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Sample records for active ulcerative colitis

  1. Fecal calprotectin and ulcerative colitis endoscopic activity index as indicators of mucosal healing in ulcerative colitis.

    Taghvaei, Tarang; Maleki, Iradj; Nagshvar, Farshad; Fakheri, Hafez; Hosseini, Vahid; Valizadeh, Seyed Mohammad; Neishaboori, Hassan

    2015-04-01

    Ulcerative colitis (UC) is a chronic, idiopathic, inflammatory large bowel disease with recurrent variable periods of exacerbation. The aim of the current study is to evaluate the correlation of UCEIS with fecal calprotectin (FC) level to assess disease activity in UC patients in order to determine whether FC can prognosticate clinical outcome and disease activity of UC instead of colonoscopic evaluation. Our endoscopic investigations revealed the extension of UC as the following: proctitis (11.6%), procto-sigmoiditis (18.5%), left-sided colitis (15.8%), extensive colitis (11.7%), and normal endoscopy (42.4%). Conclusively, we suggest that FC can be used as a reliable tool to evaluate disease activity in ulcerative colitis patients. Moreover, our findings indicate a significant correlation between FC level and mucosal healing. PMID:25366383

  2. Fecal Calprotectin and Clinical Disease Activity in Pediatric Ulcerative Colitis

    Kaija-Leena Kolho; Dan Turner

    2013-01-01

    Objective. To explore fecal calprotectin levels in pediatric ulcerative colitis (UC) in relation with the validated clinical activity index PUCAI. Methods. This study included all 37 children (median age 14 years) with UC who had calprotectin measured (PhiCal ELISA Test) by the time of PUCAI assessment at the Children's Hospital of Helsinki in a total of 62 visits. Calprotectin values 1000  μ g/g). The best cut-off value for calprotectin for predicting poor outcome was 800  μ g/g (sensitivity...

  3. Topical Rosiglitazone Treatment Improves Ulcerative Colitis by Restoring Peroxisome Proliferator-Activated Receptor-gamma Activity

    Pedersen, G.; Brynskov, Jørn

    2010-01-01

    OBJECTIVES: Impaired epithelial expression of peroxisome proliferator-activated receptor-gamma (PPAR gamma) has been described in animal colitis models and briefly in patients with ulcerative colitis, but the functional significance in humans is not well defined. We examined PPAR gamma expression...

  4. HLA-DR expression and disease activity in ulcerative colitis

    Poulsen, L O; Elling, P; Sørensen, Flemming Brandt;

    1986-01-01

    In 12 patients with active ulcerative colitis (UC) the rectal epithelial cells were analyzed for HLA-DR antigens by an immunohistochemical technique. The clinical, rectoscopic, and histologic stages were also determined. The investigations were carried out at the beginning of the study and 2 weeks...... and 3 months later. The rectal epithelial cells were HLA-DR-positive in all patients at the first two examinations. After 3 months five patients had changed to an HLA-DR-negative stage, whereas the other seven patients remained HLA-DR-positive. Closer analyses showed that expression/nonexpression of...... HLA-DR antigens on rectal epithelial cells of patients with UC could not be predicted from the clinical, rectoscopic, or histologic findings. HLA-DR expression is normally restricted to immunocompetent cells. The presence of HLA-DR antigens on epithelial cells may be a consequence of immunological...

  5. Application of fecal calprotectin and myeloperoxidase in evaluation of disease activity of ulcerative colitis

    柏明见

    2013-01-01

    Objective To explore the clinical value of fecal calprotectin and myeloperoxidase in evaluation of ulcerative colitis(UC) activity.Methods Specimens of serum and feces over the same period were collected from

  6. Surgery for Crohn's Disease and Ulcerative Colitis

    ... Crohn's Disease & Ulcerative Colitis Go Back Surgery for Crohn's Disease & Ulcerative Colitis Email Print + Share ( Disclaimer: Surgery information ... helps you to learn what to expect. About Crohn’s disease and ulcerative colitis Crohn’s disease and ulcerative colitis ...

  7. Tofacitinib in ulcerative colitis.

    Archer, Thomas P; Moran, Gordon W; Ghosh, Subrata

    2016-05-01

    Cytokines orchestrate immune and inflammatory responses involved in the pathogenesis of ulcerative colitis (UC). Protein kinases are essential for signal transduction in eukaryotic cells. Janus kinases (JAKs) are a family of protein tyrosine kinases that play a pivotal role in cytokine receptor signaling. Indeed, a major subgroup of cytokines use Type I and II cytokine receptors which signal via the activation of JAKs. Tofacitinib is an oral JAK inhibitor that has been studied in autoimmune pathologies, including UC and rheumatoid arthritis with good overall efficacy and acceptable safety profile. This literature review was performed with the goal of summarizing the knowledge on JAK inhibitors in UC treatment. PMID:27140405

  8. Fecal Calprotectin and Clinical Disease Activity in Pediatric Ulcerative Colitis

    Kolho, Kaija-Leena; Turner, Dan

    2013-01-01

    Objective. To explore fecal calprotectin levels in pediatric ulcerative colitis (UC) in relation with the validated clinical activity index PUCAI. Methods. This study included all 37 children (median age 14 years) with UC who had calprotectin measured (PhiCal ELISA Test) by the time of PUCAI assessment at the Children's Hospital of Helsinki in a total of 62 visits. Calprotectin values 1000 μg/g). The best cut-off value for calprotectin for predicting poor outcome was 800 μg/g (sensitivity 73%, specificity 72%; area under the ROC curve being 0.71 (95%CI 0.57–0.85)) and for the PUCAI best cut-off values >10 (sensitivity 62%, specificity 64%; area under the ROC curve 0.714 (95%CI 0.58–0.85)). Conclusion. The clinical relevance of somewhat elevated calprotectin during clinical remission in pediatric UC is not known and, until further evidence accumulates, does not indicate therapy escalation. PMID:23533791

  9. Spontaneous colitis in Muc2-deficient mice reflects clinical and cellular features of active ulcerative colitis.

    Ulf A Wenzel

    Full Text Available The colonic mucus layer plays a critical role in intestinal homeostasis by limiting contact between luminal bacteria and the mucosal immune system. A defective mucus barrier in animal models allows bacterial contact with the intestinal epithelium and results in spontaneous colitis. A defective mucus barrier is also a key feature of active ulcerative colitis (UC. Alterations in the immune compartment due to intestinal bacterial breach in mice lacking the colon mucus barrier have not been characterized and correlated to active UC.To characterize alterations in the immune compartment due to intestinal bacterial breach in Muc2-/- mice, which lack the colon mucus barrier, and correlate the findings to active UC.Bacterial contact with colon epithelium and penetration into colon tissue was examined in Muc2-/- mice and colon biopsies from patients with active UC using fluorescence microscopy and qPCR. Neutrophils, lymphocytes, CD103+ dendritic cell subsets and macrophages in colon from Muc2-/- mice and biopsies from UC patients were quantitated by flow cytometry.Inflamed UC patients and Muc2-/- mice had bacteria in contact with the colon epithelium. Bacterial rRNA was present in colonic mucosa in humans and Muc2-/- mice and in the draining lymph nodes of mice. Inflamed Muc2-/- mice and UC patients had elevated colon neutrophils, T cells and macrophages while a reduced frequency of CD103+ DCs was present in the inflamed colon of both mice and humans.The parallel features of the colon immune cell compartment in Muc2-/- mice and UC patients supports the usefulness of this model to understand the early phase of spontaneous colitis and will provide insight into novel strategies to treat UC.

  10. Treatment of experimental ulcerative colitis.

    Lazebnik, L B; Lychkova, A E; Knyazev, O V

    2012-10-01

    The effects of infliximab, an anticytokine drug, on the course of inflammatory process was studied on the model of ulcerative colitis induced by injection of picrylsulfonic acid. Infliximab prevented the development of toxic dilatation and a drop of bioelectric activity of smooth muscles via maintenance of activity of the intramural nervous system neurons. PMID:23113311

  11. Plasma matrix metalloproteinase-1 and tissue inhibitor of metalloproteinases-1 as biomarkers of ulcerative colitis activity

    Wiercinska-Drapalo, Alicja; Jaroszewicz, Jerzy; Flisiak, Robert; Prokopowicz, Danuta

    2003-01-01

    AIM: Overexpression of mucosal metalloproteinases (MMP) have been demonstrated recently in inflammatory bowel disease. Their activity can be counterbalanced by the tissue inhibitor of metalloproteinases (TIMP). The aim of this study was to evaluate the effect of ulcerative colitis (UC) on MMP-1 and TIMP-1 plasma concentrations, as two possible biomarkers of the disease activity.

  12. Genetics Home Reference: ulcerative colitis

    ... my area? Other Names for This Condition colitis gravis idiopathic proctocolitis inflammatory bowel disease, ulcerative colitis type ... for professional medical care or advice. Users with questions about a personal health condition should consult with ...

  13. Ulcerative colitis in infancy

    Md Rukunuzzaman

    2011-01-01

    Full Text Available Ulcerative colitis (UC is a chronic idiopathic inflammatory disorder of colon. Frequency of UC is gradually increasing over few years worldwide. Prevalence is 35 to 100/100 000 people in USA, 1% of them are infants. UC develops in a genetically predisposed individual with altered intestinal immune response. An eight-month-old girl presented with loose bloody stool, growth failure, and moderate pallor. The girl was diagnosed as a case of UC by colonoscopy and biopsy. Treatment was thereafter started with immunosuppressive drugs. After initial induction therapy with parenteral steroid and infliximab, the patient is now on remission with azathioprine and mesalamine. UC is rare in Bangladesh, especially in children, and it is rarer during infancy. Several conditions like infective colitis, allergic colitis, Meckel′s diverticulitis, Crohn′s disease, etc. may mimic the features of UC. So, if a child presents with recurrent bloody diarrhea, UC should be considered as differential diagnosis.

  14. The economics of mesalazine in active ulcerative colitis and maintenance in the Netherlands

    Connolly, M. P.; Boersma, C.; Oldenburg, B.

    2012-01-01

    Background: In this study we investigate the costs and benefits of topical mesalazine combined with oral mesalazine therapy for active ulcerative colitis (UC), and once daily (OD) mesalazine 2 grams versus twice daily (BID) for maintaining UC remission. Methods: Two decision analytic models were con

  15. Attenuated apoptosis response to Fas-ligand in active ulcerative colitis

    Seidelin, Jakob B; Nielsen, Ole H

    2008-01-01

    From mainly carcinoma cell line studies, apoptosis has been thought to play a major role in the pathogenesis of ulcerative colitis (UC). Apoptosis has been suggested to be due to a Fas ligand / Fas receptor interaction, but has never been studied in cells from patients with active UC. The aim was...

  16. Attenuated apoptosis response to Fas-ligand in active ulcerative colitis

    Seidelin, J.B.; Nielsen, Ole Haagen

    2008-01-01

    BACKGROUND: From mainly carcinoma cell line studies, apoptosis has been thought to play a major role in the pathogenesis of ulcerative colitis (UC). Apoptosis has been suggested to be due to a Fas ligand / Fas receptor interaction, but has never been studied in cells from patients with active UC....

  17. Crohn's Disease and Ulcerative Colitis: Emotional Factors

    ... Ulcerative Colitis: Emotional Factors Q & A Go Back Crohn’s Disease and Ulcerative Colitis: Emotional Factors Q & A Email ... WHAT IS THE CAUSE OF ULCERATIVE COLITIS AND CROHN’S DISEASE? The origin of IBD is still unknown. It ...

  18. Ulcerative Colitis in Infancy

    Md Rukunuzzaman; A. S. M. Bazlul Karim

    2011-01-01

    Ulcerative colitis (UC) is a chronic idiopathic inflammatory disorder of colon. Frequency of UC is gradually increasing over few years worldwide. Prevalence is 35 to 100/100 000 people in USA, 1% of them are infants. UC develops in a genetically predisposed individual with altered intestinal immune response. An eight-month-old girl presented with loose bloody stool, growth failure, and moderate pallor. The girl was diagnosed as a case of UC by colonoscopy and biopsy. Treatment was thereafter ...

  19. Impaired sulphation of phenol by the colonic mucosa in quiescent and active ulcerative colitis.

    Ramakrishna, B S; Roberts-Thomson, I C; Pannall, P R; Roediger, W E

    1991-01-01

    Substantial amounts of phenols are produced in the human colon by bacterial fermentation of protein. In the colonic mucosa of animals, phenols are inactivated predominantly by conjugation with sulphate. The purpose of this study was to confirm sulphation of phenols by isolated colonocytes from man and to evaluate mucosal sulphation in inflammatory bowel disease using the phenol, paracetamol, in rectal dialysis bags. The incubation of paracetamol with colonocytes isolated from resected colon specimens (n = 7) yielded a mean (SE) value of 7.0 (0.9) mumols/g dry weight of paracetamol sulphate after 60 minutes but virtually undetectable values of paracetamol glucuronide. Paracetamol sulphate was detected in rectal dialysates from all control subjects, with a mean (SE) value of 4.2 (0.8) nmol/hour. Sulphation was significantly impaired (p less than 0.01) in 19 patients with active ulcerative colitis (0.6 (0.2) nmol/hour) and in 17 patients with ulcerative colitis in remission (1.1 (0.4) nmol/hour). Sulphation in eight patients with Crohn's colitis (4.3 (2.1) nmol/hour) was similar to that in control subjects. Impairment of the capacity of the mucosa to sulphate phenols in quiescent and active ulcerative colitis may pose a metabolic burden on colonic epithelial cells, which are continuously exposed to endogenous phenols from the colonic lumen. PMID:1991638

  20. Left Ventricular Thrombosis in Ulcerative Colitis

    Tarek Saleh

    2010-07-01

    Full Text Available Left ventricular thrombi usually occur in the setting of an acute myocardial infarction, left ventricular aneurysm, or dilated cardiomyopathy. In the absence of ventricular wall motion abnormalities, they are rare. This report describes a patient with ulcerative colitis in whom two-dimensional echocardiography revealed a left intraventricular mass. Thrombosis in ulcerative colitis is a serious condition and can occur in a very young population. This case also shows that left ventricular thrombi can occur in the active setting of ulcerative colitis.

  1. Nutritional follow-up of patients with ulcerative colitis during periods of intestinal inflammatory activity and remission

    Juliana Ripoli; Sender Jankiel Miszputen; Orlando Ambrogini Jr; Luciana de Carvalho

    2010-01-01

    CONTEXT: Ulcerative colitis is an inflammatory bowel disease involving superficial inflammation of the mucosa of the colon, rectum, and anus, sometimes including the terminal ileum. When in clinical activity, the disease is characterized by various daily evacuations containing blood, mucus and/or pus alternating periods of remission. OBJECTIVE: To compare nutritional parameters (dietary, biochemical and anthropometric) among patients with ulcerative colitis followed up on an outpatient basis ...

  2. Correlation between low bone density and disease activity in patients with ulcerative colitis.

    Amiriani, Taghi; Besharat, Sima; Pourramezan, Zahra; Mirkarimi, Honey Sadat; Aghaei, Mehrdad; Joshaghani, Hamidreza; Roshandel, Gholamreza; Faghani, Maryam; Besharat, Mahsa

    2015-01-01

    BACKGROUND Different clinical and epidemiological studies using dual-energy X-ray absorptiometry have shown an increased prevalence of low bone mineral density in patients with inflammatory bowel diseases. The aim of this study was to assess the correlation between bone density and the disease activity in patients with ulcerative colitis. METHODS In this cross-sectional study, 52 patients with ulcerative colitis (duration of the disease less than 5 years) were invited to our research center, Golestan province, northeast of Iran, during February 2012 up to August 2012. A demographic checklist and Simple Clinical Colitis Activity Index was completed for each patients and 5 cc of blood sample was taken after obtaining the informed consent. We used colorimetry method for measuring serum calcium, UV method for serum phosphorus and ELISA for serum vitamin D. Dual-energy X-ray absorptiometry was done to evaluate the bone density. Data analysis was done using SPSS software version 16. Normality of data was assessed using Kolmogorov- Smirnov test. T and ANOVA tests were used if data had normal distribution. Mann-Whitney U or Kruskal-Wallis tests were used for the remaining data. Correlation between qualitative variables was evaluated by Chi-square test. RESULTS The mean (±SD) age and disease activity of the patients were 37.72 (±12.18) years and 4.78 (±1.98), respectively. There were no correlation between disease activity and mean age. Low bone density was seen in 30.8%, 11.5%, and 15.4% in spine, femur neck, and hip, respectively. There was no relationship between Z-score of total hip, spine, and femur neck with disease activity, age, and duration of disease (p>0.05). CONCLUSION Our results showed an acceptable rate of low bone density in patients with ulcerative colitis without any correlation with the disease activity index. PMID:25628850

  3. Correlation Between Low Bone Density and Disease Activity in Patients with Ulcerative Colitis

    Amiriani, Taghi; Besharat, Sima; Pourramezan, Zahra; Mirkarimi, Honey Sadat; Aghaei, Mehrdad; Joshaghani, Hamidreza; Roshandel, Gholamreza; Faghani, Maryam; Besharat, Mahsa

    2015-01-01

    BACKGROUND Different clinical and epidemiological studies using dual-energy X-ray absorptiometry have shown an increased prevalence of low bone mineral density in patients with inflammatory bowel diseases. The aim of this study was to assess the correlation between bone density and the disease activity in patients with ulcerative colitis. METHODS In this cross-sectional study, 52 patients with ulcerative colitis (duration of the disease less than 5 years) were invited to our research center, Golestan province, northeast of Iran, during February 2012 up to August 2012. A demographic checklist and Simple Clinical Colitis Activity Index was completed for each patients and 5 cc of blood sample was taken after obtaining the informed consent. We used colorimetry method for measuring serum calcium, UV method for serum phosphorus and ELISA for serum vitamin D. Dual-energy X-ray absorptiometry was done to evaluate the bone density. Data analysis was done using SPSS software version 16. Normality of data was assessed using Kolmogorov– Smirnov test. T and ANOVA tests were used if data had normal distribution. Mann-Whitney U or Kruskal-Wallis tests were used for the remaining data. Correlation between qualitative variables was evaluated by Chi-square test. RESULTS The mean (±SD) age and disease activity of the patients were 37.72 (±12.18) years and 4.78 (±1.98), respectively. There were no correlation between disease activity and mean age. Low bone density was seen in 30.8%, 11.5%, and 15.4% in spine, femur neck, and hip, respectively. There was no relationship between Z-score of total hip, spine, and femur neck with disease activity, age, and duration of disease (p>0.05). CONCLUSION Our results showed an acceptable rate of low bone density in patients with ulcerative colitis without any correlation with the disease activity index. PMID:25628850

  4. Assessment of the influence of the inflammatory process on the activation of blood platelets and morphological parameters in patients with ulcerative colitis (colitis ulcerosa

    Halina Kemona

    2011-04-01

    Full Text Available Ulcerative colitis (colitis ulcerosa is a non-specific inflammatory bowel disease of unknown etiology. The symptoms which are observed in the course of ulcerative colitis are: an increase in the number of leukocytes and blood platelets, an increase in the concentration of IL-6 and anemia. Blood platelets are the key element, linking the processes of hemostasis, inflammation and the repair of damaged tissues. Activation of blood platelets is connected with changes in their shape and the occurrence of the reaction of release. P-selectin appears on the surfaces of activated blood platelets and the concentration level of soluble P-selectin increases in the blood plasma. The aim of this study was to define whether the increased number of blood platelets in patients with ulcerative colitis accompanies changes in their activation and morphology. A total of 16 subjects with ulcerative colitis and 32 healthy subjects were studied. Mean platelet count, morphological parameters of platelets and MPC were measured using an ADVIA 120 hematology analyzer. Concentrations of sP-selectin and IL-6 in serum were marked by immunoassay (ELISA. MPC, concentration of sP-selectin and IL-6 were significantly higher in subjects with ulcerative colitis compared to those in the healthy group. There was a decrease of MPV in patients with ulcerative colitis, which is statistically significant. Chronic inflammation in patients with ulcerative colitis causes an increase in the number of blood platelets, a change in their morphology and activation. Decreased MPV value reflects activation and the role blood platelets play in the inflammatory process of the mucous membrane of the colon. A high concentration of sP-selectin, which is a marker of blood platelet activation, demonstrates their part in the inflammatory process. The increase in the concentration of sP-selectin correlated positively with the increase in concentration of IL-6. This is why it may be a useful marker

  5. Assessment of the influence of the inflammatory process on the activation of blood platelets and morphological parameters in patients with ulcerative colitis (colitis ulcerosa

    Beata Polińska

    2011-04-01

    Full Text Available Ulcerative colitis (colitis ulcerosa is a non-specific inflammatory bowel disease of unknown etiology. Thesymptoms which are observed in the course of ulcerative colitis are: an increase in the number of leukocytes andblood platelets, an increase in the concentration of IL-6 and anemia. Blood platelets are the key element, linkingthe processes of hemostasis, inflammation and the repair of damaged tissues. Activation of blood platelets is connectedwith changes in their shape and the occurrence of the reaction of release. P-selectin appears on the surfacesof activated blood platelets and the concentration level of soluble P-selectin increases in the blood plasma. The aimof this study was to define whether the increased number of blood platelets in patients with ulcerative colitisaccompanies changes in their activation and morphology. A total of 16 subjects with ulcerative colitis and 32healthy subjects were studied. Mean platelet count, morphological parameters of platelets and MPC were measuredusing an ADVIA 120 hematology analyzer. Concentrations of sP-selectin and IL-6 in serum were marked byimmunoassay (ELISA. MPC, concentration of sP-selectin and IL-6 were significantly higher in subjects with ulcerativecolitis compared to those in the healthy group. There was a decrease of MPV in patients with ulcerativecolitis, which is statistically significant. Chronic inflammation in patients with ulcerative colitis causes an increase inthe number of blood platelets, a change in their morphology and activation. Decreased MPV value reflects activationand the role blood platelets play in the inflammatory process of the mucous membrane of the colon. A highconcentration of sP-selectin, which is a marker of blood platelet activation, demonstrates their part in the inflammatoryprocess. The increase in the concentration of sP-selectin correlated positively with the increase in concentrationof IL-6. This is why it may be a useful marker of the activity of

  6. The correlation between fecal calprotectin, simple clinical colitis activity index and biochemical markers in ulcerative colitis during high-dose steroid treatment

    Theede, Klaus; Kiszka-Kanowitz, Marianne; Nielsen, Anette Mertz;

    2014-01-01

    OBJECTIVE: Monitoring active ulcerative colitis (UC) is essential for making correct and timely treatment decisions. The current monitoring is based on symptom scores and biochemical markers, among which the role of fecal calprotectin (FC) is debated. The aims were to assess the development in FC...

  7. Cholangiographic findings in ulcerative colitis

    Endoscopic retrograde cholangiography (ERC) was performed in 28 patients with hepatobiliary disease associated with ulcerative colitis. The films were reviewed and correlated with diagnoses at liver biopsy. Thirteen patients with extrahepatic as well as intrahepatic bile duct abnormalities had characteristic cholangiographic findings compatible with sclerosing cholangitis, together with cholangiocarcinoma in one patient. Six patients had intrahepatic bile duct involvement only, and the cholangiographic abnormalities differed from those of sclerosing cholangitis. In 5 of these patients cirrhosis of the liver was found at biopsy or clinically. The result indicates that in patients with hepatobiliary disease suggested in association with ulcerative colitis, ERC gives valuable information. (Auth.)

  8. Raised serum activity of phospholipase A2 immunochemically related to group II enzyme in inflammatory bowel disease: its correlation with disease activity of Crohn's disease and ulcerative colitis.

    Minami, T.; Tojo, H; Shinomura, Y; Tarui, S; Okamoto, M

    1992-01-01

    Calcium dependent phospholipase A2 activity in the mixed micelles of 1-palmitoyl-2-oleoyl-phosphatidylglycerol and cholate was measured in sera of 39 patients with Crohn's disease, 40 patients with ulcerative colitis, and 40 healthy controls. The phospholipase A2 activity was significantly raised in those sera of the patients with active Crohn's disease and those with moderate and severe ulcerative colitis. The major phospholipase A2 activity derived from the sera was separated into two peaks...

  9. A rare complication of ulcerative colitis: Pyoderma gangrenosum

    AKIN, Hatice Şule; Coşkun, Adil; KARATAY, Pınar; SAVK, Ekin; Yaşa, Mehmet Hadi

    2011-01-01

    Pyoderma gangrenosum is a rare inflammatory skin illness characterized by ulcers. It can be seen with unknown etiology or with some systemic disorders such as ulcerative colitis, Crohn's disease and monoclonal gammopathy. Ulcers may be seen as single or multiple. We present in this article a pyoderma gangrenosum case that occurred with the activation of ulcerative colitis. A 21-year-old male was admitted to our hospital with a one-month history of symptoms of bloody and mucoid defecation with...

  10. Management of pediatric ulcerative colitis

    Turner, Dan; Levine, Arie; Escher, Johanna C; Griffiths, Anne M; Russell, Richard K; Dignass, Axel; Dias, Jorge Amil; Bronsky, Jiri; Braegger, Christian P; Cucchiara, Salvatore; de Ridder, Lissy; Fagerberg, Ulrika L; Hussey, Séamus; Hugot, Jean-Pierre; Kolacek, Sanja; Kolho, Kaija Leena; Lionetti, Paolo; Paerregaard, Anders; Potapov, Alexander; Rintala, Risto; Serban, Daniela E; Staiano, Annamaria; Sweeny, Brian; Veerman, Gigi; Veres, Gabor; Wilson, David C; Ruemmele, Frank M

    2012-01-01

    Pediatric ulcerative colitis (UC) shares many features with adult-onset disease but there are some unique considerations; therefore, therapeutic approaches have to be adapted to these particular needs. We aimed to formulate guidelines for managing UC in children based on a systematic review (SR) of...

  11. Activation of nuclear factor kappaB in colonic mucosa from patients with collagenous and ulcerative colitis

    Jørgensen, V.L.; Perner, A.; Hansen, A.; Eugen-Olsen, J; Rask-Madsen, Jørgen; Andresen, L; Jørgensen, V L; Perner, A; Hansen, A; Rask-Madsen, J

    2005-01-01

    Expression of inducible nitric oxide synthase (iNOS) is greatly upregulated in the colonic mucosa of patients with collagenous and ulcerative colitis. As the transcription factor nuclear factor kappaB (NFkappaB) is a major inducer of iNOS gene expression, we compared activation and transcriptional...

  12. Adalimumab for induction of clinical remission in moderately to severely active ulcerative colitis: results of a randomised controlled trial

    W. Reinisch; W.J. Sandborn; D.W. Hommes; G. D'Haens; S. Hanauer; S. Schreiber; R. Panaccione; R.N. Fedorak; M.B. Tighe; B. Huang; W. Kampman; A. Lazar; R. Thakkar

    2011-01-01

    Objective The aim of this study was to assess the efficacy and safety of adalimumab (ADA), a recombinant human monoclonal antibody against tumour necrosis factor alpha (TNF), for the induction of clinical remission in anti-TNF naive patients with moderately to severely active ulcerative colitis. Met

  13. Rectal administration of d-alpha tocopherol for active ulcerative colitis: A preliminary report

    Seyed Amir Mirbagheri; Behtash Ghazi Nezami; Solmaz Assa; Mannan Hajimahmoodi

    2008-01-01

    AIM: To investigate the anti-oxidant and anti-neutrophil recruitment effects of rectal d-alpha (d-α) tocopherol administration on mild and moderately active ulcerative colitis (UC).METHODS: Fifteen patients with mild and moderately active ulcerative colitis were enrolled in an open-label study of d-α tocopherol enema (8000 U/d) for 12 wk. All patients were receiving concomitant therapy with 5-aminosalicylic acid derivatives (5-ASA) and/or immunomodulator medications. Endoscopic evaluation was performed at baseline and after 4th and 12th weeks. Disease activity was measured with the Mayo disease activity index (DAI) and remission was defined as DAI of≤2 with no blood in stool. Clinical response was defined as a DAI reduction of≥2.RESULTS: At the end of 12th week, the average DAI score significantly decreased compared to the beginning of the study (2.3±0.37 vs 8±0.48, P < 0.0001). One patient was withdrawn after 3 wk for being unavailable to follow-up. On the 4th week of therapy, 12 patients showed clinical response, 3 of whom (21.4%) achieving remission. After 12 wk, all 14 patients responded clinically to the therapy and remission was induced in 9 of them (64%). No patient reported adverse events or was hospitalized due to worsened disease activity.CONCLUSION: This preliminary report suggests that rectal d-α tocopherol may represent a novel therapy for mild and moderately active UC. The observed results might be due to the anti-inflammatory and anti-oxidative properties of vitamin E.

  14. Bacterial colonization of colonic crypt mucous gel and disease activity in ulcerative colitis.

    Rowan, Fiachra

    2012-02-01

    OBJECTIVE: To optimize total bacterial 16S rRNA quantification in microdissected colonic crypts in healthy controls and patients with ulcerative colitis (UC) and to characterize the findings with disease activity. BACKGROUND: Microscopic and molecular techniques have recently converged to allow bacterial enumeration in remote anatomic locations [eg, crypt-associated mucous gel (CAMG)]. The aims of this study were to combine laser capture microdissection (LCM) and 16S rRNA-based quantitative polymerase chain reaction (qPCR) to determine total bacterial copy number in CAMG both in health and in UC and to characterize the findings with disease activity. METHODS: LCM was used to microdissect CAMG from colonic mucosal biopsies from controls (n = 20) and patients with acute (n = 10) or subacute (n = 10) UC. Pan-bacterial 16S rRNA copy number per millimeter square in samples from 6 locations across the large bowel was obtained by qPCR using Desulfovibrio desulfuricans as a reference strain. Copy numbers were correlated with the UC disease activity index (UCDAI) and the simple clinical colitis activity index (SCCAI). RESULTS: Bacterial colonization of CAMG was detectable in all groups. Copy numbers were significantly reduced in acute UC. In subacute colitis, there was a positive correlation between copy number and UCDAI and SCCAI in the ascending, transverse and sigmoid colon. CONCLUSIONS: This study describes a sensitive method of quantitatively assessing bacterial colonization of the colonic CAMG. A positive correlation was found between CAMG bacterial load and subacute disease activity in UC, whereas detectable bacterial load was reduced in acute UC.

  15. Ciprofloxacin and probiotic Escherichia coli Nissle add-on treatment in active ulcerative colitis

    Petersen, Andreas Munk; Mirsepasi, Hengameh; Halkjær, Sofie Ingdam;

    2014-01-01

    BACKGROUND AND AIM: Ulcerative colitis (UC) is a chronic inflammatory bowel disease. The probiotic bacterium Escherichia coli Nissle 1917 (EcN) has been used to maintain and induce clinical remission in UC. Our aim was to test the effect of Ciprofloxacin and/or orally administered EcN as add-on to...

  16. Antiviral treatment in patients with cytomegalovirus positive ulcerative colitis

    Kadir; Ozturk

    2014-01-01

    Cytomegalovirus(CMV) is a common virus in patients with ulcerative colitis receiving immunosuppressive drugs. Many studies suggested that CMV infection is an exacerbating factor in patients with ulcerative colitis. The role of CMV in exacerbations of ulcerative colitis has been discussed. One of studies starting this discussion is an article entitled "CMV positive ulcerative colitis: A single center experience and literature review" by Kopylov et al. However, we think that there are some points that should be emphasized about the study. Especially, the small number of patients in the study has led to meaningless results. Large controlled prospective trials are needed to clarify the benefit of antiviral therapy for active ulcerative colitis patients.

  17. Turner Syndrome with Ulcerative Colitis

    Hyodo, Hiromi; TOMITA, Yuichiro; Hirai, Kohta; HIRAKAWA, Hitoshi; Ueno, Shigeru; Ishiguro, Hiroyuki

    2009-01-01

    Turner syndrome is a chromosomal disease frequently associated with autoimmune disorders including diabetes mellitus, thyroid disease and inflammatory bowel disease (IBD). Although the etiology of IBD has not been fully elucidated, genetic analysis has recently revealed several susceptibility genes. Recently, cases with Turner syndrome associated with IBD have been reported. We report here a 13-yr-old girl with Turner syndrome associated with ulcerative colitis. The patient was undergoing gro...

  18. Radiographical evaluation of ulcerative colitis

    Deepak, Parakkal; Bruining, David H.

    2014-01-01

    Radiographical modalities have become important diagnostic tools in cases of ulcerative colitis (UC). Imaging can be used non-invasively to determine the extent of involvement, severity of disease and to detect disease-related complications and extra-intestinal inflammatory bowel disease (IBD) manifestations. While abdominal X-rays and barium enemas still retain their relevance in specific clinical settings, the use of computed tomography enterography (CTE) or magnetic resonance enterography ...

  19. Current treatment of ulcerative colitis

    Johannes Meier; Andreas Sturm

    2011-01-01

    Ulcerative colitis (UC) is a chronic disease featuring recurrent inflammation of the colonic mucosa. The goal of medical treatment is to rapidly induce a steroid-free remission while at the same time preventing complications of the disease itself and its treatment. The choice of treatment depends on severity, localization and the course of the disease. For proctitis, topical therapy with 5-aminosalicylic acid (5-ASA) compounds is used. More extensive or severe disease should be treated with oral and local 5-ASA compounds and corticosteroids to induce remission. Patients who do not respond to this treatment require hospitalization. Intravenous steroids or, when refractory, calcineurin inhibitors (cyclosporine, tacrolimus), tumor necrosis factor-α antibodies (infliximab) or immunomodulators (azathioprine, 6-mercaptopurine) are then called for. Indications for emergency surgery include refractory toxic megacolon, perforation, and continuous severe colorectal bleeding. Close collaboration between gastroenterologist and surgeon is mandatory in order not to delay surgical therapy when needed. This article is intended to give a general, practice- orientated overview of the key issues in ulcerative colitis treatment. Recommendations are based on published consensus guidelines derived from national and international guidelines on the treatment of ulcerative colitis.

  20. Location and activity of ulcerative and Crohn's colitis by 111In leukocyte scan. A prospective comparison study

    A prospective blinded study comparing the 111In leukocyte scan to barium enema, colonoscopy, or surgery or a combination of these, was carried out in 15 patients (10 with active ulcerative colitis and 5 with active Crohn's colitis). Correlation of disease location to colonic regions between indium scan and other diagnostic studies was excellent in 11 instances, good in 2, and poor in 3. In 2 of the 3 studies where major disagreement occurred, the comparative barium enema was performed greater than 2 mo after the indium scan. Disease activity, estimated by the intensity of radionuclide uptake, was compared to clinical disease activity assessed by the Crohn's Disease Activity Index for both forms of colitis. The relative degree of inflammation estimated by the indium scan correlated well with the independent clinical assessment (correlation coefficient . 0.81). The indium 111 leukocyte scan appears to be an accurate, noninvasive method for assessing the extent and the severity of the inflammation in patients with acute ulcerative or Crohn's colitis

  1. Probiotics and prebiotics in ulcerative colitis.

    Derikx, Lauranne A A P; Dieleman, Levinus A; Hoentjen, Frank

    2016-02-01

    The intestinal microbiota is one of the key players in the etiology of ulcerative colitis. Manipulation of this microflora with probiotics and prebiotics is an attractive strategy in the management of ulcerative colitis. Several intervention studies for both the induction and maintenance of remission in ulcerative colitis patients have been performed. Most of these studies evaluated VSL#3 or E. Coli Nissle 1917 and in general there is evidence for efficacy of these agents for induction and maintenance of remission. However, studies are frequently underpowered, lack a control group, and are very heterogeneous investigating different probiotic strains in different study populations. The absence of well-powered robust randomized placebo-controlled trials impedes the widespread use of probiotics and prebiotics in ulcerative colitis. However, given the promising results that are currently available, probiotics and prebiotics may find their way to the treatment algorithm for ulcerative colitis in the near future. PMID:27048897

  2. Faecal mucus degrading glycosidases in ulcerative colitis and Crohn's disease.

    Rhodes, J M; Gallimore, R; Elias, E; Allan, R N; Kennedy, J F

    1985-08-01

    Because the normal faecal flora includes bacteria which can produce mucus-digesting glycosidases, it follows that increased digestion of colonic mucus by these bacterial enzymes could be important in the pathogenesis of ulcerative colitis. Faecal activities of potential mucus-degrading glycosidases have therefore been assayed in samples from patients with inflammatory bowel disease and normal controls. The enzymes alpha-D-galactosidase, beta-D-galactosidase, beta-NAc-D-glucosaminidase alpha-L-fucosidase and neuraminidase were assayed. Considerable glycosidase activity was present in most faecal samples. Similar activities of all the enzymes assayed were found in faeces from patients with ulcerative colitis, Crohn's disease and normal controls and there was no significant correlation with disease activity. These results imply that relapse of ulcerative colitis is not initiated by increased degradation of colonic mucus by faecal glycosidases but do not exclude a role for bacterial mucus degradation in the pathogenesis of ulcerative colitis. PMID:2991089

  3. Clinical value of fecal calprotectin in determining disease activity of ulcerative colitis

    Jun-Ying Xiang; Qin Ouyang; Guo-Dong Li; Nan-Ping Xiao

    2008-01-01

    AIM:To investigate possibility and clinical application of fecal calprotectin in determining disease activity of ulcerative colitis (UC).METHODS: The enzyme-linked immunosorbent assay(ELISA) was used to measure the concentrations of calprotectin in feces obtained from 66 patients with UC and 20 controls. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), acid glycoprotein (AGP) were also measured and were compared with calprotectin in determining disease activity of UC. The disease activity of UC was also determined by the Sutherland criteria.RESULTS: The fecal calprotectin concentration in the patients with active UC was significantly higher than that in the inactive UC and in the controls (402.16±48.0 μg/g vs 35.93±3.39 μg/g, 11.5±3.42 μg/g, P < 0.01). The fecal calprotectin concentration in the inactive UC group was significantly higher than that in the control group (P < 0.05). A significant difference was also found in the patients with active UC of mild, moderate and severe degrees. The area under the curve of the receiver operating characteristics (AUCROC) was 0.975, 0.740, 0.692 and 0.737 for fecal calprotectin, CRP, ESR and AGP,respectively. There was a strong correlation between the fecal calprotectin concentration and the endoscopic gradings for UC (r = 0.866, P < 0.001).CONCLUSION: Calprotectin in the patient's feces can reflect the disease activity of UC and can be used as a rational fecal marker for intestinal inflammation in clinical practice. This kind of marker is relatively precise, simple and noninvasive when compared with other commonly-used markers such as CRP, ESR and AGR.

  4. Clinical value of fecal calprotectin in determining disease activity of ulcerative colitis

    Xiang, Jun-Ying; Ouyang, Qin; Li, Guo-Dong; Xiao, Nan-Ping

    2008-01-01

    AIM: To investigate possibility and clinical application of fecal calprotectin in determining disease activity of ulcerative colitis (UC). METHODS: The enzyme-linked immunosorbent assay (ELISA) was used to measure the concentrations of calprotectin in feces obtained from 66 patients with UC and 20 controls. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), acid glycoprotein (AGP) were also measured and were compared with calprotectin in determining disease activity of UC. The disease activity of UC was also determined by the Sutherland criteria. RESULTS: The fecal calprotectin concentration in the patients with active UC was significantly higher than that in the inactive UC and in the controls (402.16 ± 48.0 μg/g vs 35.93 ± 3.39 μg/g, 11.5 ± 3.42 μg/g, P < 0.01). The fecal calprotectin concentration in the inactive UC group was significantly higher than that in the control group (P < 0.05). A significant difference was also found in the patients with active UC of mild, moderate and severe degrees. The area under the curve of the receiver operating characteristics (AUCROC) was 0.975, 0.740, 0.692 and 0.737 for fecal calprotectin, CRP, ESR and AGP, respectively. There was a strong correlation between the fecal calprotectin concentration and the endoscopic gradings for UC (r = 0.866, P < 0.001). CONCLUSION: Calprotectin in the patient’s feces can reflect the disease activity of UC and can be used as a rational fecal marker for intestinal inflammation in clinical practice. This kind of marker is relatively precise, simple and noninvasive when compared with other commonly-used markers such as CRP, ESR and AGP. PMID:18176961

  5. Asymptomatic ulcerative colitis and pyoderma gangrenosum

    Nanda Arti

    1990-01-01

    Full Text Available A Total of 11 patients of pyoderma gangrenosum (PG; 5 males and 6 females were observed over 8 years. The ages ranged between 35-72 years. Nine patients were associated with ulcerative colitis, one with chronic renal failure, and one was labelled idiopathic. Three of the 9 patients of PG, who had ulcerative colitis presented first with skin lesions and had clinically silent, but acute, ulcerative colitis, diagnosed only after colonoscopy and rectal biopsy. This highlights the need for investigation including colonoscopy and biopsy even in asymptomatic patients of PG. Most of the cases benefitted from medical treatment (Corticosteroids + Salazopyrin.

  6. Intestinal microecology in rats with ulcerative colitis

    韩晓霞

    2013-01-01

    Objective To study the abundance and diversity ofthe gut flora in rats with dextran sulfate sodium(DSS)-induced ulcerative colitis(UC)to provide new knowledge about the pathogenesis of this disease.Methods Twenty-six

  7. PET/CT colonography: a novel non-invasive technique for assessment of extent and activity of ulcerative colitis

    Das, Chandan J.; Sharma, Raju [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India); Makharia, Govind K.; Tiwari, Rajeew P. [All India Institute of Medical Sciences, Department of Gastroenterology and Human Nutrition, New Delhi (India); Kumar, Rakesh; Kumar, Rajender; Malhotra, Arun [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India)

    2010-04-15

    Extent of involvement and activity of ulcerative colitis (UC) is best evaluated by colonoscopy. Colonoscopy however carries risk during acute exacerbation. We investigated the utility of PET/CT colonography for assessment of extent and activity of UC. Within a 1-week window, 15 patients with mild to moderately active UC underwent colonoscopy and PET/CT colonography 60 min after injection of 10 mCi of {sup 18}F-fluorodeoxyglucose (FDG). PET activity score based on the amount of FDG uptake and endoscopic mucosal activity in seven colonic segments of each patient was recorded. The mean maximum standardized uptake value (SUV{sub max}) of seven segments was compared with activity in liver. A PET activity grade of 0, 1, 2 or 3 was assigned to each region depending upon their SUV{sub max} ratio (colon segment to liver). The extent of disease was left-sided colitis in five and pancolitis in ten. The mean Ulcerative Colitis Disease Activity Index (UCDAI) was 7.6. The number of segments involved as per colonoscopic evaluation and PET/CT colonography was 67 and 66, respectively. There was a good correlation for extent evaluation between the two modalities (kappa 55.3%, p = 0.02). One patient had grade 0 PET activity, nine had grade 2 and five had grade 3 PET activity. In six patients, there was one to one correlation between PET activity grades with that of endoscopic grade. One patient showed activity in the sacroiliac joint suggesting active sacroiliitis. PET/CT colonography is a novel non-invasive technique for the assessment of extent and activity of the disease in patients with UC. (orig.)

  8. Desulfovibrio bacterial species are increased in ulcerative colitis.

    Rowan, Fiachra

    2012-02-01

    BACKGROUND: Debate persists regarding the role of Desulfovibrio subspecies in ulcerative colitis. Combined microscopic and molecular techniques enable this issue to be investigated by allowing precise enumeration of specific bacterial species within the colonic mucous gel. The aim of this study was to combine laser capture microdissection and quantitative polymerase chain reaction to determine Desulfovibrio copy number in crypt-associated mucous gel in health and in acute and chronic ulcerative colitis. METHODS: Colonic mucosal biopsies were harvested from healthy controls (n = 19) and patients with acute (n = 10) or chronic (n = 10) ulcerative colitis. Crypt-associated mucous gel was obtained by laser capture microdissection throughout the colon. Pan-bacterial 16S rRNA and Desulfovibrio copy number\\/mm were obtained by polymerase chain reaction at each locus. Bacterial copy numbers were interrogated for correlation with location and disease activity. Data were evaluated using a combination of ordinary linear methods and linear mixed-effects models to cater for multiple interactions. RESULTS: Desulfovibrio positivity was significantly increased in acute and chronic ulcerative colitis at multiple levels within the colon, and after normalization with total bacterial signal, the relative Desulfovibrio load was increased in acute colitis compared with controls. Desulfovibrio counts did not significantly correlate with age, disease duration, or disease activity but interlevel correlations were found in adjacent colonic segments in the healthy control and chronic ulcerative colitis groups. CONCLUSION: The presence of Desulfovibrio subspecies is increased in ulcerative colitis and the data presented suggest that these bacteria represent an increased percentage of the colonic microbiome in acute ulcerative colitis.

  9. Effect of probiotics on pro-inflammatory cytokines and NF-κB activation in ulcerative colitis

    Sahar; K; Hegazy; Mohamed; M; El-Bedewy

    2010-01-01

    AIM:To demonstrate the therapeutic effect of probiotics in patients with ulcerative colitis(UC),and their effect on inflammatory mediators and nuclear factor(NF)κB activation in these patients.METHODS:Thirty patients with mild to moderate UC were randomly classified into two groups:sulfasalazine group,who received sulfasalazine 2400 mg/d;and probiotic group,who received sulfasalazine 2400 mg/d with probiotic.The patients were investigated before and after 8 wk of treatment with probiotic(Lactobacillus delbr...

  10. Endoscopic findings can predict the efficacy of leukocytapheresis for steroid-naive patients with moderately active ulcerative colitis

    Yasushi Umehara; Masatoshi Kudo; Masanori Kawasaki

    2008-01-01

    AIM:To investigate the therapeutic usefulness of leukocytapheresis (LCAP;Cellsoba) in steroid-naive patients with moderately active ulcerative colitis (UC).METHODS:Eighteen steroid-naive patients with moderately active UC received one LCAP session every week for five consecutive weeks.RESULTS:The remission rate 8 weeks after the last LCAP session was 61.1% (11/18).All three patients with deep ulcers showed worsening after LCAP.For the remaining 15 patients,who had erosions or geographic ulcers,the average clinical activity index (CAI) score dropped significantly from 9.4 to 3.8eight weeks after the last LCAP session (t=4.89,P=0.001).The average C-reactive protein (CRP) levels before and after LCAP were 1.2 mg/dL and 1.0 mg/dL,respectively.Of the patients with erosions,geographic ulcers,and deep ulcers,100% (9/9),33.3% (2/6),and 0% (0/3) were in remission 8 weeks after the last LCAP session,respectively (x2=7.65,P < 0.005).Fortyeight weeks after the last LCAP session,the remission rates for patients with erosions and geographic ulcers were 44.4% (4/9) and 16.7% (1/6),respectively.Only one patient suffered a mild adverse event after LCAP (nausea).CONCLUSION:LCAP is a useful and safe therapy for steroid-naive UC patients with moderate disease activity.Moreover,the efficacy of the treatment can be predicted on the basis of endoscopic findings.

  11. Funcionalidad de la glicoproteína P linfocitaria en la colitis ulcerosa P-glycoprotein functional activity in peripheral blood lymphocytes in ulcerative colitis

    Catalina M. Cortada

    2009-10-01

    Full Text Available La glicoproteína gp-P, codificada por el MDR1 es una bomba de eflujo transmembrana capaz de movilizar una gran cantidad de fármacos de uso frecuente. Se expresa en la cara luminal del epitelio intestinal, en linfocitos y otros tejidos con función de barrera. MDR1 ha sido postulado como gen candidato en la colitis ulcerosa. El objetivo del presente trabajo fue evaluar la función de la gp-P en linfocitos aislados de sangre periférica de pacientes con colitis en actividad (n = 27 clasificados clínicamente como refractarios (n=16 o respondedores (n = 11 al tratamiento. Se estudió el eflujo de rodamina 123, sustrato de la glicoproteína P, en ausencia y presencia del inhibidor verapamilo (100 μM determinando la fluorescencia intracelular por citometría de flujo. Los resultados se expresaron evaluando el comportamiento de dos marcadores que corresponden al % de células que contienen máxima (M1/mínima (M2 concentración del colorante, reflejando inactividad/actividad de la bomba. Utilizando el test de Kruskal-Wallis y post test de Dunn, se observaron diferencias significativas entre refractarios versus respondedores (p P-glycoprotein (P-gp, encoded by MDR-1, is a transmembrane efflux pump that has been involved in relevant clinical drug transport. It is expressed in lymphocytes, luminal epithelium of colon and other tissues with barrier function. MDR1 was proposed as a candidate gene for ulcerative colitis. The aim of the present work was to investigate the role of P-gp in therapeutic response of ulcerative colitis by studying its functionality in lymphocytes isolated from peripheral blood. Samples were taken from 27 patients with active colitis classified clinically in refractory (n = 16 and responders (n = 11 to treatment. Rhodamine 123 (a fluorescent P-glycoprotein substrate efflux was studied by flow cytometry as absence and presence of an inhibitor (verapamil, 100 μM. Data were expressed evaluating the behaviour of two markers defined

  12. Management and treatment of distal ulcerative colitis

    Andrea Calafiore

    2013-12-01

    Full Text Available Ulcerative colitis (UC is a chronic inflammatory condition that is confined to the colonic mucosa. Its main symptoms include diarrhea, rectal bleeding and abdominal pain. Approximately two-thirds of UC patients have disease confined distal to the splenic flexure, which can be treated effectively with topical therapy. This means the active drug can be delivered directly to the site of inflammation, limiting the systemic absorption and potential side effects. Topical treatment with aminosalicylates is the most effective approach in the treatment of these forms, provided that the formulation reaches the upper margin of the disease. Given this, the suppository formulation is the treatment of choice for proctitis and distal sigmoiditis. Thanks to their proximal spread, enemas, foams and gels represent the treatment of choice for proctosigmoiditis and for distal ulcerative colitis. Oral aminosalicylates are less effective than topical therapies in patients with active disease, while the combination of topical and oral treatment is more effective in patients refractory to topical or oral mono-therapy. Topically administered aminosalicylates play an important role in the maintenance of remission, but the long-term adhesion to therapy is poor. For this reason, the oral formulation is the first-line therapy in the maintenance of remission. Refractory patients can be treated with topical steroids or systemic steroids and TNF-alpha inhibitors in severe forms.

  13. Golimumab in unresponsive ulcerative colitis

    Lippert E

    2014-05-01

    Full Text Available Elisabeth Lippert, Martina Müller, Claudia Ott University Hospital Regensburg, Department of Internal Medicine I, Regensburg, Germany Abstract: Ulcerative colitis (UC is a chronic inflammation mainly affecting the colon mucosa. It predominantly occurs in younger patients. Until recently, the main goals in the treatment of UC were to temper the symptoms, such as diarrhea, pain, and weight loss, by using mesalazine and steroids. With newer medications, such as immunomodulators (thiopurines and the biologics providing blockade of tumor necrosis factor (TNF, the goals of the therapy in UC have changed to long-term remission and mucosal healing. The first available anti-TNF therapy in UC included infusion therapy with infliximab every few weeks. In 2012, subcutaneously administered adalimumab gained approval for the treatment of UC in Germany. In patients with a mild disease, therapy with mesalazine, orally or topically, can be sufficient. In patients with moderate to severe disease, therapy with azathioprine or anti-TNF is often required to reach disease control; however, this is only efficient in about two-thirds of patients. Some patients either show no response or a lost response while on treatment. So, further medical options are warranted in the treatment of UC. With golimumab, a new approach in the treatment of mild to moderate UC recently became available in Germany and is a promising new option in the therapy regimen for patients with UC. Keywords: anti-TNF, biological therapy, inflammatory bowel disease

  14. Vedolizumab as induction and maintenance therapy for ulcerative colitis

    Feagan, Brian G; Rutgeerts, Paul; Sands, Bruce E;

    2013-01-01

    Gut-selective blockade of lymphocyte trafficking by vedolizumab may constitute effective treatment for ulcerative colitis.......Gut-selective blockade of lymphocyte trafficking by vedolizumab may constitute effective treatment for ulcerative colitis....

  15. Antiviral treatment in patients with cytomegalovirus positive ulcerative colitis

    Kadir OZTURK

    2014-01-01

    Cytomegalovirus (CMV) is a common virus in patients with ulcerative colitis receiving immunosuppressive drugs. Many studies suggested that CMV infection is an exacerbating factor in patients with ulcerative colitis. The role of CMV in exacerbations of ulcerative colitis has been discussed. One of studies starting this discussion is an article entitled “CMV positive ulcerative colitis: A single center experience and literature review” by Kopylov et al. However, we think that there are some poi...

  16. Characteristics and therapeutic efficacy of sulfasalazine in patients with mildly and moderately active ulcerative colitis

    Qi-Kui Chen; Zhong-Lin Yu; Shi-Zheng Yuan; Zhuo-Fu Wen; Ying-Qiang Zhong; Cu-Jun Li; Hui-Sheng Wu; Can-Rong Mai; Peng-Yan Xie; Yu-Min Lu

    2005-01-01

    AIM: To investigate the characteristics and short-term efficacy of sulfasalazine (SASP) in patients with mildly and moderately active ulcerative colitis (UC).METHODS: Two hundred and twenty-eight patients with mildly and moderately active UC were recruited, 106patients in 1993-1995, and 122 patients in 2000-2002,they were assigned as the 1990s group (n = 106) and the 2000s group (n = 122), prospectively. The general characteristics, clinical manifestations, colonoscopic and histological data were compared between the two groups.The short-term efficacy and safety of SASP 3 g per d were evaluated.RESULTS: Between 2000s and 1990s groups, the gender ratio of men to women was 1:1.18 and 1:1.04, 57.4%and 50.9% of the patients were between 30 and 49 years old. The gender ratio and age of UC patients were not significantly different. The total course of 50.0% and 37.1% of UC patients was less than 1 year (P<0.05), 10.6% and 31.2% of the cases had a duration of more than 5 years (P<0.05) in 2000s and 1990s groups, respectively. The most common clinical type was first episode in 2000s group and chronic relapse in 1990s group. The patients showed a higher frequency of abdominal pain and tenderness in 1990s group than in 2000s group. Erosions were found in 84.4% and 67.9% of patients in 2000s and 1990s groups (P<0.05). Rough and granular mucosa (67.9%vs43.4%, P<0.05)and polyps (47.2% vs 32.8%, P<0.05)were identified in 1990s group more than in 2000s group.There were no significant differences in clinical, colonoscopic and histological classifications. After SASP (1 g thrice per d) treatment for 6 wk, the clinical, colonoscopic and histological remission rates were 71.8%, 21.8% and 16.4%,respectively. In 79 patients with clinical remission, 58.2%and 67.1% remained grade 1 in colonoscopic and histological findings, respectively. The overall effects in first episode type (complete remission in 10, 18.9%, partial remission in 28, 52.8%, and improvement in 9, 17.0%) were

  17. Amyloid Goiter Secondary to Ulcerative Colitis

    Bunyamin Aydin

    2016-01-01

    Full Text Available Diffuse amyloid goiter (AG is an entity characterized by the deposition of amyloid in the thyroid gland. AG may be associated with either primary or secondary amyloidosis. Secondary amyloidosis is rarely caused by inflammatory bowel diseases. Secondary amyloidosis is relatively more common in the patients with Crohn’s disease, whereas it is highly rare in patients with ulcerative colitis. Diffuse amyloid goiter caused by ulcerative colitis is also a rare condition. In the presence of amyloid in the thyroid gland, medullary thyroid cancer should be kept in mind in the differential diagnosis. Imaging techniques and biochemical tests are not very helpful in the diagnosis of secondary amyloid goiter and the definitive diagnosis is established based on the histopathologic analysis and histochemical staining techniques. In this report, we present a 35-year-old male patient with diffuse amyloid goiter caused by secondary amyloidosis associated with ulcerative colitis.

  18. Amyloid Goiter Secondary to Ulcerative Colitis.

    Aydin, Bunyamin; Koca, Yavuz Savas; Koca, Tugba; Yildiz, Ihsan; Gerek Celikden, Sevda; Ciris, Metin

    2016-01-01

    Diffuse amyloid goiter (AG) is an entity characterized by the deposition of amyloid in the thyroid gland. AG may be associated with either primary or secondary amyloidosis. Secondary amyloidosis is rarely caused by inflammatory bowel diseases. Secondary amyloidosis is relatively more common in the patients with Crohn's disease, whereas it is highly rare in patients with ulcerative colitis. Diffuse amyloid goiter caused by ulcerative colitis is also a rare condition. In the presence of amyloid in the thyroid gland, medullary thyroid cancer should be kept in mind in the differential diagnosis. Imaging techniques and biochemical tests are not very helpful in the diagnosis of secondary amyloid goiter and the definitive diagnosis is established based on the histopathologic analysis and histochemical staining techniques. In this report, we present a 35-year-old male patient with diffuse amyloid goiter caused by secondary amyloidosis associated with ulcerative colitis. PMID:27051538

  19. Atypical disease phenotypes in pediatric ulcerative colitis

    Levine, Arie; de Bie, Charlotte I; Turner, Dan; Cucchiara, Salvatore; Sladek, Malgorzata; Murphy, M Stephen; Escher, Johanna C; Pærregaard, Anders

    2013-01-01

    Definitive diagnosis of pediatric ulcerative colitis (UC) may be particularly challenging since isolated colitis with overlapping features is common in pediatric Crohn's disease (CD), while atypical phenotypes of UC are not uncommon. The Paris classification allows more accurate phenotyping of...... atypical inflammatory bowel disease (IBD) patients. Our aim was to identify the prevalence of atypical disease patterns in new-onset pediatric UC using the Paris classification....

  20. Increased expression of T-cell KV1.3 and KCa3.1 channels in the inflamed intestinal wall from patients with active ulcerative colitis

    Hansen, Lars Koch; Larsen, Dorte; Sadda, Veeranjaneyulu; Nielsen, Gorm; Klinge, Lone; Schaffalitzky de Muckadell, Ove B.; Knudsen, Torben; Kjeldsen, Jens; Köhler, Ralf

    INTRODUCTION: T-cell KV1.3 and KCa3.1 channels have been proposed to be important effector proteins during T-cell activation and also in autoimmune disease by controlling T-cell motility, cytokine production, and proliferation. The role of KV1.3 channels in ulcerative colitis (UC) has not been...

  1. Ulcerative Colitis associated with Sclerosing Cholangitis and Autoimmune Hepatitis

    Hoduț Andrei

    2013-04-01

    Full Text Available Introduction: Ulcerative colitis is a chronic intestinal inflammation, part of inflammatory bowel disease, which also includes Crohn’s disease. Both have extraintestinal manifestations, but those that tend to occur more commonly with ulcerative colitis include chronic active hepatitis, pyoderma gangrenosum and ankylosing spondylitis. Many individuals present with overlapping non-diagnostic features of more than one of these conditions that is referred to in the literature as autoimmune overlap syndrome. Sclerosing cholangitis associated with IBD is often referred to as overlap syndrome.

  2. Manipulation of enteric flora in ulcerative colitis

    Mario Guslandi

    2005-01-01

    @@ TO THE EDITOR Reviewing the available therapeutic options in the medical treatment of ulcerative colitis, Xu et al.[1], have omitted to mention an important aspect in the pharmacological management of the disease, namely the possibility to promote clinical and endoscopic improvement by manipulating the enteric flora.

  3. Cerebral Arterial Thrombosis in Ulcerative Colitis

    Giovanni Casella

    2013-01-01

    Full Text Available Thrombosis, mainly venous, is a rare and well-recognized extraintestinal manifestation of inflammatory bowel disease (IBD. We describe a 25-year-old Caucasian man affected by ulcerative colitis and sclerosing cholangitis with an episode of right middle cerebral arterial thrombosis resolved by intraarterial thrombolysis. We perform a brief review of the International Literature.

  4. Anti-inflammatory activity of probiotic Bifidobacterium: Enhancement of IL-10 production in peripheral blood mononuclear cells from ulcerative colitis patients and inhibition of IL-8 secretion in HT-29 cells

    Imaoka, Akemi; Shima, Tatsuichiro; Kato, Kimitoshi; Mizuno, Shigeaki; Uehara, Toshiki; Matsumoto, Satoshi; Setoyama, Hiromi; Hara, Taeko; Umesaki, Yoshinori

    2008-01-01

    AIM: To determine the anti-inflammatory activity of probiotic Bifidobacteria in Bifidobacteria-fermented milk (BFM) which is effective against active ulcerative colitis (UC) and exacerbations of UC, and to explore the immunoregulatory mechanisms.

  5. Psychological status in Iranian patients with ulcerative colitis and its relation to disease activity and quality of life

    Mahshid Tabatabaeian

    2015-01-01

    Full Text Available Background: Psychological profile of inflammatory bowel disease patients is not well studied in Iran. We investigated the psychological status of Iranian patients with ulcerative colitis (UC and its relationship with disease activity and quality of life (QOL. Materials and Methods: A cross-sectional study was conducted on adult UC patients. The Lichtiger Colitis Activity Index, Hospital Anxiety and Depression Scale, General Health Questionnaire-12, and WHOQOL-BREF, were completed by the patients. Results: From 120 studied patients, 35 (29.2%, 48 (40.0%, and 46 (38.3% had significant anxiety, depression, and psychological distress, respectively. Anxiety, depression, and psychological distress were strongly correlated with disease activity (r = 0.357 to 0.439, P < 0.01. Disease activity was negatively correlated with all QOL dimensions (r = −0.245 to −0.550, P < 0.01. Anxiety, depression, and psychological distress were also negatively correlated with all QOL domains (r = −0.356 to −0.789, P < 0.01. In the regression models, anxiety was independently associated with active disease (β = 4.150, P = 0.049. Furthermore, disease activity was associated with the physical health (β = −0.371, P < 0.001. For almost all of the QOL domains, depression and psychological distress were independent predictors (β = −0.296 to −0.453, P < 0.001. Conclusion: Anxiety, depression, and psychological distress are highly frequent in UC patients of our society and are strongly associated with disease activity. Depression and psychological distress are important predictors of poor QOL in these patients. Further prospective studies, as well as clinical trials, are warranted in this regard.

  6. Update in the treatment of paediatric ulcerative colitis.

    Greifer, Melanie K; Markowitz, James F

    2006-10-01

    Ulcerative colitis is an important disease in the paediatric population. Ulcerative colitis is one of the chronic inflammatory bowel diseases, and is medically incurable. However, the arsenal of medications has grown as knowledge of the pathogenesis of this disease advances. This review looks at the classical treatments for children with ulcerative colitis, including the 5-aminosalicylates, corticosteroids and imunomodulators, as well as biological therapy and other, newer modalities. PMID:17020417

  7. Evaluation of dairy allergy among ulcerative colitis patients

    judaki, Arezo; Hafeziahmadi, Mohamadreza; Yousefi, Atefe; Havasian, Mohamad Reza; Panahi, Jafar; Sayehmiri, Koroush; Alizadeh, Sajjad

    2014-01-01

    The intestine is the largest mucosal organ of the body and also the first line immune homeostasis. Inflammatory bowel disease or IBD is divided into ulcerative colitis and Crohn's disease. One of the problems that can occur with UC is dietary allergy to some foods. This study aimed to evaluated the dairy allergy among patients with ulcerative colitis. This study is a Case - control study, that studied 72 patients with Ulcerative Colitis, after recording history of the disease, colonoscopy and...

  8. Quality of life in patients with ulcerative colitis treated surgically

    Kozłowska, Katarzyna A.; Bączyk, Grażyna; Krokowicz, Piotr

    2014-01-01

    Introduction Ulcerative colitis belongs to the group of inflammatory bowel diseases. The specific symptoms and chronic nature of the disease significantly affect the quality of patients’ lives. Quality-of-life assessment helps to define its determining factors as well as the efficiency of surgical procedures. Aim Quality-of-life evaluation of patients with ulcerative colitis treated surgically. Material and methods A retrospective review was carried out on 35 patients with ulcerative colitis,...

  9. The Serum S100B Level as a Biomarker of Enteroglial Activation in Patients with Ulcerative Colitis

    Asuman Celikbilek

    2014-01-01

    Full Text Available Objective. Recent studies have demonstrated that enteric glial cells (EGC participate in the homeostasis of the gastrointestinal tract. This study investigated whether enteroglial markers, including S100B protein and glial fibrillary acidic protein (GFAP, can serve as noninvasive indicators of EGC activation and disease activity in UC patients. Methods. This clinical prospective study included 35 patients with UC and 40 age- and sex-matched controls. The diagnosis of UC was based on standard clinical, radiological, endoscopic, and histological criteria. Clinical disease activity was evaluated using the Modified Truelove-Witts Severity Index. Serum samples were analyzed for human GFAP and S100B using commercial enzyme-linked immunosorbent assay kits. Results. GFAP was not detected in the serum of either UC patients or controls (P>0.05. However, we found a significant (P0.05. The serum S100B levels did not differ between UC patients with active disease (24 patients, 68.6% or in remission (11 patients, 31.4% (P>0.05. Conclusions. Ulcerative colitis patients had significantly lower serum S100B levels, while GFAP was of no diagnostic value in UC patients.

  10. Associations between diet and disease activity in ulcerative colitis patients using a novel method of data analysis

    Curno Richard

    2005-02-01

    Full Text Available Abstract Background The relapsing nature and varying geographical prevalence of ulcerative colitis (UC implicates environmental factors such as diet in its aetiology. Methods In order to determine which foods might be related to disease activity in UC a new method of dietary analysis was developed and applied. Eighty-one UC patients were recruited at all stages of the disease process. Following completion of a 7 d diet diary, clinical assessment including a sigmoidoscopic examination (scale 0 (normal mucosa to 6 (very active disease was conducted. Food weights for each person were adjusted (divided by the person's calorific intake for the week. Each food consumed was given a food sigmoidoscopy score (FSS calculated by summing the products of the (adjusted weight of food consumed and sigmoidoscopy score for each patient and occurrence of food and dividing by the total (adjusted weight of the food consumed by all 81 patients. Thus, foods eaten in large quantities by patients with very active disease have high FSSs and vice versa. Foods consumed by Results High FSS foods were characterized by high levels of the anti-thiamin additive sulfite (Mann-Whitney, p Conclusions The dietary analysis method described provides a new tool for establishing relationships between diet and disease and indicates a potentially therapeutic diet for UC.

  11. Leisure-time physical activity in Canadians living with Crohn disease and ulcerative colitis: population-based estimates.

    Mack, Diane E; Wilson, Philip M; Gilmore, Jennica C; Gunnell, Katie E

    2011-01-01

    The purpose of this study was to provide population-based estimates of leisure-time physical activity (LTPA) in Canadians diagnosed with Crohn disease (CD) or ulcerative colitis (UC). Data were derived from the Canadian Community Health Survey Cycle 3.1 (2005). Those diagnosed with CD (n = 474; 61.60% female) or UC (n = 637; 65.10% female) were compared with those not reporting CD/UC (n = 113,685; 53.60% female). The most prevalent forms of LTPA reported were walking and gardening/yard work. Individuals with CD were more likely to be classified as "inactive" (OR = 1.34; 95% CI [1.12, 1.61]) and less likely to be "active" (OR = 0.69; 95% CI [0.55, 0.87]) than those not reporting CD/UC. These trends were mirrored for those living with UC, although statistical significance was not attained. Despite claims advocating the benefits of LTPA for ameliorating complications associated with CD/UC, prevalence estimates from a population-based sample of Canadians living with CD/UC suggest that the majority do not meet current public health guidelines. Results offer benchmarks for prevalence of LTPA in those diagnosed with CD/UC. Findings suggest that many living with this condition will not benefit from the protective role of LTPA on complications associated with CD/UC. PMID:21814062

  12. Dr.Dong Demao's Experience in Treating Chronic Ulcerative Colitis

    徐凌云

    2004-01-01

    @@ Chronic ulcerative colitis (chronic non-specific ulcerative colitis) is a kind of non-specific inflammation occurred in the colonic mucosa layers. As a lingering and troublesome condition that often attacks people aged 20-40, it is characterized by recurrent diarrhea, abdominal pain, pus- and mucus-stained stools in clinic.

  13. Controlled trial of azathioprine in chronic ulcerative colitis.

    Kirk, A P; Lennard-Jones, J E

    1982-01-01

    A double-blind controlled trial of azathioprine in a dose of 2-2.5 mg/kg body weight over six months was conducted among 44 patients with active chronic ulcerative colitis. Three patients treated with placebo did not complete the trial because their disease became so severe that colectomy was performed. Among patients who completed the trial the mean dose of prednisolone necessary to control the disease decreased in those treated with azathioprine and those treated with placebo; the reduction...

  14. Diagnostic Value of Fecal Calprotectin in Patient with Ulcerative Colitis

    Zamani, Hamed; Barzin, Gilda; Yousefinia, Mahsa; Mohammadkhani, Ashraf; Ostovaneh, Mohammad Reza; Sharifi, Amir Houshang; Tayebi, Sirous; Malekzadeh, Reza; Ansari, Reza

    2013-01-01

    BACKGROUND Ulcerative colitis (UC) is characterized by recurrent episodes of inflammation limited to the mucosal layer of the colon. Calprotectin is a zinc and calcium binding protein derived from neutrophils and monocytes. It is easily detectable in tissue samples, body fluids, and stools, which makes it a potentially valuable marker of inflammation. The aim of the current study is to evaluate the value of fecal calprotectin (FC) as a marker of disease activity in patients with UC. METHODS S...

  15. Apparent change of Rhesus blood group typing in a case of ulcerative colitis.

    Tien, S L; Ong, Y W; Ng, H S

    1991-08-01

    An interesting case of ulcerative colitis with an apparent change of Rhesus blood group typing is described. To our knowledge, this has not been reported before. We postulate that during the initial active phase of ulcerative colitis, an unknown D-like antigen, possibly bacterial in origin, could temporarily give rise to a Rhesus D-positive blood group typing in a patient with Rhesus D-negative blood type. Interestingly, with continuous immunosuppressive therapy for ulcerative colitis, the patient did not develop anti-D antibodies despite multiple transfusions with D-positive blood. PMID:1776013

  16. Best practice in the management of mild-to-moderately active ulcerative colitis and achieving maintenance of remission using mesalazine

    Munkholm, P.; Michetti, P.; Probert, C.S.; Elkjaer, M.; Marteau, P.

    2010-01-01

    management from the patient perspective based on a range of clinical and patient-focused evidence. By highlighting patient preferences in disease management it is envisaged that this review will aid physicians to optimize treatment decisions with the different mesalazine preparations available. Eur J...... improve not only patient quality of life, and decrease the number harmed by adverse events from more potent drugs, but can also save valuable healthcare costs by avoiding high-cost treatment interventions associated with acute ulcerative colitis. This review will consider several elements of mesalazine...

  17. Turner Syndrome Associated with Ulcerative Colitis

    Takaya, Junji; Teraguchi, Masayuki; Ikemoto, Yumiko; Yoshimura, Ken; Yamato, Fumiko; Higashino, Hirohiko; Kobayashi, Yohnosuke; Kaneko, Kazunari

    2006-01-01

    We report the case of a 7-yr-old girl with Turner syndrome, ulcerative colitis (UC) and coarctation of the aorta. The diagnosis of Turner syndrome was made in early infancy (karyotype analysis 45, X). Growth hormone treatment was started at 3 yr and 2 mo of age. From the age of 4 yr and 5 mo, the patient suffered from persistent diarrhea with traces of blood and intermittent abdominal discomfort. As these symptoms gradually deteriorated, she was referred to our clinic at the age of 7 yr for f...

  18. Cellular and Molecular Immunopathogenesis of Ulcerative Colitis

    Suzhen Zhang; Xuhui Zhao; Dechun Zhang

    2006-01-01

    Ulcerative colitis (UC) is an inflammatory disease of the rectal and colonic mucosa and seems to result from a complex series of interactions between susceptibility genes, the environment and the immune system. Various components of the mucosal immune system are implicated in the immunopathogenesis of UC. Evidence from animal models also suggests that an altered immune response to the commensal microflora of the host plays a central role in the development of UC. So in this review, we elucidate the cells and molecules which are implicated in the immunopathogenesis of the disease from four aspects: antigens in the intestine, dendritic cells, toll like receptors and NF-κB in the UC.

  19. How does disease location affect acute phase reactants in ulcerative colitis?

    Serkan Ipek

    2015-07-01

    Conclusion: CRP, ESR, WBC, PLT counts and albumin levels are of limited value in determining disease activity in ulcerative colitis patients, especially in those with proctitis. [Int J Res Med Sci 2015; 3(7.000: 1589-1593

  20. Safety and efficacy of Profermin(R) to induce remission in ulcerative colitis

    Krag, Aleksander; Israelsen, Hans; von Ryberg, Bjørn;

    2012-01-01

    AIM: To test the efficacy and safety of Profermin(R) in inducing remission in patients with active ulcerative colitis (UC). METHODS: The study included 39 patients with mild to moderate UC defined as a Simple Clinical Colitis Activity Index (SCCAI) > 4 and < 12 (median: 7.5), who were treated ope...

  1. Nutritional follow-up of patients with ulcerative colitis during periods of intestinal inflammatory activity and remission

    Juliana Ripoli

    2010-03-01

    Full Text Available CONTEXT: Ulcerative colitis is an inflammatory bowel disease involving superficial inflammation of the mucosa of the colon, rectum, and anus, sometimes including the terminal ileum. When in clinical activity, the disease is characterized by various daily evacuations containing blood, mucus and/or pus alternating periods of remission. OBJECTIVE: To compare nutritional parameters (dietary, biochemical and anthropometric among patients with ulcerative colitis followed up on an outpatient basis over a period of 1 year and during periods of intestinal inflammatory activity and remission. METHODS: Sixty-five patients were studied over a period of 1 year and divided into two groups: group 1 with inflammatory disease activity (n = 24, and group 2 without disease activity (n = 41. Anthropometric measures, biochemical parameters, quantitative food intake, and qualitative food frequency were analyzed. RESULTS: A significant reduction in body mass index and weight and in the intake of energy, proteins, lipids, calcium, iron and phosphorus was observed in the group with inflammatory activity (group 1 when compared to the period of clinical remission. The most affected food groups were cereals, legumes, oils, and fats. In contrast, in group 2 significant differences in triceps and sub scapular skin fold thickness, total protein, hemoglobin and hematocrit were observed between the first and final visit. Calcium and vitamin B6 intake, as well as the consumption of legumes, meat and eggs, and sugar and sweets, was significantly higher than on the first visit. CONCLUSION: Patients with ulcerative colitis followed up on an outpatient basis tend to be well nourished. However, the nutritional aspects studied tend to worsen during the period of inflammatory disease activity.CONTEXTO: A retocolite ulcerativa inespecífica compreende uma das doenças inflamatórias intestinais, com características de inflamação superficial da mucosa do cólon, reto, ânus, podendo

  2. Efficacy and safety of granulocyte, monocyte/macrophage adsorptive in pediatric ulcerative colitis

    Ruuska, Tarja; Küster, Peter; Grahnquist, Lena; Lindgren, Fredrik; Wewer, Anne Vibeke

    2016-01-01

    AIM: To investigate efficacy and safety for granulocyte, monocyte apheresis in a population of pediatric patients with ulcerative colitis. METHODS: The ADAPT study was a prospective, open-label, multicenter study in pediatric patients with moderate, active ulcerative colitis with pediatric ulcerative colitis activity index (PUCAI) of 35-64. Patients received one weekly apheresis with Adacolumn® granulocyte, monocyte/macrophage adsorptive (GMA) apheresis over 5 consecutive weeks, optionally followed by up to 3 additional apheresis treatments over 3 consecutive weeks. The primary endpoint was the change in mean PUCAI between baseline and week 12; the secondary endpoint was improvement in PUCAI categorized as (Significant Improvement, PUCAI decrease of ≥ 35), Moderate Improvement (PUCAI decrease of 20 pediatric patients with moderate active Ulcerative Colitis. No new safety signals were reported. The present data contribute to considering GMA apheresis as a therapeutic option in pediatric patients having failed first line therapy. PMID:27158208

  3. Effect of glucocorticoids on rectal transport in normal subjects and patients with ulcerative colitis.

    Sandle, G I; Hayslett, J. P.; Binder, H J

    1986-01-01

    The acute effects of single pharmacological doses of glucocorticoid hormones on net electrolyte and water transport and electrical potential difference (pd) in the rectum was studied in control subjects and in patients with either active or inactive ulcerative colitis, using a dialysis technique. Compared with 17 control subjects, nine patients with active ulcerative colitis exhibited marked decreases in net sodium absorption and rectal pd, while these transport parameters were normal in six ...

  4. Golimumab for the treatment of ulcerative colitis

    Löwenberg M

    2014-03-01

    Full Text Available Mark Löwenberg,1 Nanne KH de Boer,2 Frank Hoentjen3 1Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands; 2Department of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, the Netherlands; 3Inflammatory Bowel Disease Center, Radboud University Medical Center, Nijmegen, the Netherlands Abstract: The introduction of therapeutic antibodies against tumor necrosis factor (TNF had a major impact on the treatment of ulcerative colitis (UC. Infliximab and adalimumab are powerful agents that are used for remission induction and maintenance therapy in UC and have an acceptable safety profile. However, a proportion of UC patients for whom therapy with anti-TNF agents is indicated fail or become intolerant to treatment with infliximab or adalimumab. Hence, there remains an unmet need for novel anti-TNF agents. Golimumab (Simponi®, a human anti-TNF antibody that is administered by monthly subcutaneous injections, is the most recently introduced TNF blocker for the treatment of UC. Here, we will discuss recent literature on clinical efficacy and safety of golimumab induction and maintenance treatment in patients with UC. Furthermore, we will discuss the positioning of golimumab for UC in current treatment algorithms. Keywords: ulcerative colitis, UC, antitumor necrosis factor, TNF, antibodies, golimumab

  5. Therapeutic Efficacy of pH-Dependent Release Formulation of Mesalazine on Active Ulcerative Colitis Resistant to Time-Dependent Release Formulation: Analysis of Fecal Calprotectin Concentration

    Kousaku Kawashima; Shunji Ishihara; Takafumi Yuki; Koji Onishi; Yoshinori Kushiyama; Hirofumi Fujishiro; Youichi Miyaoka; Mika Yuki; Yoshinori Komazawa; Takashi Tanimura; Hiroki Sonoyama; Yasumasa Tada; Ryusaku Kusunoki; Akihiko Oka; Nobuhiko Fukuba

    2014-01-01

    Purpose. Few reports have compared the clinical efficacy of a pH-dependent release formulation of mesalazine (pH-5-ASA) with a time-dependent release formulation (time-5-ASA). We examined whether pH-5-ASA is effective for active ulcerative colitis (UC) in patients resistant to time-5-ASA. Methods. We retrospectively and prospectively analyzed the efficacy of pH-5-ASA in mildly to moderately active UC patients in whom time-5-ASA did not successfully induce or maintain remission. The clinical e...

  6. Infliximab-associated alveolitis after treatment for severe left-sided ulcerative colitis.

    Veerappan, Sundaram G

    2012-02-01

    Here we describe a patient with ulcerative colitis who developed alveolitis after infliximab therapy. With earlier case reports of development of alveolitis in rheumatoid arthritis patients after infliximab infusion, the temporal relationship between the infliximab therapy and the development of alveolitis in this case, raises the possibility that the two might be causally related. With an increasing trend towards treating moderate to severely active ulcerative colitis patients with infliximab as a rescue therapy, clinicians should be aware of this potentially serious complication.

  7. Probiotics in the Management of Ulcerative Colitis.

    Chibbar, Richa; Dieleman, Levinus A

    2015-01-01

    Rapid progress has been made to understand the pathophysiology of inflammatory bowel diseases and to identify new treatments. Interaction of the gut microbiota on the host inflammatory response has suggested that alternative therapies, such as probiotics, might have a complementary role in treating and preventing disease flares. Multiple probiotics and their formulations have been studied for both the induction and maintenance of remission of ulcerative colitis (UC); however, mainly Escherichia coli Nissle 1917 and VSL#3 have been shown to provide significant benefits for the prevention and treatment of mild to moderate UC. Although these data are promising, there is still a paucity of robust, randomized-controlled trials to suggest that probiotics be utilized as part of a standard treatment regimen. With continued research and a movement toward carefully selected, individualized management based on an individual's specific microbiota composition and function, probiotics may become an integral part of tailored therapy for UC. PMID:26447965

  8. [Surgery of ulcerative colitis using ileoanal anastomosis].

    Utsunomiya, J; Oota, M; Matsumoto, M; Natori, H

    1985-09-01

    The ideal surgical treatment for ulcerative colitis is the ileoanal anastomosis (IAA), which, however, is not yet generally accepted as a practical procedure because of a suboptimal fecal function, frequent postoperative complications and technical difficulties. Based on one (U.) of the authors experiences on 36(34) polyposis and 19(12) colitis (paracentesis indicate the number of cases in (U.)'s previous appointment, Tokyo Medical and Dental University, 1977-1983). The practical procedure of IAA can be achieved by combining the following basic principles; a direct anastomosis of J-shape ileal pouch to the anal sphincteric mechanism, temporarily exclusion of the anastomosis by a loop-ileostomy, mucosectomy confined to the lower rectum leaving the short muscular cuff, and meticulous dissection of inflamed mucosa of the anal canal minimizing the damage to the internal sphincter which is achieved by the prone ano-abdominal approach. At elective operation, the procedure can be performed either as primary surgery or as the secondary following rectum preserving operation, in which, coeco-rectal anastomosis is advisable for preserving the ileocolic vessels that is helpful for J-pouch construction. In emergency surgical program, IAA is still be preserved as a final restructive surgery following colectomy with an open rectal exclusion or Turnbull' s total colonic exclusion. In this occasion, an ascendicostomy is advisable for preserving the ileocolic vessels. PMID:4088260

  9. Interleukin-6 induces S100A9 expression in colonic epithelial cells through STAT3 activation in experimental ulcerative colitis.

    Min Jeoung Lee

    Full Text Available BACKGROUND: Intestinal epithelium is essential for maintaining normal intestinal homeostasis; its breakdown leads to chronic inflammatory pathologies, such as inflammatory bowel diseases (IBDs. Although high concentrations of S100A9 protein and interleukin-6 (IL-6 are found in patients with IBD, the expression mechanism of S100A9 in colonic epithelial cells (CECs remains elusive. We investigated the role of IL-6 in S100A9 expression in CECs using a colitis model. METHODS: IL-6 and S100A9 expression, signal transducer and activator of transcription 3 (STAT3 phosphorylation, and infiltration of immune cells were analyzed in mice with dextran sulfate sodium (DSS-induced colitis. The effects of soluble gp130-Fc protein (sgp130Fc and S100A9 small interfering (si RNA (si-S100A9 on DSS-induced colitis were evaluated. The molecular mechanism of S100A9 expression was investigated in an IL-6-treated Caco-2 cell line using chromatin immunoprecipitation assays. RESULTS: IL-6 concentrations increased significantly in the colon tissues of DSS-treated mice. sgp130Fc or si-S100A9 administration to DSS-treated mice reduced granulocyte infiltration in CECs and induced the down-regulation of S100A9 and colitis disease activity. Treatment with STAT3 inhibitors upon IL-6 stimulation in the Caco-2 cell line demonstrated that IL-6 mediated S100A9 expression through STAT3 activation. Moreover, we found that phospho-STAT3 binds directly to the S100A9 promoter. S100A9 may recruit immune cells into inflamed colon tissues. CONCLUSIONS: Elevated S100A9 expression in CECs mediated by an IL-6/STAT3 signaling cascade may play an important role in the development of colitis.

  10. Mindfulness May Be Helpful for People with Ulcerative Colitis

    ... R S T U V W X Y Z Mindfulness May Be Helpful for People With Ulcerative Colitis Share: meditation_man_three_women.jpg © Jupiter Images Mindfulness-based stress reduction (MBSR), a type of meditation, ...

  11. Extraintestinal manifestations in Crohn's disease and ulcerative colitis

    Isene, Rune; Bernklev, Tomm; Høie, Ole;

    2015-01-01

    BACKGROUND: In chronic inflammatory bowel disease (IBD) (Crohn's disease [CD] and ulcerative colitis [UC]), symptoms from outside the gastrointestinal tract are frequently seen, and the joints, skin, eyes, and hepatobiliary area are the most usually affected sites (called extraintestinal...

  12. Clostridium difficile Infection Worsens the Prognosis of Ulcerative Colitis

    María E Negrón

    2014-01-01

    Full Text Available BACKGROUND: The impact of Clostridium difficile infections among ulcerative colitis (UC patients is well characterized. However, there is little knowledge regarding the association between C difficile infections and postoperative complications among UC patients.

  13. Pathogenesis and biomarkers of carcinogenesis in ulcerative colitis

    Thorsteinsdottir, Sigrun; Gudjonsson, Thorkell; Nielsen, Ole Haagen; Vainer, Ben; Seidelin, Jakob Benedict

    2011-01-01

    One of the most serious complications of ulcerative colitis is the development of colorectal cancer. Screening patients with ulcerative colitis by standard histological examination of random intestinal biopsy samples might be inefficient as a method of cancer surveillance. This Review focuses on...... the current understanding of the pathogenesis of ulcerative colitis-associated colorectal cancer and how this knowledge can be transferred into patient management to assist clinicians and pathologists in identifying patients with ulcerative colitis who have an increased risk of colorectal cancer....... Inflammation-driven mechanisms of DNA damage, including the generation and effects of reactive oxygen species, microsatellite instability, telomere shortening and chromosomal instability, are reviewed, as are the molecular responses to genomic stress. We also discuss how these mechanisms can be translated into...

  14. Ulcerative colitis Presenting as leukocytoclastic vasculitis of skin

    Sabiye Akbulut; Ersan Ozaslan; Firdevs Topal; Levent Albayrak; Burcak Kayhan; Cumali Efe

    2008-01-01

    A number of cutaneous changes are known to occur in the course of inflammatory bowel diseases (IBD),including pyoderma gangrenosum, erythema nodosum,perianal disease, erythematous eruptions, urticaria, and purpura. However, occurrence of skin manifestations prior to the development of ulcerative colitis is a rare occasion. Here, we report a case of ulcerative colitis associated with leukocytoclastic vasculitis in which the intestinal symptoms became overt 8 mo after the development of skin lesions.

  15. Acute respiratory distress syndrome associated with severe ulcerative colitis

    Shiho; Sagara; Yasuo; Horie; Yumiko; Anezaki; Hideaki; Miyazawa; Masahiro; Iizuka

    2010-01-01

    Various extraintestinal manifestations including pulmonary abnormalities have been reported in patients with ulcerative colitis. Acute respiratory distress syndrome (ARDS) is a serious and fatal pulmonary manifestation. We have experienced a 67-year-old male patient with ARDS associated with a severe type of ulcerative colitis (UC). Severe dyspnea symptoms occurred during the treatment of UC in a previous hospital and the patient was transferred to our hospital on June 27, 2007. Both blood and sputa culture...

  16. Randomised controlled trial of azathioprine withdrawal in ulcerative colitis.

    Hawthorne, A. B.; Logan, R. F.; Hawkey, C. J.; Foster, P. N.; Axon, A T; Swarbrick, E T; Scott, B B; Lennard-Jones, J E

    1992-01-01

    OBJECTIVE--To determine whether azathioprine can prevent relapse in ulcerative colitis. DESIGN--One year placebo controlled double blind trial of withdrawal or continuation of azathioprine. SETTING--Outpatient clinics of five hospitals. SUBJECTS--79 patients with ulcerative colitis who had been taking azathioprine for six months or more. Patients in full remission for two months or more (67), and patients with chronic low grade or corticosteroid dependent disease (12) were randomised separate...

  17. Temporal Comorbidity of Mental Disorder and Ulcerative Colitis

    Cawthorpe, David; Davidson, Marta

    2015-01-01

    The authors used physician diagnoses from Calgary, Alberta, for patient visits from fiscal years 1994 to 2009 for treatment of any presenting concern (763,449 patients) to identify 5113 patients with a diagnosis of ulcerative colitis, and found 4192 patients also had a diagnosis of a mental disorder. Patients with mental disorder had a significantly higher annual prevalence. The mental disorder grouping neuroses/depression was most likely to arise before diagnosis of ulcerative colitis.

  18. Crohn's disease and ulcerative colitis in the same patient.

    White, C.L.; Hamilton, S R; Diamond, M. P.; Cameron, J. L.

    1983-01-01

    A well documented case of a patient with both Crohn's disease and ulcerative colitis is presented. A 29 year old woman underwent resection of her terminal ileum and ascending colon for typical Crohn's disease with ileocolitis. Eleven years later, an ileoproctocolectomy was performed for typical ulcerative colitis involving the left colon. The resection specimen also showed evidence of colonic Crohn's disease near the anastomotic site. This unusual case shows that Crohn's disease and ulcerativ...

  19. Cerebral venous sinus thrombosis as presenting feature of ulcerative colitis.

    Ennaifer, R; Moussa, A; Mouelhi, L; Salem, M; Bouzaidi, S; Debbeche, R; Trabelsi, S; Najjar, T

    2009-01-01

    Thrombosis is a well recognized complication of inflammatory bowel disease that occurs in 1.3 to 6.4% of patients, however, cerebral vascular involvement is unusual. We present the case of a 16-year-old female in whom cerebral venous thrombosis was the presenting symptom of an active ulcerative pancolitis. Thrombophilia screen (plasma levels of proteins C and S, antithrombin, antibeta2-glycoprotein, lupus anticoagulant and anticardiolipin antibodies, activated protein C resistance, homocystein level antinuclear antibodies) was negative. The patient was successfully treated with anticoagulant therapy, phenobarbital and sulfasalazine. Cerebral venous thrombosis is an exceptional presenting feature of ulcerative colitis. Disease activity may play a major role in the occurrence of thrombosis. PMID:19902870

  20. Diagnostic Value of Fecal Calprotectin in Patient with Ulcerative Colitis

    Zamani, Hamed; Barzin, Gilda; Yousefinia, Mahsa; Mohammadkhani, Ashraf; Ostovaneh, Mohammad Reza; Sharifi, Amir Houshang; Tayebi, Sirous; Malekzadeh, Reza; Ansari, Reza

    2013-01-01

    BACKGROUND Ulcerative colitis (UC) is characterized by recurrent episodes of inflammation limited to the mucosal layer of the colon. Calprotectin is a zinc and calcium binding protein derived from neutrophils and monocytes. It is easily detectable in tissue samples, body fluids, and stools, which makes it a potentially valuable marker of inflammation. The aim of the current study is to evaluate the value of fecal calprotectin (FC) as a marker of disease activity in patients with UC. METHODS Seventy three eligible subjects underwent ileocolonoscopy and multiple biopsies were obtained from different parts of the colon and terminal ileum. All patients underwent blood and stool sampling as well as an interview to assess the disease severity utilizing ulcerative colitis activity index (UCAI), subjectively. The diagnostic value of the FC in comparison with Mayo disease activity index as the gold standard technique, was then evaluated. RESULTS Mean FC level increased linearly according to Mayo disease activity index (r=0.44, p 21.4 ng/ml was able to discriminate between active and inactive phases of UC according to Mayo disease activity index>2 with 72.3% sensitivity and 73.1% specificity. The combination of FC > 21.4 ng/ml and UCAI score of 7 had a 46.8% sensitivity and 88% specificity to diagnose Mayo disease activity index >2. Furthermore, FC level 2. PMID:24829673

  1. Treatment of severe steroid refractory ulcerative colitis

    Gert Van Assche; Séverine Vermeire; Paul Rutgeerts

    2008-01-01

    Although systemic steroids are highly efficacious in ulcerative colitis (UC),failure to respond to steroids sUll poses an important challenge to the surgeon and physician alike. Even if the life Lime risk of a fulminant UC flare is only 20%, this condition is potentially life threatening and should be managed in hospital. If patients fail 3 to 5 d of intravenous corticosteroids and optimal supportive care, they should be considered for any of three options: intravenous cyclosporine (2 mg/kg for 7 d, and serum level controlled),infliximab (5 mg/kg N,0-2-6 wk) or total colectomy.The choice between these three options is a medicalsurgical decision based on clinical signs, radiological and endoscopic findings and blood analysis (CRP, serum albumin).Between 65 and 85% of patients will initially respond to cyclosporine and avoid colectomy on the short term. Over 5 years only 50% of initial responders avoid colectomy and outcomes are better in patients naive to azathioprine (bridging strategy).The data on infliximab as a medical rescue in fulminant colitis are more limited although the efficacy of this anti tumor necrosis factor (TNF) monoclonal antibody has been demonstrated in a controlled trial. Controlled data on the comparative efficacy of cyclosporine and infliximab are not available at this moment. Both drugs are immunosuppressants and are used in combination with steroids and azathioprine, which infers a risk of serious, even fatal, opportunistic infections. Therefore,patients not responding to these agents within 5-7 d should be considered for colectomy and responders should be closely monitored for infections.

  2. Complement activation capacity in plasma before and during high-dose prednisolone treatment and tapering in exacerbations of Crohn's disease and ulcerative colitis

    Baatrup Gunnar

    2005-09-01

    Full Text Available Abstract Background Ulcerative colitis (UC and Crohn's disease (CD are characterized by intestinal inflammation mainly caused by a disturbance in the balance between cytokines and increased complement (C activation. Our aim was to evaluate possible associations between C activation capacity and prednisolone treatment. Methods Plasma from patients with exacerbations of UC (n = 18 or CD (n = 18 were collected before and during high dose prednisolone treatment (1 mg/kg body weight and tapering. Friedman's two way analysis of variance, Mann-Whitney U test and Wilcoxon signed-rank sum test were used Results Before treatment, plasma from CD patients showed significant elevations in all C-mediated analyses compared to the values obtained from 38 healthy controls (p Conclusion Our findings indicate that C activation capacity is up-regulated significantly in plasma from CD patients. The decreases observed after prednisolone treatment reflect a general down-regulation in immune activation.

  3. Colonic production of nitric oxide gas in ulcerative colitis, collagenous colitis and uninflamed bowel

    Perner, Anders; Lassen, Inge Nordgaard; Matzen, Peter;

    2002-01-01

    ulcerative colitis, 10 patients with collagenous colitis and 20 controls with uninflamed mucosa. METHODS: The tip of a Teflon tube was placed in the caecum during colonoscopy. Subsequently, argon was infused at a constant rate for 70-180 min. Argon and NO in gas sampled from the rectum were measured by...

  4. Optimal management of steroid-dependent ulcerative colitis

    Khan HMW

    2015-11-01

    Full Text Available Hafiz M Waqas Khan,1 Faisal Mehmood,1 Nabeel Khan2 1Department of Medicine, King Edward Medical University, Lahore, Pakistan; 2Section of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia VA Medical Center, Philadelphia, PA, USA Abstract: Ulcerative colitis (UC is a chronic inflammatory condition that is variable in both extent and severity of disease as well as response to therapy. Corticosteroids (CSs were the first drugs used in the management of UC and are still used for induction of remission. However, because of their extensive side-effect profile, they are not utilized for maintenance of remission. In view of this, CS-free remission has become an important end point while evaluating therapeutic agents used in the management of UC. This review highlights the results of various studies conducted to evaluate the efficacy of different medications to attain CS-free remission in the setting of active UC. The drugs reviewed include established agents such as thiopurines, methotrexate, infliximab, adalimumab, vedolizumab, golimumab, and newer experimental agents, and if all else fails, colectomy will be performed. The efficacy of these drugs is evaluated individually. Our aim is to provide a synopsis of the work done in this field to date. Keywords: ulcerative colitis, steroid dependent, thiopurines, MTX, adalimumab, infliximab

  5. Selective blockade of leukotriene production by a single dose of the FPL 64170XX 0.5% enema in active ulcerative colitis

    Kjeldsen, J; Laursen, L S; Hillingsø, Jens; Mertz-Nielsen, A; Bukhave, K; Rask-Madsen, J; Lauritsen, K

    1995-01-01

    5-Lipoxygenase products of arachidonic acid metabolism are thought to play a central role in the secondary amplification of the inflammatory response of several inflammatory diseases, including ulcerative colitis. FPL 64170XX is a selective inhibitor of the enzyme 5-lipoxygenase. Concentrations of...... containing 0.5% of FPL 64170XX. Repeated measures analysis of leukotriene B4, after adjusting for baseline, showed a significant treatment effect (P = 0.0014). The concentration of leukotriene B4 from rectal dialysates in patients receiving the active drug dropped to 15% (95% confidence interval 5-40%) of...... the placebo level in the second dialysis following administration of FPL 64170XX 0.5%. By contrast, prostaglanding E2 concentrations doubled (P = 0.0068) in patients receiving FPL 64170XX 0.5% with no change in the placebo group. These findings demonstrate that a single dose of FPL 64170XX 0.5% enema...

  6. Inherited determinants of Crohn's disease and ulcerative colitis phenotypes

    Cleynen, Isabelle; Boucher, Gabrielle; Jostins, Luke;

    2016-01-01

    BACKGROUND: Crohn's disease and ulcerative colitis are the two major forms of inflammatory bowel disease; treatment strategies have historically been determined by this binary categorisation. Genetic studies have identified 163 susceptibility loci for inflammatory bowel disease, mostly shared...... between Crohn's disease and ulcerative colitis. We undertook the largest genotype association study, to date, in widely used clinical subphenotypes of inflammatory bowel disease with the goal of further understanding the biological relations between diseases. METHODS: This study included patients from 49...... centres in 16 countries in Europe, North America, and Australasia. We applied the Montreal classification system of inflammatory bowel disease subphenotypes to 34,819 patients (19,713 with Crohn's disease, 14,683 with ulcerative colitis) genotyped on the Immunochip array. We tested for genotype...

  7. Hydrophobic adhesin of E coli in ulcerative colitis.

    Burke, D A; Axon, A T

    1988-01-01

    Pathogenic E coli have adhesive properties which are mirrored by an increase in their surface hydrophobicity. E coli isolated from patients with ulcerative colitis possess a mannose resistant adhesin similar to that found in pathogenic E coli. In this study 42 E coli isolates from patients with colitis have been compared with 15 from controls to assess hydrophobicity and cellular adherence. The salting out method and the buccal epithelial cell technique were used respectively. E coli isolated...

  8. Fulminant ulcerative colitis in late pregnancy and the puerperium.

    Anderson, J. B.; Turner, G. M.; Williamson, R C

    1987-01-01

    Four patients underwent emergency colectomy during pregnancy or the puerperium for complications of ulcerative proctocolitis. Three had inactive colitis at conception, while in the fourth the disease started during pregnancy. Three patients required subtotal colectomy and ileostomy for toxic dilatation during the third trimester or within 5 days of delivery, and the fourth underwent proctocolectomy postpartum for intractable colitis. There were no maternal deaths but 2 of 4 infants died. One ...

  9. Refractory ulcerative colitis and iatrogenic colorectal Kaposi's sarcoma.

    Girelli, C M; Serio, G; Rocca, E; Rocca, F

    2009-02-01

    Colorectal Kaposi's sarcoma, a human herpes virus-8 associated mesenchymal tumour, is exceedingly rare in human immunodeficiency virus-negative subjects and almost always reported in association with severe, refractory, inflammatory bowel disease. In this paper we report a case--the second from Italy--of a colorectal Kaposi's sarcoma in a human immunodeficiency virus-negative, heterosexual man with severe refractory ulcerative colitis. Kaposi's sarcoma developed after starting glucocorticosteroid therapy, supporting the theory that colorectal Kaposi's sarcoma associated with ulcerative colitis is iatrogenic. PMID:18054849

  10. [Neutrophilic dermatosis in ulcerative colitis occurring in advanced age].

    López Maldonado, M D; Calvo Catalá, J; Ronda Gasulla, A; Hortelano Martínez, E; Herrera Ballester, A; Febrer Bosch, I

    1994-08-01

    The Neutrophilic dermatosis (ND) is considered as an independent entity with diverse clinical manifestations among which there are: gangrenous pyoderma, nodous erythema, Sweets Syndrome, vesiculopustula eruptions associated to ulcerous colitis and intestinal short circuit syndrome with or without short circuit. Histologically, they are characterized by infiltration of polymorphonuclear neutrophils, generally at the dermic level, but also at the epidermic. They are usually associated to systemic diseases, especially to chronic intestinal inflammatory disease. Our aim was to describe two forms of clinical presentation of neutrophilic dermatosis: gangrenous pyoderma and vesiculopustula eruption, associated to ulcerous colitis starting at advances ages. PMID:7772690

  11. [Ulcerous colitis and infection with cytomegalovirus, herpes simplex virus and clostridium difficile].

    Arnold, C; von Sanden, S; Theilacker, C; Blum, H E

    2008-08-01

    The treatment of severe flares of ulcerative colitis is based on systemic corticosteroids, immunomodulators such as cyclosporine and azathioprine and in some cases TNF-alpha-antagonists, respectively. These immunosuppressed patients are susceptible for infectious pathogens. Here we report the case of a patient with a severe flare of ulcerative colitis that was first treated with systemic corticosteroids combined with immunomodulators and subsequent with infliximab. The patient then experienced an infection with Clostridium difficile and cytomegalovirus of the colon and a Herpes simplex esophagitis, respectively. After specific treatment the patient responded well to the immunosuppressive therapy. This case illustrates that infections have to be considered before systemic treatment of an acute flare of ulcerative colitis is instituted especially in the case of disease activation during immunosuppressive treatment. PMID:18759202

  12. A rare case of ulcerative colitis exacerbated by VZV infection.

    Nishimura, Satoshi; Yoshino, Takuya; Fujikawa, Yoshiki; Watanabe, Masaki; Yazumi, Shujiro

    2015-12-01

    A 16-years old man with severe ulcerative colitis (UC) was admitted to our hospital. After initiating treatment with corticosteroid for UC, chicken pox appeared. At the same time of appearance of chicken pox, the disease activity of UC was exacerbated. After initiating the treatment with acyclovir, both chicken pox and UC improved. Because colonoscopic findings revealed the remaining of moderately active UC, initiating the treatment with infliximab could induce clinical remission of UC without relapse of varicella-zoster virus (VZV) infection. This is a very rare case of UC with concomitant VZV infection. According to our report, the vaccination for VZV prior to immunosuppressive treatments would be necessary for VZV naïve patients with UC. PMID:26552918

  13. Lansoprazole-associated collagenous colitis: Diffuse mucosal cloudiness mimicking ulcerative colitis

    Mitsuro Chiba; Takeshi Sugawara; Haruhiko Tozawa; Hidehiko Tsuda; Toru Abe; Takuo Tokairin; Iwao Ono; Eriko Ushiyama

    2009-01-01

    There have only been a few reports on lansoprazoleassociated collagenous colitis. Colonic mucosa of collagenous colitis is known to be endoscopically normal. We present a case of collagenous colitis where the mucosa showed diffuse cloudiness mimicking ulcerative colitis. A 70-year-old woman developed watery diarrhea four to nine times a day. She had interstitial pneumonia at 67 and reflux esophagitis at 70 years. Lansoprazole 30 mg/d had been prescribed for reflux esophagitis for nearly 6 mo. Lansoprazole was withdrawn due to its possible side effect of diarrhea. Colonoscopy disclosed diffuse cloudiness of the mucosa which suggested ulcerative colitis. Consequently sulfasalazine 2 g/d was started. The patient's diarrhea dramatically disappeared on the following day. However, biopsy specimens showed subepithelial collagenous thickening and infiltration of inflammatory cells in the lamina propria, confirming the diagnosis of collagenous colitis. One month after sulfasalazine therapy was initiated, colonoscopic and histological abnormalities resolved completely. Five months later the diarrhea recurred. The findings on colonoscopy and histology were the same as before, confirming a diagnosis of collagenous colitis relapse. We found that the patient had begun to take lansoprazole again 3 mo ahead of the recent diarrhea. Withdrawal of lansoprazole promptly resolved the diarrhea. Endoscopic and histological abnormalities were also completely resolved, similar to the first episode. Retrospectively, the date of commencement of sulfasalazine and discontinuation of lansoprazole in the first episode was found to be the same. We conclude that this patient had lansoprazole-associated collagenous colitis.

  14. Emergency surgery of fulminant ulcerative colitis and toxic megacolon

    Natsikas B.

    2007-03-01

    Full Text Available SUMMARY Subtotal colectomy and ileostomy (SCI is now urgently used as the life-saving management of the severe, life - threatening, progressions in the course of ulcerative colitis (UC. PURPOSE. To evaluate the efficacy of SCI in patients with severe colitis, we reviewed our own experience in 12 patients with this condition. METHODS. Patients undergoing SCI included 6 males and 6 females aged 12 to 56 years (mean 35,8 years. The duration of the disease averaged 29 months (range 4 to 92 months. Three had had their disease less than 6 months. Eleven patients had total colitis and only one patient had left-sided colitis. Three patients endured a continuous course and in 9 the course was intermittent. All were anemic with protein concentration less than 5 gm/dl at the time of surgery. Five patients had fulminant colitis with severe hemorrhage and seven patients with pancolitis developed toxic megacolon with unrecognized perforation in one case preoperatively. All patients underwent an emergency SCI with either intrapelvic oversewing the rectum (7 patients or exteriorizing it as a mucus fistula (5 patients. One patient with toxic megacolon died in the first postoperative day because of uncontroled septic shock. The remainder 11 patients survived and later underwent rectectomy, anal mucosectomy and ileal pouch anal anastomosis (IPAA. CONCLUSION. SCI for patients with fulminant ulcerative colitis and toxic megacolon is a life-saving procedure which gives the chance for ileal pouch anal anastomosis (IPAA a second time. Key Words: Ulcerative colitis, fulminant colitis, toxic megacolon, subtotal colectomy.

  15. Sulfate-reducing bacteria colonize pouches formed for ulcerative colitis but not for familial adenomatous polyposis.

    Duffy, M

    2012-02-03

    PURPOSE: Ileal pouch-anal anastomosis remains the "gold standard" in surgical treatment of ulcerative colitis and familial adenomatous polyposis. Pouchitis occurs mainly in patients with a background of ulcerative colitis, although the reasons for this are unknown. The aim of this study was to characterize differences in pouch bacterial populations between ulcerative colitis and familial adenomatous pouches. METHODS: After ethical approval was obtained, fresh stool samples were collected from patients with ulcerative colitis pouches (n = 10), familial adenomatous polyposis (n = 7) pouches, and ulcerative colitis ileostomies (n = 8). Quantitative measurements of aerobic and anaerobic bacteria were performed. RESULTS: Sulfate-reducing bacteria were isolated from 80 percent (n = 8) of ulcerative colitis pouches. Sulfate-reducing bacteria were absent from familial adenomatous polyposis pouches and also from ulcerative colitis ileostomy effluent. Pouch Lactobacilli, Bifidobacterium, Bacteroides sp, and Clostridium perfringens counts were increased relative to ileostomy counts in patients with ulcerative colitis. Total pouch enterococci and coliform counts were also increased relative to ileostomy levels. There were no significant quantitative or qualitative differences between pouch types when these bacteria were evaluated. CONCLUSIONS: Sulfate-reducing bacteria are exclusive to patients with a background of ulcerative colitis. Not all ulcerative colitis pouches harbor sulfate-reducing bacteria because two ulcerative colitis pouches in this study were free of the latter. They are not present in familial adenomatous polyposis pouches or in ileostomy effluent collected from patients with ulcerative colitis. Total bacterial counts increase in ulcerative colitis pouches after stoma closure. Levels of Lactobacilli, Bifidobacterium, Bacteroides sp, Clostridium perfringens, enterococci, and coliforms were similar in both pouch groups. Because sulfate-reducing bacteria are

  16. Therapeutic Efficacy of pH-Dependent Release Formulation of Mesalazine on Active Ulcerative Colitis Resistant to Time-Dependent Release Formulation: Analysis of Fecal Calprotectin Concentration

    Kawashima, Kousaku; Ishihara, Shunji; Yuki, Takafumi; Onishi, Koji; Kushiyama, Yoshinori; Miyaoka, Youichi; Yuki, Mika; Komazawa, Yoshinori; Tanimura, Takashi; Sonoyama, Hiroki; Tada, Yasumasa; Kusunoki, Ryusaku; Fukuba, Nobuhiko; Oshima, Naoki; Moriyama, Ichiro; Kinoshita, Yoshikazu

    2014-01-01

    Purpose. Few reports have compared the clinical efficacy of a pH-dependent release formulation of mesalazine (pH-5-ASA) with a time-dependent release formulation (time-5-ASA). We examined whether pH-5-ASA is effective for active ulcerative colitis (UC) in patients resistant to time-5-ASA. Methods. We retrospectively and prospectively analyzed the efficacy of pH-5-ASA in mildly to moderately active UC patients in whom time-5-ASA did not successfully induce or maintain remission. The clinical efficacy of pH-5-ASA was assessed by clinical activity index (CAI) before and after switching from time-5-ASA. In addition, the efficacy of pH-5-ASA on mucosal healing (MH) was evaluated in a prospective manner by measuring fecal calprotectin concentration. Results. Thirty patients were analyzed in a retrospective manner. CAI was significantly reduced at both 4 and 8 weeks after switching to pH-5-ASA. In the prospective study (n = 14), administration of pH-5-ASA also significantly reduced CAI scores at 4 and 8 weeks in these patients who were resistant to time-5-ASA. In addition, fecal calprotectin concentration was significantly decreased along with improvement in CAI after switching to pH-5-ASA. Conclusions. Our results suggest that pH-5-ASA has clinical efficacy for mildly to moderately active patients with UC in whom time-5-ASA did not successfully induce or maintain remission. PMID:25478568

  17. Therapeutic Efficacy of pH-Dependent Release Formulation of Mesalazine on Active Ulcerative Colitis Resistant to Time-Dependent Release Formulation: Analysis of Fecal Calprotectin Concentration

    Kousaku Kawashima

    2014-01-01

    Full Text Available Purpose. Few reports have compared the clinical efficacy of a pH-dependent release formulation of mesalazine (pH-5-ASA with a time-dependent release formulation (time-5-ASA. We examined whether pH-5-ASA is effective for active ulcerative colitis (UC in patients resistant to time-5-ASA. Methods. We retrospectively and prospectively analyzed the efficacy of pH-5-ASA in mildly to moderately active UC patients in whom time-5-ASA did not successfully induce or maintain remission. The clinical efficacy of pH-5-ASA was assessed by clinical activity index (CAI before and after switching from time-5-ASA. In addition, the efficacy of pH-5-ASA on mucosal healing (MH was evaluated in a prospective manner by measuring fecal calprotectin concentration. Results. Thirty patients were analyzed in a retrospective manner. CAI was significantly reduced at both 4 and 8 weeks after switching to pH-5-ASA. In the prospective study (n=14, administration of pH-5-ASA also significantly reduced CAI scores at 4 and 8 weeks in these patients who were resistant to time-5-ASA. In addition, fecal calprotectin concentration was significantly decreased along with improvement in CAI after switching to pH-5-ASA. Conclusions. Our results suggest that pH-5-ASA has clinical efficacy for mildly to moderately active patients with UC in whom time-5-ASA did not successfully induce or maintain remission.

  18. Assessment of Disease-Related Therapeutic Protein Drug-Drug Interaction for Etrolizumab in Patients With Moderately to Severely Active Ulcerative Colitis.

    Wei, Xiaohui; Kenny, Jane R; Dickmann, Leslie; Maciuca, Romeo; Looney, Caroline; Tang, Meina T

    2016-06-01

    The efficacy and safety of etrolizumab, a humanized IgG1 mAb, were evaluated in patients with ulcerative colitis (UC) in a phase 2 study (EUCALYPTUS). The current study assessed the risk of therapeutic protein drug-drug interaction (TP-DDI) of etrolizumab on CYP3A activity in patients with UC. Literature review was performed to compare serum proinflammatory cytokine levels and pharmacokinetic (PK) parameters of CYP3A substrate drugs between patients with inflammatory bowel disease (IBD) and healthy subjects. Treatment effect of etrolizumab on CYP3A activity was evaluated by measuring colonic CYP3A4 mRNA expression and serum C-reactive protein (CRP) in EUCALYPTUS patients. Literature data suggested similar levels between IBD patients and healthy subjects for serum proinflammatory cytokines and PK parameters of CYP3A substrate drugs. Additionally, treatment with etrolizumab did not change colonic CYP3A4 mRNA expression or serum CRP levels in UC patients. In conclusion, our results indicate a low TP-DDI risk for etrolizumab in UC patients, particularly on medications metabolized by CYP3A. PMID:26412221

  19. Anti-inflammatory effects of nicotine in obesity and ulcerative colitis

    Kirchgessner Annette

    2011-08-01

    Full Text Available Abstract Cigarette smoke is a major risk factor for a number of diseases including lung cancer and respiratory infections. Paradoxically, it also contains nicotine, an anti-inflammatory alkaloid. There is increasing evidence that smokers have a lower incidence of some inflammatory diseases, including ulcerative colitis, and the protective effect involves the activation of a cholinergic anti-inflammatory pathway that requires the α7 nicotinic acetylcholine receptor (α7nAChR on immune cells. Obesity is characterized by chronic low-grade inflammation, which contributes to insulin resistance. Nicotine significantly improves glucose homeostasis and insulin sensitivity in genetically obese and diet-induced obese mice, which is associated with suppressed adipose tissue inflammation. Inflammation that results in disruption of the epithelial barrier is a hallmark of inflammatory bowel disease, and nicotine is protective in ulcerative colitis. This article summarizes current evidence for the anti-inflammatory effects of nicotine in obesity and ulcerative colitis. Selective agonists for the α7nAChR could represent a promising pharmacological strategy for the treatment of inflammation in obesity and ulcerative colitis. Nevertheless, we should keep in mind that the anti-inflammatory effects of nicotine could be mediated via the expression of several nAChRs on a particular target cell.

  20. Severe ulcerative colitis: At what point should we define resistance to steroids?

    Maria Esteve; Javier P Gisbert

    2008-01-01

    Corticoesteroids are still the first-line treatment for active ulcerative colitis more than 50 years after the publication of trials assessing their beneficial effect, with about a 50% remission rate in cases of severe disease. The mortality related to severe attacks of ulcerative colitis has decreased dramatically, to less than 1%, in experienced centers, due to the appropriate use of intensive therapeutic measures (intravenous steroids, fluids and electrolytes, artificial nutritional support, antibiotics, etc),along with timely decision-making about second-line medical therapy and early identification of patients requiring colectomy. One of the most difficult decisions in the management of severe ulcerative colitis is knowing for how long corticosteroids should be administered before deciding that a patient is a non-responder. Studies assessing the outcome of acute attacks after steroid initiation have demonstrated that, n steroid-sensitive patients, the response generally occurs early on, in the first days of treatment. Different indexes to predict treatment failure, when applied on the third day of treatment, have demonstrated a high positive predictive value for colectomy. In contrast to this resolute approach, which is the most widely accepted, other authors have suggested that in some patients a complete and prolonged response to steroids may take longer. Either way, physicians taking care of these patients need to recognize that severe ulcerative colitis may be life-threatening, and they need to be careful with excessively prolonged medical treatment and delayed surgery.

  1. A case of ulcerative colitis presenting as pyoderma gangrenosum and lung nodule

    Li, Xin; Chandra, Subhash

    2014-01-01

    Pyoderma gangrenosum is a phenomenon of cutaneous ulceration where etiology is not well understood. About half of the cases have an associated extracutanoeus manifestation or associated systemic diseases. Most commonly associated systemic disorders include inflammatory bowel disease, hematologic malignancies, autoimmune arthritis, and vasculitis. We are reporting a case where pyoderma gangrenosum has presenting features for ulcerative colitis.Keywords: ulcerative colitis; pyoderma gangrenosum...

  2. Chronic eosinophilic pancreatitis and ulcerative colitis in a horse.

    Breider, M A; Kiely, R G; Edwards, J F

    1985-04-15

    A generalized debilitating disease in a horse was believed to be related to hypersensitivity to migrating strongyle larvae. The clinical signs included weight loss, diarrhea, and ulcers on all 4 coronary bands. The mare's condition deteriorated rapidly, so the mare was euthanatized and necropsied. The major histopathologic findings were chronic multifocal eosinophilic pancreatitis, hepatic portal fibrosis, biliary hyperplasia, and chronic ulcerative eosinophilic colitis. This case was similar to previously reported cases of chronic eosinophilic gastroenteritis in horses. Although the etiologic agent was not evident, the distribution and character of the lesions were consistent with a hypersensitivity response to migrating parasitic larvae, most probably Strongylus equinus. PMID:3997643

  3. Ulcerative colitis associated with chronic granulomatous disease: case report.

    Imanzade, Farid; Sayarri, Aliakbar; Tajik, Pantea

    2015-01-01

    Chronic Granulomatous Disease (CGD) is an inherited primary immunodeficiency disease which increases the body's susceptibility to infections caused by certain bacteria and fungi. CGD is a rare disease, caused by four genes, one type is 1X linked and the other three are "autosomal recessive". Although clinical presentation is variable, but characteristic features are recurrent pneumonia, lymphadenitis, hepatic or other abscesses. Gastrointestinal tract symptoms are common in x-linked recessive form of CGD. These include gastric and esophageal obstruction and inflammatory bowel disease. GI involvement including small and large intestines, the findings of luminal narrowing and the presence of granuloma can make it difficult to distinguish from Crohn's disease. On the other hands according to the literature ulcerative colitis is rarely reported in patients with CGD. Our case presented with ulcerative colitis with CGD. PMID:26328046

  4. Treatment tactics in patient with rectal cancer complicating ulcerative colitis

    Yu. A. Barsukov

    2012-01-01

    Full Text Available A successful treatment of a young patient with a 15-year anamnesis of ulcerative colitis, who has been diagnosed with rectal cancer, is presented in this case report. A non-standard surgical intervention has been performed following all principles of oncologic surgery. A subtotal colectomy has been performed with ultra-low anterior resection of rectum. Ascendoanal anastomosis has been performed forming the neo-rectum. There were no complications in postoperative period. Considering disease stage (T3N1M0 adjuvant XELOX was administered for 6 months along with 2 cycles of prophylactic treatment with 5-aminosalycilic acid. During 2-years follow-up there are no signs of rectal cancer and ulcerative colitis progression. After pelvic electrostimulation defecation frequency decreased to 3–4 times per day, a patient has complete social rehabilitation.

  5. Common carotid arterial thrombosis associated with ulcerative colitis

    Hitoshi Nogami; Tsuneo Iiai; Satoshi Maruyama; Tatsuo Tani; Katsuyoshi Hatakeyama

    2007-01-01

    A 26-year-old woman with ulcerative colitis was transferred to our hospital with left hemiparesis due to cerebral infarction. Cervical ultrasonography and magnetic resonance imaging angiography revealed thrombosis at the right common carotid artery and the right internal carotid artery. Antithrombotic and anticoagulant therapies were commenced. After about 2 wk of the treatment, the frequency of her diarrhea increased. She underwent emergency subtotal colectomy, but 10 d later an abundant hemorrhage from the remnant rectum occurred, so the remnant rectum was resected and an ileal pouch anal anastomosis was performed. Antithrombotic and anticoagulant therapies were continued, but neither her neurological status nor magnetic resonance imaging angiography findings showed subsequent changes. She was discharged 3 mon after operation. This is a rare case of common carotid arterial thrombosis occurring as a complication of ulcerative colitis, in which antithrombotic and anticoagulant therapies are considered to provoke a deterioration of the patient's bowel disease.

  6. Fulminant herpes simplex hepatitis in a patient with ulcerative colitis.

    Shlien, R D; Meyers, S; Lee, J A; Dische, R; Janowitz, H D

    1988-01-01

    A 16 year old girl with ulcerative colitis developed hepatitis with a high fever, leukopenia and a marked rise in serum transaminases without jaundice. There were no skin, oral, or genital lesions. Liver biopsy was precluded by abnormalities in coagulation. Postmortem examination of the liver by light and electron microscopy, culture, immunoperoxidase and immunofluorescent staining confirmed the diagnosis of hepatitis due to type 1 herpes simplex virus. Despite the rarity, this viral aetiolog...

  7. Managing Ulcerative Colitis – The Guidelines and Beyond

    Mitchell RKL Lie

    2013-11-01

    Full Text Available Management guidelines offer clinicians clear, evidence-based and often succinct treatment advice. For ulcerative colitis these guidelines describe the use of 5-ASA, corticosteroids, thiopurines, cyclosporine, and anti-TNFα therapies. However, guidelines do have some drawbacks, mainly a lack of concrete advice concerning patients resistant to these aforementioned therapies. This review gives a short overview of current guidelines and addresses treatment alternatives for conventional therapies.

  8. Ulcerative Colitis Associated with Aplastic Anemia; A Case Report

    Ghavidel, Ali

    2013-01-01

    Anemia is the most common hematologic disorder in patients with ulcerative colitis (UC). In some cases, normochromic anemia results from the presence of chronic disease; however blood loss or malabsorption may lead to an iron deficiency anemia with hypochromic appearance. Other rare hematologic manifestations associated with UC include myelodysplastic syndromes and leukemia. Several investigators have suggested a clinical association between inflammatory bowel disease and myelodysplastic synd...

  9. Immunomodulators and Immunosuppressants for Japanese Patients with Ulcerative Colitis

    Shigeki Bamba; Tomoyuki Tsujikawa; Masaya Sasaki; Yoshihide Fujiyama; Akira Andoh

    2011-01-01

    Ulcerative colitis (UC) is characterized by a long-standing chronic course with remissions and exacerbations. Previously, patients do not respond to 5-aminosalicylic acid compounds and corticosteroids are considered for colectomies, however, in recent years, alternative treatments emerged for steroid-refractory or steroid-dependent UC. In this review article, we focus on immunomodulators (such as azathioprine [AZA] and 6-mercaptopurine [6-MP]) and immunosuppressants (such as cyclosporine A [C...

  10. Two Cases of Diffuse Duodenitis Associated with Ulcerative Colitis

    Katsuya Endo; Masatake Kuroha; Hisashi Shiga; Yoichi Kakuta; Seiichi Takahashi; Yoshitaka Kinouchi; Tooru Shimosegawa

    2012-01-01

    The upper gastrointestinal tract is not generally considered a target organ in ulcerative colitis (UC). However, several cases showing upper gastrointestinal involvement in UC have been reported. In this report, we present 2 rare cases of diffuse duodenitis accompanying pancolonic UC. Case patient 1 was a 44-year-old man who developed diffuse duodenitis shortly after colectomy and was successfully treated with mesalazine. Case patient 2 was a 25-year-old woman who developed diffuse duodenitis...

  11. The Role of Fecal Calprotectin in Investigating Pediatric Ulcerative Colitis

    Fatih Ünal; Evren Semizel; Muhittin Serdar; Çiğdem Ömür Ecevit; Yılmaz Karaca; Emine Mert Yılmaz; Hasan Kocaefe; Hasan Erhun Kasırga

    2012-01-01

    Introduction: Fecal calprotectin (FCP) can be found in high concentrations in inflammatory bowel disease due to the increase in leucocyte turnover in intestinal wall or increase of migration of neutrophils into the lumen. In this study, we aimed to determine the FCP values of the ulcerative colitis (UC) patients at the time of diagnosis and to investigate the applicability and effectiveness of this non-invasive method in the diagnosis of the disease, routinely.Materials and Methods: A total o...

  12. Limb Loss Caused by Thrombosis led to the Diagnosis of Ulcerative Colitis

    Seyed Mohammad Vahid Hosseini

    2010-03-01

    Full Text Available Arterial thrombosis associated with ulcerative colitis usuallyoccurs in the postoperative period with a good response to anticoagulanttherapy and embolectomy. Our patient was a 14-yearoldgirl with ulcerative colitis who presented with bilateral pulslessextremities, which did not respond to medical treatmentand embolectomy. Subsequent colectomy did not save herlimbs. The repeated thrombosis caused gangrene of extremitiesin the below knee region leading to bilateral amputation.Thrombosis can be the first presentation of ulcerative colitis.

  13. Diet in the Aetiology of Ulcerative Colitis: A European Prospective Cohort Study

    Hart, Andrew R; Luben, Robert; Olsen, Anja;

    2008-01-01

    Background/Aims: The causes of ulcerative colitis are unknown, although it is plausible that dietary factors are involved. Case-control studies of diet and ulcerative colitis are subject to recall biases. The aim of this study was to examine the prospective relationship between the intake of...... was supplied and the subjects were followed up for the development of ulcerative colitis. Each incident case was matched with four controls and dietary variables were divided into quartiles. Results: A total of 139 subjects with incident ulcerative colitis were identified. No dietary associations were...

  14. Autoimmunity in ulcerative colitis: humoral and cellular immune response bytropomyosin in ulcerative colitis

    Xin Geng; Masato Taniguchi; Hui Hui Dai; JJ-C Lin; Jim Lin; Kiron Moy Das

    2000-01-01

    AIM Autoimmunity has been emphasized in the pathogenesis of ulcerative colitis (UC). We reported thattropomyosin (TM) or TM related protein is a putative autoantigen in UC. In human fibroblast, at least 8isoforms of TM have been identified with molecular weight range from 30kD to 40kD, depending upon theisoforms, and human TM isoforms (hTM5) has been found the main isoform in human intestinal epithelialcells. In this study, hTM5 was used as a putative auto-antigen for the humoral and T cell immune responses inpatients with UC, Crohn's disease (CD) and healthy subjects (HS) as controls.METHODS Anti-bTM antibody was examined by enzyme-linked immunosorbent assay using human sera(UC 59, CD 28, HS 26) against hTM isoforms. The IFN-γ production by peripheral blood T cells followingstimulation by recombinant hTM5 was analyzed by ELISPOT assay.RESULTS Anti-hTM5 antibody (IgG1) was detected in 15/59 (25.4%) patients with UC, 3/28 (10.γ%)with CD, and 3/26 (11.5%) of HS. The OD value in UC was significantly higher than in CD and HS groups(P < 0.05; P < 0.01 respectively). Western blot analysis demonstrated immunoreactivity against hTM5 inseveral UC sera. ELISPOT assay demonstrated that IFN-γ production is significantly higher in UC (7/18),39.0%), compared with CD (0/8, 0%) and HS (0/7, 0%), (P<0.05).CONCLUSION A significantly higher immune response to hTM5 was present in UC compared to CD andHS. Further studies of the hTM5/peptides may provide immuno-biochemical mechanism of autoimmuneprocess in UC.

  15. Herpes simplex virus colitis complicating ulcerative colitis: A case report and brief review on superinfections.

    Schunter, Marco Oliver; Walles, Thorsten; Fritz, Peter; Meyding-Lamadé, Uta; Thon, Klaus-Peter; Fellermann, Klaus; Stange, Eduard Friedrich; Lamadé, Wolfram

    2007-09-01

    In patients with inflammatory bowel disease herpes simplex virus infection has been described as a major cause of morbidity and mortality, especially in immunocompromised individuals. Here we present the case of a 35-year old woman with an exacerbation of ulcerative colitis caused by herlpes simplex virus infection (HSV-2). The diagnosis was confirmed histologically following subtotal colectomy. After intravenous treatment with aciclovir for 2 weeks postoperative hematochezia stopped. Herpes simplex virus colitis is a rare but potentially fatal complication of immunosuppressive treatment in patients with inflammatory bowel disease. Prompt diagnosis and efficient antiviral therapy are mandatory to improve prognosis. PMID:21172183

  16. Interleukin-6 Induces S100A9 Expression in Colonic Epithelial Cells through STAT3 Activation in Experimental Ulcerative Colitis

    Lee, Min Jeoung; Lee, Jin-Ku; Choi, Ji Won; Lee, Chang-Seok; Sim, Ji Hyun; Cho, Chung-Hyun; Lee, Kwang-Ho; Cho, Ik-Hyun; Chung, Myung-Hee; Kim, Hang-Rae; Ye, Sang-Kyu

    2012-01-01

    Background Intestinal epithelium is essential for maintaining normal intestinal homeostasis; its breakdown leads to chronic inflammatory pathologies, such as inflammatory bowel diseases (IBDs). Although high concentrations of S100A9 protein and interleukin-6 (IL-6) are found in patients with IBD, the expression mechanism of S100A9 in colonic epithelial cells (CECs) remains elusive. We investigated the role of IL-6 in S100A9 expression in CECs using a colitis model. Methods IL-6 and S100A9 exp...

  17. Florid urticarial vasculitis heralding a flare up of ulcerative colitis.

    Boules, Evon; Lyon, Calum

    2014-01-01

    A 75-year-old man with ulcerative colitis (UC) and diet controlled diabetes mellitus presented with a 3-week history of slightly itchy, red plaques on both lower limbs ascending gradually to cover the trunk and arms. One week later, he developed a flare up of his UC. Routine blood tests showed modest drop in haemoglobin (122 g/L) and C reactive protein (85 mg/L). Serology was remarkable for high antiproteinase 3 (c-ANCA). Serum electrophoresis showed a mildly positive paraprotein band (γ region). Stool culture was negative. Urine analysis showed proteinuria. Skin biopsy showed features of urticarial vasculitis (UV). He underwent a flexible sigmoidoscopy after the flare up showed mildly active UC. The patient was given hydrocortisone for 7 days and then prednisolone. Both rash and UC subsided. Electrophoresis was repeated 4 weeks later showing normal pattern. Prednisolone has been gradually reduced. Although rare, UV can be considered as one of the skin manifestations of UC. PMID:25535230

  18. Cytomegalovirus and ulcerative colitis: Place of antiviral therapy.

    Pillet, Sylvie; Pozzetto, Bruno; Roblin, Xavier

    2016-02-14

    The link between cytomegalovirus (CMV) infection and inflammatory bowel diseases remains an important subject of debate. CMV infection is frequent in ulcerative colitis (UC) and has been shown to be potentially harmful. CMV reactivation needs to be diagnosed using methods that include in situ detection of viral markers by immunohistochemistry or by nucleic acid amplification techniques. Determination of the density of infection using quantitative tools (numbers of infected cells or copies of the genome) is particularly important. Although CMV reactivation can be considered as an innocent bystander in active flare-ups of refractory UC, an increasing number of studies suggest a deleterious role of CMV in this situation. The presence of colonic CMV infection is possibly linked to a decreased response to steroids and other immunosuppressive agents. Some treatments, notably steroids and cyclosporine A, have been shown to favor CMV reactivation, which seems not to be the case for therapies using anti-tumor necrosis factor drugs. According to these findings, in flare-ups of refractory UC, it is now recommended to look for the presence of CMV reactivation by using quantitative tools in colonic biopsies and to treat them with ganciclovir in cases of high viral load or severe disease. PMID:26877608

  19. Colitis

    ... MT, Lichtenstein GR. Ulcerative colitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran’s Gastrointestinal and ... of the colon and rectum. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran’s Gastrointestinal and ...

  20. Altered colonic mucosal Polyunsaturated Fatty Acid (PUFA derived lipid mediators in ulcerative colitis: new insight into relationship with disease activity and pathophysiology.

    Mojgan Masoodi

    Full Text Available OBJECTIVES: Ulcerative colitis (UC is a relapsing inflammatory disorder of unconfirmed aetiology, variable severity and clinical course, characterised by progressive histological inflammation and with elevation of eicosanoids which have a known pathophysiological role in inflammation. Therapeutic interventions targetting eicosanoids (5-aminosalicylates (ASA are effective first line and adjunctive treatments in mild-moderate UC for achieving and sustaining clinical remission. However, the variable clinical response to 5-ASA and frequent deterioration in response to cyclo-oxygenase (COX inhibitors, has prompted an in depth simultaneous evaluation of multiple lipid mediators (including eicosanoids within the inflammatory milieu in UC. We hypothesised that severity of inflammation is associated with alteration of lipid mediators, in relapsing UC. DESIGN: Study was case-control design. Mucosal lipid mediators were determined by LC-MS/MS lipidomics analysis on mucosal biopsies taken from patients attending outpatients with relapsing UC. Univariate and multivariate statistical analyses were used to investigate the association of mucosal lipid mediators, with the disease state and severity graded histologically. RESULTS: Levels of PGE2, PGD2, TXB2, 5-HETE, 11-HETE, 12-HETE and 15-HETE are significantly elevated in inflamed mucosa and correlate with severity of inflammation, determined using validated histological scoring systems. CONCLUSIONS: Our approach of capturing inflammatory mediator signature at different stages of UC by combining comprehensive lipidomics analysis and computational modelling could be used to classify and predict mild-moderate inflammation; however, predictive index is diminished in severe inflammation. This new technical approach could be developed to tailor drug treatments to patients with active UC, based on the mucosal lipid mediator profile.

  1. Efficacy of Adalimumab as a long term maintenance therapy in ulcerative colitis.

    McDermott, Edel

    2013-03-01

    Adalimumab is a recombinant human IgG1 monoclonal antibody to TNF-alpha. There are limited data with regard to its efficacy in ulcerative colitis. We report experience of adalimumab in ulcerative colitis in a single centre with a focus on the ability of this agent to maintain response and avoid colectomy in the medium to long-term.

  2. Systemic lupus erythematosus in association with ulcerative colitis: related autoimmune diseases.

    Stevens, H P; Ostlere, L S; Rustin, M H

    1994-03-01

    We report a patient who developed urticaria, angio-oedema and polyarthropathy secondary to the hypocomplementaemic urticarial vasculitis syndrome, a year prior to the onset of ulcerative colitis. Ten years later, primary sclerosing cholangitis and the antiphospholipid syndrome developed concomitantly. We believe this patient represents only the second reported case of idiopathic systemic lupus erythematosus (SLE) occurring in association with ulcerative colitis. PMID:8148283

  3. A precordial rub in a boy with a severe attack of ulcerative colitis.

    Badina, Laura; Ferrara, Giovanna; Guastalla, Pierpaolo; Barbi, Egidio

    2014-04-01

    A case of a pneumomediastinum mimicking a pericarditis in a boy with an occult perforation due to ulcerative colitis is reported. Pneumomediastinum is a rare complication of severe attacks of ulcerative colitis, with or without the previous development of a toxic megacolon, that should be considered in the differential diagnosis. PMID:24694884

  4. Genesis of anxiety, depression, and ongoing abdominal discomfort in ulcerative colitis-like colon inflammation

    Chen, Jinghong; Winston, John H.; Fu, Yu; Guptarak, Jutatip; Jensen, Kathryn L.; Shi, Xuan-Zheng; Green, Thomas A; Sarna, Sushil K.

    2014-01-01

    Psychological disorders are prevalent in patients with inflammatory bowel disease; the underlying mechanisms remain unknown. We tested the hypothesis that ulcerative colitis-like inflammation induced by dextran sodium sulfate (DSS) exacerbates the ongoing spontaneous activity in colon-projecting afferent neurons that induces abdominal discomfort and anxiety, and depressive-like behaviors in rats. In this study, we used the conditioned place preference and standard tests for anxiety- and depre...

  5. Immunohistochemical Studies on Galectin Expression in Colectomised Patients with Ulcerative Colitis

    Mattias Block; Johan Mölne; Hakon Leffler; Lars Börjesson; Breimer, Michael E

    2016-01-01

    Introduction. The aetiology and pathogenesis of ulcerative colitis (UC) are essentially unknown. Galectins are carbohydrate-binding lectins involved in a large number of physiological and pathophysiological processes. Little is known about the role of galectins in human UC. In this immunohistochemical exploratory study, both epithelial and inflammatory cell galectin expression were studied in patients with a thoroughly documented clinical history and were correlated with inflammatory activity...

  6. Overall and cause-specific mortality in ulcerative colitis

    Jess, Tine; Gamborg, Michael; Munkholm, Pia;

    2007-01-01

    studies on overall and cause-specific mortality in patients with UC. METHODS: The MEDLINE search engine and abstracts from international conferences were searched for relevant literature by use of explicit search criteria. STATA meta-analysis software was used to calculate pooled risk estimates (SMR......OBJECTIVES: It remains debated whether patients with ulcerative colitis (UC) are at greater risk of dying and whether a possible alteration in mortality can be attributed to specific causes of death. We aimed to clarify this issue by conducting a meta-analysis of population-based inception cohort...... estimate was 1.1 (95% confidence interval [CI] 0.9-1.2, P= 0.42). However, greater risk of dying was observed during the first years of follow-up, in patients with extensive colitis, and in patients from Scandinavia. Metaregression analysis showed an increase in SMR by increasing cohort size. UC...

  7. Tc-99m HMPAO labelled white blood cell scintigraphy in the assessment of the extent and severity of active ulcerative colitis

    Full text: Aim: In this study it was aimed to assess the role of Tc-99m HMPAO labelled white blood cell (WBC) scintigraphy on different imaging times in the assessment of disease extent and severity in active ulcerative colitis (UC). Materials and Methods: Twenty-one consecutive patients (10 women, 11 men; mean age: 42.4 12 years) with active UC were prospectively studied. Clinical evaluation, laboratory analysis, endoscopy-biopsy, and scintigraphy were performed within three days before any treatment. Scintigraphy was performed 1, 2, and 4 h after 111-185 MBq Tc-99m HMPAO labelled WBC injection. Large bowel was evaluated in 4 segments (recto-sigmoid, descending, transverse and ascending colon) during the endoscopy and scintigraphy. Clinical activity score (CAS), endoscopic activity score (EAS), and scintigraphic activity score (SAS) at 1 hr, 2 hr, and 4 hr were calculated for each patient. Results: Scintigraphy showed 80%, 83%, and 80% agreement in the number of pathological segment with comparing endoscopy, at 1 hr, 2 hr and 4 hr imaging, respectively. Sensitivity, specificity, and accuracy values of Tc-99m HMPAO labelled WBC scintigraphy were calculated as follow, respectively: 1 hr imaging: 86%, 73%, 83%; 2 hr imaging: 89 %, 74 %, 86 %; 4 hr imaging: 90%, 58%, 83% in the detecting of active inflammatory segments using by endoscopy as gold standard. Statistically significant correlations were found between EAS and SAS for 2 hr and 4 hr imaging (r=0.64 and r=0.66, respectively). There were also significant correlations between CAS and SAS for 2 hr and 4 hr imaging (r=0.59 and r=0.62, respectively). Conclusion: Tc-99m HMPAO labelled WBC scintigraphy at 2 hr well correlated with endoscopy in the assessment of the extent of UC. Because of the higher correlation values of 4 hr SAS than 2 hr SAS with CAS and EAS, our results indicated that late scintigraphic imaging (4 h) might be useful in the evaluation of the severity of UC. (author)

  8. Effects of topical ropivacaine on eicosanoids and neurotransmitters in the rectum of patients with distal ulcerative colitis

    Hillingsø, J.G.; Kjeldsen, J.; Schmidt, P.T.; Rasmussen, T.N.; Fischer-Hansen, B.; Holst, J.J.; Lauritsen, K.; Bukhave, Klaus; Rask-Madsen, J.

    2002-01-01

    Background: Topical administration of lidocaine has been suggested to have beneficial clinical effects in patients with active ulcerative colitis, but the mechanism of action, if any, remains obscure. As local anaesthetics may exert anti-inflammatory actions through their inhibition of nervous......, thromboxane B-2 and prostaglandin E-2 in rectal dialysates and concentrations of substance P, neurokinin A, somatostatin, vasoactive intestinal polypeptide and calcitonin gene-related peptide in rectal biopsies from 19 patients with active, distally located, ulcerative colitis were measured before and after...

  9. Increased levels of homocysteine in patients with ulcerative colitis

    Sabiye; Akbulut; Emin; Altiparmak; Firdevs; Topal; Ersan; Ozaslan; Metin; Kucukazman; Ozlem; Yonem

    2010-01-01

    AIM: To investigate serum levels of homocysteine (Hcys) and the risk that altered levels carry for thrombosis development in ulcerative colitis (UC) patients. METHODS: 55 UC patients and 45 healthy adults were included. Hcys, vitamin B12 and folic acid levels were measured in both groups. Clinical history and thrombo- embolic events were investigated. RESULTS: The average Hcys level in the UC patients was 13.3 ± 1.93 μmmol/L (range 4.60-87) and was higher than the average Hcys level of the control group whi...

  10. Decrease of reactive-oxygen-producing granulocytes and release of IL-10 into the peripheral blood following leukocytapheresis in patients with active ulcerative colitis

    Hiroyuki Hanai; Kenji Takai; Takayuki Iida; Ken Takeuchi; Fumitoshi Watanabe; Yasuhiko Maruyama; Masataka Kikuyama; Tatsuo Tanaka; Kenji Kondo; Kou Tanaka

    2005-01-01

    AIM: To investigate the clinical efficacy of leukocytapheresis (LCAP) in patients with active ulcerative colitis (UC), and to elucidate the mechanisms by determining the changes in the cytokine levels in the peripheral blood and of the functions of the peripheral blood leukocytes in these patients.METHODS: The subjects were 19 patients with active UC, with a mean clinical activity index (CAI) of 9.2. The LCAP was conducted using Cellsorba E. In each session of LCAP, 2-3 L of blood at the flow rate of 30-50 mL/min was processed. The treatment was carried out in approximately 1-h sessions, once a week, for 5-10 wk. Blood samples for determination of the cytokine levels were collected from the inflow side of the column (site of dehematization; at the start of LCAP) and outflow side of the column (at the end of LCAP). Blood samples for the determination of reactive-oxygen-producing cells were collected from the peripheral blood before and after LCAP.RESULTS: LCAP resulted in clinical improvement in all the 19 patients of UC recruited for this study. Remission (CAI: ≤4) was noted in 15 (79%) of the 19 patients. The blood level of the pro-inflammatory cytoline IL-6 was found to be decreased following treatment by LCAP, and the level of the anti-inflammatory cytokine IL-10 at the outflow side of the LCAP column was found to be significantly elevated as compared to that at the inflow side of the column. The reactive-oxygen-producing granulocytes in the peripheral blood of UC patients was increased as compared to that in healthy persons and the increase was found to be decreased following treatment by LCAP.CONCLUSION: LCAP exerted a high therapeutic efficacy in patients with active UC. Our findings suggest that LCAP is associated with enhanced production of the inhibitory cytokine IL-10 to indirectly inhibit the functions of the inflammatory leukocytes, and that inflammation is also considerably attenuated by the direct removal of reactiveoxygen-producing neutrophils from

  11. Fecal Calprotectin is an Accurate Tool and Correlated to Seo Index in Prediction of Relapse in Iranian Patients With Ulcerative Colitis

    Hosseini, Seyed Vahid; Jafari, Peyman; Taghavi, Seyed Alireza; Safarpour, Ali Reza; Rezaianzadeh, Abbas; Moini, Maryam; Mehrabi, Manoosh

    2015-01-01

    Background: The natural clinical course of Ulcerative Colitis (UC) is characterized by episodes of relapse and remission. Fecal Calprotectin (FC) is a relatively new marker of intestinal inflammation and is an available, non-expensive tool for predicting relapse of quiescent UC. The Seo colitis activity index is a clinical index for assessment of the severity of UC. Objectives: The present study aimed to evaluate the accuracy of FC and the Seo colitis activity index and their correlation in p...

  12. Isotretinoin and ulcerative colitis: A case report and review of the literature

    Ioannis; Papaconstantinou; Anastasios; Stefanopoulos; Aspasia; Papailia; Christos; Zeglinas; Ioannis; Georgopoulos; Spyridon; Michopoulos

    2014-01-01

    This case report describes a case of ulcerative colitisthe onset of which occurred after the use of isotreti-noin for acne treatment. Our patient, a healthy maleyoung adult, after several months of isotretinoin use,developed gastrointestinal disorders and after thoroughmedical workup was diagnosed with ulcerative colitis.The literature regarding a possible correlation betweenisotretinoin use and ulcerative colitis is scarce. Never-theless, recent epidemiological studies have shed morelight on this possible association.

  13. A subset of ulcerative colitis with positive proteinase-3antineutrophil cytoplasmic antibody

    Jin Xu; Chuan-Hua Yang; Xiao-Yu Chen; Xu-Hang Li; Min Dai; Shu-Dong Xiao

    2008-01-01

    A small subset of patients with active ulcerative colitis is non-responsive to major known non-biological therapies.We reported 5 patients with positive serum proteinase-3 antineutrophil cytoplasmic antibody (PR3-ANCA) and tried to (1) identify the common clinical features of these patients; (2) investigate the efficacy of a novel therapy using a Chinese medicine compound; and (3) attract more gastroenterologists to be engaged in further study of this subset of patients. The common manifestations of disease in these 5 patients included recurrent bloody diarrhea and inflammatory lesions involving the entire colorectal mucosa. Initial treatment with intravenous methylprednisolone successfully induced remission.Four of these 5 patients were steroid-dependence,and immunosuppressants, such as azathioprine and cyclophosphamide, were ineffective. In 3 patients,only the particular Chinese medicine compound could induce and maintain remission. One patient underwent colectomy. No vascular inflammatory lesions were found by histopathological examination. Although more cases are needed for confirmation, our study indicates that ulcerative colitis with positive PR3-ANCA may belong to a subtype of refractory ulcerative colitis. The particular Chinese medicine compound used in our study is by far the most effective in the management of these patients,with additional advantages of having no noticeable sideeffects and less financial burden.

  14. [Management of diagnosis and treatment in ulcerative colitis].

    Klotz, Caroline; Barret, Maximilien; Dhooge, Marion; Oudjit, Ammar; Chaussade, Stanislas; Coriat, Romain; Abitbol, Vered

    2015-02-01

    Ulcerative colitis (UC) is a chronic inflammatory bowel disease limited to the mucosa and affecting the rectum and the colon continuously. Salicylates are the first line treatment for moderate forms. Corticosteroids are used to induce remission, but are not given as maintenance therapy. Thiopurines are indicated as maintenance therapy in case of failure of salicylates or cortico-dependence. Anti TNF alpha are indicated in cortico-resistant severe flares or if cortico- dependence. Vedolizumab (anti-integrin) is the first non anti-TNF alpha biotherapy available for the treatment of UC. Severe acute colitis is a medical emergency; diagnosis is based on Lichtiger score. An emergency colectomy for severe acute colitis is indicated in cases of surgical complication or resistance to medical therapy. UC patients with extension beyond splenic flexure are at risk of colorectal cancer, increasing with the duration of the disease, severity of mucosal inflammation, family history of colorectal cancer, and the existence of sclerosing cholangitis. Annual surveillance colonoscopy is required in patients with sclerosing cholangitis regardless of the extension of their UC. PMID:25534469

  15. The Role of Fecal Calprotectin in Investigating Pediatric Ulcerative Colitis

    Fatih Ünal

    2012-12-01

    Full Text Available Introduction: Fecal calprotectin (FCP can be found in high concentrations in inflammatory bowel disease due to the increase in leucocyte turnover in intestinal wall or increase of migration of neutrophils into the lumen. In this study, we aimed to determine the FCP values of the ulcerative colitis (UC patients at the time of diagnosis and to investigate the applicability and effectiveness of this non-invasive method in the diagnosis of the disease, routinely.Materials and Methods: A total of 19 patients with UC (10 females, 9 males, age: 11.5±3.5 years old whoose stool samples collected during the diagnosis period and 20 healthy controls (10 female, 10 male, age: 10.3±4.5 years old were included in the study. Stool samples were collected for FCP analysis by ELISA method at the time of diagnosis and before the treatment period.Results: FCP values of the UC group were statistically higher than the control group. FCP values of the UC and control groups were 398.4 µg/gr stool (56.7-2450 and 19.4 µg/gr stool (2-81, respectively (p0.05. High CRP values (89.4%, elevation of erythrocyte sedimentation rate (84.2%, leukocytosis (73.6%, thrombocytosis (68.4%, anemia (89.4%, and hypoalbuminemia (52.6% were found.Conclusions: FCP values of the UC patients were found to be statistically higher than the control group, and increase in FCP values has been observed with increasing disease activity. Therefore, we believe that the determination of FCP could be useful at the time of diagnosis and during follow-up of the patients with UC. (Journal of Current Pediatrics 2012; 10: 80-4

  16. ERK controls epithelial cell death receptor signalling and cellular FLICE-like inhibitory protein (c-FLIP) in ulcerative colitis

    Seidelin, Jakob Benedict; Coskun, Mehmet; Vainer, Ben;

    2013-01-01

    Intestinal epithelial cell (IEC) death signalling through the Fas receptor is impaired in active ulcerative colitis (UC). This is possibly due to the activation of cytoprotective pathways resulting in limitation of the tissue injury secondary to inflammation. We hypothesized that inflammatory sig...

  17. Maintenance of Efficacy and Continuing Safety of Golimumab for Active Ulcerative Colitis: PURSUIT-SC Maintenance Study Extension Through 1 Year

    Gibson, Peter R; Feagan, Brian G; Sandborn, William J; Marano, Colleen; Strauss, Richard; Johanns, Jewel; Padgett, Lakshmi; Collins, Judith; Tarabar, Dino; Hebzda, Zbigniew; Rutgeerts, Paul; Reinisch, Walter

    2016-01-01

    Objectives: The safety and efficacy of subcutaneous golimumab through 2 years of maintenance therapy was evaluated in patients with moderate-to-severe ulcerative colitis (UC). Methods: Patients completing treatment through week 52 (placebo, golimumab 50, 100, every-4-weeks (q4w)) and evaluations at week 54 were eligible for this long-term extension (LTE) trial. Patients receiving placebo or golimumab 50 mg with worsening disease during the LTE could receive golimumab 100 mg. Efficacy assessments included the Mayo physician's global assessment (PGA) subscore, inflammatory bowel disease questionnaire (IBDQ), and corticosteroid use. Patients who were randomized to golimumab at PURSUIT-Maintenance baseline and continued receiving golimumab during the LTE were analyzed for efficacy (using intention-to-treat and “as observed” analyses; N=195) and safety (N=200). Patients treated with golimumab at any time from induction baseline through week 104 (N=1240) constituted the overall safety population. Results: Baseline demographics and disease characteristics of patients entering the LTE receiving golimumab were similar to those of all patients randomized to golimumab maintenance at baseline. At week 104, 80.5% (157/195) of patients had a PGA=0/1 (range weeks 56–104: 80.5–91.8%) and 56.4% (110/195) had a PGA=0 (weeks 56–104: range: 53.8–58.5%). Through week 104, 86% of patients maintained inactive or mild disease activity. Among 174 corticosteroid-free patients at week 54, 88.5% remained corticosteroid-free at week 104. At week 104, 62.2% (120/193) had an IBDQ score ≥170. Tuberculosis, opportunistic infection, and malignancy rates were low, and the overall safety profile was similar to that reported through week 54. Two non-melanoma skin cancers, one metastatic colon cancer, and two deaths (biventricular heart dysfunction, sepsis) occurred between weeks 54 and 104. Conclusion: Subcutaneous golimumab q4w through 2 years maintained clinical benefit and reduced

  18. Microarray Assisted Gene Discovery in Ulcerative Colitis

    Brusgaard, Klaus

    on the activation of different downstream pathways. Thus it seems that different genetic backgrounds can lead to similar clinical manifestations, and as well determines the susceptibility to IBD. In the previous micro array based expression studies on UC the main target has been to point to new...

  19. Effects of topical ropivacaine on eicosanoids and neurotransmitters in the rectum of patients with distal ulcerative colitis

    Hillingsø, J.G.; Kjeldsen, J.; Schmidt, P.T.;

    2002-01-01

    Background: Topical administration of lidocaine has been suggested to have beneficial clinical effects in patients with active ulcerative colitis, but the mechanism of action, if any, remains obscure. As local anaesthetics may exert anti-inflammatory actions through their inhibition of nervous re...

  20. Effects of topical ropivacaine on eicosanoids and neurotransmitters in the rectum of patients with distal ulcerative colitis

    Hillingsø, Jens; Kjeldsen, J; Schmidt, P T;

    2002-01-01

    BACKGROUND: Topical administration of lidocaine has been suggested to have beneficial clinical effects in patients with active ulcerative colitis, but the mechanism of action, if any, remains obscure. As local anaesthetics may exert anti-inflammatory actions through their inhibition of nervous re...

  1. Hospitalized ulcerative colitis patients have an elevated risk of thromboembolic events

    Jennifer Y Wang; Jonathan P Terdiman; Eric Vittinghoff; Tracy Minichiello; Madhulika G Varma

    2009-01-01

    AIM: To compare thromboembolism rates between hospitalized patients with a diagnosis of ulcerative colitis and other hospitalized patients at high risk for thromboembolism. To compare thromboembolism rates between patients with ulcerative colitis undergoing a colorectal operation and other patients undergoing colorectal operations. METHODS: Data from the National Hospital Discharge Survey was used to compare thromboembolism rates between (1) hospitalized patients with a discharge diagnosis of ulcerative colitis and those with diverticulitis or acute respiratory failure, and (2) hospitalized patients with a discharge diagnosis of ulcerative colitis who underwent colectomy and those with diverticulitis or colorectal cancer who underwent colorectal operations. RESULTS: Patients diagnosed with ulcerative colitis had similar or higher rates of combined venous thromboembolism (2.03%) than their counterparts with diverticulitis (0.76%) or respiratory failure (1.99%), despite the overall greater prevalence of thromboembolic risk factors in the latter groups. Discharged patients with colitis that were treated surgically did not have significantly different rates of venous or arterial thromboembolism than those with surgery for diverticulitis or colorectal cancer. CONCLUSION: Patients with ulcerative colitis who do not undergo an operation during their hospitalization have similar or higher rates of thromboembolism than other medical patients who are considered to be high risk for thromboembolism.

  2. Budesonide for ulcerative colitis Budesonida en el tratamiento de la colitis ulcerosa

    I. Marín-Jiménez

    2006-05-01

    Full Text Available In this review, we examined studies published on oral and topical formulations of budesonide (Entocort® and Budenofalk®, in Spain: Entocord® and Intestifalk® for the treatment of ulcerative colitis. This glycocorticosteroid has a potent local action and an important first-pass liver metabolism. It has proven successful over the last years as a controlled-release formulation. It obtained results similar to prednisolone, without the latter's significant suppression of plasma cortisol. Many publications exist on the effects of oral budesonide for the treatment of Crohn's disease (CD. These have led to the registration of this drug for the treatment of CD. Studies on oral formulations of budesonide for the treatment of ulcerative colitis (UC are scarce. After reviewing published evidence, we suggest the conduction of controlled trials for the treatment of UC to obtain evidence-based efficacy and safety results in order to benefit patients with this form of inflammatory bowel disease (IBD.En esta revisión repasamos los estudios publicados hasta la fecha con las formulaciones orales y las preparaciones tópicas rectales de budesonida (Entocort® y Budenofalk®, en España Entocord® e Intestifalk® para el tratamiento de la colitis ulcerosa. Este glucocorticosteroide de una elevada acción tópica y un importante metabolismo de primer paso hepático se ha utilizado en los últimos años como una formulación de liberación controlada, proporcionando resultados similares a la prednisolona pero sin suprimir de forma apreciable los niveles de cortisol plasmático. Aunque se han publicado muchos estudios sobre los efectos de la budesonida oral para el tratamiento de la enfermedad de Crohn, los estudios sobre esta misma forma galénica de administración de budesonida para el tratamiento de los pacientes con colitis ulcerosa son escasos. Después de revisar los trabajos publicados al respecto, se sugiere la necesidad de realizar un estudio controlado

  3. Clinical value analysis of routine ultrasound combined with endoscopic ultrasonography in judging ulcerative colitis

    Jing-Mei Tuo; Zhi-Hong Han

    2016-01-01

    Objective:To study the clinical value of routine ultrasound combined with endoscopic ultrasonography in judging ulcerative colitis.Methods: A total of 60 cases of patients with ulcerative colitis were collected as observation group of research and 60 cases of healthy volunteers were collected as control group of research. Intestinal wall thickness was detected by white light endoscopy, abdominal intestinal ultrasound and endoscopic ultrasonography; TNF-α, IL-1β, IL-4 and IL-10 contents were detected by Elisa kit; Th1, Th2, Th17 and Treg ratios were detected by flow cytometry.Results: (1) intestinal wall thickness: intestinal wall thickness of both active UC patients and quiescent UC patients was significantly higher than that of control group, intestinal wall thickness of active UC patients was significantly higher than that of quiescent UC patients and the higher the degree of activity, the higher the intestinal wall thickness; (2) inflammatory mediators: TNF-α and IL-1β contents in intestinal mucosa of active UC patients were higher than those of quiescent UC patients and positively correlated with intestinal wall thickness; IL-4 and IL-10 contents were lower than those of quiescent UC patients and negatively correlated with intestinal wall thickness; (3) T cell contents: Th1 and Th17 cell contents in intestinal mucosa of active UC patients were higher than those of quiescent UC patients and positively correlated with intestinal wall thickness; Th2 and Treg cell contents in intestinal mucosa of active UC patients were lower than those of quiescent UC patients and negatively correlated with intestinal wall thickness.Conclusion: Routine ultrasound combined with endoscopic ultrasonography can accurately determine the severity of ulcerative colitis; measured intestinal wall thickness is closely correlated with the degree of inflammation and abnormal immune response.

  4. Treatment with diammonium glycyrrhizinate down-regulates M30 expression in ulcerative colitis in rats

    原皓

    2013-01-01

    Objective To assess the therapeutic effect of diammonium glycyrrhizinate(DG) on2,4,6-trinitro-benzene sulfonic acid(TNBS)-induced ulcerative colitis in rats and to explore the underlying mechanisms by

  5. Crohn's disease, ulcerative colitis, and measles vaccine in an English population, 1979–1998

    Seagroatt, V; Goldacre, M.

    2003-01-01

    Study objectives: To study the hospitalised incidence of Crohn's disease (CD) and ulcerative colitis (UC) from 1979 to 1998; and to determine whether the introduction of the measles vaccination programme was associated with an increase in the young.

  6. Successfully Treated Acute Fulminant Myocarditis Induced by Ulcerative Colitis with Extracorporeal Life Support and Infliximab

    Kim, Han-Kyul; Kim, Kun Il; Jung, Sung Won; Mun, Hee-Sun; Cho, Jung Rae; Lee, Namho

    2016-01-01

    We report a case of successfully treated acute fulminant myocarditis induced by ulcerative colitis with extracorporeal life support and infliximab. Myocarditis is a rare but crucial complication during an exacerbation of inflammatory bowel disease. In our case, we applied extracorporeal membrane oxygenation (ECMO) for cardiac rest under impression of acute myocarditis associated with ulcerative colitis, and added infliximab for uncontrolled inflammation by corticosteroid. As a result, our patient was completely recovered with successful weaning of ECMO.

  7. Disodium cromoglycate in the treatment of ulcerative colitis and Crohn's disease.

    Binder, V; Elsborg, L.; Greibe, J; Hendriksen, C; Høj, L; Jensen, K. B.; Kristensen, E.; Madsen, J R; Marner, B; Riis, P; Willumsen, L

    1981-01-01

    A controlled clinical study on disodium cromoglycate (DSCG) at a dose of 800 mg per day versus placebo was carried out in 141 patients with ulcerative colitis and 25 patients with Crohn's disease. Those of the ulcerative colitis patients who had been on sulphasalazine treatment continued that treatment during the trial (101 patients). Forty patients were intolerant of sulphasalazine. No patient received steroids during the last month before the study. Patients with Crohn's disease had their p...

  8. Studies of barrier function in patients with ulcerative colitis and pouchitis

    Persborn, Mats

    2011-01-01

    Background and aim: The cause of ulcerative colitis (UC) is largely unknown. However, there is a presumed genetic component to susceptibility and altered intestinal barrier function has been implicated in the pathophysiology of ulcerative colitis. There is evidence that the increased intestinal permeability in IBD is partly controlled by delicate intercellular circuits in the colonic tissue linked to the enteric nervous system. Little is, however, known about how this is regulated in detail. ...

  9. Distal Ulcerative Colitis Refractory to Rectal Mesalamine: Role of Transdermal Nicotine versus Oral Mesalamine

    Guslandi, Mario; Frego, Roberto; Viale, Edi; Testoni, Pier Alberto

    2002-01-01

    BACKGROUND: Distal ulcerative colitis usually responds to treatment with rectal mesalamine, but the management of refractory cases is poorly defined.AIM: To evaluate the possible therapeutic benefit of transdermal nicotine versus oral mesalamine.PATIENTS AND METHODS: Thirty patients with left-sided ulcerative colitis unresponsive to treatment with a mesalamine 4 g enema at bedtime were randomly allocated to additional therapy with either transdermal nicotine 15 mg daily or oral mesalamine 800...

  10. Fecal calprotectin is a useful marker to diagnose ulcerative colitis from irritable bowel syndrome

    Hamid Kalantari; Akhtar Taheri; Majid Yaran

    2015-01-01

    Background: This study was aimed to evaluate the predictive value of fecal calprotectin in patients with ulcerative colitis from patients with irritable bowel syndrome (IBS). Materials and Methods: Between May and October 2013, 88 adult patients, between the age 18 and 65 years with a history of chronic diarrhea of unknown origin were assessed. Standard colonoscopies were performed in all patients to assess ulcerative colitis. Before colonoscopies, they were asked to supply a stool speci...

  11. Metabolic induction of experimental ulcerative colitis by inhibition of fatty acid oxidation.

    Roediger, W E; Nance, S.

    1986-01-01

    There is some evidence that failure of fatty acid or beta-oxidation in the epithelium of the colonic mucosa is associated with the development of ulcerative colitis. We tested the hypothesis that inhibition of fatty acid oxidation in the colonic mucosa of the rat reproduces the histological, clinical and biochemical lesions of acute ulcerative colitis of man. A specific inhibitor of beta-oxidation, sodium 2-bromo-octanoate, was instilled rectally for 5 days or exposed to isolated colonic epit...

  12. Remission induction and maintenance effect of probiotics on ulcerative colitis: A meta-analysis

    2010-01-01

    AIM:To evaluate the induction of remission and main-tenance effects of probiotics for ulcerative colitis.METHODS: Information was retrieved from MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. The induction of remission and promotion of mainte-nance were compared between probiotics treatment and non-probiotics treatment in ulcerative colitis.RESULTS: Thirteen randomized controlled studies met the selection criteria. Seven studies evaluated the remission rate, and eight studies estimated the re...

  13. Fulminant ulcerative colitis associated with steroid-resistant minimal change disease and psoriasis: A case report

    2007-01-01

    A 43-year-old Chinese patient with a history of psoriasis developed fulminant ulcerative colitis after immunosuppressive therapy for steroid-resistant minimal change disease was stopped. Minimal change disease in association with inflammatory bowel disease is a rare condition. We here report a case showing an association between ulcerative colitis, minimal change disease,and psoriasis. The possible pathological link between 3 diseases is discussed.

  14. Stereomicroscopic examination of stained rectal biopsies in ulcerative colitis and Crohn's disease

    Poulsen, Steen Seier

    1980-01-01

    Rectal biopsy samples from 22 healthy control subjects, 54 patients with ulcerative colitis, and 34 with Crohn's disease with involvement of the colon or rectum were investigated in a stereomicroscopic study. Samples were stained as whole mounts with Alcian Green before the stereomicroscopic...... examination. In ulcerative colitis, biopsies almost constantly showed changes in the mucosal surface pattern, including irregular, enlarged crypt openings filled with exudate, granulated and bulging surface, and patchy localization of the goblet cells. There was a close correlation between the...

  15. Immune thrombocytopenic purpura in ulcerative colitis: a case report and systematic review

    Subhash Chandra

    2014-04-01

    Full Text Available Over 100 extraintestinal manifestations are reported in ulcerative colitis (UC. A commonly reported hematological manifestation is autoimmune hemolytic anemia. On rare occasions, immune thrombocytopenic purpura (ITP has been reported with UC. The presence of thrombocytopenia can complicate the clinical scenario as the number of bloody bowel movements is an important indicator of disease activity in UC. A proposed theory for this association is antigenic mimicry between a platelet surface antigen and bacterial glycoprotein. We are reporting a case of UC and associated ITP managed successfully with anti-TNF therapy. We also performed a systemic review of case reports and a case series reporting this association.

  16. Metabonomics of human fecal extracts characterize ulcerative colitis, Crohn's disease and healthy individuals

    Bjerrum, Jacob Tveiten; Wang, Yulan; Hao, Fuhua;

    2015-01-01

    This study employs spectroscopy-based metabolic profiling of fecal extracts from healthy subjects and patients with active or inactive ulcerative colitis (UC) and Crohn's disease (CD) to substantiate the potential use of spectroscopy as a non-invasive diagnostic tool and to characterize the fecal...... metabolome in inflammatory bowel disease (IBD). Stool samples from 113 individuals (UC 48, CD 44, controls 21) were analyzed by (1)H nuclear magnetic resonance (NMR) spectroscopy (Bruker 600 MHz, Bruker BioSpin, Rheinstetten, Germany). Data were analyzed with principal component analysis and orthogonal...

  17. Anti-inflammatory activity of probiotic Bifidobacterium:Enhancement of IL-10 production in peripheral blood mononuclear cells from ulcerative colitis patients and inhibition of IL-8 secretion in HT-29 cells

    Akemi Imaoka; Tatsuichiro Shima; Kimitoshi Kato; Shigeaki Mizuno; Toshiki Uehara; Satoshi Matsumoto; Hiromi Setoyama; Taeko Hara; Yoshinori Umesaki

    2008-01-01

    AIM: To determine the anti-inflammatory activity of probiotic Bifidobacteria in Bifidobacteria-fermented milk (BFM) which is effective against active ulcerative colitis (UC) and exacerbations of UC, and to explore the immunoregulatory mechanisms.METHODS: Peripheral blood mononuclear cells (PBMNC)from UC patients or HT-29 cells were co-cultured with heat-killed probiotic bacteria or culture supernatant of Bifidobacterium breve strain Yakult (BbrY) or Bifidobacterium bifidum strain Yakult (BbiY) to estimate the amount of IL-10 or IL-8 secreted.RESULTS: Both strains of probiotic Bifidobacteria contained in the BFM induced IL-10 production in PBMNC from UC patients, though BbrY was more effective than BbiY.Conditioned medium (CM) and DNA of both strains inhibited IL-8 secretion in HT-29 cells stimulated with TNF-α, whereas no such effect was observed with heatkilled bacteria.The inhibitory effect of CM derived from BbiY was greater than that of CM derived from BbrY.DNAs of the two strains had a comparable inhibitory activity against the secretion of IL-8.CM of BbiY induced a repression of IL-8 gene expression with a higher expression of IκB-ζ mRNA 4 h after culture of HT-29 cells compared to that in the absence of CM.CONCLUSION: Probiotic Bifidobacterium strains in BFM enhance IL-10 production in PBMNC and inhibit IL-8 secretion in intestinal epithelial cells, suggesting that BFM has anti-inflammatory effects against ulcerative colitis.

  18. Transcriptional analysis of left-sided colitis, pancolitis, and ulcerative colitis-associated dysplasia

    Bjerrum, Jacob T; Nielsen, Ole H; Riis, Lene B; Pittet, Valerie; Mueller, Christoph; Rogler, Gerhard; Olsen, Jørgen

    2014-01-01

    BACKGROUND: It is unknown why patients with extensive ulcerative colitis (UC) have a higher risk of colorectal cancer compared with patients with left-sided UC. This study characterizes the inflammatory processes in left-sided UC, pancolitis, and UC-associated dysplasia at the transcriptional level...... compared with left-sided UC and controls, whereas laminin γ2 (LAMC2) was found with a lower expression in dysplasia compared with the remaining 3 groups. CONCLUSIONS: This study demonstrates pancolitis and left-sided UC as distinct inflammatory processes at the transcriptional level, and identifies INSRA......, MKNK2, and LAMC2 as potential critical transcripts in the inflammation-driven preneoplastic process of UC....

  19. Computed tomography of Crohn`s disease and ulcerative colitis; Computertomographische Morphologie von Morbus Crohn und Colitis ulcerosa

    Klein, H.M. [Klinik fuer Radiologische Diagnostik der RWTH, Aachen (Germany); Wein, B. [Klinik fuer Radiologische Diagnostik der RWTH, Aachen (Germany); Adam, G. [Klinik fuer Radiologische Diagnostik der RWTH, Aachen (Germany); Ruppert, D. [Klinik fuer Radiologische Diagnostik der RWTH, Aachen (Germany); Guenther, R.W. [Klinik fuer Radiologische Diagnostik der RWTH, Aachen (Germany)

    1995-07-01

    We analysed the CT examinations of 109 patients with 197 involved bowel locations. 81 patients suffered from Crohn`s disease, 28 from ulcerative colitis. Diagnosis was based on the combination of clinical, endoscopic and histopathologic findings. Three radiologists evaluated the CT series concerning the presence of morphologic changes analogous to conventional radiographic findings. In Crohn`s disease, we found irregular outer contours in 26% of cases. The bowel wall was thickened in 82%. In acute phases, the bowel wall was thickened in 100%. Abscess and fistula as complications of inflammatory disease were present in 26 and 14% respectively. In ulcerative colitis, a target sign of the bowel wall was present in 40%, whereas in Crohn`s disease a homogeneous wall density was present in all but two cases. Reduced attenuation due to submucosal fat deposits was found in 16% and mucosal tunneling in 27% of cases with ulcerative colitis. Even if severe mucosal destructions were found, the outer contour of the gut was smooth and regular in 95% of the ulcerative colitis cases. CT can provide additional information on acuity, extent and complications in inflammatory bowel disease. In combination with conventional radiographic findings a three-step classification for Crohn`s disease and ulcerative colitis (early changes, acute and chronic phase) can be proposed. (orig./MG) [Deutsch] Wir untersuchten computertomographisch 109 Patienten mit 197 erkrankten Darmsegmenten. 81 Patienten litten an M. Crohn und 28 an Colitis ulcerosa. Die Diagnose wurde durch Kombination klinischer, endoskopischer, radiologischer und bioptischer Befunde gesichert. Drei Radiologen bewerteten die Computertomographien und verglichen die Ergebnisse mit den konventionell-radiologischen Befunden. Bei den Patienten mit M. Crohn fanden wir in 26% der Faelle eine irregulaere aeussere Darmwand. Eine Darmwandverdickung lag in 82% vor und fand sich regelmaessig in Darmabschnitten mit floriden Veraenderungen

  20. A case of ulcerative colitis presenting as pyoderma gangrenosum and lung nodule

    Xin Li

    2014-02-01

    Full Text Available Pyoderma gangrenosum is a phenomenon of cutaneous ulceration where etiology is not well understood. About half of the cases have an associated extracutanoeus manifestation or associated systemic diseases. Most commonly associated systemic disorders include inflammatory bowel disease, hematologic malignancies, autoimmune arthritis, and vasculitis. We are reporting a case where pyoderma gangrenosum has presenting features for ulcerative colitis.

  1. Antibiotic-responsive histiocytic ulcerative colitis in 9 dogs.

    Hostutler, Roger A; Luria, Brian J; Johnson, Susan E; Weisbrode, Steven E; Sherding, Robert G; Jaeger, Jordan Q; Guilford, W Grant

    2004-01-01

    Canine histiocytic ulcerative colitis (HUC) is characterized by colonic inflammation with predominantly periodic acid-Schiff (PAS)-positive macrophages. The inflammation results in colonic thickening, ulcerations, and distortion of normal glandular architecture. Resultant clinical signs consist of chronic large bowel diarrhea, tenesmus, and marked weight loss, and the disease frequently results in euthanasia. Conventional therapy consists of some combination of prednisone, azathioprine, sulfasalazine, and metronidazole. Nine dogs (8 Boxers and 1 English Bulldog) with histologic confirmation of HUC were treated with antibiotic therapy (either with enrofloxacin alone or in combination with metronidazole and amoxicillin). Clinical signs, physical examination findings, laboratory abnormalities, and the histologic severity of the disease were evaluated. Four of the 9 dogs had been treated previously with conventional therapy and had failed to respond favorably; then, these dogs were placed on antibiotic therapy (enrofloxacin, n = 1; enrofloxacin, metronidazole, and amoxicillin, n = 3) and had resolution of clinical signs within 3-12 days. Five dogs were treated solely with antibiotic therapy (enrofloxacin, n = 1; enrofloxacin and metronidazole, n = 1; enrofloxacin, metronidazole, and amoxicillin, n = 3), and clinical signs resolved in 2-7 days. Repeated biopsy specimens were obtained from 5 dogs after treatment, and all showed marked histologic improvement. The increase in body weight after treatment was statistically significant (P = .01). Three dogs currently are not on any treatment and have had resolution of clinical signs for up to 14 months. These observations suggest that an infectious agent responsive to antibiotics plays an integral role in the clinical manifestation of canine HUC, and they support the use of antibiotics in its treatment. PMID:15320587

  2. Anti-inflammatory effect of Diammonium Glycyrrhizinate in a rat model of ulcerative colitis

    Hao Yuan; Wan-Sheng Ji; Ke-Xiang Wu; Jian-Xin Jiao; Liang-Hua Sun; Yong-Tang Feng

    2006-01-01

    AIM: To explore the anti-inflammatory mechanism of Diammonium Glycyrrhizinate in a rat model of ulcerative colitis induced by acetic acid.METHODS: Spragur-Dawley female rats were divided into four groups: Diammonium Glycyrrhizinate group,dexamethasone group, acetic acid control and normal control group. Colonic inflammation was evaluated by disease activity index, gross morphologic damage,histological injury and colonic myeloperoxidase activity.Immunohistochemistry was used to detect the expression of NF-κB, TNF-α and ICAM-1 in colonic mucosa.RESULTS: Compared to the acetic acid control, both Diammonium Glycyrrhizinate and dexamethasone showed a significant anti-inflammatory effect (P<0.01).The expression of NF-κB, TNF-α and ICAM-1 in colonic mucosa was significantly lower in the Diammonium Glycyrrhizinate group and dexamethasone group than in the acetic acid group.CONCLUSION: Diammonium Glycyrrhizinate could reduce inflammatory injury in a rat model of ulcerative colitis. This may occur via suppression of NF-κB, TNF-α and ICAM-1 in colonic mucosa.

  3. Hyperhomocysteinemia in ulcerative colitis is related to folate levels

    Petros Zezos; Georgia Papaioannou; Nikolaos Nikolaidis; Themistoclis Vasiliadis; Olga Giouleme; Nikolaos Evgenidis

    2005-01-01

    AIM: To study the prevalence and clinical significance of hyperhomocysteinemia (hHcys), an independent factor for arterial and venous thrombosis, in a group of patients with ulcerative colitis (UC).METHODS: Fasting homocysteine (Hcys), folate, and vitamin B12 serum levels were measured in 40 UC patients and 50 healthy controls. Clinical data regarding UC were gathered.RESULTS: Median serum Hcys levels in UC patients were similar to those in controls (12.26 μmol/L vs 12.32 μmol/L), but the prevalence of hHcys was higher in UC patients than in controls (30% vs 10%, P= 0.028). UC significantly increased the risk of hHcys (adjusted odds ratio: 4.125;95% CI: 1.26-13.44). Multivariate regression analysis showed that male sex, folate and vitamin B12 deficiency or lower serum values were significant independent predictors of higher Hcys levels in UC patients (r2 = 0.4; P<0.001).CONCLUSION: hHcys is common in UC patients and it is related to folate and vitamin B12 deficiency or lower serum values. It would be reasonable for patients with UC to receive folate and vitamin B complex supplements as a prophylactic measure.

  4. Evaluation of Food Intake in Ulcerative Colitis Patients

    Z Faghfoori

    2010-04-01

    Full Text Available Introduction: Ulcerative colitis (UC is a chronic inflammatory disorder of the colon of unknown cause that is associated with important nutrition deficiencies such as protein-energy malnutrition, vitamin and mineral deficiencies. Because no study has been carried out to date in Iran, the aim of this pilot study was the assessment of dietary intake of these patients. Methods: In this pilot study, 41 UC patients whose disease severity was mild or moderate were selected. Data about diet restrictions were collected via a questionnaire and dietary intake was assessed 3 times during a 2 month period with 30 days interval and 3-day food-recall (9days in general. Results: Subjects were 26 men and 15 women and 65.9% patients avoided completely or limited milk intake. Dietary limitation about fruits and vegetables was 24.4 and 43.9 percent, respectively and legumes intake was 58.5%. Mean calorie intake in 41 patients was 2125.14±60.83 calories/day and in two groups, calcium and fiber intake was significantly less than the standard dietary recommendation. Conclusion: Dietary intake examination showed some deficiencies such as calcium and iron deficiency and fiber intake was low because the intake of fruits, vegetables and legumes was limited.

  5. Two Cases of Diffuse Duodenitis Associated with Ulcerative Colitis

    Katsuya Endo

    2012-01-01

    Full Text Available The upper gastrointestinal tract is not generally considered a target organ in ulcerative colitis (UC. However, several cases showing upper gastrointestinal involvement in UC have been reported. In this report, we present 2 rare cases of diffuse duodenitis accompanying pancolonic UC. Case patient 1 was a 44-year-old man who developed diffuse duodenitis shortly after colectomy and was successfully treated with mesalazine. Case patient 2 was a 25-year-old woman who developed diffuse duodenitis under a steroid-free condition and was successfully treated with prednisolone. The 2 patients had Helicobacter pylori-negative duodenitis that resembled colonic lesions of UC in both the endoscopic and histological findings. No evidence of Crohn’s disease was found in these cases. We diagnosed both cases as typical UC-associated diffuse duodenitis. The occurrence of gastrointestinal involvement in UC has been attracting attention because such lesions could potentially open a new window for studying the etiology and pathogenesis of UC. Further studies involving a large number of patients are needed to clarify whether the upper gastrointestinal tract is a target organ in UC.

  6. Ulcerative colitis and Crohn's disease tissue cytotoxins

    McLaren, L.C.; Gitnick, G.

    1982-06-01

    Bowel-wall tissue filtrates from patients with inflammatory bowel disease produce cytopathic effects in tissue culture. The cytopathic effects inducers have been reported to have the characteristics of a small RNA virus. Clostridium difficile toxin also produces cytopathic effects and has been found in the stools of patients with Crohn's disease and ulcerative colitis. The present study concerns the further characterization of the cytopathic inducers in tissues of inflammatory bowel disease patients. It was found that they are nonsedimentable at 148,000 g for 2 h and resistant to inactivation by UV light. They are proteins that are distinct from C. difficile toxin and are unique cytotoxins which are associated with the early cytopathic effects observed in Riff-free chick embryo and rabbit ileum cell cultures. These results suggest that the early cytopathic effects previously described are not produced by a virus. They do not explain the delayed cytopathic effects seen in rabbit ileum or WI-38 cells.

  7. Developments in the treatment of moderate to severe ulcerative colitis: focus on adalimumab

    Freeman HJ

    2013-11-01

    Full Text Available Hugh J FreemanDepartment of Medicine (Gastroenterology, University of British Columbia, Vancouver, BC, Canada Abstract: In selected patients with moderate to severe active ulcerative colitis who have failed to respond or are poorly responsive to standard pharmacologic forms of treatment with corticosteroids and immunosuppressive agents, therapy with a biological agent may be considered. While infliximab is an established tumor necrosis factor blocker and has a longer history of clinical use, adalimumab is an alternative in the same class and may be employed as an initial biological agent, if indicated for treatment of the disease. Adalimumab may have special appeal to stable users able to self-inject in a home setting rather than a centralized infusion center. Short-term adverse effects have been limited, but long-term adverse events can be serious and remain less well defined. Recently, another agent, subcutaneous golimumab, has also been reported to induce and maintain clinical response and remission in clinical trials, but a large experience has not been accumulated to date in clinical practice. In the future, other biological agents with novel and distinct mechanisms of therapeutic action may become available. Keywords: ulcerative colitis, anti-tumor necrosis factor inhibitors, biological therapy, infliximab, adalimumab

  8. Specific immunotherapy plus Clostridium butyricum alleviates ulcerative colitis in patients with food allergy.

    Bin Lan; Yang, Fan; Lu, Dong; Lin, Zhenlv

    2016-01-01

    The aberrant T cell activation plays an important role in the pathogenesis of intestinal inflammation, such as ulcerative colitis (UC). C. butyricum (Cb) is a probiotic and has been employed in the treatment of immune diseases. This study tests a hypothesis that specific immunotherapy (SIT) plus oral Cb (an over-the-counter probiotic) alleviates the UC symptoms. In this study, we conducted a randomized, double-blind, clinical study at our hospital. A total of 80 patients with relapsing-remitting ulcerative colitis and high levels of specific IgE antibody was randomly divided into 4 groups, and were treated with SIT or/and Cb, or placebo, respectively for 1 year. The results showed that a food antigen-specific Th2 polarization immune response was observed in UC patients with food allergy (FA). The frequency of regulatory B cells was significantly less in UC patients with FA as compared with healthy subjects. The UC patients with FA were treated with SIT and Cb showed significant amelioration of UC clinical symptoms, reduction of using UC-control medicines, and suppression of the skewed Th2 polarization, which did not occur in those treated with either SIT alone, or Cb alone, or placebo. In conclusion, combination of SIT and Cb efficiently alleviates a fraction of UC patients. PMID:27167186

  9. Steroid-refractory ulcerative colitis and associated primary sclerosing cholangitis treated with infliximab

    Ileana Duca

    2013-01-01

    Full Text Available Primary sclerosing cholangitis is an infrequent extraintestinal manifestation of ulcerative colitis. Damage to bile ducts is irreversible and medical therapies to prevent progression of the disease are usually ineffective. We describe a patient with long-standing ulcerative colitis, which was refractory to corticosteroid therapy who developed primary sclerosing cholangitis (biochemical stage II/IV in the course of his pancolitis. Treatment with infliximab (5 mg/kg as an induction dose followed by maintenance doses every two months was indicated because of steroid-dependent disease associated to primary sclerosing cholangitis as well as sacroiliitis and uveitis and previous episode of severe azathioprine-related hepatic toxicity. At present, after two years of follow-up, the patient is asymptomatic with normal liver tests and complete resumption of daily life activities. This case draws attention to the usefulness of anti-tumor necrosis factor-alpha therapy for the management of primary sclerosing cholangitis as extraintestinal manifestation of inflammatory bowel disease.

  10. Clinical significance of serum sex hormones protein and lipid determination in patients with ulcerative colitis

    Objective: To investigate the relationships between changes of serum sex hormones levels and protein-lipid metabolism in patients with ulcerative colitis. Methods: Serum levels of estradiol (E2) pregnenedione (P), prolactin(PRL), luteinizing hormone (LH), follicle-stimulating hormone (FSH) (with CLIA), sree testos (T, with RIA) and total-protein (TP), albumin (Alb), globulin (G), albumin/globulinratio (A/G) total-cholesterd (TC), high density lipoprotein cholesterols (LDL-C) (with biochemistry were determined in 72 patients) with ulcerative colitis and 72 controls. Results: The serum levels of T, LH, FSH, TP, Alb, A/G, TC, LDL-C in patients with ulcerative colitis were significantly lower than those in controls (P2, PRL in patients with ulcerative colitis were significantly higher than those in controls (P2 were negatively correlated with TP, A/G and TC (P2 levels in the female sex (P>0.05) as well as between LH, FSH and T levels in the male sex (P>0.05). Conclusion: The abnormal serum levels of sex hormone might contribute to the development of hypoproteinaemia and lowered lipid levels in patients with ulcerative colitis. Treatment with correction of serum sex hormones levels might be beneficial to the patients. (authors)

  11. Sulphomucin expression in ileal pouches: emerging differences between ulcerative colitis and familial adenomatous polyposis pouches.

    Bambury, Niamh

    2012-02-03

    PURPOSE: We characterized the expression of sialomucin and sulphomucin in pouches fashioned for familial adenomatous polyposis and ulcerative colitis. We correlated sulphomucin expression with bacterial colonization and mucosal inflammation. METHODS: Ethical approval and informed consent were obtained. Mucosal biopsies from 9 patients with familial adenomatous polyposis and 12 with ulcerative colitis were obtained. Sulphomucin levels were assessed by using the high iron-diamine stain. Mucous gel layer composition was correlated with villous height, crypt depth, and total mucosal thickness. Mucous gel layer composition was correlated with acute and chronic inflammatory infiltrates. Colonization by a panel of seven bacterial species (including sulphate reducing bacteria) was established and correlated with sulphomucin levels. RESULTS: High-iron-diamine positivity (i.e., sulphomucin expression) was greater in ulcerative colitis pouch mucous gel (2.083 +\\/- 0.5 vs. 0.556 +\\/- 0.4, P = 0.003). Sulphomucin expression correlated with reduced crypt depth, villous height, and total mucosal thickness. In the ulcerative colitis group, chronic inflammatory infiltrate scores were significantly greater for high-iron-diamine-positive patients. Colonization by sulphate reducing bacteria was increased in high-iron-diamine-positive patients. CONCLUSIONS: Sulphomucin expression is increased in the mucous gel layer of the ulcerative colitis pouch compared with that of the familial adenomatous polyposis pouch. Sulphomucin expression is associated with colonization by sulphate-reducing bacteria and increased chronic inflammation.

  12. Utility of fecal calprotectin as a discriminative biomarker between ulcerative colitis and irritable bowel syndrome and its ability to be used for the assessment of the remission stage of ulcerative colitis

    Hossam M Elsaadany; Mohammed F Almaghraby; Awatif A Edrees; Yasser M Elsherbiny; Roobina K Kumar

    2016-01-01

    Background and aim Fecal calprotectin (FC) has been proposed in recent studies as a sensitive, specific biomarker for the diagnosis of ulcerative colitis (UC). Hence, the present study sought to investigate the efficacy of FC for the diagnosis and monitoring of UC, as well as to assess the correlation of FC with other disease activity indexes. Research design and methods The present study included 96 consecutive patients who presented with lower gastrointestinal complaints. Patients ...

  13. Bacteria penetrate the normally impenetrable inner colon mucus layer in both murine colitis models and patients with ulcerative colitis

    Johansson, Malin E. V.; Gustafsson, Jenny K.; Holmén-Larsson, Jessica; Jabbar, Karolina S.; Xia, Lijun; Xu, Hua; Ghishan, Fayez K.; Carvalho, Frederic A.; Gewirtz, Andrew T; Sjövall, Henrik; Hansson, Gunnar C.

    2013-01-01

    Objective The inner mucus layer in mouse colon normally separates bacteria from the epithelium. Do humans have a similar inner mucus layer and are defects in this mucus layer a common denominator for spontaneous colitis in mice models and ulcerative colitis (UC)? Methods and results The colon mucus layer from mice deficient in Muc2 mucin, Core 1 O-glycans, Tlr5, interleukin 10 (IL-10) and Slc9a3 (Nhe3) together with that from dextran sodium sulfate-treated mice was immunostained for Muc2, and...

  14. Retrospective Evaluation of Cases Diagnosed with Ulcerative Colitis

    Gülseren Şahin

    2012-04-01

    Full Text Available In­tro­duc­ti­on: Inflammatory bowel disease (IBD is a chronic inflammatory disease of the gastrointestinal canal characterised by remissions and exacerbations. This study aimed to make a retrospective evaluation of clinical and laboratory findings of patients being monitored with a diagnosis of IBD.Materials and Methods: Medical records of 18 patients with a diagnosis of IBD and 7 years of follow-up at our pediatric gastroenterology departments were investigated with respect to demographic data, complaints on presentation and accompanying diseases. Unusual findings from physical examination, endoscopic findings, histopathological findings and the applied treatments were examined.Results: The 18 patients (10 female, 8 male included in this study had a mean age of 13.6±2.9 years and the mean time from onset of symptoms to diagnosis was 6.9±4.5 months. Seventeen patients were diagnosed with ulcerative colitis and 1 patient with intermediate colitis. There was a positive family history of the disease in 2 patients (11%. At the time of diagnosis, the most common complaints on presentation were found to be abdominal pain (100%, bloody diarrhea (94.5% and tenesmus (44.4%. The most frequent laboratory findings were CRP positivity (89%, increased sedimentation rate (83.3% and iron-deficient anaemia (77.7%. On colonoscopy, pancolitis involvement (66.6% was most frequently encountered. Accompanying diseases to IBD were found to be familial Mediterranean fever (FMF (11%, celiac disease (5.5% and Heliobacter pylori gastritis (5.5%. One patient (5.5% who did not respond to medical treatment for pancolitis involvement underwent a colectomy. Discussion: The number of diagnoses of IBD in childhood is gradually increasing. Nonetheless, it can be difficult to define diseases with non-specific symptoms and this may cause a delay in diagnosis. Because of the association of autoimmune diseases with IBD, despite appropriate therapy, diseases with no remission

  15. Fecal Microbial Composition of Ulcerative Colitis and Crohn’s Disease Patients in Remission and Subsequent Exacerbation

    Edgar S Wills; Jonkers, Daisy M. A. E.; Paul H Savelkoul; Masclee, Ad A.; Pierik, Marieke J.; John Penders

    2014-01-01

    BACKGROUND: Limited studies have examined the intestinal microbiota composition in relation to changes in disease course of IBD over time. We aimed to study prospectively the fecal microbiota in IBD patients developing an exacerbation during follow-up. DESIGN: Fecal samples from 10 Crohn's disease (CD) and 9 ulcerative colitis (UC) patients during remission and subsequent exacerbation were included. Active disease was determined by colonoscopy and/or fecal calprotectine levels. Exclusion crit...

  16. Oxidative Stress and Carbonyl Lesions in Ulcerative Colitis and Associated Colorectal Cancer

    Zhiqi Wang; Sai Li; Yu Cao; Xuefei Tian; Rong Zeng; Duan-Fang Liao; Deliang Cao

    2016-01-01

    Oxidative stress has long been known as a pathogenic factor of ulcerative colitis (UC) and colitis-associated colorectal cancer (CAC), but the effects of secondary carbonyl lesions receive less emphasis. In inflammatory conditions, reactive oxygen species (ROS), such as superoxide anion free radical (O2 ∙−), hydrogen peroxide (H2O2), and hydroxyl radical (HO∙), are produced at high levels and accumulated to cause oxidative stress (OS). In oxidative status, accumulated ROS can cause protein dy...

  17. Impact of lipoprotein lipase gene polymorphisms on ulcerative colitis

    Toshihito Kosaka; Taizou Shiraishi; Masatoshi Watanabe; Takayuki Yamamoto; Ai Nakahara; Takahiko Katoh; Junji Yoshino; Kazuo Inui; Takao Wakabayashi; Kazumu Okushima; Takashi Kobayashi; Hironao Miyoshi; Yuta Nakamura; Shigekazu Hayashi

    2006-01-01

    AIM: To examine the influence of lipoprotein lipase (LPL)gene polymorphism in ulcerative colitis (UC) patients.METHODS: Peripheral blood was obtained from 131 patients with UC and 106 healthy controls for DNA extraction. We determined LPL gene polymorphisms affecting the enzyme at Ser447stop, as well as Hind Ⅲ and Pvu Ⅱ polymorphisms using PCR techniques. PCR products were characterized by PCR-RFLP and direct sequencing.Polymorphisms were examined for association with clinical features in UC patients. Genotype frequencies for LPL polymorphisms were also compared between UC patients and controls.RESULTS: In patients with onset at age 20 years or younger, C/G and G/G genotypes for Ser447stop polymorphism were more prevalent than C/C genotype (OR= 3.13, 95% CI = 0.95-10.33). Patients with H+/- or H-/-genotype for HindⅢ polymorphism also were more numerous than those with H+/+ genotype (OR = 2.51, 95%CI = 0.85-7.45). In the group with H+/+ genotype for HindⅢ polymorphism, more patients had serum triglyceride concentrations over 150 mg/dL than patients with H+/- or H-/- genotype (P < 0.01, OR = 6.46, 95% CI =1.39-30.12). Hypertriglycemia was also more prevalent in patients with P+/+ genotypes for Pvu Ⅱ polymorphism (P< 0.05, OR = 3.0, 95% CI = 1.06-8.50). Genotype frequency for LPL polymorphism did not differ significantly between UC patients and controls.CONCLUSION: Ser447stop and HindⅢ LPL polymorphisms may influence age of onset of UC, while HindⅢand PvuⅡ polymorphisms influence serum triglyceride in UC patients.

  18. Nutritional modulators of ulcerative colitis: Clinical efficacies and mechanistic view

    Mi-Kyung Sung

    2013-01-01

    Full Text Available Ulcerative colitis (UC is an inflammation-associated disease of the colon and rectum. The onset and progress of the disease are directly influenced by the nature of the intestinal microflora, the intestinal barrier function, and the immunological responses of the host. The epithelial invasion of pathogenic bacteria due to excess contact and/or barrier dysfunction is related to inflammation mediated by intestinal immune responses. Although the etiology of UC is not clearly understood, recent studies have shown a rising incidence of UC worldwide, and this phenomenon is more prominent in Asian countries and in Asian immigrants in Western countries. The increased prevalence of UC also contributes to an increased risk of developing colorectal cancer. Environmental factors, including changes in dietary habits, have been suggested as major risk factors of UC. A systematic review showed a negative association between UC risk and vegetable intake, whereas total fat, omega-6 fatty acids and meat intake were positively associated with an increased risk of UC. Individual dietary factors and energy balance have been suggested as having important roles in inducing changes in the microbial population and intestinal barrier integrity and in regulating inflammatory immune responses, directly or indirectly. Excess energy intake is now known to increase pathogenic microbial populations. Likewise, the application of appropriate probiotics may reverse the pathogenic progression of the disease. In the meantime, dietary anti-inflammatory compounds, including omega-3 fatty acids and other phytochemicals, may directly suppress inflammatory responses in the course of UC development. In this review, the increased prevalence of UC and its management are interpreted from the standpoint of nutritional modulation to regulate the intestinal microflora population, intestinal epithelium permeability, and inflammatory responses.

  19. Sweet's syndrome: an unusual cutaneous feature of Crohn's disease or ulcerative colitis. The South West Gastroenterology Group.

    Travis, S; Innes, N; Davies, M G; Daneshmend, T; Hughes, S

    1997-07-01

    Sweet's syndrome is characterized by tender, red inflammatory nodules or papules, usually affecting the upper limbs, face or neck. It is part of the group of acute neutrophilic dermatoses that includes pyoderma gangrenosum, but can be distinguished by its appearance, distribution and histological features. Four patients with Sweet's syndrome and Crohn's disease are reported. A total of 30 cases from the literature suggest that Sweet's syndrome is an unusual extraintestinal manifestation of either Crohn's disease or ulcerative colitis. There is a strong predilection for women (87%), patients with colonic disease (100%) and those with other extraintestinal features (77%). The rash is associated with active disease in 67-80%, but may precede the onset of intestinal symptoms in 21% and has been reported 3 months after proctocolectomy for ulcerative colitis. PMID:9262983

  20. Evaluation of 5 versus 10 granulocyteaphaeresis sessions in steroid-dependent ulcerative colitis: A pilot, prospective, multicenter, randomized study

    Elena Ricart; Maria Esteve; Montserrat Andreu; Francesc Casellas; David Monfort; Miquel Sans; Natalia Oudovenko; Raúl Lafuente; Julián Panés

    2007-01-01

    AIM: To evaluate the efficacy of 5 compared to 10 granulocyteaphaeresis sessions in patients with active steroid-dependent ulcerative colitis.METHODS: In this pilot, prospective, multicenter randomized trial, 20 patients with moderately active steroid-dependent ulcerative colitis were randomized to 5 or 10 granulocyteaphaeresis sessions. The primary objective was clinical remission at wk 17. Secondary measures included endoscopic remission and steroid consumption.RESULTS: Nine patients were randomized to 5 granulocyteaphaeresis sessions (group 1) and L1 patients to 10 granulocyteaphaeresis sessions (group 2). At wk 17, 37.5% of patients in group 1 and 45.45% of patients in group 2 were in clinical remission. Clinical remission was accompanied by endoscopic remission in all cases.Eighty-six percent of patients achieving remission were steroid-free at wk 17. Daily steroid requirements were significantly lower in group 2. Eighty-nine per cent of patients remained in remission during a one year follow-up. One serious adverse event, not related to the study therapy, was reported.CONCLUSION: Granulocyteaphaeresis is safe and effective for the treatment of steroid-dependent ulcerative colitis. In this population, increasing the number of aphaeresis sessions is not associated with higher remission rates, but affords a significant steroid-sparing effect.

  1. A Phase II dose ranging, double-blind, placebo-controlled study of alicaforsen enema in subjects with acute exacerbation of mild to moderate left-sided ulcerative colitis

    S.J.H. van Deventer; M.K. Wedel; B.F. Baker; S. Xia; E. Chuang; P.B. Miner

    2006-01-01

    Alicaforsen is an antisense oligonucleotide designed to inhibit expression of human intercellular adhesion molecule 1. Previous clinical studies have demonstrated activity of alicaforsen enema in ulcerative colitis and pouchitis. To determine the minimally effective dosing regimen of alicaforsen ene

  2. Genesis of anxiety, depression, and ongoing abdominal discomfort in ulcerative colitis-like colon inflammation.

    Chen, Jinghong; Winston, John H; Fu, Yu; Guptarak, Jutatip; Jensen, Kathryn L; Shi, Xuan-Zheng; Green, Thomas A; Sarna, Sushil K

    2015-01-01

    Psychological disorders are prevalent in patients with inflammatory bowel disease; the underlying mechanisms remain unknown. We tested the hypothesis that ulcerative colitis-like inflammation induced by dextran sodium sulfate (DSS) exacerbates the ongoing spontaneous activity in colon-projecting afferent neurons that induces abdominal discomfort and anxiety, and depressive-like behaviors in rats. In this study, we used the conditioned place preference and standard tests for anxiety- and depression-like behaviors. DSS rats developed anxiety- and depression-like behaviors 10 to 20 days after the start of inflammation. Single-fiber recordings showed an increase in the frequency of spontaneous activity in L6-S1 dorsal root ganglion (DRG) roots. Prolonged desensitization of transient receptor potential vanilloid 1 (TRPV1)-expressing colonic afferents by resiniferatoxin (RTX) suppressed the spontaneous activity, as well as the anxiety- and depressive-like behaviors. Reduction in spontaneous activity in colon afferents by intracolonic administration of lidocaine produced robust conditioned place preference (CPP) in DSS rats, but not in control rats. Patch-clamp studies demonstrated a significant decrease in the resting membrane potential, lower rheobase, and sensitization of colon-projecting L6-S1 DRG neurons to generate trains of action potentials in response to current injection in DSS rats. DSS inflammation upregulated the mRNA levels of transient receptor potential ankyrin 1 and TRPV1 channels and downregulated that of Kv1.1 and Kv1.4 channels. Ulcerative colitis-like inflammation in rats induces anxiety- and depression-like behaviors, as well as ongoing abdominal discomfort by exacerbating the spontaneous activity in the colon-projecting afferent neurons. Alterations in the expression of voltage- and ligand-gated channels are associated with the induction of mood disorders following colon inflammation. PMID:25411361

  3. Unusual Case of Cerebral Venous Sinus Thrombosis in Patient with Ulcerative Colitis in Remission.

    Meher, Lalit Kumar; Dalai, Siba Prasad; Panda, Sameer; Hui, Pankaj Kumar; Nayak, Sachidananda

    2016-05-01

    Ulcerative colitis (UC) is an idiopathic autoimmune inflammatory disease of the gastrointestinal tract. Cerebral venous sinus thrombosis along with deep vein thrombosis, pulmonary embolism and arterial thrombosis have occasionally been reported as a complication in the active phase of UC being attributed to its pro-thrombotic state. This paper depicts a 38-year-old female with a history of UC in remission who developed sudden onset headache, blurring of vision and seizures. Subsequent diagnosis of cerebral venous sinus thrombosis was made with MRI venography and treated with low molecular weight heparin with complete resolution of symptoms. The highlights of this case underscore the importance of evaluating cerebral venous sinus thrombosis as a cause of acute onset neurological deterioration in a setting of inflammatory bowel disease. It also emphasizes on the hypothesis that the risk of venous thrombosis or other hypercoagulable states have no direct relationship with the disease activity or flare-up. PMID:27437291

  4. A study of endotoxemia in ulcerative colitis and Crohn's disease. I. Clinical study.

    Aoki,Kunitake

    1978-06-01

    Full Text Available Endotoxin (lipopolysaccharide, LPS and LPS antibody in the blood were studied in 61 cases of ulcerative colitis (U.C. by radioimmunoassay. Lysozyme (LZM concentration was also studied by the turbidimetric method. As a result, it was found that the blood LPS value as well as serum LZM concentration reflects the clinical observations. The case of endotoxemia in the active phase group showed a positive correlation between the LPS value and LZM concentration. LPS antibody which could not be detected in many cases of the active phase, had a high titer in cases of remission with a long history of the disease. These results would suggest that in U.C. with damaged intestinal mucosal barrier, LPS originating from intestinal flora enters into the blood and aggravates the disease and further that this invading LPS releases LZM into the blood. The same studies were performed on 7 cases of Crohn's disease and the same result was obtained.

  5. 1H NMR-based spectroscopy detects metabolic alterations in serum of patients with early-stage ulcerative colitis

    Highlights: •Twenty ulcerative colitis patients and nineteen healthy controls were enrolled. •Increased 3-hydroxybutyrate, glucose, phenylalanine, and decreased lipid were found. •We report early stage diagnosis of ulcerative colitis using NMR-based metabolomics. -- Abstract: Ulcerative colitis (UC) has seriously impaired the health of citizens. Accurate diagnosis of UC at an early stage is crucial to improve the efficiency of treatment and prognosis. In this study, proton nuclear magnetic resonance (1H NMR)-based metabolomic analysis was performed on serum samples collected from active UC patients (n = 20) and healthy controls (n = 19), respectively. The obtained spectral profiles were subjected to multivariate data analysis. Our results showed that consistent metabolic alterations were present between the two groups. Compared to healthy controls, UC patients displayed increased 3-hydroxybutyrate, β-glucose, α-glucose, and phenylalanine, but decreased lipid in serum. These findings highlight the possibilities of NMR-based metabolomics as a non-invasive diagnostic tool for UC

  6. {sup 1}H NMR-based spectroscopy detects metabolic alterations in serum of patients with early-stage ulcerative colitis

    Zhang, Ying; Lin, Lianjie [Second Department of Gastroenterology, Shengjing Hospital, China Medical University, Shenyang 110004 (China); Xu, Yanbin [Wanlei Life Sciences (Shenyang) Co., Ltd., Shenyang 110179 (China); Lin, Yan; Jin, Yu [Second Department of Gastroenterology, Shengjing Hospital, China Medical University, Shenyang 110004 (China); Zheng, Changqing, E-mail: changqing_zheng@126.com [Second Department of Gastroenterology, Shengjing Hospital, China Medical University, Shenyang 110004 (China)

    2013-04-19

    Highlights: •Twenty ulcerative colitis patients and nineteen healthy controls were enrolled. •Increased 3-hydroxybutyrate, glucose, phenylalanine, and decreased lipid were found. •We report early stage diagnosis of ulcerative colitis using NMR-based metabolomics. -- Abstract: Ulcerative colitis (UC) has seriously impaired the health of citizens. Accurate diagnosis of UC at an early stage is crucial to improve the efficiency of treatment and prognosis. In this study, proton nuclear magnetic resonance ({sup 1}H NMR)-based metabolomic analysis was performed on serum samples collected from active UC patients (n = 20) and healthy controls (n = 19), respectively. The obtained spectral profiles were subjected to multivariate data analysis. Our results showed that consistent metabolic alterations were present between the two groups. Compared to healthy controls, UC patients displayed increased 3-hydroxybutyrate, β-glucose, α-glucose, and phenylalanine, but decreased lipid in serum. These findings highlight the possibilities of NMR-based metabolomics as a non-invasive diagnostic tool for UC.

  7. Safety and efficacy of Profermin(R) to induce remission in ulcerative colitis

    Aleksander Krag; Hans Israelsen; Bjφrn von Ryberg; Klaus K Andersen; Flemming Bendtsen

    2012-01-01

    AIM:To test the efficacy and safety of Profermin(R) in inducing remission in patients with active ulcerative colitis (UC).METHODS:The study included 39 patients with mild to moderate UC defined as a Simple Clinical Colitis Activity Index (SCCAI) > 4 and < 12 (median:7.5),who were treated open-label with Profermin(R) twice daily for 24 wk.Daily SCCAI was reported observer blinded via the Internet.RESULTS:In an intention to treat (ITT) analysis,the mean reduction in SCCAI score was 56.5%.Of the 39 patients,24 (62%) reached the primary endpoint,which was proportion of patients with ≮ 50% reduction in SCCAI.Our secondary endpoint,the proportion of patients in remission defined as SCCAI ≤ 2.5,was in ITT analysis reached in 18 of the 39 patients (46%).In a repeated-measure regression analysis,the estimated mean reduction in score was 5.0 points (95% CI:4.1-5.9,P < 0.001) and the estimated mean time taken to obtain half the reduction in score was 28 d (95% CI:26-30).There were no serious adverse events (AEs) or withdrawals due to AEs.Profermin(R)was generally well tolerated.CONCLUSION:Profermin(R) is safe and may be effective in inducing remission of active UC.

  8. Different therapy for different types of ulcerative colitis in China

    Xue-Liang Jiang; Hui-Fei Cui

    2004-01-01

    AIM: To study the different therapy for different types of ulcerative colitis (UC) in China.METHODS: Among 102 UC patients, 42 chronic relapse type UC patients were randomly divided into olsalazine sodium treatment group (n=21) and SASP group (n=-21).Clinical effects and safety were observed in the 2 groups.Forty-two first episode type UC patients were randomly divided into Heartleaf houttuynia herb treatment group (n=21) and SASP group (n=21). Clinical effects were observed in the 2 groups while ultrastructure of colonic mucosa, ICAM-1 and the pressure of distant colon were studied in Heartleaf houttuynia herb group. Eighteen patients (8 males, 10 females) with refractory UC and unresponsive to high-dose prednisolone and sulfasalazine therapy more than one month were treated with Kangshuanling (7 200 U/d). Prednisolone was gradually stopped and sulfasalazine was maintained. Stool frequency,rectal bleeding, colonoscopy, general well-being, histology were observed and CD62p, CD63, CD54, Pgp-170 (flow cytometry), TXA2 (RIA), blood platelet aggregation rate and thrombosis length in vitro were assessed.RESUL TS: In the 42 chronic relapse type UC patients, the overall clinical effects of olsalazine sodium group (complete remission in 16, improvement in 4, inefficiency in L) were better than those of SASP group (complete remission in 10,improvement in 4, inefficiency in 7, P<0.05). Symptomatic remission of olsalazine sodium group (complete remission in 15, partial remission in 5, inefficiency in 1) was better than that of SASP group (complete remission in 10, partial remission in 5, inefficiency in 6, P<0.05). The colonoscopic remission of olsalazine sodium group(complete remission in 11, partial remission in 9, inefficiency in 1) was better than that of SASP group (complete remission in 7, partial remission in 8, inefficiency in 6, P<0.05). The histologic remission of olsalazine sodium group (complete remission in 13, partial remission in 7, inefficiency in in 1

  9. Laboratory markers in ulcerative colitis: Current insights and future advances

    Michele; Cioffi; Antonella; De; Rosa; Rosalba; Serao; Ilaria; Picone; Maria; Teresa; Vietri

    2015-01-01

    Ulcerative colitis(UC)and Crohn’s disease(CD)are the major forms of inflammatory bowel diseases(IBD)in man.Despite some common features,these forms can be distinguished by different genetic predisposition,risk factors and clinical,endoscopic and histological characteristics.The aetiology of both CD and UC remains unknown,but several evidences suggest that CD and perhaps UC are due to an excessive immuneresponse directed against normal constituents of the intestinal bacterial flora.Tests sometimes invasive are routine for the diagnosis and care of patients with IBD.Diagnosis of UC is based on clinical symptoms combined with radiological and endoscopic investigations.The employment of non-invasive biomarkers is needed.These biomarkers have the potential to avoid invasive diagnostic tests that may result in discomfort and potential complications.The ability to determine the type,severity,prognosis and response to therapy of UC,using biomarkers has long been a goal of clinical researchers.We describe the biomarkers assessed in UC,with special reference to acute-phase proteins and serologic markers and thereafter,we describe the new biological markers and the biological markers could be developed in the future:(1)serum markers of acute phase response:The laboratory tests most used to measure the acute-phase proteins in clinical practice are the serum concentration of C-reactive protein and the erythrocyte sedimentation rate.Other biomarkers of inflammation in UC include platelet count,leukocyte count,and serum albumin and serum orosomucoid concentrations;(2)serologic markers/antibodies:In the last decades serological and immunologic biomarkers have been studied extensively in immunology and have been used in clinical practice to detect specific pathologies.In UC,the presence of these antibodies can aid as surrogate markers for the aberrant host immune response;and(3)future biomarkers:The development of biomarkers in UC will be very important in the future.The progress

  10. Clinical significance of serum procalcitonin and C-reaction protein in the patients with ulcerative colitis

    李楠

    2014-01-01

    Objective To approach on clinical value of serum procalcitonin(PCT)and C-reactive protein(CRP)in diagnosis of ulcerative colitis(UC).Methods The PCT and CRP levels in 120 UC patients and 20 healthy volunteers were measured.Results The levels of serum T PCT and CRP levels in active UC and catabolic UC were higher than control group[(1.56±0.36)vs(0.33±0.16)μg/L,(6.57±2.96)vs(0.33±0.16)μg/L,(6.78±3.85)vs(0.68±0.23)mg/L,(23.46±12.53)vs(0.68±0.23)

  11. Novel Techniques in Endoscopy Are Useful in Evaluating Patients with Ulcerative Colitis

    Takafumi Ando

    2011-01-01

    Full Text Available Ulcerative colitis (UC, one of the most common forms of chronic inflammatory bowel disease, is characterized by exacerbations and remissions. Even when conventional colonoscopy suggests remission and a normal mucosal finding, microscopic or histological abnormalities may persist, and relapse may be imminent. Confocal microendoscopy allows histological diagnosis during the endoscopic examination. High-resolution video-magnifying colonoscopy with chromoscopy enables the observation of colorectal mucosal pit patterns and prediction of the probability of subsequent disease relapse in patients in remission. Endoscopic ultrasonography provides an immediate and accurate evaluation of the health status of the colonic wall without the need to wait for histological results and provides an indication of the efficacy of treatment. These novel endoscopic techniques are useful for the evaluation of disease activity and the efficacy of treatment in patients with UC and the prediction of relapse.

  12. Crohn's disease but not chronic ulcerative colitis induces the expression of PAI-1 in enteric neurons

    Laerum, O.D.; Illemann, M.; Skarstein, A.;

    2008-01-01

    wall. The PAI-1 was seen in the perikarya of the neurons and a few proximal axons, whereas nerves were negative. uPAR was seen in nerves in all types of lesion varying from 21% to 88% of the cases, most frequent in colon adenocarcinomas. No uPAR-positive nerves were detected in normal colon......OBJECTIVES: Chronic inflammation of the intestinal wall is the common characteristic of Crohn's disease and ulcerative colitis; disorders, which in some cases can be difficult to distinguish. The inflammation also affects the local neuronal plexuses of the enteric nervous system. It is known that...... plasminogen activator inhibitor-1 (PAI-1) and urokinase receptor (uPAR) are upregulated in neurons after experimental peripheral nerve injury and have been linked to nerve regeneration. METHODS: The expression of PAI-1 and uPAR in neuronal cells in lesions of the gastrointestinal tract was analyzed by...

  13. Desulfovibrio desulfuricans Bacteremia in an Immunocompromised Host with a Liver Graft and Ulcerative Colitis

    Verstreken, Isabel; Laleman, Wim; Wauters, Georges; Verhaegen, Jan

    2012-01-01

    Desulfovibrio spp. are anaerobic, sulfate-reducing, nonfermenting, Gram-negative bacteria found in the digestive tract of humans. Identification of these species with conventional methods is difficult. The reported case of a Desulfovibrio desulfuricans bacteremia occurring in an immunocompromised host with ulcerative colitis confirms that this organism may be a possible opportunistic human pathogen.

  14. Interferon β-1a in ulcerative colitis: a placebo controlled, randomised, dose escalating study

    Nikolaus, S.; RUTGEERTS, P; Fedorak, R.; Steinhart, A H; Wild, G E; Theuer, D; Möhrle, J.; Schreiber, S

    2003-01-01

    Background and aims: Administration of interferon (IFN)-β may represent a rational approach to the treatment of ulcerative colitis through its immunomodulatory and anti-inflammatory effects. The present study was performed to evaluate the efficacy and tolerability of IFN-β-1a.

  15. Ulcerative colitis and esclerosant cholangitis in children and adolescents; case report and literature revision

    In spite of being considered rare in the pediatric practice, the intestinal inflammatory illness is recognized now with more frequency in children of all the ages. In fact, 25 to 30% of all the patients with Crohn illness, and 20% the patients with ulcerative colitis, they consult before the 20 years. A case is presented of patient of 15 years with primary esclerosant cholangitis

  16. Ultrastructure of interstitial cells of Cajal at the colonic submuscular border in patients with ulcerative colitis

    Rumessen, J J

    1996-01-01

    Submuscular interstitial cells of Cajal (ICC) are putative pacemaker cells of the colonic external muscle. Although motility disturbances and smooth muscle dysfunction are prevalent in patients with ulcerative colitis (UC), ICC have never been studied in this disease. The aim of this study was to...

  17. Radionuclide evaluation of gastric, intestinal and pancreatic function in nonspecific ulcerative colitis

    Stomach and intestine motorevacuator function, small intestine absorptive finction and pancreas functional state in case of nonspecific ulcerous colitis were studied by complex radionuclide examinations. Data, methods and results on treatment depending on clinical severity and dissemination of the pathological process are presented the pathological process are presented

  18. Upregulation of cIAP2 in regenerating colonocytes in ulcerative colitis

    Seidelin, J.B.; Vainer, Ben; Andresen, L.; Nielsen, Ole Haagen

    2007-01-01

    It has been reported that colonocytes in ulcerative colitis (UC) upregulate anti-apoptotic cytoprotective pathways. An expression-profiling study of apoptosis-related genes suggested that the cellular inhibitor of apoptosis protein-2 (cIAP2) could be upregulated in epithelial cells in UC. The rol...

  19. 11beta-hydroxysteroid dehydrogenase 1 and 2 expression in colon from patients with ulcerative colitis

    Žbánková, Šárka; Bryndová, Jana; Leden, Pavel; Kment, M.; Švec, A.; Pácha, Jiří

    2007-01-01

    Roč. 22, č. 7 (2007), s. 1019-1023. ISSN 0815-9319 R&D Projects: GA MZd NR8576; GA MZd NK6723 Institutional research plan: CEZ:AV0Z5011922 Keywords : 11beta-hydroxysteroid dehydrogenace * glucocorticoid metabolism * ulcerative colitis Subject RIV: FB - Endocrinology, Diabetology, Metabolism, Nutrition Impact factor: 1.673, year: 2007

  20. Dramatic improvement of severe acne pustolosa after adalimumab in a patient with ulcerative colitis.

    Rispo, Antonio; Musto, Dario; Imperatore, Nicola; Testa, Anna; Rea, Matilde; Castiglione, Fabiana

    2016-04-01

    A 22-year-old male with extensive steroid-dependent/azathioprine-refractory ulcerative colitis and preexistent severe refractory acne pustolosa (AP) was successfully treated with adalimumab for both conditions. Severe AP could be considered a further indication, instead of a relative restriction, to anti-TNFα in steroid-dependent IBD patients needing therapy with this class of drugs. PMID:27099725

  1. The incidence of Crohn's disease and ulcerative colitis since 1995 in Danish children and adolescents

    Larsen, Michael Due; Baldal, Mira Eggebrecht; Nielsen, Rasmus Gaardskær;

    2016-01-01

    OBJECTIVE: Worldwide the incidence of pediatric Crohn's disease (CD) and ulcerative colitis (UC) is suspected to be increasing. Based on unselected nationwide register data the aim of this study is to examine the change in incidence of CD and UC in children and adolescents in Denmark. MATERIALS AND...

  2. The incidence of ulcerative colitis (1995-2011) and Crohn's disease (1995-2012)

    Nørgård, Bente Mertz; Nielsen, Jan; Fonager, Kirsten;

    2014-01-01

    BACKGROUND AND AIMS: The incidence of ulcerative colitis (UC) and Crohn's disease (CD) has increased during the 20th century in North America and Western Europe. However, there are conflicting reports whether the incidence has declined, stabilized or even continued to increase. No nationwide Danish...

  3. Type I collagen and its daughter peptides for targeting mucosal healing in ulcerative colitis: A new treatment strategy.

    Ramadass, Satiesh Kumar; Jabaris, Sugin Lal; Perumal, Ramesh Kannan; HairulIslam, Villianur Ibrahim; Gopinath, Arun; Madhan, Balaraman

    2016-08-25

    Ulcerative colitis, particularly the chronic persistent form is characterized by the presence of active inflammation and extensive areas of ulceration in the colonic mucosa. The existing treatment protocol aims at only reducing intestinal inflammation, rather than targeting mucosal ulceration. In this study, type I collagen and its daughter peptides called collagen hydrolysate, highly popular reconstructive materials for tissue engineering applications, are hypothesized as healing matrices to target the recuperation of internal mucosal ulceration. The clinical assessments on day 10 of dextran sodium sulfate induced colitis in mice model revealed that both the collagen (1.56±0.29) and collagen hydrolysate treatments (1.33±0.33) showed a significant reduction in the rectal bleeding compared to the reference mesalamine treatment (2.50±0.33) and untreated negative control (2.40±0.40). VEGF, a potent angiogenic growth factor, over expressed during UC was down-regulated by collagen hydrolysate (1.06±0.25) and collagen (1.76±0.45) to a greater extent than by mesalamine (2.59±0.51) and untreated control (4.17±0.15). The down-regulation of proinflammatory cytokines such as TNF-α, IL-1β, and IL-6 also follows the same pattern. Histological observations were in accordance with the clinical indicators. Both collagen and collagen hydrolysate treatments showed significant reduction in mucosal damage score and facilitated faster regeneration of damaged mucosa. PMID:27185300

  4. Oxidative Stress and Carbonyl Lesions in Ulcerative Colitis and Associated Colorectal Cancer

    Zhiqi Wang

    2016-01-01

    Full Text Available Oxidative stress has long been known as a pathogenic factor of ulcerative colitis (UC and colitis-associated colorectal cancer (CAC, but the effects of secondary carbonyl lesions receive less emphasis. In inflammatory conditions, reactive oxygen species (ROS, such as superoxide anion free radical (O2∙-, hydrogen peroxide (H2O2, and hydroxyl radical (HO∙, are produced at high levels and accumulated to cause oxidative stress (OS. In oxidative status, accumulated ROS can cause protein dysfunction and DNA damage, leading to gene mutations and cell death. Accumulated ROS could also act as chemical messengers to activate signaling pathways, such as NF-κB and p38 MAPK, to affect cell proliferation, differentiation, and apoptosis. More importantly, electrophilic carbonyl compounds produced by lipid peroxidation may function as secondary pathogenic factors, causing further protein and membrane lesions. This may in turn exaggerate oxidative stress, forming a vicious cycle. Electrophilic carbonyls could also cause DNA mutations and breaks, driving malignant progression of UC. The secondary lesions caused by carbonyl compounds may be exceptionally important in the case of host carbonyl defensive system deficit, such as aldo-keto reductase 1B10 deficiency. This review article updates the current understanding of oxidative stress and carbonyl lesions in the development and progression of UC and CAC.

  5. Mesalamine Dose Escalation Reduces Fecal Calprotectin In Patients With Quiescent Ulcerative Colitis

    Osterman, Mark T.; Aberra, Faten N; Cross, Raymond; Liakos, Steven; McCabe, Robert; Shafran, Ira; Wolf, Douglas; Hardi, Robert; Nessel, Lisa; Brensinger, Colleen; Gilroy, Erin; Lewis, James D.

    2014-01-01

    Background & Aims Among patients with quiescent ulcerative colitis (UC), lower fecal concentrations of calprotectin are associated with lower rates of relapse. We performed an open-label, randomized, controlled trial to investigate whether increasing doses mesalamine reduce concentrations of fecal calprotectin (FC) in patients with quiescent UC. Methods We screened 119 patients with UC in remission, based on Simple Clinical Colitis Activity Index scores, FC >50 mcg/g, and intake of no more than 3g/day of mesalamine. Participants taking mesalamine formulations other than multimatrix mesalamine were switched to multimatrix mesalamine (2.4 g/day) for 6 weeks; 52 participants were then randomly assigned (1:1) to a group that continued its current dose of mesalamine (controls, n=26) or a group that increased its dose by 2.4 g/day for 6 weeks (n=26). The primary outcome was continued remission with FC200 mcg/g compared to those with FC <200 mcg/g (P=.01). Conclusion Among patients with quiescent UC and increased levels of FC, increasing the dose of mesalamine by 2.4 g/day reduced fecal concentrations of calprotectin to those associated with lower rates of relapse. Clinicaltrials.gov: NCT00652145 PMID:24793028

  6. The effect of third-party reporting on adoption of evidence-based mesalazine regimens in ulcerative colitis: an observational study

    Kruis, W.; Leifeld, L.; Morgenstern, J.; Pfutzer, R.; Reimers, B.; Ceplis-Kastner, S.; Auchter, K.H.; Han, H.; Metz, K.; Gutberlet, H.; Beuthner, D.; Gerhard, B.; Lampe, D.; Look, M.; Scholze, K.; Striemer, R.; Gynz-Rekowski, M.E. von; Wengler, K.; Walff, R.; Schmidt-Heinevetter, G.; Gille, K.; Nordhoff, S.; Schulte-Witte, H.; Behrendt, J.; Hahn, A.; Al-Shamaa, A.; Widjaja, A.; Göbel, U.; Landry, W.; Leib, H.H.; Epping-Stippel, L.; Niedermeyer, H.; Pakravan, F.; Krüger, P.; Shoilewa, A.; Schwarzhoff, R.; Grubitzsch, M.; Weisflog, M.; Koßler-Wiesweg, C.; Röcken, A.; Hermans, M.L.; Jaehn, T.; Kihn, R.; Stern, M.; Fink, R.; Geyer, P.; Herold, C.; Meyer-Hilse, F.; Olejnik, H.; Samel, S.T.; Treml, O.; Bamberger, A.; Bruhn, J.; Holch, P.; Keck, B.; Arnauld, P. von; Aldinger, I.; Schmidt, J.T.; Schwarz, H.; Schmidt, K.; Syamken, S.; Bierbaum, C.; Schulz, J.; Jessen, K.; Stegen, G.; Hohn, H.; Weber, C.; Schwerdtfeger, M.; Theuerkauf, B.; Stölzle, B.; Botzler, R.; Dietz, A.; Sellinger, M.; Uebel, P.; Fiedler, J.; Schink, U.; Will, E.; Gratz, T.; Küppers, F.; Asdonk, D.; Kellner, H.; Konrad, T.; Erren, P.; Horn, J.; Klein, U.; Hebel, M.; Hoesl, M.; Pfäffl, S.; Bartner, J.; Donabauer, B.; Schöniger, F.; Brandt, W.; Grümmer, H.; Klaus, M.; Wiechmann, H.; Schönfeld, G.; Knigge, K.P.; Sehland, D.; Strotmann, H.J.; Frank, B.; Wankmüller, C.; Frey, H.; Kienle, U.; Linde, A.; Hommel, E.; Teubner, K.; Wust, C.; Dewitz, G. von; Andersen, M.; Hackelsberger, A.; Hammann, V.

    2013-01-01

    BACKGROUND AND AIMS: The optimal mesalazine dosing strategy for ulcerative colitis (UC) continues to evolve. The current study aimed to explore whether documenting drug use could prompt changes in prescribing habits. METHODS: In a multicenter, prospective, observational study, outpatients with activ

  7. Technetium-99m hexamethyl propylene amine oxime-labeled leukocyte scintigraphy at three different times in active ulcerative colitis. Comparison with colonoscopy and clinico-biochemical parameters in the assessment of disease extension and severity

    In this study, our objective was to define the usefulness of technetium-99m hexamethyl propylene amine oxime (Tc-99m HMPAO)-labeled leukocyte scintigraphy at three different time points in the assessment of disease extension and severity in patients with active ulcerative colitis (UC). Twenty-one consecutive patients (10 women, 11 men; mean age 42.4±12 years) with active UC were prospectively studied. All patients were diagnosed by colonoscopy and histopathology prior to inclusion. Scintigraphy was performed at 1 h, 2 h, and 4 h after Tc-99m HMPAO-labeled leukocyte injection. Clinic-biochemical activity score, total colonoscopic activity score, and total scintigraphic activity score at 1 h, 2 h, and 4 h were calculated for each patient. Sensitivity, specificity, and accuracy values of Tc-99m HMPAO-labeled leukocyte scintigraphy were calculated as follows, respectively: 1 h imaging 86%, 73%, and 83%; 2 h imaging 89%, 74%, and 86%; 4 h imaging 90%, 58%, and 83% in the detection of active inflammatory segments. Even though no statistically significant difference was found between 1 h, 2 h, and 4 h imaging with respect to the sensitivity, specificity of labeled leukocyte scintigraphy, the largest area under the curve value was found for 2 h imaging. Tc-99m HMPAO-labeled leukocyte scintigraphy has been found to be correlated well with colonoscopy in the assessment of both the extension and severity of UC. We recommend 2 h scintigraphic imaging because it provides the largest area under the curve value and decreases the number of false-positive results. (author)

  8. Generalized Pyoderma Gangrenosum Associated with Ulcerative Colitis: Successful Treatment with Infliximab and Azathioprine.

    Chatzinasiou, Foteini; Polymeros, Dimitrios; Panagiotou, Maro; Theodoropoulos, Konstadinos; Rigopoulos, Dimitrios

    2016-04-01

    management of special situations in patients with ulcerative colitis, systemic corticosteroids are recommended (9). Treatment with corticosteroids (e.g. prednisolone 1-2 mg per kg/day or pulse therapy with 1 g of methylprednisolone) aims to prevent progression and rapidly stop inflammation (6). Additional mesalamine and corticosteroids may be effective in patients with bowel disease (10). In recent years, tumor necrosis alpha (TNF-α) inhibitors, such as infliximab and adalimumab, were reported to be effective for PG associated with IBD. These drugs block the biological activity of TNF-α, which effects regulatory T cells, restoring their capacity to inhibit cytokine production. The TNF-α inhibitors thus suppress the inflammatory processes that is involved in the pathogenesis of PG (11). Infliximab, a chimeric monoclonal antibody, is given by infusion at weeks 0, 2, and 6 and then every 8 weeks, usually at a dosage of 5 mg/kg. UC of patients with frequent disease relapse or those that are resistant or dependent on corticosteroids is often treated with purine antimetabolites, such as azathioprine (AZA) (10). AZA, a purine antimetabolite (2.5 mg per kg/day) is administered for its steroid-sparing effects. The response occurs after 2 to 4 weeks (6, 10). Infliximab can be combined with AZA. Patients with UC treated with infliximab plus AZA were more likely to achieve corticosteroid-free remission at 16 weeks than those receiving either monotherapy (10,12). PMID:27149138

  9. Risk for colorectal cancer in ulcerative colitis: Changes, causes and management strategies

    Peter Laszlo Lakatos; Laszlo Lakatos

    2008-01-01

    The risk of colorectal cancer for any patient with ulcerative colitis is known to be elevated, and is estimated to be 2% after 10 years, 8% after 20 years and 18% after 30 years of disease. Risk factors for cancer include extent and duration of ulcerative colitis, primary sclerosing cholangitis, a family history of sporadic colorectal cancer, severity of histologic bowel inflammation, and in some studies, young age at onset of colitis. In this review, the authors discuss recent epidemiological trends and causes for the observed changes. Population-based studies published within the past 5 years suggest that this risk has decreased over time, despite the low frequency of colectomies. The crude annual incidence rate of colorectal cancer in ulcerative colitis ranges from approximately 0.06% to 0.16% with a relative risk of 1.0-2.75. The exact mechanism for this change is unknown; it may partly be explained by the more widespread use of maintenance therapy and surveillance colonoscopy.

  10. Development of perianal ulcer as a result of acute fulminant amoebic colitis

    Takayuki Torigoe; Yoshifumi Nakayama; Koji Yamaguchi

    2012-01-01

    We report a case of acute fulminant amoebic colitis that resulted in the development of a perianal ulcer in a 29-year-old Japanese homosexual man with acquired immunodeficiency syndrome (AIDS).The patient was admitted to our hospital with a persistent perianal abscess that was refractory to antibiotic therapy administered at another hospital.On admission,we observed a giant ulcer in the perianal region.At first,cytomegalovirus colitis was suspected by blood investigations.Ganciclovir therapy was initiated; however,the patient developed necrosis of the skin around the anus during therapy.We only performed end-sigmoidostomy and necrotomy to avoid excessive surgical invasion.Histopathological examination of the surgical specimen revealed the presence of trophozoite amoebae,indicating a final diagnosis of acute fulminant amoebic colitis.The patient's postoperative course was favorable,and proctectomy of the residual rectum was performed 11 mo later.Amoebic colitis is one of the most severe complications affecting patients with AIDS.Particularly,acute fulminant amoebic colitis may result in a poor prognosis; therefore,staged surgical therapy as a less invasive procedure should be considered as one of the treatment options for these patients.

  11. Accuracy of abdominal ultrasound and MRI for detection of Crohn disease and ulcerative colitis in children

    Ziech, Manon L.W.; Smets, Anne M.J.B.; Lavini, Cristina; Caan, Matthan W.A.; Nederveen, Aart J.; Bipat, Shandra; Stoker, Jaap [Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Hummel, Thalia Z.; Benninga, Marc A.; Kindermann, Angelika [Emma Children' s Hospital, Academic Medical Center, Department of Pediatric Gastroenterology, Amsterdam (Netherlands); Nievelstein, Rutger A.J. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Roelofs, Joris J.T.H. [Academic Medical Center, Department of Pathology, Amsterdam (Netherlands)

    2014-11-15

    Endoscopy is currently the primary diagnostic technique for inflammatory bowel disease (IBD) in children. To assess the accuracy of US and dynamic contrast-enhanced MRI for diagnosing inflammatory bowel disease and for distinguishing Crohn disease and ulcerative colitis in comparison to a reference standard. Consecutive children with suspected IBD underwent diagnostic workup including ileocolonoscopy and upper gastrointestinal endoscopy as the reference standard, abdominal US, and MR enterography and colonography at 3 T. The protocol included a dynamic contrast-enhanced 3-D sequence. Sensitivity, specificity and kappa values were calculated for one ultrasonographer and two MRI observers. We included 28 children (15 boys) with mean age 14 years (range 10-17 years). The diagnosis was IBD in 23 children (72%), including 12 with Crohn disease, 10 with ulcerative colitis and 1 with indeterminate colitis. For the diagnosis of inflammatory bowel disease the sensitivity was 55% for US and 57% (both observers) for MR entero- and colonography, and the specificity was 100% for US and 100% (observer 1) and 75% (observer 2) for MR entero- and colonography. Combined MRI and US had sensitivity and specificity of 70% and 100% (observer 1) and 74% and 80% (observer 2), respectively. With the addition of a dynamic contrast-enhanced MR sequence, the sensitivity increased to 83% and 87%. US and MRI could only distinguish between Crohn disease and ulcerative colitis when terminal ileum lesions were present. US and MR entero- and colonography have a high accuracy for diagnosing inflammatory bowel disease in children but cannot be used to distinguish Crohn disease and ulcerative colitis. (orig.)

  12. Accuracy of abdominal ultrasound and MRI for detection of Crohn disease and ulcerative colitis in children

    Endoscopy is currently the primary diagnostic technique for inflammatory bowel disease (IBD) in children. To assess the accuracy of US and dynamic contrast-enhanced MRI for diagnosing inflammatory bowel disease and for distinguishing Crohn disease and ulcerative colitis in comparison to a reference standard. Consecutive children with suspected IBD underwent diagnostic workup including ileocolonoscopy and upper gastrointestinal endoscopy as the reference standard, abdominal US, and MR enterography and colonography at 3 T. The protocol included a dynamic contrast-enhanced 3-D sequence. Sensitivity, specificity and kappa values were calculated for one ultrasonographer and two MRI observers. We included 28 children (15 boys) with mean age 14 years (range 10-17 years). The diagnosis was IBD in 23 children (72%), including 12 with Crohn disease, 10 with ulcerative colitis and 1 with indeterminate colitis. For the diagnosis of inflammatory bowel disease the sensitivity was 55% for US and 57% (both observers) for MR entero- and colonography, and the specificity was 100% for US and 100% (observer 1) and 75% (observer 2) for MR entero- and colonography. Combined MRI and US had sensitivity and specificity of 70% and 100% (observer 1) and 74% and 80% (observer 2), respectively. With the addition of a dynamic contrast-enhanced MR sequence, the sensitivity increased to 83% and 87%. US and MRI could only distinguish between Crohn disease and ulcerative colitis when terminal ileum lesions were present. US and MR entero- and colonography have a high accuracy for diagnosing inflammatory bowel disease in children but cannot be used to distinguish Crohn disease and ulcerative colitis. (orig.)

  13. Cytomegalovirus infection masquerading as an ulcerative colitis flare-up: case report and review of the literature.

    Begos, D. G.; Rappaport, R; Jain, D.

    1996-01-01

    We report the case of a patient with a case of cytomegalovirus (CMV) colitis, which presented as a flare-up of her ulcerative colitis. Standard treatment for the flare-up, which included intravenous corticosteroids, bowel rest, topical salicylates and ultimately colectomy were not effective. The patient did not improve until therapy with intravenous ganciclovir was initiated. There have been 26 previous reports of CMV colitis complicating inflammatory bowel disease (IBD). The diagnosis is not...

  14. The Effect of Calendula Officinalis in Therapy of Acetic Acid Induced Ulcerative Colitis in Dog as an Animal Model

    Mehrabani, D; M. Ziaei; Hosseini, S.V; Ghahramani, L; Bananzadeh, A M; Ashraf, M. J.; Amini, A; Amini, M; Tanideh, N

    2011-01-01

    Background In patients with ulcerative colitis (UC), the repeated cycle of injury and repair of intestinal mucosa has been reported to increase the risk of colon cancer. So, a safe and efficient therapy is required for the treatment and prophylaxis for the disease.This study aims to investigate the efficacy of Calendula officinalis extract in treatment of experimentally induced ulcerative colitis in dog animal model. Methods During fall 2010, 10 out-bred female German dogs (1-2 years old; wei...

  15. Biologics in the management of ulcerative colitis – comparative safety and efficacy of TNF-α antagonists

    Afzali, Anita

    2015-01-01

    Rebecca Fausel,1 Anita Afzali1,2 1Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA, USA; 2Inflammatory Bowel Disease Program, UW Medicine – Harborview Medical Center, Seattle, WA, USA Abstract: Ulcerative colitis can cause debilitating symptoms and complications such as colonic strictures, colonic dysplasia, colorectal cancer, and toxic megacolon or perforation. Goals of treatment in ulcerative colitis include resolution of gastrointestin...

  16. Biologics in the management of ulcerative colitis – comparative safety and efficacy of TNF-α antagonists

    Fausel R; Afzali A

    2015-01-01

    Rebecca Fausel,1 Anita Afzali1,2 1Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA, USA; 2Inflammatory Bowel Disease Program, UW Medicine – Harborview Medical Center, Seattle, WA, USA Abstract: Ulcerative colitis can cause debilitating symptoms and complications such as colonic strictures, colonic dysplasia, colorectal cancer, and toxic megacolon or perforation. Goals of treatment in ulcerative colitis include resolution of gastrointestinal s...

  17. Olsalazine versus placebo in the treatment of mild to moderate ulcerative colitis: a randomised double blind trial.

    Feurle, G E; Theuer, D; Velasco, S; Barry, B A; Wördehoff, D; Sommer, A; Jantschek, G; Kruis, W.

    1989-01-01

    The effect of olsalazine, an analogue of sulphasalazine, consisting of two molecules 5-aminosalicylic acid linked by an azobond has been investigated for the treatment of ulcerative colitis. In a randomised double blind trial we compared 2 g olsalazine with placebo for four weeks. Of the 105 patients, with mild to moderate ulcerative colitis, entered in the trial 52 received olsalazine, and 53 placebo. Treatment had to be terminated prematurely because of untoward effects of olsalazine (mainl...

  18. Surgical Site Infection and Validity of Staged Surgical Procedure in Emergent/Urgent Surgery for Ulcerative Colitis

    Uchino, Motoi; Ikeuchi, Hiroki; Matsuoka, Hiroki; Takahashi, Yoshiko; Tomita, Naohiro; Takesue, Yoshio

    2013-01-01

    Although restorative proctocolectomy is recognized as a standard procedure for ulcerative colitis, infectious complications after surgery cannot be disregarded. The aim of this study was to define predictors of surgical site infection (SSI) in urgent/emergent surgery for ulcerative colitis. We performed prospective SSI surveillance for 90 consecutive patients. Possible risk factors were analyzed by logistic regression analyses. Incidences of incisional SSI (i-SSI) and organ/space SSI were 31....

  19. Epidemiology of appendicectomy in primary sclerosing cholangitis and ulcerative colitis: its influence on the clinical behaviour of these diseases

    Florin, T H J; Pandeya, N; Radford-Smith, G. L.

    2004-01-01

    Background and aims: Appendicectomy and smoking are environmental factors that are known to influence ulcerative colitis (UC). The phenotype of UC is different in patients with coexistent primary sclerosing cholangitis (PSC). This study investigates the interaction of appendicectomy and PSC on the epidemiology and clinical behaviour of colitis.

  20. Glycosylation and sulphation of colonic mucus glycoproteins in patients with ulcerative colitis and in healthy subjects.

    Morita, H; Kettlewell, M G; Jewell, D P; Kent, P W

    1993-07-01

    Studies have been made of mucus glycoprotein biosynthesis in different regions of the lower gastrointestinal tract in normal patients and those with ulcerative colitis (UC), active or inactive, by means of 3H-glucosamine (3H-GlcNH2)--35S-sulphate double labelling of epithelial biopsy specimens under culture conditions. The time based rate of 3H-GlcNH2 labelling of mucus in rectal tissue was similar to that in active or inactive UC whereas the rate of 35SO4(2) labelling was significantly increased in active disease. The 3H specific activities measuring the amount of isotopic incorporation into surface and tissue mucus glycoproteins were increased in patients with active UC compared with normal or inactive subjects. The 35S specific activities did not differ significantly between patients with active UC and those in remission. In the rectum, glycosylation of mucus glycoproteins decreases with the increasing age of the patient. Regional differences in 3H-labelling of mucus components are reported for ascending colon, transverse colon, sigmoid colon, and rectum. Sulphation (35S-labelling) was higher in all parts of the colon in left sided UC. Results point to accelerated glycosylation of core proteins in the active phase of UC. PMID:8344580

  1. Protective Effect of Calculus Bovis Sativus on Dextran Sulphate Sodium-Induced Ulcerative Colitis in Mice

    Xiping Li

    2015-01-01

    Full Text Available Calculus Bovis Sativus (CBS is a commonly used traditional Chinese medicine, which has been reported to exhibit antispasmodic, fever-reducing, anti-inflammatory, and gallbladder-repairing effects. The present study aims to investigate the protective effect of CBS on dextran sulphate sodium- (DSS- induced ulcerative colitis (UC in mice. C57BL/6 male mice were exposed to 5% DSS in drinking water. CBS was given orally at 50 and 150 mg/kg once per day for 7 days. Body weight, disease activity index (DAI, colon length, colonic myeloperoxidase (MPO activity, superoxide dismutase (SOD activity, and malondialdehyde (MDA and nitric oxide (NO levels were measured. Administration of CBS significantly reserved these changes, decreased the MPO activity and MDA and NO level, and increased the SOD activity in the colon tissue. Histological observation suggested that CBS alleviated edema, mucosal damage, and inflammatory cells infiltration induced by DSS in the colon. Moreover, CBS significantly downregulated the mRNA expression of tumor necrosis factor-α (TNF-α, interleukin- (IL- 1β and IL-6 in the colon tissue. Our data suggested that CBS exerted protective effect on DSS-induced UC partially through the antioxidant and anti-inflammatory activities.

  2. Protective Effect of Calculus Bovis Sativus on Dextran Sulphate Sodium-Induced Ulcerative Colitis in Mice.

    Li, Xiping; Xu, Yanjiao; Zhang, Chengliang; Deng, Li; Chang, Mujun; Yu, Zaoqin; Liu, Dong

    2015-01-01

    Calculus Bovis Sativus (CBS) is a commonly used traditional Chinese medicine, which has been reported to exhibit antispasmodic, fever-reducing, anti-inflammatory, and gallbladder-repairing effects. The present study aims to investigate the protective effect of CBS on dextran sulphate sodium- (DSS-) induced ulcerative colitis (UC) in mice. C57BL/6 male mice were exposed to 5% DSS in drinking water. CBS was given orally at 50 and 150 mg/kg once per day for 7 days. Body weight, disease activity index (DAI), colon length, colonic myeloperoxidase (MPO) activity, superoxide dismutase (SOD) activity, and malondialdehyde (MDA) and nitric oxide (NO) levels were measured. Administration of CBS significantly reserved these changes, decreased the MPO activity and MDA and NO level, and increased the SOD activity in the colon tissue. Histological observation suggested that CBS alleviated edema, mucosal damage, and inflammatory cells infiltration induced by DSS in the colon. Moreover, CBS significantly downregulated the mRNA expression of tumor necrosis factor-α (TNF-α), interleukin- (IL-) 1β and IL-6 in the colon tissue. Our data suggested that CBS exerted protective effect on DSS-induced UC partially through the antioxidant and anti-inflammatory activities. PMID:26579201

  3. Clinical trial: probiotic treatment of acute distal ulcerative colitis with rectally administered Escherichia coli Nissle 1917 (EcN)

    Matthes Harald; Krummenerl Thomas; Giensch Manfred; Wolff Corinna; Schulze Jürgen

    2010-01-01

    Abstract Background Probiotics are effective in inflammatory bowel diseases. Clinical effectiveness and dose dependency of E. coli Nissle (EcN) enemas were investigated in ulcerative colitis (UC). Methods In a double-blind study, 90 patients with moderate distal activity in UC were randomly assigned to treatment with either 40, 20, or 10 ml enemas (N = 24, 23, 23) containing 10E8 EcN/ml or placebo (N = 20). The study medication was taken once daily for at least 2 weeks. After 2, 4 and/or 8 we...

  4. Sodium arsenite reduces severity of dextran sulfate sodium-induced ulcerative colitis in rats

    Joshua J. MALAGO; Hortensia NONDOLI

    2008-01-01

    The histopathological features and the associated clinical findings of ulcerative colitis (UC) are due to persistent inflammatory response in the colon mucosa. Interventions that suppress this response benefit UC patients. We tested whether sodium arsenite (SA) benefits rats with dextran sulfate sodium (DSS)-colitis. The DSS-colitis was induced by 5% DSS in drinking water. SA (10 mg/kg; intraperitoneally) was given 8 h before DSS treatment and then every 48 h for 3 cycles of 7,14 or 21 d. At the end of each cycle rats were sacrificed and colon sections processed for histological examination. DSS induced diarrhea, loose stools, hemoccult positive stools, gross bleeding, loss of body weight, loss of epithelium, crypt damage, depletion of goblet cells and infiltration of inflammatory cells. The severity of these changes increased ir the order of Cycles 1,2 and 3. Treatment of rats with SA significantly reduced this severity and improved the weight gain.

  5. Genetic update on inflammatory factors in ulcerative colitis: Review of the current literature

    Patricia; Sarlos; Erzsebet; Kovesdi; Lili; Magyari; Zsolt; Banfai; Andras; Szabo; Andras; Javorhazy; Bela; Melegh

    2014-01-01

    Ulcerative colitis(UC) is one of the main types of inflammatory bowel disease, which is caused by dysregulated immune responses in genetically predisposed individuals. Several genetic factors, including interleukin and interleukin receptor gene polymorphisms and other inflammation-related genes play central role in mediating and modulating the inflammation in the human body, thereby these can be the main cause of development of the disease. It is clear these data are very important for understanding the base of the disease, especially in terms of clinical utility and validity, but summarized literature is exiguous for challenge health specialist that can used in the clinical practice nowadays. This review summarizes the current literature on inflammationrelated genetic polymorphisms which are associated with UC. We performed an electronic search of Pubmed Database among publications of the last 10 years, using the following medical subject heading terms: UC, ulcerative colitis, inflammation, genes, polymorphisms, and susceptibility.

  6. A case report of severe ulcerative colitis with mediastinal and subcutaneous emphysema.

    Terasaki, Kei; Okuyama, Yusuke; Ueda, Tomohiro; Matsuyama, Kiichi; Urata, Yoji; Yoshida, Norimasa

    2016-01-01

    A 17-year-old boy developed prominent mediastinal and subcutaneous emphysema while receiving treatment with 5-aminosalicylic acid (5-ASA) and oral corticosteroids for severe ulcerative colitis. We ruled out infection and initiated oral administration of tacrolimus, after which both the underlying disease and mediastinal and subcutaneous emphysema improved. However, he continued to experience repeated bouts of ulcerative colitis, so we ultimately opted for surgical intervention. Although mediastinal and subcutaneous emphysema is rare, it is one of the known extra-intestinal complications and can be particularly concerning. In this patient, mediastinal and subcutaneous emphysema might have been caused by the vulnerability of pulmonary alveolar walls to steroid medication and the increase of pulmonary alveolar pressure with abdominal pain and breath holding. Here, we report a case of inflammatory bowel disease with mediastinal and subcutaneous emphysema, along with a review of the literature. PMID:26947047

  7. [EHEC-associated colon stenosis after ulcerous-chronic haemorrhagic colitis and consecutive resulting ileus].

    Lipp, M J; Schirmer, J; Feyerabend, B; Stavrou, G A; Cordruwisch, W; Faiss, S; Oldhafer, K J

    2012-05-01

    We report on the case of a segmentally emphasised, ulcerous chronic haemorrhagic colitis with the development of granulation tissue und scarred fibrosis with consecutive resulting stenosis of the colon. A 49-year-old male patient was infected with enterohaemorrhagic Escherichia coli bacteria during the EHEC-epidemic in northern Germany in early summer 2011. In the course of the infection the patient suffered from haemolytic uraemic syndrome (HUS) with acute renal failure and neurological symptoms. Haemodialysis and plasmapheresis had become mandatory. A simultaneous ileus was estimated to be of paralytic origin. One month after treatment of the acute phase of the infection a CT scan of the abdomen was performed and discovered a symptomatic stenosis of the proximal colon transversum. This obstruction needed to be treated by performing a right hemicolectomy with an ileo-transverso anastomosis. After surgery the patient recovered continuously. The histopathological examination verified an ulcerous-chronic haemorrhagic colitis on the background of an EHEC infection. PMID:22581700

  8. Maintaining remission in ulcerative colitis – role of once daily extended-release mesalamine

    Lilliana Oliveira

    2011-02-01

    Full Text Available Lilliana Oliveira, Russell D CohenThe Department of Medicine, Section of Gastroenterology, University of Chicago Medical Center, Chicago, IL, USAAbstract: The aminosalicylates (5-ASA; also referred to as mesalamine-based agents are considered as first-line in the maintenance of remission of mild to moderate ulcerative colitis (UC. Traditionally these agents have required a large pill burden and multiple daily dosing regimens which may account for the low adherence rates, especially in patients in remission. Extended-release mesalamine is the first once daily mesalamine product approved by the Food and Drug Administration for the maintenance of UC remission. This review will examine the pharmacokinetics, dosing, efficacy, and safety data of extended-release mesalamine, and discuss the potential role of improving medication compliance and decreasing costs in UC maintenance.Keywords: ulcerative colitis, 5-ASA, mesalamine, adherence, compliance, quality of life, costs

  9. A protein-truncating R179X variant in RNF186 confers protection against ulcerative colitis.

    Rivas, Manuel A; Graham, Daniel; Sulem, Patrick; Stevens, Christine; Desch, A Nicole; Goyette, Philippe; Gudbjartsson, Daniel; Jonsdottir, Ingileif; Thorsteinsdottir, Unnur; Degenhardt, Frauke; Mucha, Sören; Kurki, Mitja I; Li, Dalin; D'Amato, Mauro; Annese, Vito; Vermeire, Severine; Weersma, Rinse K; Halfvarson, Jonas; Paavola-Sakki, Paulina; Lappalainen, Maarit; Lek, Monkol; Cummings, Beryl; Tukiainen, Taru; Haritunians, Talin; Halme, Leena; Koskinen, Lotta L E; Ananthakrishnan, Ashwin N; Luo, Yang; Heap, Graham A; Visschedijk, Marijn C; MacArthur, Daniel G; Neale, Benjamin M; Ahmad, Tariq; Anderson, Carl A; Brant, Steven R; Duerr, Richard H; Silverberg, Mark S; Cho, Judy H; Palotie, Aarno; Saavalainen, Päivi; Kontula, Kimmo; Färkkilä, Martti; McGovern, Dermot P B; Franke, Andre; Stefansson, Kari; Rioux, John D; Xavier, Ramnik J; Daly, Mark J; Barrett, J; de Lane, K; Edwards, C; Hart, A; Hawkey, C; Jostins, L; Kennedy, N; Lamb, C; Lee, J; Lees, C; Mansfield, J; Mathew, C; Mowatt, C; Newman, B; Nimmo, E; Parkes, M; Pollard, M; Prescott, N; Randall, J; Rice, D; Satsangi, J; Simmons, A; Tremelling, M; Uhlig, H; Wilson, D; Abraham, C; Achkar, J P; Bitton, A; Boucher, G; Croitoru, K; Fleshner, P; Glas, J; Kugathasan, S; Limbergen, J V; Milgrom, R; Proctor, D; Regueiro, M; Schumm, P L; Sharma, Y; Stempak, J M; Targan, S R; Wang, M H

    2016-01-01

    Protein-truncating variants protective against human disease provide in vivo validation of therapeutic targets. Here we used targeted sequencing to conduct a search for protein-truncating variants conferring protection against inflammatory bowel disease exploiting knowledge of common variants associated with the same disease. Through replication genotyping and imputation we found that a predicted protein-truncating variant (rs36095412, p.R179X, genotyped in 11,148 ulcerative colitis patients and 295,446 controls, MAF=up to 0.78%) in RNF186, a single-exon ring finger E3 ligase with strong colonic expression, protects against ulcerative colitis (overall P=6.89 × 10(-7), odds ratio=0.30). We further demonstrate that the truncated protein exhibits reduced expression and altered subcellular localization, suggesting the protective mechanism may reside in the loss of an interaction or function via mislocalization and/or loss of an essential transmembrane domain. PMID:27503255

  10. Printed patient education interventions to promote guided self management of ulcerative colitis : a systematic review

    Kanwar, Himabha

    2013-01-01

    Background: Ulcerative colitis (UC) occurs in remissions and relapses and requires frequent outpatient follow-ups for management by specialists. These visits may not always coincide with the need for attention leading to unnecessary outpatient visits, nonattendances, inadequate monitoring, patient dissatisfaction and increased costs. Self management and shared decision making with health professionals may help overcome such challenges. Use of printed patient education interventions as a se...

  11. Secretion of Alpha-Hemolysin by Escherichia coli Disrupts Tight Junctions in Ulcerative Colitis Patients

    Mirsepasi-Lauridsen, Hengameh Chloé; Du, Zhengyu; Struve, Carsten; Charbon, Godefroid; Karczewski, Jurgen; Krogfelt, Karen Angeliki; Petersen, Andreas Munk; Wells, Jerry M

    2016-01-01

    Objectives: The potential of Escherichia coli (E. coli) isolated from inflammatory bowel disease (IBD) patients to damage the integrity of the intestinal epithelium was investigated. Methods: E. coli strains isolated from patients with ulcerative colitis (UC) and healthy controls were tested for virulence capacity by molecular techniques and cytotoxic assays and transepithelial electric resistance (TER). E. coli isolate p19A was selected, and deletion mutants were created for alpha-hemolysin ...

  12. Personality dimensions and type D personality in female patients with ulcerative colitis

    Marzieh Sadat Sajadinejad; Hossein Molavi; Karim Asgari; Mehrdad Kalantari; Peyman Adibi

    2012-01-01

    Aim : Psychological factors such as personality traits may affect the adjustment capacity and Quality of Life (QOL) in Ulcerative Colitis (UC) patients. Type D personality has some similarities with general personality traits of UC patients. The aims of this study were to compare NEO personality profile and type D personality between healthy normal group and UC patients; and to determine the possible relationship between type D personality and QOL in UC patients. Materials and Methods : The s...

  13. Lung and Intestine: A Specific Link in an Ulcerative Colitis Rat Model

    Yuan Liu; Xin-Yue Wang; Xue Yang; Shan Jing; Li Zhu; Si-Hua Gao

    2013-01-01

    Background. To investigate the link and mechanisms between intestine and lung in the ulcerative colitis (UC) rat model. Materials and Methods. We used the UC rat model by immunological sensitization combined with local 2, 4, 6-trinitrobenzene sulfonic acid (TNBS) in 50% ethanol enema, observed dynamically animal general state and body weight, examined the histological and functional changes in the colon, lung, liver, and kidney tissues, and detected microvascular endothelium response towards ...

  14. Ulcerative colitis and Sweet’s syndrome: A case report and review of the literature

    Ali, Massud; Duerksen, Donald R

    2008-01-01

    A 47-year-old man with a history of ulcerative colitis on prednisone and azathioprine was admitted to the hospital with a four-day history of fever, skin rash, arthralgias and leukocytosis. A skin biopsy demonstrated neutrophilic infiltration of the dermis that was consistent with Sweet’s syndrome. He improved after several days with an increase in his prednisone and azathioprine. Sweet’s syndrome is a rare cutaneous manifestation of inflammatory bowel disease, with approximately 40 cases rep...

  15. Exploratory clinical development of ropivacaine, a local anaesthetic, in ulcerative colitis

    Arlander, Eva

    2003-01-01

    The aims of this thesis were to explore the clinical pharmacology of ropivacaine gel as a potential new rectal therapy for ulcerative colitis (UC). The studies included pharmacokinetics, tolerability, preliminary efficacy in patients, formulation factors and drug-drug interactions. These results paved the way for the start of a larger scale dose finding study in patients. UC is an idiopathic inflammation involving part of or the entire colon, and characterised by early o...

  16. Ulcerative colitis and neurofibromatosis type 1 with bilateral psoas muscle neurofibromas: a case report

    Hamid Tavakkoli; Mehrnaz Asadi; Parvin Mahzouni; Abdolali Foroozmehr

    2009-01-01

    • The most common gastrointestinal involvement in  eurofibromatosis is due to tumoral lesions which may  resent with gastrointestinal bleeding or obstruction. We report a case of concurrent ulcerative colitis and  eurofibromatosis.A 39 year-old woman, known case of neurofibromatosis, was admitted to our department with complaint of chronic bl...

    • Primary ileo-anal pouch anastomosis in patients with acute ulcerative colitis

      Hermann, Jacek; Szmeja, Jacek; Kościński, Tomasz; Meissner, Wiktor; Drews, Michał

      2013-01-01

      Introduction Proctocolectomy with ileal pouch-anal anastomosis (IPAA) was performed in ulcerative colitis (UC) for emergent or urgent indications in three stages. Since the three-step procedure imposes enormous demands on a patient, there was an attempt to introduce primary IPAA for urgent indications. The aim of this study was to compare early complications after Hartmann's colectomy (HC) and IPAA in a selected group of patients. Material and methods Medical records of 274 patients who under...

    • Possible role of REG Iα protein in ulcerative colitis and colitic cancer

      Sekikawa, A.; Fukui, H.; Fujii, S; Nanakin, A; Kanda, N; Uenoyama, Y; Sawabu, T; Hisatsune, H; Kusaka, T; Ueno, S.; Nakase, H; Seno, H; Fujimori, T; Chiba, T.

      2005-01-01

      Background and aims: Although regenerating gene (REG) Iα protein may be involved in the inflammation and carcinogenesis in the gastrointestinal tract, its pathophysiological role in ulcerative colitis (UC) and the resulting colitic cancer remains unclear. We investigated expression of the REG Iα gene and its protein in UC and colitic cancer tissues. We examined whether cytokines are responsible for REG Iα gene expression and whether REG Iα protein has a trophic and/or an antiapoptotic effect ...

    • Leech Induced Pyoderma Gangrenosum in an Ulcerative Colitis Patient: A Case Report

      Sadeghi, Anahita; Navabakhsh, Behrouz; Izadi Vahedi, Niloofar

      2016-01-01

      Pyoderma gangrenosum (PG) is a painful skin lesion that results from excessive inflammatory response to a host of traumatic, inflammatory, or neoplastic processes in susceptible individuals. A clear pathogenetic mechanism as well as an exhaustive list of potential triggers for PG is yet to be fully characterized. This case documents the occurrence of pyoderma gangrenosum following leech-therapy in a patient who is a known case of ulcerative colitis and it deserves attention because leeches ha...

    • Advances in treatment of ulcerative colitis with herbs: From bench to bedside

      Wan, Ping; Chen, Hao; Guo, Yuan; Bai, Ai-Ping

      2014-01-01

      Ulcerative colitis (UC), an idiopathic inflammatory disorder in the colon, has become a clinical challenge, owing to the increasing incidence and poor prognosis. The conventional treatments for UC including aminosalicylates, corticosteroids, and immunosuppressants, induce remission in only half of patients. Meanwhile, the treatments often come with serious side effects which can be life-threatening. Herbal medicine, one of the most common traditional Chinese medicine modalities, has been intr...

  1. Enhanced expression of proproliferative and antiapoptotic genes in ulcerative colitis-associated neoplasia

    Švec, J.; Musílková, Jana; Bryndová, Jana; Jirásek, T.; Mandys, V.; Kment, M.; Pácha, Jiří

    2010-01-01

    Roč. 16, č. 7 (2010), s. 1127-1137. ISSN 1078-0998 R&D Projects: GA MZd(CZ) 1A8651; GA MZd(CZ) NS9982; GA AV ČR(CZ) IAA500110605 Institutional research plan: CEZ:AV0Z50110509 Keywords : ulcerative colitis * colorectal cancer Subject RIV: FD - Oncology ; Hematology Impact factor: 4.613, year: 2010

  2. Fecal calprotectin level correlated with both endoscopic severity and disease extent in ulcerative colitis

    Kawashima, Kousaku; Ishihara, Shunji; Yuki, Takafumi; Fukuba, Nobuhiko; Oshima, Naoki; Kazumori, Hideaki; Sonoyama, Hiroki; Yamashita, Noritsugu; Tada, Yasumasa; Kusunoki, Ryusaku; Oka, Akihiko; Mishima, Yoshiyuki; Moriyama, Ichiro; Kinoshita, Yoshikazu

    2016-01-01

    Background The relationship between fecal calprotectin (FC) and disease extent in ulcerative colitis (UC) has not been fully elucidated. The aim of this study was to clarify the correlation of FC with disease extent and severity in UC patients. Methods UC patients scheduled to undergo an ileocolonoscopy were enrolled and fecal samples for FC measurement were collected prior to the procedure. A Mayo endoscopic subscore (MES) was determined for each of 5 colonic segments. To evaluate the associ...

  3. Asymptomatic and Persistent Elevation of Pancreatic Enzymes in an Ulcerative Colitis Patient

    Elisa Liverani; Filippo Leonardi; Lucia Castellani; Carla Cardamone; Andrea Belluzzi

    2013-01-01

    Azathioprine has been extensively used in the management of inflammatory bowel diseases. It might cause pancreatic damage in the form of either asymptomatic elevation in serum amylase/lipase or overt acute pancreatitis. Here we report the case of a 61-year-old patient with ulcerative colitis who had been treated with azathioprine for three years, achieving clinical remission. During treatment he presented an asymptomatic elevation of serum pancreatic enzymes, without any signs of pancreatitis...

  4. Testing nicotine gum for ulcerative colitis patients. Experience with single-patient trials.

    Lashner, B A; Hanauer, S B; Silverstein, M D

    1990-07-01

    Epidemiologic studies have documented an association between nonsmoking and ulcerative colitis and case reports have demonstrated that symptoms improve with smoking and worsen with removal of a nicotine source. A double-blind randomized crossover trial for individual ulcerative colitis patients (single-patient trial, or N of 1 clinical trial) was designed to study the safety, patient acceptance, and the effectiveness of nicotine gum in improving patient symptoms and proctoscopic appearance of involved colon. Seven nonsmoking patients chewed up to 10 squares/day (20 mg) of nicotine gum or placebo gum for two weeks. Therapy was crossed-over every two weeks over the eight-week trial. Effectiveness was judged from comparisons between nicotine-gum and placebo-gum periods of patient self-reported symptoms at the conclusion of each two-week period using visual analog scales and proctoscopic appearance using ordered categorical scales. Three of seven patients, all three of whom were former smokers, demonstrated sufficient improvement without adverse effects to warrant institution of nicotine gum into their drug treatment regimens. Three patients demonstrated an uncertain response, despite tolerating the drug, and have not had nicotine gum added to their regimens. One patient could not tolerate the medication and was withdrawn from the study. No serious side effects were noted. We conclude that a randomized trial for an individual patient is a useful method for evaluating treatment regimens for ulcerative colitis and that nicotine gum may be effective therapy for individual patients with ulcerative colitis who demonstrate an objective response with few adverse effects. PMID:2194767

  5. Fatal ulcerative colitis in a western lowland gorilla (Gorilla gorilla gorilla).

    Lankester, Felix; Mätz-Rensing, Kerstin; Kiyang, J.; Jensen, Siv Aina; Weiss, Sabrina; Leendertz, Fabian

    2008-01-01

    A captive western lowland gorilla (Gorilla gorilla gorilla) presented with watery diarrhoea that progressed to become profuse and haemorrhagic. Faecal analyses revealed Balantidium (B.) coli trophozoites and salmonella-like bacteria. Despite treatment the gorilla died on the 5th day after onset of symptoms. Post-mortem examination revealed a severe erosive-ulcerative superficial and deep colitis. Histological examination of post-mortem samples of the colon showed plentiful B. coli invading in...

  6. Gene-Gene and Gene-Environment Interactions in Ulcerative Colitis

    Wang, Ming-Hsi; FIOCCHI, CLAUDIO; Zhu, Xiaofeng; Ripke, Stephan; Kamboh, M. Ilyas; Rebert, Nancy; Duerr, Richard H.; Achkar, Jean-Paul

    2013-01-01

    Genome-wide association studies (GWAS) have identified at least 133 ulcerative colitis (UC) associated loci. The role of genetic factors in clinical practice is not clearly defined. The relevance of genetic variants to disease pathogenesis is still uncertain because of not characterized gene-gene and gene-environment interactions. We examined the predictive value of combining the 133 UC risk loci with genetic interactions in an ongoing inflammatory bowel disease (IBD) GWAS. The Wellcome Trust...

  7. Ulcerative colitis specific cytotoxic IgG-autoantibodies against colonic epithelial cancer cells.

    Auer, I O; Grosch, L; Hardörfer, C; A. Röder

    1988-01-01

    Serum antibodies cytotoxic to the colon cancer cell line RPMI 4788 were studied in 42 patients with ulcerative colitis, 61 patients with Crohn's disease, 27 patients with other inflammatory diseases (disease-controls) and 22 healthy controls. Cytotoxicity of antibodies towards RPMI 4788 was studied by means of a chromium release assay using peripheral blood mononuclear leucocytes of healthy subjects as effector cells. Using a four hour antibody dependent cell mediated cytotoxicity assay sera ...

  8. Nutritional support and dietary interventions for patients with ulcerative colitis: current insights

    Hill RJ

    2016-01-01

    Rebecca J Hill Children's Nutrition Research Centre, Child Health Research Centre, The University of Queensland, South Brisbane, Australia Abstract: Ulcerative colitis (UC) demonstrates a remitting and relapsing course, and patients have long believed diet plays a role in their symptoms. Ad hoc removal of foods and food groups from the diet without strong evidence for therapeutic benefit places patients at risk for nutritional deficiencies. This review discusses the need for nutritio...

  9. Heat shock factor 2 levels are associated with the severity of ulcerative colitis.

    Jiarong Miao

    Full Text Available BACKGROUND AND AIMS: The morbidity of ulcerative colitis (UC is increasing in China every year. In addition, there is a lack of accurate diagnostic indices with which to evaluate the activity of the disease. The aim of this study was to identify UC-associated proteins as biomarkers for the diagnosis, and objective assessment of disease activity. METHODS: Differential expression of serum proteins from UC patients compared to normal controls was analyzed by two-dimensional electrophoresis (2-DE and matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF-MS. The expression of heat shock factor 2(HSF2in colonic mucosa in Crohn's disease, Behcet's disease, ulcerative colitis, intestinal tuberculosis, infective enteritis, intestinal lymphoma, and normal controls was investigated by immunohistochemistry (IHC. The expression of the HSF2 in colonic mucosa of UC subjects with varying severity of disease was measured by real time-PCR and Western Blots. The expression of HSF2 was inhibited by HSF2 small interfering RNA (siRNA transfection in Caco-2 cells. The concentrations of HSF2, IL-1β, and TNF-α in serum and IL-1β, and TNF-α in the supernatants of transfected Caco-2 cells were determined by ELISA. RESULTS: HSF2 was differentially expressed in UC patients compared to normal controls. HSF2 expression was significantly higher in the intestinal mucosa of UC patients compared to other six groups. The results of immunohistochemistry, real time-PCR, Western Blots, and ELISA showed that the expression of HSF2 increased in parallel with the severity of UC. The serum concentration of HSF2 also positively correlated with levels of IL-1β and TNF-α. After down-regulation expression of HSF2 in Caco-2 cells by RNA interference, the productions of IL-1β and TNF-α stimulated by lipopolysaccharide (LPS increased dramatically. CONCLUSIONS: HSF2 appears to be a potential novel molecular marker for UC activity, and may provide a basis

  10. [Environmental risk factors in Crohn's disease and ulcerative colitis (excluding tobacco and appendicectomy)].

    Jantchou, Prévost; Monnet, Elisabeth; Carbonnel, Franck

    2006-01-01

    A rapid increase in the incidence of Crohn's disease and ulcerative colitis in developed countries, the occurrence of Crohn's disease in spouses, and a lack of complete concordance in monozygotic twins are strong arguments for the role of environmental factors in inflammatory bowel disease (IBD). Research in the field of environmental factors in IBD is based upon epidemiological (geographical and case-control), clinical and experimental studies. The role of two environmental factors has clearly been established in IBD. Smoking is a risk factor for Crohn's disease and a protective factor for ulcerative colitis; appendectomy is a protective factor for ulcerative colitis. Many other environmental factors for IBD have been investigated, including infectious agents, diet, drugs, stress and social status. They are detailed in the present review. Among them, atypical Mycobacteria, oral contraceptives and antibiotics could play a role in Crohn's disease. To date, three hypotheses associate environmental factors with the pathophysiology of IBD (loss of tolerance of intestinal immune system towards commensal bacterial flora): the hygiene, infection and cold chain hypotheses. Much work remains to be done to identify risk factors for IBD. Research identifying environmental factors that might cause a predisposition to IBD is useful. It may lead to disease prevention in subjects who are genetically predisposed and disease improvement in patients. PMID:16885870

  11. Ulcerative colitis and neurofibromatosis type 1 with bilateral psoas muscle neurofibromas: a case report

    Hamid Tavakkoli

    2009-08-01

    Full Text Available

    • The most common gastrointestinal involvement in  eurofibromatosis is due to tumoral lesions which may  resent with gastrointestinal bleeding or obstruction. We report a case of concurrent ulcerative colitis and  eurofibromatosis.A 39 year-old woman, known case of neurofibromatosis, was admitted to our department with complaint of chronic bloody diarrhea. After thorough clinical examination and paraclinical assessments,  ncluding colonoscopy and biopsy, ulcerative colitis was confirmed as the cause of gastrointestinal bleeding. Another rare finding in this patient was bilateral neurofibroma in psoas muscle that was detected on abdominal spiral Computer Tomography scan.
    • KEYWORDS: Ulcerative Colitis, Neurofibromatosis, Von Recklinghausen’s Disease, Mast Cells, Bilateral   urofibroma, Psoas Muscle.

  12. Steroid-sparing strategies in the management of ulcerative colitis: Efficacy of leukocytapheresis

    Manabu Shiraki; Takayuki Yamamoto

    2012-01-01

    Active ulcerative colitis (UC) is frequently associated with infiltration of a large number of leukocytes into the bowel mucosa.Leukocytapheresis is a novel nonpharmacologic approach for active UC,in which leukocytes are mechanically removed from the circulatory system.Current data indicate that leukocytapheresis is efficacious in improving response and remission rates with excellent tolerability and safety in patients with UC.Corticosteroid therapy remains a mainstay in the treatment of active UC; however,long-term,high doses of corticosteroids usually produce predictable and potentially serious side effects.If leukocytapheresis can spare patients from exposure to corticosteroids,the risk of steroid-induced adverse events should be minimized.This may be of great benefit to patients because severe side effects of steroids seriously impair healthrelated quality of life.In this article,we reviewed cur rent evidence on whether leukocytapheresis can avoid or reduce the use of corticosteroids in the management of patients with UC.Several studies have shown that leukocytapheresis was effective for steroid-na(i)ve patients with active UC.Furthermore,both short-term and long-term studies have demonstrated the steroidsparing effects of leukocytapheresis therapy in patients with UC.Although the evidence level is not striking,the available data suggest that leukocytapheresis can avoid or reduce the use of corticosteroids in the management of UC.Large,well-designed clinical trials are necessary to more accurately evaluate the steroid-sparing effects of leukocytapheresis in the management of UC.

  13. Clinical Significance and Assessment of Cytokines in Various Stages of Ulcerative Colitis

    ZOU; Kaifang(

    2001-01-01

    [1]Herfarth H H Bocher U Janardhanam R et al.Subtherapeutic corticostevoids potentiate the ability of interleukin 10 to prevent chronic inflammation in rates.Gastroenterology 1998 115:856[2]Strong S A Pizarro T T Klein J S et al.Proinflammatory cytokines differentially modulate their own expression in human intestinal mucosal mesenchymal cells.Gastroenterology 1998 114:1244[3]Nikolaus S Bauditz J Giouchettii P et al.Increased secretion of pro-inflammatory cytkines by circulating Polymorphnuclear neutrophils and regulation by interleukin 10 during intestinal inflammation.Gut 1998 42:470[4]安子元.溃疡性结肠炎的诊断标准.新消化病杂志 1994 2(1)57[5]Mahida Y R Wu K Jewell D P.Enhanced production of interlukin-1β in mononuclear cells isolated from mucosa with active ulcerative colitis and crohn's disease.Gut 1989 30:835[6]Fiorentino D F Zlotnik A Vieira P et al.IL-10 acts on the antigen presenting cell to inhibit cytokine production by Th1 cells.J Immunol 1991 146(10):3444[7]Nielsen O H Koppen T Rudiger N et al.Involvement of interleukin 4 and interleukin 10 in inflammatory bowel disease.Dig Dis Sci 1996 41(9)1786[8]Schreiber S Heinig T Thieve H G et al.Immunoregulatory role of interleukin10 in patients with inflammatory bowel disease.Gastroenterology 1995 108 (5) :1434[9]Steidler L Hans W.Treatment of murine colitis by Iactococcus Iactis secreting interleukin-10.Science 2000 289:352

  14. Development of ulcerative colitis during the course of rheumatoid arthritis: Association with selective IgA deficiency

    Yuki Asada; Yohei Mizuta; Kiyoshi Migita; Masahiro Ito; Shigeru Kohno; Hajime Isomoto; Saburo Shikuwa; Chun Yang Wen; Eiichiro Fukuda; Masaru Miyazato; Kenta Okamoto; Takashi Nakamura; Hitoshi Nishiyama

    2006-01-01

    A 56-year-old woman with a 29-year history of rheumatoid arthritis (RA) was admitted to the hospital, complaining of high fever, abdominal pain and severe bloody diarrhea. Colonoscopy revealed friable and edematous mucosa with spontaneous bleeding, diffuse erosions and ulcers extending from the rectum to the distal transverse colon. Histopathological findings of rectal biopsies were compatible with ulcerative colitis (UC). Being diagnosed as having severe active leftside UC, she was successfully treated with intravenous methylprednisolone followed by prednisolone and leukocytapheresis. Laboratory tests revealed low serum and saliva IgA levels, which might play a role in the development of UC. To our knowledge, this is the first case of UC occurring during the course of PA, accompanied by selective IgA deficiency.

  15. The Correlation of the Contents of Fecal Calprotectin and the Activity of Colitis in Ulcerative Colitis and its Value as an Indicator of Disease Activity%粪钙卫蛋白含量和结肠炎活动性之间的关系及临床应用价值

    余剑波; 李春生; 林闯; 凌寿坚; 李林; 梁红; 禢少华

    2011-01-01

    Objective To evaluate the correlation of the contents of fecal calprotectin and activity of colitis in ulcerative colitis, and evaluate the accuracy of fecal calprotectin as a non-invasive indicator of disease activity . The references are erythroeyte sedimentation rate (ESR) and C-reactive protein (CRP). Methods 18 healthy persons as control and 45 patients with UC were recruited after colonoscopy. All were asked to collect 5g of stool sample for determining fecal calprotectin by an enzyme--linked immunosorbent assay. The disease activity of UC was evaluated according to colonoscopic and histological criteria. CRP,ESR were also measured. Results The fecal calprotectin concentration among patients with active UC(578.5ug/g)was significantly higher than that of inactive UC group(10.84 ug/g, P<0.01)and healthy controls(4.94 ug/g, P <0.01). The difference between control group and inactive group was not statistically significant ( P>0.05). Significant difference existed between each active grades(Ⅰ, Ⅱ, Ⅲ )and inactive phase of UC( P <0.01). There has a significant correlation between endoscopic grades of disease activity and fecal calprotectin concentration( r=0.965, P<0.01). The correlation coefficient between CRP/ESR and histological grades were 0.952 ( P <0.01) and 0.948 ( P<0.01) respectively. Both were lower than that of calprotectin. Conclusion Fecal calprotectin levels reflect the disease activity in UC and can be used to monitor the response to treatment and detect relapses. It was an objective, simple and noninvasive measurement and was better than ESR and serum CRP.%目的 探讨溃疡性结肠炎(UC)患者粪钙卫蛋白含量(Fecal calprotectin content,FCC)和结肠活动性之间的关系,以明确粪钙卫蛋白作为炎症性肠病诊断标志物的临床价值.方法 肠镜确诊的UC患者45例,肠镜前/后留取5 g粪便用ELISA测定FCC;并检ESR和CRP.炎症活动性根据内镜和病理学标准判断.肠镜正常的18例

  16. Pyoderma gangrenosum of articulations carpi associated with ulcerative colitis: one case report

    Meng, Xia; Zhu, Xinying; Chen, Liping; Wu, Jing; Liu, Gaifang; Xia, Bing

    2015-01-01

    Pyoderma gangrenosum (PG), an extra-intestinal manifestation of ulcerative colitis (UC), is extremely rare. Up to now, there is no any data reported the occurrence of PG in joints, especially in China. The management of PG associated with UC is a therapeutic challenge. Our report here showed that a female patient diagnosed as UC complained a pustule in the dorsal side of left wrist, primarily was diagnosed as bone tuberculosis. The pustule progressed rapidly into a severe painful necrolytic cutaneous ulcer with a pale purple irregular destructive ulcer edge, this patient was diagnosed by UC complicated with PG, and skin lesions were cured by UC treatment. Here, we for the first time present a case acquired correct diagnosis and successful treatment of UC associated with PG of articulations carpi. We report this case here in order to provide more information about this disease to more doctors, furthermore, to decrease the rates of misdiagnosis and missed diagnosis. PMID:26770554

  17. Atypical presentation of pioderma gangrenosum complicating ulcerative colitis:Rapid disappearance with methylprednisolone

    Paolo Aseni; Stefano Di Sandro; Plamen Mihaylov; Luca Lamperti; Luciano Gregorio De Cadis

    2008-01-01

    Piodermal gangrenosum (PG) is an uncommon ulcerative cutaneous dermatosis associated with a variety of systemic diseases,including inflammatory bowel disease (IBD),arthritis,leukaemia,hepatitis,and primary billiary cirrhosis.Other cutaneous ulceration resembling PG had been described in literature.There has been neither laboratory finding nor histological feature diagnostic of PG,and diagnosis of PG is mainly made based on the exclusion criteria.We present here a patient,with ulcerative colitis (UC)who was referred to the emergency section with a large and rapidly evolving cutaneous ulceration.Laboratory and microbiological investigation associated with histological findings of the ulcer specimen allowed us to exclude autoimmune and systemic diseases as well as immuno-proliferative disorders.An atypical presentation of PG with UC was diagnosed.Pulse boluses of i.v.methyl-prednisolone were started,and after tapering steroids,complete resolution of the skin lesion was achieved in 3 wk.The unusual rapid healing of the skin ulceration with steroid mono-therapy and the atypical cutaneous presentation in this patient as well as the risk of misdiagnosis of PG in the clinical practice were discussed.

  18. Oral delivery of Bifidobacterium longum expressing α-melanocyte-stimulating hormone to combat ulcerative colitis.

    Wei, Pijin; Yang, Yan; Ding, Qing; Li, Xiuying; Sun, Hanxiao; Liu, Zhaobing; Huang, Junli; Gong, Yahui

    2016-02-01

    α-Melanocyte-stimulating hormone (α-MSH) is a tridecapeptide derived from pro-opiomelanocortin that exhibits potent anti-inflammatory properties by regulating the production of inflammatory mediators. This peptide has been well established in several inflammatory models, including inflammatory bowel disease (IBD). However, its extremely short duration in vivo limits its clinical application. To address this limitation, Bifidobacterium was used here as a carrier to deliver α-MSH. We utilized α-MSH-engineered Bifidobacterium against IBD, which is closely linked to immune and intestinal microbiota dysfunction. First, we constructed a Bifidobacterium longum secreting α-MSH (B. longum-α-MSH). We then tested the recombinant α-MSH expression and determined its bioactivity in HT-29 cells. To assess its effectiveness, B. longum-α-MSH was used against an ulcerative colitis (UC) model in rats induced by dextran sulfate sodium. The data showed that α-MSH expression in B. longum-α-MSH was effective, and its biological activity was similar to the synthesized one. This UC model experiment indicated that B. longum-α-MSH successfully colonized the intestinal gut, expressed bioactive α-MSH and had a significant anti-inflammatory effect. The results demonstrate the feasibility of preventing IBD by using B. longum-α-MSH. PMID:26567174

  19. Clinical significance of mucosal suppressors of cytokine signaling 3 expression in ulcerative colitis

    Yoshihiro Miyanaka; Yoshitaka Ueno; Shinji Tanaka; Kyoko Yoshioka; Tsuyoshi Hatakeyama; Masaru Shimamoto; Masaharu Sumii; Kazuaki Chayama

    2007-01-01

    AIM: To investigate the clinical significance of mucosal expression of suppressors of cytokine signaling 1 (SOCS1)and SOCS3 in human ulcerative colitis (UC).METHODS: Biopsy specimens for histological analysis and mRNA detection were obtained endoscopically from the rectum of 62 patients with UC (36 men; age 13-76 years). The patients were classified endoscopically according to Matts' grade (grade 1 to 4). Expression of SOCS1 and SOCS3 mRNAs was quantified in samples by competitive reverse transcription-polymerase chain reaction (RT-PCR). GAPDH was used as an internal control for efficiency of RT-PCR and amount of RNA.RESULTS: SOCS3 mRNA expression was significantly higher in inflamed mucosa of UC than in inactive mucosa.The level of expression was well correlated with the degree of both endoscopic and histologic inflammation.Interestingly, among the patients in remission, the group with relatively low expression of SOCS3 showed a higher rate of remission maintenance over a 12-mo period. In contrast, SOCS1 mRNA was expressed in both inflamed and non-inflamed colonic mucosa and was not correlated with the activity of colonic mucosa or prognosis.CONCLUSION: These observations suggest that increased expression of mucosal SOCS3, but not of SOCS1, may play a critical role in the development of the colonic inflammation of UC.

  20. Promising biological therapies for ulcerative colitis: A review of the literature

    Hirotada; Akiho; Azusa; Yokoyama; Shuichi; Abe; Yuichi; Nakazono; Masatoshi; Murakami; Yoshihiro; Otsuka; Kyoko; Fukawa; Mitsuru; Esaki; Yusuke; Niina; Haruei; Ogino

    2015-01-01

    Ulcerative colitis(UC) is a chronic lifelong condition characterized by alternating flare-ups and remission. There is no single known unifying cause, and the pathogenesis is multifactorial, with genetics, environmental factors, microbiota, and the immune system all playing roles. Current treatment modalities for UC include 5-aminosalicylates, corticosteroids, immunosuppressants(including purine antimetabolites, cyclosporine, and tacrolimus), and surgery. Therapeutic goals for UC are evolving. Medical treatment aims to induce remission and prevent relapse of disease activity. Infliximab, an anti-tumor necrosis factor(TNF)-α monoclonal antibody, is the first biological agent for the treatment of UC. Over the last decade, infliximab and adalimumab(anti-TNF-α agents) have been used for moderate to severe UC, and have been shown to be effective in inducing and maintaining remission. Recent studies have indicated that golimumab(another anti-TNF-α agent), tofacitinib(a Janus kinase inhibitor), and vedolizumab and etrolizumab(integrin antagonists), achieved good clinical remission and response rates in UC. Recently, golimumab and vedolizumab have been approved for UC by the United States Food and Drug Administration. Vedolizumab may be used as a first-line alternative to anti-TNF-α therapy in patients with an inadequate response to corticosteroids and/or immunosuppressants. Here, we provide updated information on various biological agents in the treatment of UC.

  1. Reduction of dendritic cells by granulocyte and monocyte adsorption apheresis in patients with ulcerative colitis.

    Waitz, Grit; Petermann, Sebastian; Liebe, Stefan; Emmrich, Joerg; Ramlow, Wolfgang

    2008-09-01

    The influence of the granulocyte/monocyte apheresis (GMCAP) on cell populations participating in mechanisms of tolerance, e.g. dendritic cells (DCs), is still not very clear. In a first step, we aimed to investigate changes in the DC population of patients suffering from ulcerative colitis (UC) (n = 13) compared to healthy subjects (n = 9). In a second step, we studied the changes in peripheral DCs in a small group of patients with active UC before and after Adacolumn apheresis (n = 7). For this purpose, plasmacytoid and myeloid DCs and their maturation markers CD40, CD80, and CD86 were measured using four-color flow cytometry in the peripheral blood. After apheresis, and in acute flare-ups, we identified a significantly lower number of lymphocytes, plasmacytoid, and myeloid DCs. In conclusion, the additional removal of peripheral DCs by GMCAP, which otherwise would contribute to the inflammatory process in the gut, may lead to a higher tolerogeneic status towards luminal antigens. PMID:18253828

  2. Immunohistochemical Studies on Galectin Expression in Colectomised Patients with Ulcerative Colitis

    Mattias Block

    2016-01-01

    Full Text Available Introduction. The aetiology and pathogenesis of ulcerative colitis (UC are essentially unknown. Galectins are carbohydrate-binding lectins involved in a large number of physiological and pathophysiological processes. Little is known about the role of galectins in human UC. In this immunohistochemical exploratory study, both epithelial and inflammatory cell galectin expression were studied in patients with a thoroughly documented clinical history and were correlated with inflammatory activity. Material and Methods. Surgical whole intestinal wall colon specimens from UC patients (n=22 and controls (n=10 were studied. Clinical history, pharmacological treatment, and modified Mayo-score were recorded. Tissue inflammation was graded, and sections were stained with antibodies recognizing galectin-1, galectin-2, galectin-3, and galectin-4. Results. Galectin-1 was undetectable in normal and UC colonic epithelium, while galectin-2, galectin-3, and galectin-4 were strongly expressed. A tendency towards diminished epithelial expression with increased inflammatory grade for galectin-2, galectin-3, and galectin-4 was also found. In the inflammatory cells, a strong expression of galectin-2 and a weak expression of galectin-3 were seen. No clear-cut correlation between epithelial galectin expression and severity of the disease was found. Conclusion. Galectin expression in patients with UC seems to be more dependent on disease focality and individual variation than on degree of tissue inflammation.

  3. Prediction of clinical and endoscopic responses to anti-tumor necrosis factor-α antibodies in ulcerative colitis.

    Morita, Yukihiro; Bamba, Shigeki; Takahashi, Kenichiro; Imaeda, Hirotsugu; Nishida, Atsushi; Inatomi, Osamu; Sasaki, Masaya; Tsujikawa, Tomoyuki; Sugimoto, Mitsushige; Andoh, Akira

    2016-08-01

    Objective In patients with ulcerative colitis (UC), the relationship between the initial endoscopic findings and the response to anti-tumor necrosis factor (TNF)-α antibodies remains unclear. We herein evaluated the potential of endoscopic assessment using the ulcerative colitis endoscopic index of severity (UCEIS) to predict the response to anti-TNF-α antibodies. Methods We enrolled 64 patients with UC undergoing anti-TNF-α maintenance therapy with infliximab (IFX) or adalimumab (ADA) between April 2010 and March 2015. Anti-TNF-α trough levels were determined by ELISA. Endoscopic disease activity was assessed using the UCEIS. Results The clinical response rate at 8 weeks was 77.4% for IFX and 66.7% for ADA. Serum albumin levels were significantly higher and the UCEIS bleeding descriptor before treatment was significantly lower in the responders than in the non-responders (p CRP levels at 2 weeks were significantly lower in the responders (p CRP levels), is useful for the prediction of the treatment outcome of UC patients in response to anti-TNF-α antibodies. PMID:26888161

  4. Pyoderma gangrenosum associated with ulcerative colitis: response to infliximab Pioderma gangrenoso asociado a colitis ulcerosa: respuesta a infliximab

    A. López San Román

    2004-06-01

    Full Text Available Pyoderma gangrenosum is an extraintestinal manifestation of inflammatory bowel disease that can be therapeutically troublesome. We comment on the case of a patient with clinically inactive ulcerat-ive colitis who progressively developed necrotic lesions on both tibial aspects of his legs, which corresponded both clinically and histologically to pyoderma gangrenosum. Treatment with steroids and azathioprine could not control this complication. A single dose of infliximab 5 mg/kg was given, achieving an impressive response of the skin lesions followed by complete healing 3 months later. Infliximab can be useful in the management of refractory extraintestinal manifestations of inflammatory bowel disease.Dentro de las manifestaciones extraintestinales de la enfermedad inflamatoria intestinal, el pioderma gangrenoso plantea con frecuencia dificultades terapéuticas. Presentamos el caso de un enfermo diagnosticado de colitis ulcerosa, inactiva en ese momento, que presentó un pioderma gangrenoso en miembros inferiores y no respondió a esteroides y azatioprina. Se administró una dosis de 5 mg/kg de infliximab obteniendo una rápida mejoría de las lesiones y la completa curación a los 3 meses. Infliximab puede ser útil en manifestaciones extraintestinales de la enfermedad inflamatoria intestinal, como el pioderma gangrenoso, si no responden a los tratamientos habituales.

  5. Pre-operative use of anti-TNF-α agents and the risk of post-operative complications in patients with ulcerative colitis - a nationwide cohort study

    Nørgård, B M; Nielsen, J; Qvist, N;

    2012-01-01

    It is still controversial whether pre-operative anti-tumour necrosis factor-alpha (anti-TNF-α) agents increase post-operative complications in patients with ulcerative colitis (UC).......It is still controversial whether pre-operative anti-tumour necrosis factor-alpha (anti-TNF-α) agents increase post-operative complications in patients with ulcerative colitis (UC)....

  6. Predictive factors for a severe clinical course in ulcerative colitis: Results from population-based studies

    Wanderås, Magnus Hofrenning; Moum, Bjørn A; Høivik, Marte Lie; Hovde, Øistein

    2016-01-01

    Ulcerative colitis (UC) is characterized by chronic inflammation of the large bowel in genetically susceptible individuals exposed to environmental risk factors. The disease course can be difficult to predict, with symptoms ranging from mild to severe. There is no generally accepted definition of severe UC, and no single outcome is sufficient to classify a disease course as severe. There are several outcomes indicating a severe disease course, including progression of the disease’s extension, a high relapse rate, the development of acute severe colitis, colectomy, the occurrence of colorectal cancer and UC-related mortality. When evaluating a patient’s prognosis, it is helpful to do so in relation to these outcomes. Using these outcomes also makes it easier to isolate factors predictive of severe disease. The aims of this article are to evaluate different disease outcomes and to present predictive factors for these outcomes.

  7. Mesalamine induced symptom exacerbation of ulcerative colitis: Case report and brief discussion

    Maneesh; Kumar; Gupta; Scott; Pollack; John; J; Hutchings

    2010-01-01

    This paper describes a rare case in which the oral ad-ministration of mesalamine resulted in the exacerbation of ulcerative colitis (UC) in a patient who was previously responsive to mesalamine and whose colitis had been in remission for eight years. Mesalamine and other 5-ami-nosalicylic acid compounds are the mainstay of treatment for UC; however up to 8% of patients are unable to take the medications due to intolerance or hypersensitivity reactions. Common drug reactions are fever, nausea, di-arrhea and abdominal pain; however, exacerbation of UC has rarely been reported. This study highlights the impor-tance of ruling out mesalamine as the causative agent in cases of UC exacerbations.

  8. A Maximum Likelihood Estimator of a Markov Model for Disease Activity in Crohn's Disease and Ulcerative Colitis for Annually Aggregated Partial Observations

    Borg, Søren; Persson, U.; Jess, T.; Thomsen, Ole Østergaard; Ljung, T.; Riis, L.; Munkholm, P.

    2010-01-01

    Hospital, Copenhagen, Denmark, during 1991 to 1993. The data were aggregated over calendar years; for each year, the number of relapses and the number of surgical operations were recorded. Our aim was to estimate Markov models for disease activity in CD and UC, in terms of relapse and remission, with a...

  9. A Maximum Likelihood Estimator of a Markov Model for Disease Activity in Crohn's Disease and Ulcerative Colitis for Annually Aggregated Partial Observations

    Borg, Søren; Persson, U.; Jess, T.;

    2010-01-01

    cycle length of 1 month. The purpose of these models was to enable evaluation of interventions that would shorten relapses or postpone future relapses. An exact maximum likelihood estimator was developed that disaggregates the yearly observations into monthly transition probabilities between remission...... observed data and has good face validity. The disease activity model is less suitable for UC due to its transient nature through the presence of curative surgery...... Hospital, Copenhagen, Denmark, during 1991 to 1993. The data were aggregated over calendar years; for each year, the number of relapses and the number of surgical operations were recorded. Our aim was to estimate Markov models for disease activity in CD and UC, in terms of relapse and remission, with a...

  10. Long-term Compliance with Oral 5-aminosalicylic Acid Therapy and Risk of Disease Recurrence in Patients with Ulcerative Colitis

    Prosberg, Michelle V; Vester-Andersen, Marianne K; Andersson, Mikael; Jess, Tine; Andersen, Jon T; Vind, Ida; Bendtsen, Flemming

    2016-01-01

    BACKGROUND: Noncompliance to long-term medical therapy is a well-known problem among patients treated for ulcerative colitis, but studies of long-term consequences in unselected patients are lacking. The authors aimed to determine the risk of recurrence according to long-term compliance with oral 5......-aminosalicylic acid among unselected patients with ulcerative colitis. METHODS: The authors conducted a 7-year follow-up study of a population-based inception cohort of 243 Danish patients with ulcerative colitis diagnosed from 2003 to 2004. Compliance was defined as consumption of ≥80% of prescribed oral 5...... treatment, or colectomy) in compliant versus noncompliant patients. RESULTS: In total, 182 patients(75%) experienced at least 1 recurrence during follow-up. For the first year after diagnosis, risk of recurrence did not differ significantly between compliant and noncompliant patients. For 1 to 3 years...

  11. Development of ulcerative colitis in a patient with multiple sclerosis following treatment with interferonβ 1a

    Eckart Schott; Friedemann Paul; Jens T Wuerfel; Frauke Zipp; Birgit Rudolph; Bertram Wiedenmann; Daniel C Baumgart

    2007-01-01

    To alert clinicians to a potential novel adverse drug effect of interferonβ 1a, we herein report a patient with relapsing-remitting multiple sclerosis who developed ulcerative colitis following treatment with interferonβ 1a. Ulcerative colitis persisted despite discontinuation of interferonβ 1a treatment and switching the patient to glatiramer acetate. Tacrolimus (FK506),6-mercaptopurine, and prednisolone were required to induce remission. Both ulcerative colitis and multiple sclerosis were eventually well controlled using this regimen. Our report underscores that caution should be exercised when prescribing immunostimulatory agents in patients with inflammatory bowel disease (IBD) and challenges current efforts to stimulate innate immunity as a novel therapeutic concept for IBD.

  12. Anti-inflammatory effect of Prunus armeniaca L. (Apricot) extracts ameliorates TNBS-induced ulcerative colitis in rats

    Minaiyan, M.; Ghannadi, A.; Asadi, M; Etemad, M.; Mahzouni, P.

    2014-01-01

    Prunus armeniaca L. (Apricot) is a tree cultivated in different parts of the world. Apricot kernel as a good dietary supplement has shown antioxidant, anti-inflammatory and other pharmacologic properties which suggest that it may be functional as an anticolitis agent. In this study we evaluated the effects of apricot kernel extract and oil on ulcerative colitis in rats. Rats were fasted for 36 h before the experiment. Colitis was induced by intra-rectal instillation of 50 mg/kg trinitrobenzen...

  13. A study of the effects of Cydonia oblonga Miller (Quince) on TNBS-induced ulcerative colitis in rats

    Minaiyan, M.; Ghannadi, A.; Etemad, M.; Mahzouni, P.

    2012-01-01

    Cydonia oblonga Miller (Quince) from Rosaceae family is a fruit tree cultivated in many countries mainly in Iran. This study was carried out to investigate the effect of quince juice (QJ) and quince hydroalcoholic extract (QHE) on ulcerative colitis (UC) induced by TNBS (trinitrobenzene sulfonic acid) in rats. Rats were grouped (n=6) and fasted for 36 h before colitis induction. TNBS was instilled into the colon with a hydroalcoholic carrier and then treatments were made for 5 days starting 6...

  14. COMPARATIVE EFFICACY OF DIFFERENT REFERENCE DRUGS ON TRINITROBENZENESULFONIC ACID-INDUCED ULCERATIVE COLITIS IN THE RAT MODEL

    P.S.Venkatesan; M. Deecaraman; M. Vijayalakshmi

    2013-01-01

    Crohn’s disease and Ulcerative colitis were chronic inflammatory disorders of the bowel categorized as inflammatory bowel diseases. Trinitrobenzene sulfonic acid (TNBS)-induced colitis was one of the most common methods for studying inflammatory bowel disease in animal models. Several factors may, however, affect its reproducibility, rate of animal mortality, and macroscopic and histopathological outcomes.The current study was undertaken with the objective to validate the main contributing fa...

  15. Small cell carcinoma in ulcerative colitis - new treatment option: a case report

    Tzeveleki Ioanna; Vasiliadou Kalliopi; Anthimidis Georgios; Efthimiadis Christoforos; Kosmidis Christoforos; Fotiadis Panagiotis; Basdanis Georgios

    2010-01-01

    Abstract Background The most common type of carcinoma associated with ulcerative colitis (UC) is adenocarcinoma. We present a case of primary rectal small cell carcinoma in a patient with a history of UC. Methods A 34-year-old male diagnosed with UC for 10 years was not consistent with the usual annual follow-up and presented with mucoid-bloody diarrhea. Colonoscopy revealed a rectal mass 2 cm distant from the anal verge. The patient underwent a total proctocolectomy with preservation of the ...

  16. Relationship between Various Chinese Medicine Types and T-cell Subsets in Patients with Ulcerative Colitis

    常廷民; 李秀敏; 赵习德

    2009-01-01

    Objective:To investigate the relationship between various Chinese medicine(CM) types and T-cell subsets(CD4~+ and CD8~+) in the colonic mucous membranes of patients with ulcerative colitis(UC).Methods: Fifty UC patients were enrolled,after differentiation into four types by CM syndromes,i.e.,the internal heat-damp accumulation type(IHDA),the qi-stagnancy with blood stasis type(QSBS),the Pi(脾)-Shen(肾) yang-deficiency type(PSYD) and the yin-blood deficiency type(YBD).From every patient,3-5 pieces of intest...

  17. Intra-aortic mural thrombosis and splenic infarction in association with ulcerative colitis.

    Kok, H K

    2010-03-04

    BACKGROUND: Arterial thrombosis is a very rare, but recognised complication of inflammatory bowel disease that can result in significant morbidity and mortality. CASE PRESENTATION: We present the case of a 48-year-old female with previously well-controlled ulcerative colitis who presented with severe left upper quadrant abdominal pain. Imaging investigations subsequently revealed a large intra-aortic mural thrombus extending into the coeliac axis complicated by splenic infarction. This occurred in the absence of other prothrombotic states such as thrombophilias or vasculitis. CONCLUSION: This case highlights the frequently overlooked association between inflammatory bowel disease and arterial thrombosis.

  18. Case of ulcerative colitis%溃疡性结肠炎案

    吴佳; 李胜吾; 张钰敏; 胡幼平

    2011-01-01

    Patient,female,30 years old,a stewardess.Date of visit:11 Nov.2009.Main complaints:repeated occurrence of abdominal distention,defecation with pus and blood for more than 2 years.She had abdominal distension,defecation with pus and blood,repeatedly 2 years ago.She was diagnosed as ulcerative colitis by Huaxi Hospital,Sichuan University,and was given Mesalazine Suppositories to relieve the symptoms.However,her symptoms couldn't be controlled satisfactorily.

  19. Efficacy of infliximab in acute severe ulcerative colitis: A single-centre experience

    Stephen J Halpin

    2013-01-01

    Full Text Available AIM: To suggest infliximab (IFX is effective for acute severe ulcerative colitis, from real-life clinical practice. METHODS: All patients receiving IFX for the treatment of acute severe ulcerative colitis in a single centre were included. Data were extracted from clinical records in order to assess response to IFX therapy. The primary endpoint was colectomy-free survival, and secondary outcomes included glucocorticosteroid-free remission and safety, which was evaluated by recording deaths and adverse events. Demographic and clinical characteristics of those who underwent colectomy and those who were colectomy-free, both at discharge from their index admission, and during follow-up after an initial response to IFX were compared. RESULTS: Forty-four patients (16 females, mean age 36 years received IFX between May 2006 and January 2012 for acute severe ulcerative colitis. The median duration of follow-up post-first infusion was 396 d (interquartile range = 173-828 d. There were 21 (47.7% patients with < 1 year of follow-up, 10 (22.7% with 1 years to 2 years of follow-up, and 13 (29.5% with > 2 years of follow-up post-first infusion of IFX. Overall, 35 (79.5% responded to IFX, avoiding colectomy during their index admission, 29 (65.9% were colectomy-free at last point of follow-up (median follow-up 396 d, and 25 (56.8% were in glucocorticosteroid-free remission at end of follow-up. There was one death from post-operative sepsis, 20 d after a single IFX infusion. Colectomy rates were generally lower among those “bridging” to thiopurine. Of 18 patients “bridged” to thiopurine therapy, 17 (94.4% were colectomy-free, and 15 (83.3% were in glucocorticosteroid-free remission at study end. No predictors of response were identified. CONCLUSION: IFX is effective for acute severe ulcerative colitis in real-life clinical practice. Two-thirds of patients avoided colectomy, and more than 50% were in glucocorticosteroid-free remission.

  20. Risk of ulcerative colitis and Crohn's disease among offspring of patients with chronic inflammatory bowel disease

    Orholm, Marianne; Fonager, Kirsten; Sørensen, Henrik Toft

    1999-01-01

    ) and Crohn's disease (CD) among first-degree relatives of patients with these diseases. To give more precise risk estimates we conducted a nationwide study using population-based data from the Danish National Registry of Patients (NRP). METHODS: All patients from the entire Danish population (5......OBJECTIVE: The incidence of inflammatory bowel disease (IBD) varies among and within countries, but several studies have indicated that genetic factors may play an important role in the etiology of IBD. A Danish regional study has observed an almost 10-fold increased risk for ulcerative colitis (UC...

  1. Dietary Supplement Therapies for Inflammatory Bowel Disease: Crohn's Disease and Ulcerative Colitis.

    Parian, Alyssa; Limketkai, Berkeley N

    2016-01-01

    Inflammatory bowel disease (IBD) including ulcerative colitis and Crohn's disease are chronic relapsing and remitting chronic diseases for which there is no cure. The treatment of IBD frequently requires immunosuppressive and biologic therapies which carry an increased risk of infections and possible malignancy. There is a continued search for safer and more natural therapies in the treatment of IBD. This review aims to summarize the most current literature on the use of dietary supplements for the treatment of IBD. Specifically, the efficacy and adverse effects of vitamin D, fish oil, probiotics, prebiotics, curcumin, Boswellia serrata, aloe vera and cannabis sativa are reviewed. PMID:26561079

  2. Value of Fecal Calprotectin in Activity Evaluation of Ulcerative Colitis%粪钙卫蛋白在溃疡性结肠炎活动性分级评价中的临床意义

    郐国虎; 李春雨

    2013-01-01

    Objective To explore the value of fecal calprotectin (FCP) in the activity evaluation for ulcerative colitis (UC).Methods Sixty three patients with UC (UC group) and 30 patients with gastrointestinal symptoms but without abnormal results of colonoscopy (control group),who were treated in The Forth Affiliated Hospital of China Medical University between Sep.2007 to Dec.2009 were enrolled to examine the FCP,C-creative protein (CRP),and erythrocyte sedimentation rate (ESR).Then comparison between UC group and control group was performed.Results Levels of FCP and CRP in active grade Ⅰ,Ⅱ,and Ⅲ group were all significantly higher than those of control group and inactive UC group (P< 0.05),with the increase of active grade of UC,the level of FCP gradually increased (P< 0.05).The levels of CRP in active grade Ⅱ and Ⅲ group were all significantly higher than those of grade Ⅰ group (P < 0.05),but didn't differed between active grade Ⅱ and Ⅲ group (P>0.05).There were no significant difference among 5 groups on ESR (P>0.05).Levels ofFCP (rs=0.807,P<0.01),CRP (rs=0.651,P<0.01),and ESR (rs=0.371,P<0.05) in active grade group were significantly related to histological grade under colonoscopy.Conclusion FCP examination is simple,inexpensive,repeatable,and noninvasive,and FCP can be used as an marker of activity evaluation in UC.%目的 探讨粪钙卫蛋白在溃疡性结肠炎(UC)活动性评价中的临床意义.方法 收集2007年9月至2009年12月期间中国医科大学附属第四医院肛肠外科确诊为UC的患者63例及结肠镜检查结果正常但存在相应消化道症状的患者30例,检测并比较其粪钙卫蛋白、红细胞沉降率及C反应蛋白水平.结果 活动期Ⅰ、Ⅱ及Ⅲ级组的粪钙卫蛋白和C反应蛋白水平均高于对照组和缓解组(P<0.05),且随活动期级别增高,粪钙卫蛋白的水平逐渐增高(P<0.05);活动期Ⅱ级及Ⅲ级组的C反应蛋白水平均高于Ⅰ级组(P<0

  3. Therapeutic efficacy of the Qing Dai in patients with intractable ulcerative colitis

    Hideo Suzuki

    2013-01-01

    Full Text Available Ulcerative colitis (UC is a chronic inflammatory bowel disease that may become intractable when treated with conventional medications such as aminosalicylates, corticosteroids, and azathioprine. The herbal medicine Qing Dai has traditionally been used in Chinese medicine to treat UC patients, but there is a lack of published data on the efficacy of Qing Dai in UC treatment. We report several cases of patients with intractable UC who take Qing Dai in a retrospective observational study. Furthermore, we explore the mechanisms of action of Qing Dai. Nine patients with active UC who received conventional medications but wished to receive Qing Dai as an alternative medication were included in our analysis. The UC severity level was determined based on the clinical activity index (CAI. Additionally, 5 of the 9 patients were endoscopically evaluated according to the Matts grading system. Each patient received 2 g/d of Qing Dai orally and continued taking other medications for UC as prescribed. Electron spin resonance was applied to explore the mechanisms of action of Qing Dai. After 4 mo of treatment with Qing Dai, the CAI score decreased from 8.3 ± 2.4 to 2.4 ± 3.4 (mean ± SD; P < 0.001. Similarly, the endoscopic Matts grade decreased from 3.4 ± 0.5 to 2.2 ± 0.8 (P = 0.02. Six of 7 patients who were on prednisolone upon enrollment in the study were able to discontinue this corticosteroid. Electron spin resonance revealed that Qing Dai possesses strong hydroxyl radical scavenging activity. Qing Dai showed significant clinical and endoscopic efficacy in patients who failed to respond to conventional medications. Scavenging of hydroxyl radicals appears to be a potential mechanism through which Qing Dai acts, but the significance of the scavenging ability of Qing Dai with respect to the anti-inflammatory effect in UC patients warrants further investigation.

  4. Nutritional support and dietary interventions for patients with ulcerative colitis: current insights

    Hill RJ

    2016-04-01

    Full Text Available Rebecca J Hill Children's Nutrition Research Centre, Child Health Research Centre, The University of Queensland, South Brisbane, Australia Abstract: Ulcerative colitis (UC demonstrates a remitting and relapsing course, and patients have long believed diet plays a role in their symptoms. Ad hoc removal of foods and food groups from the diet without strong evidence for therapeutic benefit places patients at risk for nutritional deficiencies. This review discusses the need for nutritional support in UC and the role of dietary modification in its management in humans. Current evidence suggests patients with UC are not nutritionally compromised during remission, but with increasing disease activity, nutritional status is worth monitoring, in particular through body composition assessment and investigation for anemia. There is no clear evidence for dietary modulation to relieve symptoms in UC. Neither enteral nutrition nor parenteral nutrition is efficacious for symptom control or mucosal healing. While early studies suggested avoidance of dairy foods, no recent work has replicated these results. A low intake of insoluble fiber is recommended during acute disease flares; however, the role of fiber in modulating the gut microbiota and their metabolites warrants further attention. Several studies have investigated polyunsaturated fatty acids for UC; however, current evidence is not supportive for either inactive or active disease. There is emerging evidence that curcumin supplementation may be a new dietary treatment option. Often, evidence for therapeutic diets is difficult to interpret due to the reporting of combined results for both Crohn's disease and UC. In general, there is no evidenced specific dietary advice for patients with UC other than to follow healthy eating guidelines. Further work should determine if diet as treatment efficacy lies in modification of dietary patterns, thereby investigating the synergistic relationship between foods and

  5. Effects of probiotic on intestinal mucosa of patients with ulcerative colitis

    Hai-Hong Cui; Xue-Qing Chen; Cun-Long Chen; Ji-De Wang; Yu-Jie Yang; Yong Cun; Jin-Bao Wu; Yu-Hu Liu; Han-Lei Dan; Yan-Ting Jian

    2004-01-01

    AIM: To investigate the effects of probiotic on intestinal mucosae of patients with ulcerative colitis (UC), and to evaluate the role of probiotic in preventing the relapse of UC.METHODS: Thirty patients received treatment with sulphasalazine (SASP) and glucocorticoid and then were randomly administered bifid triple viable capsule (BIFICO) (1.26 g/d), or an identical placebo (starch) for 8 wk. Fecal samples were collected for stool culture 2 wk before and after the randomized treatments. The patients were evaluated clinically, endoscopically and histologically after 2 mo of treatment or in case of relapse of UC. p65 and IκB expressions were determined by Western blot analysis.DNA-binding activity of NF-κB in colonic nuclear extracts was detected by electrophoretic mobility shift assay (EMSA). mRNA expressions of cytokines were identified by semi-quantitative assay, reverse transcriptasepolymerase chain reaction (RT-PCR).RESULTS: Three patients (20%) in the BIFICO group had relapses during 2-mo follow-up period, compared with 14 (93.3%) in placebo group (P<0.01). The concentration of fecal lactobacilli, bifidobacteria was significantly increased in BIFICO-treated group only (P<0.01).The expressions of NF-κB p65 and DNA binding activity of NF-κB were significantly attenuated in the treatment group than that in control (P<0.05). The mRNA expression of anti-inflammatory cytokines was elevated in comparison with the control group.CONCLUSION: The probiotic could impede the activation of NF-κB, decrease the expressions of TNF-α and IL-1β and elevate the expression of IL-10.These results suggest that oral administration of this new probiotic preparation is effective in preventing flare-ups of chronic UC. It may become a prophylactic drug to decrease the relapse of UC.

  6. Single Nucleotide Polymorphisms that Increase Expression of the GTPase RAC1 are Associated with Ulcerative Colitis

    Muise, Aleixo M; Walters, Thomas; Xu, Wei; Shen-Tu, Grace; Guo, Cong-Hui; Fattouh, Ramzi; Lam, Grace Y; Wolters, Victorien M; Bennitz, Joshua; Van Limbergen, Johan; Renbaum, Paul; Kasirer, Yair; Ngan, Bo-Yee; Turner, Dan; Denson, Lee A; Sherman, Philip M; Duerr, Richard H; Cho, Judy; Lees, Charlie W; Satsangi, Jack; Wilson, David C; Paterson, Andrew D; Griffiths, Anne M; Glogauer, Michael; Silverberg, Mark S; Brumell, John H

    2011-01-01

    Background & Aims RAC1 is a GTPase that has an evolutionarily conserved role in coordinating immune defenses, from plants to mammals. Chronic inflammatory bowel diseases (IBD) are associated with dysregulation of immune defenses. We studied the role of RAC1 in IBD using human genetic and functional studies and animal models of colitis. Methods We used a candidate gene approach to HapMap-Tag single nucleotide polymorphisms (SNPs) in a discovery cohort; findings were confirmed in 2 additional cohorts. RAC1 mRNA expression was examined from peripheral blood cells of patients. Colitis was induced in mice with conditional disruption of Rac1 in phagocytes by administration of dextran sulphate sodium (DSS). Results We observed a genetic association between RAC1 with ulcerative colitis (UC) in a discovery cohort, 2 independent replication cohorts, and in combined analysis for the SNPs rs10951982 (Pcombined UC = 3.3 × 10–8, odds ratio [OR]=1.43 [1.26–1.63]) and rs4720672 (Pcombined UC=4.7 × 10–6, OR=1.36 [1.19–1.58]). Patients with IBD who had the rs10951982 risk allele had increased expression of RAC1, compared to those without this allele. Conditional disruption of Rac1 in macrophage and neutrophils of mice protected them against DSS-induced colitis. Conclusion Studies of human tissue samples and knockout mice demonstrated a role for the GTPase RAC1 in the development of UC; increased expression of RAC1 was associated with susceptibility to colitis. PMID:21684284

  7. Fecal microbial composition of ulcerative colitis and Crohn's disease patients in remission and subsequent exacerbation.

    Edgar S Wills

    Full Text Available BACKGROUND: Limited studies have examined the intestinal microbiota composition in relation to changes in disease course of IBD over time. We aimed to study prospectively the fecal microbiota in IBD patients developing an exacerbation during follow-up. DESIGN: Fecal samples from 10 Crohn's disease (CD and 9 ulcerative colitis (UC patients during remission and subsequent exacerbation were included. Active disease was determined by colonoscopy and/or fecal calprotectine levels. Exclusion criteria were pregnancy, antibiotic use, enema use and/or medication changes between consecutive samples. The microbial composition was assessed by 16S rDNA pyrosequencing. RESULTS: After quality control, 6,194-11,030 sequences per sample were available for analysis. Patient-specific shifts in bacterial composition and diversity were observed during exacerbation compared to remission, but overarching shifts within UC or CD were not observed. Changes in the bacterial community composition between remission and exacerbation as assessed by Bray-Curtis dissimilarity, were significantly larger in CD versus UC patients (0.59 vs. 0.42, respectively; p = 0.025. Thiopurine use was found to be a significant cause of clustering as shown by Principal Coordinate Analysis and was associated with decreases in bacterial richness (Choa1 501.2 vs. 847.6 in non-users; p<0.001 and diversity (Shannon index: 5.13 vs. 6.78, respectively; p<0.01. CONCLUSION: Shifts in microbial composition in IBD patients with changing disease activity over time seem to be patient-specific, and are more pronounced in CD than in UC patients. Furthermore, thiopurine use was found to be associated with the microbial composition and diversity, and should be considered when studying the intestinal microbiota in relation to disease course.

  8. Birth outcome in women with ulcerative colitis and Crohn's disease, and pharmacoepidemiological aspects of anti-inflammatory drug therapy

    Nørgård, Bente Mertz

    2011-01-01

    conception, iii) the risk of adverse birth outcome in women with Crohn's disease according to type of anti-inflammatory drug treatment in pregnancy (sulfasalazine/5-aminosalicylic acid, steroids or azathioprine/6-mercaptopurine), and iv) the impact of disease activity in women with Crohn's disease on adverse......, including patients with ulcerative colitis and Crohn's disease. The third part (and the latest publications) includes birth outcome in women with Crohn's disease; and the methods of cohort establishment in these studies are developed and improved due to the knowledge gathered from conducting the earlier...... increased risk of preterm birth when women give birth 0-6 months after establishment of the diagnosis. It is considered whether the increased risk may be influenced by disease activity around the time of establishing the diagnosis. 2) No increased risk of giving birth to children with low birth weight...

  9. Peripheral Blood Based Discrimination of Ulcerative Colitis and Crohn’s Disease from Non-IBD Colitis by Genome-Wide Gene Expression Profiling

    Ferenc Sipos; Orsolya Galamb; Barnabás Wichmann; Tibor Krenács; Kinga Tóth; Katalin Leiszter; Györgyi Műzes; Tamás Zágoni; Zsolt Tulassay; Béla Molnár

    2011-01-01

    A molecular diagnostic assay using easily accessible peripheral blood would greatly assist in the screening and diagnosis of ulcerative colitis (UC) and Crohn’s disease (CD). Transcriptional profiles in blood/biopsy samples from 12 UC (6/12), 9 CD (5/9), 6 non-inflammatory bowel disease (non-IBD) colitis (6/0), and 11 healthy (11/11) patients were assessed by Affymetrix HGU133Plus2.0 microarrays. Prediction analysis of microarrays, discriminant and ROC analyses were performed, the results wer...

  10. Benefit–risk assessment of golimumab in the treatment of refractory ulcerative colitis

    Pugliese D

    2016-02-01

    Full Text Available Daniela Pugliese, Carla Felice, Rosario Landi, Alfredo Papa, Luisa Guidi, Alessandro Armuzzi Inflammatory Bowel Disease Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy Abstract: Significant advances in the management of patients with ulcerative colitis (UC have been made since the introduction of anti-tumor necrosis factor (TNF-alpha agents, especially for those who fail or do not tolerate conventional therapies. Two drugs, infliximab first, then adalimumab afterward, showed effectiveness in inducing and maintaining long-term remission both in pivotal trials as well as in clinical practice. However, approximately 25% of patients with UC, who fail or do not tolerate all available therapies, require a colectomy for refractory disease. The therapeutic scenario of UC has been recently upgraded by the introduction of golimumab, the latest anti TNF-alpha agent to be approved. Golimumab is a totally humanized monoclonal antibody, administered by a subcutaneous injection every 4 weeks. Treatment with golimumab has shown to be effective to induce sustained clinical benefit in tough-to-treat patients with UC, including steroid and/or immunosuppressive refractory and steroid-dependent patients. In this review, we summarize all available efficacy and safety data of golimumab in UC, analyzing the potential therapeutic position for the treatment of refractory patients with UC. Keywords: ulcerative colitis, refractoriness, anti-TNF-alpha, golimumab 

  11. Narrowband image and the p53 protein immunoexpression in patients with ulcerative colitis and dysplasia

    Patients with pancolitis and long-standing ulcerative colitis are at increased risk of developing colorectal cancer, so it is advisable to colonoscopic surveillance. The objective of this study was to identify the endoscopic visualization system of imaging with narrowband and overexpression of the p53 protein as procedures useful for the research of Dysplasia in patients with ulcerative colitis and pancolitis, of eight or more years of evolution. A prospective, descriptive study was performed on 50 patients. The Fisher exact probability test was used for the statistical study and of square Chi, with a level of significance α = 0.05. Shown with narrow-band image increases the likelihood of finding suggestive areas of Dysplasia, reduces the amount of biopsy and gets a higher proportion of diagnoses of Dysplasia in fewer samples (70.4%). The overexpression of the p53 protein was associated with the presence of dysplasia (80.0%) p < 0.001 and is immunoexpress in samples with a high degree of severity of dysplasia and the low grade. Concluded that imaging with narrowband system and overexpression of the p53 protein are procedures useful for the research of Dysplasia in these patients. (author)

  12. Well leg compartment syndrome after surgery for ulcerative colitis in the lithotomy position: A case report

    Enomoto, Tsuyoshi; Ohara, Yusuke; Yamamoto, Masayoshi; Oda, Tatsuya; Ohkohchi, Nobuhiro

    2016-01-01

    Introduction Well leg compartment syndrome (WLCS) is an uncommon and severe complication that occurs after colorectal surgery in the lithotomy position. Presentation of case The current patient was a 28-year-old male suffering from ulcerative colitis. He was underwent elective proctectomy, including ileal J pouch formation and anal anastomosis with temporary loop ileostomy. The ileoanal pouch procedure was quite difficult, and during this procedure, the high lithotomy and head down tilt positions were continued for 255 min. After the operation, the patient complained of severe cramping pain, swelling and serious tenderness on palpation in both legs. On the first postoperative day, the patient's complaints gradually worsened. The intra-compartmental pressure was measured, and WLCS was diagnosed. Emergency bilateral fasciotomy was performed. Initially, the patient had a sensory deficit and analgesia, however, his sensory disturbance and pain had almost recovered two months after fasciotomy by rehabilitation. Discussion In the current case, the important factors associated with the development of WLCS are thought to be a prolonged operative time in which the patient is placed in the high lithotomy position during ileoanal pouch procedure. Conclusion We would thus like to emphasize that operations for the ileoanal pouch procedure to treat ulcerative colitis have a high potential for inducing WLCS, because it usually requires a prolonged operative time in which the patient remains in the high lithotomy position. PMID:27085103

  13. Pneumocystis jiroveci pneumonia and pneumomediastinum in an anti-TNFα naive patient with ulcerative colitis

    James C Lee, Deborah C Bell, Richard M Guinness, Tariq Ahmad

    2009-04-01

    Full Text Available We report the case of a 21-year-old man who was noted to have pneumomediastinum during an admission for an acute flare of ulcerative colitis. At that time, he was on maintenance treatment with azathioprine at a dose of 1.25 mg/kg per day, and had not received supplementary steroids for 9 mo. He had never received anti-tumor necrosis factor (TNFα therapy. Shortly after apparently effective treatment with intravenous steroids and an increased dose of azathioprine, he developed worsening colitic and new respiratory symptoms, and was diagnosed with Pneumocystis jiroveci (carinii pneumonia (PCP. Pneumomediastinum is rare in immunocompetent hosts, but is a recognized complication of PCP in human immunodeficiency virus (HIV patients, although our patient’s HIV test was negative. Treatment of PCP with co-trimoxazole resulted in resolution of both respiratory and gastrointestinal symptoms, without the need to increase the steroid dose. There is increasing vigilance for opportunistic infections in patients with inflammatory bowel disease following the advent of anti-TNFα therapy. This case emphasizes the importance of considering the possibility of such infections in all patients with inflammatory bowel disease, irrespective of the immunosuppressants they receive, and highlights the potential of steroid-responsive opportunistic infections to mimic worsening colitic symptoms in patients with ulcerative colitis.

  14. Absorption studies after eleal J-pouch anastomosis for ulcerative colitis

    Absorption studies were performed in 17 patients with ulcerative colities operated on with colectomy and an ileal two-limbed J-pouch anastomosis. The patients were studied 3 and ≥ 18 months after closure of the temporary ileostomy. Increased stool mass was found in all patients and was unchanged with time. Moderate steatorrhoea was present in 29% of the patients 3 months postoperatively, but faecal fat excretion normalized with time. Calcium absoption was normal in all but one patient regardless of time after operation. An abnormal bacterial deconjugatio, evaluated by a 14C-glycocholic acid breath test was present in 27% of the patients and increased significantly with time. 40% of the patients had increased faecal bile acid excretion. B12 malabsorption was present in 29-35% of the patients. In conclusion, ileal J-pouch anastomosis for ulcerative colitis causes increased stool mass in all patients and produces moderate bile acid deconjugation and malabsoption in about one-third to half. Substitution therapy with vitamin B12 is necessary in about one-third of the patients. Intestinal adaptation as far as absorption is concerned is minimal after the first 3 postoperative months. 29 refs., 8 figs

  15. Predictors of response to anti-tumor necrosis factor therapy in ulcerative colitis

    Evanthia; Zampeli; Michalis; Gizis; Spyros; I; Siakavellas; Giorgos; Bamias

    2014-01-01

    Ulcerative colitis(UC) is an immune-mediated, chronic inflammatory disease of the large intestine. Its course is characterized by flares of acute inflammation and periods of low-grade chronic inflammatory activity or remission. Monoclonal antibodies against tumor necrosis factor(anti-TNF) are part of the therapeutic armamentarium and are used in cases of moderate to severe UC that is refractory to conventional treatment with corticosteroids and/or immunosuppressants. Therapeutic response to these agents is not uniform and a large percentage of patients either fail to improve(primary non-response) or lose response after a period of improvement(secondary non-response/loss of response). In addition, the use of anti-TNF agents has been related to uncommon but potentially serious adverse effects that preclude their administration or lead to their discontinuation. Finally, use of these medications is associated with a considerable cost for the health system. The identification of parameters thatmay predict response to anti-TNF drugs in UC would help to better select for patients with a high probability to respond and minimize risk and costs for those who will not respond. Analysis of the major clinical trials and the accumulated experience with the use of anti-TNF drugs in UC has resulted to the report of such prognostic factors. Included are clinical and epidemiological characteristics, laboratory markers, endoscopic indicators and molecular(immunological/genetic) signatures. Such predictive parameters of long-term outcomes may either be present at the commencement of treatment or determined during the early period of therapy. Validation of these prognostic markers in large cohorts of patients with variable characteristics will facilitate their introduction into clinical practice and the best selection of UC patients who will benefit from anti-TNF therapy.

  16. KAG-308, a newly-identified EP4-selective agonist shows efficacy for treating ulcerative colitis and can bring about lower risk of colorectal carcinogenesis by oral administration.

    Watanabe, Yusuke; Murata, Takahiko; Amakawa, Masahiro; Miyake, Yoshihide; Handa, Tango; Konishi, Katsuhiko; Matsumura, Yasushi; Tanaka, Takuji; Takeuchi, Koji

    2015-05-01

    Agonists for EP4 receptor, a prostaglandin E2 receptor subtype, appear to be a promising therapeutic strategy for ulcerative colitis (UC) due to their anti-inflammatory and epithelial regeneration activities. However, the clinical development of orally-available EP4 agonists for mild to moderate UC has not yet been reported. Furthermore, the possibility of an increased risk of colitis-associated cancer (CAC) through direct proliferative effects on epithelial cells via EP4 signaling has not been ruled out. Recently, we identified KAG-308 as an orally-available EP4-selective agonist. Here, we investigated the pharmacological and pharmacokinetic profiles of KAG-308. Then, we compared KAG-308 and sulfasalazine (SASP) for their abilities to prevent colitis and promote mucosal healing in a mouse model of dextran sulfate sodium (DSS)-induced colitis. Finally, the effect of KAG-308 treatment on CAC was evaluated in an azoxymethane (AOM)/DSS-induced CAC mouse model. KAG-308 selectively activated EP4 and potently inhibited tumor necrosis factor-α production in peripheral whole blood and T cells. Oral administration of KAG-308, which showed relatively high bioavailability, suppressed the onset of DSS-induced colitis and promoted histological mucosal healing, while SASP did not. KAG-308 also prevented colorectal carcinogenesis by inhibiting colitis development and consequently decreasing mortality in a CAC model, whereas SASP had marginal effects. In contrast, MF-482, an EP4 antagonist, increased mortality. These results indicated that orally-administered KAG-308 suppressed colitis development and promoted mucosal healing. Moreover, it exhibited preventive effects on colorectal carcinogenesis, and thus may be a new therapeutic strategy for the management of UC that confers a reduced risk of colorectal carcinogenesis. PMID:25704618

  17. Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine

    KRUIS, W.; Frič, P; Pokrotnieks, J; Lukáš, M; Fixa, B; Kaščák, M; Kamm, M A; Weismueller, J; Beglinger, C; Stolte, M; Wolff, C.; Schulze, J.

    2004-01-01

    Background and aim: Evidence exists for the pathogenic role of the enteric flora in inflammatory bowel disease. Probiotics contain living microorganisms which exert health effects on the host. We compared the efficacy in maintaining remission of the probiotic preparation Escherichia coli Nissle 1917 and established therapy with mesalazine in patients with ulcerative colitis.

  18. Gram-negative bacteria account for main differences between faecal microbiota from patients with ulcerative colitis and healthy controls

    Vigsnæs, Louise Kristine; Brynskov, J.; Steenholdt, C.;

    2012-01-01

    Detailed knowledge about the composition of the intestinal microbiota may be critical to unravel the pathogenesis of ulcerative colitis (UC), a human chronic inflammatory bowel disease, since the intestinal microbes are expected to influence some of the key mechanisms involved in the inflammatory...

  19. Iatrogenic colorectal Kaposi sarcoma complicating a refractory ulcerative colitis in a human immunodeficiency negative-virus patient.

    Hamzaoui, Lamine; Kilani, Houda; Bouassida, Mahdi; Mahmoudi, Moufida; Chalbi, Emna; Siai, Karima; Ezzine, Heykel; Touinsi, Hassen; Azzouz, Mohamed M'saddak; Sassi, Sadok

    2013-01-01

    Kaposi sarcoma is a mesenchymal tumor associated to a human herpes virus-8. It often occurs in human immunodeficiency virus-positive subjects. Colorectal localization is rare. We report the case of a colorectal Kaposi sarcoma complicating a refractory ulcerative colitis treated with surgery after the failure of immunomodulator therapy in a human immunodeficiency virus-negative heterosexual man. PMID:24396560

  20. Level of Fecal Calprotectin Correlates With Endoscopic and Histologic Inflammation and Identifies Patients With Mucosal Healing in Ulcerative Colitis

    Theede, Klaus; Holck, Susanne; Ibsen, Per;

    2015-01-01

    BACKGROUND & AIMS: In patients with ulcerative colitis (UC), mucosal healing is an important goal of treatment. However, mucosal healing is difficult to determine on the basis of clinical evaluation alone, and endoscopy is uncomfortable and can cause complications. Fecal calprotectin (FC) is a...

  1. Meta-analysis identifies 29 additional ulcerative colitis risk loci, increasing the number of confirmed associations to 47

    Anderson, Carl A; Boucher, Gabrielle; Lees, Charlie W;

    2011-01-01

    signals in 9,628 cases and 12,917 controls. We identified 29 additional risk loci (P <5 × 10(-8)), increasing the number of ulcerative colitis-associated loci to 47. After annotating associated regions using GRAIL, expression quantitative trait loci data and correlations with non-synonymous SNPs, we...

  2. Epidemiologic study of 80 patients with ulcerative colitis referred to Imam Hospital in Ardabil city during 2004-2011

    Vahid Sadeghifard

    2014-08-01

    Results: Mean age of patients was 36.4 (SD=18.4. Duration of symptoms onset until diagnosis was 8 months. Male to female ratio was 0.8/1. 38(47.5% of patients were male and 42 (52.5% were female. 3 (3.75% of patients have history of positive UC and 4 (5% history of appendectomy. According to colonoscopy finding, 1 (1.25% have rectum involvement, 27 (33.75% recto sigmoid, 23 (28.75% left side colon and 4 (5% have pan colitis. Conclusion: Results showed that in compare with other places, clinical signs of ulcerative colitis in Ardabil province are different and so doing other d epidemiologic studies based on population to determine incidence and prevalence ulcerative colitis in Ardabil province is necessary. [Int J Res Med Sci 2014; 2(4.000: 1417-1422

  3. Utilidad de la ecografía en la valoración de la extensión de la colitis ulcerosa Usefulness of digestive ultrasonography in assessment of ulcerative colitis extent

    D. Martínez Ares

    2007-07-01

    should be avoided upon finding severe endoscopic lesions in patients with ulcerative colitis. However, knowledge of the precise extent of disease is quite important for disease prognosis and the making of therapeutic decisions. Therefore, any validation of a non-invasive technique to assess the extent of ulcerative colitis gains a lot of interest and importance. Material and method: the study included patients that were previously diagnosed of having ulcerative colitis or were beginning to suffer from the disease. A prospective and blind evaluation was carried out to determine the precision of digestive ultrasonography in assessment of ulcerative colitis extent. All ultrasonography was carried out by the same person and was always performed prior to carrying out a full endoscopic study, which is used as the gold standard. The hydrocolonic ultrasonograpy technique was not used in any of the cases. Results: a total of 20 patients -13 males (65% and 7 females (35%, with an average age of 51.7 years (aged between 24-82 years- were included in the study. Endoscopic studies revealed severe disease in 5 cases (25%, moderate disease in 12 patients (60%, and mild lesions in the 3 remaining cases (15%. A colonic ultrasonogram was considered satisfactory in 18 cases (90%, and the extent of disease as established by ultrasonography was in all cases consistent with that established through colonoscopy: 3 patients (16.6% had ulcerative proctitis, 9 patients (50% had left-sided ulcerative colitis, and 6 (33.3% had extensive colitis. Conclusions: digestive ultrasonography allows to study the colon in most patients, especially when inflammatory activity is present, and provides a greater accuracy in assessing ulcerative colitis extent, which is independent of its activity level.

  4. Biologics in the management of ulcerative colitis – comparative safety and efficacy of TNF-α antagonists

    Fausel R

    2015-01-01

    Full Text Available Rebecca Fausel,1 Anita Afzali1,2 1Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA, USA; 2Inflammatory Bowel Disease Program, UW Medicine – Harborview Medical Center, Seattle, WA, USA Abstract: Ulcerative colitis can cause debilitating symptoms and complications such as colonic strictures, colonic dysplasia, colorectal cancer, and toxic megacolon or perforation. Goals of treatment in ulcerative colitis include resolution of gastrointestinal symptoms, healing of colonic mucosa, and prevention of disease complications. Our treatment armamentarium has expanded dramatically over the past 10 years, and we now have multiple biologic agents approved for the treatment of moderate-severe disease, in addition to conventional therapies such as 5-aminosalicylates, thiopurines, and corticosteroids. In this review, we will provide a detailed discussion of the three tumor necrosis factor-alpha (TNF-α inhibitors currently approved for treatment of ulcerative colitis: infliximab, adalimumab, and golimumab. All three agents are effective for inducing and maintaining clinical response and remission in patients with ulcerative colitis, and they have comparable safety profiles. There are no head-to-head trials comparing their efficacy, and the choice of agent is most often based on insurance coverage, route of administration, and patient preference. Combination therapy with an immunomodulator is proven to be more effective than anti-TNF monotherapy, and patients who lose response to an anti-TNF agent should undergo dose intensification in order to regain clinical response. Despite therapeutic optimization, a significant percentage of patients will not achieve clinical remission with anti-TNF agents, and so newer therapies are on the horizon. Keywords: ulcerative colitis, inflammatory bowel disease, infliximab, adalimumab, golimumab

  5. Ulcerative Colitis

    ... given by injection. Health care providers will screen patients for tuberculosis and hepatitis B before starting treatment with anti-TNF medications. ... and disseminates research findings through its clearinghouses and education ... among patients, health professionals, and the public. Content produced by ...

  6. Ulcerative Colitis

    ... Research Training & Career Development Grant programs for students, postdocs, and faculty Research at NIDDK Labs, faculty, and ... diabetes, digestive and liver diseases, kidney diseases, weight control and nutrition, urologic diseases, endocrine and metabolic diseases, ...

  7. Safety and clinical efficacy of granulocyte and monocyte adsorptive apheresis therapy for ulcerative colitis

    Takayuki Yamamoto; Satoru Umegae; Koichi Matsumoto

    2006-01-01

    Active ulcerative colitis (UC) is frequently associated with infiltration of a large number of leukocytes into the bowel mucosa. Therefore, removal of activated circulating leukocytes by apheresis has the potential for improving UC. In Japan, since April 2000, leukocytapheresis using Adacolumn has been approved as the treatment for active UC by the Ministry of Health and Welfare. The Adacolumn is an extracorporeal leukocyte apheresis device filled with cellulose acetate beads, and selectively adsorbs granulocytes and monocytes/macrophages. To assess the safety and clinical efficacy of granulocyte and monocyte adsorptive apheresis (GMCAP) for UC, we reviewed 10 open trials of the use of GMCAP to treat UC. One apheresis session (session time, 60 min) per week for five consecutive weeks (a total of five apheresis sessions) has been a standard protocol. Several studies used modified protocols with two sessions per week, with 90-min session, or with a total of 10 apheresis sessions.Typical adverse reactions were dizziness, nausea,headache, flushing, and fever. No serious adverse effects were reported during and after GMCAP therapy, and almost all the patients could complete the treatment course. GMCAP is safe and well-tolerated. In the majority of patients, GMCAP therapy achieved clinical remission or improvement. GMCAP is a useful alternative therapy for patients with steroid-refractory or -dependent UC.GMCAP should have the potential to allow tapering the dose of steroids, and is useful for shortening the time to remission and avoiding re-administration of steroids at the time of relapse. Furthermore, GMCAP may have efficacy as the first-line therapy for steroid-naive patients or patients who have the first attack of UC. However,most of the previous studies were uncontrolled trials. To assess a definite efficacy of GMCAP, randomized, doubleblind, sham-controlled trials are necessary. A seriousproblem with GMCAP is cost; a single session costs (¥)145 000 ($1 300

  8. Infliximab induces clinical, endoscopic and histological responses in refractory ulcerative colitis Infliximab induce respuesta clínica, endoscópica e histológica en la colitis ulcerosa refractaria

    F. Bermejo

    2004-02-01

    Full Text Available Background: infliximab is a monoclonal antiTNF-α antibody that has repeatedly shown to be effective in the management of Crohn's disease. However, data are scarce about its efficacy in ulcerative colitis. Aim: to describe the joint experience of three Spanish hospitals in the use of infliximab in patients with active refractory ulcerative colitis. Patients and methods: we present seven cases of ulcerative colitis (6 with chronic active disease despite immunosuppressive therapy, and one with acute steroid-refractory ulcerative colitis treated with infliximab 5 mg/kg of body weight. Clinical response was evaluated by means of the Clinical Activity Index at 2, 4 and 8 weeks after initial infusion. Biochemical (erythrocyte sedimentation rate and C-reactive protein, endoscopic, and histological changes were also assessed. Results: mean age of patients was 45.8 ± 17 years (range 23-77; 4 were female. No adverse effects were recorded. Inflammatory activity diminished significantly in 6 of 7 patients (85.7%; CI 95%: 42-99% both from a clinical (p = 0.01 and biochemical (p Introducción: infliximab, un anticuerpo monoclonal quimérico antiTNF-α ha demostrado su eficacia en pacientes con enfermedad de Crohn. Sin embargo, son escasos los datos sobre su efectividad en el tratamiento de la colitis ulcerosa. Objetivo: describir la experiencia conjunta de 3 hospitales españoles en el uso de infliximab en enfermos con CU activa resistente a otros tratamientos. Pacientes y métodos: se presentan 7 casos de colitis ulcerosa (6 con enfermedad crónicamente activa a pesar de tratamiento con inmunosupresor y 1 con colitis aguda grave refractaria a esteroides tratados con infliximab a dosis de 5 mg/kg de peso. Se evaluó la respuesta clínica mediante un Índice de Actividad Clínica trascurridas 2, 4 y 8 semanas de la infusión inicial. Así mismo, se estudiaron los cambios analíticos (velocidad de sedimentación y proteína C reactiva, endoscópicos e histol

  9. Small cell carcinoma in ulcerative colitis - new treatment option: a case report

    Tzeveleki Ioanna

    2010-11-01

    Full Text Available Abstract Background The most common type of carcinoma associated with ulcerative colitis (UC is adenocarcinoma. We present a case of primary rectal small cell carcinoma in a patient with a history of UC. Methods A 34-year-old male diagnosed with UC for 10 years was not consistent with the usual annual follow-up and presented with mucoid-bloody diarrhea. Colonoscopy revealed a rectal mass 2 cm distant from the anal verge. The patient underwent a total proctocolectomy with preservation of the anal sphincters, construction of an ileal reservoir, anastomosis of the reservoir to the anus (J configuration and protective loop ileostomy. Results Histological examination showed undifferentiated small cell carcinoma. Conclusions This is the first case of small cell carcinoma in a background of UC reported to be treated surgically and the patient and has no reccurence 18 months postoperatively.

  10. Influences of the colonic microbiome on the mucous gel layer in ulcerative colitis.

    Lennon, Gráinne

    2014-04-01

    The colonic mucus gel layer (MGL) is a critical component of the innate immune system acting as a physical barrier to microbes, luminal insults, and toxins. Mucins are the major component of the MGL. Selected microbes have the potential to interact with, bind to, and metabolize mucins. The tolerance of the host to the presence of these microbes is critical to maintaining MGL homeostasis. In disease states such as ulcerative colitis (UC), both the mucosa associated microbes and the constituent MGL mucins have been shown to be altered. Evidence is accumulating that implicates the potential for mucin degrading bacteria to negatively impact the MGL and its stasis. These effects appear more pronounced in UC.   This review is focused on the host-microbiome interactions within the setting of the MGL. Special focus is given to the mucolytic potential of microbes and their interactions in the setting of the colitic colon.

  11. Mesalazine preparations for the treatment of ulcerative colitis: Are all created equal?

    Bei; Ye; Daniel; R; van; Langenberg

    2015-01-01

    Oral mesalazine(also known as mesalamine) is a 5-aminosalicylic acid compound used in the treatment of mild to moderate ulcerative colitis, with high rates of efficacy in induction and maintenance of remission.The therapeutic effect of mesalazine occurs topically at the site of diseased colonic mucosa. A myriad of oral mesalazine preparations have been formulated with various drug delivery methods to minimize systemic absorption and maximise drug availability at the inflamed colonic epithelium. It remains unclear whether different oral mesalazine formulations are bioequivalent. This review aims to evaluate the differences between mesalazine formulations based on the currently available literature and explore factors which may influence the selection of one agent above another.

  12. Flare-up of ulcerative colitis after systemic corticosteroids:A strong case for Strongyloides

    2008-01-01

    Super-imposed infection with intestinal organisms can mimic a flare-up of underlying disease in patients with inflammatory bowel disease (IBD). We report a case of patient with long standing ulcerative colitis (UC), who presented with abdominal pain, diarrhea and low- grade fever after receiving systemic corticosteroids for an unrelated disorder. Despite a negative stool examination, a peripheral eosinophilia reappeared upon tapering down of a corticosteroid dose. Subsequently, duodenal biopsies showed evidence for Strongyloides, presumably acquired 20 years ago when the patient was residing in Brazil. The patient fully recovered following anti-helmintic therapy. This case underscores the importance of considering Strongyloides in the work-up of flaring-up IBD patients, even if a history of residing or traveling to endemic areas is in the distant past.

  13. Herpes simplex induced necrotizing tonsillitis in an immunocompromised patient with ulcerative colitis.

    Jansen, Laura; Vos, Xander G; Löwenberg, Mark

    2016-02-16

    We here present the case of a 22-year-old female of Suriname ethnicity with ulcerative colitis who received treatment with mercaptopurine and infliximab. She presented herself with a severe necrotizing tonsillitis due to herpes simplex virus type-1 (HSV-1). Combination therapy consisting of immunomodulators and anti-tumor necrosis factor (TNF) agents is increasingly being used. Anti-TNF therapy is associated with an increased risk of developing serious infections, and especially patients receiving combination treatment with thiopurines are at an increased risk. We here show that HSV infections can cause a severe tonsillitis in immunocompromised patients. Early recognition is essential when there is no improvement with initial antibiotic therapy within the first 24 to 72 h. HSV infections should be in the differential diagnosis of immunocompromised patients presenting with a necrotizing tonsillitis and can be confirmed by polymerase chain reaction. Early treatment with antiviral agents should be considered especially if antibiotic treatment fails in such patients. PMID:26881193

  14. Leech Induced Pyoderma Gangrenosum in an Ulcerative Colitis Patient: A Case Report.

    Sadeghi, Anahita; Navabakhsh, Behrouz; Izadi Vahedi, Niloofar

    2016-01-01

    Pyoderma gangrenosum (PG) is a painful skin lesion that results from excessive inflammatory response to a host of traumatic, inflammatory, or neoplastic processes in susceptible individuals. A clear pathogenetic mechanism as well as an exhaustive list of potential triggers for PG is yet to be fully characterized. This case documents the occurrence of pyoderma gangrenosum following leech-therapy in a patient who is a known case of ulcerative colitis and it deserves attention because leeches have been part of medical armamentarium since ancient times and have re-emerged in the last century relying on their ancient charm and modern research revealing potential benefits of several bioactive substances in their saliva. PMID:26933484

  15. Advances in treatment of ulcerative colitis with herbs: from bench to bedside.

    Wan, Ping; Chen, Hao; Guo, Yuan; Bai, Ai-Ping

    2014-10-21

    Ulcerative colitis (UC), an idiopathic inflammatory disorder in the colon, has become a clinical challenge, owing to the increasing incidence and poor prognosis. The conventional treatments for UC including aminosalicylates, corticosteroids, and immunosuppressants, induce remission in only half of patients. Meanwhile, the treatments often come with serious side effects which can be life-threatening. Herbal medicine, one of the most common traditional Chinese medicine modalities, has been introduced for centuries into clinical treatment of many human diseases such as infections and functional disorders. Recently, the potential effectiveness of herbs has been suggested as the treatment of UC, as shown by a variety of clinical trials and experimental studies. The herbs reported in the literature include aloe vera gel, butyrate, tormentil extracts, wheat grass juice, and curcumin. In the review, bioactivity of the herbs and their involvement in UC treatment are discussed. PMID:25339799

  16. A double conundrum: concurrent presentation of Hashimoto's thyroiditis and ulcerative colitis.

    Singh, Gurpreet; Brien, Susie; Taylor, Ellen

    2016-01-01

    We describe a case of a 31-year-old man who presented with a 3-day history of crampy abdominal pain, anorexia, malaise and diarrhoea of increasing frequency, with the passage of both mucus and haematochezia. The patient's biochemical investigations revealed hyponatraemia, hypothyroidism and elevated inflammatory markers. The patient underwent an ultrasound and fine-needle aspiration of the thyroid and was diagnosed as having Hashimoto's thyroiditis. He was started on thyroxine and fluid was restricted. He was also investigated for alternative causes of hyponatraemia. With improvement in his hyponatraemia, the patient underwent a colonoscopy with biopsies confirming a concurrent diagnosis of ulcerative colitis. He was started on mesalazine and prednisolone and discharged from hospital. He suffered a flare shortly after discharge and was readmitted to hospital. He was again discharged, on a higher dose of prednisolone, with outpatient follow-up at our hospital's gastroenterology clinic. PMID:27107058

  17. Positions of selective leukocytapheresis in the medical therapy of ulcerative colitis

    Hiroyuki Hanai

    2006-01-01

    Ulcerative colitis (UC) and Crohn's disease (CD) are the major forms of idiopathic inflammatory bowel disease (IBD). Both UC and CD are debilitating chronic disorders that afflict millions of individuals throughout the world with symptoms which impair function and quality of life. The etiology of IBD is inadequately understood and therefore, drug therapy has been empirical instead of being based on sound understanding of IBD pathogenesis. This is a major factor for poor drug efficacy and drug related side effects that often add to the disease complexity. The development of biologicals notably infliximab to intercept tumor necrosis factor (TNF)-α reflects some progress, albeit major concern about their side effects and lack of long-term safety and efficacy profiles. However, IBD seems to be perpetuated by inflammatory cytokines like TNF-α, interleukin (IL)-1β,IL-6 and IL-8 for which activated peripheral granulocytes and monocytes/macrophages (GM) are major sources.Further, in IBD, peripheral GMs are elevated with activation behavior, increased survival time and are found in vast numbers within the inflamed intestinal mucosa; they are suspected to be major factors in the immunopathogenesis of IBD. Hence, peripheral blood GMs should be appropriate targets of therapy. The Adacolumn is a medical device developed for selective depletion of GM by receptor-mediated adsorption (GMA). Clinical data show GMA, in patients with steroid dependent or steroid refractory UC, is associated with up to 85% efficacy and tapering or discontinuation of steroids, while in steroid na(i)ve patients (the best responders), GMA spares patients from exposure to steroids. Likewise, GMA at appropriate intervals in patients at a high risk of clinical relapse suppresses relapse thus sparing the patients from the morbidity associated with IBD relapse. Further, GMA appears to reduce the number of patients being submitted to colectomy or exposure to unsafe immunosupressants.First UC episode

  18. Natural history of cytomegalovirus infection in a series of patients diagnosed with moderate-severe ulcerative colitis

    Valeria Criscuoli; Maria Rosa Rizzuto; Luigi Montalbano; Elena Gallo; Mario Cottone

    2011-01-01

    AIM: To evaluate the natural history of human cytomegalovirus (HCMV) infection in a series of 28 ulcerative colitis patients in whom the search for HCMV was positive.METHODS: A series of 85 patients with moderate-severe ulcerative colitis flare-up were evaluated for a HCMV search by performing a haematoxylin and eosin stain,immunohistochemical assay and nested polymerase chain reaction on rectal biopsies. Among 85 screened patients (19 of whom were steroid resistant/dependant),28 were positive for HCMV; after remission the patients were followed up clinically and histologically.RESULTS: Among the 22 patients with complete followup,in 8 (36%) patients HCMV-DNA persisted in the intestinal specimens. Among the HCMV positive patients,4 (50%) experienced at least one moderate-severe flare-up of colitis without evidence of peripheral HCMV.Among the 14 HCMV negative patients, 3 with pouches developed pouchitis and 5 out of 11 (45%) experienced a colitis flare-up.CONCLUSION: Our preliminary results suggest that HCMV may remain in the colon after an acute colitis flareup despite remission; it seems that the virus is not responsible for the disease relapse.

  19. Short- and long-term outcomes of ileal pouch-anal anastomosis for ulcerative colitis

    Teixeira Magaly Gemio

    2003-01-01

    Full Text Available Ileal pouch-anal anastomosis was an important advancement in the treatment of ulcerative colitis. The aim of this study was to determine whether early complications of ileal pouch-anal anastomosis in patients with ulcerative colitis are associated with poor late functional results. PATIENTS AND METHODS: Eighty patients were operated on from 1986 to 2000, 62 patients with ileostomy and 18 without. The early and late complications were recorded. Specific emphasis has been placed on the incidence of pouchitis with prolonged follow-up. RESULTS: The ileostomy was closed an average of 9.2 months after the first operation. Fourteen patients were excluded from the long-term evaluation; 6 patients were lost to regular follow-up, 4 died, and 4 patients still have the ileostomy. Of the 4 patients that died, 1 died from surgical complications. Early complications after operation (41 occurred in 34 patients (42.5%. Late complications (29 occurred in 25 patients as follows: 16 had pouchitis, 3 associated with stenosis and 1 with sexual dysfunction; 5 had stenosis; and there was 1 case each of incisional hernia, ileoanal fistula, hepatic cancer, and endometriosis. Pouchitis occurred in 6 patients (9.8% 1 year after ileal pouch-anal anastomosis, 9 (14.8% after 3 years, 13 (21.3% after 5 years, and 16 (26.2% after more than 6 years. The mean daily stool frequency was 12 before and 5.8 after operation. One pouch was removed because of fistulas that appeared 2 years later. CONCLUSIONS: Ileal pouch-anal anastomosis is associated with a considerable number of early complications. There was no correlation between pouchitis and severe disease, operation with or without ileostomy, or early postoperative complications. The incidence of pouchitis was directly proportional to duration of time of follow-up.

  20. Altered cGMP dynamics at the plasma membrane contribute to diarrhea in ulcerative colitis.

    Arora, Kavisha; Sinha, Chandrima; Zhang, Weiqiang; Moon, Chang Suk; Ren, Aixia; Yarlagadda, Sunitha; Dostmann, Wolfgang R; Adebiyi, Adebowale; Haberman, Yael; Denson, Lee A; Wang, Xusheng; Naren, Anjaparavanda P

    2015-10-01

    Ulcerative colitis (UC) belongs to inflammatory bowel disorders, a group of gastrointestinal disorders that can produce serious recurring diarrhea in affected patients. The mechanism for UC- and inflammatory bowel disorder-associated diarrhea is not well understood. The cystic fibrosis transmembrane-conductance regulator (CFTR) chloride channel plays an important role in fluid and water transport across the intestinal mucosa. CFTR channel function is regulated in a compartmentalized manner through the formation of CFTR-containing macromolecular complexes at the plasma membrane. In this study, we demonstrate the involvement of a novel macromolecular signaling pathway that causes diarrhea in UC. We found that a nitric oxide-producing enzyme, inducible nitric oxide synthase (iNOS), is overexpressed under the plasma membrane and generates compartmentalized cGMP in gut epithelia in UC. The scaffolding protein Na(+)/H(+) exchanger regulatory factor 2 (NHERF2) bridges iNOS with CFTR, forming CFTR-NHERF2-iNOS macromolecular complexes that potentiate CFTR channel function via the nitric oxide-cGMP pathway under inflammatory conditions both in vitro and in vivo. Potential disruption of these complexes in Nherf2(-/-) mice may render them more resistant to CFTR-mediated secretory diarrhea than Nherf2(+/+) mice in murine colitis models. Our study provides insight into the mechanism of pathophysiologic occurrence of diarrhea in UC and suggests that targeting CFTR and CFTR-containing macromolecular complexes will ameliorate diarrheal symptoms and improve conditions associated with inflammatory bowel disorders. PMID:26261085

  1. Ulcerative colitis as a polymicrobial infection characterized by sustained broken mucus barrier

    Chen, Shui-Jiao; Liu, Xiao-Wei; Liu, Jian-Ping; Yang, Xi-Yan; Lu, Fang-Gen

    2014-01-01

    To reduce medication for patients with ulcerative colitis (UC), we need to establish the etiology of UC. The intestinal microbiota of patients with inflammatory bowel disease (IBD) has been shown to differ from that of healthy controls and abundant data indicate that it changes in both composition and localization. Small intestinal bacterial overgrowth is significantly higher in IBD patients compared with controls. Probiotics have been investigated for their capacity to reduce the severity of UC. The luminal surfaces of the gastrointestinal tract are covered by a mucus layer. This normally acts as a barrier that does not allow bacteria to reach the epithelial cells and thus limits the direct contact between the host and the bacteria. The mucus layer in the colon comprises an inner layer that is firmly adherent to the intestinal mucosa, and an outer layer that can be washed off with minimal rinsing. Some bacteria can dissolve the protective inner mucus layer. Defects in renewal and formation of the inner mucus layer allow bacteria to reach the epithelium and have implications for the causes of colitis. In this review, important elements of UC pathology are thought to be the intestinal bacteria, gut mucus, and the mucosa-associated immune system. PMID:25071341

  2. Amaranthus roxburghianus root extract in combination with piperine as a potential treatment of ulcerative colitis in mice

    Sunil A.Nirmal; Jayashri M.Ingale; Shashikant R.Pattan; Sanjay B.Bhawar

    2013-01-01

    OBJECITVE:The present work was undertaken to determine the effects of Amaranthus roxburghianus Nevski.(Amaranthaceae) root alone and in combination with piperine in treating ulcerative colitis (UC) in mice.METHODS:Swiss albino mice were divided into seven groups (n =6).Standard group received prednisolone (5 mg/kg,intraperitoneally).Treatment groups received hydroalcoholic extract of roots of A.roxburghianus (50 and 100 mg/kg,per oral) and a combination of hydroalcoholic extract of roots of A.roxburghianus (50 and 100 mg/kg,per oral) and piperine (5 mg/kg,per oral).Ulcer index,colitis severity,myeloperoxidase (MPO),malondialdehyde and glutathione were estimated from blood and tissue.Column chromatography of the extract was done and purified fractions were analyzed by gas chromatography-mass spectroscopy (GC-MS).RESULTS:Treatment with the combination of hydroalcoholic extract of A.roxburghianus and piperine showed minimal ulceration,hemorrhage,necrosis and leucocyte infiltration by histopathological observation.Acetic acid increased MPO levels in blood and colon tissue to 355 U/mL and 385 U/mg,respectively.The combination of hydroalcoholic extract of A.roxburghianus (100 mg/kg) and piperine (5 mg/kg) significantly decreased MPO in blood and tissue to 182 U/mL and 193 U/mg,respectively (P < 0.05).Similarly,this combination significantly reduced malondialdehyde levels and increased glutathione levels in blood and tissue.Various phytoconstituents were detected by GC-MS.CONCLUSION:The combination of hydroalcoholic extract of A.roxburghianus and piperine is effective in the treatment of UC and the effects are comparable with the standard drug prednisolone.4H-pyran-4-one,2,3-dihydro-3,5-dihydroxy-6-methyl,eugenol and benzene,and 1-(1,5-dimethyl-4-hexenyl)-4-methyl are reported having analgesic,anti-inflammatory,and antioxidant properties; they may play a role in the biological activity of A.roxburghianus root.

  3. Use of infliximab in the prevention and delay of colectomy in severe steroid dependant and refractory ulcerative colitis

    Robert P Willert, Ian Craig Lawrance

    2008-04-01

    Full Text Available AIM: To determine if infliximab can prevent or delay surgery in refractory ulcerative colitis (UC.METHODS: UC patients who failed to have their disease controlled with conventional therapies and were to undergo colectomy if infliximab failed to induce a clinical improvement were reviewed. Patients were primarily treated with a single 5 mg/kg infliximab dose. The Colitis Activity Index (CAI was used to determine response and remission. Data of 8 wk response and colectomy rates at 6 mo and 12 mo were collected.RESULTS: Fifteen patients were included, 7 with UC unresponsive or intolerant to IV hydrocortisone, and 8 with active disease despite oral steroids (all but one with therapeutic dosage and duration of immunomodulation. All the IV hydrocortisone-resistant/intolerant patients had been on azathioprine/6-MP < 8 wk. At 8 wk, infliximab induced a response in 86.7% (13/15 with 40% in remission (6/15. Within 6 mo of treatment 26.7% (4/15 had undergone colectomy and surgery was avoided in 46.6% (7/15 at 12 mo. The colectomy rate at 12 mo in those on immunomodulatory therapy < 8 wk at time of infliximab was 12.5% (1/8 compared with 100% (7/7 in patients who were on long-term maintenance immunomodulators (P < 0.02.CONCLUSION: Infliximab prevented colectomy due to active disease in immunomodulatory-naïve, refractory UC patients comparable to the use of Cyclosporine. In patients, however, on effective dosage and duration of immunomodulation at time of infliximab therapy colectomy was not avoided.

  4. Two brothers with skewed thiopurine metabolism in ulcerative colitis treated successfully with allopurinol and mercaptopurine dose reduction.

    Hoentjen, Frank; Hanauer, Stephen B; de Boer, Nanne K; Rubin, David T

    2012-01-01

    Thiopurine therapy effectively maintains remission in inflammatory bowel disease. However, many patients are unable to achieve optimum benefits from azathioprine or 6-mercaptopurine because of undesirable metabolism related to high thiopurine methyltransferase (TPMT) activity characterized by hepatic transaminitis secondary to increased 6-methylmercaptopurine (6-MMP) production and reduced levels of therapeutic 6-thioguanine nucleotide (6-TGN). Allopurinol can optimize this skewed metabolism. We discuss two brothers who were both diagnosed with ulcerative colitis (UC). Their disease remained active despite oral and topical mesalamines. Steroids followed by 6-mercaptopurine (MP) were unsuccessfully introduced for both patients and both were found to have high 6-MMP and low 6-TGN levels, despite normal TMPT enzyme activity, accompanied by transaminitis. Allopurinol was introduced in combination with MP dose reduction. For both brothers addition of allopurinol was associated with successful remission and optimized MP metabolites. These siblings with active UC illustrate that skewed thiopurine metabolism may occur despite normal TPMT enzyme activity and can lead to adverse events in the absence of disease control. We confirm previous data showing that addition of allopurinol can reverse this skewed metabolism, and reduce both hepatotoxicity and disease activity, but we now also introduce the concept of a family history of preferential MP metabolism as a clue to effective management for other family members. PMID:22147254

  5. Influencia de una combinación de lactobacilos + bifidobacterias sobre la actividad de la enfermedad, el hábito defecatorio y el estado nutricional de pacientes con colitis ulcerosa Influence of a combination of lactobacilli and bifidobacteria upon disease activity, stool pattern and nutritional status of ulcerative colitis patients

    S. Santana Porbén

    2010-12-01

    én resultó en una disminución de la actividad de la enfermedad y la ESR Eritrosedimentación, respectivamente [Cambio en el Índice de Actividad Clínica: Grupo Control: -1,1 ± 3,2 vs Grupo Tratamiento: -4,1 ± 3,3; p A quasi-experimental clinical assay was carried out to assess the tolerance, safety and usefulness of a 4 lactobacili + 1 bifidobacterium combination as adjuvant to the pharmacological treatment of UC Ulcerative colitis patients differing in mucosal change. The effectiveness of the probiotic treatment was assessed from changes in patient´s stool pattern, body composition, and selected biochemical indicators of disease activity and nutritional status. Fifty patients entered consecutively in the trial between December 2005-June 2009 (Control Group: 29; Treatment Group: 21. Twenty of them completed treatment with probiotics. Effectiveness of regular pharmacological treatment was recorded with 24 control patients. Thirty-six days of probiotic treatment per patient were accumulated. Probiotic treatment obedience rate was 99.3%. Five days of treatment were lost due to non-availability of the product. No adverse reactions were reported after probiotic treatment. Two deaths were recorded after completion of the study, one on each group. Improvement in the quality of the stools [RR Relative risk: 1.69; 95% IC: 0.87-3.27]; frequency [RR: 1.35; 95% IC: 0.15-11.90]; and volume [RR: 1.11; 95% IC: 0.16-7.63] was observed in treated patients, although biological variability prevented these trends to become statistically significant. Probiotic treatment also resulted in reduction of occurrence of nocturnal depositions [RR: 1.75; 95% IC: 0.53-5.73]. Probiotic treatment prevented the onset of undesirable changes in stool pattern of treated patients who presented free of symptoms, but observed effect was no superior to that of medication administered. Probiotic treatment did not influence upon presence of blood in stools. Probiotic treatment also resulted in reduction of

  6. 99mTc-Mesalamine as potential agent for diagnosis and monitoring of ulcerative colitis. Labelling, characterisation and biological evaluation

    Mesalamine was labelled with technetium-99m (99mTc) in high radiolabelling yield (∼98.4 %), in vitro stability (∼4 h) and in serum persistence (∼24 h). Optimum labelling conditions were investigated. The structure of the complex was confirmed using in silico analysis. Molecular docking was performed to evaluate the complex binding to its biochemical target, the PPARc receptor. Biodistribution and clearance studies were performed in normal and ulcerative colitis models in mice. The tracer's localization was highest (∼65.2 %) in microbial model compared to chemical model (∼42.4 %) and normal mice (∼22.1 %) at 60 min post injection. All data supported the usefulness of 99mTc-mesalamine as a radiotracer for ulcerative colitis. (author)

  7. Antineutrophil antibodies associated with ulcerative colitis interact with the antigen(s) during the process of apoptosis

    Mallolas, J; Esteve, M; Rius, E; Cabre, E; Gassull, M

    2000-01-01

    BACKGROUND—Cell death by apoptosis seems to be an important mechanism for translocation to the cell surface of a variety of intracellular components capable of inducing autoantibody production.
AIMS—To identify the cellular location of antigen (Ag)-antineutrophil cytoplasmic antibodies (ANCA) in non-apoptotic human neutrophils, and to assess if ANCA associated with ulcerative colitis reacts with neutrophil antigen(s) during neutrophil apoptosis. The cellular distribution of Ag-ANCA in apoptot...

  8. Genome-wide association study of ulcerative colitis identifies three new susceptibility loci, including the HNF4A region.

    CORVIN, AIDEN PETER

    2009-01-01

    PUBLISHED Ulcerative colitis (UC) is a common form of inflammatory bowel disease with a complex aetiology. As part of the Wellcome Trust Case Control Consortium 2, we performed a genome- wide association scan for UC in 2361 cases and 5417 controls. Loci showing evidence of association at P < 1 ? 10 ?5 were followed up by genotyping in an independent set of 2321 cases and 4818 controls. We find genome-wide significant evidence of association at three new loci, each cont...

  9. Role of pharmacoepidemiology studies in addressing pharmacovigilance questions: a case example of pancreatitis risk among ulcerative colitis patients using mesalazine

    Russo, Leo; Schneider, Gary; Gardiner, Margarita Hauser; Lanes, Stephan; Streck, Paul; Rosen, Susan

    2014-01-01

    Purpose Well-designed pharmacoepidemiology studies address several limitations of postmarketing spontaneous reports in regard to signal evaluation. This study evaluated a signal of disproportionate reporting of acute pancreatitis cases observed in patients with ulcerative colitis (UC) treated with MMX Multi Matrix System® (MMX®) mesalazine and demonstrated how inherent limitations of postmarketing reports were overcome. Methods Adults with UC who were new users of MMX mesalazine or another br...

  10. Development of gut inflammation in mice colonized with mucosa-associated bacteria from patients with ulcerative colitis

    Du, Z.; Hudcovic, T.; Mrázek, J.; Kozáková, H.; Šrůtková, D.; Schwarzer, M.; Tlaskalová-Hogenová, H.; Kostovčík, M.; Kverka, Miloslav

    2015-01-01

    Roč. 7, dec 21 (2015), s. 32. ISSN 1757-4749 R&D Projects: GA MŠk(CZ) ED1.1.00/02.0109; GA ČR(CZ) GAP303/12/0535 Institutional support: RVO:68378041 Keywords : dysbiosis * microbiota * germ-free mice * ulcerative colitis Subject RIV: FR - Pharmacology ; Medidal Chemistry Impact factor: 2.281, year: 2014

  11. Mechanisms of adherence of a probiotic Lactobacillus strain during and after in vivo assessment in ulcerative colitis patients

    Dunne, Colum; Kelly, Peter; O'Halloran, Sile; Soden, Declan; Bennett, Mary; von Wright, Atte; Vilpponen-Salmela, Terttu; Kiely, Barry; O'Mahony, Liam; Collins, J. Kevin; O'Sullivan, Gerald C; Shanahan, Fergus

    2004-01-01

    In a pilot-scale, open-label study to determine the ability of well-characterized probiotic Lactobacillus salivarius UCC118 cells to adhere to human epithelial cells in situ , the bacterial strain was administered to ulcerative colitis patients at approximately 109 CFU/day for 12 days. Microbiological analysis of biopsy specimens demonstrated that the ingested bacteria effectively adhered to both inflamed and non-inflamed mucosa of the large bowel in significant numbers. In previous report...

  12. Fecal Bacteriotherapy: A Case Report in an Immunosuppressed Patient with Ulcerative Colitis and Recurrent  Clostridium difficile Infection

    Hadeel Zainah

    2012-01-01

    Full Text Available We report a case of ulcerative colitis (UC and recurrent Clostridium difficile infection (CDI where the patient was on immunomodulatory therapy and had successful CDI eradication after fecal transplantation. This is the first case report in the literature documenting successful C. difficile eradication in an immunosuppressed patient. We feel that fecal transplantation should be studied as a treatment option in these patients.

  13. The polymicrobial Actinomyces naeslundii and Pseudomonas aeruginosa sepsis in a patient with ulcerative colitis 2 months after colonoscopy.

    Topić, Mirjana Balen; Desnica, Boško; Vicković, Ninoslava; Skuhala, Tomislava; Bayer, Kristijan; Bukovski, Suzana

    2014-02-01

    We describe a case of an abrupt onset of polymicrobial Actinomyces naeslundii/Pseudomonas aeruginosa sepsis in a patient with a previously silent abdominal actinomycosis, developed 2 months after colonoscopy when the diagnosis of a left-sided ulcerative colitis was established. Prolonged high-dose ceftriaxone therapy was clinically effective, albeit accompanied by the development of a reversible pseudocholelithiasis that persisted for 5 months. PMID:24297267

  14. Low hygiene and exposure to infections may be associated with increased risk for ulcerative colitis in a North Indian population

    Sood, Ajit; Amre, Devendra; Midha, Vandana; Sharma, Suresh,; Sood, Neena; Thara, Amandeep; Bansal, Manu; Juyal, Garima; Thelma, Bittianda Kuttapa; Seidman, Ernest

    2014-01-01

    Background Previous studies have attempted to link hygiene hypothesis with IBD. However most of these studies come from developed countries where the level of hygiene is high and universal. Very little data is available from developing countries. The present study explores the truth of hygiene hypotheses and other risk factors for ulcerative colitis (UC) in a North Indian population where the prevalence of UC has been increasing. Methods A total of 518 patients diagnosed with UC and 188 age-m...

  15. Anti-inflammatory effect of Prunus armeniaca L. (Apricot) extracts ameliorates TNBS-induced ulcerative colitis in rats.

    Minaiyan, M; Ghannadi, A; Asadi, M; Etemad, M; Mahzouni, P

    2014-01-01

    Prunus armeniaca L. (Apricot) is a tree cultivated in different parts of the world. Apricot kernel as a good dietary supplement has shown antioxidant, anti-inflammatory and other pharmacologic properties which suggest that it may be functional as an anticolitis agent. In this study we evaluated the effects of apricot kernel extract and oil on ulcerative colitis in rats. Rats were fasted for 36 h before the experiment. Colitis was induced by intra-rectal instillation of 50 mg/kg trinitrobenzene sulfonic acid in male Wistar rats. Treatments were started 6 h after colitis induction and continued every 24 h for 5 days. Apricot kernel extract (100, 200, 400 mg/kg p.o. and 100, 400 mg/kg i.p.) and apricot kernel extract/oil (100, 200, 400 mg/kg p.o.) were used as experimental treatments and prednisolone (4 mg/kg p.o. or i.p.) was used as reference drug. On the day 6, colon tissue was removed and macroscopic and pathologic parameters were evaluated. Ulcer index and total colitis index as representative of macroscopic and histologic parameters respectively showed ameliorating effects in experimental groups especially those treated by intraperitoneal administration route. Results also demonstrated that oil fraction was not able to potentiate the effects of extract. These data suggest that apricot kernel extracts (with or without oil) can be introduced for further mechanistic and clinical studies as a complementary medicine for inflammatory bowel disorders. PMID:25657793

  16. The Mutyh base excision repair gene influences the inflammatory response in a mouse model of ulcerative colitis.

    Ida Casorelli

    Full Text Available BACKGROUND: The Mutyh DNA glycosylase is involved in the repair of oxidized DNA bases. Mutations in the human MUTYH gene are responsible for colorectal cancer in familial adenomatous polyposis. Since defective DNA repair genes might contribute to the increased cancer risk associated with inflammatory bowel diseases, we compared the inflammatory response of wild-type and Mutyh(-/- mice to oxidative stress. METHODOLOGY/PRINCIPAL FINDINGS: The severity of colitis, changes in expression of genes involved in DNA repair and inflammation, DNA 8-oxoguanine levels and microsatellite instability were analysed in colon of mice treated with dextran sulfate sodium (DSS. The Mutyh(-/- phenotype was associated with a significant accumulation of 8-oxoguanine in colon DNA of treated mice. A single DSS cycle induced severe acute ulcerative colitis in wild-type mice, whereas lesions were modest in Mutyh(-/- mice, and this was associated with moderate variations in the expression of several cytokines. Eight DSS cycles caused chronic colitis in both wild-type and Mutyh(-/- mice. Lymphoid hyperplasia and a significant reduction in Foxp3(+ regulatory T cells were observed only in Mutyh(-/- mice. CONCLUSIONS: The findings indicate that, in this model of ulcerative colitis, Mutyh plays a major role in maintaining intestinal integrity by affecting the inflammatory response.

  17. The anti-ulcerative colitis effects of Annona squamosa Linn. leaf aqueous extract in experimental animal model.

    Ibrahim, Rasha Ym; Hassan, Amal I; Al-Adham, Eithar K

    2015-01-01

    This study aimed to evaluate the anti-inflammatory effects of Annona squamosa (A. squamosa) leaf aqueous extract against acetic acid induced colitis in rats with a trial to explore its use for the treatment of colon inflammation. Sprague Dawley rats weighing 180-200 g were used in this study. Treatment with A. squamosa extract at dose 300 mg/kg for 4 weeks counteracted acetic acid induced ulcerative colitis by a significant decrease (P<0.05) of colonic tissue of malondialdehyde (MDA) and significant increases of catalase (CAT), glutathione (GSH) and glutathione peroxidase (Gpx) compared to ulcerative colitis control group. Furthermore, induction of oxidative stress was observed in the colonic tissue through the levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG) which significant increase in colonic tissue DNA by acetic acid. Moreover AA induced significant increase in serum interleukin-10 (IL10), tumor necrosis factor-α (TNF-α), transforming growth factor (TGF 1β), and C reactive protein (CRP) as compared to the control group. On the contrary, our results showed AA induced significant decrease of vascular endothelial growth factor (VEGF) and thyroid hormones triiodothyronin and thyroxin (T3 & T4) in installed group with AA as compared to control which significantly improved after treatment with A. squamosa leaf extract. Histopathological observation in our study confirmed the biochemical study. Thus, therapeutic method offer a sign to analyze further the effectiveness of A. squamosa as a unique agent for alleviating colitis. PMID:26885156

  18. Lung disease and ulcerative colitis--mesalazine-induced bronchiolitis obliterans with organizing pneumonia or pulmonary manifestation of inflammatory bowel disease?

    Moeser, A; Pletz, M W; Hagel, S; Kroegel, C; Stallmach, A

    2015-09-01

    Ulcerative colitis can be associated with numerous extraintestinal organ manifestations. Pulmonary disease in inflammatory bowel disease (IBD) is supposed to be a rare entity and has to be distinguished from infectious complications and side-effects of medications used in the treatment of IBD. We present the case of a 20-year-old male patient with ulcerative colitis and a 4-week history of respiratory symptoms, malaise, fever and respiratory insufficiency under a medication with mesalazine. Computed tomography showed bilateral subpleural consolidations, bronchoscopy revealed signs of acute bronchitis. The diagnostic work-up ruled out an infectious cause. Under the tentative diagnosis of a mesalazine-induced bronchiolitis obliterans with organizing pneumonia (BOOP) the medication with mesalazine was withdrawn and the patient received a corticosteroid trial. The symptoms quickly improved and prednisone was tapered and stopped after 6 months. Unexpectedly, lung function after complete resolution of respiratory symptoms revealed a residual obstructive ventilatory defect that might be due to an asymptomatic pulmonary manifestation of ulcerative colitis. A review of the literature shows that pulmonary manifestations in IBD as well as pulmonary toxicity of mesalazine might not be as rare as expected and should be included as differential diagnoses in the work-up of respiratory symptoms in patients with IBD. A pragmatic therapeutic approach is reasonable in critically ill patients as it is not always easy to distinguish both entities. PMID:26367026

  19. Downregulation of electroacupuncture at ST36 on TNF-α in rats with ulcerative colitis

    Li Tian; Yu-Xin Huang; Min Tian; Wei Gao; Qing Chang

    2003-01-01

    AIM: To investigate the regulatory effect of electroacupuncture (EA) at Zusanli (ST36) on tumor necrosis factor-alpha (TNFα) in rats with ulcerative colitis (UC), and further elucidate the therapeutic mechanism of EA on UC.METHODS: Thirty-two male Sprague-Dawley (SD) rats were randomly divided into four groups (n=-8): normal control group, UC control group, UC+ST36 group and UC+nonacupoint group. A solution containing ethanol and 2,4,6-trinitrobenzenesulfonic acid (TNBS) was instilled into the distal colon in the rat (at a dose of 100 mg/kg) to set up UC rat model. Rats in wakefulness state of UC+ST36 group were stimulated at ST36 by EA once a day, while those of UC+nonacupoint group were done at 0.5 cm beside ST36. After 10d treatment, all rats were sacrificed simultaneously. Colon musocal inflammation and damage were assessed by measuring colon mass, morphologic damage score, colonic myeloperoxidase enzyme (MPO) activity, serum TNF-α and colonic TNF-α mRNA level. Morphologic damage score was examined under stereomicroscope. Colonic MPO activity was measured by spectrophotometer method. Serum TNF-αconcentration was determined by radioimmunoassay (RIA).Colonic TNF-α mRNA expression level was analyzed by semiquantitative reverse transcription polymerase chain reaction (RT-PCR).RESULTS: Ratio of colonic mass/body mass (mC/mB) and activity of colonic MPO (μkat/g tissue) markedly increased (8.5±2.6 vs 2.5±0.4; 145±25 vs 24±8, P<0.01 vs normal control group). Compared with normal control rats, serum TNF-α and colonic TNF-α mRNA level in UC control group were increased 2.5 fold (2 278±170 vs 894±248, P<0.01)and 4.3 fold (0.98±0.11 vs 0.23±0.11, P<0.01)respectively. After EA at ST36, mc/mB and MPO activity were reduced significantly (5.3±2.0 vs 8.5±2.6; 104±36 vs145±25, P<0.01, 0.05) compared with those of UC control group. Serum TNF-α and colonic TNF-α mRNA level were inhibited by EA stimulation at ST36 (P<0.01). The inhibitory rate was 16

  20. Inflammatory cytokine gene polymorphism profiles in Turkish patients with ulcerative colitis

    İlhami Gök

    2015-02-01

    Full Text Available Aim To investigate IL-1α, IL-1β, IL-1R , IL-4RA, TGF-β, TNF-α and IFN-γ, genes polymorphism in Turkish patients with ucerative colitis (UC. Methods An analysis was carried out at Trabzon Karadeniz Technical University Medicine Faculty Gastroenterology polyclinics between March 2005 and May 2011 on 51 patient with UC (cases and 100 healthy individuals (controls. PCR-SSP and cytokine gene panel (Helderberg kits based techniques for analysis of gene polymorphisms were used. Results Changes in allelic frequencies of each of the investigated eight cytokine genes polymorphisms in patient with ulcerative colitis were found. Among the allelic genes analyzed here, the highest statistically significant change was observed in the position TNF-α -308 G/A (339.7%. The following increases were observed in IL-IR mspa T/C variation (179.4%, IFN-γ 5644A/T variation (77.4%, and in IL-1β -511T/C SNPs (35.9% . In other analyzed genes, allelic changes were found to be decreasing for TGF- β codon10C / T (-71.9%, IL4RA + 1902G / A (-47.3 %, and for IL- 1α -889T / C (-37.7%. The lowest negative change (-25.9% was observed in the allele frequency in IL- 1β 3962T / C (p<0.000. In addition, there were changes in genotypic frequencies investigated seven gene polymophic site and only one of cytokine gene IL-1β 3962TT/TC/CC was not changed. Conclusion Genes polymorphism is not itself the only determining factor for clinical diagnoses. However, it can be used in the clinical diagnosis of UC in order to determine the low level or high level variations in cytokine gene polymorphisms.

  1. Ulcerative colitis in a multiracial Asian country: Racial differences and clinical presentation among Malaysian patients

    Yan-Mei Tan; Khean-Lee Goh

    2005-01-01

    AIM: To determine the prevalence of ulcerative colitis (UC) in Malaysian patients and to establish the spectrum of the disease seen in Malaysian patients.METHODS: Data were obtained retrospectively from a review of the medical records of in- and out-patients with a diagnosis of UC at the University Hospital, Kuala Lumpur between 1985 and 1998.RESULTS: There were 45 confirmed cases of UC, of which 3 were foreigners, who were excluded from analysis.Thirty new cases of UC were diagnosed during the study period. Their mean age at presentation was 33.0±10.0 years.The highest prevalence of UC was 17.9/100 000 hospital admissions in the Indians, followed by 11.2/100 000 hospital admissions in the Chinese. The lowest prevalence was 3.7/100 000 hospital admissions in the Malays. The prevalence of UC was significantly higher in the Indians and the Chinese when compared with the Malays with an OR of 4.89 (CI = 2.02-12.24; χ2 = 15.45, P<0.001) and 3.06 (CI = 1.24-7.78; χ2 = 6.30; P= 0.012) respectively. The extent of colonic disease was similar in the Malay and Indian patients. In contrast, distal or left-sided colitis predominated in the Chinese with an OR of 8.17 (95%CI = 1.31-64.87;χ2 = 5.53, P = 0.02). Extraintestinal manifestations were uncommon (11.9%).CONCLUSION: UC is an uncommon disease in Malaysia,but racial differences exist. The Indians had the highest prevalence of UC with the Chinese demonstrating the least extensive disease.

  2. Versatile methods for synthesizing organic acid salts of quaternary berberine-type alkaloids as anti-ulcerative colitis agents.

    Zhang, Zhi-Hui; Li, Jing; Zhang, Hai-Jing; Deng, An-Jun; Wu, Lian-Qiu; Li, Zhi-Hong; Song, Hong-Rui; Wang, Wen-Jie; Qin, Hai-Lin

    2016-06-01

    Two versatile methods to synthesize kinds of organic acid salts of quaternary berberine-type alkaloids were investigated in order to determine which is more efficient to improve the liposolubility of the target compounds and to explore the efficacy of the target compounds as anti-ulcerative colitis (UC) agents. Overall evaluation according to the reaction results and yields of the final products indicated that the synthetic method using tertiary (±)-8-acylmethyldihydroberberine-type alkaloids as key intermediates is superior to that of using tertiary dihydroberberine-type alkaloids as intermediates. Ten target compounds were synthesized using quaternary berberine chloride and quaternary coptisine chloride as starting materials, respectively, and the anti-UC activity of some target compounds was evaluated in an in vitro x-box-binding protein 1 (XBP1) transcriptional activity assay using dual luciferase reporter detection. At 10 μM, the tested compounds were found to activate the transcription of XBP1 target at almost the same level as that of quaternary coptisine chloride. The synthesized target compounds were also found to share higher liposolubility than the inorganic acid salts of quaternary berberine-type alkaloid. PMID:27097666

  3. Sulphation of colonic and rectal mucin in inflammatory bowel disease: reduced sulphation of rectal mucus in ulcerative colitis.

    Raouf, A H; Tsai, H H; Parker, N; Hoffman, J; Walker, R J; Rhodes, J M

    1992-11-01

    1. Normal colonic mucin is heavily sulphated and this increases its resistance to degradation by bacterial enzymes. Any defect in mucus sulphation could therefore be important in the pathogenesis of ulcerative colitis. 2. Rectal biopsies taken at colonoscopy from patients with ulcerative colitis (n = 9), patients with Crohn's disease (n = 6) and control subjects (n = 16) were cultured for 24 h in the presence of N-[3H]acetylglucosamine and [35S]sulphate. Mucin was then extracted and purified, and the ratio of [35S]sulphate to N-[3H]acetylglucosamine incorporated into pure mucin was assessed. 3. The ratio of [35S]sulphate to N-[3H]acetylglucosamine incorporated into mucin was significantly reduced in rectal biopsies taken from patients with ulcerative colitis (0.463, 0.305-0.703, geometric mean and 95% confidence intervals) compared with control subjects (0.857, 0.959-1.111, P < 0.01). In patients with Crohn's disease the reduction in this ratio (0.559, 0.378-0.829) did not quite reach statistical significance (P = 0.06). There was no difference between the ratio of [35S]sulphate to N-[3H]acetylglucosamine incorporated into mucin in Crohn's disease and that in ulcerative colitis (P = 0.26). 4. In control subjects the ratio of [35S]sulphate to N-[3H]acetylglucosamine incorporated into mucin was higher in the rectal biopsies (0.882, 0.618-1.022) than in their paired proximal colonic biopsies (0.602, 0.421-0.861; P < 0.01), but this regional variation was not observed in either ulcerative colitis (rectum: 0.450, 0.262-0.773; right colon: 0.470, 0.321-0.690, P = 0.3) or Crohn's disease (rectum: 0.459, 0.260-0.815; right colon: 0.492, 0.260-0.929, P = 0.8).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1335401

  4. Ileal lesions in patients with ulcerative colitis after ileo-rectal anastomosis: Relationship with colonic metaplasia

    Livia Biancone; Francesco Pallone; Emma Calabrese; Giampiero Palmieri; Carmelina Petruzziello; Sara Onali; Giuseppe Sigismondo Sica; Marta Cossignani; Giovanna Condino; Kiron Moy Das

    2008-01-01

    AIM:To assess whether in ulcerative colitis (UC) patients with ileo-rectal anastomosis (IRA),ileal lesions may develop in the neo-terminal-ileum and their possible relation with phenotypic changes towards colonic epithelium.METHODS:A total of 19 patients with IRA under regular follow up were enrolled,including 11.UC and 8 controls (6 Crohn's disease,CD;1 familial adenomatous polyposis,FAP;1 colon cancer,colon K).Ileal lesions were identified by ileoscopy with biopsies taken from the ileum (involved and uninvolved) and from the rectal stump.Staining included HE and immunohistochemistry using monoclonal antibodies against colonic epithelial protein CEP (Das-1) and human tropomyosin isoform 5,hTMS (CG3).Possible relation between development of colonic metaplasia and ileal lesions was investigated.RESULTS:Stenosing adenocarcinoma of the rectal stump was detected in 1 UC patient.The neo-terminal ileum was therefore investigated in 10/11 UC patients.Ileal ulcers were detected in 7/10 UC,associated with colonic metaplasia in 4/7 (57.1%) and Das-1 and CG3 reactivity in 3/4 UC.In controls,recurrence occurred in 4/6 CD,associated with colonic metaplasia in 3/4 and reactivity with Das-1 and CG3 in 2/3.CONCLUSION:Present findings suggest that in UC,ileal lesions associated with changes towards colonic epithelium may develop also after IRA.Changes of the ileal content after colectomy may contribute to the development of colonic metaplasia,leading to ileal lesions both in the pouch and in the neo-terminal ileum after IRA.

  5. Dysregulated Circulating Dendritic Cell Function in Ulcerative Colitis Is Partially Restored by Probiotic Strain Lactobacillus casei Shirota

    Elizabeth R. Mann

    2013-01-01

    Full Text Available Background. Dendritic cells regulate immune responses to microbial products and play a key role in ulcerative colitis (UC pathology. We determined the immunomodulatory effects of probiotic strain Lactobacillus casei Shirota (LcS on human DC from healthy controls and active UC patients. Methods. Human blood DC from healthy controls (control-DC and UC patients (UC-DC were conditioned with heat-killed LcS and used to stimulate allogeneic T cells in a 5-day mixed leucocyte reaction. Results. UC-DC displayed a reduced stimulatory capacity for T cells (P<0.05 and enhanced expression of skin-homing markers CLA and CCR4 on stimulated T cells (P<0.05 that were negative for gut-homing marker β7. LcS treatment restored the stimulatory capacity of UC-DC, reflecting that of control-DC. LcS treatment conditioned control-DC to induce CLA on T cells in conjunction with β7, generating a multihoming profile, but had no effects on UC-DC. Finally, LcS treatment enhanced DC ability to induce TGFβ production by T cells in controls but not UC patients. Conclusions. We demonstrate a systemic, dysregulated DC function in UC that may account for the propensity of UC patients to develop cutaneous manifestations. LcS has multifunctional immunoregulatory activities depending on the inflammatory state; therapeutic effects reported in UC may be due to promotion of homeostasis.

  6. Matrix metalloproteinases in the restorative proctocolectomy pouch of pediatric ulcerative colitis

    Laura M(a)kitalo; Maija Piekkala; Merja Ashorn; Mikko Pakarinen; Antti Koivusalo; Riitta Karikoski; Johanna Natunen

    2012-01-01

    AIM:To investigate matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) in pouch mucosa of pediatric onset ulcerative colitis (UC).METHODS:In this cross-sectional study,28 patients with pediatric onset UC underwent ileal pouch biopsy 13 years (median) after proctocolectomy.Expression of MMPs-3,-7,-8,-9,-12 and-26 and TIMPs-1,-2 and-3 in samples was examined using immunohistochemichal methods,and another biopsy was used to evaluate the grade of histological inflammation.Two investigators independently graded the immunohistochemical specimens in a semiquantitative fashion,using a scale marking staining intensity as follows:0 =less than 20 positive cells; 1 =20-50 positive cells; 2 =50-200 positive cells; 3 =over 20 positive cells.Fecal calprotectin and blood inflammatory markers [serum C-reactive protein (CRP) and erythrocyte sedimentation rate] were determined during a follow-up visit to examine correlations between these markers and the expression of MMPs and TIMPs.RESULTS:Of the 28 patients with pediatric onset UC,nine had not experienced pouchitis,whereas thirteen reported a single episode,and six had recurrent pouchitis (≥ 4 episodes).At the time of the study,six patients required metronidazole.In all of the others,the most recent episode of pouchitis had occurred over one month earlier,and none were on antibiotics.Only four samples depicted no sign of inflammation,and these were all from patients who had not had pouchitis.Two samples were too small to determine the grade of inflammation,but both had suffered pouchitis,the other recurrent.No sample depicted signs of colonic metaplasia.Most pouch samples showed expression of epithelial (e) and stromal (s) MMP-3 (e,n =22; s,n =20),MMP-7 (e,n =28; s,n =27),MMP-12 (e,n =20; s,n =24),TIMP-2 (e,n =23; s,n =23) and MMP-3 (e,n =23; s,n =28) but MMP-8 (e,n =0; s,n =1),MMP-9 (e,n =0; s,n =9) and MMP-26 (e,n =0; s,n =3) and TIMP-1 (n =0,both) were lacking.In samples with low grade of inflammatory activity

  7. A study of the effects of Cydonia oblonga Miller (Quince) on TNBS-induced ulcerative colitis in rats.

    Minaiyan, M; Ghannadi, A; Etemad, M; Mahzouni, P

    2012-04-01

    Cydonia oblonga Miller (Quince) from Rosaceae family is a fruit tree cultivated in many countries mainly in Iran. This study was carried out to investigate the effect of quince juice (QJ) and quince hydroalcoholic extract (QHE) on ulcerative colitis (UC) induced by TNBS (trinitrobenzene sulfonic acid) in rats. Rats were grouped (n=6) and fasted for 36 h before colitis induction. TNBS was instilled into the colon with a hydroalcoholic carrier and then treatments were made for 5 days starting 6 h after colitis induction with different doses of QJ (200, 400, 800 mg/kg), QHE (200, 500 & 800 mg/kg) orally, QJ (400 mg/kg) and QHE (200 and 500 mg/kg) intraperitoneally. The colon tissue was removed and tissue damages were scored after macroscopic and histopathologic assessments. Albeit the examined doses of QJ and QHE were apparently effective to reduce the extent of UC lesions, only the greatest doses (500 and 800 mg/kg) resulted in significant alleviation. Weight/Length ratio as an illustrative of tissue inflammation and extravasation was also diminished with quince treatments while the results correlated with macroscopic and histopathologic evaluations. These data suggest that QJ and QHE were effective to diminish inflammation and ulcer indices in this murine model of acute colitis. Although QHE with different doses was effective in induced colitis, the dose and/or route of administration dependency was not confirmed. So quince fractions could be considered as a suitable anticolitic alternative, however further studies are needed to support this hypothesis for clinical setting. PMID:23181087

  8. Rectal hepatoid carcinoma with liver metastases in a patient affected by ulcerative colitis

    Giacomo Borgonovo; Francesco Razzetta; Michela Assalino; Emanuela Varaldo; Maria Puglisi; Paola Ceppa

    2008-01-01

    BACKGROUND: Hepatoid tumors (HTs) are rare extra-hepatic neoplasms with the histological features, biochemical proifle and, sometimes, even clinical course of hepatocellular carcinoma. We present a case of rectal hepatoid adenocarcinoma with metachronous liver metastases. METHODS: Four months after total procto-colectomy for a rectal adenocarcinoma (Astler-Coller C2), a 42-year-old man with ulcerative colitis showed hypoechoic masses in the hepatic parenchyma by abdominal ultrasonography. Carcinoembryonic antigen was normal, but alpha-fetoprotein was 32 000 μg/L. Fine-needle biopsy revealed that liver masses were positive for hepatocellular carcinoma. The patient underwent left hepatectomy and alcoholisation of a small deep nodule in segment 8. RESULTS:  Immunohistochemistry and albumin mRNA in situ hybridization suggested that the nodules were metastases of a HT. The patient was well during the ifrst 6 months and refused any adjuvant chemotherapy. He died from liver failure 19 months after initial diagnosis. CONCLUSIONS: HT is a rare colon cancer. The preoperative diagnosis of this tumor requires a high degree of suspicion, the availability of a panel of immunohistochemical markers, and a certain amount of luck. The prognosis is poor despite an aggressive and multimodal therapeutic strategy. So far, none of the hypotheses proposed about the origin and the biology of these tumors is convincing.

  9. Fecal Microbiota Transplantation for Ulcerative Colitis: A Systematic Review and Meta-Analysis.

    Yanqiang Shi

    Full Text Available Fecal microbiota transplantation (FMT has been recognized as a novel treatment for ulcerative colitis (UC. However, its efficacy and safety remain unclear.We conducted this systematic review to assess the efficacy and safety of FMT in UC.PubMed, EMBASE, Cochrane Central, Web of Science Core Collection, and three other Chinese databases were searched for reports of FMT in UC with clear outcomes.We estimated pooled rates [with 95% confidence interval (CI] of clinical remission among 15 cohort studies and clinical response among 16 cohort studies.Twenty five studies (2 randomized controlled trials, 15 cohort studies, and 8 case studies with 234 UC patients were included. Overall, 41.58% (84/202 patients achieved clinical remission (CR and 65.28% (126/193 achieved clinical response. Among the cohort studies, the pooled estimate of patients who achieved CR and clinical response were 40.5% (95% CI 24.7%-58.7%, and 66.1% (95% CI 43.7%-83.0%. Most adverse events were slight and self-resolving. The analyses of gut microbiota in 7 studies showed that FMT could increase microbiota diversity and richness, similarity, and certain change of bacterial composition.FMT provides a promising effect for UC with few adverse events. Successful FMT may be associated with an increase in microbiota diversity and richness, similarity, and certain change of bacterial composition.

  10. [NONSPECIFIC ULCERATIVE COLITIS COMPLICATED WITH MULTIPLE REPETITIVE PERFORATIONS AND DIFFUSE FECALIC PERITONITIS (CASE REPORT)].

    Antadze, A; Mukhashavria, G; Lekvtadze, N; Tomadze, G; Chikobava, G

    2016-06-01

    Nonspecific ulcerative colitis is disease with complicated and not fully studied etiology and pathogenesis, and treatment of its complications is very difficult. Especially complicated is disease course with repetitive bleeding, toxic megacolon and perforation. We present a quite rare case of complication with multiple, especially repetitive perforations of transverse colon. After 13 days from the performance of subtotal colectomy, the patient underwent to the relaparotomy because of secondary perforation of sygmoid colon 2-3 cm lower from its cult and iliac intestine 0.2-0.3 cm distance from nearby ileostoma. The full eventration took place on the 6th day and was performed repetitive laparotomy. On the 8th day patient was released from artificial ventilation of lungs and on the 66th day from hospitalization patient was discharged from the hospital with satisfactory status. Such kind of serious course of the treatment process was determined by the late hospitalization and developed serious complications. Situation mentioned above more impressively underlines the value of the positive result of presented case. PMID:27441530

  11. Atypical Mycobacterial Infection Presenting as Persistent Skin Lesion in a Patient with Ulcerative Colitis

    Giorgos Bamias

    2011-01-01

    Full Text Available Immunosuppressive drugs are commonly used for the treatment of inflammatory bowel disease. Patients receiving immunosuppressants are susceptible to a variety of infections with opportunistic pathogens. We present a case of skin infection with Mycobacterium chelonae in a 60-year-old Caucasian woman with ulcerative colitis who had been treated with corticosteroids and azathioprine. The disease manifested with fever and rash involving the right leg. Infliximab was administered due to a presumptive diagnosis of pyoderma gangrenosum, leading to worsening of the clinical syndrome and admission to our hospital. Routine cultures from various sites were all negative. However, Ziehl-Neelsen staining of pus from the lesions revealed acid-fast bacilli, and culture yielded a rapidly growing mycobacterium further identified as M. chelonae. The patient responded to a clarithromycin-based regimen. Clinicians should be aware of skin lesions caused by atypical mycobacteria in immunocompromised patients with inflammatory bowel disease. Furthermore, they should be able to thoroughly investigate and promptly treat these conditions.

  12. Selective biologics for ulcerative colitis and Crohn's disease – clinical utility of vedolizumab

    Petkau JM

    2016-03-01

    Full Text Available Jill MV Petkau, Bertus Eksteen Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada Abstract: Inflammatory bowel disease (IBD encompasses a cluster of different disease phenotypes which are broadly classified into ulcerative colitis and Crohn's disease. Disease pathogenesis is driven by abnormal host immune responses to their resident gut microbiome in genetically susceptible individuals. Clinical disease features and outcomes are heterogenous and not unexpected as over 163 genetic loci are associated with disease susceptibility, and there are great variability in environmental exposures. Despite this variability, there has been relatively few efficacious therapies for particularly moderate-to-severe IBD. Treatment has been dominated by antitumor necrosis alpha agents with significant success but equally potentially serious adverse events. Therapeutic targeting of leucocyte trafficking has emerged as a viable alternative therapy, with vedolizumab being the lead compound. This review focuses primarily on its biological function as a selective gut immunotherapy, its safety and efficacy, and its emerging role as a mainstream therapy in managing IBD. Keywords: adhesion molecule antagonist, anti-α4β7 integrin, inflammatory bowel disease, leukocyte trafficking, monoclonal antibody, selective gut immunotherapy, tumor necrosis factor alpha

  13. Severe chest pain in a pediatric ulcerative colitis patient after 5-aminosalicylic acid therapy

    2008-01-01

    Severe reactions to mesalamine products are rarely seen in pediatric patients. We report a case of a 12-year-old boy who had a severe cardiac reaction to a mesalamine product Asacol. Past medical history is significant for ulcerative colitis (UC) diagnosed at 9 years of age. Colo- noscopy one week prior to admission revealed pancoli- tis. He was treated with Asacol 800 mg three times per day and prednisone 20 mg/d. He was subsequently ad- mitted to the hospital for an exacerbation of his UC and started on intravenous solumedrol. He had improvement of his abdominal pain and diarrhea. The patient com- plained of new onset of chest pain upon initiating Asacol therapy. Electrocardiogram (ECG) revealed non-specific ST-T wave changes with T-wave inversion in the lateral leads. Echocardiogram (ECHO) revealed low-normal to mildly depressed left ventricular systolic function. The left main coronary artery and left anterior descending artery were mildly prominent measuring 5 mm and 4.7 mm, respectively. His chest pain completely resolved within 24-36 h of discontinuing Asacol. A repeat echo- cardiogram performed two days later revealed normal left ventricular function with normal coronary arteries (< 3.5 mm). Onset of chest pain after Asacol and im- mediate improvement of chest pain, as well as improve- ment of echocardiogram and ECG findings after discon- tinuing Asacol suggests that our patient suffered from a rare drug-hypersensitivity reaction to Asacol.

  14. “Mucosal healing” in ulcerative colitis:Between clinical evidence and market suggestion

    Cristiano; Pagnini; Francesca; Menasci; Stefano; Festa; Gianenrico; Rizzatti; Gianfranco; Delle; Fave

    2014-01-01

    In recent decades,the prominent role of endoscopy in the management of ulcerative colitis(UC)has been translated into the concept of mucosal healing(MH)as a fundamental therapeutic end-point.This is partially the consequence of growing evidence of a positive prognostic role of MH on the disease course and partially due to market cues indicating a higher rate of MH in patients treated by novel potent biologic agents.The aim of the present review is to clarify the current knowledge of MH in UC,analyzing the definition,the putative prognostic role and the association of MH with the current drugs used to treat UC patients.Because solid data about the management of UC patients based solely on the healing of the mucosa are not yet available,a tailored approach for individual patients thatconsiders the natural history of UC and the presence of prognostic indicators of aggressive disease is desirable.Consequently,unnecessary examinations and treatment would be avoided and restricted to UC patients who require the maximum amount of effort to affect the disease course in the short and long term.

  15. Concurrent Ulcerative Colitis and Neurofibromatosis Type 1: The Question of a Common Pathway.

    Adams, William; Mitchell, Lisa; Candelaria-Santiago, Roberto; Hefner, Jody; Gramling, Joseph

    2016-02-01

    Patients with neurofibromatosis type 1 (NF1) are prone to the development of gastrointestinal stromal tumors, which may present clinically with hematochezia, obstruction, or abdominal pain. These symptoms are also commonly associated with the presentation of ulcerative colitis (UC). Within the past 5 years, there have been 2 reports of concurrent NF1 and UC and a common pathophysiologic pathway involving mast cells has been postulated. We present the case of a 15-year-old boy with a known history of NF1 who presented with 3 months of hematochezia and loose stools. A colonoscopy revealed pancolitis and histology demonstrating acute cryptitis, focal crypt abscesses, and architectural distortion consistent with UC. Due to the paucity of reported cases, the findings of both diseases in the same individual could reasonably be discounted as coincidence. However, in light of increasing reports of concurrent NF1 and UC, advances in characterizing the microenvironment within neurofibromas, and recent findings regarding potential shared genetic susceptibility, it is increasingly possible that the proposed common pathway is accurate. Our case adds to the literature and underscores the need for further investigation. PMID:26823541

  16. Pouchitis and pre-pouch ileitis developed after restorative proctocolectomy for ulcerative colitis: A case report

    Takashi Iwata; Takayuki Yamamoto; Satoru Umegae; Koichi Matsumoto

    2007-01-01

    We report a case of pouchitis and pre-pouch ileitis, and inflammation in the neo-terminal ileum proximal to the pouch, developed after restorative proctocolectomy for ulcerative colitis. A 35-year old female presented with fever and abdominal pain five weeks after ileostomy closure following proctocolectomy. Computed tomography showed collection of feces in the pouch and proximal ileum. A drainage tube was placed in the pouch perianally,and purulent feces were discharged. With antibiotic treatment, her symptoms disappeared, but two weeks later, she repeatedly developed fever and abdominal pain along with anal bleeding. Pouchscopy showed mucosal inflammation in both the pouch and the pre-pouch ileum. The mucosal cytokine production was elevated in the pouch and pre-pouch ileum. With antibiotic and corticosteroid therapy, her symptoms were improved along with improvement of endoscopic inflammation and decrease of mucosal cytokine production. The fecal stasis with bacterial overgrowth is the major pathogenesis of pouchitis and pre-pouch ileitis in our case.

  17. Asymptomatic and Persistent Elevation of Pancreatic Enzymes in an Ulcerative Colitis Patient

    Elisa Liverani

    2013-01-01

    Full Text Available Azathioprine has been extensively used in the management of inflammatory bowel diseases. It might cause pancreatic damage in the form of either asymptomatic elevation in serum amylase/lipase or overt acute pancreatitis. Here we report the case of a 61-year-old patient with ulcerative colitis who had been treated with azathioprine for three years, achieving clinical remission. During treatment he presented an asymptomatic elevation of serum pancreatic enzymes, without any signs of pancreatitis at imaging. This evidence brought us to reassess the drug dosage, without achieving a normalization of biochemical analysis. Autoimmune pancreatitis was excluded. One year after the suspension of azathioprine, we still face persistent high levels of amylase/lipase. Normalization of enzymatic values in patients who develop intolerance to azathioprine, in the form of either asymptomatic elevation in serum amylase/lipase or overt acute pancreatitis, is usually achieved in about two months after stopping drug intake. Asymptomatic elevation in serum pancreatic enzymes in the absence of pancreatic disease is reported in the literature and defined as “Gullo’s syndrome,” but nobody of the subjects studied had been treated in the past with pancreatotoxic drugs. Might this case be defined as “benign pancreatic hyperenzymemia”?

  18. The incidence of postoperative venous thrombosis among patients with ulcerative colitis.

    O'Connor, O J

    2012-02-03

    BACKGROUND: Patients with Ulcerative Colitis (UC) have inherent prothrombotic tendencies. It is unknown whether this necessitates the use of additional perioperative anti-thrombotic prophylaxis when such patients require major surgery. METHODS: The postoperative courses of 79 patients with UC undergoing 180 major abdominal and pelvic operations were examined for clinical and radiological evidence of venous thrombosis. Eighteen patients with Familial Adenomatous Polyposis (FAP) having surgery (35 operations) of similar magnitude were also studied. Standard anti-thrombosis prophylaxis was utilised in all patients. RESULTS: Nine patients with UC were clinically suspected of developing postoperative venous thrombosis, but only three (3.8%) had their diagnosis confirmed radiologically (all had a pulmonary embolus). Therefore, the overall postoperative thrombosis rate, on an intention to treat basis, was 1.7% (3\\/180). No patient with FAP developed significant venous thrombosis. CONCLUSION: Standard perioperative antithrombotic modalities are sufficient to maintain any potential increase in postoperative thrombotic risk at an acceptable level in patients with UC undergoing operative intervention.

  19. The ulcerative colitis marker protein WAFL interacts with accessory proteins in endocytosis

    You Fu Pan, Ing-Marie Viklund, Heng Hang Tsai, Sven Pettersson, Ichiro N. Maruyama

    2010-01-01

    Full Text Available Ulcerative colitis (UC is one of the major forms of inflammatory bowel disease with unknown cause. A molecular marker, WAFL, has recently been found to be up-regulated in the inflamed colonic mucosa of UC patients. Towards understanding biological function of WAFL, we analyzed proteins interacting with WAFL in HEK-293 cells by immunoprecipitation and mass spectrometry. Among four proteins found to specifically interact with WAFL, both KIAA0196 and KIAA1033 bind to α-appendage of the adaptor protein complex 2 (AP2, which acts as an interaction hub for accessory proteins in endocytosis mediated by clathrin-coated vesicle (CCV. The specific interaction between WAFL and KIAA0196 was also confirmed in human colorectal carcinoma HCT-116 cells by co-immunoprecipitation with specific antibodies. Meta-analyses of the databases of expressed genes suggest that the three genes are co-expressed in many tissues and cell types, and that their molecular function may be classified in the category of 'membrane traffic protein'. Therefore, these results suggest that WAFL may play an important role in endocytosis and subsequent membrane trafficking by interacting with AP2 through KIAA0196 and KIAA1033.

  20. Clinical trial: probiotic treatment of acute distal ulcerative colitis with rectally administered Escherichia coli Nissle 1917 (EcN

    Matthes Harald

    2010-04-01

    Full Text Available Abstract Background Probiotics are effective in inflammatory bowel diseases. Clinical effectiveness and dose dependency of E. coli Nissle (EcN enemas were investigated in ulcerative colitis (UC. Methods In a double-blind study, 90 patients with moderate distal activity in UC were randomly assigned to treatment with either 40, 20, or 10 ml enemas (N = 24, 23, 23 containing 10E8 EcN/ml or placebo (N = 20. The study medication was taken once daily for at least 2 weeks. After 2, 4 and/or 8 weeks the clinical DAI was assessed together with tolerance to treatment. Patients who reached clinical DAI ≤ 2 within that time were regarded as responders. Results According to ITT analysis the number of responders was not significantly higher in the EcN group than in the placebo group (p = 0.4430, 2-sided. However, the Jonckheere-Terpstra rank correlation for dose-dependent efficacy indicated a significant correlation of per-protocol responder rates (p = 0.0446, 2-sided. Time to remission was shortest with EcN 40 ml, followed by EcN 20 ml. The number of adverse events did not differ notably. Conclusion In contrast to ITT analysis, efficacy of rectal EcN application was significant in PP and points to EcN as a well tolerated treatment alternative in moderate distal UC. Trial registration German Clinical Trials Register DRK00000234.

  1. Evaluation of Protective Effect of Hydro-alcoholic Extract of Fruit Peels of Punica granatum Linn against Ulcerative Colitis in Rats

    Ashar Kalangottil

    2014-07-01

    Full Text Available The study was designed to evaluate the protective effect of hydro-alcoholic extract of fruits peels of Punica granatum Linn. against acetic acid and trinitrobenzene sulfonic acid (TNBS induced ulcerative colitis in rats. Acute oral toxicity study was performed to find out the test dose according to OECD guidelines 425 and hydro-alcoholic extract of P. granatum fruit peel (PGPE was found to be safe at a dose of 2000 mg/kg body weight. The animals pretreated with hydro-alcoholic extract of P. granatum fruit peel (200 mg/kg and 400 mg/kg respectively significantly restored the altered hematological, biochemical parameters to normal levels when compared with control. The protective effect of P. granatum peel extract was comparable to standard sulfasalazine. The findings of the present study revealed that the hydro-alcoholic extract of P. granatum fruit peel possessed a dose dependent significant inhibitory activity against ulcerative colitis. The results obtained established the efficacy of the Punica granatum fruit peel against inflammatory bowel diseases possibly by its anti-inflammatory and antioxidant properties.

  2. Role and mechanisms of action of Escherichia coli Nissle 1917 in the maintenance of remission in ulcerative colitis patients: An update

    Scaldaferri, Franco; Gerardi, Viviana; Mangiola, Francesca; Lopetuso, Loris Riccardo; Pizzoferrato, Marco; Petito, Valentina; Papa, Alfredo; Stojanovic, Jovana; Poscia, Andrea; Cammarota, Giovanni; Gasbarrini, Antonio

    2016-01-01

    Ulcerative colitis (UC) is a chronic inflammatory disease, whose etiology is still unclear. Its pathogenesis involves an interaction between genetic factors, immune response and the “forgotten organ”, Gut Microbiota. Several studies have been conducted to assess the role of antibiotics and probiotics as additional or alternative therapies for Ulcerative Colitis. Escherichia coli Nissle (EcN) is a nonpathogenic Gram-negative strain isolated in 1917 by Alfred Nissle and it is the active component of microbial drug Mutaflor® (Ardeypharm GmbH, Herdecke, Germany and EcN, Cadigroup, In Italy) used in many gastrointestinal disorder including diarrhea, uncomplicated diverticular disease and UC. It is the only probiotic recommended in ECCO guidelines as effective alternative to mesalazine in maintenance of remission in UC patients. In this review we propose an update on the role of EcN 1917 in maintenance of remission in UC patients, including data about efficacy and safety. Further studies may be helpful for this subject to further the full use of potential of EcN. PMID:27350728

  3. Adherence to surveillance guidelines for dysplasia and colorectal carcinoma in ulcerative and Crohn's colitis patients in the Netherlands

    Anne F van Rijn; Paul Fockens; Peter D Siersema; Bas Oldenburg

    2009-01-01

    AIM: To study adherence to the widely accepted surveillance guidelines for patients with long-standing colitis in the Netherlands. METHODS: A questionnaire was sent to all 244 gastroenterologists in the Netherlands. RESULTS: The response rate was 63%. Of all gastroenterologists, 95% performed endoscopic surveillance in ulcerative colitis (UC) patients and 65% in patients with Crohn's colitis. The American Gastroenterological Association (AGA) guidelines were followed by 27%, while 27% and 46% followed their local hospital protocol or no specific protocol, respectively. The surveillance was correctly initiated in cases of pancolitis by 53%, and in cases of left-sided colitis by 44% of the gastroenterologists. Although guidelines recommend 4 biopsies every 10 cm, less than 30 biopsies per colonoscopy were taken by 73% of the responders. Only 31%, 68% and 58% of the gastroenterologists referred patients for colectomy when low-grade dysplasia, high-grade dysplasia (HGD) or Dysplasia Associated Lesion or Mass (DALM) was present, respectively. CONCLUSION: Most Dutch gastroenterologists perform endoscopic surveillance without following international recommended guidelines. This practice potentially leads to a decreased sensitivity for dysplasia, rendering screening for colorectal cancer in this population highly ineffective.

  4. Omega 3 fatty acids supplementation has an ameliorative effect in experimental ulcerative colitis despite increased colonic neutrophil infiltration Los suplementos de ácidos grasos omega 3 tienen efectos beneficiosos en colitis ulcerosa a pesar del aumento de la infiltracción por neutrófilos del colon

    Ioannis Varnalidis

    2011-10-01

    Full Text Available Purpose: omega 3 polyunsaturated fatty acids have anti-inflammatory properties and can be beneficial in the treatment of inflammatory diseases, such as ulcerative colitis. Dextran sodium sulphate (DSS colitis in rats appears to mimic nearly all of the morphological characteristics and lesion distributions of ulcerative colitis. The purpose of the current study was to investigate the efficacy of omega 3 fatty acids in the treatment of experimental ulcerative colitis. Methods: thirty-six Wistar rats were randomly assigned to group A or group B receiving 5% dextran sulfate sodium (DSS in their drinking water for eight days. For the next eight days post-DSS, group A animals received tap-water, and group B animals were fed a nutritional solution containing high levels of omega 3 polyunsaturated fatty acids (ProSure®, Abbott Laboratories, Zwolle, Netherlands once per day, administrated with a orogastric feeding tube. Results: animals fed an omega 3 rich diet exhibited a statistically significant increase in hematocrit and hemoglobin levels, compared to animals drinking tap water, and a trend towards histopathological and clinical improvement, with the administration of omega 3 fatty acids ameliorating epithelial erosion by day 8 post-DSS, but no statistically significant difference was observed between group A and group B animals at 4 or 8 days post-DSS. Also, a statistically significant increase in neutrophil infiltration was observed, as depicted by myelohyperoxidase activity. Conclusion: our findings support a positive role of omega 3 polyunsaturated fatty acids supplementation in an experimental model of ulcerative colitis despite the increased colonic neutrophil infiltration. Further studies are needed in order to investigate the role of increased neutrophils in colonic mucosa.

  5. COMPARATIVE EFFICACY OF DIFFERENT REFERENCE DRUGS ON TRINITROBENZENESULFONIC ACID-INDUCED ULCERATIVE COLITIS IN THE RAT MODEL

    P.S.Venkatesan

    2013-06-01

    Full Text Available Crohn’s disease and Ulcerative colitis were chronic inflammatory disorders of the bowel categorized as inflammatory bowel diseases. Trinitrobenzene sulfonic acid (TNBS-induced colitis was one of the most common methods for studying inflammatory bowel disease in animal models. Several factors may, however, affect its reproducibility, rate of animal mortality, and macroscopic and histopathological outcomes.The current study was undertaken with the objective to validate the main contributing factors to this method and compare the effects of different reference drugs upon better amelioration of trinitrobenzenesulfonic acid (TNBS induced colitis. With the above objectives, ulcerative colitis was induced by intrarectal administration of TNBS in male Wistar rats at a dose rate of 20 mg in 0.5 mL of ethanol per animal for all groups except the negative control group, which received 0.5 mL of normal saline. Different reference drugs like dexamethasone (1 mg/kg, intraperitoneally (i.p. and 2 mg/kg, orally (p.o., hydrocortisone acetate (20 mg/kg, i.p.; 20 mg/kg, enema and sulfasalazine 500mg/kg ,p.o.were administered daily once from Day 3 to 9 except the negative and positive controls which received normal saline at the rate of 10 mL/kg body weight. All the animals were sacrificed on Day 10; the colons were excised and the colon morphology and net weight of the colon segment were graded and measured, respectively. The intestinal damage had improved significantly in the experiment groups that received different reference drugs which is comparable with sulfasalazine treated group. The experimental observations, gross pathology of intestinal lesions and statistical analysis reveals no significant difference among the different reference drugs treated groups.

  6. Effects of Guchang Capsule on Dextran Sulphate Sodium-Induced Experimental Ulcerative Colitis in Mice

    Liu, Baoshan; Liu, Tong; Wang, Xiaohong; Zheng, Xin; Wang, Hong; Ma, Lin

    2016-01-01

    Guchang capsule (GC) is a Chinese materia medica standardized product extracted from 15 Chinese traditional medical herbs and it has been clinically used in the treatment of intestinal disease. In this study, in order to extend the research of GC in intestinal disease, we were aiming to evaluate potential effects of GC on dextran sulphate sodium- (DSS-) induced murine experimental colitis and to elucidate the underlying mechanisms. GC treatment attenuated DSS-induced body weight loss and reduced the mortality. Moreover, GC treatment prevented DSS-induced colonic pathological damage; meanwhile it inhibited proinflammatory cytokines production in colon tissues. In vitro, GC significantly reduced LPS-induced proinflammatory cytokines production via inhibiting the activation of NF-κB in macrophage cells, and the expressions of several long noncoding RNAs (lncRNAs) which were reported in regulating NF-κB signaling pathway were obviously affected by adding GC into culture medium. In conclusion, our data suggested that administration of GC exhibits therapeutic effects on DSS-induced colitis partially through regulating the expression of NF-κB related lncRNAs in infiltrating immune cells. PMID:27313642

  7. Macrophage and dendritic cell subsets in IBD: ALDH+ cells are reduced in colon tissue of patients with ulcerative colitis regardless of inflammation

    Maria K Magnusson; Brynjólfsson, Siggeir F; Dige, Anders; Uronen-Hansson, Heli; Börjesson, Lars G.; Bengtsson, Jonas L.; Gudjonsson, Sigurdur; Öhman, Lena; Agnholt, Jørgen; Sjövall, Henrik; Agace, William W; Wick, Mary Jo

    2015-01-01

    Disruption of the homeostatic balance of intestinal dendritic cells (DCs) and macrophages (MQs) may contribute to inflammatory bowel disease. We characterized DC and MQ populations, including their ability to produce retinoic acid, in clinical material encompassing Crohn’s ileitis, Crohn’s colitis and ulcerative colitis (UC) as well as mesenteric lymph nodes (MLNs) draining these sites. Increased CD14+DRint MQs characterized inflamed intestinal mucosa while total CD141+ or CD1c+ DCs numbers w...

  8. Frequency, predictors, and consequences of maintenance infliximab therapy intensification in ulcerative colitis

    Luis Fernández-Salazar

    2015-09-01

    Full Text Available Introduction: Infliximab (IFX therapy intensification in ulcerative colitis (UC is more common than established in pivotal studies. Objectives: To establish the frequency and form of intensification for UC in clinical practice, as well as predictors, and to compare outcomes between intensified and non-intensified treatment. Methods: A retrospective study of 10 hospitals and 144 patients with response to infliximab (IFX induction. Predictive variables for intensification were analyzed using a Cox regression analysis. Outcome, loss of response to IFX, and colectomy were compared between intensified and non-intensified therapy. Results: Follow-up time from induction to data collection: 38 months [interquartile range (IQR, 20-62]. Time on IFX therapy: 24 months (IQR, 10-44. In all, 37% of patients required intensification. Interval was shortened for 36 patients, dose was increased for 7, and 10 subjects received both. Concurrent thiopurine immunosuppressants (IMM and IFX initiation was an independent predictor of intensification [Hazard ratio, 0.034; p, 0.006; CI, 0.003-0.371]. In patients on intensified therapy IFX discontinuation for loss of response (30.4% vs. 10.2%; p, 0.002, steroid reintroduction (35% vs. 18%; p, 0.018, and colectomy (22% vs. 6.4%; p, 0.011 were more common. Of patients on intensification, 17% returned to receiving 5 mg/kg every 8 weeks. Conclusions: Intensification is common and occasionally reversible. IMM initiation at the time of induction with IFX predicts non-intensification. Intensification, while effective, is associated with poorer outcome.

  9. Ulcerative colitis in smokers, non-smokers and ex-smokers

    Guillermo Bastida; Belén Beltrán

    2011-01-01

    Smoking is a major environmental factor that interferes in the establishment and clinical course of ulcerative colitis (UC). Firstly, the risk of smoking status impact in the development of UC is reviewed, showing that current smoking has a protective association with UC.Similarly, being a former smoker is associated with an increased risk of UC. The concept that smoking could have a role in determining the inflammatory bowel disease phenotype is also discussed. Gender may also be considered, as current smoking delays disease onset in men but not in women. No clear conclusions can be driven from the studies trying to clarify whether childhood passive smoking or prenatal smoke exposure have an influence on the development of UC, mainly due to methodology flaws. The influence of smoking on disease course is the second aspect analysed. Some studies show a disease course more benign in smokers that in non-smokers, with lower hospitalizations rates, less flare-ups, lower use of oral steroids and even less risk of proximal extension. This is not verified by some other studies. Similarly, the rate of colectomy does not seem to be determined by the smoking status of the patient.The third issue reviewed is the use of nicotine as a therapeutic agent. The place of nicotine in the treatment of UC is unclear, although it could be useful in selected cases, particularly in recent ex-smokers with moderate but refractory attacks of UC. Finally, the effect of smoking cessation in UC patients is summarised. Given that smoking represents a major worldwide cause of death,for inpatients with UC the risks of smoking far outweigh any possible benefit. Thus, physicians should advise,encourage and assist UC patients who smoke to quit.

  10. Bacterial bile metabolising gene abundance in Crohn's, ulcerative colitis and type 2 diabetes metagenomes.

    Alain Labbé

    Full Text Available We performed an analysis to determine the importance of bile acid modification genes in the gut microbiome of inflammatory bowel disease and type 2 diabetic patients. We used publicly available metagenomic datasets from the Human Microbiome Project and the MetaHIT consortium, and determined the abundance of bile salt hydrolase gene (bsh, 7 alpha-dehydroxylase gene (adh and 7-alpha hydroxysteroid dehydrogenase gene (hsdh in fecal bacteria in diseased populations of Crohn's disease (CD, Ulcerative Colitis (UC and Type 2 diabetes mellitus (T2DM. Phylum level abundance analysis showed a significant reduction in Firmicute-derived bsh in UC and T2DM patients but not in CD patients, relative to healthy controls. Reduction of adh and hsdh genes was also seen in UC and T2DM patients, while an increase was observed in the CD population as compared to healthy controls. A further analysis of the bsh genes showed significant differences in the correlations of certain Firmicutes families with disease or healthy populations. From this observation we proceeded to analyse BSH protein sequences and identified BSH proteins clusters representing the most abundant strains in our analysis of Firmicute bsh genes. The abundance of the bsh genes corresponding to one of these protein clusters was significantly reduced in all disease states relative to healthy controls. This cluster includes bsh genes derived from Lachospiraceae, Clostridiaceae, Erysipelotrichaceae and Ruminococcaceae families. This metagenomic analysis provides evidence of the importance of bile acid modifying enzymes in health and disease. It further highlights the importance of identifying gene and protein clusters, as the same gene may be associated with health or disease, depending on the strains expressing the enzyme, and differences in the enzymes themselves.

  11. A Genome-Wide Methylation Approach Identifies a New Hypermethylated Gene Panel in Ulcerative Colitis

    Kang, Keunsoo; Bae, Jin-Han; Han, Kyudong; Kim, Eun Soo; Kim, Tae-Oh; Yi, Joo Mi

    2016-01-01

    The cause of inflammatory bowel disease (IBD) is still unknown, but there is growing evidence that environmental factors such as epigenetic changes can contribute to the disease etiology. The aim of this study was to identify newly hypermethylated genes in ulcerative colitis (UC) using a genome-wide DNA methylation approach. Using an Infinium HumanMethylation450 BeadChip array, we screened the DNA methylation changes in three normal colon controls and eight UC patients. Using these methylation profiles, 48 probes associated with CpG promoter methylation showed differential hypermethylation between UC patients and normal controls. Technical validations for methylation analyses in a larger series of UC patients (n = 79) were performed by methylation-specific PCR (MSP) and bisulfite sequencing analysis. We finally found that three genes (FAM217B, KIAA1614 and RIBC2) that were significantly elevating the promoter methylation levels in UC compared to normal controls. Interestingly, we confirmed that three genes were transcriptionally silenced in UC patient samples by qRT-PCR, suggesting that their silencing is correlated with the promoter hypermethylation. Pathway analyses were performed using GO and KEGG databases with differentially hypermethylated genes in UC. Our results highlight that aberrant hypermethylation was identified in UC patients which can be a potential biomarker for detecting UC. Moreover, pathway-enriched hypermethylated genes are possibly implicating important cellular function in the pathogenesis of UC. Overall, this study describes a newly hypermethylated gene panel in UC patients and provides new clinical information that can be used for the diagnosis and therapeutic treatment of IBD. PMID:27517910

  12. Selective Allosteric Inhibition of MMP9 Is Efficacious in Preclinical Models of Ulcerative Colitis and Colorectal Cancer.

    Derek C Marshall

    Full Text Available Expression of matrix metalloproteinase 9 (MMP9 is elevated in a variety of inflammatory and oncology indications, including ulcerative colitis and colorectal cancer. MMP9 is a downstream effector and an upstream mediator of pathways involved in growth and inflammation, and has long been viewed as a promising therapeutic target. However, previous efforts to target matrix metalloproteinases (MMPs, including MMP9, have utilized broad-spectrum or semi-selective inhibitors. While some of these drugs showed signs of efficacy in patients, all MMP-targeted inhibitors have been hampered by dose-limiting toxicity or insufficient clinical benefit, likely due to their lack of specificity. Here, we show that selective inhibition of MMP9 did not induce musculoskeletal syndrome (a characteristic toxicity of pan-MMP inhibitors in a rat model, but did reduce disease severity in a dextran sodium sulfate-induced mouse model of ulcerative colitis. We also found that MMP9 inhibition decreased tumor growth and metastases incidence in a surgical orthotopic xenograft model of colorectal carcinoma, and that inhibition of either tumor- or stroma-derived MMP9 was sufficient to reduce primary tumor growth. Collectively, these data suggest that selective MMP9 inhibition is a promising therapeutic strategy for treatment of inflammatory and oncology indications in which MMP9 is upregulated and is associated with disease pathology, such as ulcerative colitis and colorectal cancer. In addition, we report the development of a potent and highly selective allosteric MMP9 inhibitor, the humanized monoclonal antibody GS-5745, which can be used to evaluate the therapeutic potential of MMP9 inhibition in patients.

  13. Therapeutic infliximab drug level in a child born to a woman with ulcerative colitis treated until gestation week 31

    Steenholdt, Casper; Al-Khalaf, Magid; Ainsworth, Mark A;

    2012-01-01

    A 26 year old woman with ulcerative colitis was treated with regular infliximab (IFX) infusions until gestation week 31, and gave birth to a healthy child at gestation week 37. Maternal IFX trough level was relatively high during the course of pregnancy. In the infant, therapeutic level of IFX was...... detectable at week 16 after birth, but not at reassessment at week 28. Anti-IFX antibodies were consistently below the detection limit in the patient and in the child. This case illustrates that IFX is transferred through the placenta to the embryo, and may result in therapeutic drug levels in the newborn...

  14. Induction of experimental acute ulcerative colitis in rats by administration of dextran sulfate sodium at low concentration followed by intracolonic administration of 30% ethanol

    2007-01-01

    Several models of experimental ulcerative colitis have been reported previously. However, none of these models showed the optimum characteristics. Although dextran sulfate sodium-induced colitis results in inflammation resembling ulcerative colitis, an obvious obstacle is that dextran sulfate sodium is very expensive. The aim of this study was to develop an inexpensive model of colitis in rats. Sprague-Dawley rats were treated with 2% dextran sulfate sodium in drinking water for 3 d followed by an intracolonic administration of 30% ethanol. The administration of 2% dextran sulfate sodium followed by 30% ethanol induced significant weight loss, diarrhea and hematochezia in rats. Severe ulceration and inflammation of the distal part of rat colon were developed rapidly. Histological examination showed increased infiltration of polymorphonuclear leukocytes,lymphocytes and existence of cryptic abscesses and dysplasia. The model induced by dextran sulfate sodium at lower concentration followed by 30% ethanol is characterized by a clinical course, localization of the lesions and histopathological features similar to human ulcerative colitis and fulfills the criteria set out at the beginning of this study.

  15. ANTIBODIES TO THE CYTOPLASM OF NEUTROPHILS: A MARKER OF UNFAVORABLE CLINICAL COURSE IN NON-SPECIFIC ULCERATIVE COLITIS

    A. G. Kharitonov

    2010-01-01

    Full Text Available Antibodies to the cytoplasm of neutrophils (p-ANCA are detectable in 67% of patients with ulcerative colitis (UC. We have revealed typical clinical features of the patients with diagnostic p-ANCA titer, i.e., longer disease duration, prolonged fevers, and increased stool frequency. Moreover, thrombocytosis, leukocytosis and hypoalbuminemia are more common in this group. By endoscopic examination, mucosal ulcers of the colon are significantly more frequent in this group of patients. We have also noted higher rates of severe and relapsing cases among p-ANCA-positive patients. The data obtained allow us to suggest that the diagnostic titers of p-ANCA are predictive for unfavorable prognosis in UC.

  16. A RETROSPECTIVE EVALUATION OF PATIENTS WITH NON ALARMING LOWER GASTROINTESTINAL SYMPTOMS AND COLONOSCOPIC FINDINGS OF ILEAL OR COLONIC ULCERATIONS AND HISTOPATHOLOGICAL EVIDENCE OF NONSPECIFIC COLITIS

    Jeffey

    2016-05-01

    Full Text Available BACKGROUND The clinical course and treatment modalities for patients with non alarming lower gastrointestinal symptoms and colonoscopic findings of isolated or random ileal or colonic ulcerations which are histologically proven to be non-specific inflammation, are unknown. OBJECTIVE To evaluate the clinical course and significance of non-specific colonic inflammation in patients presenting with lower gastrointestinal symptoms of hypogastric or iliac fossa pain and altered bowel habits. DESIGN Single Centre Retrospective Analysis. SETTING Tertiary Care Referral Hospital. PATIENTS AND INTERVENTIONS All patients presenting with lower GI symptoms and who had colonoscopic evidence of isolated or random ileal or colonic ulcerations with histopathologic evidence of mild or active inflammation analysed by a single pathologist between January 2012– December 2012 were followed up either as outpatient visit or by telephonic interview. Patients with alarm symptoms, red flags, age more than 60 years and other co morbid illness were excluded. MAIN OUTCOME MEASUREMENTS The clinical courses of these patients were followed up for a mean period of 39 months. RESULTS Of the 31 patients who were included, 6 were lost to follow up. 19 patients were off medications and asymptomatic during the follow up. 2 patients were asymptomatic with mesalamine tablets and another asymptomatic patient had resorted to homeopathic medication. Of the two patients who were on mesalamine, one had endoscopic evidence of linear ulcerations in rectum and the second patient had peri appendiceal inflammation on colonoscopy, both of whom had mild or focal colitis histologically. 3 patients were symptomatic during the follow up but only on symptomatic medications on and off, of which one of them had aphthous ulcerations throughout the entire colon and the other had histologically active chronic ileitis. LIMITATIONS Retrospective data and a relatively short follow up and small patient number

  17. Dramatic Changes of Matrix Metalloproteinases-7 and Lysozyme in the Ulcerative Colitis of Mice Induced by Dextran Sulfate Sodium

    KANG Jing-jing; YANG Yu-rong; LIANG Hong-de; ZHAO De-ming; TENG Ke-dao; JIAO Xi-lan; WANG Ping-li; SUN Zhe; NI Pei-pei; WANG Zhi-feng; ZHANG Rui

    2014-01-01

    Ulcerative colitis (UC) is a lifelong illness with profound emotional and social impacts, and could cause serious damage to large intestine, especially in colon. However, the pathogenesis of UC remained unclear. The present study attempts to ifnd out the role of matrix metalloproteinases-7 (MMP-7) and lysozyme in the pathogenesis of UC through a mice model induced by dextran sulfate sodium (DSS). The UC model was evaluated both by disease activity index (DAI) and the intestinal histopathology. The results show that there is a high correlation between the DAI score and the pathological changes of colon. Interleukin-6 (IL-6) serum levels and large intestinal lfuids levels in UC mice are always higher than that of the control groups, which might be associated with the degree of the inlfammation damage in the colon. The change tendency of the MMP-7 mRNA and protein expressions are both up-regulated ifrstly and then down-regulated from 1 to 5 d in the colon, but only the MMP-7 protein is up-regulated at 7 d again. The up-regulated MMP-7 levels in the early stage of UC may play a protective role through the activated defensins, while the down-regulated levels in the mid-later stage of UC may be connected with the severe lesions in the colon. However, the up-regulated MMP-7 levels in the later stage of UC in the colon may also contribute to the tissue repair or be served as a marker to CRC (colorectal cancer). The distribution of lysozyme protein indicates that there may be Paneth-like cells in the colon. Both the changes of MMP-7 and lysozyme in the small intestine may play a protective role for the safe environment of the whole gut, especially to the colon of UC.

  18. Fecal Microbial Composition of Ulcerative Colitis and Crohn’s Disease Patients in Remission and Subsequent Exacerbation

    Wills, Edgar S.; Jonkers, Daisy M. A. E.; Savelkoul, Paul H.; Masclee, Ad A.; Pierik, Marieke J.; Penders, John

    2014-01-01

    Background Limited studies have examined the intestinal microbiota composition in relation to changes in disease course of IBD over time. We aimed to study prospectively the fecal microbiota in IBD patients developing an exacerbation during follow-up. Design Fecal samples from 10 Crohn’s disease (CD) and 9 ulcerative colitis (UC) patients during remission and subsequent exacerbation were included. Active disease was determined by colonoscopy and/or fecal calprotectine levels. Exclusion criteria were pregnancy, antibiotic use, enema use and/or medication changes between consecutive samples. The microbial composition was assessed by 16S rDNA pyrosequencing. Results After quality control, 6,194–11,030 sequences per sample were available for analysis. Patient-specific shifts in bacterial composition and diversity were observed during exacerbation compared to remission, but overarching shifts within UC or CD were not observed. Changes in the bacterial community composition between remission and exacerbation as assessed by Bray-Curtis dissimilarity, were significantly larger in CD versus UC patients (0.59 vs. 0.42, respectively; p = 0.025). Thiopurine use was found to be a significant cause of clustering as shown by Principal Coordinate Analysis and was associated with decreases in bacterial richness (Choa1 501.2 vs. 847.6 in non-users; p<0.001) and diversity (Shannon index: 5.13 vs. 6.78, respectively; p<0.01). Conclusion Shifts in microbial composition in IBD patients with changing disease activity over time seem to be patient-specific, and are more pronounced in CD than in UC patients. Furthermore, thiopurine use was found to be associated with the microbial composition and diversity, and should be considered when studying the intestinal microbiota in relation to disease course. PMID:24608638

  19. Anti-inflammatory effects of methanolic extract of green algae Caulerpa mexicana in a murine model of ulcerative colitis

    Mariana A.O. Bitencourt

    2015-12-01

    Full Text Available Abstract Inflammatory bowel diseases, which include Crohn's disease and ulcerative colitis, are characterized by chronic and relapsed gut inflammation. Caulerpa mexicana is a type of green marine algae that can be found in tropical areas, such as the Brazilian Coastland. These macrophytes exhibit in vitro and in vivo anti-inflammatory properties such as the ability to reduce both cell migration to different sites and edema formation induced by chemical irritants. The aim of this study was to examine the effect of the C. mexicana methanolic extract on the treatment of colitis induced by dextran sodium sulfate. Acute experimental colitis was induced in BALB/c mice by treatment with 3% dextran sodium sulfate orally for 14 days. During this 14-day period, C. mexicana methanolic extract (2 mg/kg/day was given intravenously on alternate days. Treatment with the methanolic extract significantly attenuated body weight loss and severe clinical symptoms. This was associated with a remarkable amelioration of colonic architecture disruption and a significant reduction in pro-inflammatory cytokine production. These results suggest that the anti-inflammatory action of C. mexicana methanolic extract on colorectal sites may be a useful therapeutic approach for inflammatory bowel diseases.

  20. Is there a role for vedolizumab in the treatment of ulcerative colitis and Crohn’s disease?

    Gilroy L

    2014-05-01

    Full Text Available Leah Gilroy, Patrick B Allen Department of Gastroenterology, Ulster Hospital, Dundonald, Belfast, Northern Ireland Abstract: Inflammatory bowel disease (IBD is an important cause of morbidity and mortality for millions of patients worldwide. Current treatment options include corticosteroids, 5-aminosalicylates, immunosuppressants, and TNFα antagonists. However, these are frequently ineffective in achieving sustained response and remission over time. At present, gastroenterologists lack safe and effective treatments if patients fail anti-TNF therapy. Vedolizumab is a promising new agent for IBD patients refractory to anti-TNF therapy. Vedolizumab is an integrin antagonist which is thought to act by reducing inflammation by selectively inhibiting leukocyte migration in the gut. Emerging evidence from clinical trials suggests a potential role for vedolizumab in both ulcerative colitis (UC and Crohn’s disease (CD, particularly in patients who have previously failed biological therapy. The safety profile of vedolizumab appears reasonable, possibly because it has a “gut-selective” mode of action, with no reported cases of progressive multifocal leukoencephalopathy, a condition which has been linked to another integrin antagonist, natalizumab. This review discusses the available evidence for integrin antagonists and their potential role in the management of IBD. Keywords: vedolizumab, ulcerative colitis, Crohn’s disease, inflammatory bowel disease

  1. Generation of MHC class I-restricted cytotoxic T cell lines and clones against colonic epithelial cells from ulcerative colitis.

    Yonamine, Y; Watanabe, M; Kinjo, F; Hibi, T

    1999-01-01

    We established CTL lines and clones against colonic epithelial cells from PBLs of patients with ulcerative colitis by continuous stimulation with HLA-A locus-matched colonic epithelial cell lines. We developed a nonradioactive europium release cytotoxicity assay to detect CTLs. PBLs from 3 of 12 patients but not from any of 14 normal controls who shared at least one haplotype of HLA-A locus with two colonic epithelial cell lines, CW2 and ACM, showed increased cytotoxicity against these lines. Three CTL lines established from the PBLs of patients showed increased cytotoxicity against HLA-A locus-matched CW2 or ACM but not against matched lung or esophagus cell lines. The phenotypes of CTL lines were alpha beta-TCR+ CD3+ CD8+ CD16-. The CTL line MS showed increased cytotoxicity against freshly isolated colonic epithelial cells but not against cells with a different HLA-A locus. Two CTL clones were generated from MS and clone 3-2, expressing CD3+ CD8+ CD4- CD56-, showed high MHC class I-restricted cytotoxicity against the colonic epithelial cells. These results indicated that CTLs against colonic epithelial cells may contribute to epithelial cell damage in ulcerative colitis. PMID:10080107

  2. Update on the role of modified release mesalamine in the management of ulcerative colitis and Crohn’s disease

    Glen A Doherty

    2009-12-01

    Full Text Available Glen A Doherty, Mark A PeppercornCenter for Inflammatory Bowel Disease, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston MA, USAAbstract: 5-aminosalicyclates (5-ASA remain a key first-line therapy for patients with ulcerative colitis (UC. A range of 5-ASA preparations is available and Eudragit-S® coated modified release formulations of mesalamine, such as Asacol®, remain among the most popular choices. We here review the current understanding of the mechanism of action of 5-ASA in inflammatory bowel disease. We evaluate evidence supporting the efficacy and safety of modified release mesalamine for both induction and remission maintenance in UC, including a review of the data from the recent ASCEND studies. We also examine the controversial issue of the role of mesalamine in treatment of Crohn’s disease (CD and highlight data supporting its use following surgically induced remission of CD. Evidence supporting the use of mesalamine as prophylaxis for colorectal cancer and dysplasia will be considered. Finally, recent developments in our understanding of how to use modified release mesalamine in a safe and cost-effective manner are evaluated, including discussion of the importance of studying patient non-adherence as a key component of future studies in this area.Keywords: mesalamine (mesalazine, 5-aminosalicyclate, ulcerative colitis, Crohn’s disease, modified release

  3. The GRADE approach for assessing new technologies as applied to apheresis devices in ulcerative colitis

    Cabriada-Nuño Jose

    2010-06-01

    Full Text Available Abstract Background In the last few years, a new non-pharmacological treatment, termed apheresis, has been developed to lessen the burden of ulcerative colitis (UC. Several methods can be used to establish treatment recommendations, but over the last decade an informal collaboration group of guideline developers, methodologists, and clinicians has developed a more sensible and transparent approach known as the Grading of Recommendations, Assessment, Development and Evaluation (GRADE. GRADE has mainly been used in clinical practice guidelines and systematic reviews. The aim of the present study is to describe the use of this approach in the development of recommendations for a new health technology, and to analyse the strengths, weaknesses, opportunities, and threats found when doing so. Methods A systematic review of the use of apheresis for UC treatment was performed in June 2004 and updated in May 2008. Two related clinical questions were selected, the outcomes of interest defined, and the quality of the evidence assessed. Finally, the overall quality of each question was taken into account to formulate recommendations following the GRADE approach. To evaluate this experience, a SWOT (strengths, weaknesses, opportunities and threats analysis was performed to enable a comparison with our previous experience with the SIGN (Scottish Intercollegiate Guidelines Network method. Results Application of the GRADE approach allowed recommendations to be formulated and the method to be clarified and made more explicit and transparent. Two weak recommendations were proposed to answer to the formulated questions. Some challenges, such as the limited number of studies found for the new technology and the difficulties encountered when searching for the results for the selected outcomes, none of which are specific to GRADE, were identified. GRADE was considered to be a more time-consuming method, although it has the advantage of taking into account patient

  4. Perception gaps between patients with ulcerative colitis and healthcare professionals: an online survey

    Schreiber Stefan

    2012-08-01

    Full Text Available Abstract Background The purpose of this study was to examine the differing perspectives and perceptual gaps relating to ulcerative colitis (UC symptoms and their management between patients and healthcare professionals (HCPs. Methods Structured, cross-sectional, Web-based questionnaires designed to assess a variety of disease indices were completed by adult patients with UC and HCPs involved in the care of patients with UC from Canada, France, Germany, Ireland, Spain, and the United Kingdom. Results Surveys were completed by 775 patients, 475 physicians, and 50 nurses. Patient self-reported classification of disease severity revealed generally greater severity (mild, 32%; moderate, 53% compared with physician and nurse estimates of UC severity among their caseloads (mild, 52% and 49%; moderate, 34% and 37%, respectively. Patients reported that an average of 5.5 (standard deviation, 11.0 flares (self-defined occurred over the past year, compared with 3.4 and 3.8 flares per year estimated by physicians and nurses. Perceived flare triggers differed between patients (stress ranked first and HCPs (natural disease course ranked first. Fifty-five percent of patients stated that UC symptoms over the past year had affected their quality of life, while physicians and nurses estimated that 35% to 37% of patients would have a reduced quality of life over the same period. Patients ranked urgency and pain as the most bothersome symptoms, while physicians and nurses ranked urgency and stool frequency highest. About half of patients (47% defined remission as experiencing no symptoms; by comparison, 62% to 63% of HCPs defined remission as requiring the complete absence of symptoms. HCPs (doctors/nurses in general practice and/or hospital were regarded by patients as their main source of UC information by 72%; however, 59% reported not arranging regular visits to see their HCPs. Conclusions This large survey identified important differences between patients' and

  5. Complete resolution of non‐necrotizing lung granuloma and pyoderma gangrenosum after restorative proctocolectomy in a woman with severe ulcerative colitis and cytomegalovirus infection

    Sartini, Alessandro; Bianchini, Marcello; Schepis, Filippo; Marzi, Luca; De Maria, Nicola; Villa, Erica

    2016-01-01

    Key Clinical Message Here, we report the unusual case of an ulcerative colitis female patient presenting together with cytomegalovirus infection, pyoderma gangrenosum and a noncaseating lung granuloma, both resistant to immunomodulatory drugs which dramatically obtained a clinical stable remission after restorative proctocolectomy.

  6. Complete resolution of non-necrotizing lung granuloma and pyoderma gangrenosum after restorative proctocolectomy in a woman with severe ulcerative colitis and cytomegalovirus infection.

    Sartini, Alessandro; Bianchini, Marcello; Schepis, Filippo; Marzi, Luca; De Maria, Nicola; Villa, Erica

    2016-02-01

    Here, we report the unusual case of an ulcerative colitis female patient presenting together with cytomegalovirus infection, pyoderma gangrenosum and a noncaseating lung granuloma, both resistant to immunomodulatory drugs which dramatically obtained a clinical stable remission after restorative proctocolectomy. PMID:26862424

  7. Serial Fecal Calprotectin and Lactoferrin Measurements for Early Diagnosis of Pouchitis After Proctocolectomy for Ulcerative Colitis: Is Pouchoscopy No Longer Needed?

    Schoepfer, Alain; Reinisch, Walter

    2015-06-01

    This editorial discusses the role of serial measurements of fecal calprotectin or fecal lactoferrin for the early detection of pouchitis in patients with ulcerative colitis having undergone procto-colectomy with ileo-pouch-anal anastomosis. Furthermore, the role of fecal calprotectin and fecal lactoferrin for the monitoring of pouchitis is highlighted. PMID:26052770

  8. Genetic analysis of innate immunity in Crohn's disease and ulcerative colitis identifies two susceptibility loci harboring CARD9 and IL18RAP

    Zhernakova, Alexandra; Festen, Eleanora M; Franke, Lude; Trynka, Gosia; van Diemen, Cleo C; Monsuur, Alienke J; Bevova, Marianna; Nijmeijer, Rian M; van 't Slot, Ruben; Heijmans, Roel; Boezen, Hendrika; van Heel, David A; van Bodegraven, Adriaan A; Stokkers, Pieter C F; Wijmenga, Cisca; Crusius, J Bart A; Weersma, Rinse K

    2008-01-01

    The two main phenotypes of inflammatory bowel disease (IBD)--Crohn's disease (CD) and ulcerative colitis (UC)--are chronic intestinal inflammatory disorders with a complex genetic background. Using a three-stage design, we performed a functional candidate-gene analysis of innate immune pathway in IB

  9. Deep resequencing of GWAS loci identifies rare variants in CARD9, IL23R and RNF186 that are associated with ulcerative colitis

    Beaudoin, M.; Goyette, P.; Boucher, G.; Lo, K.S.; Rivas, M.A.; Stevens, C.; Alikashani, A.; Ladouceur, M.; Ellinghaus, D.; Torkvist, L.; Goel, G.; Lagace, C.; Annese, V.; Bitton, A.; Begun, J.; Brant, S.R.; Bresso, F.; Cho, J.H.; Duerr, R.H.; Halfvarson, J.; McGovern, D.P.; Radford-Smith, G.; Schreiber, S.; Schumm, P.L.; Sharma, Y.; Silverberg, M.S.; Weersma, R.K.; Quebec, I.B.D.G.C.; Consortium, N.I.G.; International, I.B.D.G.C.; D'Amato, M.; Vermeire, S.; Franke, A.; Lettre, G.; Xavier, R.J.; Daly, M.J.; Rioux, J.D.; Jong, D.J. de

    2013-01-01

    Genome-wide association studies and follow-up meta-analyses in Crohn's disease (CD) and ulcerative colitis (UC) have recently identified 163 disease-associated loci that meet genome-wide significance for these two inflammatory bowel diseases (IBD). These discoveries have already had a tremendous imp

  10. Deep Resequencing of GWAS Loci Identifies Rare Variants in CARD9, IL23R and RNF186 That Are Associated with Ulcerative Colitis

    Beaudoin, Melissa; Goyette, Philippe; Boucher, Gabrielle; Lo, Ken Sin; Rivas, Manuel A.; Stevens, Christine; Alikashani, Azadeh; Ladouceur, Martin; Ellinghaus, David; Torkvist, Leif; Goel, Gautam; Lagace, Caroline; Annese, Vito; Bitton, Alain; Begun, Jakob; Brant, Steve R.; Bresso, Francesca; Cho, Judy H.; Duerr, Richard H.; Halfvarson, Jonas; McGovern, Dermot P. B.; Radford-Smith, Graham; Schreiber, Stefan; Schumm, Philip L.; Sharma, Yashoda; Silverberg, Mark S.; Weersma, Rinse K.; D'Amato, Mauro; Vermeire, Severine; Franke, Andre; Lettre, Guillaume; Xavier, Ramnik J.; Daly, Mark J.; Rioux, John D.

    2013-01-01

    Genome-wide association studies and follow-up meta-analyses in Crohn's disease (CD) and ulcerative colitis (UC) have recently identified 163 disease-associated loci that meet genome-wide significance for these two inflammatory bowel diseases (IBD). These discoveries have already had a tremendous imp

  11. Onset of Ulcerative Colitis during a Low-Carbohydrate Weight-Loss Diet and Treatment with a Plant-Based Diet: A Case Report.

    Chiba, Mitsuro; Tsuda, Satoko; Komatsu, Masafumi; Tozawa, Haruhiko; Takayama, Yuko

    2016-01-01

    Overweight and obesity are global health concerns. Various effective weight-loss diets have been developed, including the Atkins diet. The Atkins diet is known as an extreme low-carbohydrate diet. This diet reduces body weight and has gained widespread popularity. However, the metabolite profiles of such a diet have been shown to be detrimental to colonic health. Therefore, a concern for the long-term health effects of this diet exists. We encountered a case in which ulcerative colitis developed while the patient was following the Atkins diet.A man, 172 cm in height and weighing 72 kg, at age 36 years followed a low-carbohydrate weight-loss diet. His weight decreased to 66 kg as desired. Thereafter he noticed bloody stool. Colonoscopy revealed diffuse inflammation limited to the rectum, and he was diagnosed with ulcerative colitis. He underwent an educational hospitalization for ulcerative colitis. A plant-based/semivegetarian diet was provided during hospitalization. Bloody stool disappeared during hospitalization and he achieved remission without medication for inflammatory bowel disease.This case indicates that an onset of ulcerative colitis can be an adverse event to a low-carbohydrate weight-loss diet. PMID:26824967

  12. Electroacupuntura en el tratamiento de la colitis ulcerosa experimental en ratas Sprague Dawley - Electro acupuncture in the treatment of experimental ulcerous colitis in Sprague Dawley rats

    Molina Martínez, José L.

    2010-08-01

    Full Text Available ResumenSe realizó un estudio sobre la efectividad terapéutica de la electroacupuntura (EA en la colitis ulcerosa (CU provocada experimentalmente en ratas Sprague Dawley por administración intracolónica de una disolución de ácido acético al 4%. El experimento se realizó en 57 ratas distribuidas en tres grupos: Grupo I (control placebo, al que se administró solución salina fisiológica mediante instilación intracolónica, Grupo II (control no tratado y Grupo III (estudio, integrado ambos por animales en que se reprodujo artificialmente la colitis ulcerosa. El estudio histopatológico de muestras tomadas mediante biopsias permitió corroborar la instauración de la entidad. Los acupuntos seleccionados fueronLI-4 (Hegu y ST-36 (Zusanli y la aplicación de la EA se realizó a las 24, 48 y 72 horas posteriores a la reproducción experimental de la CU. En las condiciones del estudio se comprobó que una sesión de EA a las 24 horas posteriores a la reproducción de la entidad, posee efecto anti inflamatorio y mejora notablemente la lesión tisular, no siendo eficaz en los tratamientos realizados a las 48 y 72 horas, influyendo en ello el mecanismo de transducción. Mediante el estudio histopatológico de muestras tomadas mediante biopsias se puede evaluar el estado de la mucosa en la CU y su respuesta al tratamiento mediante EA, sin necesidad de acudir a otros procedimientos más sofisticados y costosos. Se comprobó que el modelo experimental utilizado es adecuado para estudios sobre esta afección.SummaryA study was carried out on the therapeutic effectiveness ofelectroacupuncture (EA in the ulcerous colitis (UC experimentally provoked in Sprague Dawley rats by intracolonic administration of a 4 % acetic acid dissolution. The experiment was realized in 57 rats distributed in three groups: Group I (placebo control, to which physiological saline solution was administered by intracolonic instillation, Group II (not treated control and Group

  13. EVALUATION OF ANTI ULCER ACTIVITY OF AEGLE MARMELOS LEAVES EXTRACT

    Ashoka M. Shenoy*, Rajnikant Singh, Rajan Moses Samuel, R. Yedle and A.R. Shabraya

    2012-01-01

    The objective of present study is to evaluate the anti ulcer activity of methanolic extract of leaves of Aegle marmelos. The cause of ulceration in patients is mainly due to hypersecretion of gastric juice and pepsin. In traditional system of medicine a number of herbal preparations have been used for the treatment of peptic ulcers. The anti-ulcer activity of methanolic extract of Aegle marmelos leaves was investigated by aspirin plus pylorus ligation induced gastric ulcer in rats, Indometh...

  14. Autoimmune Hemolytic Anemia Triggered by Infection with Human Parvovirus B19 after Total Abdominal Colectomy for Ulcerative Colitis.

    Iida, Tomoya; Satoh, Shuji; Nakagaki, Suguru; Shimizu, Haruo; Kaneto, Hiroyuki

    2016-01-01

    A 50-year-old man was admitted to our hospital for an adhesive ileus 14 years after total abdominal colectomy for ulcerative colitis (UC). The ileus decreased with conservative treatment, however, autoimmune hemolytic anemia (AIHA) was diagnosed due to worsening anemia, a positive direct Coombs test, low haptoglobin, high lactase dehydrogenase, reticulocytosis, and an increase in the erythroblastic series in a bone-marrow examination. Human parvovirus B19 (PV-B19) IgM and PV-B19 DNA were present, indicating the development of AIHA triggered by an infection with PV-B19. The patient is currently being monitored after spontaneous remission. This is the first report of UC after total abdominal colectomy complicated by AIHA triggered by PV-B19 infection. PMID:26984090

  15. Unravelling the ultrastructure of ascending colon fluids from patients with ulcerative colitis by cryogenic transmission electron microscopy

    Müllertz, Anette; Fatouros, Dimitrios G; Vertzoni, Maria; Reppas, Christos

    2013-01-01

    level, samples from the lumen of ascending colon were collected from patients with ulcerative colitis in remission. METHODS: After ultracentrifugation, the supernatants of two samples (one with high and one with low cholesterol level) were visualized by means of cryogenic transmission electron...... microscopy. KEY FINDINGS: In the supernatants with high cholesterol content, micellar-like structures, bilayer fragments, open vesicles, and uni-, bi- and trilamellar vesicles were abundant. In addition, crystals of cholesterol were frequently observed. In contrast, in the sample with low cholesterol content......, oily solids, plates of cholesterol monohydrate and elongated structures were present. Few unilamellar vesicles were occasionally visualized. CONCLUSIONS: The current study gives direct evidence, for the first time, of the existence of 'remnants' of lipolytic products in the fasted ascending colon. The...

  16. Perinuclear anti-neutrophil cytoplasmic antibodies (p-anca) in chronic ulcerative colitis: Experience in a Mexican institution

    Jesus K Yamamoto-Furusho; Takeshi Takahashi-Monroy; Omar Vergara-Fernandez; Edgardo Reyes; Luis Uscanga

    2006-01-01

    AIM: To assess the prevalence and clinical value of p-ANCA in a sample of Mexican ulcerative colitis (UC) patients.METHODS: In a prospective, IRB-approved protocol,p-ANCA was determined in 80 patients with UC (mean age, 32 ± 12.9 years). The severity and extension of disease were determined by clinical methods, searching a statistical association with p-ANCA status.RESULTS: p-ANCA were detected in 41 (51%) patients.Severity of disease was the only clinical variable statistically associated with their presence (P < 0.0001; OR = 9;CI 95% = 3.2-24.7).CONCLUSION: The prevalence of p-ANCA was similar to that reported in other countries. Their presence was associated to UC severity, but offered no more information than the obtained by clinical methods.

  17. Pyoderma Gangrenosum with Ulcerative Colitis Successfully Treated by the Combination of Granulocyte and Monocyte Adsorption Apheresis and Corticosteroids.

    Ohno, Masashi; Koyama, Shigeki; Ohara, Mariko; Shimamoto, Kazumi; Kobayashi, Yu; Nakamura, Fumiyasu; Mitsuru, Kazuki; Andoh, Akira

    2016-01-01

    A 36-year-old woman was admitted to our hospital due to swelling and redness of the left lateral malleolus and dorsum of the left foot with severe pain, with a flare-up of ulcerative colitis (UC). A pathologic examination by skin biopsy led to a diagnosis of pyoderma gangrenosum (PG). She was treated with the intravenous administration of prednisolone (60 mg/day), and granulocyte and monocyte adsorption apheresis (GMA) was performed twice-a-week for 5 weeks. This treatment dramatically improved both the skin and colonic mucosal lesions. These results suggest that a combination of GMA and corticosteroids might be recommendable to induce the remission of serious PG complicated with UC. PMID:26726081

  18. [A Case of Peristomal Cutaneous Ulcer Following Amebic Colitis Caused by Entamoeba histolytica].

    Sasaki, Yu; Yoshida, Tetsuya; Suzuki, Jun; Kobayashi, Seiki; Sato, Tomotaka

    2016-01-01

    A 66-year-old Japanese male with a history of a rectal ulcer and rectovesical fistula following brachytherapy and radiotherapy for prostate cancer, who had undergone colostomy and vesicotomy presented with a painful peristomal ulcer of approximately 5 x 2.5cm adjacent to the direction of 6 o'clock of the stoma in his left lower abdomen. Although he was admitted to be treated with intravenous antibiotics and topical debridement, the ulcer was rapidly increasing. In the laboratory findings, WBC was 12,400/μL, CRP was 16.9 mg/dL, ESR was 105mm in the first hour. Contrast enhanced CT images showed a wide high density area of skin and subcutaneous tissue around the stoma and dillitation of the transverse and descending colon. Colonoscopy showed furred profound ulcers in the rectum. A biopsy from the ulcer floor submitted to histopathology showed necrotic tissue with a mixed inflammatory infiltrates mainly composed of neutrophils and lymphocytes in the dermis. We suspected pyoderma gangrenosum with an inflammatory bowel disease in the beginning. Although he was started on oral prednisolone 60 mg daily, the ulcer did not respond to treatment. Additional methylprednisolone pulse therapy, intravenous cyclosporine and granulocytapheresis were also ineffective. A biopsy specimen from the skin ulcer margin showed erythrophagocytosis by trophozoites of amebae which were identified on PAS stained slides. The PCR method and stool examination showed positive for Entamoeba histolytica (E. histolytica), but serum antibodies were negative. Within two weeks of treatment with oral metronidazole 2,250 mg/day and topical metronidazole ointment, resolution of the ulcer was observed, then the prednisolone dosage was tapered. A split-thickness skin graft was used to cover the ulcer with a successful result. Even though we originally misdiagnosed this case, we finally reached a diagnosis of amebiasis. It is important to take account of amebiasis in the differential diagnosis of intractable

  19. IL-33 promotes GATA-3 polarization of gut-derived T cells in experimental and ulcerative colitis

    Seidelin, Jakob Benedict; Coskun, Mehmet; Kvist, Peter Helding; Holm, Thomas Lindebo; Holgersen, Kristine; Nielsen, Ole Haagen

    2015-01-01

    BACKGROUND: In the respiratory mucosa, interleukin (IL)-33, has been shown to enhance T helper 2 (TH2)-type responses through the master regulatory gene GATA-3. IL-33 is upregulated in ulcerative colitis (UC), and the aim was to assess if IL-33 holds a similar key position in the shaping of the...... were isolated from PAC IL-10 -/- mice and stimulated with IL-33.RESULTS: The colonic IL-33 expression was significantly upregulated all forms of colitis (P < 0.01) and correlated with disease severity score and inflammation (P < 0.001), and with GATA-3 expression levels (P < 0.01); no correlation with...... the TH1-specific T-bet expression was observed. MesLN T cells stimulated with IL-33 had increased GATA-3 expression, and showed an IL-33 dose-dependent increase in secreted TH2-type cytokines, whereas this effect was abolished by blocking IL-33 signaling. The non-TH2-type cytokine IL-17 was...

  20. Mucosa-associated but not luminal Escherichia coli is augmented in Crohn’s disease and ulcerative colitis

    de Souza Helton Luis

    2012-12-01

    Full Text Available Abstract Background Escherichia coli is believed to participate in the etiology of Crohn’s disease (CD and possibly of ulcerative colitis (UC, due at least in part to the observed rise in the number of these bacteria in the gut microbiota of CD and UC patients. Nevertheless, it is not fully understood whether this quantitative variation occurs equally throughout the mucosal and luminal spaces of the gut. To assess this question, stools and mucosa biopsies from distinct intestinal sites were cultured aiming at determining their E. coli concentration. The cultures were additionally screened for the presence of some virulence genes of pathogenic E. coli. Results Analyses of clinical materials from 14 controls (38 biopsies and 14 stools samples, 11 CD (25 biopsies and 11 stools samples and 7 UC patients (18 biopsies and 7 stools samples indicated no significant variation in the number of E. coli present in stools, but a rise of at least one log10 CFU/mg in biopsies from the ileum of CD patients and the sigmoid and rectum of CD and UC patients. The cultures were screened for the presence of E. coli attaching and effacing (eae, invasion plasmid antigen H (ipaH, aggregative adherence transcriptional activator (aggR, Shiga cytotoxins (stx, and heat labile enterotoxin (elt and the following serine proteases autotransporters of Enterobacteriaceae (SPATE genes: plasmid encoded toxin (pet, secreted autotransporter toxin (sat, Shigella extracellular protein (sepA, protein involved in intestinal colonization (pic and Shigella IgA-like protease homolog (sigA. Six of the 10 genes screened were detected in the total of samples investigated: aggR, eae, pet, sat, sepA and sigA. No difference in the prevalence of any of these markers was observed in cultures from different clinical materials or groups of patients. Methods Bacterial quantitation was carried out following cultures of diluted samples suspensions in MacConkey agar, Wilkins Chalgren agar for anaerobes

  1. ANTI-ULCER ACTIVITY OF LEGUMINOSAE PLANTS

    Noemi D. PAGUIGAN

    2014-03-01

    Full Text Available Context Ulcer is the most common gastrointestinal disturbance resulting from an inadequate gastric mucosal defense. Several drugs are available in the market to address the disease; however, these drugs are associated with unnecessary side effects. Objectives Previous research have confirmed the efficacy of plant extracts for possible treatment of the disease. This research aims to evaluate the anti-ulcer properties of medicinal plants. Methods Methanol extracts from the leaves of Intsia bijuga, Cynometra ramiflora, Tamarindus indica, Cassia javanica, Cassia fistula, Bauhini purpurea, Senna spectabilis, Senna siamea and Saraca thaipingensis were evaluated for their anti-ulcer activity using HCl-ethanol as ulcerogen. Results All extracts showed inhibitory activity with I. bijuga, T. indica, S. spectabilis and S. thaipingensis exhibiting more than 50% inhibition. S. thaipingensis showed the highest activity at 80%. S. spectabilis and S. thaipingensis were partitioned further into hexane, ethyl acetate and aqueous fractions. The aqueous and ethyl acetate fractions of S. spectabilis showed significant increased in its activity while the hexane and ethyl acetate fractions of S. thaipingensis gave higher activity than its aqueous portions. Conclusions We conclude that plant extracts are potential sources of new anti-ulcer agents.

  2. Melatonin reduces bacterial translocation and apoptosis in trinitrobenzene sulphonic acid-induced colitis of rats

    Alper Akcan, Can Kucuk, Erdogan Sozuer, Duygu Esel, Hizir Akyildiz, Hulya Akgun, Sabahattin Muhtaroglu, Yucel Aritas

    2008-01-01

    AIM: To investigate the effects of exogenous melatonin on bacterial translocation and apoptosis in a rat ulcerative colitis model.METHODS: Rats were randomly assigned to three groups: groupI: control, group II: experimental colitis, group III: colitis plus melatonin treatment. On d 11 after colitis, plasma tumor necrosis factor-α, portal blood endotoxin levels, colon tissue myeloperoxidase and caspase-3 activity were measured. Bacterial translocation was quantified by blood, lymph node, liver...

  3. Activation of the Renin-Angiotensin System Promotes Colitis Development

    Yongyan Shi; Tianjing Liu; Lei He; Urszula Dougherty; Li Chen; Sarbani Adhikari; Lindsay Alpert; Guolin Zhou; Weicheng Liu; Jiaolong Wang; Deb, Dilip K.; John Hart; Liu, Shu Q.; John Kwon; Joel Pekow

    2016-01-01

    The renin-angiotensin system (RAS) plays pathogenic roles in renal and cardiovascular disorders, but whether it is involved in colitis is unclear. Here we show that RenTgMK mice that overexpress active renin from the liver developed more severe colitis than wild-type controls. More than 50% RenTgMK mice died whereas all wild-type mice recovered. RenTgMK mice exhibited more robust mucosal TH17 and TH1/TH17 responses and more profound colonic epithelial cell apoptosis compared to wild-type cont...

  4. Influencia de una combinación de lactobacilos + bifidobacterias sobre la actividad de la enfermedad, el hábito defecatorio y el estado nutricional de pacientes con colitis ulcerosa Influence of a combination of lactobacilli and bifidobacteria upon disease activity, stool pattern and nutritional status of ulcerative colitis patients

    S. Santana Porbén

    2010-01-01

    Se condujo un ensayo clínico quasi-experimental para evaluar la tolerancia, seguridad y utilidad de una combinación de 4 lactobacilos + 1 bifidobacteria añadida a la medicación regular de pacientes de CU Colitis ulcerosa con daño mucosal variable. La efectividad del tratamiento con probióticos se estimó de cambios en el hábito defecatorio del enfermo, la composición corporal, e indicadores bioquímicos selectos de la actividad de la enfermedad, y el estado nutricional. Cincuenta enfermos ingre...

  5. Cost-effectiveness of adalimumab, infliximab or vedolizumab as first-line biological therapy in moderate-to-severe ulcerative colitis

    Yokomizo, Lauren; Limketkai, Berkeley; Park, K. T.

    2016-01-01

    Background There are no head-to-head randomised controlled trials (RCTs) comparing the effectiveness of biologics in ulcerative colitis (UC). We aimed to assess the cost-effectiveness of adalimumab, infliximab and vedolizumab as first-line agents to induce clinical remission and mucosal healing (MH) in UC. Methods We constructed a decision tree based on a payer's perspective in the USA to estimate the first year costs of adalimumab, infliximab or vedolizumab to achieve clinical remission and ...

  6. E-health empowers patients with ulcerative colitis: a randomised controlled trial of the web-guided 'Constant-care' approach

    Elkjaer, Margarita; Shuhaibar, Mary; Burisch, Johan;

    2010-01-01

    The natural history of ulcerative colitis requires continuous monitoring of medical treatment via frequent outpatient visits. The European health authorities' focus on e-health is increasing. Lack of easy access to inflammatory bowel disease (IBD) clinics, patients' education and understanding of...... the importance of early treatment at relapse is leading to poor compliance. To overcome these limitations a randomised control trial 'Constant-care' was undertaken in Denmark and Ireland....

  7. Differences in Visceral Fat and Fat Bacterial Colonization between Ulcerative Colitis and Crohn’s Disease. An In Vivo and In Vitro Study

    Zulian, Alessandra; Cancello, Raffaella; Ruocco, Chiara; Gentilini, Davide; Di Blasio, Anna Maria; Danelli, Piergiorgio; Micheletto, Giancarlo; Cesana, Elisabetta; Invitti, Cecilia

    2013-01-01

    Crohn’s disease (CD) is notably characterized by the expansion of visceral fat with small adipocytes expressing a high proportion of anti-inflammatory genes. Conversely, visceral fat depots in ulcerative colitis (UC) patients have never been characterized. Our study aims were a) to compare adipocyte morphology and gene expression profile and bacterial translocation in omental (OM) and mesenteric (MES) adipose tissue of patients with UC and CD, and b) to investigate the effect of bacterial inf...

  8. Differences in Visceral Fat and Fat Bacterial Colonization between Ulcerative Colitis and Crohn’s Disease. An In Vivo and In Vitro Study

    Alessandra Zulian; Raffaella Cancello; Chiara Ruocco; Davide Gentilini; Anna Maria Di Blasio; Piergiorgio Danelli; Giancarlo Micheletto; Elisabetta Cesana; Cecilia Invitti

    2013-01-01

    Crohn's disease (CD) is notably characterized by the expansion of visceral fat with small adipocytes expressing a high proportion of anti-inflammatory genes. Conversely, visceral fat depots in ulcerative colitis (UC) patients have never been characterized. Our study aims were a) to compare adipocyte morphology and gene expression profile and bacterial translocation in omental (OM) and mesenteric (MES) adipose tissue of patients with UC and CD, and b) to investigate the effect of bacterial inf...

  9. Deposits of terminal complement complex (TCC) in muscularis mucosae and submucosal vessels in ulcerative colitis and Crohn's disease of the colon.

    Halstensen, T S; Mollnes, T.E.; O. Fausa; Brandtzaeg, P

    1989-01-01

    Extensively washed, ethanol fixed and paraffin embedded colonic specimens from 15 patients with ulcerative colitis (UC) and nine patients with Crohn's disease (CD) of the colon, ileal specimens from six patients with CD of the ileum, and histologically normal control specimens obtained from 10 patients operated for colonic carcinoma, were examined by immunohistochemistry with a monoclonal antibody specific for a neoepitope in the C9 part of the terminal complement complex (TCC). The submucosa...

  10. Three ulcerative colitis susceptibility loci are associated with primary sclerosing cholangitis and indicate a role for IL2, REL and CARD9

    Janse, Marcel; Lamberts, Laetitia E.; Franke, Lude; Raychaudhuri, Soumya; Ellinghaus, Eva; MuriBoberg, Kirsten; Melum, Espen; Folseraas, Trine; Schrumpf, Erik; Bergquist, Annika; Bjornsson, Einar; Fu, Jingyuan; Westra, Harm Jan; Groen, Harry JM; Fehrmann, Rudolf SN

    2011-01-01

    Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease characterized by inflammation and fibrosis of the bile ducts. Both environmental and genetic factors contribute to its pathogenesis. To further clarify its genetic background, we investigated susceptibility loci recently identified for ulcerative colitis (UC) in a large cohort of 1186PSC patients and 1748 controls. Single nucleotide polymorphisms (SNPs) tagging 13 UC susceptibility loci were initially genotyped in 854...

  11. Anti-TNF alpha in the treatment of ulcerative colitis: A valid approach for organ-sparing or an expensive option to delay surgery?

    Rizzo, Gianluca; Pugliese, Daniela; Armuzzi, Alessandro; Coco, Claudio

    2014-01-01

    Ulcerative colitis (UC) is an inflammatory bowel disease affecting large bowel with variable clinical course. The history of disease has been modified by the introduction of biologic therapy, in particular Infliximab (IFX), that has demonstrated efficacy in inducing fast symptoms remission, promoting mucosal healing and maintaining long-term remission. However, surgery is still needed for UC patients: in case of failure of medical therapy and if acute complications or a malignancy occurred. S...

  12. Onset of Ulcerative Colitis during a Low-Carbohydrate Weight-Loss Diet and Treatment with a Plant-Based Diet: A Case Report

    Chiba, Mitsuro; Tsuda, Satoko; Komatsu, Masafumi; Tozawa, Haruhiko; Takayama, Yuko

    2016-01-01

    Overweight and obesity are global health concerns. Various effective weight-loss diets have been developed, including the Atkins diet. The Atkins diet is known as an extreme low-carbohydrate diet. This diet reduces body weight and has gained widespread popularity. However, the metabolite profiles of such a diet have been shown to be detrimental to colonic health. Therefore, a concern for the long-term health effects of this diet exists. We encountered a case in which ulcerative colitis develo...

  13. Relaionship of mental-psychological factors and ulcerative colitis%精神心理因素与溃疡性结肠炎的关系

    朱磊; 赵钢

    2011-01-01

    我国溃疡性结肠炎的发病率呈逐年增高的趋势.已知多重因素导致了溃疡性结肠炎的发生发展,精神心理因素也起到了重要的作用.了解精神心理因素对溃疡性结肠炎患者的影响是很必要的,及时识别精神心理因素并积极干预治疗可以缓解病情进展、改善患者的生活质量.本文即对精神心理因素与溃疡性结肠炎的关系进行综述.%The prevalence of ulcerative colitis has been increased annually in China. Multiple determinants induce the occurrence and development of this disease. Among these factors, mental-psychological disorders play an important role. It is necessary for us to know the mental-psychological impact on the patients with ulcerative colitis. Recognition and intervention of mental-psychological disorders in these patients may relieve the progression of disease and improve the quality of life. This review focuses on the relationship between mental-psychological factors and ulcerative colitis.

  14. Severity of ulcerative colitis is associated with a polymorphism at diamine oxidase gene but not at histamine N-methyltransferase gene

    Elena García-Martín; Juan L Mendoza; Carmen Martínez; Carlos Taxonera; Elena Urcelay; José M Ladero; Emilio G de la Concha; Manuel Díaz-Rubio; José AG Agúndez

    2006-01-01

    AIM: To analyse the role of two common polymorphisms in genes coding for histamine metabolising enzymes as it relates to the risk to develop ulcerative colitis (UC) and the clinical course of these patients.METHODS: A cohort of 229 unrelated patients with UC recruited from a single centre and 261 healthy volunteers were analysed for the presence of Thr105Ile and His645Asp amino acid substitutions at histamine N-methyltransferase (HNMT) and diamine oxidase (ABP1) enzymes, respectively, by amplification-restriction procedures. All patients were phenotyped and followed up for at least 2 years (mean time 11 years).RESULTS: There were no significant differences in the distribution of ABP1 alleles between ulcerative colitis patients and healthy individuals [OR (95% CI) for variant alleles= 1.22 (0.91-1.61)]. However, mutated ABP1 alleles were present with higher frequency among the 58 patients that required immunosuppresive drugs [OR (95 % CI) for carriers of mutated alleles 2.41 (1.21-4.83;P=0.006)], with a significant gene-dose effect (P= 0.0038). In agreement with the predominant role of ABP1 versus HNMT on local histamine metabolism in human bowel, the frequencies for carriers ofHNMT genotypes or mutated alleles were similar among patients,regardless clinical evolution, and control individuals.CONCLUSION: The His645Asp polymorphism of the histamine metabolising enzyme ABP1 is related to severity of ulcerative colitis.

  15. Randomized clinical trial: pharmacokinetics and safety of multimatrix mesalamine for treatment of pediatric ulcerative colitis

    Cuffari C

    2016-02-01

    Full Text Available Carmen Cuffari,1 David Pierce,2 Bartosz Korczowski,3 Krzysztof Fyderek,4 Heather Van Heusen,5 Stuart Hossack,6 Hong Wan,5 Alena YZ Edwards,7 Patrick Martin5 1Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; 2Shire, Basingstoke, UK; 3Medical College, University of Rzeszów, Rzeszów, Poland; 4University Children’s Hospital of Cracow, Cracow, Poland; 5Shire, Wayne, PA, USA; 6Covance Clinical Research Unit Limited, Leeds, UK; 7ICON Early Phase Services, Marlow, Buckinghamshire, UK Background: Limited data are available on mesalamine (5-aminosalicylic acid; 5-ASA use in pediatric ulcerative colitis (UC.Aim: To evaluate pharmacokinetic and safety profiles of 5-ASA and metabolite acetyl-5-ASA (Ac-5-ASA after once-daily, oral administration of multimatrix mesalamine to children and adolescents with UC.Methods: Participants (5–17 years of age; 18–82 kg, stratified by weight with UC received multimatrix mesalamine 30, 60, or 100 mg/kg/day once daily (to 4,800 mg/day for 7 days. Blood samples were collected pre-dose on days 5 and 6. On days 7 and 8, blood and urine samples were collected and safety was evaluated. 5-ASA and Ac-5-ASA plasma and urine concentrations were analyzed by non-compartmental methods and used to develop a population pharmacokinetic model.Results: Fifty-two subjects (21 [30 mg/kg]; 22 [60 mg/kg]; 9 [100 mg/kg] were randomized. On day 7, systemic exposures of 5-ASA and Ac-5-ASA exhibited a dose-proportional increase between 30 and 60 mg/kg/day cohorts. For 30, 60, and 100 mg/kg/day doses, mean percentages of 5-ASA absorbed were 29.4%, 27.0%, and 22.1%, respectively. Simulated steady-state exposures and variabilities for 5-ASA and Ac-5-ASA (coefficient of variation approximately 50% and 40%–45%, respectively were similar to those observed previously in adults at comparable doses. Treatment-emergent adverse events were

  16. The mechanism of iNOS gene modulation on acupuncture and moxibustiontreatment for ulcerative colitis in rats

    Huan Gan Wu; Hai Bin Lu; Chen Zhao; Zheng Shi; Hiu Rong Liu; Hah Ping Chen

    2000-01-01

    AIM To observe the effect of acupuncture and moxibustion on the expression of IL-1β and iNOSmRNA inrats, with ulcerative colitis.METHODS Surgical samples of fresh human colonic mucosa was homogenized by adding appropriateamount of normal saline and centrifuged at 3000 r/min. Protein content of the supernatant was measuredand then mixed with Freund adjuvant, and injected into the plantae of the rats models, then into theplantae, dorsa, inguen and abdominal cavities (no Freund adjuvant for the last injection) on the 10th, 17th,24th and 31st day respectively. When serum titer of anti-colonic antibody has reached to a certain level,20 mL/L formalin and antigen fluid (no Freund adjuvant) were administered by enema to set up ulcerativecolitis rat mode. The animals were randomly divided into four groups: model control group (MC = 8),electroacupuncture group (EP=8), herbs partition moxibustion group (HPM= 8) and normal control group(NC=8). HPM: Mosa cones made of refined mugwort floss were placed on the medicinal pads (medicinalpad dispensing: Radix Aconiti Praeparata, cortex Cinnamomi, etc. ) for qihai (RN6) and tianshu (ST25,bilateral) and ignited. Two moxa cones were used for each acupuncture once a day and 14 times in all. EP:tisnshu (bilateral) and qihai were stimulated by the intermittent pulse with 2Hz frequency, 4mA intensity for20 minutes once a day and 14 times in all. After treatment, all rats were killed simultaneously. The spleenwas separated and distal colon was dissected. Total tissue RNA was isolated by the guanidinium thiocyanate-phenol-chloroform extraction method. RT-PCR technique was used to observe the expression of IL-1β andiNOSmRNA no Freund adjuvant.RESULTS IL-1β and iNOSmRNA were not detected in the spleen and colonic mucosa of NC rats, whilethey were significantly expressed in those of MC rats. IL-1β and iNOSmRNA were markedly lower in EF andHPM rats than those in MC rats. There were no significant difference in the levels of IL-1β and i

  17. 粪便钙卫蛋白及髓过氧化物酶在评估溃疡性结肠炎活动性的应用%Application of fecal calprotectin and myeloperoxidase in evaluation of disease activity of ulcerative colitis

    柏明见; 龙彦; 冯珍如; 李俊霞; 闫存玲; 李志艳; 史晓敏; 郑新芝

    2013-01-01

    Objective To explore the clinical value of fecal calprotectin and myeloperoxidase in evaluation of ulcerative colitis (UC) activity.Methods Specimens of serum and feces over the same period were collected from 49 ulcerative colitis (UC) patients (32 male and 17 female)and 35 healthy controls (23 male and 12 female).ELISA was used to measure the concentration of calprotectin and myeloperoxidase in feces.The clinical information (including Mayo clinic activity index.Baron endoscopic score) of UC patients were collected.All patients were divided into active and inactive group by Mayo clinic activity index,the active group was further divided into three subgroups,the mild group,the moderate group and the severe group.Fecal calprotectin and myeloperoxidase,serum ESR and CRP were compared among different groups,receiver operating curve (ROC) were obtained to evaluate the diagnostic efficacy of the UC activity.Results The fecal calprotectin concentration was significantly higher in active UC group than that in inactive UC group [6000.0 (3050.8,8759.5) vs.336.8 (227.5,1731.0),Z =-3.357,P =0.001],the same to inactive UC group and the controls[336.8(227.5,1731.0) vs.29.0(21.3,48.8),Z =-5.607,P =0.001].The fecal myeloperoxidase concentration of the active UC group was significantly higher than that of the inactive UC group[1231.2(757.9,1481.1) vs.603.6(265.2,819.4),Z =-3.658,P =0.001],but there was no significant difference between the inactive UC group and the controls [603.6 (265.2,819.4) vs.453.5(140.8,750.2),Z =-1.033,P =0.302].There was no significant difference of fecal calprotectin levels among different active subgroups.Fecal myeloperoxidase concentration between the mild activity group and the moderate activity group was significant [667.3 (467.5,1000.4) vs.1259.6 (1213.3,1932.8),Z =-2.475,P =0.005],but there was no significant difference between the moderate activity group and the severe activity group [1259.6 (1213.3,1932.8) vs.1239.0 (793.9,1403.0),Z =-1.350,P =0

  18. Presence of intestinal Mycobacterium avium subspecies paratuberculosis (MAP DNA is not associated with altered MMP expression in ulcerative colitis

    Halwe Jörg M

    2011-04-01

    Full Text Available Abstract Background Mycobacterium avium subspecies paratuberculosis (MAP is suspected to be a causative agent in human Crohn's disease (CD. Recent evidence suggests that pathogenic mycobacteria and MAP can induce the expression of Matrix Metalloproteinases (MMP, which are the main proteases in the pathogenesis of mucosal ulcerations in inflammatory bowel disease (IBD. Within this study we assessed the prevalence of intestinal MAP specific DNA in patients with Crohn's disease, ulcerative colitis (UC, and healthy controls. We further analysed regulation patterns of MMPs in mucosal tissues of UC patients with and without intestinal MAP DNA detection. Methods Colonic biopsy samples were obtained from 63 Norwegian and German IBD patients and 21 healthy controls. RNA was quantified by quantitative real-time polymerase chain reaction (PCR to study MMP gene expression in both pathological and healthy mucosal specimens. The presence of MAP DNA in colonic mucosa was examined using MAP specific PCR. Results MAP DNA was detected in 20% of UC patients and 33% of healthy controls but only in 7% of patients with CD. UC patients treated with corticosteroids exhibited a significantly increased frequency of intestinal MAP DNA compared to those not receiving corticosteroids. Expression of MMP-1, -2, -7, -9, -13, -19, -28 and TNF-α did not differ between UC patients with presence of intestinal MAP DNA compared to those without. MMP-2, MMP-9 and MMP-13 were significantly decreased in UC patients receiving corticosteroids. Conclusions The presence of intestinal MAP specific DNA is not associated with altered MMP expression in UC in vivo. Corticosteroids are associated with increased detection of intestinal MAP DNA and decreased expression of certain MMPs. Frequent detection of MAP DNA in healthy controls might be attributable to the wide environmental distribution of MAP and its presence in the food-chain.

  19. 益气活血解毒法对溃疡性结肠炎血浆血小板活化的临床及实验研究%Clinical study and animal experiment on benefiting vital Qi, activating blood flow and detoxication on plasma platelet activation during ulcerative colitis

    安贺军; 王新月; 于玫; 沈静

    2011-01-01

    [目的]探讨益气活血解毒法对溃疡性结肠炎(UC)血浆血小板活化的影响.[方法]分临床研究及动物实验两部分;临床研究以90例溃疡性结肠炎复发患者按随机数字表法随机分为2组,中药治疗组45例,西药对照组45例.治疗3个月后对完全缓解及有效病例(其中治疗组39例,对照组32例)进行为期6个月的随访.治疗组给予益气活血解毒立法的中药汤剂.对照组给予柳氮磺胺吡啶治疗,并各与20例作正常对照.动物实验用三硝基苯磺酸(TNBS)复制实验性大鼠UC模型,将其随机分为模型组、西药对照组、中药治疗组,并设正常对照组.进行反映血小板活化程度的特异性标志物P-选择素的检测.[结果]临床研究中,治疗前UC患者血浆P-选择素水平明显高于正常健康人(P0.05);停药10d时,中药组明显低于西药组(P<0.05).[结论]以益气活血解毒立法的中药溃结复发方与西药比较,可有效降低血浆P-选择素水平,从而阻抑血小板活化,可能是抗溃结复发作用机制之一.%[Objective]To investigate the influence of benefiting vital QI activating blood flow and detoxication on plasma platelet activation during ulcerative colitis (UC).[Methods]The study included clinical study and animal experiment.In clinical study, 90 cases with recurrent UC were randomly divided into the treatment group (n=45) and the control group (n=45) according to the random table.Three months after treatment, the cases of complete remission and effective cases were followed-up for 6 months (39 cases in treatment group, 32 in control group).The patients of treatment group received medicinal decoction of TCM consisting of herbs with benefiting vital Qi, activating blood flow and detoxication; the control group was treated with salazosulfapyridine.In animal experiment, UC was induced with TNBS in rats and then randomly divided into model control group, western medicine group, the traditional Chinese medicine

  20. Animal models of ulcerative colitis and their application in drug research

    Low D; Nguyen DD; Mizoguchi E

    2013-01-01

    Daren Low,1 Deanna D Nguyen,1,2 Emiko Mizoguchi1,2 1Gastrointestinal Unit, Department of Medicine, 2Center for the Study of Inflammatory Bowel Disease, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA Abstract: The specific pathogenesis underlying inflammatory bowel disease is complex, and it is even more difficult to decipher the pathophysiology to explain for the similarities and differences between two of its major subtypes, Crohn's disease and ulcerative...

  1. Reversal of Refractory Ulcerative Colitis and Severe Chronic Fatigue Syndrome Symptoms Arising from Immune Disturbance in an HLADR/DQ Genetically Susceptible Individual with Multiple Biotoxin Exposures

    Gunn, Shelly R.; Gibson Gunn, G.; Mueller, Francis W.

    2016-01-01

    Patient: Male, 25 Final Diagnosis: Ulcerative colitis and chronic fatigue syndrome Symptoms: Colitis • profound fatigue • multi-joint pain • cognitive impairment • corneal keratitis Medication: — Clinical Procedure: VIP replacement therapy Specialty: Family Medicine Objective: Unusual clinical course Background: Patients with multisymptom chronic conditions, such as refractory ulcerative colitis (RUC) and chronic fatigue syndrome (CFS), present diagnostic and management challenges for clinicians, as well as the opportunity to recognize and treat emerging disease entities. In the current case we report reversal of co-existing RUC and CFS symptoms arising from biotoxin exposures in a genetically susceptible individual. Case Report: A 25-year-old previously healthy male with new-onset refractory ulcerative colitis (RUC) and chronic fatigue syndrome (CFS) tested negative for autoimmune disease biomarkers. However, urine mycotoxin panel testing was positive for trichothecene group and air filter testing from the patient’s water-damaged rental house identified the toxic mold Stachybotrys chartarum. HLA-DR/DQ testing revealed a multisusceptible haplotype for development of chronic inflammation, and serum chronic inflammatory response syndrome (CIRS) biomarker testing was positive for highly elevated TGF-beta and a clinically undetectable level of vasoactive intestinal peptide (VIP). Following elimination of biotoxin exposures, VIP replacement therapy, dental extractions, and implementation of a mind body intervention-relaxation response (MBI-RR) program, the patient’s symptoms resolved. He is off medications, back to work, and resuming normal exercise. Conclusions: This constellation of RUC and CFS symptoms in an HLA-DR/DQ genetically susceptible individual with biotoxin exposures is consistent with the recently described CIRS disease pathophysiology. Chronic immune disturbance (turbatio immuno) can be identified with clinically available CIRS biomarkers and

  2. Receptor binding sites for substance P in surgical specimens obtained from patients with ulcerative colitis and Crohn disease

    Mantyh, C.R.; Gates, T.S.; Zimmerman, R.P.; Welton, M.L.; Passaro, E.P. Jr.; Vigna, S.R.; Maggio, J.E.; Kruger, L.; Mantyh, P.W.

    1988-05-01

    Several lines of evidence indicate that tachykinin neuropeptides (substance P (SP), substance K (SK), and neuromedin K (NK)) play a role in regulating the inflammatory and immune responses. To test this hypothesis in a human inflammatory disease, quantitative receptor autoradiography was used to examine possible abnormalities in tachykinin binding sites in surgical specimens from patients with inflammatory bowel disease. In all cases, specimens were processed for quantitative receptor autoradiography by using /sup 125/I-labeled Bolton-Hunter conjugates of NK, SK, and SP. In colon tissue obtained from ulcerative colitis and Crohn disease patients, very high concentrations of SP receptor binding sites are expressed by arterioles and venules located in the submucosa, muscalairs mucosa, external circular muscle, external longitudinal muscle, and serosa, in contrast to control patients. These results demonstrate that receptor binding sites for SP, but not SK or NK, are ectopically expressed in high concentrations by cells involved in mediating inflammatory and immune responses. These data suggest that SP may be involved in the pathophysiology of inflammatory bowel disease and might provide some insight into the interaction between the nervous system and the regulation of inflammation and the immune response in human inflammatory disease.

  3. The Increased Expression of CCL20 and CCR6 in Rectal Mucosa Correlated to Severe Inflammation in Pediatric Ulcerative Colitis

    Keiichi Uchida

    2015-01-01

    Full Text Available Background/Aims. The aim of this study is to clarify the differences of CCL20 and CCR6 expression, chemokine correlated to intestinal homeostasis, between pediatric and adult ulcerative colitis (UC patients. Methods. Onehundred forty-one patients who underwent proctocolectomy were divided to two groups including childhood-onset UC (CUC, <16 years old, n=24 and adult-onset UC (AUC, ≧16 years old, n=117. A total of 141 formalin-fixed, paraffin-embedded tissue samples of rectum were obtained from these patients. Histological inflammation of rectum in resected specimen was evaluated by using Geboes histological assessment. In immunohistochemistry study, the CCL20 expression was evaluated by intensity and the stained area, and the CCR6 expression was evaluated by lymphocytes infiltration pattern. Results. CCL20 score and CCR6 positive lymphocytes infiltration pattern were statistically significantly correlated with histological inflammation severity of UC in all patients (P<0.05. CCL20 and CCR6 expression in CUC were statistically significantly higher than that in AUC in all or pathologically severe cases (P<0.05. Conclusions. CCL20 and CCR6 may play a significant role in local damage and pathological changes in UC especially pediatric patients. In the future, our understanding of the differences in CCL-CCR6 interaction between adults and children may lead to the pathogenesis of IBD.

  4. HLA-DR, DQ and T cell antigen receptor constant beta genes in Japanese patients with ulcerative colitis.

    Kobayashi, K; Atoh, M; Konoeda, Y; Yagita, A; Inoko, H; Sekiguchi, S

    1990-01-01

    We studied the T cell antigen receptor (TcR) constant beta chain genes on HLA typed Japanese patients with ulcerative colitis (UC). A TcR constant beta EcoRI 6.0-kb fragment was present in all Japanese UC patients (n = 17) but completely absent in the controls (n = 35) (chi2 = 47.6, P less than 0.001). The frequency of HLA-DR2 antigen was significantly higher in UC patients (85% versus 28% in controls, P less than 0.001). Furthermore, HLA-DQw1 antigen was also increased in UC patients (96% versus 60% in controls, P less than 0.001). However, HLA-DR4 antigen was significantly decreased in UC patients (12% versus 37%, P = 0.02). HLA-DR1 antigen was not found in UC patients and was present in only 15% of the controls. These results suggest that TcR beta chain and HLA-DQw1 antigen may be important in the pathogenesis of Japanese UC. Images Fig. 1 PMID:1973647

  5. Association of HLA-DRB1 Alleles with Ulcerative Colitis in the City of Kerman, South Eastern Iran

    Mojgan Mohammadi

    2015-10-01

    Full Text Available The association of HLA class II genes with ulcerative colitis (UC as an autoimmune disease has been investigated for several years. However, factors responsible for genetic predisposition of this disease have so far not been clearly understood. In this study, for the first time, we aimed to investigate the association between HLA-DRB1 types and UC in the population of Kerman, a city southeast Iran.HLA typing was performed among 85 UC patients and 95 healthy controls using PCRamplification, employing sequence specific primers (PCR-SSP. The DRB1 frequencies were determined in the patients and controls.HLA-DRB1*04 was negatively associated with UC. Furthermore, HLA-DRB1*13 was significantly associated with severity of the disease (p=0.01 among UC patients.This is the novel result that describes an association of HLA-DRB1*13 with UC and also shows the protective role of HLA-DRB1*04 against the disease in people of Kerman.

  6. Persistence of gene expression changes in noninflamed and inflamed colonic mucosa in ulcerative colitis and their presence in colonic carcinoma

    Yuji Toiyama; Akira Mizoguchi; Kazushi Kimura; Toshimitsu Araki; Shigeyuki Yoshiyama; Kouhei Sakaguchi; Chikao Miki; Masato Kusunoki

    2005-01-01

    AIM: A few studies have applied genomic-wide gene expression analysis in inflamed colon tissue sample in ulcerative colitis (UC). We reported the first study of non-inflamed mucosal gene expression in UC and explored its clinical implication.METHODS: Non-inflamed mucosa was obtained from 6 UC patients who received total colectomy. The gene expression of UC in noninfliamed mucosa was monitored with a microarray. For a selected gene, RT-PCR was performed to verify array results and to further examine expression pattern in inflamed mucosa of UC, colorectal cancer tissue and normal mucosa using additional matched pairs.RESULTS: Two genes showing 2.5-fold decreased expression with significance set at in UC samples were bomeo box a4 (HOXa4) and mads box transcription enhancer factor 2, polypeptide B (MEF2b). RT-PCR showed that MEF2b expression in non-inflamed mucosa was significantly downregulated, whereas the expression of MEF2b increased in accordance with the severity of mucosal inflammation. HOXa4 expression both in inflamed and non-inflamed mucosa in UC was consistently downregulated, and the downregulation of HOXa4 was also found in colorectal carcinoma.CONCLUSION: It is suggested that the MEF2b expression in UC which increase in accordance with inflammation may be induced by the inflammatory mediator. In contrast the downregulation of HOXa4 may be partly involved in the pathogenesis of disease including UC and UC-related carcinogenesis.

  7. Novel pH-sensitive hydrogels for 5-aminosalicylic acid colon targeting delivery: in vivo study with ulcerative colitis targeting therapy in mice.

    Bai, Xia Yan; Yan, Yan; Wang, Lin; Zhao, Lan Gui; Wang, Ke

    2016-07-01

    Current guidelines recommend patients with active and mild-to-moderate ulcerative colitis (UC), who have received initial therapy with 5-aminosalicylic acid (5-ASA). In this study, a novel drug delivery vehicle achieved by pH-sensitive hydrogels was applied to 5-ASA. In our previous work, a novel P(CE-MAA-MEG) pH-sensitive hydrogel was successfully synthesized by the heat-initiated free radical polymerization method. The aim of this study is to investigate its site-specific delivering of drugs to the colon and evaluate its colon-targeting characteristic in vivo. 5-ASA was chosen as a model drug and successfully loaded in the hydrogel. In vitro investigations were carried out to evaluate its release process. Above all, animal treatment results reveal an obvious effect on the UC healing. Therefore, all results suggested that the developed 5-ASA-P(CE-MAA-MEG) hydrogel (5-ASA-GEL) as a colon-targeting vector might have a great potential application in the UC therapy. PMID:25693641

  8. Quality of Life Is Related to Fecal Calprotectin Concentrations in Colonic Crohn Disease and Ulcerative Colitis, but not in Ileal Crohn Disease.

    Gauss, Annika; Geib, Thomas; Hinz, Ulf; Schaefert, Rainer; Zwickel, Philipp; Zawierucha, Anna; Stremmel, Wolfgang; Klute, Lukas

    2016-04-01

    To formulate therapy goals, we aimed to define the relationship between fecal calprotectin and health-related quality of life in inflammatory bowel diseases (IBDs). This retrospective single-center cross-sectional study included ambulatory IBD patients who had completed standardized questionnaires comprising items of health-related quality of life (Short Inflammatory Bowel Disease Questionnaire) and clinical disease activity scores, and who had provided stool samples for calprotectin determination within 30 days of questionnaire completion. Correlation analyses were performed between the indicated parameters. Post hoc analysis was conducted, taking into account only data from patients with fecal calprotectin concentrations measured within 3 days of questionnaire completion. One hundred ninety-seven patients with Crohn disease and 111 patients with ulcerative colitis were enrolled in the study. Lower fecal calprotectin concentrations were associated with better health-related quality of life. The correlations were weak, but stronger if only fecal calprotectin concentrations measured within 3 days of questionnaire completion were included (results for 3 days; Crohn disease: n = 86, rS = -0.419, P care should be taken to keep the time between clinical evaluation of IBD patients and the determination of fecal calprotectin concentrations as short as possible. PMID:27100452

  9. GFAP和COX-2在中重度活动期溃疡性结肠炎活检标本中的表达及其临床意义%Expressions and Clinical Significance of GFAP and COX-2 in Biopsy Specimens of Moderate to Severe Active Ulcerative Colitis

    钟英强; 颜蓉; 黄花荣; 林莹; 夏忠胜

    2011-01-01

    Background:It has been reported that enteric glial cells (EGC) and cyclooxygenase-2 (COX-2) are involved in the process of inflammation in intestine. Aims: To investigate the expressions and clinical significance of glial fibrillary acidic protein (GFAP), a specific marker of glial cells, and COX-2 in biopsy specimens of inflamed mucosa of moderate to severe active ulcerative colitis (UC). Methods: Expressions of GFAP and COX-2 in biopsy specimens of 30 cases of moderate to severe active UC, 30 cases of irritable bowel syndrome with diarrhea (IBS-D) and 30 cases of healthy subjects were determined by immunohistochemistry (IHC). Results: The high-intensity expression rate and IHC score of GFAP in UC group were lower than those in IBS-D group and normal control group, and were higher in moderate UC than in severe UC (P<0.05). The high-intensity expression rate and IHC score of COX-2 in UC group were higher than those in IBS-D group and normal control group, and were lower in moderate UC than in severe UC (P<0.05). The high-intensity expression rate of COX-2 increased significantly in pan-colonic UC (P<0.05), while the expression of GFAP was not correlated with disease extent. Conclusions: Expression intensity of GFAP is decreased and that of COX-2 is increased in active UC. Both are correlated with the severity of UC.%背景:研究发现肠神经胶质细胞(EGC)和环氧合酶-2(COX-2)参与了肠道炎症的发生、发展过程.目的:探讨神经胶质细胞特异性标记物胶质纤维酸性蛋白(GFAP)和COX-2在中重度活动期溃疡性结肠炎(UC)病变部位活检标本中的表达及其临床意义.方法:中重度活动期UC、腹泻型肠易激综合征(IBS-D)和正常对照者各30例纳入研究,以免疫组化方法检测活检标本中的GFAP、COX-2表达.结果:UC组GFAP强阳性表达率和免疫组化评分均低于IBS-D组和正常对照组,其中中度UC显著高于重度UC (P<0.05);UC组COX-2强阳性表达率和免疫组化评分均

  10. Colitis ulcerosa

    Nielsen, Ole Haagen; Jess, Tine; Bjerrum, Jacob Tveiten; Seidelin, Jakob B

    2013-01-01

    Ulcerative colitis (UC) is a prevalent inflammatory bowel disease of the colonic mucosa affecting approximately 20,000-25,000 Danes. Apart from subgroups with early onset, extensive and long-standing inflammation, or primary sclerosing cholangitis the risk of developing colorectal cancer is of the...

  11. A Complicated Case of Tacrolimus-Induced Rapid Remission after Cesarean Section in the Early Third Trimester for Refractory Severe Ulcerative Colitis Flaring in the Initial Period of Gestation

    Takashi Mizushima

    2011-04-01

    Full Text Available A 36-year-old woman who had been diagnosed with ulcerative colitis at the age of 17 years was referred to our hospital because of severe abdominal pain and repeated bloody diarrhea that persisted during pregnancy despite combination therapy with high-dose corticosteroids and weekly granulocyte and monocyte adsorptive apheresis (GMA. She underwent combination therapy consisting of high-dose corticosteroids, intensive GMA (two sessions per week and vancomycin, which was used to eradicate Clostridium difficile, under total parenteral nutrition control until the estimated weight of her fetus reached 1,000 g. This combination therapy was partially successful, resulting in almost complete disappearance of abdominal pain and a marked decrease in stool frequency. However bloody diarrhea persisted and the patient developed anemia and hypoalbuminemia and was unable to prolong her gestation time. Cesarean section was conducted at 28 weeks of gestation without any congenital abnormalities or neurological defects. Oral administration of tacrolimus was begun 7 days after cesarean section, which was followed by rapid induction of remission. Corticosteroids were then gradually tapered off. Tacrolimus is one therapeutic option after cesarean section in pregnant patients who do not respond well to GMA and high-dose corticosteroids for persistent active ulcerative colitis.

  12. 全面分析溃疡性结肠炎发病的危险因素%Comprehensive Analysis of the Risk Factors of Ulcerative Colitis

    张文婷; 吴小平

    2011-01-01

    Ulcerative colitis is a chronic non-specific colitis disease, and is the combined result of multi-factors. In the study process of its risk factors, using the methods of systems theory to take into account the role of risk factors , especially the influence of psychosocial factors under the new medical model, could be able to grasp a more comprehensive mechanism of ulcerative colitis' occurrence. Accordingly,there would be a better guide of clinical treatment.%溃疡性结肠炎是一种慢性非特异性结肠炎症,是多因素共同作用的综合结果.在研究其发病因素的过程中,应用系统论的方法综合考虑各危险因素的作用,尤其是在新的医学模式下社会心理因素对其的影响,能更加全面的把握溃疡性结肠炎发生的作用机制,从而更好地指导临床治疗的开展.

  13. Increased Production of Lysozyme Associated with Bacterial Proliferation in Barrett's Esophagitis, Chronic Gastritis, Gluten-induced Atrophic Duodenitis (Celiac Disease), Lymphocytic Colitis, Collagenous Colitis, Ulcerative Colitis and Crohn's Colitis.

    Rubio, Carlos A

    2015-12-01

    The mucosa of the esophagus, the stomach, the small intestine, the large intestine and rectum are unremittingly challenged by adverse micro-environmental factors, such as ingested pathogenic and non-pathogenic bacteria, and harsh secretions with digestive properties with disparate pH, as well as bacteria and secretions from upstream GI organs. Despite the apparently inauspicious mixture of secretions and bacteria, the normal GI mucosa retains a healthy state of cell renewal. To by-pass the tough microenvironment, the epithelia of the GI react by speeding-up cell exfoliation, by increasing peristalsis, eliminating bacteria through secretion of plasma cell-immunoglobulins and by increasing production of natural antibacterial enzymes (lysozyme) and host defense peptides (defensin-5). Lysozyme was recently found up-regulated in Barrett's esophagitis, in chronic gastritis, in gluten-induced atrophic duodenitis (celiac disease), in collagenous colitis, in lymphocytic colitis and in Crohn's colitis. This up-regulation is a response directed towards the special types of bacteria thriving in the microenvironment in each of the aforementioned clinical inflammatory maladies. The purpose of that up-regulation is to protect the mucosa affected by the ongoing chronic inflammation. Bacterial antibiotic resistance continues to exhaust our supply of effective antibiotics. The future challenge is how to solve the increasing menace of bacterial resistance to anti-bacterial drugs. Further research on natural anti-bacterial enzymes such as lysozyme, appears mandatory. PMID:26637845

  14. Anti-Ulcer Activity of Essential Oil Constituents

    Francisco de Assis Oliveira

    2014-05-01

    Full Text Available Essential oils have attracted considerable worldwide attention over the last few decades. These natural products have wide-ranging pharmacological activities and biotechnological applications. Faced with the need to find new anti-ulcer agents and the great effort on the development of drugs for the treatment of ulcers, in this review, the anti-ulcer activities of 21 bioactive compounds found in essential oils are discussed.

  15. Anti-Ulcer Activity of Essential Oil Constituents

    Francisco de Assis de Oliveira; Luciana Nalone Andrade; Élida Batista Vieira de Sousa; Damião Pergentino de Sousa

    2014-01-01

    Essential oils have attracted considerable worldwide attention over the last few decades. These natural products have wide-ranging pharmacological activities and biotechnological applications. Faced with the need to find new anti-ulcer agents and the great effort on the development of drugs for the treatment of ulcers, in this review, the anti-ulcer activities of 21 bioactive compounds found in essential oils are discussed.

  16. Interventional effect of electroacupuncture combined with medicine on monoamine neurotransmitters in hypothalamus of rats with ulcerative colitis

    2007-01-01

    BACKGROUND: Ulcerative colitis (UC) is conventionally treated with sulfasalazine and other aminosalicylic acids. The symptoms of UC can be rapidly controlled, but high recurrence, severe adverse reactions and other shortages exist commonly. Whether electroacupuncture combined with medicine can make up these shortages remains unclear.OBJECTIVE: This study was to observe the regulatory effect of electroacupuncture combined with medicine on monoamine neurotransmitter in hypothalamus of rats with ulcerative colitis, and to analyze the pathogenesis of UC and the action pathway of electroacupuncture combined with medicine.DESIGN: A randomized controlled observation.SETTING: Shanghai Institute of Acupuncture and Meridian.MATERIALS: Thirty involved male SD rats of clean grade, weighing (200 ±20) g, were provided by the Experimental Animal Center, Shanghai University of Traditional Chinese Medicine. Sulfasalazine was produced in the Shanghai Sanwei Pharmaceutical Co., Ltd [certification No. (1995)002083].METHODS: This study was carried out in the State Laboratory (grade 3) for Acupuncture and Immunology,Shanghai Institute of Acupuncture and Meridian. The involved 30 rats were randomized into 5 groups:normal group, model group, electroacupuncture group, medicine group and electroacupuncture combined with medicine group, with 6 rats in each group. Rats in the latter 4 groups were prepared into models of UC.In the electroacupuncture group, Zusanli(shuang) point was selected. Electro-acupuncture apparatus (G6805 Ⅱ type) was connected to the point and used to stimulate it with continuous wave, frequency of 2 Hz, electrical intensity 4 mA, 20 minutes a day, for 14 days successively. In the medicine group, rats were intragastrically administrated with sulfasalazine, twice a day, 3 mL once, for 14 days successively. In the electroacupuncture combined with medicine group, rats were treated with electroacupuncture and medicine simultaneously as described in the previous two groups

  17. Integrating analysis reveals microRNA-mediated pathway crosstalk among Crohn's disease, ulcerative colitis and colorectal cancer.

    Bai, Jing; Li, Yongsheng; Shao, Tingting; Zhao, Zheng; Wang, Yuan; Wu, Aiwei; Chen, Hong; Li, Shengli; Jiang, Chunjie; Xu, Juan; Li, Xia

    2014-07-29

    Inflammatory bowel disease (IBD), which can increase the risk of colorectal cancer (CRC), includes two primary subtypes, ulcerative colitis (UC) and Crohn's disease (CD). Although several individual genes involved in inflammation or cancer characterization have been identified, it is still difficult to elucidate functional relationship details between the molecules underlying pathogenesis at the system level. The global effect of miRNAs on genes or their involved functions is also poorly understood. We first integrated genome-wide gene expression profiles and biological pathway information to explore the underlying associations among UC, CD and CRC at the function and gene level. After identifying the pathways regulated by miRNAs, a global map of miRNA-mediated pathway crosstalk shared by the three diseases was further constructed to vertically explain the links of three level alterations. The three types of diseases have close associations with each other at the levels of function, gene and miRNA regulation. Several key biological pathways are involved in the three diseases, related to the immune system and inflammation, metabolism, or cell proliferation and apoptosis etc. Moreover, miRNAs exhibit dominant effects on multiple pathways. It is worth noting that UC shows relatively close associations with CD and CRC at the three levels. Finally, the miRNAs could mediate the crosstalk within or between pathways. For example, hsa-miR-125b, hsa-miR-335 and hsa-miR-155 mediated the crosstalk between three metabolic pathways. The crosstalk within the Toll-like receptor signaling pathway could be mediated by hsa-miR-124, hsa-miR-146a and hsa-mir-221/222. Our results make sense for the prevention and treatment of intestinal-related chronic inflammation or cancer. PMID:24949825

  18. Design and Evaluation of Colon Specific Delivery of Budesonide Core in Coat Matrix Tablet Used In Local Ulcerative Colitis

    Mallikarjuna Gouda M

    2016-03-01

    Full Text Available In the present investigation planned to study the less explored sterculia gum as matrix carrier of Budesonide to colon. Developed the formulations from B1 to B4 contains alone sterculia gum and its proportion increased gradually in the formulation. The formulations B5 to B10 contain the sterculia gum in combination with Eudragit S 100 and the hydrophilic, hydrophobic polymer. The budesonide core in coat matrix tablets was prepared by direct compression method. The powder bed of the formulations is evaluated for pre compressional characteristics like bulk density, tapped density, compressibility index and angle of repose. The compressed budesonide core in coat matrix tablets were evaluated for post compressional characteristics like thickness, diameter, hardness, disintegration, friability and to understand the drug release pattern and to correlate the in vivo condition, the in vitro dissolution performed in three different gastro intestinal pH at 1.2, pH 7.4 and pH 6.8 with and without 4% rat cecal content. The in vitro dissolution results of formulations ascertain that sterculia gum alone in formulation uncontrolled the drug release in first 5 hrs and carried lesser amount of drug to colon. The formulations B8 in the first 5 hours released 4.3% and carried the larger amount of drug to colon and in absence of rat cecal content released 90% and in presences of 4% rat cecal content released 99% of drug, indicating the sterculia gum undergoes enzymatic degradation and this formulation is considered as potential in targeting the budesonide to colon in the local ulcerative colitis.

  19. Infliximab therapy for moderately severe Crohn’s disease and ulcerative colitis: a retrospective comparison over 6 years

    Raed Alzafiri

    2011-01-01

    Full Text Available Raed Alzafiri1, Christina A Holcroft2, Paula Malolepszy1, Albert Cohen1, Andrew Szilagyi11Jewish General Hospital, Division of Gastroenterology, Department of Medicine, McGill University School of Medicine, Montreal, Quebec, Canada; 2Centre for Clinical Epidemiology and Community Studies, McGill University School of Medicine, Montreal, Quebec, CanadaBackground: Infliximab has shown benefit in Crohn’s disease (CD and ulcerative colitis (UC.Objective: Evaluation of long-term outcome of therapy for both diseases.Methods: We analyzed retrospectively patients treated at infusion centers from one institution. Demographic, laboratory parameters leading up to biologic therapy and the subsequent pattern of outcomes in either disease were established as a database. Initial failure, subsequent need to change therapy, or need to adjust therapy were evaluated. Kruskal–Wallis (nonparametric tests to compare two groups and Kaplan–Meier survival curve analysis were used to compare outcomes.Results: Over approximately 6 years, 71 CD and 26 UC patients received 999 and 215 infusions, respectively, for a median of 62 months. Of these, 17% for CD and 19% for UC patients were primary failures. Following the start of infliximab, 18% of CD and 11% of UC patients required stoppage and switching to another type of therapy. In either CD or UC patients, 54% or 62%, respectively, continued therapy without the need to change to other treatments. Few serious side effects were noted. No important statistically significant differences in treatment patterns or outcome were observed between the groups.Discussion: Long-term treatment of both inflammatory bowel diseases reflects outcomes of clinical trials.Conclusions: This study emphasizes similarities between CD and UC and reports therapeutic success for an extended time.Keywords: infliximab, inflammatory bowel diseases

  20. Therapeutic Effect of Oridonin Tablet on Acetic Acid-induced Ulcerative Colitis in Mice%冬凌草甲素片对醋酸诱导的小鼠溃疡性结肠炎的治疗作用

    臧凯宏; 杜丽东; 刘晓梅; 马骏; 任远

    2012-01-01

    目的 考察冬凌草甲素片口服给药对醋酸诱导的小鼠溃疡性结肠炎的治疗作用.方法 醋酸诱导的溃疡性结肠炎小鼠分别给予不同剂量的冬凌草甲素片灌胃给药,给药7d后,考察冬凌草甲素片对溃疡性结肠炎小鼠病变活动(体质量、便潜血及粪便性状)的影响,以及对结肠病理组织学变化,结肠髓过氧化物酶活性及胸腺和脾脏指数的影响.结果 冬凌草甲素片口服给药可剂量依赖性的降低结肠炎小鼠的病变活动、减轻结肠炎症、降低髓过氧化物酶活性,改善免疫器官脏器指数,以冬凌草甲素片高剂量给药组的作用更为显著.结论 高剂量冬凌草甲素片口服给药对醋酸诱导的小鼠溃疡性结肠炎具有治疗作用,其机制可能与冬凌草甲素的抗炎和免疫调节作用有关.%OBJECTIVE To investigate the therapeutic effect of Oridonin tablet on acetic acid-induced ulcerative colitis in mice.METHODS Oridonin tablets at different dosages were administered orally to acetic acid-induced colitis mice.After 7 days of treatment,the effects of Oridonin tablet on disease activity (i.e.body weight,stool blood,and stool consistency),colonic macroscopic and histological score,myleoperoxidase activity,and thymic and splenic indexes were evaluated in acetic acid-induced ulcerative colitis in mice.RESULTS Oridonin tablet treatment dose-dependently reduced the disease activity,attenuated colonic inflammation and myleoperoxidase activity,and improved the thymic and splenic indexes in acetic acid-induced ulcerative colitis in mice,especially in high dose of Oridonin tablet treated group.CONCLUSION High dose of Oridonin tablet treatment shows therapeutic effect on acetic acid-induced ulcerative colitis in mice,the underlying mechanism may have close correlation with its anti-inflammatory and immune regulatory effects.

  1. Evaluation of Protective Effect of Hydro-alcoholic Extract of Fruit Peels of Punica granatum Linn against Ulcerative Colitis in Rats

    Ashar Kalangottil; Karunakar Hegde; Naseeb K M

    2014-01-01

    The study was designed to evaluate the protective effect of hydro-alcoholic extract of fruits peels of Punica granatum Linn. against acetic acid and trinitrobenzene sulfonic acid (TNBS) induced ulcerative colitis in rats. Acute oral toxicity study was performed to find out the test dose according to OECD guidelines 425 and hydro-alcoholic extract of P. granatum fruit peel (PGPE) was found to be safe at a dose of 2000 mg/kg body weight. The animals pretreated with hydro-alcoholic extract of P....

  2. Genome-wide Gene Expression Analysis of Mucosal Colonic Biopsies and Isolated Colonocytes Suggests a Continuous Inflammatory State in the Lamina Propria of Patients with Quiescent Ulcerative Colitis

    Bjerrum, Jacob Tveiten; Hansen, Morten; Olsen, Jørgen; Nielsen, Ole Haagen; Bjerrum, J.T.; Hansen, M.; Olsen, J.; Nielsen, O.H.

    2010-01-01

    syndrome (controls, n = 10). After isolation of colonocytes and subsequent extraction of total RNA, GWGE data were acquired using Human Genome U133 Plus 2.0 GeneChip Array (Affymetrix, Santa Clara, CA). Data analysis was carried out by principal component analysis and projection to latent structure......Background: Genome-wide gene expression (GWGE) profiles of mucosal colonic biopsies have suggested the existence of a continuous inflammatory state in quiescent ulcerative colitis (UC). The aim of this study was to use DNA microarray-based GWGE profiling of mucosal colonic biopsies and isolated...

  3. Genetic Analysis of Innate Immunity in Crohn's Disease and Ulcerative Colitis Identifies Two Susceptibility Loci Harboring CARD9 and IL18RAP

    Zhernakova, Alexandra; Festen, Eleanora M.; Franke, Lude; Trynka, Gosia; Diemen, Cleo C van; Monsuur, Alienke J.; Bevova, Marianna; Nijmeijer, Rian M.; van ‘t Slot, Ruben; Heijmans, Roel; Boezen, H. Marike; van Heel, David A; van Bodegraven, Adriaan A.; Stokkers, Pieter C. F.; Wijmenga, Cisca

    2008-01-01

    The two main phenotypes of inflammatory bowel disease (IBD)—Crohn's disease (CD) and ulcerative colitis (UC)—are chronic intestinal inflammatory disorders with a complex genetic background. Using a three-stage design, we performed a functional candidate-gene analysis of innate immune pathway in IBD. In phase I, we typed 354 SNPs from 85 innate immunity genes in 520 Dutch IBD patients (284 CD, 236 UC) and 808 controls. In phase II, ten autosomal SNPs showing association at p < 0.006 in phase I...

  4. Association of the HLA-DRB1*0701 allele with perinuclear anti-neutrophil cytoplasmatic antibodies in Mexican patients with severe ulcerative colitis

    Jesus K Yamamoto-Furusho; Luis Uscanga-Domínguez; Alondra Lopez-Martinez; Julio Granados

    2006-01-01

    AIM: To determine the association between the HLA-DRB1 alleles and perinuclear anti-neutrophil cytoplasmatic antibodies (p-ANCA) positive in Mexican patients with ulcerative colitis (UC).METHODS: Ninety Mexican mestizo patients (45 females) with UC, confirmed by biopsy, were studied. High resolution HLA typing was performed by PCR-SSO reverse dot blot and PCR-SSP. Molecular typing techniques were applied to define HLA-DRB1 alleles. Enzyme-linked immunosorbent assay and immunofluorescence techniques were used to detect p-ANCA.RESULTS: Forty-eight (53%) UC patients were positive for p-ANCA by ELISA and IF. We found that p-ANCA-positive UC patients had a significantly increased frequency of HLA-DR7 compared with p-ANCA-negative controls (22% vs 5.1%; pC=0.02, OR=5.2, CI 95%:1.06-37.82). Disease activity was scored as severe in 20 patients, moderate in 8, mild in 14 and no activity in the remaining 38 patients according to the Truelove and Witts criteria. Subgroup analysis showed a significantly increased frequency of the HLA-DRB1*07 allele in 15 of 20 UC patients with severe activity of UC and p-ANCA positivity [100% vs 0%; pC=0.0000001; OR=35]. No significant differences were found between p-ANCA positive patients, HLA-DR alleles and other clinical features such as extraintestinal manifestations, proctocolectomy and extension.CONCLUSION: The HLA-DRB1*07 is associated with p-ANCA positive UC Mexican patients.

  5. Changes of plasma fasting carnitine ester profile in patients with ulcerative colitis

    Judit Bene; Mária Figler; Katalin Komlósi; Viktória Havasi; Gábor Talián; Beáta Gasztonyi; Krisztina Horváth; Gyula Mózsik; Béla Hunyady; Béla Melegh

    2006-01-01

    AIM: To determine the plasma carnitine ester profile in adult patients with ulcerative culitis (UC) and compared with healthy control subjects.METHOD: Using ESI triple quadrupole tandem mass spectrometry, the carnitine ester profile was measured in 44 patients with UC and 44 age- and sex-matched healthy controls.RESULTS: There was no significant difference in the fasting free carnitine level between the patients with UC and the healthy controls. The fasting propionyl(0.331 ±0.019 vs0.392 ± 0.017 μmol/L), butyryl(0.219 ± 0.014 vs 0.265± 0.012), and isovalerylcarnitine (0.111 ± 0.008 vs 0.134± 0.008) levels were decreased in the UC patients. By contrast, the level of octanoyl- (0.147 ± 0.009 vs 0.114 ± 0.008),decanoyl- (0.180 ± 0.012 vs 0.137 ± 0.008), myristoyl(0.048 ± 0.003 vs 0.039 ± 0.003), palmitoyl- (0.128 ± 0.006vs 0.109 ± 0.004), palmitoleyl- (0.042±0.003vs 0.031 ± 0.002) and oleylcarnitine (0.183 ± 0.007vs 0.163 ± 0.007; P < 0.05 in all comparisons) were increased in the patients with UC.CONCLUSION: Our data suggest selective involvement of the carnitine esters in UC patients, probably due to their altered metabolism.

  6. Predictive factors of poor response to intravenous cyclosporine in steroid-refractory ulcerative colitis Factores predictivos de mala respuesta precoz a la ciclosporina endovenosa en la colitis ulcerosa grave corticorrefractaria

    J. W. Huamán Ríos

    2009-03-01

    Full Text Available Background: the treatment of severe ulcerative colitis (UC flares includes measures such as hospitalization and intravenous steroids. Despite this, a quarter of patients are refractory to treatment. Given the availability of new therapeutic strategies in patients with steroid-refractory UC (cyclosporine, infliximab, apheresis, surgery it is necessary to predict which treatment will be most effective for each patient. Objectives: to determine which clinical or biological factors discriminate the lack of response to cyclosporine in steroid-refractory UC. Methods: forty one flares of steroid-refractory UC in 35 patients treated with intravenous cyclosporine have been included. The response to cyclosporine was assessed at day 10 of treatment by using the modified Truelove and Witts disease activity score. Variables with prognostic significance were determined by a univariate analysis comparing groups with complete response and no-response, and an analysis of multiple linear regression. Results: complete response was obtained in 41 flares (48%, partial response in 22%, and lack of response in 29%. The univariate analysis showed a significant difference in four predictive factors: higher age (p = 0.008, thrombocytosis (p = 0.01, disease extent (pancolitis vs. left-sided disease (p = 0.04, and having received cyclosporine previously (p = 0.01. A multiple linear regression analysis confirmed the significance of higher age, thrombocytosis, and having received cyclosporine previously as predictive factors of poor response. Conclusion: higher age, thrombocytosis and previous use of cyclosporine predispose to poor response to intravenous cyclosporine in severe flares of steroid-refractory UC.Introducción: el tratamiento de los brotes graves de colitis ulcerosa (CU incluye medidas como la hospitalización y corticoides e.v., a pesar de ello, en una cuarta parte de los pacientes no se consigue inducir la remisión. Dada la disponibilidad de diferentes

  7. Efficacy and safety of tumor necrosis factor-α blockers for ulcerative colitis: A systematic review and meta-analysis of published randomized controlled trials

    Yun-Na Song

    2015-03-01

    Full Text Available To evaluate the efficacy and safety of TNF-α blockers for ulcerative colitis. A systematic search for randomized controlled trials (RCTs of TNF-α blockers for treatment of ulcerative colitis (UC were performed in PubMed, Web of Science, Embase and cochrane clinical trial. We estimated Pooled estimates of the odds ratio (OR and relevant 95% confidence interval (CI using fixed effects model or random effects model as appropriate. Heterogeneity, publication bias, and subgroup analyses were conducted. Nine randomized controlled studies met the selection criteria with a total of 2518 patients. Five studies compared Infliximab with placebo. Two studies compared Infliximab to corticosteroids. Two studies compared Adalimumab to placebo. One study compared subcutaneous golimumab to placebo. Short-term response, short-term remission, long-term remission and mucosal healing were better in the TNF-α blocker group than in the control group (p < 0.05. TNF-α blockers decreased the colectomy rate and serious adverse reactions (p < 0.05. The TNF-α blockers were superior to controls in achieving short-term clinical response/remission, long-term remission and mucosal healing and decreased the colectomy rate and serious adverse reactions.

  8. Treatment of ulcerative colitis by ozone therapy via colon therapy system%结肠水疗加三氧治疗溃疡性结肠炎

    梁仲惠; 耿焱; 易亚萍; 苏莉雅

    2012-01-01

    目的 观察结肠水疗加三氧治疗溃疡性结肠炎的效果.方法 治疗组36例和对照组35例,两组均予口服柳氮磺胺吡啶片1g,每天3次,治疗组经结肠途径治疗系统清洗肠道加用三氧疗法,治疗观察3周.结果 治疗组总有效率94.44%明显优于对照组94.29%(P< 0.05).结论 三氧疗法经结肠途径治疗溃疡性结肠炎疗效好,值得进一步推广应用.%Objective To observe the clinical efficacy of ozone therapy via colon therapy system in treatment of ulcerative colitis. Methods Thirty-six patients in treatment group and 35 patients in control group that were treated with sulfasalazine for 3 weeks. Additionally, patients in treatment group received ozone therapy via colon therapy system. The efficacy of each group was observed at the end of the third week, respectively. Results In comparison with control group, the overall outcome in treatment group was satisfactory. Conclusion Ozone therapy via colon therapy system in treatment of ulcerative colitis via colon therapy system is effective and feasible.

  9. Metabonomics in Ulcerative Colitis: Diagnostics, Biomarker Identification, And Insight into the Pathophysiology

    Bjerrum, Jacob T; Nielsen, Ole H; Hao, Fuhua;

    2010-01-01

    -projection to latent structure-discriminant analysis using the SIMCA P+11 software package (Umetrics, Umea, Sweden) and Matlab environment. Significant differences between controls and active UC were discovered in the metabolic profiles of biopsies and colonocytes. In the biopsies from patients with active UC...

  10. N-acetyl-L-cysteine combined with mesalamine in the treatment of ulcerative colitis: Randomized, placebo-controlled pilot study

    Luis G Guijarro; David Prieto-Merino; Venancio Gonzalez Lara; Amado Salvador Pe(n)a; Jose Mate; Javier P Gisbert; Jose Luis Perez-Calle; Ignacio Marín-Jimenez; Encarna Arriaza; Tomás Olleros; Maria Delgado; Maria S Castillejo

    2008-01-01

    AIM: To evaluate the effectiveness and safety of oral N-acetyI-L-cysteine (NAC) co-administration with mesalamine in ulcerative colitis (UC) patients.METHODS: Thirty seven patients with mild to moderate UC were randomized to receive a fourowk course of oral mesalamine (2.4 g/d) plus N-acetyI-L-cysteine (0.8 g/d)(group A) or mesalamine plus placebo (group B).Patients were monitored using the Modified TrueloveWitts Severity Index (MIWSI). The primary endpoint was clinical remission (MIWSI ≤ 2) at 4 wk. Secondary endpoints were clinical response (defined as a reduction from baseline in the MIWSI of≥ 2 points) and drug safety. The serum TNF-α, interleukin-6, interleukin-8 and MCP-1 were evaluated at baseline and at 4 wk of treatment.RESULTS: Analysis per-protocol criteria showed clinical remission rates of 63% and 50% after 4 wk treatment with mesalamine plus N-acetyI-L-cysteine (group A) and mesalamine plus placebo (group 13) respectively (OR = 1.71;95% CI: 0.46 to 6.36; P = 0.19; NNT = 7.7). Analysis of variance (ANOVA) of data indicated a significant reduction of MIWSI in group A (P = 0.046) with respect to basal condition without significant changes in the group B (P = 0.735) during treatment. Clinical responses were 66% (group A) vs 44% (group B) alter 4 wk of treatment (OR = 2.5; 95% CI: 0.64 to 9.65; P = 0.11; NNT = 4.5).Clinical improvement in group A correlated with a decrease of IL-8 and MCP-1. Rates of adverse events did not differ significantly between both groups.CONCLUSION: In group A (oral NAC combined with mesalamine) contrarily to group B (mesalamine alone),the clinical improvement correlates with a decrease of chemokines such as MCP-1 and IL-8. NAC addition not produced any side effects.

  11. Medication adherence and persistence in the treatment of Canadian ulcerative colitis patients: analyses with the RAMQ database

    Lachaine Jean

    2013-01-01

    Full Text Available Abstract Background Although high non-adherence to medication has been noticed for ulcerative colitis (UC, little is known about adherence to mesalamine treatments and determinants that can predict adherence. The objective of this study was to assess adherence and persistence to mesalamine treatments and their potential determinants in mild to moderate UC patients in a real-life setting in Quebec, Canada. Methods A retrospective prescription and medical claims analysis was conducted using a random sample of mesalamine users with UC. For inclusion, patients were required to initiate an oral mesalamine treatment between January 2005 and December 2009. Patients with a diagnosis of Crohn’s disease were excluded. Treatment adherence (medication possession ratio [MPR] and persistence were evaluated over a 1-year period after the index prescription using the Kaplan-Meier method with log-rank test and stepwise regression to identify potential determinants. Results A sample of 1,681 of the new oral mesalamine users (mean age = 55.3 patients was obtained. Overall, the percentage of patients with a MPR of 80% or greater at 12 months was 27.7%, while persistence was 45.5%. Among patients treated with mesalamine delayed/extended-release tablets (Mezavant®, adherence and persistence were 40.9% and 71.9%, respectively. Predictors of high adherence included, male gender (OR=1.3; 95% confidence interval [CI]=1.1–1.6, older age (>60 years; OR=1.6; 95% CI=1.3–2.0 and current use of corticosteroids (OR=1.4; 95% CI=1.1–1.8. Predictors of high persistence included male sex (OR=1.4; 95% CI=1.1–1.7, current use of corticosteroids (OR=1.4; 95% CI=1.1–1.7 and presence of hypertension or respiratory diseases (OR=1.2; 95% CI=1.01–1.55. Conclusions The majority of patients with UC exhibited low adherence and persistence to mesalamine treatments. Various determinants of improved adherence and persistence were identified.

  12. Anti-ulcer activity of Ipomoea batatas tubers (sweet potato

    Vandana Panda

    2012-04-01

    Full Text Available Background: Peptic ulcers occur in that part of the gastrointestinal tract which is exposed to gastric acid and pepsin, i.e., the stomach and duodenum. Gastric and duodenal ulcers are common pathologies that may be induced by a variety of factors such as stress, smoking and noxious agents including non-steroidal anti-inflammatory drugs. Ipomoea batatas tubers (sweet potato contain ample amounts of antioxidants. It has been proven already by many scientific studies that antioxidants have ulcer healing properties. In reference to this, we tried assessing the ulcer healing effect of Ipomoea batatas tubers. Methods: The anti-ulcer activity of the tubers of Ipomoea batatas (sweet potato was studied in cold stress and aspirin-induced gastric ulcers in Wistar rats. Methanolic extracts of Ipomoea batatas tubers (TE at two doses, viz., 400 and 800 mg /kg were evaluated in cold stress and aspirin-induced gastric ulcer models using cimetidine and omeprazole respectively as standards. The standard drugs and the test drugs were administered orally for 7 days in the cold stressmodel and for 1 day in the aspirin-induced gastric ulcer model. Gastroprotective potential, status of the antioxidant enzymes {superoxide dismutase (SOD, catalase (CAT, glutathione peroxidase (GPx and glutathione reductase(GR} along with GSH, and lipid peroxidation were studied in both models. Results: The results of the present study showed that TE possessed gastroprotective activity as evidenced by its significant inhibition of mean ulcer score and ulcer index and a marked increase in GSH, SOD, CAT, GPx, and GR levels and reduction in lipid peroxidation in a dose dependant manner.Conclusion: The present experimental findings suggest that tubers of Ipomoea batatas may be useful for treating peptic ulcers.

  13. Fecal Calprotectin Predicts Relapse and Histological Mucosal Healing in Ulcerative Colitis

    Theede, Klaus; Holck, Susanne; Ibsen, Per;

    2016-01-01

    . Fecal calprotectin (FC) was measured 2 to 3 days before the sigmoidoscopy. The tissue samples were evaluated for neutrophilic inflammation. We aimed at testing the predictive performance of FC and histological inflammatory activity on disease relapse. RESULTS: A baseline FC level of more than 321 mg...

  14. Antileukotrienic phenethylamido derivatives of arylalkanoic acids in the treatment of ulcerative colitis

    Junek, R.; Kverka, Miloslav; Jandera, A.; Panajotová, V.; Šatinský, D.; Macháček, M.; Kuchař, M.

    2009-01-01

    Roč. 44, č. 1 (2009), s. 332-344. ISSN 0223-5234 R&D Projects: GA ČR GD310/03/H147 Institutional research plan: CEZ:AV0Z50200510 Keywords : N-Phenethyl-2-arylacetamides * Antileukotrienic activity * QSAR Subject RIV: EC - Immunology Impact factor: 3.269, year: 2009

  15. High-density mapping of the MHC identifies a shared role for HLA-DRB1*01:03 in inflammatory bowel diseases and heterozygous advantage in ulcerative colitis

    Goyette, Philippe; Boucher, Gabrielle; Mallon, Dermot;

    2015-01-01

    Genome-wide association studies of the related chronic inflammatory bowel diseases (IBD) known as Crohn's disease and ulcerative colitis have shown strong evidence of association to the major histocompatibility complex (MHC). This region encodes a large number of immunological candidates, includi...

  16. ANTI PEPTIC ULCER ACTIVITY OF THE LEAVES OF Amaranthus spinosus L. IN RATS

    TANAYA GHOSH; PRASENJIT MITRA; DEBIPRASAD GHOSH; PRASANTA KUMAR MITRA

    2013-01-01

    Anti peptic ulcer activity of the leaves of Amaranthus spinosus L., a plant of Eastern Himalaya, was studied in peptic ulcer models in rats. Gastric and duodenal ulcers were induced by ethanol and cysteamine respectively. Results were compared with omeprazole, a known drug for peptic ulcer. It was found out that the leaves of Amaranthus spinosus L. exerted anti peptic ulcer activity against ethanol and cysteamine induced peptic ulcerations but the activity was less than that of omeprazole.

  17. Anti-ulcer activity of Ficus religiosa leaf ethanolic extract

    Marslin Gregory; B Divya; Revina Ann Mary; M M Hipolith Viji; V K Kalaichelvan; V Palanivel

    2013-01-01

    Objective:To evaluate the anti-ulcer activity and acute toxicity of Ficus religiosa (F. religiosa) leaf ethanolic extract in animal models. Methods:Anti-ulcer activity of F. religiosa ethanolic extract (250 and 500 mg/kg body weight) was studied on stress induced ulcer animal models. Ranitidine was used as standard. The anti-ulcer activity of F. religiosa was evaluated with the help of ulcer area and histopatholgical examination. Preliminary phyto-chemical screening and acute toxicity studies of F. religiosa also carried out. Results: Results showed that the extract treatments prevented ulcer area and gastric secretion in a dose-dependent manner. Administration of 2 000 mg/kg extract did not show any acute toxicity in albino mice. Preliminary phytochemical analysis identified the presence of flavonoids in the ethanolic extract of F. religiosa. Conclusions: The extract is non-toxic even at relatively high concentrations. The anti-ulcer activity is probably due to the presence of flavanoids.

  18. Role of Intestinal Microbiota in Ulcerative Colitis – Effects of Novel Carbohydrate Preparations

    Vigsnæs, Louise Kristine

    2011-01-01

    reported, which could affect colonic health. In the experimental part of this thesis, the fecal microbiota derived from UC patients in either remission or with active disease and healthy subjects was quantified using quantitative Real‐Time PCR (qPCR) to examine the microbiota composition. The results...... examined in a study of this thesis to elucidate, if the adhesion capacity is different depending on disease state. For this purpose, an in vitro dynamic gut model was used. Several bacterial taxa from both lumen and mucus were quantified using qPCR. The results revealed that the bacterial community of the...... mucus differed from that of the lumen and that lactobacilli and bifidobacteria derived from UC patients had a significant decreased capacity to colonize mucus than observed for similar bacterial groups originating from healthy subjects. This suggests that the inflammatory state in UC may influence the...

  19. Role of fecal calprotectin in evaluation of disease activity and recurrence of ulcerative colitis%粪便中钙卫蛋白水平对溃疡性结肠炎患者疾病严重程度和复发的评估价值

    林松挺

    2016-01-01

    目的:探讨粪便中钙卫蛋白(calprotectin,CP)水平对溃疡性结肠炎(ulcerative colitis,UC)的诊断价值、疾病的严重程度以及预后复发的评估作用.方法:采集72例活动期UC患者、28例缓解期UC患者和1 8例健康成人粪便样本,使用ELISA方法检测粪便中CP水平.分析其对疾病的诊断,疾病严重程度,治疗后疾病缓解,以及对疾病发生发展的预测价值.结果:研究发现活动期UC患者粪便中CP水平(373.2 μg/g±89.8 μg/g)明显高于缓解期UC患者(78.6 μg/g±24.3 μg/g)和健康对照者(46.9 μg/g±15.3 μg/g)(P<0.001),尤其发现重症UC患者比中度和轻度UC患者粪便中CP明显升高(P<0.01).进一步分析发现,UC患者粪便中CP水平与Mayo评分和C反应蛋白呈正相关关系(P<0.01).活动期UC患者经过有效药物治疗后,粪便中CP水平明显下降(P<0.001),而病情复发患者粪便中的CP水平再次显著升高(P<0.001).结论:我们研究证实了活动期UC患者粪便中CP水平明显升高,并能够预测UC的疾病活动程度,判断病情预后和复发,提示粪便中CP是一项有效的指标,用于判断UC疾病发生发展.

  20. Pyoderma Gangrenosum: A Rare Cause of Breast Ulceration

    Duke, Georgina; Samaraee, Ahmad Al; Husain, Akhtar; Meggitt, Simon; Fasih, Tarannum

    2012-01-01

    Breast ulceration is an alarming sign for clinicians and places a significant physical and psychological burden on the patient. We report a rare presentation of pyoderma gangrenosum of the breast in a patient known to have ulcerative colitis but no active underlying disease process and no history of breast tissue trauma. This case report with literature review highlights the importance of considering pyoderma gangrenosum as a differential diagnosis in breast ulcers.

  1. Ulcerative colitis - discharge

    ... and slow your heart rate, deep breathing exercises, hypnosis, or other ways to relax. Examples include doing ... medicines. You may use acetaminophen (Tylenol) for mild pain. Drugs such as aspirin, ibuprofen (Advil, Motrin), or ...

  2. Complications of collagenous colitis

    Hugh James Freeman

    2008-01-01

    Microscopic forms of colitis have been described, including collagenous colitis. This disorder generally has an apparently benign clinical course. However, a number of gastric and intestinal complications, possibly coincidental, may develop with collagenous colitis. Distinctive inflammatory disorders of the gastric mucosa have been described, including lymphocytic gastritis and collagenous gastritis. Celiac disease and collagenous sprue (or collagenous enteritis) may occur. Colonic ulceration has been associated with use of nonsteroidal anti-inflammatory drugs, while other forms of inflammatory bowel disease, including ulcerative colitis and Crohn's disease, may evolve from collagenous colitis. Submucosal "dissection", colonic fractures or mucosal tears and perforation from air insufflation during colonoscopy may occur and has been hypothesized to be due to compromise of the colonic wall from submucosal collagen deposition. Similar changes may result from increased intraluminal pressure during barium enema contrast studies. Finally, malignant disorders have also been reported, including carcinoma and lymphoproliferative disease.

  3. Clinical and economic outcomes in a population-based European cohort of 948 ulcerative colitis and Crohn's disease patients by Markov analysis

    Odes, S.; Vardi, H.; Friger, M.;

    2010-01-01

    P>Background Forecasting clinical and economic outcomes in ulcerative colitis (UC) and Crohn's disease (CD) patients is complex, but necessary. Aims To determine: the frequency of treatment-classified clinical states; the probability of transition between states; and the economic outcomes. Methods....../surgical remission (medication-free) and mild disease (on 5-aminosalicylates, antibiotics, topical corticosteroids), comprising 28% and 62% of UC cycles and 24% and 51% of CD cycles respectively. The probability of drug-response in patients receiving systemic corticosteroids/immunomodulators was 0.74 in UC, 0.66 in...... CD. Both diseases had similar likelihood of persistent drug-dependency or drug-refractoriness. Surgery was more probable in CD, 0.20, than UC, 0.08. In terms of economic outcomes, surgery was costlier in UC per cycle, but the outlay over 10 years was greater in CD. Drug-refractory UC and CD cases...

  4. Clinical and economic outcomes in a population-based European cohort of 948 ulcerative colitis and Crohn's disease patients by Markov analysis

    Odes, S.; Vardi, H.; Friger, M.;

    2010-01-01

    P>Background Forecasting clinical and economic outcomes in ulcerative colitis (UC) and Crohn's disease (CD) patients is complex, but necessary. Aims To determine: the frequency of treatment-classified clinical states; the probability of transition between states; and the economic outcomes. Methods...... CD. Both diseases had similar likelihood of persistent drug-dependency or drug-refractoriness. Surgery was more probable in CD, 0.20, than UC, 0.08. In terms of economic outcomes, surgery was costlier in UC per cycle, but the outlay over 10 years was greater in CD. Drug-refractory UC and CD cases...... engendered high costs in the cohort. Conclusions Most patients on 5-aminosalicylates, corticosteroids and immunomodulators had favourable clinical and economic outcomes over 10 years. Drug-refractory and surgical patients exhibited greater long-term expenses...

  5. Glycoaminoglycan (GAG) deficiency in protective barrier as an underlying, primary cause of ulcerative colitis, Crohn's disease interstitial cystitis and possibly Reiter's syndrome.

    Russell, A L

    1999-04-01

    Ulcerative colitis, Crohn's disease and interstitial cystitis share many common features, the most important of which is a defect in the glycoaminoglycan (GAG) defensive barrier. This defect allows penetration of toxins causing localized inflammatory response, followed by fibrosis and distant pathological changes, together with a myriad of biochemical and immunological changes. The latter has caused confusion as to etiology of the aforementioned disorders. This hypothesis is somewhat supported by the fact that agents such as glucosamine and pentosan polysulphate (Elmiron) that replace the GAG layer, improve the conditions. The potential for extrapolation of this hypothesis to atherosclerosis and arthropathies exists. There is a great danger in modern medical research that if one misses the wood for the trees, one becomes hopelessly lost in the minutiae of research. At present, it is embarrassing that ulcerative colitis (UC), Crohn's (CR) and interstitial cystitis (IC) are the cause of a great deal of morbidity and occasionally mortality, yet after intensive research, the etiology and effective treatment eludes us. The research in the past has focused extensively on inflammatory response in the mucosal lining, and biochemical, infective and immunological changes in the serum. This has led to a vast array of research pathways that seem at the present time to be totally lost and, might I say, aimless in direction, as a cause for these conditions, that remain amongst the most imperically treated in modern medicine. Another possible syndrome in this class would be Reiter's, which has many features in common with the above. The basic tenet of a GAG deficiency hypothesis is that, as shown in Figure 1A, an intact GAG layer provides, firstly, a mechanical and electrostatic defence against penetration of infective agents, toxins, antigenic protein moieties, etc. and, secondly, the prevention of extravasation of body fluid components. A degraded GAG layer is the start of the

  6. Role of psychological factors in pathogenesis of ulcerative colitis%心理因素在溃疡性结肠炎中的作用及机制

    张云云; 王志荣

    2013-01-01

    溃疡性结肠炎(ulcerative colitis,UC)是一种直肠及结肠慢性炎症性疾病,目前病因尚未明确,现认为多种因素参与了UC的发生及发展,其中心理因素起了重要作用.随着心理神经免疫学的概念逐渐被接受,目前认为情绪可通过神经系统来影响人体免疫功能.有研究表明,心理应激可能通过改变脑-肠轴功能、兴奋植物神经、促进神经递质释放及改变细菌黏膜交互作用等途径参与肠道炎症的发生发展.本文综述了近年来心理因素在UC中的作用及机制,并为心理干预治疗的研究做好铺垫.%Ulcerative colitis (UC) is a chronic inflammatory disease of the colon of unknown etiology.Multiple factors induce the occurrence and development of UC.Among these factors,psychological factors play an important role.As psychoneuroimmunology concept is gradually being accepted,it is currently believed that emotion can affect immune function through the nervous system.Recent studies suggest that psychological stress can be involved in alterations in intestinal inflammation by changing brain-gut axis function,exciting vegetative nerve,releasing neurotransmitters and altering bacterial-mucosal interactions.This paper reviews recent advances in understanding the role of psychological factors in the pathogenesis of UC and emphasizes the ways for the development of therapeutic psychological interventions.

  7. Reversal of Refractory Ulcerative Colitis and Severe Chronic Fatigue Syndrome Symptoms Arising from Immune Disturbance in an HLA-DR/DQ Genetically Susceptible Individual with Multiple Biotoxin Exposures.

    Gunn, Shelly R; Gunn, G Gibson; Mueller, Francis W

    2016-01-01

    BACKGROUND Patients with multisymptom chronic conditions, such as refractory ulcerative colitis (RUC) and chronic fatigue syndrome (CFS), present diagnostic and management challenges for clinicians, as well as the opportunity to recognize and treat emerging disease entities. In the current case we report reversal of co-existing RUC and CFS symptoms arising from biotoxin exposures in a genetically susceptible individual. CASE REPORT A 25-year-old previously healthy male with new-onset refractory ulcerative colitis (RUC) and chronic fatigue syndrome (CFS) tested negative for autoimmune disease biomarkers. However, urine mycotoxin panel testing was positive for trichothecene group and air filter testing from the patient's water-damaged rental house identified the toxic mold Stachybotrys chartarum. HLA-DR/DQ testing revealed a multisusceptible haplotype for development of chronic inflammation, and serum chronic inflammatory response syndrome (CIRS) biomarker testing was positive for highly elevated TGF-beta and a clinically undetectable level of vasoactive intestinal peptide (VIP). Following elimination of biotoxin exposures, VIP replacement therapy, dental extractions, and implementation of a mind body intervention-relaxation response (MBI-RR) program, the patient's symptoms resolved. He is off medications, back to work, and resuming normal exercise. CONCLUSIONS This constellation of RUC and CFS symptoms in an HLA-DR/DQ genetically susceptible individual with biotoxin exposures is consistent with the recently described CIRS disease pathophysiology. Chronic immune disturbance (turbatio immuno) can be identified with clinically available CIRS biomarkers and may represent a treatable underlying disease etiology in a subset of genetically susceptible patients with RUC, CFS, and other immune disorders. PMID:27165859

  8. Pooled Resequencing of 122 Ulcerative Colitis Genes in a Large Dutch Cohort Suggests Population-Specific Associations of Rare Variants in MUC2.

    Visschedijk, Marijn C; Alberts, Rudi; Mucha, Soren; Deelen, Patrick; de Jong, Dirk J; Pierik, Marieke; Spekhorst, Lieke M; Imhann, Floris; van der Meulen-de Jong, Andrea E; van der Woude, C Janneke; van Bodegraven, Adriaan A; Oldenburg, Bas; Löwenberg, Mark; Dijkstra, Gerard; Ellinghaus, David; Schreiber, Stefan; Wijmenga, Cisca; Rivas, Manuel A; Franke, Andre; van Diemen, Cleo C; Weersma, Rinse K

    2016-01-01

    Genome-wide association studies have revealed several common genetic risk variants for ulcerative colitis (UC). However, little is known about the contribution of rare, large effect genetic variants to UC susceptibility. In this study, we performed a deep targeted re-sequencing of 122 genes in Dutch UC patients in order to investigate the contribution of rare variants to the genetic susceptibility to UC. The selection of genes consists of 111 established human UC susceptibility genes and 11 genes that lead to spontaneous colitis when knocked-out in mice. In addition, we sequenced the promoter regions of 45 genes where known variants exert cis-eQTL-effects. Targeted pooled re-sequencing was performed on DNA of 790 Dutch UC cases. The Genome of the Netherlands project provided sequence data of 500 healthy controls. After quality control and prioritization based on allele frequency and pathogenicity probability, follow-up genotyping of 171 rare variants was performed on 1021 Dutch UC cases and 1166 Dutch controls. Single-variant association and gene-based analyses identified an association of rare variants in the MUC2 gene with UC. The associated variants in the Dutch population could not be replicated in a German replication cohort (1026 UC cases, 3532 controls). In conclusion, this study has identified a putative role for MUC2 on UC susceptibility in the Dutch population and suggests a population-specific contribution of rare variants to UC. PMID:27490946

  9. Infliximabe no tratamento inicial da retocolite ulcerativa moderada e grave. Terapia top down: relato preliminar Infliximab: first line therapy in severe ulcerative colitis. Preliminary report

    Fabio Vieira Teixeira

    2008-09-01

    áfica, acreditamos que esse seja o primeiro relato em língua Portuguesa do uso de um agente biológico como primeira opção no tratamento da RCU. No entanto, mesmo com o sucesso obtido, esse relato inicial deve ser analisado com cautela. A pergunta se o uso do infliximabe seria a melhor opção na terapia inicial das formas graves da RCU, ainda precisa ser respondida por meio de estudos randomizados e controlados.The first option for the treatment of UC is both: salicylates or corticoids. Recently, in late November of 2006, the Brazilian Ministry of Health has approved infliximab (Remicade ©, Mantecorp, Brazil to treat ulcerative colitis. We report the use of infliximab as a first option for the treatment of two patients with severe ulcerative colitis. CASE REPORT: Patient 1: AZF, 52 years-old, female, was first diagnosed with UC after history and clinical examination; colonoscopy showed pancolitis with positive biopsy (crypt microabscess. Her Mayo score was 10 (range: 0 to 12 / asymptomatic to severe colitis. She received intra venous infusion of infliximab at a dose of 5mg/Kg of body weigh at week 0, 2, 6 and 14. Then, patient was given mesalazine 4.5 g / day for maintenance therapy. Clinical response was defined as a decreased from baseline in the total Mayo score of at least 3 points. At present, patient is asymptomatic with Mayo score of 3 one moth after the last dose of infliximab. Patient 2: MLA, 45 years-old, female was first diagnosed with bloody diarrhea; colonoscopy showed left colitis and the biopsy was positive for ulcerative colitis. Her Mayo score was 9. She was offered and accepted the step down treatment. She was given infliximab 5mg/Kg of body weight at week 0, 2, 6 and 14. After initial treatment with infliximab, she received mesalazine 4.2 g / day. At present, she is asymptomatic with Mayo score of 2 eighteen days after the last dose of infliximab. At our knowledge, this is the first Brazilian report of the use of infliximab as fist-line therapy in ulcerative

  10. Deep resequencing of GWAS loci identifies rare variants in CARD9, IL23R and RNF186 that are associated with ulcerative colitis.

    Mélissa Beaudoin

    Full Text Available Genome-wide association studies and follow-up meta-analyses in Crohn's disease (CD and ulcerative colitis (UC have recently identified 163 disease-associated loci that meet genome-wide significance for these two inflammatory bowel diseases (IBD. These discoveries have already had a tremendous impact on our understanding of the genetic architecture of these diseases and have directed functional studies that have revealed some of the biological functions that are important to IBD (e.g. autophagy. Nonetheless, these loci can only explain a small proportion of disease variance (~14% in CD and 7.5% in UC, suggesting that not only are additional loci to be found but that the known loci may contain high effect rare risk variants that have gone undetected by GWAS. To test this, we have used a targeted sequencing approach in 200 UC cases and 150 healthy controls (HC, all of French Canadian descent, to study 55 genes in regions associated with UC. We performed follow-up genotyping of 42 rare non-synonymous variants in independent case-control cohorts (totaling 14,435 UC cases and 20,204 HC. Our results confirmed significant association to rare non-synonymous coding variants in both IL23R and CARD9, previously identified from sequencing of CD loci, as well as identified a novel association in RNF186. With the exception of CARD9 (OR = 0.39, the rare non-synonymous variants identified were of moderate effect (OR = 1.49 for RNF186 and OR = 0.79 for IL23R. RNF186 encodes a protein with a RING domain having predicted E3 ubiquitin-protein ligase activity and two transmembrane domains. Importantly, the disease-coding variant is located in the ubiquitin ligase domain. Finally, our results suggest that rare variants in genes identified by genome-wide association in UC are unlikely to contribute significantly to the overall variance for the disease. Rather, these are expected to help focus functional studies of the corresponding disease loci.

  11. Immunomodulatory capacity of Bifidobacterium longum strains predict their efficacy in prevention of ulcerative colitis in mouse model

    Šrůtková, Dagmar; Schwarzer, Martin; Hudcovic, Tomáš; Zákostelská, Zuzana; Španová, A.; Rittich, B.; Kozáková, Hana

    Varšava : Institute of Immunology and Experimental Therapy Polish Academy of Science, 2013. s. 16. ISBN 978-83-928488-3-7. [Polish-Czech Probiotics Conference - Microbiology and Immunology of Mucosa 2013 /1./. 28.05.2013-31.05.2013, Kudowa Zdrój] Institutional support: RVO:61388971 Keywords : colitis

  12. Low dose balsalazide (1.5 g twice daily) and mesalazine (0.5 g three times daily) maintained remission of ulcerative colitis but high dose balsalazide (3.0 g twice daily) was superior in preventing relapses

    Kruis, W.; Schreiber, S; Theuer, D; Brandes, J; Schutz, E; Howaldt, S; Krakamp, B; Hamling, J; MONNIKES, H.; Koop, I; Stolte, M; Pallant, D; Ewald, U

    2001-01-01

    BACKGROUND—Balsalazide is a new 5-aminosalicylic acid (5-ASA) containing prodrug. Its efficacy in comparison with standard mesalazine therapy and the optimum dose for maintaining remission of ulcerative colitis are still unclear.
AIMS—To compare the relapse preventing effect and safety profile of two doses of balsalazide and a standard dose of Eudragit coated mesalazine.
METHODS—A total of 133 patients with ulcerative colitis in remission were recruited to participate in a double blind, multi...

  13. HELIGMOSOMOIDES POLYGYRUS BAKERI INFECTION ACTIVATES COLONIC FOXP3+ T CELLS ENHANCING THEIR CAPACITY TO PREVENT COLITIS

    Hang, Long; Blum, Arthur M.; Setiawan, Tommy; Urban, Joseph P.; Stoyanoff, Korynn M.; Weinstock, Joel V.

    2013-01-01

    Helminthic infections protect mice from colitis in murine models of inflammatory bowel disease and also may protect people. Helminths like H. bakeri (Hpb) can induce Tregs. Experiments explored if Hpb infection could protect mice from colitis through activation of colonic Treg and examined mechanisms of action. We showed that Hpb infection increased the number of T cells expressing Foxp3 in the colon. More importantly, Foxp3+/IL10- and Foxp3+/IL10+ T cell subsets isolated from the colon of Hp...

  14. Activation of aryl hydrocarbon receptor (AhR leads to reciprocal epigenetic regulation of FoxP3 and IL-17 expression and amelioration of experimental colitis.

    Narendra P Singh

    Full Text Available BACKGROUND: Aryl hydrocarbon receptor (AhR, a transcription factor of the bHLH/PAS family, is well characterized to regulate the biochemical and toxic effects of environmental chemicals. More recently, AhR activation has been shown to regulate the differentiation of Foxp3(+ Tregs as well as Th17 cells. However, the precise mechanisms are unclear. In the current study, we investigated the effect of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD, a potent AhR ligand, on epigenetic regulation leading to altered Treg/Th17 differentiation, and consequent suppression of colitis. METHODOLOGY/PRINCIPAL FINDINGS: Dextran sodium sulphate (DSS administration induced acute colitis in C57BL/6 mice, as shown by significant weight loss, shortening of colon, mucosal ulceration, and increased presence of CXCR3(+ T cells as well as inflammatory cytokines. Interestingly, a single dose of TCDD (25 µg/kg body weight was able to attenuate all of the clinical and inflammatory markers of colitis. Analysis of T cells in the lamina propria (LP and mesenteric lymph nodes (MLN, during colitis, revealed decreased presence of Tregs and increased induction of Th17 cells, which was reversed following TCDD treatment. Activation of T cells from AhR(+/+ but not AhR (-/- mice, in the presence of TCDD, promoted increased differentiation of Tregs while inhibiting Th17 cells. Analysis of MLN or LP cells during colitis revealed increased methylation of CpG islands of Foxp3 and demethylation of IL-17 promoters, which was reversed following TCDD treatment. CONCLUSIONS/SIGNIFICANCE: These studies demonstrate for the first time that AhR activation promotes epigenetic regulation thereby influencing reciprocal differentiation of Tregs and Th17 cells, and amelioration of inflammation.

  15. A Review on Medicinal Plants with Anti-Ulcer Activity

    Shaikh A. M

    2013-05-01

    Full Text Available A peptic ulcer is erosion in a segment of the gastro intestinal mucosa. It may typically in the stomach (gastric ulcer or first few centimeters of duodenum (duodenal ulcer that penetrates through the muscularis mucosae. Contrary to popular belief, ulcer is not only caused by spicy food but also most commonly due to an infection of Helicobacter Pylori and long term use of medications. Standard treatment is a combination of drugs including antibiotics and a proton pump inhibitors. Literature suggests that number of synthetic drugs are used in the management of peptic ulcers but elicit several adverse effects. Therefore Indian herbal plants stand out as being exceptional for its ethnic, ethobotanical and ethno-pharmaceutical use. In this review attempts have been made to know about some plants which may be used in treatment or prevention of peptic ulcers. Various plants like Excoecaria agallocha, Mentha arvensis, Utleria salicifolia, Emblica officinalis etc. proved active in antiulcer therapy. This combination of traditional and modern knowledge can produced better antiulcer drugs with fewer side effects. The medicinal plants are available in India and other countries, recent technologies advances have renewal interest in natural product in drug discovery.

  16. Ulcer Protective Activity of Jatropha gossypiifolia Linn. in Wistar Rats

    Vijayakumar, Arumugam Ramamoorthy; Daniel, Epison Prabu; Ilavarasan, Raju; Venkataraman, S.; Vijayakumar, S.

    2016-01-01

    Background: Several synthetic drugs are useful in the treatment of peptic ulcer, but almost of these drugs are used in prolonging time, it may cause several adverse reactions. However, the herbal medicines are more potent to the treatment and minimize the side effects. Objective: To evaluate the methanol extract of Jatropha gossypiifolia Linn. (MEJG) for gastro protective activity against Wistar rats. Materials and Methods: Anti-ulcer potency of MEJG (100 and 200 mg/kg, b.w.) was assessed using aspirin (200 mg/kg, p.o.) plus pylorus ligation ulcer model and the parameters studied were ulcer index (UI), gastric juice volume, pH, total acidity, and total acid output. Same extract was studied by ethanol-induced (80%, 5 mL/kg, intragastrically) ulcer model, and the UI and biochemical parameters were studied. Results: The oral administration of MEJG (100 and 200 mg/kg) significantly (P < 0.001) attenuated the ulcer score and anti-secretary parameters (such as the volume of gastric content, free acidity, total acidity, and total acid output) in the aspirin plus pylorus ligation rats. The extract also significantly attenuated (P < 0.001) ulcer score in ethanol-induced ulcer model and lipid peroxidation level and significantly increased the level of glutathione peroxides, catalase, and superoxide dismutase activity. The MEJG may possess active constituents such as alkaloids, glycosides, flavonoids, and terpenes, which may play a major role in gastroprotective effect in Wistar rats. Conclusion: The present study provides scientific support for the anti-ulcer activities of extracts of JG and also claimed that antioxidant potential of the extracts. However, substantiates the traditional claims for the usage of this drug in the treatment of gastric ulcer. SUMMARY The methanolic extract of jatropha gossypiifolia Linn. for gastro protective activity against aspirin plus pyloric ligation and ethanol induced ulcer models was studied in Wistar rats. JG shows significantly

  17. Comparative activities of milk components in reversing chronic colitis.

    Kanwar, J R; Kanwar, R K; Stathopoulos, S; Haggarty, N W; MacGibbon, A K H; Palmano, K P; Roy, K; Rowan, A; Krissansen, G W

    2016-04-01

    Inflammatory bowel disease (IBD) is a poorly understood chronic immune disorder for which there is no medical cure. Milk and colostrum are rich sources of bioactives with immunomodulatory properties. Here we compared the therapeutic effects of oral delivery of bovine milk-derived iron-saturated lactoferrin (Fe-bLF), angiogenin, osteopontin (OPN), colostrum whey protein, Modulen IBD (Nestle Healthsciences, Rhodes, Australia), and cis-9,trans-11 conjugated linoleic acid (CLA)-enriched milk fat in a mouse model of dextran sulfate-induced colitis. The CLA-enriched milk fat significantly increased mouse body weights after 24d of treatment, reduced epithelium damage, and downregulated the expression of proinflammatory cytokines and nitrous oxide. Modulen IBD most effectively decreased the clinical score at d 12, and Modulen IBD and OPN most effectively lowered the inflammatory score. Myeloperoxidase activity that denotes neutrophil infiltration was significantly lower in mice fed Modulen IBD, OPN, angiogenin, and Fe-bLF. A significant decrease in the numbers of T cells, natural killer cells, dendritic cells, and a significant decrease in cytokine expression were observed in mice fed the treatment diets compared with dextran sulfate administered mice. The Fe-bLF, CLA-enriched milk fat, and Modulen IBD inhibited intestinal angiogenesis. In summary, each of the milk components attenuated IBD in mice, but with differing effectiveness against specific disease parameters. PMID:26805965

  18. Celiac disease (CD, ulcerative colitis (UC, and primary sclerosing cholangitis (PSC in one patient: a family study Enfermedad celiaca (EC, colitis ulcerosa (CU y colangitis esclerosante primaria (CEP asociadas en el mismo paciente: estudio familiar

    V. Cadahía

    2005-12-01

    Full Text Available We discuss the case of a 17-year-old male who at the age of 7 was diagnosed with celiac disease (CD together with ulcerative colitis (UC and primary sclerosing cholangitis (PSC. The patient was treated with gluten-free diet and immunosuppressive drugs (azathioprine, and currently remains asymptomatic. The patient's younger, 12-year-old sister was diagnosed with CD when she was 1.5 years old, and at 7 years she developed type-I diabetes mellitus, which was difficult to control. A family study was made, and both parents were found to be affected with silent CD. All were DQ2 (+. In relation to the case and family study, we provide a series of comments related to CD and its complications.Presentamos el caso de un varón de 17 años, que a la edad de 7 años fue diagnosticado de enfermedad celiaca (EC junto con una colitis ulcerosa (CU y una colangitis esclerosante primaria (CEP asociadas. Fue tratado con DSG e inmuno-supresores tipo azatioprina y se encuentra asintomático en la actualidad. Su hermana menor de 12 años, fue diagnosticada de EC cuando tenía 1,5 años y a los 7 años desarrolló una DM tipo 1 de difícil control. Se realizó un estudio familiar y ambos padres están afectos de una EC silente. Todos ellos son DQ2 (+. A propósito del caso y estudio familiar, se hacen una serie de consideraciones sobre la enfermedad celiaca y el desarrollo de complicaciones.

  19. 粪便钙卫蛋白对溃疡性结肠炎的诊断及预测复发的价值%Research about the diagnostic and predictive value of fecal calprotectin in ulcerative colitis

    沈姞; 李俊霞; 王化虹; 谢鹏雁; 刘新光

    2011-01-01

    Objective: To investigate the diagnostic and predictive value of fecal calprotectin as a non-invasive approach in patients with ulcerative colitis ( UC ). Methods: 49 patients with ulcerative colitis, 38 patients with colon polyps, and 133 normal controls were recruited after colonoscopy. All the patients w asked to collect their stool sample one day before colonoscopy for measuring fecal calprotectin by an enzyme-linked immunosorbent assay. The disease activity of UC was evaluated according to Mayo disease activity index (UCAI). UC patients were followed up for recurrence within 2 years. Results: Fecal calprotectin concentration in active UC patients was significantly higher than the normal controls and those with colon polyps ( P 0. 05 ). Fecal calprotectin level was significantly correlated with the disease activity, mu-cosal healing and recurrence rate of UC. Conclusion: The levels of fecal calprotectin can be an objective reflection of UC disease activities and mucosal healing, and can predict the recurrence of UC patients.%目的:探讨粪便钙卫蛋白在溃疡性结肠炎(UC)诊断和预测复发方面的价值.方法:选取UC病人49例、结肠息肉38例和对照组133例,均行结肠镜检查,于检查前1d内留取粪便,采用ELISA法测定粪便钙卫蛋白的含量.UC临床分级采用Mayo疾病活动指数(UCAI),评价粪便钙卫蛋白测定作为判断UC活动性的指标,随访UC病人2年内的复发情况,评价粪便钙卫蛋白对UC复发的预测价值.结果:UC组病人活动期粪便钙卫蛋白水平显著高于对照组和息肉组(P<0.01);粪便钙卫蛋白水平与UC活动性、是否达到黏膜愈合及UC的复发显著相关.结论:粪便钙卫蛋白的含量与UC活动度呈正相关,可客观反映UC的炎症活动及黏膜愈合情况,预测UC的复发.

  20. Single Nucleotide Polymorphisms That Increase Expression of the Guanosine Triphosphatase RAC1 Are Associated With Ulcerative Colitis

    Aleixo M Muise; Walters, Thomas; Xu, Wei; Shen-Tu, Grace; Guo, Cong-Hui; Fattouh, Ramzi; Lam, Grace Y; Wolters, Victorien M; Bennitz, Joshua; Van Limbergen, Johan; Renbaum, Paul; Kasirer, Yair; Ngan, Bo-yee; Turner, Dan; Denson, Lee A.

    2011-01-01

    Background & AimsRAC1 is a guanosine triphosphatase that has an evolutionarily conserved role in coordinating immune defenses, from plants to mammals. Chronic inflammatory bowel diseases are associated with dysregulation of immune defenses. We studied the role of RAC1 in inflammatory bowel diseases using human genetic and functional studies and animal models of colitis.MethodsWe used a candidate gene approach to HapMap-Tag single nucleotide polymorphisms in a discovery cohort; findings we...