Biliary lactoferrin concentrations are increased in active inflammatory bowel disease: a factor in the pathogenesis of primary sclerosing cholangitis?

1998 ◽  
Vol 95 (5) ◽  
pp. 637-644 ◽  
Author(s):  
S. P. PEREIRA ◽  
J. M. RHODES ◽  
B. J. CAMPBELL ◽  
D. KUMAR ◽  
I. M. BAIN ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Gall Bladder ◽  
Bowel Disease ◽  
Sclerosing Cholangitis ◽  
Enterohepatic Circulation ◽  
Active Ulcerative Colitis ◽  
Chemotactic Peptides ◽  
Inflammatory Bowel ◽  
The Mean

1.One hypothesis for the link between inflammatory bowel disease and primary sclerosing cholangitis is that neutrophil activators, such as bacterial chemotactic peptides or neutrophil granule products themselves, pass from the inflamed colon to the liver via an enterohepatic circulation. However, there are no data on biliary concentrations of neutrophil granule products in patients with active and inactive inflammatory bowel disease. 2.Gall bladder bile was obtained at laparotomy from 42 patients with ulcerative colitis and 21 patients with Crohn's disease. Biliary lactoferrin and myeloperoxidase concentrations were quantified by ELISA. 3.In active ulcerative colitis, the mean lactoferrin concentration in gall bladder bile of 2.8±0.40 ;mg/l was higher than that seen after colectomy (1.2±0.11 ;mg/l; P< 0.0001) or in patients with pouchitis (1.8±0.34 ;mg/l; P = 0.06). In active Crohn's colitis, the mean lactoferrin concentration was 3.7±0.9 ;mg/l, compared with 1.1±0.24 ;mg/l in the post-colectomy group (P< 0.05) and 3.1±0.71 ;mg/l in those with active ileitis or ileocolitis. In contrast, biliary myeloperoxidase concentrations were low and comparable in all groups, with a mean concentration in the 42 patients with ulcerative colitis of 11.2±1.9 ;μg/l. 4.In contrast to myeloperoxidase, biliary lactoferrin concentrations are increased in active ulcerative colitis and Crohn's disease, and fall with colectomy and with disease remission. These findings indirectly support the hypothesis that bacterial chemotactic peptides (which induce selective degranulation of neutrophil secondary granules), and/or lactoferrin itself, undergo an enterohepatic circulation.

The Effect of Mesalamine and Nicotine in the Treatment of Inflammatory Bowel Disease

1997 ◽  
Vol 31 (7-8) ◽  
pp. 907-913 ◽  
Author(s):  
Charles R. Bonapace ◽  
David A. Mays
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Relapse Rate ◽  
Bowel Disease ◽  
Therapeutic Agent ◽  
Active Ulcerative Colitis ◽  
Steroid Dependence ◽  
Inflammatory Bowel

OBJECTIVE: To characterize the usefulness of mesalamine and nicotine in the treatment of active ulcerative colitis and inactive Crohn's disease. DATA SOURCES: Citations were selected from the MEDLINE database. Only those involving human subjects, inflammatory bowel disease, and available in English were selected. STUDY SELECTION: Selection criteria consisted of clinical trials and review articles assessing the effects of mesalamine and nicotine in active ulcerative colitis or inactive Crohn's disease and the utility of reducing steroid dependence or relapse rate. Less than 20% of the articles identified met the selection criteria. DATA SYNTHESIS: In patients with inactive Crohn's disease, mesalamine 2 g/d significantly reduced the risk of relapse in high-relapse-risk patients compared with placebo, reducing the relapse rate from 71% to 55%, but was ineffective in preventing recurrence of inactive Crohn's disease following surgical resection. Mesalamine 4 g/d was effective in decreasing weaning failure due to steroid dependence by 67%, although the relapse rate was not significant compared with placebo at the end of 12 months. Following surgical resection, mesalamine was unable to significantly reduce the incidence of recurrence compared with placebo at the end of 1 year. In patients with active ulcerative colitis, oral mesalamine 2 and 4 g/d was superior to placebo in inducing remission compared with placebo. Among patients with prior steroid or sulfasalazine treatment, rectal mesalamine 4 g hs achieved a remission rate of 78% in more than 12 weeks of therapy. Other studies have not found a dose—response relationship with lower dosages of mesalamine. Whereas nicotine 15–25 mg/d administered as a transdermal patch produced greater symptomatic improvement in active ulcerative colitis compared with placebo, nicotine 15 mg/16 h produced results no different from those with placebo in maintaining remission in inactive ulcerative colitis. Nicotine appears to have an adverse effect on the course of Crohn's disease and is not recommended. CONCLUSIONS: Mesalamine has demonstrated clinical effectiveness as a therapeutic agent in the treatment of active ulcerative colitis and inactive Crohn's disease. Although its relationship to inflammatory bowel disease has been known for many years, the usefulness of nicotine for the treatment of active ulcerative colitis requires further exploration before it can be recommended as a therapeutic agent.

scholarly journals Cerebral Arterial Thrombosis in Ulcerative Colitis

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Giovanni Casella ◽  
Claudio Camillo Cortelezzi ◽  
DeLodovici Marialuisa ◽  
Princiotta Cariddi Lucia ◽  
Verrengia Elena Pinuccia ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Arterial Thrombosis ◽  
Sclerosing Cholangitis ◽  
International Literature ◽  
Extraintestinal Manifestation ◽  
Intraarterial Thrombolysis ◽  
Inflammatory Bowel ◽  
Cerebral Arterial Thrombosis

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.

scholarly journals P521 Correlation between physician disease assessment in Ulcerative Colitis and burden of disease: ICONIC 2-year data of 120 patients in Turkey

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S498-S498
Author(s):  
O Sezgin ◽  
O Atug ◽  
C Gonen ◽  
G Can ◽  
A E Duman ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Disease Burden ◽  
Disease Assessment ◽  
Chronic Inflammatory Bowel Disease ◽  
Pictorial Representation ◽  
Final Visit ◽  
Inflammatory Bowel ◽  
The Mean

Abstract Background Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD), and the overall burden is increasing at the global level. Differences in perceptions of UC-related burden may highlight dramatic degree insufficient patient-physician communication. ICONIC is a prospective, non-interventional, observational study assessing disease burden in adults with UC using Pictorial Representation of Illness and Self Measure (PRISM). The local results of ICONIC study for Turkey are presented. Methods Patients aged ≥18 years with early UC (diagnosed ≤36 months) were enrolled. At baseline and every 6 months, patient and physician reported outcomes were collected using PRISM, the Simple Clinical Colitis Activity Index (SCCAI and P-SCCAI), The Rating Form of IBD Patients’ Concerns (RFIPC), the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), and the Patient Health Questionnaire-9 (PHQ-9). Correlations between the patient assessed PRISM and other measurement tools were evaluated with Pearson correlation coefficient. Results One hundred and twenty patients were included (77 [64.2%] female; mean age 35.2 years). Physician-assessed disease severity was: severe 23 [19.2%], moderate 42 [35.0%], mild 40 [33.3%], in remission 15 [12.5%]. The mean ± SD physician- and patient-assessed PRISM scores were 4.8 ± 2.3 cm (range: 0.0–9.0) and 4.1 ± 2.6 cm (range: 0.0–8.5) at baseline and increased to 6.1 ± 2.3 cm (range: 0.1–8.5) and 5.5 ± 2.7 cm (range: 0.0–9.3) at the final visit, respectively, indicating an improvement in the perceived disease burden. The mean values of physician-SCCAI and P-SCCAI were 3.8 ± 3.5 and 5.5 ± 4.3 at baseline and decreased to 1.4 ± 2.5 and 2.7 ± 3.2 at the final visit, respectively, showing a decrease in disease activity. At baseline, the RFIPC and PHQ-9 values were 2.7 ± 1.7 and 8.0 ± 5.5 and decreased to 2.2 ± 2.0 and 5.2 ± 4.5 at the final visit, respectively. Patient-assessed SIBDQ was 43.8 ± 14.5 at baseline and increased to 54.0 ± 13.0 at the final visit. The strongest correlation of patient-assessed PRISM was with the physician-assessed PRISM (Spearman rho = 0.69, p&lt;0.0001), followed by SCCAI (rho = -0.56, p&lt;0.0001). Differences between physician- and patient-assessed PRISM scores were statistically significant (baseline: p=0.0010 vs. final visit: p=0.0206), highlighting an underestimation of patient’s suffering by physicians. Conclusion In the Turkish ICONIC sub-study, majority of patients on treatment showed improved outcomes during the follow-up period. A moderate correlation between patient-assessed PRISM and other measurement instruments represents that PRISM may be used as surrogate marker for patient suffering.

scholarly journals Atypical Perinuclear Antineutrophil Cytoplastmic Antibodies after Colectomy in Inflammatory Bowel Disease

1997 ◽  
Vol 11 (4) ◽  
pp. 305-310 ◽  
Author(s):  
Hugh J Freeman ◽  
Brenda Roeck ◽  
Dana V Devine ◽  
Cedric J Carter
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Primary Sclerosing Cholangitis ◽  
Clinical Diagnosis ◽  
Bowel Disease ◽  
Sclerosing Cholangitis ◽  
Serological Marker ◽  
Pelvic Pouch ◽  
Inflammatory Bowel

Atypical perinuclear antineutrophil cytoplasmic antibodies (p-ANCA) have been detected in most patients with ulcerative colitis and primary sclerosing cholangitis. Persistent atypical p-ANCA have been observed in ulcerative colitis patients with a prior proctocolectomy, especially with pouchitis, suggesting that this serological marker might be predictive of subsequent development of chronic or refractory pouchitis. This study prospectively evaluated this serological marker in 24 consecutive patients with inflammatory bowel disease and prior colectomies (12 with a clinical diagnosis of ulcerative colitis and 12 with a clinical diagnosis of Crohn's disease involving the colon). Of these, 14 were positive, including 11 with extensive ulcerative colitis and three with Crohn's disease. Although two of three ulcerative colitis patients with pouchitis were positive, eight of eight ulcerative colitis patients having a pelvic pouch with no pouchitis were also positive, as was a patient who elected to have an end-ileostomy (Brooke's ileostomy). Two patients had abnormal liver chemistry tests. Both had end-stage primary sclerosing cholangitis treated with liver transplantation and were positive for this serological marker. Although atypical p-ANCA may be a marker of persistent inflammation in pelvic pouch patients, a positive test result should not be used for prognosis or as a decision-making parameter for pelvic pouch procedures.

scholarly journals THE ONSET OF CLINICAL MANIFESTATIONS IN INFLAMMATORY BOWEL DISEASE PATIENTS

2018 ◽  
Vol 55 (3) ◽  
pp. 290-295
Author(s):  
Viviane Gomes NÓBREGA ◽  
Isaac Neri de Novais SILVA ◽  
Beatriz Silva BRITO ◽  
Juliana SILVA ◽  
Maria Carolina Martins da SILVA ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Weight Loss ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Clinical Manifestations ◽  
Inflammatory Bowel ◽  
The Mean ◽  
Mean Time

ABSTRACT BACKGROUND: The diagnosis of inflammatory bowel disease is often delayed because of the lack of an ability to recognize its major clinical manifestations. OBJECTIVE: Our study aimed to describe the onset of clinical manifestations in inflammatory bowel disease patients. METHODS: A cross-sectional study. Investigators obtained data from interviews and the medical records of inflammatory bowel disease patients from a reference centre located in Brazil. RESULTS: A total of 306 patients were included. The mean time between onset of symptoms and diagnosis was 28 months for Crohn’s disease and 19 months for ulcerative colitis. The main clinical manifestations in Crohn’s disease patients were weight loss, abdominal pain, diarrhoea and asthenia. The most relevant symptoms in ulcerative colitis patients were blood in the stool, faecal urgency, diarrhoea, mucus in the stool, weight loss, abdominal pain and asthenia. It was observed that weight loss, abdominal pain and distension, asthenia, appetite loss, anaemia, insomnia, fever, nausea, perianal disease, extraintestinal manifestation, oral thrush, vomiting and abdominal mass were more frequent in Crohn’s patients than in ulcerative colitis patients. The frequencies of urgency, faecal incontinence, faeces with mucus and blood, tenesmus and constipation were higher in ulcerative colitis patients than in Crohn’s disease patients. The mean time from the onset of clinical symptoms to the diagnosis of Crohn’s disease was 37 months for patients with ileocolonic location, 26 months for patients with ileum location and 18 months for patients with colon location. In ulcerative colitis patients, the mean time from the onset of symptoms to diagnosis was 52 months for proctitis, 12 months for left-sided colitis and 12 months for extensive colitis. CONCLUSION: Ulcerative colitis presented a high frequency of intestinal symptoms, and Crohn’s disease showed a high frequency of systemic manifestations at the onset of manifestation. There was a long delay in diagnosis, but individuals with more extensive disease and more obvious symptoms showed a shorter delay.

scholarly journals Economic Impact of Inflammatory Bowel Disease in Alberta

1988 ◽  
Vol 2 (2) ◽  
pp. 53-56 ◽  
Author(s):  
B.R. Pinchbeck ◽  
J. Kirdeikis ◽  
A.B.R. Thomson
Keyword(s):  
Ulcerative Colitis ◽  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Health Care System ◽  
Bowel Disease ◽  
Average Hospital ◽  
Inflammatory Bowel ◽  
The Mean ◽  
Mean Cost ◽  
Care System

This paper attempts to estimate the cost of inflammatory bowel disease (IBO) to the health care system of Alberta. In the 1015 patients responding to a questionnaire, two types of direct costs were compared to provincial averages; physicians' fees and hospital costs. Costs were calculated using the Alberta Health Care Insurance Plan prescribed billing races. The 15-to 24-year-old age group exhibited the highest annual physician fees. This was probably due to the high incidence rate of IBD in this group. The mean cost per patient-year for Crohn's disease was estimated to be $4400 and the mean cost for ulcerative colitis was estimated to be $3020; this did not include outpatient laboratory or radiological investigations, and as such represents an underestimation of the total costs to the health care system. However, only a small minority of the patients were using a large majority of the resources: for example, for both Crohn's and ulcerative colitis, 7% of the patients accounted for 69% of hospital days. The average hospital and physician associated costs declined markedly with duration of the disease. It is estimated that the future cost of IBO to the provincial health care system (the percentage of the provincial health care budget used to diagnose and treat IBO) will double from 1985 to 2000. This underscores the need for continued and expanded research into the cause and treatment of IBO, and the importance of maintaining a health care system which can respond to the needs of these patients.

scholarly journals Extra Intestinal Manifestations in Children with Inflammatory Bowel Disease, A Single Center Report from Iran

2021 ◽  
Vol 9 (2) ◽  
pp. 5
Author(s):  
Seyed Mohsen Dehghani ◽  
Iraj Shahramian ◽  
Ali Bazi ◽  
Seyedeh Zeinab Fereidouni ◽  
Asma Erjaee ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Unknown Etiology ◽  
Single Center ◽  
Medical Sciences ◽  
Center Report ◽  
Gi Symptoms ◽  
Inflammatory Bowel ◽  
The Mean

Introduction: Inflammatory bowel disease (IBD) is a disorder of unknown etiology categorized into three groups including Crohn disease (CD), ulcerative colitis [UC], and intermediate colitis (IC). In addition to gastrointestinal (GI) symptoms, childhood IBD frequently present with extra GI manifestations. In present study, we aimed to determine extra GI symptoms in children with IBD in Iran. Methods: Children <18 years old with established IBD diagnosis referred to the Gastroenterology Clinic affiliated with Shiraz University of Medical Sciences during 2007-2017 were included. Results: Eighty-five children were assessed. CD and UC comprised 26 (30.6%) and 47 (55.3%) of the patients. The mean age was 14.09±2.5 years old with 50% of them were boys. The most frequent presenting complaint was rectal bleeding (37.2%). In patients with CD and UC, 30% and 29% of the patients represented at least one extra GI symptom. The most common extra GI manifestations were growth retardation (11.5%) and arthralgia (7.8%) in children with CD and UC respectively. Conclusions: Extra GI symptoms are relatively common in children with IBD. Caution should be taken to avoid confusion with other disorders and to timely manage these manifestations.

scholarly journals Ulcerative colitis has an aggressive course after orthotopic liver transplantation for primary sclerosing cholangitis

Gut ◽  
1998 ◽  
Vol 43 (5) ◽  
pp. 639-644 ◽  
Author(s):  
G V Papatheodoridis ◽  
M Hamilton ◽  
P K Mistry ◽  
B Davidson ◽  
K Rolles ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Liver Transplantation ◽  
Primary Sclerosing Cholangitis ◽  
Bowel Disease ◽  
Sclerosing Cholangitis ◽  
De Novo ◽  
Increased Risk ◽  
Inflammatory Bowel

Background—The course of inflammatory bowel disease after liver transplantation has been reported as variable with usually no change or improvement, but there may be an increased risk of early colorectal neoplasms. In many centres steroids are often withdrawn early after transplantation and this may affect inflammatory bowel disease activity.Aims—To evaluate the course of inflammatory bowel disease in primary sclerosing cholangitis transplant patients who were treated without long term steroids.Methods—Between 1989 and 1996, there were 30 patients transplanted for primary sclerosing cholangitis who survived more than 12 months. Ulcerative colitis was diagnosed in 18 (60%) patients before transplantation; two had previous colectomy. All patients underwent colonoscopy before and after transplantation and were followed for 38 (12–92) months. All received cyclosporin or tacrolimus with or without azathioprine as maintenance immunosuppression.Results—Ulcerative colitis course after transplantation compared with that up to five years before transplantation was the same in eight (50%) and worse in eight (50%) patients. It remained quiescent in eight and worsened in four of the 12 patients with pretransplant quiescent course, whereas it worsened in all four patients with pretransplant active course (p=0.08). New onset ulcerative colitis developed in three (25%) of the 12 patients without inflammatory bowel disease before transplantation. No colorectal cancer has been diagnosed to date.Conclusions—Preexisting ulcerative colitis often has an aggressive course, while de novo ulcerative colitis may develop in patients transplanted for primary sclerosing cholangitis and treated without long term steroids.

Enhanced synthesis of neutrophil-activating peptide-I/interleukin-8 in active ulcerative colitis

1992 ◽  
Vol 82 (3) ◽  
pp. 273-275 ◽  
Author(s):  
Y. R. Mahida ◽  
M. Ceska ◽  
F. Effenberger ◽  
L. Kurlak ◽  
I. Lindley ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Interleukin 8 ◽  
Active Ulcerative Colitis ◽  
Functional Importance ◽  
Control Subjects ◽  
Inflammatory Bowel

1. We studied neutrophil-activating peptide-1/interleukin-8 in inflammatory bowel disease. 2. Mucosal levels of neutrophil-activating peptide-1/ interleukin-8 were significantly higher in patients with active ulcerative colitis [median 74.5 (range 17.7–450.8) pg/mg] than in patients with active Crohn's disease [10.4 (4–46.9) pg/mg; P<0.002] or in normal control subjects [10.4(4–16.6) pg/mg; P <0.002]. 3. Circulating neutrophil-activating peptide-1/interleukin-8 was generally undetectable but there were higher levels of anti-neutrophil-activating peptide-1/interleukin-8 antibodies in patients with active ulcerative colitis [62.9 (3.4–239) ng/ml] than in patients with active Crohn's disease [5.9 (2.1–18.10) ng/ml; P <0.001] or in control subjects [6.1 (3.2–15.8) ng/ml; P <0.001]. 4. Neutrophil-activating peptide-1/interleukin-8 may be of specific functional importance in mediating inflammation in ulcerative colitis.

scholarly journals Prospective Evaluation of Neutrophil Autoantibodies in 500 Consecutive Patients with Inflammatory Bowel Disease

1997 ◽  
Vol 11 (3) ◽  
pp. 203-207 ◽  
Author(s):  
Hugh Freeman ◽  
Brenda Roeck ◽  
Dana Devine ◽  
Cedric Carter
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Sclerosing Cholangitis ◽  
Consecutive Series ◽  
Prospective Evaluation ◽  
Inflammatory Bowel ◽  
Antineutrophil Cytoplasmic Autoantibodies

Previous studies have shown antineutrophil cytoplasmic autoantibodies (ANCA) in patients with inflammatory bowel disease (IBD). A particular subclass, the so-called 'atypical' (perinuclear) p-ANCA type, occurs in the majority of patients with ulcerative colitis. The purpose of this prospective study was to assess, in a blinded fashion, this 'subclinical' serological marker in a consecutive series of IBD patients. Five hundred patients were evaluated, including 247 patients with ulcerative colitis and 253 with Crohn's disease involving the small and/or large intestine. Overall, 194 (38.8%) of all patients with IBD were positive, including 164 (66.3%) with ulcerative colitis and 30 (11.9%) with Crohn's disease. Except for coexistent sclerosing cholangitis, no other clinical or laboratory variable had an effect on the rate of ANCA detection. This is the largest single study of ANCA in patients with IBD and the only study to provide data solely from a single Canadian centre. Results emphasize the immunopathological differences between ulcerative colitis and Crohn's disease, and indicate that both disorders are heterogeneous inflammatory disease processes.

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