A M Cevallos ◽  
A Naeem ◽  
J E Lennard-Jones ◽  
M J G Farthing
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Immune Response ◽  
Crohn’S Disease ◽  
Antibody Response ◽  
Cell Lines ◽  
Bowel Disease ◽  
Gastrointestinal Disorders ◽  
Healthy Controls ◽  
Inflammatory Bowel

BackgroundInvestigation of anti-colon antibodies may be simplified if a sensitive method and homogeneous source of antigen were available.AimsTo examine the anti-colon antibody response using human colonic carcinoma cell lines as antigen.SubjectsPatients with inflammatory bowel disease and other gastrointestinal disorders and healthy controls were studied.MethodsComparative enzyme linked immunosorbent assays (ELISAs) were performed to assess the value of whole Caco-2, HT-29, and LS-180 cells as antigen. The antigenic determinants of the immune response were characterised by western blot analysis.ResultsSera demonstrated immunoreactivity against each of the cell lines, but different epitopes were recognised. Applying whole Caco-2 cells as antigen in an ELISA, the prevalence of anti-colon antibodies was significantly greater in patients with ulcerative colitis (36%) than Crohn’s disease (13%), other gastrointestinal disorders (13%) and healthy controls (0) (p<0.05). The immune response was not associated with one predominant antigen.ConclusionsFixed whole cell ELISA is a simple and feasible method for studying the anti-colon antibody response. This response is non-specific, being directed against multiple antigens, and is likely to be an epiphenomenon of inflammatory bowel disease, more so for ulcerative colitis than Crohn’s disease.

scholarly journals Update of Immunomodulatory Therapy for Inflammatory Bowel Disease

1994 ◽  
Vol 8 (7) ◽  
pp. 413-416
Author(s):  
Charles N Bernstein
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Immune Response ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Interleukin 1 ◽  
Immunomodulatory Agents ◽  
Proven Efficacy ◽  
Inflammatory Bowel

For several decades corticosteroids were the only potent immunomodulatory agents effective and available for active inflammatory bowel disease (IBD). The past decade ha seen an enhanced knowledge of the immune response in lBD and a better understanding of how common immunomodulatory agents work. Furthermore, more specific mediators of the abnormal immune response have been identified, so that therapy can be more targeted. Purine analogues have proven efficacy in achieving and maintaining remission in both Crohn’s disease and ulcerative colitis. Methotrexate has proven efficacy in active Crohn’s disease. Both of these classes of drugs requires weeks to months of treatment before any benefit is seen. Intravenous cyclosporine is efficacious in acute severe ulcerative colitis and can settle active disease within days of administration. It is unclear whether oral cyclosporine offers any advantage at maintaining remission, once achieved. Oral cyclosporine in Crohn’s disease has been proven to be ineffective at either achieving or maintaining remission; however, intravenous cyclosporine in Crohn’s disease has not been rigorously tested. Newer immunomodulatory agents have been designed for specific targets. and in particular monoclonal antibodies that block the effects of interleukin-1, tumour necrosis factor-alpha and the T cell receptor are available for clinical trials. We are in an era of expanding therapeutic approaches to these diseases, including the refined use of readily available agent, the development of newer, more targeted agents and a broader understanding of how agents may be effectively used simultaneously or sequentially.

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 Crohn’s disease and ulcerative colitis patient-reported outcomes signs and symptoms for the remote management of inflammatory bowel disease during the COVID-19 pandemic

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Sergio Pinto ◽  
Erica Loddo ◽  
Salvatore Paba ◽  
Agnese Favale ◽  
Fabio Chicco ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Bowel Disease ◽  
Patient Reported Outcomes ◽  
Signs And Symptoms ◽  
Patient Reported ◽  
Inflammatory Bowel ◽  
Active Patients ◽  
Active Disease

Abstract Background and aims The COVID-19 pandemic has led to a deep reorganization of hospital services including inflammatory bowel disease (IBD) units. In this situation, conversion of in-person routine follow-up visits into phone consultations might be necessary. Here we explored the feasibility of using the validated Crohn’s Disease (CD) or Ulcerative Colitis (UC) Patient-Reported Outcomes Signs and Symptoms (CD- and UC-PRO/SS) to collect data about abdominal symptoms (abdominal/S) and bowel signs and symptoms (bowel/SS) remotely. Methods CD- and UC-PRO/SS were collected during phone consultations and compared among patients with active and inactive disease. The effectiveness of therapeutic intervention in patients with active disease was assessed by PRO/SS variation. Results Twenty-one CD and 56 UC patients were evaluated by phone. Six (28.6%) CD and 15 (26.8%) UC patients were considered to have active disease. In CD the bowel/SS but not the abdominal/S module was significantly higher in active patients (mean bowel/SS 2.50 [SE ± 0.44] active vs 0.76 [SE ± 0.18] remission, p = 0.008, AUC 0.87; mean abdominal/S 1.11 [SE ± 0.38] active vs 0.24 [SE ± 0.13] remission, p = 0.066). UC-PRO/SS measures were significantly higher in active patients as compared to patients in remission (median bowel/SS 1.63 [SE ± 0.24] active vs 0.33 [SE ± 0.04] remission; p < 0.0001, AUC 0.91; mean abdominal/S 1.03 [SE ± 0.24] vs 0.37 [SE ± 0.12]; p = 0.009, AUC 0.71). Therapy was escalated in 12 patients (3 CD and 9 UC) due to disease relapse. Therapy escalation resulted in the reduction of PRO/SS as evaluated at the subsequent phone consultation. Conclusions PRO/SS might represent a feasible tool to evaluate disease activity and therapy outcome in IBD patients during periods of limited access to outpatient clinics.

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.

scholarly journals P058 INCISIONAL HERNIA REPAIR IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Hans Lovén ◽  
Rune Erichsen ◽  
Anders Tøttrup ◽  
Thue Bisgaard
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Bowel Disease ◽  
Incisional Hernia Repair ◽  
Increased Risk ◽  
Abdominal Operations ◽  
Inflammatory Bowel

Abstract Aim Patients with inflammatory bowel disease (IBD) are likely to undergo several abdominal operations and may thus be at increased risk for incisional hernia repair (IHR). The aim of the present study was to investigate risk and predictors of IHR in patients undergoing surgery for ulcerative colitis (UC) or Crohn’s disease (CD). Material and Methods Nationwide register-based study (1996-2018). Patients were followed from date of first abdominal operation until the date of the first IHR. Cumulative incidence proportion were estimated treating death as competing risk. Cox proportional hazard regression was used to explore pre-study defined predictors of IHR. Results Patients with inflammatory bowel disease (IBD) are likely to undergo several abdominal operations and may thus be at increased risk for incisional hernia repair (IHR). The present study analyzed the risk and predictors of IHR in patients undergoing surgery for ulcerative colitis (UC) or Crohn’s disease (CD). Conclusions The risk for incisional hernia repair is relatively low after IBD-surgery, although increased in UC compared with CD patients. Hernia repair predictors varied between UC and CD patients.

scholarly journals Inflammatory bowel disease: a beast of burden

2011 ◽  
pp. 57-61
Author(s):  
Dawn Farrell
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Social Life ◽  
Symptom Burden ◽  
Complex Disorders ◽  
Inflammatory Bowel ◽  
The Uk

Imagine having to empty your bowel eight or ten times a day and experiencing constant panic and fear about the location of toilet facilities. Imagine experiencing constant tiredness that impacts on all aspects of your life including work, family and social life. These are just two examples of experiences commonly suffered by individuals with a condition called inflammatory bowel disease. These people are burdened with symptoms which impact on their daily lives. This research aims to provide healthcare professionals with an understanding of the extent to which individuals with inflammatory bowel disease experience symptom burden and to identify what symptoms are most problematic. Crohn’s disease and ulcerative colitis collectively termed as inflammatory bowel disease are complex disorders. In the United Kingdom, collectively Crohn’s disease and ulcerative colitis affects approximately one person in every 250 of the population. Ulcerative colitis affects up to 120,000 people in the UK, or every 1 ...

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