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J De Flines, E Louis, N Paquot
Malabsorption syndrome is a complex clinical entity that needs to be carefully explored. Patients present frequently chronic diarrhoea associated with weight loss. These symptoms affect patient's quality of life. The assessment of this syndrome requires a detailed anamnesis, a careful clinical exam, the use of biological measurements in both blood and faeces, and, if necessary, other more complex investigations including radionuclide tests. It is important to find the right pathogenesis in order to start effective treatments if possible...
October 2018: Revue Médicale de Liège
Nikolas Plevris, Mathew Lyons, Philip W Jenkinson, Cher S Chuah, Lynne M Merchant, Rebecca J Pattenden, Eleanor F Watson, Gwo-Tzer Ho, Colin L Noble, Alan G Shand, Shahida Din, Ian D Arnott, Gareth R Jones, Charlie W Lees
Background: Adalimumab is an established treatment for Crohn's disease. Limited data are available regarding the relationship between adalimumab drug levels and serum/fecal markers of gut inflammation. We therefore aimed to characterize the relationship between adalimumab levels and biologic remission during maintenance therapy. Methods: A single-center prospective cross-sectional study was undertaken on Crohn's disease patients who had received adalimumab therapy for a minimum of 12 weeks after induction...
October 17, 2018: Inflammatory Bowel Diseases
Alessandro Sartini, Eleonora Scaioli, Elisa Liverani, Matteo Bellanova, Luigi Ricciardiello, Franco Bazzoli, Andrea Belluzzi
BACKGROUND: "Real-life" data of retention rate and persistence of adalimumab in inflammatory bowel disease are still limited. AIMS: To analyze retention rate, persistence, and safety of adalimumab in a 9-year real-life cohort of inflammatory bowel disease patients. METHODS: In this observational, retrospective single-center study, all adult patients treated with adalimumab as the first- and second-line biological treatment for steroid-dependent or refractory inflammatory bowel disease between March 2008 and March 2017 were included...
October 17, 2018: Digestive Diseases and Sciences
Miquell Miller, Kim-Nhien Vu, Allison Zemek, Andrew Shelton, Cindy Kin
No abstract text is available yet for this article.
October 17, 2018: Digestive Diseases and Sciences
Sunanda Kane
Infliximab was the first FDA approved biologic for the treatment of Crohn's disease. Data for its use before and during pregnancy in both females and males have been increasing over the last decade, but most studies have had fewer than 100 patients and inconsistent comparison to healthy control outcomes. New data from the TREAT Safety Registry have a robust N of female and male patients exposed to infliximab with known birth outcomes from both academic and community settings. There does not appear to be any increase in adverse pregnancy outcomes from this population...
October 17, 2018: American Journal of Gastroenterology
Rumiko Tsuboi, Satohiro Matsumoto, Hiroyuki Miyatani, Hirosato Mashima
An 18-year-old man diagnosed with ileocolonic Crohn's disease with circumferential strictures of the ascending colon started treatment with mesalazine and subsequently underwent right hemicolectomy. After surgery, the patient was started on adalimumab, and the clinical course was favorable. Nine months postoperatively, colonoscopy revealed granular mucosa with circumferential and continuous involvement from the transverse colon down to the rectum, findings which resembled ulcerative colitis. Mesalazine allergy was suspected, and the inflammatory findings resolved after discontinuing mesalazine...
October 17, 2018: Internal Medicine
Rajkumar Cheluvappa
The appendix contains copious lymphoid tissue and is constantly exposed to gut flora. Appendicitis followed by appendectomy (AA), when done at a young age, prevents or significantly ameliorates inflammatory bowel diseases (IBDs) in later life. Inflammatory bowel disease comprises Crohn's disease and ulcerative colitis. Our unique murine AA model is the only existing experimental model of AA. Herein, the appendiceal pathology closely resembles the pathological features of human appendicitis. Our AA model protects against experimental colitis in an age-, bacteria- and antigen-dependent manner...
October 16, 2018: Inflammatory Bowel Diseases
Honggang Wang, Bota Cui, Qianqian Li, Xiao Ding, Pan Li, Ting Zhang, Xiaozhong Yang, Guozhong Ji, Faming Zhang
INTRODUCTION: Fecal microbiota transplantation (FMT) has been used as a potential treatment option for Crohn's disease (CD). However, there is still lack of safety and efficacy evidence based on large samples of CD undergoing FMT. This study aimed to evaluate the risk factors of adverse event (AE) in the long term and the efficacy of FMT in the short term for patients with CD. METHODS: FMT via mid-gut for mild to severe CD in a single center trial (NCT01793831) was performed from October 2012 to December 2016...
October 16, 2018: Advances in Therapy
Megan R Sanctuary, Rick H Huang, Ashleigh A Jones, Marisa E Luck, Carol M Aherne, Paul Jedlicka, Edwin F de Zoeten, Colm B Collins
Pro-inflammatory cytokine TNFα antagonizes regulatory T cell (Treg) suppressive function with a measurable reduction of IL-10 protein secretion. Tregs are critical to suppress excessive immune activation, particularly within the intestine where high antigenic loads elicit chronic subclinical immune activation. Employing a TNFα-driven murine inflammatory bowel disease (IBD) model (TNFΔARE/+ ), which mirrors the Treg expansion and transmural ileitis seen in Crohn's disease, we demonstrate that the TNFα-mediated loss of Treg suppressive function coincides with induction of a specific miRNA, miR-106a in both humans and mice, via NFκB promoter binding to suppress post-transcriptional regulation of IL-10 release...
October 16, 2018: Mucosal Immunology
Danijela Dejanovic, Annemarie Amtoft, Annika Loft
Graft-versus-host-disease (GVHD) following stem cell transplantation (SCT) is a common complication in patients that have undergone allogenic SCT but rare in recipients of autologous SCT. Gastro-intestinal tract (GIT)-GVHD can be difficult to diagnose due to non-specific symptoms such as fever, nausea, diarrhea, and vomiting; a histological confirmation is therefore required. Here, we present the findings of a whole-body 18 FDG PET/CT with extensive and multifocal involvement of the GIT in a patient that developed severe acute GVHD 93 days post autologous SCT for Hodgkin's lymphoma...
October 15, 2018: Diagnostics
Salvatore Oliva, Marina Aloi, Franca Viola, Saverio Mallardo, Fortunata Civitelli, Francesca Maccioni, Cesare Hassan, Paola Papoff, Salvatore Cucchiara, Stanley A Cohen
BACKGROUND & AIMS: Pan-enteric capsule endoscopy (PCE) is effective for assessment of small intestinal and colonic Crohn's disease (CD) in pediatric patients. We aimed to determine whether PCE can be used to monitor mucosal healing and deep remission, in a treat to target strategy for pediatric patients with CD. METHODS: We performed a prospective study of 48 children with a diagnosis of CD at a tertiary care pediatric gastroenterology unit; 46 patients were included in the final analysis...
October 13, 2018: Clinical Gastroenterology and Hepatology
Daniel S Tylee, Jiayin Sun, Jonathan L Hess, Muhammad A Tahir, Esha Sharma, Rainer Malik, Bradford B Worrall, Andrew J Levine, Jeremy J Martinson, Sergey Nejentsev, Doug Speed, Annegret Fischer, Eric Mick, Brian R Walker, Andrew Crawford, Struan F A Grant, Constantin Polychronakos, Jonathan P Bradfield, Patrick M A Sleiman, Hakon Hakonarson, Eva Ellinghaus, James T Elder, Lam C Tsoi, Richard C Trembath, Jonathan N Barker, Andre Franke, Abbas Dehghan, Stephen V Faraone, Stephen J Glatt
Individuals with psychiatric disorders have elevated rates of autoimmune comorbidity and altered immune signaling. It is unclear whether these altered immunological states have a shared genetic basis with those psychiatric disorders. The present study sought to use existing summary-level data from previous genome-wide association studies to determine if commonly varying single nucleotide polymorphisms are shared between psychiatric and immune-related phenotypes. We estimated heritability and examined pair-wise genetic correlations using the linkage disequilibrium score regression (LDSC) and heritability estimation from summary statistics methods...
October 16, 2018: American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics
Grażyna Cepuch, Agnieszka Kruszecka-Krówka, Agnieszka Gniadek, Marta Daszuta, Maria Kózka
Regardless of the phase, Crohn's disease, especially in the group of adolescents, may reduce the quality of life and prevent patients from fulfilling roles assigned to this stage of development. Aim of the study: The assessment of the quality of life and its potential predictors. Methods: The study included 65 people of both sexes with Crohn's disease aged from 13 to 18 years. The result of the evaluation of therapeutic effectiveness and the activity of the disease in the study group was below 150-220 CDAI points...
October 16, 2018: Anthropologischer Anzeiger; Bericht über die Biologisch-anthropologische Literatur
Sara Karimkhani, Vahid Chaleshi, Hedieh Balaii, Peyman Tarban, Mahyar Nourian, Shiva Irani, Shabnam Shahrokh, Hamid Asadzadeh Aghdaei, Amir Houshang Mohammad Alizadeh, Mohsen Norouzinia, Mohammad Reza Zali
Background: Inflammatory bowel diseases (IBDs), which include ulcerative colitis (UC) and Crohn's disease (CD), are inflammatory disorders that affect the gastrointestinal tract. A combination of inflammatory cytokines has an important role in IBD development. Genome-wide association studies have shown that polymorphisms in the interleukin-23R gene ( IL-23R ) increase susceptibility to IBD. The aim of this study was to investigate the IL-23R 3' UTR SNP to determine a potential association between genotype distribution and IBD...
October 2018: Reports of Biochemistry & Molecular Biology
Christopher Alexakis, Sonia Saxena, Vivek Chhaya, Elizabeth Cecil, Azeem Majeed, Richard Pollok
BACKGROUND: The impact of smoking at diagnosis and subsequent smoking cessation on clinical outcomes in Crohn's disease (CD) has not been evaluated in a population-based cohort. METHODS: Using a nationally representative clinical research database, we identified incident cases of CD between 2005 and 2014. We compared the following outcomes: overall corticosteroid (CS) use; flares requiring CS; CS dependency and intestinal surgery between smokers and non-smokers at time of CD diagnosis...
October 15, 2018: American Journal of Gastroenterology
Julie Aarestrup, Tine Jess, Camilla Jannie Kobylecki, Børge G Nordestgaard, Kristine H Allin
Background and Aims: Patients with inflammatory bowel disease have increased risks of cardiovascular diseases but the role of traditional and non-traditional cardiovascular risk factors remains unclear. We investigated if the cardiovascular risk profile differs between patients with inflammatory bowel disease and individuals in the general population. Methods: We included a population of 108,789 participants from The Copenhagen General Population Study of individuals of Danish descent aged 20-100 years...
October 13, 2018: Journal of Crohn's & Colitis
Stanley Cho, Elizabeth Spencer, Robert Hirten, Ari Grinspan, Marla C Dubinsky
OBJECTIVES: Recurrent Clostridium difficile infection (RCDI) increases morbidity and mortality in patients with inflammatory bowel disease (IBD). Fecal microbiota transplant (FMT) is known to be very effective for RCDI in non-IBD patients with cure rates up to 91%. The same success rates of FMT have not been reported in IBD patients with RCDI, and the data in pediatrics is limited. We aimed to determine the effectiveness of FMT for RCDI in established pediatric IBD patients. METHODS: We performed a retrospective chart review of pediatric patients with IBD and RCDI (≥3 episodes) who underwent FMT via colonoscopy at a tertiary care IBD center...
October 12, 2018: Journal of Pediatric Gastroenterology and Nutrition
Alejandro A Gru, Eli Williams, Jacqueline M Junkins-Hopkins
Iatrogenic lymphoproliferative disorders have been described in patients receiving immunosuppressive/immunomodulatory agents outside the transplantation setting. Novel biological agents such as TNF-α blockers and JAK-inhibitors have also proven to be effective in many disorders including rheumatoid arthritis, inflammatory bowel disease (ulcerative colitis and Crohn disease), psoriasis, and others. A significant dilemma exists in those lymphoproliferative disorders associated with immunosuppressants and rheumatologic conditions, that relies on whether the association of the process is with the medication or the underlying autoimmune condition...
October 12, 2018: American Journal of Surgical Pathology
Shigeru Oshima, Mamoru Watanabe
The introduction of anti-TNF antibody therapy has changed the course of treatment for Crohn's disease. However, the fundamental mechanism for the onset of Crohn's disease is still unknown, and the treatment strategy for this disease remains suboptimal. The assessment of the disease phenotype based on key environmental factors and genetic background may indicate options for the personalized treatment of Crohn's disease. In this issue of the JCI, Liu et al. show that consumption of tobacco and the mutation of ATG16L1T300A, a prevalent Crohn's disease susceptibility allele, drive defects in cells at the bottom of the intestinal crypt, the Paneth cells...
October 15, 2018: Journal of Clinical Investigation
Yuting Qian, Tingting Bai, Juanjuan Li, Yi Zang, Tong Li, Mingping Xie, Qi Wang, Lifu Wang, Ruizhe Shen
Objective: This study aimed at investigating the clinical value of magnetic-guided capsule endoscopy (MGCE) in the diagnosis of gastrointestinal diseases in minors. Methods: Eighty-four minor patients hospitalized in the pediatric department at Ruijin Hospital between June 2015 and January 2018 were enrolled for this study. Following bowel preparation, all patients underwent MGCE. The feasibility, safety, diagnostic yield, and sensitivity of MGCE were analyzed. Patients were followed up for more than 2 weeks...
2018: Gastroenterology Research and Practice
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