Maria Lia Scribano
The COVID-19 pandemic has created a public health emergency. In this context, there are major concerns for patients with inflammatory bowel disease (IBD), particularly for those treated with immunomodulators, biologics, and Janus Kinase inhibitors. Infection susceptibility is, in fact, one of the reported risks for immunotherapy drugs. This review provides the existing evidence from worldwide case series describing: (a) the risk for the SARS-CoV-2 infection and (b) the risk of a severe infection outcome in patients with IBD treated with immunotherapy...
October 19, 2020: Digestive Diseases and Sciences
Anke L H Nguyen, Miles P Sparrow
In recent years, with the increasing availability of biologic therapies and due to safety concerns, the role of thiopurines in the management of inflammatory bowel disease has been questioned. While acknowledging that the benefit/risk ratio of biologic therapies is very high, they are expensive and are not required by a majority of patients. Therefore, thiopurines do retain an important role as steroid-sparing and maintenance agents when used as monotherapy, and in combination therapy with biologics due to their clinical and pharmacokinetic optimization of anti-tumor necrosis factor agents in particular...
October 19, 2020: Digestive Diseases and Sciences
David D Zheng, Jazila Mantis, Dawa O Gurung, Adriana Abrudescu
Extraintestinal manifestations (EIM) in inflammatory bowel disease (IBD) are common including cutaneous manifestations that either precede or follow manifestations of IBD. Cutaneous manifestations of IBD include erythema nodosum, pyoderma gangrenosum, oral lesions, and Sweet's syndrome. Cutaneous manifestations of IBD tend to recur and extensive cases may require maintenance management with immunomodulators or biologics. However, the complications and adverse effects of long-term therapy with immunosuppressive agents are numerous and need to be considered before their initiation...
September 14, 2020: Curēus
Maurizio Mennini, Alessandro Giovanni Fiocchi, Arianna Cafarotti, Marilisa Montesano, Angela Mauro, Maria Pia Villa, Giovanni Di Nardo
Food protein-induced allergic proctocolitis (FPIAP) is a condition characterized by inflammatory changes in the distal colon in response to one or more foreign food proteins because of immune-mediated reactions. FPIAP prevalence estimates range widely from 0.16% in healthy children and 64% in patients with blood in stools. In clinical practice, FPIAP is diagnosed when patients respond positively to the elimination of a suspected triggering food allergen. Nevertheless, significant proportions of infants get misdiagnosed with IgE mediated allergy and undergo unnecessary dietary changes...
October 2020: World Allergy Organization Journal
Rola Husain, Ameen Alawadhi, Etan Dayan, Mingqian Huang, Idoia Corcuera-Solano
Pyoderma gangrenosum (PG) is a rare noninfectious skin condition which clinical picture can overlap with that of the diabetic foot. Meticulous physical examination along with biopsy and magnetic resonance imaging (MRI) can make the distinction easier, saving the patients from undergoing a debilitating intervention. We report a case of pathologically proven PG in the right ankle region of a 55-year old male with known uncontrolled diabetes mellitus and inflammatory bowel disease. Radiographs revealed increased soft tissue density overlying the lateral melleolus of the right ankle...
December 2020: Radiology Case Reports
Jana Libera, Melanie Wittner, Marcus Kantowski, Robin Woost, Johanna M Eberhard, Jocelyn de Heer, Dominik Reher, Samuel Huber, Friedrich Haag, Julian Schulze Zur Wiesch
The ectoenzymes CD39 and CD73 play a major role in controlling tissue inflammation by regulating the balance between adenosine triphosphate (ATP) and adenosine. Still, little is known about the role of these two enzymes and ATP and its metabolites in the pathophysiology of inflammatory bowel disease (IBD). We isolated mononuclear cells from peripheral blood and lamina propria of the large intestine of patients diagnosed with IBD and of healthy volunteers. We then comprehensively analyzed the CD39 and CD73 expression patterns together with markers of activation (HLA-DR, CD38), differentiation (CCR7, CD45RA) and tissue-residency (CD69, CD103, CD49a) on CD4+ , CD8+ , γδ+ T cells and mucosa-associated invariant T cells using flow cytometry...
2020: Frontiers in Immunology
Marta Vuerich, Samiran Mukherjee, Simon C Robson, Maria Serena Longhi
Inflammatory bowel disease (IBD) is a serious inflammatory condition of the gastrointestinal tract. Crohn's disease (CD) and ulcerative colitis (UC) are two of the most common IBD manifestations and are both associated with unfettered inflammation, often refractory to conventional immunosuppressive treatment. In both conditions, imbalance between effector and regulatory cell immune responses has been documented and is thought to contribute to disease pathogenesis. Purinergic signaling is a known modulator of systemic and local inflammation and growing evidences point to extracellular ATP/adenosine imbalance as a key determinant factor in IBD-associated immune dysregulation...
2020: Frontiers in Immunology
Louise Gaboriau, Jean-Baptiste Davion, Sandrine Combret, Bénédicte Lebrun-Vignes, Fanny Rocher, Franck Rouby, Florence Renaud, Sandrine Morell-Dubois, Sophie Gautier
TNFα inhibitors, including adalimumab, are widely used in inflammatory rheumatologic and bowel diseases. Well-known adverse effects include: opportunistic infections, immunogenicity and new inflammatory manifestations. Myositis is an inflammatory disease, which manifests with muscle symptoms and can be life-threatening. Little is known about drug-induced myositis. We aimed to describe a case of myositis induced by adalimumab and reviewed national and international pharmacovigilance databases for other cases until 01/02/2019...
September 20, 2020: Neuromuscular Disorders: NMD
Paulina Nuñez F, Uma Mahadevan, Rodrigo Quera, Constanza Bay, Patricio Ibañez
With the advent of biologic and small molecule therapies, there has been a substantial change in the treatment of inflammatory bowel disease. These advances have had a great impact in preventing disease progression, intestinal damage and, therefore, have contributed to a better quality of life. Discordance between symptom control and mucosal healing has been demonstrated. This has led to the search for new disease control targets. The treat to target strategy, based on expert recommendations and now a randomized controlled trial, has determined that clinical and endoscopic remission should be the goal of therapy...
October 15, 2020: Gastroenterología y Hepatología
Simone Saibeni, Ludovica Scucchi, Gabriele Dragoni, Cristina Bezzio, Agnese Miranda, Davide Giuseppe Ribaldone, Angela Bertani, Fabrizio Bossa, Mariangela Allocca, Andrea Buda, Gianmarco Mocci, Alessandra Soriano, Silvia Mazzuoli, Lorenzo Bertani, Flavia Baccini, Erika Loddo, Antonino Carlo Privitera, Alessandro Sartini, Angelo Viscido, Laurino Grossi, Valentina Casini, Viviana Gerardi, Marta Ascolani, Mirko Di Ruscio, Giovanni Casella, Edoardo Savarino, Davide Stradella, Rossella Pumpo, Claudio Camillo Cortelezzi, Marco Daperno, Valeria Ciardo, Olga Maria Nardone, Flavio Caprioli, Giovanna Vitale, Maria Cappello, Michele Comberlato, Patrizia Alvisi, Stefano Festa, Michele Campigotto, Giorgia Bodini, Paola Balestrieri, Anna Viola, Daniela Pugliese, Alessandro Armuzzi, Massimo C Fantini, Gionata Fiorino
BACKGROUND AND AIMS: Restructuring activities have been necessary during the lockdown phase of the coronavirus disease 2019 (COVID-19) pandemic. Few data are available on the post-lockdown phase in terms of health-care procedures in inflammatory bowel disease (IBD) care, and no data are available specifically from IBD units. We aimed to investigate how IBD management was restructured during the lockdown phase, the impact of the restructuring on standards of care and how Italian IBD units have managed post-lockdown activities...
October 18, 2020: United European Gastroenterology Journal
Craig Haifer, Ashish Srinivasan, Yoon-Kyo An, Sherman Picardo, Daniel van Langenberg, Shankar Menon, Jakob Begun, Simon Ghaly, Lena Thin
OBJECTIVE: To examine whether non-medical switching of patients with inflammatory bowel disease (IBD) from originator infliximab to a biosimilar (CT-P13, Inflectra) is safe and clinically non-inferior to continued treatment with originator infliximab. DESIGN: Prospective, open label, multicentre, parallel cohort, non-inferiority study in seven Australian hospitals over 48 weeks, May 2017 - October 2019. PARTICIPANTS: Adults (18 years or older) with IBD receiving maintenance originator infliximab (Remicade) who had been in steroid-free clinical remission for at least 12 weeks...
October 17, 2020: Medical Journal of Australia
Michał Sienkiewicz, Patrycja Szymańska, Jakub Fichna
Inflammatory bowel disease (IBD) is a group of chronic relapsing disorders whose etiology has not been fully explained. Therefore, available therapeutic approaches for IBD patients are still insufficient. Current treatment strategies are targeted to immune system dysfunctions, often associated with alternations in the microbiota, which contribute to the development of chronic intestinal inflammation. Therapeutics include anti-inflammatory drugs such as aminosalicylates and corticosteroids, immunosuppressive agents, antibiotics, and biological agents such as infliximab and vedolizumab...
October 17, 2020: Advances in Nutrition
Anett Sánta, Kata Judit Szántó, Pál Miheller, Patrícia Sarlós, Anita Juhász, Edina Hamvas, Emese Szegedi-Hallgató, Klaudia Farkas, Beatrix Rafael, Tamás Molnár
No abstract text is available yet for this article.
October 18, 2020: Orvosi Hetilap
Chiara Lasconi, Matthew C Pahl, Diana L Cousminer, Claudia A Doege, Alessandra Chesi, Kenyaita M Hodge, Michelle E Leonard, Sumei Lu, Matthew E Johnson, Chun Su, Reza K Hammond, James A Pippin, Natalie A Terry, Louis R Ghanem, Rudolph L Leibel, Andrew D Wells, Struan F A Grant
BACKGROUND & AIMS: Inflammatory bowel disease (IBD) is a polygenic disorder principally characterized by dysregulated inflammation impacting the gastrointestinal tract. However, there is also increasing evidence for a clinical association with stress and depression. Given the role of the hypothalamus in stress responses and in the pathogenesis of depression, useful insights could be gleaned from understanding its genetic role in IBD. METHODS: We conducted genetic correlation analyses on publicly available GWAS summary statistics for depression and IBD traits to identify genetic commonalities...
October 15, 2020: Cellular and Molecular Gastroenterology and Hepatology
Andrea Cassinotti, Francesco Passamonti, Sergio Segato
In recent years, cell-based therapies have been explored in various immune-mediated inflammatory diseases, including inflammatory bowel disease (IBD). Cell therapy is the process of introducing new cells into an organism or tissue in order to treat a disease. The most studied cellular treatment in IBD was "stem cells-based therapy", which was explored according to different protocols in terms of type of donors, stem cells sources, study design and clinical endpoints. More recently, preliminary studies have also described the clinical use of "regulatory cells", which include T-reg and Tr1 cells, and "tolerogenic" dendritic cells...
October 15, 2020: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Cristina Mediavilla
It is increasingly evident that bidirectional gut-brain signaling provides a communication pathway that uses neural, hormonal, and immunological routes to regulate homeostatic mechanisms such as hunger/satiety as well as emotions and inflammation. Hence, disruption of the gut-brain axis can cause numerous pathophysiologies, including obesity and intestinal inflammatory diseases. One chemical mediator in the gut-brain axis is orexin-A, given that hypothalamic orexin-A affects gastrointestinal motility and secretion, and peripheral orexin in the intestinal mucosa can modulate brain functions, making possible an orexinergic gut-brain network...
October 14, 2020: Neurochemistry International
Eunice Wong, Robert Heuschkel, Caroline Lindsay, Sally Benson, Matthias Zilbauer
Clinical psychology intervention in paediatric gastroenterology is vital given the biopsychosocial aetiology of paediatric functional gastrointestinal disorders, and the psychological impact of chronic conditions. The aim was to assess the availability and benefit of clinical psychology in paediatric gastroenterology across the UK and Germany. A retrospective assessment of referrals (n = 936 referrals) to clinical psychology was performed at our tertiary paediatric gastroenterology centre between 2010 and 2018...
October 16, 2020: European Journal of Pediatrics
Ho-Su Lee, Evy Lobbestael, Séverine Vermeire, João Sabino, Isabelle Cleynen
Inflammatory bowel disease and Parkinson's disease are chronic progressive disorders that mainly affect different organs: the gut and brain, respectively. Accumulating evidence has suggested a bidirectional link between gastrointestinal inflammation and neurodegeneration, in accordance with the concept of the 'gut-brain axis'. Moreover, recent population-based studies have shown that inflammatory bowel disease might increase the risk of Parkinson's disease. Although the precise mechanisms underlying gut-brain interactions remain elusive, some of the latest findings have begun to explain the link...
October 16, 2020: Gut
Harrison Bell, Natasha Kamal, Uni Wong
Patients with inflammatory bowel disease, especially those on immunosuppressive therapy, are at higher risk of acquiring infectious diseases (Reich et al., 2016). For this reason, immunizations are routinely recommended in comprehensive inflammatory bowel disease care. SHINGRIX, a non-live recombinant herpes zoster vaccine, was approved by the Food and Drug Administration in 2017. Adults aged 50 and over are recommended to receive two doses of SHINGRIX. Unlike ZOSTAVAX® which is a live zoster vaccine that has been in use since 2006, SHINGRIX is safe for those on immunosuppression (Reich et al...
October 13, 2020: Vaccine
Dagmar Schierová, Jan Březina, Jakub Mrázek, Kateřina Olša Fliegerová, Simona Kvasnová, Lukáš Bajer, Pavel Drastich
Ulcerative colitis (UC) is an inflammatory bowel disease, and intestinal bacteria are implicated in the pathogenesis of this disorder. The administration of aminosalicylates (5-ASA) is a conventional treatment that targets the mucosa, while fecal microbial transplantation (FMT) is a novel treatment that directly targets the gut microbiota. The aim of this study was to identify changes in fecal bacterial composition after both types of treatments and evaluate clinical responses. Sixteen patients with active left-sided UC underwent enema treatment using 5-ASA ( n = 8) or FMT ( n = 8) with a stool from a single donor...
October 13, 2020: Cells
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