Are pANCA, ASCA, or Cytokine Gene Polymorphisms Associated with Pouchitis? Long-term Follow-up in 102 Ulcerative Colitis Patients

Aisenberg, James; Legnani, Peter; Nilubol, Naris; Cobrin, Gena M.; Ellozy, Sharif H.; Hegazi, Refaat; Yager, Jessica; Bodian, Carol; Gorfine, Stephen R.; Bauer, Joel J.; Plevy, Scott E.; Sachar, David B.

doi:10.1111/j.1572-0241.2004.04107.x

Cited by 73 publications

(59 citation statements)

References 35 publications

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“…From etiological and pathogenetic perspectives, a variety of factors may contribute to the initiation, development, and progression of the disease. These factors include genetic predisposition, 20,21 dysbiosis, 1-4 altered mucosal immunity, [22][23][24][25][26][27][28] and colonic metaplasia due to fecal stasis, 29,30 A previous study demonstrated that a decreased intramucosal pH with mucosal acidosis characteristic of hypoperfusion was associated with an increased risk for the development of pouchitis. 15 The findings of the current study suggest that pouchitis with endoscopic asymmetric inflammation may be associated with ischemic factors.…”

Section: Discussionmentioning

confidence: 97%

Asymmetric endoscopic inflammation of the ileal pouch: A sign of ischemic pouchitis?

Shen¹,

Plesec²,

Remer³

et al. 2010

Inflammatory Bowel Diseases

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Section: Discussionmentioning

confidence: 97%

Asymmetric endoscopic inflammation of the ileal pouch: A sign of ischemic pouchitis?

Shen¹,

Plesec²,

Remer³

et al. 2010

Inflammatory Bowel Diseases

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“…The reported risk factors for pouchitis also include noncarrier status of TNF allele 2, backwash ileitis, and pre-proctocolectomy thrombocytosis [22,23]. Tobacco use is protective against the development of pouchitis, and recent data surprisingly suggest that fulminant colitis leading to colectomy also may be protective [24].…”

Section: Risk Factorsmentioning

confidence: 94%

“…Genetic polymorphisms such as those of IL-1 receptor antagonist and NOD2/CARD15 may increase the risk for pouchitis [22,23].…”

Section: Risk Factorsmentioning

confidence: 99%

Surgical Prophylaxis of Pouchitis in Ulcerative Colitis

et al. 2010

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Ileal pouch-anal anastomosis (IPAA) is now the procedure of choice for most patients requiring proctocolectomy for ulcerative colitis. The J-shaped pouch, usually 15-20 cm in length, is easiest to construct and has functional outcomes identical to those of the more complex designs. IPAA is a complex procedure, and complications occur frequently. Despite the significant improvements this surgical advance has made on the quality of life in these patients, inflammation of the surgically created ileal pouch or pouchitis remains a major late postoperative complication that can often overshadow the benefits of this otherwise curative operation. Several inflammatory and noninflammatory complications can occur after IPAA. Pouchitis is the most common, occurring in ≈50% of patients. Whereas acute pouchitis can be treated rapidly and successfully in the majority of patients, refractory and chronic pouchitis remain therapeutic challenges to patients and physicians. The problem is believed to be caused by stasis of feces in the pouch with overgrowth of aerobic and anaerobic organisms. The size of the pouch has a significant influence on the incidence of pouchitis: a smaller pouch usually empties better than a larger pouch and so may be less susceptible to pouchitis.

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“…The implications of these studies include younger age at onset [10,15], younger age at colectomy [4], extensive colitis [12,17,18], backwash ileitis [4,8], extraintestinal manifestations [2,4,8,9,10,11], preoperative steroid use [13,23], smoking status [13,24,25], regular use of nonsteroidal anti-inflammatory drugs [14,24], preoperative perinuclear antineutrophil cytoplasmic antibody positivity [22,25,26], anti-CBir1 flagellin [22], and genetic factors (IL-1 receptor antagonist, NOD2/CARD 15, and TNF genes) [27,28,29]. …”

Section: Discussionmentioning

confidence: 99%

Predictive Factors for Development of Chronic Pouchitis after Ileal Pouch-Anal Anastomosis in Ulcerative Colitis

Okita

Araki²,

Hashimoto³

et al. 2013

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Background: No previous studies have examined predictive factors for chronic pouchitis after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) with consideration of changes in pouchitis subtypes during follow-up. This study evaluated the independent predictive factors for chronic pouchitis. Methods: A total of 244 consecutive patients who underwent IPAA were enrolled. We assessed the possible associations between pouchitis and clinical factors using Cox proportional hazard regression. Results: 231 patients met the inclusion criteria. 66 (28.5%) patients developed pouchitis. In 9 of 44 (20.4%) patients, antibiotic-responsive pouchitis at the first episode changed into chronic pouchitis after the occurrence of a subsequent episode. The median duration from occurrence of antibiotic-responsive pouchitis to alteration into chronic pouchitis was 502 (range 147-1,697) days. Overall pouchitis was finally classified into 35 acute pouchitis and 31 chronic pouchitis cases. Multivariate analysis revealed that a ≥7.5-g cumulative steroid dose before colectomy and a ≥500-mg monthly steroid dose just before colectomy were significant predictive factors for chronic pouchitis (p = 0.0001 and 0.0095, respectively). Conclusion: Patients with UC and a higher cumulative steroid dose before colectomy or higher monthly steroid dose just before colectomy may have a predictive factor for developing chronic pouchitis.

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Are pANCA, ASCA, or Cytokine Gene Polymorphisms Associated with Pouchitis? Long-term Follow-up in 102 Ulcerative Colitis Patients

Cited by 73 publications

References 35 publications

Asymmetric endoscopic inflammation of the ileal pouch: A sign of ischemic pouchitis?

Asymmetric endoscopic inflammation of the ileal pouch: A sign of ischemic pouchitis?

Surgical Prophylaxis of Pouchitis in Ulcerative Colitis

Predictive Factors for Development of Chronic Pouchitis after Ileal Pouch-Anal Anastomosis in Ulcerative Colitis

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