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Crohn* disease*

Wen-Guo Chen, Guo-Dong Shan, Hong Zhang, Ming Yang, Lin L, Min Yue, Guang-Wu Chen, Qing Gu, Hua-Tuo Zhu, Guo-Qiang Xu, Li-Hua Chen
The aim of the study was to evaluate the diagnostic and therapeutic value of double-balloon entoroscopy (DBE) in small bowel diseases (SBDs) in China.A retrospective review of 674 consecutive patients who underwent DBE between January 2007 and November 2015 was conducted. Patients were divided into 3 groups by age, young group (<45 years), middle-aged group (45-65 years), and elderly group (>65 years). Data were collected with regard to demographics, clinical, endoscopic findings, complications, diagnostic yield, and management...
October 2016: Medicine (Baltimore)
Katarzyna Sznurkowska, Anton Żawrocki, Jacek Sznurkowski, Maciej Zieliński, Piotr Landowski, Katarzyna Plata-Nazar, Ewa Iżycka-Świeszewska, Piotr Trzonkowski, Agnieszka Szlagatys-Sidorkiewicz, Barbara Kamińska
BACKGROUND/AIMS: To determine the proportion of T-regulatory cells (CD4(+)CD25(high)FOXP3(+) cells) in peripheral blood and the number of FOXP3(+) cells in intestinal mucosa of children with inflammatory bowel disease (IBD), and to verify whether these parameters correlate with the activity of the disease. MATERIAL AND METHODS: 24 patients newly diagnosed for IBD were included in the study: ulcerative colitis (UC; n = 13) and Crohn's disease (CD; n = 11). Seventeen healthy controls (HC) and 16 patients with irritable bowel syndrome (IBS) served as a control group for peripheral and intestinal Tregs assessment, respectively...
October 19, 2016: Immunological Investigations
Julian Panes, Vipul Jairath, Barrett G Levesque
Crohn's disease and ulcerative colitis are heterogeneous inflammatory bowel disease (IBD), and therapeutic requirements vary among patients. We have a limited capacity to predict disease progression for individual patients, so it is important that they are evaluated for presence of active disease when symptoms are mild or even absent, when patients are more likely to respond to new treatment interventions. It is then important to monitor responses to treatment, to quickly identify those therapies that are ineffective, modify or change therapy, and avoid disease complications...
October 14, 2016: Gastroenterology
Yang Tan, Xingxin Wu, Jing Sun, Wenjie Guo, Fangyuan Gong, Fenli Shao, Tao Tan, Yi Cao, Bingfeng Zheng, Yanhong Gu, Yang Sun, Qiang Xu
Interferon gamma (IFN-γ) signaling in T cells plays an important role in developing T helper 1 (Th1)-mediated inflammation. Selective regulation of IFN-γ signaling is an attractive strategy for treating Th1-mediated immune diseases. In this study, we aimed to explore possible means of targeting IFN-γ signaling by using small molecule compound. A synthetic small molecule FC9 was identified as it selectively inhibited IFN-γ signaling in T cells without suppressing interleukin 4 (IL-4) signaling. Furthermore, FC9 inhibited IFN-γ-induced Janus kinase 2 (JAK2) activation via competing with IFN-γ for binding to IFN-γ receptor 1 (IFN-γ R1)...
October 14, 2016: Biochemical Pharmacology
Mohammad A Khasawneh, Nicholas P McKenna, Zaid M Abdelsattar, Angela Johnson, Eric J Dozois, John H Pemberton, Kellie L Mathis
BACKGROUND: IPAA is the surgical treatment of choice for patients with ulcerative colitis. Limited data exist on how obesity impacts the ability of the surgeon to successfully create an IPAA. OBJECTIVE: We aimed to determine how BMI affects the ability to successfully complete the operation. DESIGN: This was a retrospective cohort study. SETTINGS: The study was conducted at a single tertiary care center. PATIENTS: We included all of the patients undergoing an IPAA for ulcerative colitis between January 2002 and August 2013 at our institution...
November 2016: Diseases of the Colon and Rectum
Phillip Minar, Kimberly Jackson, Yi-Ting Tsai, Michael J Rosen, Michael Northcutt, Marat Khodoun, Fred D Finkelman, Lee A Denson
BACKGROUND: We have previously shown that CD64 surface expression on circulating neutrophils is significantly elevated in children with newly diagnosed Crohn's disease (CD). Our primary aim was to investigate whether elevations in neutrophil CD64 in asymptomatic patients could be used to predict treatment failure during maintenance infliximab. METHODS: Pediatric CD subjects receiving maintenance infliximab in clinical remission (short pediatric CD activity index [shPCDAI] <15) were enrolled...
November 2016: Inflammatory Bowel Diseases
Jason K Hou, Christoph Gasche, Noam Z Drazin, Sarah Alandra Weaver, Orna G Ehrlich, Ridhima Oberai, Sophie Zapala, Corey A Siegel, Gil Melmed
BACKGROUND: Anemia is a common complication among patients with inflammatory bowel diseases (IBD) and is associated with high rates of IBD-related complications, resource utilization, and impaired quality of life. Despite practice guidelines for anemia in patients with IBD, gaps remain in the perceptions of anemia among health care providers. The aims of this study were to identify gaps in care and to develop a care pathway for anemia in patients with IBD. METHODS: The Crohn's & Colitis Foundation of America anemia care pathway was developed by a committee using principles of cognitive task analysis...
September 30, 2016: Inflammatory Bowel Diseases
Dana Duricova, Mathurin Fumery, Vito Annese, Peter L Lakatos, Laurent Peyrin-Biroulet, Corinne Gower-Rousseau
The incidence of Crohn's disease (CD) has been reported to increase. The aim of this review is to perform a comprehensive literature search of population-based studies focused on the natural history of paediatric-onset CD. A literature search of English and non-English language publications listed in the electronic database of MEDLINE (source PUBMED) and EMBASE from 1935 to 2016 was performed. Population-based studies or national cohorts reporting data on the short-term or long-term disease course of paediatric CD were included...
September 29, 2016: European Journal of Gastroenterology & Hepatology
Bindu Madhavi Mudduluru, Shalin Shah, Steven Shamah, Arun Swaminath
Tumor necrosis factor alpha (TNF alpha) antagonists are biologic agents used in the management of inflammatory conditions such as rheumatoid arthritis, seronegative spondyloarthropathies and inflammatory bowel disease. These agents have been recently shown to cause a syndrome called anti-TNF induced lupus (ATIL), a rare condition which has similar clinical manifestations to idiopathic systemic lupus erythematosus (SLE). Given that extra-intestinal manifestations of inflammatory bowel disease include arthritis, it can be difficult to separate arthritis due to underlying disease from drug-induced arthritis...
October 17, 2016: Postgraduate Medicine
Mackenzie L Lauro, Elizabeth A D'Ambrosio, Brian J Bahnson, Catherine Leimkuhler Grimes
Genetic mutations in the innate immune receptor nucleotide-binding oligomerization domain-containing 2 (Nod2) have demonstrated increased susceptibility to Crohn's disease, an inflammatory bowel disease which is hypothesized to be accompanied by changes in the gut microbiota. Nod2 responds to the presence of bacteria, specifically a fragment of the bacterial cell wall, muramyl dipeptide (MDP). The proposed site of this interaction is the leucine-rich repeat (LRR) domain. Surface plasmon resonance and molecular modeling were used to investigate the interaction of the LRR domain with MDP...
October 17, 2016: ACS Infectious Diseases
Lijun Du, John J Kim, Jinhua Shen, Ning Dai
The barrier function of the intestine is essential for maintaining the normal homeostasis of the gut and mucosal immune system. Abnormalities in intestinal barrier function expressed by increased intestinal permeability have long been observed in various gastrointestinal disorders such as Crohn's disease (CD), ulcerative colitis (UC), celiac disease, and irritable bowel syndrome (IBS). Imbalance of metabolizing junction proteins and mucosal inflammation contributes to intestinal hyperpermeability. Emerging studies exploring in vitro and in vivo model system demonstrate that Rho-associated coiled-coil containing protein kinase- (ROCK-) and myosin light chain kinase- (MLCK-) mediated pathways are involved in the regulation of intestinal permeability...
2016: Gastroenterology Research and Practice
Gwendalyn J Randolph, Shashi Bala, Jean-François Rahier, Michael W Johnson, Peter L Wang, ILKe Nalbantoglu, Laurent Dubuquoy, Amélie Chau, Benjamin Pariente, Alex Kartheuser, Bernd H Zinselmeyer, Jean-Frederic Colombel
Early pathological descriptions of Crohn disease (CD) argued for a potential defect in lymph transport; however, this concept has not been thoroughly investigated. In mice, poor healing in response to infection-induced tissue damage can cause hyperpermeable lymphatic collecting vessels in mesenteric adipose tissue that impair antigen and immune cell access to mesenteric lymph nodes (LNs), which normally sustain appropriate immunity. To investigate whether analogous changes might occur in human intestinal disease, we established a three-dimensional imaging approach to characterize the lymphatic vasculature in mesenteric tissue from controls or patients with CD...
October 13, 2016: American Journal of Pathology
Xiaolong Ge, Dong Hu, Yu Cao, Zhijian Liu, Chao Ding, Hongliang Tian, Jianfeng Gong, Weiming Zhu, Ning Li, Jieshou Li
BACKGROUND: Crohn's Disease (CD) is a chronic inflammatory disease accompanied by many complications, such as intra-abdominal abscess (IAA). A frequent problem in CD is the discrimination of fever caused by exacerbated bowel inflammation or IAA. METHODS: A total of 80 CD patients complaining with fever episodes were included prospectively. PCT, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell count (WBC) were evaluated on admission...
October 12, 2016: International Journal of Surgery
Tao Peng, Liming Dong, Zhihua Zhu, Jing Cui, Qian Li, Xin Li, Heshui Wu, Chunyou Wang, Zhiyong Yang
RATIONALE AND OBJECTIVES: Some deep pelvic abscesses are not accessible through anterior or lateral approaches because of the presence of organs and structures. The objective of this study was to assess the feasibility, safety, tolerability, and efficacy of a percutaneous presacral space approach by reviewing our clinical experience and the literature. MATERIALS AND METHODS: The outcomes of 12 patients, who have undergone computed tomography (CT)-guided percutaneous presacral space drainage, were retrospectively reviewed, including demographic, clinical, and morphological data in the medical records...
October 12, 2016: Academic Radiology
Yu Qi Qiao, Chen Wen Cai, Zhi Hua Ran
Inflammatory bowel disease (IBD) patients exhibit impaired control of the microbiome in the gut. "Dysbiosis" is commonly observed. A Western diet is a risk factor for the development of IBD but may have different effects on the gut microbiota in IBD and non-IBD individuals. Exclusive enteral nutrition (EEN) can induce remission in pediatric Crohn's disease (CD) with a decrease in gut microbiome diversity after EEN treatment. Although there are some theoretical benefits, the actual treatment effects of prebiotics and probiotics in IBD patients can vary...
October 15, 2016: Journal of Digestive Diseases
Matthew Weiser, Jeremy M Simon, Bharati Kochar, Adelaide Tovar, Jennifer W Israel, Adam Robinson, Gregory R Gipson, Matthew S Schaner, Hans H Herfarth, R Balfour Sartor, Dermot P B McGovern, Reza Rahbar, Timothy S Sadiq, Mark J Koruda, Terrence S Furey, Shehzad Z Sheikh
OBJECTIVE: The clinical presentation and course of Crohn's disease (CD) is highly variable. We sought to better understand the cellular and molecular mechanisms that guide this heterogeneity, and characterise the cellular processes associated with disease phenotypes. DESIGN: We examined both gene expression and gene regulation (chromatin accessibility) in non-inflamed colon tissue from a cohort of adult patients with CD and control patients. To support the generality of our findings, we analysed previously published expression data from a large cohort of treatment-naïve paediatric CD and control ileum...
October 14, 2016: Gut
Jordan Axelrad, Anuja Kriplani, Umut Ozbek, Noam Harpaz, Jean-Frederic Colombel, Steven Itzkowitz, Randall F Holcombe, Celina Ang
BACKGROUND: Inflammatory bowel disease (IBD), comprising Crohn disease and ulcerative colitis, is a risk factor for colorectal cancer (CRC). Chemotherapy toxicity may exacerbate IBD symptoms and vice versa, but data are limited. We evaluated chemotherapy tolerance and oncologic outcomes in patients with CRC with and without IBD. PATIENTS AND METHODS: Medical records of patients with CRC with and without IBD treated between 2008 and 2013 were reviewed. Where possible, patients were matched by age, sex, stage, and diagnosis year...
September 20, 2016: Clinical Colorectal Cancer
Arik Alper, Lucy Zhang, Dinesh S Pashankar
We aimed to examine correlation of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) with diagnosis of inflammatory bowel disease (IBD) and with clinical, endoscopic, histological and radiographic disease activity during follow-up. We reviewed charts of 135 children with IBD and correlated their ESR and CRP values with disease activity in various encounters over 5 years. Normal ESR and CRP values were observed in up to 28% of children with Crohn's disease and 42% of children with ulcerative colitis at diagnosis respectively...
October 12, 2016: Journal of Pediatric Gastroenterology and Nutrition
Gabriella Bröms, Fredrik Granath, Olof Stephansson, Helle Kieler
BACKGROUND: The inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC) have been associated with an increased risk of preterm birth. MATERIAL AND METHODS: We identified all 246 singleton preterm births among women with IBD between July 2006 and December 2010 as cases and an equal number of controls with IBD from the Swedish national health registers, matched by maternal age, parity and IBD diagnosis (CD/UC). From register data and medical charts, we obtained information on reproductive history, comorbidity, disease activity and drug treatment (corticosteroids, 5-aminosalicylates, sulfasalazine, thiopurines and anti-TNF) as risk factors for preterm birth...
December 2016: Scandinavian Journal of Gastroenterology
Kevin P Murphy, Patrick D McLaughlin, Maria Twomey, Vincent E Chan, Fiachra Moloney, Adrian J Fung, Faimee E Chan, Tafline Kao, Siobhan B O'Neill, Benjamin Watson, Owen J O'Connor, Michael M Maher
INTRODUCTION: We assess the ability of low-dose hybrid iterative reconstruction (IR) and 'pure' model-based IR (MBIR) images to maintain accurate Hounsfield unit (HU)-determined tissue characterization. METHODS: Standard-protocol (SP) and low-dose modified-protocol (MP) CTs were contemporaneously acquired in 34 Crohn's disease patients referred for CT. SP image reconstruction was via the manufacturer's recommendations (60% FBP, filtered back projection; 40% ASiR, Adaptive Statistical iterative Reconstruction; SP-ASiR40)...
October 13, 2016: Journal of Medical Imaging and Radiation Oncology
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