Mesenchymal Stromal Cell Therapy in the Management of Perianal Fistulas in Crohn’s Disease: An Up-To-Date Review

Crohn’s Disease (CD) is a chronic inflammatory disorder that potentially involves the entire gastrointestinal tract. Perianal fistulizing CD (pCD) is a serious and frequent complication associated with significant morbidities and a heavy negative impact on quality of life. The aim of CD treatment is to induce and maintain disease remission and to promote mucosal repair. Unfortunately, even the best therapeutic regimens in pCD do not have long-term efficacy and cause a significant number of side effects. Therefore, it is mandatory to study new therapeutical options such as the use of mesenchymal stromal cells (MSCs). These cells promote tissue repair via the induction of immunomodulation. The present review aims to analyze the existing updated scientific literature on MSCs adoption in the treatment of pCD to evaluate its efficacy and safety and to compare the use of bone marrow and adipose tissue derived MSCs, type of administration, and dose required for recovery.

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Long-term prognosis in Crohn's disease: factors that affect quality of life

Alimentary Pharmacology & Therapeutics ◽

10.1111/j.1365-2036.2006.02753.x ◽

2006 ◽

Vol 23 (3) ◽

pp. 377-385 ◽

Cited By ~ 51

Author(s):

C. CANAVAN ◽

K. R. ABRAMS ◽

B. HAWTHORNE ◽

D. DROSSMAN ◽

J. F. MAYBERRY

Keyword(s):

Quality Of Life ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Long Term Prognosis

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Prevalence and impact of allergic rhinitis in school going children

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20211565 ◽

2021 ◽

Vol 7 (5) ◽

pp. 760

Author(s):

Sucheta Gupta ◽

Vinod Gupta ◽

Akhil Gupta

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Negative Impact ◽

Community Health Center ◽

Medical Intervention ◽

House Dust Mites ◽

Inflammatory Disorder ◽

Chronic Inflammatory Disorder ◽

Co Morbidity

Background: Allergic rhinitis (AR) is a chronic inflammatory disorder affecting the nasal mucosa. There is negative impact of AR on several aspects of day to day living and quality of life (QoL), which include: daily functioning, sleep, absenteeism, school productivity and academic performance. Almost 40% of children are being affected by AR.Method: An observational study was conducted on randomly selected 100 parents of school going children aging 2 to 15 years, attending OPD in community health center, Chenani, district Udhampur, J and K, for a period of one year from June 2018 to Nov 2018. Children having frequent episodes of allergic rhinitis were enquired about their history of sneezing, runner itchy nose and eyes, thick mucus, nasal blockage or breathless with associated symptoms were selected.Results: 81% of subjects had a worse problem during specific months of the year; and 67% had itchy-watery eyes. In 15% of subjects, AR impacted daily activities. A prevalence of 28% for nasal symptoms and 14% for allergic rhino-conjunctivitis was found. Study also showed significantly higher proportion of blockers (61%) than sneeze runners (39%). 56% children had one or more co morbidity, whereas 44% had ‘nil’ co-morbidities. The most common allergens were: pollens (grass, trees and weeds), house dust mites, pets, molds, fungi and food.Conclusions: AR adversely affects quality of life of patients and furthermore studies should be conducted for more clarity on the subject, besides a timely medical intervention and treatment could possibly avoid the rising morbidity associated with the disease.

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Profiling Non-Coding RNA Levels With Clinical Classifiers in Pediatric Crohn’s Disease

10.21203/rs.3.rs-88594/v1 ◽

2020 ◽

Author(s):

Ranjit S. Pelia ◽

Suresh Venkateswaran ◽

Jason D. Matthews ◽

Yael Haberman ◽

David J. Cutler ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Disease Progression ◽

Protein Function ◽

Inflammatory Disorder ◽

Substantial Impact ◽

Chronic Inflammatory Disorder ◽

Inflammatory Status ◽

Disease Behavior ◽

Non Coding Rnas

Abstract Background: Crohn’s disease (CD) is a heritable chronic inflammatory disorder. Non-coding RNAs (ncRNAs) play an important role in epigenetic regulation by affecting gene expression, but can also directly affect protein function, thus having a substantial impact on biological processes. We investigated whether non-coding RNAs (ncRNA) at diagnosis are dysregulated during CD at different CD locations and future disease behaviors to determine if ncRNA signatures can serve as an index to outcomes. Methods: Using subjects belonging to the RISK cohort, we analyzed ncRNA from the ileal biopsies of 345 CD and 71 non-IBD controls, and ncRNA from rectal biopsies of 329 CD and 61 non-IBD controls. Sequence alignment was done (STAR package) using Human Genome version 38 (hg38) as reference panel. The differential expression (DE) analysis was performed with EdgeR package and DE ncRNAs were identified with a threshold of fold change (FC) >2 and FDR < 0.05 after multiple test corrections. Results: In total, we identified 130 CD specific DE ncRNAs (89 in ileum and 41 in rectum) when compared to non-IBD controls. Similarly, 35 DE ncRNAs were identified between B1 and B2 in ileum, whereas no differences among CD disease behaviors were noticed in rectum. We also found inflammation specific ncRNAs between inflamed and non-inflamed groups in ileal biopsies. Overall, we observed that expression of mir1244-2, mir1244-3, mir1244-4, and RN7SL2 were increased during CD, regardless of disease behavior, location, or inflammatory status. Lastly, we tested ncRNA expression at baseline as potential tool to predict the disease status, disease behaviors and disease inflammation at 3-year follow up.Conclusions: We have identified ncRNAs that are specific to disease location, disease behavior, and disease inflammation in CD. Both ileal and rectal specific ncRNA are changing over the course of CD, specifically during the disease progression in the intestinal mucosa. Collectively, our findings show changes in ncRNA during CD and may have a clinical utility in early identification and characterization of disease progression.

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Biologics in Paediatric Crohn's Disease

Gastroenterology Research and Practice ◽

10.1155/2011/287574 ◽

2011 ◽

Vol 2011 ◽

pp. 1-10 ◽

Cited By ~ 3

Author(s):

Oliver Gouldthorpe ◽

Anthony G. Catto-Smith ◽

George Alex

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Growth Parameters ◽

Case Series ◽

Limited Data ◽

Childhood Onset ◽

Biologic Drugs ◽

Life Therapy

Crohn's disease affects increasing numbers of children worldwide. Generally, childhood-onset disease runs a more severe course than in adults and has a greater impact on quality of life. Therapy in children must take account of a different set of risks for toxicity compared to adults, but also to their longevity. Biologic drugs present remarkable advantages in terms of disease control for children, especially in those whose disease cannot be controlled with conventional therapies, but their long-term risks are still being assessed. Data regarding biologic use in children is limited and mostly amounts to case series, but results have been promising, both in terms of controlling disease activity and improving growth parameters. Adverse reactions are infrequent in the short term, but loss of response is a long-term problem, particularly in children. More information is needed about very long term risks. Infliximab and adalimumab are the most studied agents in children, while there is relatively limited data on certolizumab and natalizumab. Further collection of data on these agents is still needed, but this should not restrict access to these agents for children in whom no other agent is effective.

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Mucosal Healing in Crohn’s Disease: Bull’s Eye or Bust? “The Pro Position”

Inflammatory Intestinal Diseases ◽

10.1159/000519521 ◽

2021 ◽

pp. 1-6

Author(s):

Neil O’Moráin ◽

Jayne Doherty ◽

Roisin Stack ◽

Glen A. Doherty

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Mucosal Injury ◽

Mucosal Healing ◽

Inflammatory Disorder ◽

Stricture Formation ◽

Chronic Inflammatory Disorder ◽

Non Invasive ◽

Appropriate Treatment ◽

Bull's Eye

Background: Crohn’s disease (CD) is a chronic inflammatory disorder affecting the gastrointestinal tract with disease behaviour based on the depth and severity of mucosal injury. Cumulative injury can result in complications including stricture formation and penetrating complications which often require surgical resection of diseased segments of the intestine resulting in significant morbidity. Accurate assessment of disease activity and appropriate treatment is essential in preventing complications. Summary: Treatment targets in the management of CD have evolved with the advent of more potent immunosuppressive therapy. Targeting the resolution of sub-clinical inflammation and achieving mucosal healing is associated with the prevention of stricturing and penetrating complications. Identifying non-invasive modalities to assess mucosal healing remains a challenge. Key Messages: Mucosal healing minimizes the risk of developing disease complications, prolongs steroid-free survival, and reduces hospitalization and the need for surgical intervention.

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Mo1470 Factors Associated With Long-Term Quality of Life (QL) After Ileocolic Resection (ICR) for Crohn's Disease

Gastroenterology ◽

10.1016/s0016-5085(12)64163-8 ◽

2012 ◽

Vol 142 (5) ◽

pp. S-1072

Author(s):

Felipe Bellolio ◽

Zane Cohen ◽

Helen M. MacRae ◽

J.Charles Victor ◽

Brenda I. O'Connor ◽

...

Keyword(s):

Quality Of Life ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Ileocolic Resection ◽

Factors Associated

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The Impact of Cholecystectomy on Long-Term Disease Outcomes and Quality of Life in Patients with Crohn’s Disease

Inflammatory Bowel Diseases ◽

10.1093/ibd/izaa076 ◽

2020 ◽

Author(s):

Filippos Koutroumpakis ◽

Maham Lodhi ◽

Maaz Ahsan ◽

Claudia Ramos Rivers ◽

Marc Schwartz ◽

...

Keyword(s):

Quality Of Life ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Disease Activity ◽

Hospital Admissions ◽

Tertiary Center ◽

Prospective Longitudinal ◽

The Impact

Abstract Background Cholecystectomy (CCY) is one of the most frequently performed abdominal surgeries. However, the impact of CCY in clinical settings with altered gastrointestinal physiology and anatomy, such as Crohn’s disease (CD), has not been fully characterized. We sought to investigate clinical outcomes, disease severity, and quality of life of CD patients after CCY. Methods We utilized a prospective, longitudinal registry of consented CD patients followed at a tertiary center. Crohn’s disease patients that had or had not undergone CCY formed the 2 study groups. The absence or presence of gallbladder was confirmed with abdominal CT scans obtained during routine care. Multiyear clinical, biochemical, and histologic data were collected and analyzed. Results Among 834 CD patients, 151 (18%) had undergone CCY. History of CCY was associated with higher disease activity (median Harvey-Bradshaw index; P < 0.001), more years with anemia (P = 0.048), lower albumin (P = 0.001), worse quality of life (mean Short Inflammatory Bowel Disease Questionnaire; P < 0.001), chronic abdominal pain (P < 0.001), higher risk for incident colonic dysplasia (P = 0.011), higher rates of annual hospital admissions (P = 0.004), and opioid use (P < 0.001). In multivariate analysis, CCY remained associated with higher disease activity (P < 0.001), lower albumin (P = 0.008), lower quality of life (P < 0.001), and more hospital admissions (P = 0.008), whereas CD patients with diseased ileum had higher risk for colonic dysplasia (P = 0.031). Conclusions CCY in CD patients was associated with multiple markers of disease activity and worse quality of life during multiyear follow up. This data suggests that CCY in CD patients may adversely impact the long-term clinical course.

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Transcriptional and Molecular Pathways Activated in Mesenteric Adipose Tissue and Intestinal Mucosa of Crohn’s Disease Patients

International Journal of Inflammation ◽

10.1155/2017/7646859 ◽

2017 ◽

Vol 2017 ◽

pp. 1-10 ◽

Cited By ~ 9

Author(s):

Andressa Coope ◽

Lívia Bitencourt Pascoal ◽

Francesca Aparecida Ramos da Silva ◽

José Diego Botezelli ◽

Maria de Lourdes Setsuko Ayrizono ◽

...

Keyword(s):

Adipose Tissue ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Signaling Pathways ◽

Intestinal Mucosa ◽

Inflammatory Disorder ◽

Chronic Inflammatory Disorder ◽

Mesenteric Adipose Tissue ◽

Immune Mediated ◽

First Time

Crohn’s disease (CD) is a chronic inflammatory disorder, characterized by cytokine imbalance and transcription signaling pathways activation. In addition, the increase of mesenteric adipose tissue (MAT) near the affected intestinal area is a hallmark of CD. Therefore, we evaluated the transcription signaling pathways and cytokines expression in intestinal mucosa and MAT of active CD patients. Ten patients with ileocecal CD and eight with noninflammatory diseases were studied. The biopsies of intestinal mucosa and MAT were snap-frozen and protein expression was determined by immunoblotting. RNA levels were measured by qPCR. The pIkB/IkB ratio and TNFαlevel were significantly higher in intestinal mucosa of CD when compared to controls. However, STAT1 expression was similar between intestinal mucosa of CD and controls. Considering the MAT, the pIkB/IkB ratio was significantly lower and the anti-inflammatory cytokine IL10 was significantly higher in CD when compared to controls. Finally, the protein content of pSTAT1 was higher in MAT of CD compared to controls. These findings reinforce the predominance of the proinflammatory NF-kB pathway in CD intestinal mucosa. For the first time, we showed the activation of STAT1 pathway in MAT of CD patients, which may help to understand the physiopathology of this immune mediated disease.

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Certolizumab pegol for the treatment of Crohn’s disease

Therapeutic Advances in Gastroenterology ◽

10.1177/1756283x11413315 ◽

2011 ◽

Vol 4 (6) ◽

pp. 375-389 ◽

Cited By ~ 35

Author(s):

Stefan Schreiber

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Certolizumab Pegol ◽

Fixed Dose ◽

Sustained Remission ◽

Early Therapy ◽

Rapid Induction ◽

Clinical Trial Program

In this article we provide a contemporary overview of available clinical data on certolizumab pegol, a pegylated anti-tumor necrosis factor (TNF) alpha agent that comprises a uniquely small protein, and its emerging role as a therapy for Crohn’s disease (CD). The results from a comprehensive clinical trial program suggest that certolizumab pegol offers rapid and sustained remission of moderate to severe CD. Certolizumab pegol is an effective and well-tolerated therapy both in patients who have already received biologics and in patients who are anti-TNF naïve. Benefits of therapy include a stable dosing regimen, which allows for rapid induction of a clinical response followed by long-term maintenance of response and remission under one fixed dose. Treatment with certolizumab pegol has been shown to improve function and quality of life in patients with CD, and insights into the potential mechanisms by which certolizumab pegol effects a response in CD suggest that this agent may have the potential to slow or even modify disease progression. Early therapy is particularly effective and could help control CD progression and lessen the burden of disease on patients.

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