scholarly journals Cutaneous Manifestations in Biological-Treated Inflammatory Bowel Disease Patients: A Narrative Review

2021 ◽  
Vol 10 (5) ◽  
pp. 1040
Author(s):  
Jo L. W. Lambert ◽  
Sofie De Schepper ◽  
Reinhart Speeckaert
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Cutaneous Manifestations ◽  
Cutaneous Infections ◽  
Tnf Α ◽  
Common Skin ◽  
Receptor Blockers ◽  
Infusion Reactions ◽  
Inflammatory Bowel ◽  
Lichenoid Reactions

The biologic era has greatly improved the treatment of Crohn’s disease and ulcerative colitis. Biologics can however induce a wide variety of skin eruptions, especially those targeting the TNF-α and Th17 pathway. These include infusion reactions, eczema, psoriasis, lupus, alopecia areata, vitiligo, lichenoid reactions, granulomatous disorders, vasculitis, skin cancer, and cutaneous infections. It is important to recognize these conditions as treatment-induced adverse reactions and adapt the treatment strategy accordingly. Some conditions can be treated topically while others require cessation or switch of the biological therapy. TNF-α antagonists have the highest rate adverse skin eruptions followed by ustekinumab and anti-integrin receptor blockers. In this review, we provide an overview of the most common skin eruptions which can be encountered in clinical practice when treating IBD (Inflammatory bowel disease) patients and propose a therapeutic approach for each condition.

scholarly journals Premedication Does Not Influence the Incidence of Infliximab Infusion Reactions in Pediatric Patients with Inflammatory Bowel Disease—A Single Center Case–Control Study

2021 ◽  
Vol 10 (14) ◽  
pp. 3177
Author(s):  
Edyta Szymanska ◽  
Maciej Dadalski ◽  
Joanna Sieczkowska-Golub ◽  
Dorota Jarzebicka ◽  
Monika Meglicka ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Pediatric Patients ◽  
Case Control Study ◽  
Case Control ◽  
Chi Square ◽  
Infusion Reactions ◽  
Inflammatory Bowel ◽  
The Difference ◽  
Control Study

Background: Infusion reactions (IRs) are the most common adverse events (AEs) of infliximab (IFX) treatment in patients with inflammatory bowel disease (IBD). Prophylactic premedication (PM) with corticosteroids or antihistamines prior to IFX infusions has been used in clinical practice, but its efficacy is not known. The aim of this study was to assess the influence of steroid PM on IR incidence in pediatric patients with IBD receiving IFX. Methods: We performed a case–control study that included pediatric patients with IBD receiving IFX. Patients were divided into four subgroups according to the agent and PM they received: Remicade (original drug) + PM, and two biosimilars—Reshma +/− PM, and Flixabi—PM. At our site, until 2018, PM with steroids was used as a part of standard IFX infusion (PM+); however, since then, this method has no longer been administered (PM−). IRs were divided into mild/severe reactions. Differences between subgroups were assessed with the appropriate chi-square test. Multivariate logistic regression was used to assess associations between PM and IR incidence, correcting for co-medication usage. Results: There were 105 children (55 PM+, 44 male, mean age 15 years) included in the study who received 1276 infusions. There was no difference between the PM+ and PM− subgroups, either in incidence of IR (18.2% vs. 16.0% of patients, p > 0.05) or in percentage of infusions followed by IR (2.02% vs. 1.02% of infusions, p > 0.5). The OR of developing IR when using PM was 0.34, and the difference in IRs ratio in PM+ and PM− patients was not statistically significant (95% CI, 0.034–1.9). There were 11/18 (61.1%) severe IRs (anaphylactic shock) reported in all patients (both PM+ and PM−). Conclusion: At our site, the incidence of IR was low, and PM did not decrease the incidence of IR in pediatric patients with IBD receiving IFX. These results indicate that PM with steroids should not be a standard part of IFX infusion to prevent IR.

scholarly journals Inflammatory bowel disease: the role of inflammatory cytokine gene polymorphisms

2004 ◽  
Vol 13 (3) ◽  
pp. 181-187 ◽  
Author(s):  
Joanna Balding ◽  
Wendy J. Livingstone ◽  
Judith Conroy ◽  
Lesley Mynett-Johnson ◽  
Donald G. Weir ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Disease Incidence ◽  
Strong Association ◽  
Tnf Α ◽  
Genes Encoding ◽  
Inflammatory Processes ◽  
Inflammatory Bowel ◽  
Cytokine Gene Polymorphisms

THE mechanisms responsible for development of inflammatory bowel disease (IBD) have not been fully elucidated, although the main cause of disease pathology is attributed to up-regulated inflammatory processes. The aim of this study was to investigate frequencies of polymorphisms in genes encoding pro-inflammatory and anti-inflammatory markers in IBD patients and controls. We determined genotypes of patients with IBD (n=172) and healthy controls (n=389) for polymorphisms in genes encoding various cytokines (interleukin (IL)-1β, IL-6, tumour necrosis factor (TNF), IL-10, IL-1 receptor antagonist). Association of these genotypes to disease incidence and pathophysiology was investigated. No strong association was found with occurrence of IBD. Variation was observed between the ulcerative colitis study group and the control population for the TNF-α-308 polymorphism (p=0.0135). There was also variation in the frequency of IL-6-174 and TNF-α-308 genotypes in the ulcerative colitis group compared with the Crohn's disease group (p=0.01). We concluded that polymorphisms in inflammatory genes are associated with variations in IBD phenotype and disease susceptibility. Whether the polymorphisms are directly involved in regulating cytokine production, and consequently pathophysiology of IBD, or serve merely as markers in linkage disequilibrium with susceptibility genes remains unclear.

Premedication and Infusion Reactions With Infliximab: Results From a Pediatric Inflammatory Bowel Disease Consortium

2005 ◽  
Vol 11 (5) ◽  
pp. 442-446 ◽  
Author(s):  
Douglas A Jacobstein ◽  
Jonathan E Markowitz ◽  
Barbara S Kirschner ◽  
George Ferry ◽  
Stanley A Cohen ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Pediatric Inflammatory Bowel Disease ◽  
Infusion Reactions ◽  
Inflammatory Bowel

scholarly journals Synthesis and evaluation of 6-heteroarylamino-2,4,5-trimethylpyridin-3-ols as inhibitors of TNF-α-induced cell adhesion and inflammatory bowel disease

MedChemComm ◽  
2018 ◽  
Vol 9 (8) ◽  
pp. 1305-1310 ◽  
Author(s):  
Sang Won Park ◽  
Suhrid Banskota ◽  
Pallavi Gurung ◽  
You Jin Jin ◽  
Han-eol Kang ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Cell Adhesion ◽  
Bowel Disease ◽  
Tnf Α ◽  
Inflammatory Bowel ◽  
Anti Inflammatory

Novel series of anti-inflammatory bowel disease (IBD) agent was identified through TNF-α-induced cell adhesion.

scholarly journals Mo1900 – TNF-α Inhibitors and Risk of Type 2 Diabetes in Patients with Inflammatory Bowel Disease

2019 ◽  
Vol 156 (6) ◽  
pp. S-879
Author(s):  
Marie Villumsen ◽  
Nynne Nyboe Andersen ◽  
Tine Jess ◽  
Kristine Allin
Keyword(s):  
Type 2 Diabetes ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Tnf Α ◽  
Inflammatory Bowel

Characterization of γδ T Cells in Intestinal Mucosa From Patients With Early-Onset or Long-Standing Inflammatory Bowel Disease and Their Correlation With Clinical Status

2019 ◽  
Vol 13 (7) ◽  
pp. 873-883 ◽  
Author(s):  
Elena Lo Presti ◽  
Roberto Di Mitri ◽  
Filippo Mocciaro ◽  
Anna Barbara Di Stefano ◽  
Nunzia Scibetta ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
T Cells ◽  
Intestinal Mucosa ◽  
Bowel Disease ◽  
Early Onset ◽  
Γδ T Cells ◽  
Healthy Tissue ◽  
Effector Memory ◽  
Tnf Α ◽  
Inflammatory Bowel

Abstract Background and Aims Inflammatory bowel disease [IBD] is a complex chronic inflammatory disease of the human gut with no clear aetiology. Traditionally, dysregulated adaptive immune responses play an important role even though accumulating evidence suggests a role also for innate immunity. Because of the well-known plasticity of γδ T cells, we investigated their percentage occurrence, phenotypic features and effector functions in the intestinal mucosa of early-onset and long-standing IBD patients, as compared to healthy subjects. Methods Fresh biopsies from 30 Crohn’s disease and ulcerative colitis patients were obtained and digested, and cells were analysed by flow cytometry. Results We found a reduced frequency of Vδ1 T cells in tissue from early and late IBD patients (2.24% and 1.95%, respectively, vs 5.44% in healthy tissue) but an increased frequency of Vδ2 T cells in the gut of late IBD patients (3.19% in late patients vs 1.5% in early patients and 1.65% in healthy tissue). The infiltrating Vδ2 T cells had predominant effector memory and terminally differentiated phenotypes and produced elevated levels of tumour necrosis factor-α [TNF-α] and interleukin-17 [IL-17]. The frequency of tissue Vδ2 T cells correlated with the extent of the inflammatory response and the severity of IBD. Conclusion Our study shows that tissue Vδ1 T cells are decreased in IBD patients while Vδ2 T cells are increased in the gut of IBD patients and contribute to TNF-α production. Moreover, we identify an as yet unappreciated role of Vδ2 T cells in IL-17 production in the gut of long-standing IBD patients, suggesting that they also participate in the chronic inflammatory process.

Distinct Association of Serum Vitamin D Concentration with Disease Activity and Trough Levels of Infliximab and Adalimumab during Inflammatory Bowel Disease Treatment

Digestion ◽  
2019 ◽  
Vol 101 (6) ◽  
pp. 761-770
Author(s):  
Nicolae-Catalin Mechie ◽  
Eirini Mavropoulou ◽  
Volker Ellenrieder ◽  
Steffen Kunsch ◽  
Silke Cameron ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Vitamin D ◽  
Bowel Disease ◽  
Serum Vitamin ◽  
Serum Vitamin D ◽  
Tnf Α ◽  
Inflammatory Bowel ◽  
Biochemical Remission ◽  
Zinc Levels ◽  
Trough Levels

<b><i>Background:</i></b> Studies of serum vitamin D (Vit-D) levels in patients with inflammatory bowel disease (IBD) treated with anti-tumor necrosis factor-alpha (anti-TNF-α) agents are scarce. The conjunction of Vit-D as well as zinc levels and anti-TNF-α-trough concentrations (TC) has not yet been explored. <b><i>Objectives:</i></b> To determine the association of serum Vit-D, zinc and C-reactive protein (CRP) levels with clinical and biochemical remission and a possible correlation with serum TC and antibody levels of anti-TNF-α. <b><i>Methods:</i></b> Serum Vit-D and zinc levels as well as Infliximab (IFX) and Adalimumab (ADA) TC during the maintenance phase of treatment were measured in 112 IBD patients. Statistical analysis were performed for clinical and biochemical remission. <b><i>Results:</i></b> Vit-D and zinc deficiency were detected in 58 and 4.5% of the patients respectively. In IFX-treated patients, IFX-TC, Vit-D and CRP levels were associated independently with clinical remission with an OR of 20 (95% CI 1.3–333, <i>p</i> = 0.03), 1.3 (95% CI 1.1–1.7, <i>p</i> = 0.02) and 0.4 (95% CI 0.2–0.8, <i>p</i> = 0.01) respectively. Serum IFX-TC and Vit-D levels correlated positively (<i>r</i> = 0.39, <i>p</i> = 0.001), while serum IFX-TC and CRP levels showed an inverse correlation (<i>r</i> = –0.43, <i>p</i> &#x3c; 0.001). Only ­IFX-TC associated independently with biochemical remission with a threshold of 3.1 µg/mL. In ADA-treated patients, ADA-TC associated independently with clinical and biochemical remission with an OR of 2.5 (95% CI 1.1–5.0, <i>p</i> = 0.04) and 1.3 (95% CI 1.1–1.4, <i>p</i> = 0.03) respectively. The serum zinc level was associated neither with clinical nor with biochemical remission in either cohort. <b><i>Conclusions:</i></b> Our results indicate that serum Vit-D level may be a predictive marker in addition to drug trough levels in IBD patients treated with IFX. Furthermore, due to the correlation between serum IFX and Vit-D levels, Vit-D substitution should be conducted in patients with low Vit-D levels.

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