scholarly journals Expression of the leukotriene B4 receptor, LTB4R, is perturbed in the blood of patients with Crohn’s Disease.

2020 ◽  
Author(s):  
Shahan Mamoor
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Differentially Expressed Gene ◽  
Leukotriene B4 ◽  
Line Treatment ◽  
First Line ◽  
T Cell Lymphomas ◽  
Increased Risk ◽  
Leukotriene B4 Receptor ◽  
First Line Treatment

first-line treatment which includes the 5-aminosalicylate drug mesalamine and steroids (2, 3). Both of these drugs are thought to have physiologically pleiotropic functions but it is still not understood how these drugs exert their therapeutic function in CD (4,5). Deciphering their mechanism of action can be facilitated by a basic understanding of the relevant therapeutic targets in patients with Crohn’s Disease, and can assist in determining which patients will benefit from first-line treatment with mesalamine versus top-down treatment with biologics (6) which are more beneficial but also more costly and associated with an increased risk of development of non-Hodgkin’s and hepatosplenic T-cell lymphomas (7, 8, 9). Transcriptome analysis to understand how gene expression differs in the tissues of patients with Crohn’s Disease can facilitate this understanding. We found, using two published datasets (10, 11), that the leukotriene B4 receptor, LTB4R (12, 13), was among the genes whose expression was most different when comparing blood from patients with Crohn’s Disease with blood from healthy, non-affected subjects. Interestingly, while LTB4R was also a differentially expressed gene in CD4+ CD25+ regulatory T-cells from patients with Crohn’s Disease, in Treg it was expressed at significantly lower levels compared to non-affected subjects as opposed to whole blood where it was expressed at significantly higher levels. This is the first report documenting differential expression of LTB4R in the hematopoietic tissues of patients with Crohn’s Disease.

scholarly journals Management of Crohn's disease

2015 ◽  
Vol 101 (5) ◽  
pp. 475-480 ◽  
Author(s):  
Jochen Kammermeier ◽  
Mary-Anne Morris ◽  
Vikki Garrick ◽  
Mark Furman ◽  
Astor Rodrigues ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Line Treatment ◽  
First Line ◽  
Exclusive Enteral Nutrition ◽  
Immunosuppressant Treatment ◽  
Active Disease ◽  
First Line Treatment

Crohn's disease (CD) is rapidly increasing in children so an up to date knowledge of diagnosis, investigation and management is essential. Exclusive enteral nutrition is the first line treatment for active disease. The vast majority of children will need immunosuppressant treatment and around 20% will need treatment with biologics. Recent guidelines have helped make best use of available therapies.

scholarly journals Targeted Combination Antibiotic Therapy Induces Remission in Treatment-Naïve Crohn’s Disease: A Case Series

2020 ◽  
Vol 8 (3) ◽  
pp. 371 ◽  
Author(s):  
Gaurav Agrawal ◽  
Annabel Clancy ◽  
Rijata Sharma ◽  
Roy Huynh ◽  
Sanjay Ramrakha ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Case Series ◽  
Line Treatment ◽  
First Line ◽  
Rapid Improvement ◽  
Line Therapy ◽  
Treatment Naïve ◽  
First Line Treatment

Prospective trials of anti-mycobacterial antibiotic therapy (AMAT) have proven efficacious in Crohn’s disease (CD) but use as first-line treatment in CD has not been evaluated. This paper reports the outcomes of patients with CD treated with first-line AMAT. This paper consists of a case series of treatment-naïve CD patients who received AMAT as first-line treatment between 2007 and 2014 at a single center. AMAT treatment consisted of rifabutin, clofazimine and clarithromycin, plus either ciprofloxacin, metronidazole or ethambutol. Symptoms, inflammatory blood markers, colonoscopy and histology results, in addition to, the Crohn’s Disease Activity Index (CDAI) were tabulated from patients’ clinical records, and descriptive statistics were conducted. A Wilcoxon signed-rank test assessed the difference in CDAI scores before and while on AMAT. The statistical significance was set at 5%. Clinical remission (CDAI < 150) with rapid improvement in clinical symptoms and inflammatory markers was seen in all eight patients receiving AMAT as sole therapy by 6 weeks. In all eight patients, the median CDAI score decreased significantly, from 289 prior to treatment to 62 at the 12-month follow-up (p < 0.001). Follow-up colonoscopies showed healing of CD ulcers, no visible mucosal inflammation, restoration of normal vascular patterns and complete mucosal healing on histology samples. AMAT as first-line therapy demonstrated a rapid improvement of Crohn’s disease (not previously seen when used as second-line therapy).

Mesalamine-induced myopericarditis in a paediatric patient with Crohn’s disease

2014 ◽  
Vol 25 (4) ◽  
pp. 783-786 ◽  
Author(s):  
Asha G. Nair ◽  
Russell R. Cross
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Paediatric Patient ◽  
Bowel Disease ◽  
Paediatric Population ◽  
Line Treatment ◽  
First Line ◽  
Inflammatory Bowel ◽  
First Line Treatment

AbstractMesalamine-containing products are considered first-line treatment for inflammatory bowel disease. Myocarditis is recognised as a very rare possible side effect of these medications, but has not often been described in the paediatric population. We present a case of an adolescent with Crohn’s disease who presented with myopericarditis after recent initiation of Pentasa. Once identified as the causative agent, the drug was discontinued, with subsequent normalisation of troponin and improvement of function. This case identifies the importance of prompt evaluation, diagnosis, and treatment of paediatric patients receiving mesalamine-containing medications that present with significant cardiovascular symptoms.

scholarly journals P274 Drug utilization of biologic therapy in Crohn’s disease and ulcerative colitis: A population based Danish cohort study 2015-2018

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S306-S307
Author(s):  
K Jensen ◽  
C B Jensen ◽  
C Wennerström ◽  
K J Sommer ◽  
J Burisch ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Drug Utilization ◽  
Biologic Therapy ◽  
Treatment Guidelines ◽  
Line Treatment ◽  
First Line ◽  
Biologic Treatment ◽  
First Line Treatment

Abstract Background For patients with Crohn’s disease (CD) and Ulcerative Colitis (UC) that are not adequately responding to systemic immunosuppressants, or are intolerant to conventional therapies, several biologic treatments have become available. The aim of the present study was to characterize the drug utilization and switch patterns of the biologics in respect to treatment line. Methods Using Danish national registries, the nation-wide study included individuals diagnosed with UC or CD who were biologic-naïve when initiating treatment with Infliximab (IFX), Adalimumab (ADA), Vedolizumab (VDZ), Golimumab (GOL), or Ustekinumab (UST) during years 2015-2018. The hazard ratios (HR) of switching or discontinuing from first treatment were explored using Cox regression adjusted for health-related and socio-economic parameters at treatment initiation. A therapy switch was defined as the administration of a biologic therapy different from the current within 90 days from last biologic dispensing period. Results Among 1,836 CD patients and 1,886 UC patients, IFX was used as first line biologic treatment in 91% (1,667) of CD patients and 92% (1,740) of UC patients. This was followed by ADA with 7% (129), VDZ with 2% (35) and UST with 0.2% (5) for CD patients, and ADA with 5% (88), VDZ with 2% (34) and GOL with 1% (24) for the UC patients, (figure 1). In total, 18% (338) of CD patients and 24% (451) of UC patients switched biologic during the study period. Among CD patients with IFX as first-line treatment, 12% (207/1667) switched to ADA, whereas 6% (96/1667) switched to VDZ. UC patients with IFX as first-line treatment, 6% (105/1740) switched to ADA, and 12% (201/1740) to VDZ. When administered ADA as first-line treatment, 11% (14/129) shifted to IFX in the CD patients, and 17% (15/88) shifted to IFX in the UC patients. Overall, 6% (111) of CD patients and 9% (163) of UC patients experienced ≥2 therapy switches during the study period. Comparing ADA to IFX as first-line treatment, there was a higher risk of discontinuation of treatment among CD patients (HR: 2.25 (95% confidence interval: 1.71; 2.97)) and in UC patients (1.93 (1.42; 2.63)), whereas no difference in risk of switch to another biologic treatment was observed. In both CD and UC patients, analyses of VDZ, GOL, and UST as first-line were impaired due to few events. Conclusion More than 90% of CD and UC patients initiating biologic therapy had IFX as their first-line biologic treatment, which is recommended by the official treatment guidelines. The reason for deviation from treatment guidelines or switch in therapy should be explored in further studies as well as the higher incidence of treatment discontinuation for ADA as first-line treatment.

scholarly journals Uveitis and Myositis as Immune Complications in Chemorefractory NK/T-Cell Nasal-Type Lymphoma Successfully Treated with Allogeneic Stem-Cell Transplant

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Maria José Gómez-Crespo ◽  
Aránzazu García-Raso ◽  
Jose Luis López-Lorenzo ◽  
Teresa Villaescusa ◽  
María Rodríguez-Pinilla ◽  
...  
Keyword(s):  
T Cell ◽  
Lower Limbs ◽  
Manuscript Preparation ◽  
Cell Transplant ◽  
Line Treatment ◽  
First Line ◽  
Inflammatory Myositis ◽  
T Cell Lymphomas ◽  
Nk T Cell ◽  
First Line Treatment

NK/T-cell lymphomas are a group of clonal proliferations of NK- or, rarely, T-cell types and have peculiar clinicopathologic features. Most common site of involvement is the upper aerodigestive tract (nasal cavity, nasopharynx, paranasal sinuses, and palate). Association of autoimmune paraneoplastic disorders with NK/T-cell lymphomas is not well studied. Our patient was diagnosed with NK/T-cell lymphoma stage IV with skin involvement and treated frontline with CHOEP regimen. While he was under treatment, two immune complications presented: anterior uveitis of autoimmune origin refractory to steroids and myositis in lower limbs muscles. Autologous transplantation was rejected due to confirmed early relapse after first-line treatment, and the patient received second-line treatment according to the SMILE scheme, reaching complete response after four cycles. The patient underwent allogeneic transplantation and at the time of manuscript preparation is alive despite multiple complications. The disease should be suspected in patients with rhinitis or recurrent sinusitis, and early biopsy is recommended for all patients to avoid a delay in diagnosis. Our patient also presented symptoms of disease progression after first-line treatment, representing a paraneoplastic process, a very rare phenomenon in T-type lymphomas. This case is novel for the appearance of an inflammatory myositis, a histologically verified paraneoplastic phenomenon that responded to treatment for lymphoma.

scholarly journals P042 EXPRESSION LEVELS OF LEUKOTRIENE B4 RECEPTOR IN CROHN'S DISEASE

2009 ◽  
Vol 3 (1) ◽  
pp. 11
Author(s):  
C. Babakissa ◽  
J. Plante ◽  
S. Turcotte ◽  
M. Rola-Pleszczynski
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Leukotriene B4 ◽  
Expression Levels ◽  
Leukotriene B4 Receptor

scholarly journals Comparison of gemcitabin, cisplatin, and dexamethasone (GDP), CHOP, and CHOPE in the first-line treatment of peripheral T-cell lymphomas

Hematology ◽  
2016 ◽  
Vol 21 (9) ◽  
pp. 536-541 ◽  
Author(s):  
Bo Jia ◽  
Shaoxuan Hu ◽  
Jianliang Yang ◽  
Shengyu Zhou ◽  
Peng Liu ◽  
...  
Keyword(s):  
T Cell ◽  
Line Treatment ◽  
First Line ◽  
T Cell Lymphomas ◽  
Peripheral T Cell Lymphomas ◽  
First Line Treatment

scholarly journals DOP54 Real-world effectiveness of thiopurine monotherapy in Crohn’s Disease: Is there still a place for thiopurines in the biological era?

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S089-S090
Author(s):  
A Rezazadeh Ardabili ◽  
S F G Jeuring ◽  
Z Mujagic ◽  
M J L Romberg-Camps ◽  
A A van Bodegraven ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Maintenance Therapy ◽  
Treatment Option ◽  
Real World ◽  
Population Based ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment

Abstract Background In current guidelines, thiopurines are still recommended as first-line maintenance therapy for patients with Crohn’s disease (CD). Due to their lack of immunogenicity, oral administration route and low costs, thiopurines are an attractive first-line treatment option. However, in recent studies the position of thiopurine monotherapy in CD has been questioned as a result of relatively lower overall effectiveness rates compared to ulcerative colitis. Real-world long-term effectiveness data substantiating the use and position of thiopurines in CD management remain sparse. We assessed long-term effectiveness of thiopurine monotherapy in CD using the population-based IBD South-Limburg (IBDSL) cohort. Methods All CD patients in the IBDSL cohort starting thiopurine monotherapy as first-line maintenance therapy between 1991–2014 were included. Thiopurine monotherapy was defined effective if either: (1) no escalation to biological treatment, (2) no course of corticosteroids, (3) no resective surgery or, (4) no hospitalization for active disease was required whilst on thiopurine treatment. Patients with early treatment discontinuation (i.e. &lt;3 months) were identified, including reason of discontinuation. Long-term effectiveness was assessed adjusting for differences in follow-up between patients using Kaplan-Meier analysis. Potential risk factors for therapy failure were identified using Cox regression. Results In total, 643/1162 (55.3%) CD patients (median follow-up: 8.5 years IQR 5.0–13.2) received first-line thiopurine monotherapy after a median of 9.7 months (IQR 3.2–31.3) after diagnosis. Therapy was discontinued within three months in 164 patients (25.5%), mainly due to adverse events [Figure 1]. Thiopurine monotherapy was effective for the duration of treatment in 229/479 (35.6%) patients, corresponding to estimated effectiveness rates of 62.9%, 43.9% and 31.2% after 1, 5 and 10 years, respectively [Figure 1–2]. No significant difference in effectiveness was observed after stratifying for era of thiopurine initiation (pre-biological (1991–1998) vs. biological (&gt;1999) era, p=0.84). Factors associated with thiopurine failure were stricturing disease (aHR 1.41, 95%CI 1.01–1.96) and upper GI involvement (aHR 1.52, 95%CI 1.02–2.28) at diagnosis. During follow-up, 40/229 patients with a durable response discontinued treatment due to quiescent disease. Of these, 35 patients (87.5%) remained without treatment 24 months after discontinuation. Conclusion Real-world data from this population-based study demonstrate that thiopurine monotherapy remains an effective and durable first-line treatment option for CD, even in the biological era. These results should be considered in the ongoing discussion regarding the position of thiopurine therapy.

Sign in / Sign up

Export Citation Format

Share Document