scholarly journals Serological Assessment of the Quality of Wound Healing Processes in Crohn’s Disease

2019 ◽  
Vol 28 ◽  
pp. 175-182 ◽  
Author(s):  
Shu Sun ◽  
Morten Asser Karsdal ◽  
Joachim Høg Mortensen ◽  
Yunyun Luo ◽  
Jens Kjeldsen ◽  
...  
Keyword(s):  
Wound Healing ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Factor Xiii ◽  
Fibrin Clot ◽  
Healthy Controls ◽  
Impaired Wound Healing ◽  
Chronic Inflammatory Condition ◽  
D Dimer

Background & Aims: Crohn’s disease (CD) is a chronic inflammatory condition characterized by continuous mucosal damage and ongoing wound healing of the intestines. The fibrinolytic system is involved in early parts of the wound healing process. Fibrin is a key mediator of primary blood clot formation and is formed by cross-linking of fibrinogen. To gain insights into the dynamics of wound healing in CD patients we investigated the conversion of fibrinogen into fibrin by the pro-peptide FPA, the amount of factor XIII cross-linked fibrin and total fibrin clot. Methods: Serum samples of 35 CD patients, 15 non-inflammatory bowel disease (non-IBD) patients and 39 age-matched healthy controls were analyzed for three novel neo-epitope markers: D-fragment and D-dimer, reflecting the degradation of total fibrin clot and factor XIII cross-linked fibrin, as well as FPA, reflecting synthesis of fibrin. Results: Crohn’s disease patients had a significantly lower D-dimer level (p=0.0001) compared to healthy controls. Crohn’s disease and non-IBD patients had a significantly higher level of FPA (p<0.0001) and D-fragment/D-dimer ratio (p<0.0001 and p=0.02). FPA, D-dimer and D-fragment/D-dimer ratio could distinguish CD patients from healthy controls with area under the curve of 0.92 (95% CI 0.83-0.97), 0.78 (95% CI 0.67-0.87) and 0.85 (95% CI 0.75-0.93), respectively. Conclusion: Wound healing parameters were clearly changed in CD patients. FPA levels were higher in CD patients as compared to healthy controls, indicating more ongoing wound healing. D-dimer levels were lower in CD patients than in healthy controls, indicating impaired wound healing due to poor quality of factor XIII cross-linked fibrin and clot resolution.

multiple donors. Three women had normal pregnancies and deliveries at term. Several groups have replicated this work with spouse leukocytes and successful deliveries result in more than 50% of the women treated. Crohn's Disease Crohn's disease is an inflammatory condition of the gastrointestinal tract which presents with diarrhea and crampy abdominal pain. Recurrence of disease following surgery is common -nearly half of the patients will develop symptoms of recurrence within ten years of surgical resection of all diseased bowel. Immune function is abnormal and patients are often treated with immunosuppressive steroids. Transfused patients have significantly decreased total lymphocyte and t-cell counts following surgery despite being clinically well. Increasing numbers of units of blood received are associated with progressively lower numbers of lymphocytes at follow-up. Several groups have studied the effect of blood transfusion on the outcome Crohn's disease because the immunosuppressive effects of transfusion might benefit patients in the same way steroids affect the course to the disease. Most of the studies observed that untransfused patients exhibited higher rates of recurrence than transfused patients (37-40). The studies suggest that transfusion may influence the course of diseases which are thought to have an immune or autoimmune basis and clinically respond to steroids. Crohn's disease patients with more severe disease, those with lower hemoglobins and serum albumins, undergoing resection of more bowel, should have higher recurrence rates. Yet, these patients when transfused have recurrence rates comparable to untransfused patients with higher hemoglobins and albumins and less bowel resected. Wound Healing It has recently been recognized that lymphocytes contribute to wound healing which is primarily mediated by macrophages. Lymphocytes secrete lymphokines which enhance fibroblast replication, migration and collagen synthesis. In vivo depletion of lymphocytes impairs skin wound healing. Since transfusions inhibit lymphocyte function, transfusion-induced inhibition of lymphocyte function should lead to impaired wound healing (41). Rats undergoing ileocolic resection with primary anastomosis and transfusion with saline, syngeneic or allogeneic blood were sacrificed three and seven days following surgery and the bursting pressure of the anastomosis measured. Bursting pressure was significantly lower following transfusion with syngeneic or allogeneic blood in comparison to saline. Hydroxyproline content of the anastomoses was reduced and anastomotic abscesses were common in the transfused animals. This study clearly implicates blood transfusion in impaired wound healing. D iabetes In man, insulin dependent diabetes mellitus is associated with decreases in both the number and functional activity of suppresser T lymphocytes. In the Bio-Breeding rat, diabetes develops when the animals develop pancreatic insulitis, suggesting a cell-mediated immune pathogenesis. Diabetes is prevented in these animals by treating them with immunosuppressive agents such as anti-lymphocyte serum, steroids, cyclosporin, irradiation, neonatal thymectomy, or blood transfusion (42).

1995 ◽  
pp. 299-299
Keyword(s):  
Wound Healing ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Blood Transfusion ◽  
Allogeneic Blood ◽  
Bursting Pressure ◽  
Lymphocyte Function ◽  
Serum Albumins ◽  
Recurrence Rates ◽  
Impaired Wound Healing

THE EVALUATION OF SERUM SEROTONIN LEVEL AMONG PATIENTS WITH CROHN’S DISEASE AND ITS IMPACT ON QUALITY OF LIFE

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S55-S55
Author(s):  
Marcin Sochal ◽  
Piotr Bialasiewicz ◽  
Agata Gabryelska ◽  
Renata Talar-Wojnarowska ◽  
Jakub Fichna ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Sleep Quality ◽  
Sleep Fragmentation ◽  
Clinical Severity ◽  
Serotonin Level ◽  
Intestinal Physiology ◽  
Tnf Α

Abstract Background and aims Serotonin affects intestinal physiology, mood, as well as circadian rhythm. Moreover, serotonin has proinflammatory function. Therefore, the aim of this study was to investigate the role of serotonin in clinical severity of Crohn’s Disease (CD) and its effect on pain and sleep quality. Methods Fifty-nine CD patients (34 in exacerbation and 25 in remission according to the Harvey-Bradshaw Index-HBI) and 25 health control individuals(HC) were recruited. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) and subjective severity of pain by the Visual Analog Scale (VAS). Seventeen patients were treated with anti-TNF-α induction therapy for 14 weeks. Results Serotonin level was higher in CD (145.12ng/mL, IQR:98.14–179.25) compared to HC (87.52ng/mL, IQR:70.04–129.39; p=0.002) and in exacerbation of CD (157.66ng/mL, IQR:111.94–197.64) compared to remission (122.33ng/mL, IQR:83.28–163.67; p=0.029). Serotonin level with cut-off point of 92.45 ng/mL is useful for distinguishing participants with CD from HC (sensitivity: 78%, specificity: 60%, positive predictive value: 82%). Positive correlation between serotonin and HBI (r=0.279, p=0.032) and severity of diarrhoea (r=0.260, p=0.047) were found. Serotonin does not correlate with PSQI (r=0.152, p=0.168), but correlates with presence of sleep fragmentation for example by getting up to use the bathroom (joined 5b-5j PSQI questions; r=0.270, p=0.039). Correlations between serotonin and VAS were also obtained (r=0.220, p=0.045). Moreover, serotonin level significantly decreased after anti-TNF-α therapy (192.35ng/mL, IQR:150.36–225.56 vs. 121.11ng/mL, IQR:91.28–188.87; p=0.006). The study was funded by National Science Centre, Poland (#2018/31/N/NZ5/03715). Conclusions Serotonin level correlates with the severity of CD and decreases after anti-TNF-α therapy. It is associated with sleep fragmentation, which may be caused by diarrhea.

scholarly journals Effect of Originator Infliximab Treatment on Disease-Related Hospitalizations, Work Productivity and Activity Impairment, and Health Resource Utilization in Patients with Crohn’s Disease in a Real-Life Setting: Results of a Prospective Multicenter Study in Germany

2020 ◽  
pp. 1-13
Author(s):  
Niels Teich ◽  
Michael Bläker ◽  
Frank Holtkamp-Endemann ◽  
Eric Jörgensen ◽  
Andreas Stallmach ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Multicenter Study ◽  
Work Productivity ◽  
Infliximab Treatment ◽  
Prospective Multicenter Study ◽  
Hospitalization Rates ◽  
The Mean

<b><i>Introduction:</i></b> Infliximab (IFX) therapy is efficacious for inducing and maintaining symptomatic remission in patients with Crohn’s disease (CD), but whether this benefit results in reduced hospitalization rates and therefore may improve patients’ quality of life in an economically sensible way is conflicting so far. <b><i>Methods:</i></b> We conducted a noninterventional, multicenter, open-label, prospective study to evaluate the effect of originator IFX treatment on patient-reported outcomes and disease-related hospitalizations in adult CD patients in Germany treated for the first time with IFX according to label. <b><i>Results:</i></b> Two hundred and ninety-four patients were included in the study. We observed a statistically significant reduction in the number of CD-related hospitalizations from the year before baseline (mean 1.00 per patient, SD ± 0.93) to the mean value of the 1st (0.62, SD ± 0.95) and 2nd year (0.32, SD ± 0.75) of the observation period (<i>p</i> &#x3c; 0.0001). After 3 months of IFX therapy, work productivity and activity increased by an average of 12.6 and 17.1%, respectively. Patient’s clinical outcome was markedly improved as the total CD activity index (CDAI) sum score continuously decreased from baseline to month 24 and the mean score of the total inflammatory bowel disease questionnaire (IBDQ) changed substantially from 141 at baseline to 172 after 24 months of IFX treatment. Additionally, the number of work incapacity days declined. Recently, no new safety issues of IFX have been identified. <b><i>Conclusion:</i></b> In this large, prospective, multicenter study on disease-related hospitalization rates, work productivity, capacity for daily activities, and HRQoL in patients with CD, IFX significantly reduces their hospitalization rates and improves work productivity, daily activity, and quality of life over 24 months.

Sa595 DIETARY INFLAMMATORY POTENTIAL AND FOOD PATTERNS IN RELATION TO GUT MICROBIOME AMONG CHILDREN WITH CROHN'S DISEASE: A COMPARATIVE STUDY WITH HEALTHY CONTROLS

2021 ◽  
Vol 160 (6) ◽  
pp. S-566
Author(s):  
Jessica Breton ◽  
Vincent Tu ◽  
Ceylan Tanes ◽  
Maire A. Conrad ◽  
Kelly Kachelries ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Comparative Study ◽  
Gut Microbiome ◽  
Healthy Controls ◽  
Food Patterns

scholarly journals Strategies for Preventing Endoscopic Recurrence of Crohn’s Disease 1 Year after Surgery: A Network Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Jin-shan Feng ◽  
Jin-yu Li ◽  
Xiu-yan Chen ◽  
Zheng Yang ◽  
Shang-hai Li
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Meta Analysis ◽  
Credible Interval ◽  
Ileal Resection ◽  
Randomized Controlled ◽  
Endoscopic Recurrence ◽  
Central Database ◽  
Lactobacillus Gg

Objective. To assess the benefits of different treatments that aim to prevent the endoscopic recurrence of Crohn’s disease (CD) after ileal resection. Methods. Randomized controlled trials (RCTs) were searched from MEDLINE, Embase, and the Cochrane Central Database. All the included RCTs with an endoscopic recurrence outcome which was defined as Rutgeerts’ score ≥ i2 have a duration of more than 1 year. The quality of the included RCTs was assessed by the Cochrane Risk of Bias Tool. Pairwise treatment effects were estimated through a Bayesian random effects network meta-analysis by using the OpenBUGS 1.4 software and reported as odds ratios (ORs) with a 95% credible interval (CI). Results. Fourteen RCTs (877 participants) were included. Two strategies were superior to placebo for preventing endoscopic recurrence of CD at 1 year after surgery: infliximab (d, −5.475; 95% CI, −10.47 to –1.632) and adalimumab (d, −7.273; 95% CI, −13.84 to −2.585). Nine strategies were not effective: budesnoid, mesalazine (in both high and low dose), azathioprine, Tripterygium wilfordii, mesalazine + infliximab, ornidazole, untreated intervention, and Lactobacillus GG. Conclusions. Except for infliximab and adalimumab, other strategies included in our analysis were not effective for preventing endoscopic recurrence of CD at 1 year after ileal resection.

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