Breastfeeding and genetic factors in the etiology of inflammatory bowel disease in children

Mikhailov, Theresa A.; Furner, Sylvia E.

doi:10.3748/wjg.15.270

Cited by 48 publications

(30 citation statements)

References 79 publications

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“…In accordance with a meta-analysis stating a beneficial role of breastfeeding for CD and UC, 49,66 our results show a significantly reduced duration of breastfeeding in children with UC. Surprisingly, the rate of breastfeeding in patients with celiac disease was higher compared with control subjects, in contrast to previous studies.…”

Section: Discussionsupporting

confidence: 91%

Cesarean Delivery Is Associated With Celiac Disease but Not Inflammatory Bowel Disease in Children

et al. 2010

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Section: Discussionsupporting

confidence: 91%

Cesarean Delivery Is Associated With Celiac Disease but Not Inflammatory Bowel Disease in Children

et al. 2010

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“…While several studies have shown a protective effect of breastfeeding, others have shown no such association 173 178. A meta-analysis of 14 case–control studies showed that breastfeeding protects against CD and UC;179 this protective effect appeared to be greater in CD than UC,180 and may be modulated via the microbiota. The hypothesis that a paramyxovirus such as measles or vaccination against such viruses might cause IBD remains controversial 181.…”

Section: Environmental Factorsmentioning

confidence: 99%

Geographical variability and environmental risk factors in inflammatory bowel disease

Bernstein

Vatn

et al. 2013

Gut

505

332

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The changing epidemiology of inflammatory bowel disease (IBD) across time and geography suggests that environmental factors play a major role in modifying disease expression. Disease emergence in developing nations suggests that epidemiological evolution is related to westernisation of lifestyle and industrialisation. The strongest environmental associations identified are cigarette smoking and appendectomy, although neither alone explains the variation in incidence of IBD worldwide. Urbanisation of societies, associated with changes in diet, antibiotic use, hygiene status, microbial exposures and pollution have been implicated as potential environmental risk factors for IBD. Changes in socioeconomic status might occur differently in different geographical areas and populations and, consequently, it is important to consider the heterogeneity of risk factors applicable to the individual patient. Environmental risk factors of individual, familial, community-based, country-based and regionally based origin may all contribute to the pathogenesis of IBD. The geographical variation of IBD provides clues for researchers to investigate possible environmental aetiological factors. The present review aims to provide an update of the literature exploring geographical variability in IBD and to explore the environmental risk factors that may account for this variability.

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“…58 The authors showed that the major part of mercaptopurine was excreted in breast milk within the first 4 hours after drug intake and the estimated maximum exposure of drug to the infant was <0.008 mg mercaptopurine/kg/day, representing <1% of the maternal dose. These findings indicate that breast-feeding during treatment with azathioprine generally seems safe and led the authors to conclude that breast-feeding should be recommended considering the otherwise beneficial effects (in fact, it seems quite plausible that breast-feeding would have a protective effect on the development of IBD [59][60][61] ). In summary, based on the large experience in transplantation patients, azathioprine and mercaptopurine are often continued during pregnancy.…”

Section: Azathioprine/mercaptopurinementioning

confidence: 99%

Safety of immunomodulators and biologics for the treatment of inflammatory bowel disease during pregnancy and breast-feeding

Gisbert

2010

Inflammatory Bowel Diseases

124

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The aim of this article is to critically review available data regarding the safety of immunomodulators and biological therapies during pregnancy and breast-feeding in women with inflammatory bowel disease. Methotrexate and thalidomide can cause congenital anomalies and are contraindicated during pregnancy (and breast-feeding). Although thiopurines have a Food and Drug Administration (FDA) rating D, available data suggest that these drugs are safe and well tolerated during pregnancy. Although traditionally women receiving azathioprine or mercaptopurine have been discouraged from breast-feeding because of theoretical potential risks, it seems that these drugs may be safe in this scenario. Treatment with cyclosporine for steroid-refractory ulcerative colitis (UC) during pregnancy can be considered safe and effective, and the use of this drug should be considered in cases of severe UC as a means of avoiding urgent surgery. Breast-feeding is contraindicated for patients receiving cyclosporine. Biological therapies appear to be safe in pregnancy, as no increased risk of malformations has been demonstrated. Therefore, the limited clinical results available suggest that the benefits of infliximab and adalimumab in attaining response and maintaining remission in pregnant patients might outweigh the theoretical risks of drug exposure to the fetus. Stopping therapy in the third trimester may be considered, as it seems that transplacental transfer of infliximab is low prior to this. Certolizumab differs from infliximab and adalimumab in that it is a Fab fragment of an antitumor necrosis factor alpha monoclonal antibody, and therefore it may not be necessary to stop certolizumab in the third trimester. The use of infliximab is probably compatible with breast-feeding.

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Breastfeeding and genetic factors in the etiology of inflammatory bowel disease in children

Cited by 48 publications

References 79 publications

Cesarean Delivery Is Associated With Celiac Disease but Not Inflammatory Bowel Disease in Children

Cesarean Delivery Is Associated With Celiac Disease but Not Inflammatory Bowel Disease in Children

Geographical variability and environmental risk factors in inflammatory bowel disease

Safety of immunomodulators and biologics for the treatment of inflammatory bowel disease during pregnancy and breast-feeding

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