scholarly journals Glucocorticosteroids in the treatment of inflammatory bowel disease and approaches to minimizing systemic activity

2013 ◽  
Vol 6 (2) ◽  
pp. 137-156 ◽  
Author(s):  
Cosimo Prantera ◽  
Stefano Marconi
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
The United States ◽  
Prolonged Treatment ◽  
Medline Search ◽  
Inflammatory Conditions ◽  
Number Of Patients ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Maintenance Of Remission

Inflammatory bowel diseases (IBDs) are a group of inflammatory conditions characterized by chronic, uncontrolled inflammation of the gastrointestinal tract. Reported prevalence is high in the United States and northern Europe, while the incidence varies greatly across the rest of Europe. Glucocorticosteroids are the standard treatment for IBD, but due to adverse events their use can be limited. However, new formulations of glucocorticosteroids have been developed to reduce systemic activation. The aim of this review was to assess and summarize the efficacy and safety of new formulations of glucocorticosteroids. A MEDLINE search identified publications focused on new formulations of nonsystemic steroid-based drugs for IBD and benefits and limitations of each of the new glucocorticosteroid formulations were identified. Budesonide has good efficacy and is an established treatment for Crohn’s disease; it has been shown to be beneficial for the induction of remission in these patients, although it is not recommended for the maintenance of induced remission. Glucocorticosteroids are not recommended for the maintenance of remission in patients with IBD. However, a recent study suggested that beclomethasone dipropionate may be effective for prolonged treatment in patients in the postacute phase of Crohn’s disease who were treated with a short course of systemic steroids. The efficacy of fluticasone propionate and prednisolone metasulphobenzoate in IBD is not well established given the small number of patients enrolled in the few published clinical trials. While the tolerability of these glucocorticosteroids is favourable, more research comparing these new agents with traditional systemic glucocorticosteroids is warranted.

Biologic Therapy in Crohn’s Disease–What We Have Learnt So Far

2020 ◽  
Vol 21 (8) ◽  
pp. 792-806
Author(s):  
Kinga Majchrzak ◽  
Jakub Fichna
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Biologic Therapy ◽  
Clinical Symptoms ◽  
Autoimmune Disorder ◽  
Biological Drugs ◽  
Wide Range ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Maintenance Of Remission

Crohn’s disease (CD) is an autoimmune disorder from the group of inflammatory bowel diseases. The etiology of CD is not clear; currently, the interaction between the genetic, immunological and environmental factors is assumed as the cause of the disease. Partial knowledge of those factors has led to the development of drugs, which control the clinical symptoms and improve the overall condition of the infected; the main objective of the modern therapeutic strategies is the induction and maintenance of remission. Among the wide range of available treatments, older generation molecules: mesalazine, corticosteroids and thiopurine derivatives as well as biological drugs and biosimilars can be distinguished. Moreover, some novel biologics and small molecule drugs have shown potential in CD clinical trials, providing safe and effective results. This article provides an overview of the achievements in the field of biologic therapy, its efficacy and safety with an indication of future directions in CD treatment.

scholarly journals P234 Frequency detectiveness of some viral infections in patients with inflammatory bowel diseases

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S259-S260
Author(s):  
G Babayeva-Sadigova ◽  
Z Babayev ◽  
G Asadova ◽  
U Mahmudov ◽  
F Quliyev ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Inflammatory Bowel Diseases ◽  
Viral Infections ◽  
Herpes Simplex Viruses ◽  
Number Of Patients ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Endoscopic Picture

Abstract Background The prevalence of opportunistic infections in individuals with inflammatory bowel disease (IBD) remains relevant. Viral infections are a common cause of systemic inflammation of the digestive tract. Clinically expressed herpes and parvovirus infections are a serious problem, especially for people with prolonged immunosuppression. The aim of the study was t o assess the incidence of certain herpes and parvovirus infections in patients with IBD. Methods In total, 189 patients with IBD, 102 with ulcerative colitis and 87 with Crohn’s disease were examined. Of the number of patients: 98 women, 91man. The age of patients is from 16 to 63 years (mean age 41.4 ± 4.8). In addition to a standard examination, disease activity was assessed by indicators of highly sensitive C-reactive protein, homocysteine, vitamin D in blood serum, albumin in urine, calprotectin and lactoferrin in faeces. All patients underwent serological blood tests by ELISA for specific antibodies to herpes viruses and IgG/IgM antibodies to parvovirus B19, determination of DNA to herpes simplex viruses of types 1-2,6(HSV1-2?HSV6), Epstein–Barr (EBV}, cytomegalovirus (CMV), herpes zoster (HZV) by PCR in blood and mucosal biopsy, and also avidity. Results Among patients with IBD, active infections (herpes and parvoviruses) in the blood occurred in 81 patients (42.8%); of them, 39 patients (20.6%) were diagnosed with monoherpesvirus infections, in 16 patients parvovirus (8.4%), and in 26 (13.8%) cases, active mixed viral infections were detected. In 79 cases (41.7%) of PCR biopsy material was positive for isolated infection: 36 cases (19%) of CMV, 21 cases (11.1%) of EBV, 22 cases (11.6%) of HSV6. Tissue viral infection was found in 34 patients (17.9%). Clinical endoscopic and laboratory indicators of activity in IBD were significantly higher in patients with active viral infections (p ˂ 0.05), which indicates the negative effect of chronic active herpes and parvovirus infections on the course of inflammatory bowel diseases. However, significant differences between patients with ulcerative colitis and Crohn’s disease were not detected. Conclusion The frequency of occurrence of herpes and parvovirus lesions in patients with IBD in the blood is more than 42.8%, isolated infection in the tissue in 41.7%, and mixed infection in 17.9% of the number of patients. The clinical endoscopic picture, as well as laboratory data indicate a more severe course of diseases in the presence of these infections.

scholarly journals Reações adversas no tratamento da doença inflamatória intestinal em um Ambulatório de Referência / Adverse reactions in inflammatory bowel disease treatment in a Reference Center

2020 ◽  
Vol 65 (1) ◽  
pp. 1
Author(s):  
Bruna Romano Correa ◽  
Mylena Scheneider Becale ◽  
Felipe Bertollo Ferreira ◽  
Fabiano Quarto Martins ◽  
Ana Paula Hamer Sousa Clara ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Inflammatory Bowel Diseases ◽  
Bowel Disease ◽  
Adverse Reactions ◽  
Inflammatory Conditions ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Introdução: A Doença Inflamatória Intestinal que compreende, principalmente, a Doença de Crohn e a Retocolite Ulcerativa, consiste em um grupo de condições inflamatórias crônicas que afetam predominantemente o trato gastrointestinal de indivíduos suscetíveis expostos a fatores de risco ambientais. Estudos recentes demonstram que a incidência e a prevalência da doença vêm aumentando em diferentes regiões do mundo. Em paralelo, há crescimento na utilização de imunomoduladores e terapias biológicas, tornando necessária a análise de seus riscos e impactos. Devido às terapias de longa duração com medicamentos sujeitos a efeitos nocivos, pacientes em vigência de tratamento podem evoluir com reações adversas. Objetivos: Analisar a ocorrência de reações adversas a medicamento durante o tratamento farmacológico de pacientes do Ambulatório de Referência de Doenças Inflamatórias Intestinais do Hospital Santa Casa de Misericórdia em Vitória – ES. Métodos: Estudo observacional e analítico de pesquisa documental retrospectiva através da coleta de dados durante o mês de outubro de 2020, em registros de pacientes em acompanhamento clínico. Conclusão: O perfil de reações adversas a medicamentos do estudo concordou majoritariamente com dados da literatura. Por meio desses dados será possível desenvolver estratégias voltadas ao rastreio, prevenção e redução das reações adversas a medicamentos, contribuindo para a diminuição da morbimortalidade e dos custos inerentes ao tratamento.Palavras chave: Reações adversas relacionadas a medicamentos, Efeitos colaterais, Doença de Crohn, Colite ulcerativa, Doenças inflamatórias intestinais ABSTRACT Introduction: Inflammatory Bowel Disease, which mainly comprises Crohn’s Disease and Ulcerative Colitis, consists of a group of chronic inflammatory conditions that predominantly affect the gastrointestinal tract of susceptible individuals exposed to environmental risk factors. Recent studies show that the incidence and prevalence of the disease has been increasing in different regions of the world. In parallel, there is a growth in the use of immunomodulators and biological therapies, making it necessary to analyze their risks and impacts. Due to long-term therapies with drugs subject to harmful effects, patients undergoing treatment may evolve with adverse reactions. Objective: To analyze the occurrence of adverse reactions to drugs during the pharmacological treatment of patients at the Reference Clinic for Inflammatory Bowel Diseases at Hospital Santa Casa de Misericórdia in Vitória - ES (HSCMV). Methods: This is an observational and analytical study of retrospective documentary research was carried out through of data during the month of October 2020, in patient records under clinical follow-up. Conclusion: The adverse drug reactions (ADR) profile of the study mostly agreed with data from the literature. Through these data, it will be possible to develop strategies aimed at screening, preventing and reducing ADRs, contributing to the reduction of morbidity and mortality and costs inherent to treatment. Keywords: Drug-related adverse reactions, Side effects, Crohn’s disease, Ulcerative colitis, Inflammatory bowel diseases

Localization and Activity of Inflammatory Bowel Disease Using 111ln Leukocyte Imaging

1988 ◽  
Vol 27 (03) ◽  
pp. 83-86 ◽  
Author(s):  
B. Briele ◽  
F. Wolf ◽  
H. J. Biersack ◽  
F. F. Knapp ◽  
A. Hotze
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Cell Uptake ◽  
Disease Extent ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Leukocyte Imaging

A prospective study was initiated to compare the clinically proven results concerning localization/extent and activity of inflammatory bowel diseases with those of 111ln-oxine leukocyte imaging. All patients studied were completely examined with barium enema x-ray, clinical and laboratory investigations, and endoscopy with histopathology. A total of 31 leukocyte scans were performed in 15 patients (12 with Crohn’s disease, 3 with ulcerative colitis). The scans were graded by comparing the cell uptake of a lesion (when present) and a bone marrow area providing a count ratio (CR). The inflammatory lesions were correctly localized on 26 leukocyte scans, and in 21 scans the scintigraphically estimated extent of disease was identical to endoscopy. In 5 cases the disease extent was underestimated, 4 scans in patients with relapse of Crohn’s disease were falsely negative, and in one patient with remission truly negative. The scintigraphically assessed disease activity was also in a good agreement with clinical disease activity based on histopathology in all cases. We conclude that leukocyte imaging provides valuable information about localization and activity of inflammatory bowel disease.

scholarly journals The role of epigenetic modifications for the pathogenesis of Crohn's disease

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
M. Hornschuh ◽  
E. Wirthgen ◽  
M. Wolfien ◽  
K. P. Singh ◽  
O. Wolkenhauer ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Adaptive Immune Response ◽  
Adaptive Immune ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
New Biomarkers ◽  
Insight Into ◽  
Specific Evaluation

AbstractEpigenetics has become a promising field for finding new biomarkers and improving diagnosis, prognosis, and drug response in inflammatory bowel disease. The number of people suffering from inflammatory bowel diseases, especially Crohn's disease, has increased remarkably. Crohn's disease is assumed to be the result of a complex interplay between genetic susceptibility, environmental factors, and altered intestinal microbiota, leading to dysregulation of the innate and adaptive immune response. While many genetic variants have been identified to be associated with Crohn's disease, less is known about the influence of epigenetics in the pathogenesis of this disease. In this review, we provide an overview of current epigenetic studies in Crohn's disease. In particular, we enable a deeper insight into applied bioanalytical and computational tools, as well as a comprehensive update toward the cell-specific evaluation of DNA methylation and histone modifications.

scholarly journals Inflammatory Bowel Disease: An Overview of Immune Mechanisms and Biological Treatments

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Bruno Rafael Ramos de Mattos ◽  
Maellin Pereira Gracindo Garcia ◽  
Julia Bier Nogueira ◽  
Lisiery Negrini Paiatto ◽  
Cassia Galdino Albuquerque ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Severe Disease ◽  
Biological Therapies ◽  
Promising Alternative ◽  
Biological Treatments ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
And Behavior

Inflammatory bowel diseases (IBD) are characterized by chronic inflammation of the intestinal tract associated with an imbalance of the intestinal microbiota. Crohn’s disease (CD) and ulcerative colitis (UC) are the most widely known types of IBD and have been the focus of attention due to their increasing incidence. Recent studies have pointed out genes associated with IBD susceptibility that, together with environment factors, may contribute to the outcome of the disease. In ulcerative colitis, there are several therapies available, depending on the stage of the disease. Aminosalicylates, corticosteroids, and cyclosporine are used to treat mild, moderate, and severe disease, respectively. In Crohn’s disease, drug choices are dependent on both location and behavior of the disease. Nowadays, advances in treatments for IBD have included biological therapies, based mainly on monoclonal antibodies or fusion proteins, such as anti-TNF drugs. Notwithstanding the high cost involved, these biological therapies show a high index of remission, enabling a significant reduction in cases of surgery and hospitalization. Furthermore, migration inhibitors and new cytokine blockers are also a promising alternative for treating patients with IBD. In this review, an analysis of literature data on biological treatments for IBD is approached, with the main focus on therapies based on emerging recombinant biomolecules.

Quality of Life Considering Patients with Chronic Inflammatory Bowel Diseases - Natural and Parenteral Nutrition

2014 ◽  
Vol 86 (9) ◽  
Author(s):  
Aneta Raczkowska ◽  
Michał Ławiński ◽  
Aleksandra Gradowska ◽  
Urszula Zielińska-Borkowska
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Parenteral Nutrition ◽  
Inflammatory Bowel Diseases ◽  
Nutritional Therapy ◽  
Bowel Diseases ◽  
Inflammatory Bowel

AbstractOne of the elements of treatment considering inflammatory bowel diseases is nutritional therapy. The duration of the above-mentioned depends on the prevalence of such symptoms as fever, bowel move-ments, length of the functioning gastrointestinal tract, stoma and intestinal fistula presence. Nutritional therapy is an essential element of successful treatment alongside pharmacological, surgical, and biological therapy, as well as other methods. Crohn's disease and ulcerative colitis considered as chronic diseases, lead towards physical and biopsychosocial disability, being responsible for the reduction in the quality of life.was to determine the quality of life after surgical procedures in case of patients diagnosed with Crohn's disease and ulcerative colitis, subjected to natural and parenteral nutrition.The study group comprised 52 patients from the Department of Gastroen-terology, Military Medical Institute, and Department of Surgery and Clinical Nutrition, Clinical Hospital in Warsaw. The study was performed between October, 2011 and April, 2012. The World Health Organization Quality of Life Instrument - Bref (WHOQOL-BREF) questionnaire was used to deter-mine the patients’ quality of life.A lower quality of life was observed in case of patients subjected to parenteral nutrition, poor education, disease symptoms exacerbation, in the majority-rural inhabitants. The quality of life does not depend on gender, type of disease, family status, and additional medical care.

scholarly journals A Rare Case of Gastric Crohn’s Disease Complicated by Gastric Carcinoma

2018 ◽  
pp. 1-6
Author(s):  
Marwah Sami M Hussain ◽  
Bandar Idrees Ali ◽  
Abdullah Alzahrani
Keyword(s):  
Gastric Cancer ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Inflammatory Bowel Diseases ◽  
Rare Case ◽  
Small Bowel Adenocarcinoma ◽  
Disease Case ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Upper Gastrointestinal

Background: Inflammatory bowel diseases are strongly associated with colorectal cancer. In addition, a few cases reported with gastric and small bowel adenocarcinoma in gastroduodenal Crohn’s disease. Case report: We reported a case of a 47-Year-old female, who was referred to our surgical department and after a routine gastroscopy which revealed a lesion. Biopsy confirmed gastric well-differentiated adenocarcinoma of limited gastric Crohn’s disease, for a patient on regular anti Crohn’s medication. The patient underwent varying laparoscopic distal gastrectomy. She received adjuvant chemotherapy treatment and thereafter, she was cancer free within the period of 3- years of regular follow up. Conclusion: The only way to diagnose such lesions of a rare case of gastric cancer in a patient with Crohn’s disease is to regularly carry out upper gastrointestinal examinations. Keywords: Inflammatory bowel diseases, Crohn’s disease, Upper gastrointestinal tract Crohn’s disease, Gastric cancer

scholarly journals Pathogenesis and management of gastrointestinal inflammation and fibrosis: from inflammatory bowel diseases to endoscopic surgery

2021 ◽  
Vol 41 (1) ◽  
Author(s):  
Kentaro Iwata ◽  
Yohei Mikami ◽  
Motohiko Kato ◽  
Naohisa Yahagi ◽  
Takanori Kanai
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Tissue Repair ◽  
Relevant Literature ◽  
Surgical Techniques ◽  
Treatment Strategies ◽  
Extended Resection ◽  
Bowel Diseases ◽  
Technical Advances ◽  
Inflammatory Bowel

AbstractGastrointestinal fibrosis is a state of accumulated biological entropy caused by a dysregulated tissue repair response. Acute or chronic inflammation in the gastrointestinal tract, including inflammatory bowel disease, particularly Crohn’s disease, induces fibrosis and strictures, which often require surgical or endoscopic intervention. Recent technical advances in endoscopic surgical techniques raise the possibility of gastrointestinal stricture after an extended resection. Compared to recent progress in controlling inflammation, our understanding of the pathogenesis of gastrointestinal fibrosis is limited, which requires the development of prevention and treatment strategies. Here, we focus on gastrointestinal fibrosis in Crohn’s disease and post-endoscopic submucosal dissection (ESD) stricture, and we review the relevant literature.

scholarly journals The gene encoding the B-cell activating factor and B-lymphocyte stimulator (BAFF/BLyS), TNFSF13B, is differentially expressed in the blood of patients with Crohn’s Disease.

2020 ◽  
Author(s):  
Shahan Mamoor
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
B Lymphocyte ◽  
Differentially Expressed ◽  
Gene Encoding ◽  
B Cell Activating Factor ◽  
Bowel Diseases ◽  
B Lymphocyte Stimulator ◽  
Inflammatory Bowel ◽  
Disease Analysis

Inflammatory bowel diseases (IBD) include Crohn’s Disease and Ulcerative Colitis (1). We mined published microarray data to understand how gene expression in the hematopoietic compartment of patients with Crohn’s Disease is most different from that of healthy controls (2-4). Across two datasets (2, 3), we found that BAFF, also known as the B-lymphocyte stimulator (BLyS), encoded by the gene TNFSF13B (5), was differentially expressed in the blood of patients with Crohn’s Disease . Analysis of a third dataset (4) revealed that BAFF was among the genes most differentially expressed in monocyte-derived macrophages from patients with Crohn’s Disease. Serum BAFF, fecal BAFF, and BAFF expression in the intestinal mucosa has been demonstrated to be increased in patients with IBD (6, 7). We show here that expression of BAFF in the peripheral blood of patients with Crohn’s Disease is also increased.

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