Vitamin D status in children with inflammatory bowel disease

2021 ◽  
Vol 19 (1) ◽  
pp. 5-10
Author(s):  
I.Yu. Pronina ◽  
◽  
V.S. Tsvetkova ◽  
A.S. Potapov ◽  
E.L. Semikina ◽  
...  

Objective. To study vitamin D status in children with inflammatory bowel diseases (IBD) depending on the diagnosis, gender, age and a season of examination. Patients and methods. The study included 244 children (130 boys and 114 girls) aged 3 to 18 years. The patients were divided into 2 groups depending on the nosological form of disease: Crohn’s disease (CD) – 130 children, ulcerative colitis (UC) – 114 children. Blood vitamin D levels were determined by the method of competitive electrochemiluminescence. Results. Normal levels of vitamin D (>30 ng/ml) were found only in 11.1% of children with IBD (in 11.5% with CD and 10.5% with UC). Vitamin D status corresponded to deficiency levels in 65.9% of cases, of them 15.2% had deep deficiency (<10 ng/ml). Vitamin D status decreased with increasing age of the patients (ρ = -0.2686). No statistically significant differences were found in vitamin D levels that would be dependent on the season of examination, neither were they found in groups of patients with CD and UC. Conclusion. The study showed an extremely low vitamin D status in patients with IBD. The problem of assessing vitamin D levels in children with IBD and its monitoring as well as development of individual algorithms for supplementation remains topical. Key words: vitamin D, inflammatory bowel disease, Crohn’s disease, ulcerative colitis, children

2015 ◽  
Vol 2015 ◽  
pp. 1-16 ◽  
Author(s):  
Marco Ardesia ◽  
Guido Ferlazzo ◽  
Walter Fries

Vitamin D deficiency has been recognized as an environmental risk factor for Crohn’s disease since the early 80s. Initially, this finding was correlated with metabolic bone disease. Low serum 25-hydroxyvitamin D levels have been repeatedly reported in inflammatory bowel diseases together with a relationship between vitamin D status and disease activity. Subsequently, low serum vitamin D levels have been reported in various immune-related diseases pointing to an immunoregulatory role. Indeed, vitamin D and its receptor (VDR) are known to interact with different players of the immune homeostasis by controlling cell proliferation, antigen receptor signalling, and intestinal barrier function. Moreover, 1,25-dihydroxyvitamin D is implicated in NOD2-mediated expression of defensin-β2, the latter known to play a crucial role in the pathogenesis of Crohn’s disease (IBD1 gene), and several genetic variants of the vitamin D receptor have been identified as Crohn’s disease candidate susceptibility genes. From animal models we have learned that deletion of the VDR gene was associated with a more severe disease. There is a growing body of evidence concerning the therapeutic role of vitamin D/synthetic vitamin D receptor agonists in clinical and experimental models of inflammatory bowel disease far beyond the role of calcium homeostasis and bone metabolism.


2021 ◽  
Vol 10 (1) ◽  
pp. 99-113
Author(s):  
Deep Sharma ◽  
Rekha Rana ◽  
Kiran Thakur ◽  
Priyanka

Inflammatory Bowel Diseases are mainly a group of bowel disorders which are generally associated with chronic inflammation of the intestinal tract due to the reason of an imbalance in the presence of the intestinal microbiota. Inflammatory bowel disease can have two different types based on their clinical pathology which are mainly Crohn’s Disease and Ulcerative Colitis. Both of these clinical sub-types are most likely to be focussed among all of the inflammatory bowel diseases due to their increasing risk of incidence as well as associated difficulties in their treatment. However, the main cause of inflammatory bowel disease has not been cleared till the date but from last three decades, there is a hub of researchnes being going on to get a clear idea about the cause of disease. Among these studies most of researchers have found the role of Nucleotide Oligomerization Domain 2 genes in the pathophysiology of disease. For the treatment of ulcerative colitis, there are severalapproaches available, based on the severity of the disease. Aminosalicylates are used to treat mild disease, use of corticosteroids is the effective treatment in the moderate case whereas use of cyclosporine in severe disease. In Crohn’s disease, drug choices are dependent on both location and behavior ofthe disease. Nowadays, the advanced treatments have been included such as use of monoclonal antibodiesor fusion proteins including anti-TNF drugs as biological therapy of disease. Also the post treatment remission of this disease makes it more complicated to be cured.


Author(s):  
Bruna Romano Correa ◽  
Mylena Scheneider Becale ◽  
Felipe Bertollo Ferreira ◽  
Fabiano Quarto Martins ◽  
Ana Paula Hamer Sousa Clara ◽  
...  

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


1988 ◽  
Vol 27 (03) ◽  
pp. 83-86 ◽  
Author(s):  
B. Briele ◽  
F. Wolf ◽  
H. J. Biersack ◽  
F. F. Knapp ◽  
A. Hotze

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.


2020 ◽  
Vol 15 (3) ◽  
pp. 216-233 ◽  
Author(s):  
Maliha Naseer ◽  
Shiva Poola ◽  
Syed Ali ◽  
Sami Samiullah ◽  
Veysel Tahan

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.


2021 ◽  
Author(s):  
Burton I Korelitz ◽  
Judy Schneider

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.


2005 ◽  
Vol 288 (2) ◽  
pp. G169-G174 ◽  
Author(s):  
Gert Van Assche ◽  
Paul Rutgeerts

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.


2011 ◽  
pp. 57-61
Author(s):  
Dawn Farrell

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 ...


Medicina ◽  
2008 ◽  
Vol 44 (1) ◽  
pp. 27 ◽  
Author(s):  
Jurgita Šventoraitytė ◽  
Aida Žvirblienė ◽  
Gediminas Kiudelis ◽  
Rimantas Žalinkevičius ◽  
Aurelija Žvirblienė ◽  
...  

Objective. Perturbed immune homeostasis elicited by misbalanced production of proinflammatory and anti-inflammatory cytokines is characteristic of inflammatory bowel disease. The aim of this study was to evaluate cytokine profile in patients with different forms of inflammatory bowel disease – ulcerative colitis and Crohn’s disease – during clinical remission phase. Material and methods. Production of proinflammatory Th1 cytokines (tumor necrosis factoralpha (TNF-a), interferon-gamma (IFN-g)) and anti-inflammatory Th2 cytokines (interleukin- 10 (IL-10) and interleukin-13 (IL-13)) was analyzed in peripheral blood mononuclear cells of patients with inflammatory bowel disease (9 with ulcerative colitis and 9 with Crohn’s disease) and control subjects (n=11) by enzyme-linked immunosorbent assay (two-site ELISA). Results. The results of the study revealed that the level of TNF-a after stimulation with phytohemagglutinin in patients with Crohn’s disease was significantly higher in comparison to both patients with ulcerative colitis and controls (P<0.001 and P<0.01, respectively). The secretion of IFN-g both in patients with Crohn’s disease and ulcerative colitis was lower than that in controls (P=0.05 and P<0.01, respectively), but it normalized after stimulation with phytohemagglutinin. The levels of IL-10 and IL-13 were significantly (P<0.01) higher in patients with Crohn’s disease than in patients with ulcerative colitis and control group before and after stimulation with phytohemagglutinin. Conclusions. The results of our study provide evidence that in patients with inflammatory bowel disease, the imbalance between production of proinflammatory Th1 and anti-inflammatory Th2 cytokines persists even during remission of the disease, and disturbances of immune homeostasis are significantly more expressed in patients with Crohn’s disease than in patients with ulcerative colitis.


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