scholarly journals BIOLOGICAL THERAPY PENETRATION FOR INFLAMMATORY BOWEL DISEASE IN LATIN AMERICA: CURRENT STATUS AND FUTURE CHALLENGES

2019 ◽  
Vol 56 (3) ◽  
pp. 318-322 ◽  
Author(s):  
Abel Botelho QUARESMA ◽  
Claudio Saddy Rodrigues COY ◽  
Aderson Omar Mourão Cintra DAMIÃO ◽  
Gilaad G KAPLAN ◽  
Paulo Gustavo KOTZE
Keyword(s):  
Systematic Review ◽  
Latin America ◽  
Latin American ◽  
Biological Agents ◽  
Current Status ◽  
Current Evidence ◽  
Future Challenges ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Different Characteristics

ABSTRACT BACKGROUND: The introduction of anti-TNF agents represented a landmark in the management of both Crohn’s disease (CD) and ulcerative colitis (UC), with improved efficacy and safety when compared with conventional treatment. However, significant challenges still exist in Latin America to facilitate the access of biological agents for physicians and patients. OBJECTIVE: The aim of this review was to summarize current evidence on penetration of biological agents for CD and UC in Latin America. METHODS: Data are derived from a previous complete systematic review that explored different characteristics of inflammatory bowel diseases (IBD) in Latin America. The studies fully included in this previous systematic review which contained detailed descriptions of the percentage of use of biological agents in different cohorts throughout Latin American and Caribbean countries were included, and descriptive findings were compiled, describing CD and UC penetration of these drugs in different patient cohorts from different countries. RESULTS: From the 61 studies included in the original systematic review, only 19 included data of the percentage of patients treated with biological agents. Anti-TNF use in CD varied from 1.51% in Mexico up to 46.9% in Colombia, with most of the studies describing anti-TNF use in approximately 20%-40% of CD patients. On the other side, the frequency of the use of biologics was clearly lower in UC, varying from 0% in 2009 to up 16.2% in 2018, according to two different Mexican studies. Only two studies described the penetration of anti-TNF agents in IBD overall: 13.4% in a Colombian and 37.93% in a Brazilian study. No studies described percentage of use of new biologic agents (vedolizumab and ustekinumab). CONCLUSION: Penetration of anti-TNF agents in Latin America is comparable to the rest of the world in CD, but lower in UC. With the increase in the incidence and prevalence of IBD, specific strategies to increase access to anti-TNF agents in UC and new biological agents overall are warranted.

Subclinical Atherosclerosis in Patients With Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis

Angiology ◽  
2016 ◽  
Vol 68 (5) ◽  
pp. 447-461 ◽  
Author(s):  
Guo-Cui Wu ◽  
Rui-Xue Leng ◽  
Qi Lu ◽  
Yin-Guang Fan ◽  
De-Guang Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Diseases ◽  
Meta Analysis ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Current Evidence ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
And Control

We evaluated the differences in major markers of cardiovascular (CV) risk between inflammatory bowel diseases (IBDs) and controls by a systematic review and a meta-analysis. We searched PubMed, EMBASE, and Cochrane databases for literature comparing CV risk markers in IBDs and controls. The overall mean carotid intima–media thickness (CIMT), flow-mediated dilation (FMD%), and carotid–femoral pulse wave velocity (cfPWV) difference between patients with IBDs and control groups were calculated. Twenty-eight studies were included in the meta-analysis, including 16 studies with data on CIMT, 7 studies reporting FMD%, and 9 studies on cfPWV. Compared to controls, patients with IBDs showed significantly higher CIMT (standardized mean difference [ SMD]: 0.534 mm; 95% confidence interval [CI], 0.230 to 0.838; P = .001), significantly lower FMD% ( SMD, −0.721%; 95% CI, −1.020 to −0.421; P < .0001), and significantly increased cfPWV ( SMD, 0.849; 95% CI, 0.589 to 1.110; P < .0001). When analyzing subgroups with ulcerative colitis and Crohn disease (CD), all results were still significant except CIMT in CD. Our findings support the current evidence for an elevated CV burden in patients with IBD and support the clinical utility of markers of subclinical atherosclerosis in the management of these patients.

scholarly journals Progression of Inflammatory Bowel Diseases Throughout Latin America and the Caribbean: A Systematic Review

2020 ◽  
Vol 18 (2) ◽  
pp. 304-312 ◽  
Author(s):  
Paulo Gustavo Kotze ◽  
Fox E. Underwood ◽  
Aderson Omar Mourão Cintra Damião ◽  
Jose Geraldo P. Ferraz ◽  
Rogerio Saad-Hossne ◽  
...  
Keyword(s):  
Systematic Review ◽  
Latin America ◽  
Inflammatory Bowel Diseases ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
The Caribbean

scholarly journals Butyrate and the Fine-Tuning of Colonic Homeostasis: Implication for Inflammatory Bowel Diseases

2021 ◽  
Vol 22 (6) ◽  
pp. 3061
Author(s):  
Naschla Gasaly ◽  
Marcela A. Hermoso ◽  
Martín Gotteland
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Barrier Function ◽  
Cell Types ◽  
Fine Tuning ◽  
Current Evidence ◽  
Aryl Hydrocarbon ◽  
Gut Barrier Function ◽  
Bowel Diseases ◽  
Inflammatory Processes ◽  
Inflammatory Bowel

This review describes current evidence supporting butyrate impact in the homeostatic regulation of the digestive ecosystem in health and inflammatory bowel diseases (IBDs). Butyrate is mainly produced by bacteria from the Firmicutes phylum. It stimulates mature colonocytes and inhibits undifferentiated malignant and stem cells. Butyrate oxidation in mature colonocytes (1) produces 70–80% of their energetic requirements, (2) prevents stem cell inhibition by limiting butyrate access to crypts, and (3) consumes oxygen, generating hypoxia and maintaining luminal anaerobiosis favorable to the microbiota. Butyrate stimulates the aryl hydrocarbon receptor (AhR), the GPR41 and GPR109A receptors, and inhibits HDAC in different cell types, thus stabilizing the gut barrier function and decreasing inflammatory processes. However, some studies indicate contrary effects according to butyrate concentrations. IBD patients exhibit a lower abundance of butyrate-producing bacteria and butyrate content. Additionally, colonocyte butyrate oxidation is depressed in these subjects, lowering luminal anaerobiosis and facilitating the expansion of Enterobacteriaceae that contribute to inflammation. Accordingly, gut dysbiosis and decreased barrier function in IBD seems to be secondary to the impaired mitochondrial disturbance in colonic epithelial cells.

Aspectos Nutricionais Associados a Patogênese das Doenças Inflamatórias Intestinais: uma Revisão Sistemática / Nutritional Feature Associated with the Pathogenesis of Inflammatory Bowel Diseases: A Systematic Review

2021 ◽  
Vol 4 (4) ◽  
pp. 17329-17350
Author(s):  
Ana Paula Fernandes Da Silva ◽  
Luciano de Albuquerque Mello ◽  
Ellen Mariane Santana Da Fonseca ◽  
Larissa Eloísa De Lima ◽  
Luana Jasiela Alves Maranhão ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Diseases ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Machine Learning-based Prediction Models for Diagnosis and Prognosis in Inflammatory Bowel Diseases: A Systematic Review

2021 ◽  
Author(s):  
Nghia H Nguyen ◽  
Dominic Picetti ◽  
Parambir S Dulai ◽  
Vipul Jairath ◽  
William J Sandborn ◽  
...  
Keyword(s):  
Machine Learning ◽  
Systematic Review ◽  
Risk Prediction ◽  
Statistical Models ◽  
Prediction Models ◽  
Risk Of Bias ◽  
Learning Models ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Machine Learning Models

Abstract Background and Aims There is increasing interest in machine learning-based prediction models in inflammatory bowel diseases (IBD). We synthesized and critically appraised studies comparing machine learning vs. traditional statistical models, using routinely available clinical data for risk prediction in IBD. Methods Through a systematic review till January 1, 2021, we identified cohort studies that derived and/or validated machine learning models, based on routinely collected clinical data in patients with IBD, to predict the risk of harboring or developing adverse clinical outcomes, and reported its predictive performance against a traditional statistical model for the same outcome. We appraised the risk of bias in these studies using the Prediction model Risk of Bias ASsessment (PROBAST) tool. Results We included 13 studies on machine learning-based prediction models in IBD encompassing themes of predicting treatment response to biologics and thiopurines, predicting longitudinal disease activity and complications and outcomes in patients with acute severe ulcerative colitis. The most common machine learnings models used were tree-based algorithms, which are classification approaches achieved through supervised learning. Machine learning models outperformed traditional statistical models in risk prediction. However, most models were at high risk of bias, and only one was externally validated. Conclusions Machine learning-based prediction models based on routinely collected data generally perform better than traditional statistical models in risk prediction in IBD, though frequently have high risk of bias. Future studies examining these approaches are warranted, with special focus on external validation and clinical applicability.

scholarly journals Diversion proctocolitis and the problem of the forgotten rectum in inflammatory bowel diseases: A systematic review

2021 ◽  
Author(s):  
Arianna Dal Buono ◽  
Michele Carvello ◽  
David B. Sachar ◽  
Antonino Spinelli ◽  
Silvio Danese ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Diseases ◽  
Bowel Diseases ◽  
Inflammatory Bowel

scholarly journals The Role of Carrageenan in Inflammatory Bowel Diseases and Allergic Reactions: Where Do We Stand?

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3402
Author(s):  
Barbara Borsani ◽  
Raffaella De Santis ◽  
Veronica Perico ◽  
Francesca Penagini ◽  
Erica Pendezza ◽  
...  
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Experimental Models ◽  
Gelling Agent ◽  
Current Evidence ◽  
Allergic Reactions ◽  
Processed Foods ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Carrageenan (CGN) is a high molecular weight polysaccharide extracted from red seaweeds, composed of D-galactose residues linked in β-1,4 and α-1,3 galactose-galactose bond, widely used as a food additive in processed foods for its properties as a thickener, gelling agent, emulsifier, and stabilizer. In recent years, with the spread of the Western diet (WD), its consumption has increased. Nonetheless, there is a debate on its safety. CGN is extensively used as an inflammatory and adjuvant agent in vitro and in animal experimental models for the investigation of immune processes or to assess the activity of anti-inflammatory drugs. CGN can activate the innate immune pathways of inflammation, alter the gut microbiota composition and the thickness of the mucus barrier. Clinical evidence suggests that CGN is involved in the pathogenesis and clinical management of inflammatory bowel diseases (IBD), indeed food-exclusion diets can be an effective therapy for disease remission. Moreover, specific IgE to the oligosaccharide α-Gal has been associated with allergic reactions commonly referred to as the “α-Gal syndrome”. This review aims to discuss the role of carrageenan in inflammatory bowel diseases and allergic reactions following the current evidence. Furthermore, as no definitive data are available on the safety and the effects of CGN, we suggest gaps to be filled and advise to limit the human exposure to CGN by reducing the consumption of ultra-processed foods.

Neighborhood environment, self-rated health and quality of life in Latin America

2019 ◽  
Vol 35 (2) ◽  
pp. 196-204 ◽  
Author(s):  
Luis F Gomez ◽  
Carolina Soto-Salazar ◽  
José Guerrero ◽  
María Garcia ◽  
Diana C Parra
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Latin America ◽  
Latin American ◽  
Neighborhood Environment ◽  
Bibliographic Databases ◽  
Cross Sectional ◽  
Negatively Associated ◽  
Self Rated Health

Abstract To conduct a systematic review examining the associations between neighborhood environments and self-rated health (SRH) and health-related quality of life (HR-QOL) in the urban context of Latin America. We conducted a structured search of quantitative studies in three bibliographic databases published in Spanish, English, Portuguese and French from January 1990 to December 2015. We restricted the search to studies conducted in Latin-American cities with one million and more inhabitants. Eleven studies were finally included in the analysis. Ten were cross-sectional studies and one was a cohort follow-up study. Two studies found positive associations between accessibility to parks and HR-QOL. One study found that high neighborhood social capital was positively associated with SRH. Neighborhood socioeconomic status was positively associated with both HR-QOL and SRH in two studies. A walkable neighborhood was positively associated with SRH in two studies. Three studies included attributes related with neighborhood security perception and road safety, with higher scores of HR-QOL, both in the physical and mental dimensions, while high levels of street noise were negatively associated. Narrowness and slope of streets were negatively associated with SRH. No association was found between the perception of neighborhood security and SRH. The results of this systematic review show that several studies conducted in Latin America have found significant associations between neighborhood environment and SRH and HRQOL. However, the relatively small number of studies and the heterogeneity among them require further studies to better understand this topic in the region.

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