Objetivo: Identificar os aspectos atuais ao longo do curso da doença de Crohn (DC), desde o diagnóstico, tratamentos farmacológicos, cirúrgicos e recomendações nutricionais. Método: Este estudo é uma revisão integrativa da literatura que se respalda na busca de artigos em bases de dados, Pub Med, Lilacs, Scielo, periódicos e sites, com os seguintes descritores em “Crohn’s disease”, “Crohn’s Disease treatment”, “Inflammatory Bowel Diseases”, “Physiopathology of Inflammation”, utilizando artigos de pesquisas originais e revisões entre anos de 2014 a 2022. Esse levantamento bibliográfico foi realizado no período de 01/03/2022 a 20/10/2022. Resultados: De um total de 1850 artigos encontrados, foram selecionados 84 artigos que se enquadravam no escopo da revisão. Discussão: Atualmente todo o curso da DC se mostra bem completa, desde seu diagnóstico ao tratamento que pode envolver medicamentos biológicos, além da necessidade de uma dieta adequada a fim de se evitar desnutrição do paciente. Conclusão: Visto toda a complexidade englobada na DC, é primordial a atuação de equipe multidisciplinar na conduta do tratamento do paciente, o que pode contribuir imensamente para a qualidade de vida e adesão ao tratamento pelo paciente.
Chronic kidney disease (CKD) progression and complications are associated with increased oxidative stress, as well as with Nrf2 inactivation. Lipoic acid (LA) has been considered an inducer of Nrf2 antioxidant response. We tested whether oral administration of LA provides beneficial effects in experimental CKD in rats. Wistar rats underwent 5/6 nephrectomy (CKD group) or sham laparotomy. Seven days later, CKD group was divided into three subgroups that received: (i) LA continuously in the drinking water (100 mg/kg/day), (ii) LA by gavage every other day (100 mg/kg), or (iii) no LA treatment. LA treatment lasted until day 60. Plasma urea and creatinine, 24 hproteinuria, glomerulosclerosis, interstitial fibrosis/tubular atrophy, and Nrf2 activation were analyzed. All parameters measured were significantly altered in the untreated CKD group, compared with the sham group, as expected. Oral LA administration, either in the drinking water or by gavage, did not improve significantly any parameter, comparing the treated-groups with the untreated CKD group. These results indicate that oral LA administration for 53 days was ineffective to reactivate Nrf2 in the remnant kidney of uremic rats, likely preventing improvements in biochemical and histopathological markers of renal function.
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