Factors Affecting Ulcerative Colitis Flare-Ups: Associations With Smoking Habits and Other Patient Characteristics

Malibary, Nadim; Ezzat, Mohammed; Mogharbel, Ahmed M; Kouzaba, Khalid A; Alkadi, Abdulaziz A; Malki, Usama H; Gharib, Sultan M; Altowairqi, Faisal M; Saadah, Omar I.; Mosli, Mahmoud

doi:10.7759/cureus.19834

Cited by 2 publications

(4 citation statements)

References 33 publications

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“…The clinical course of UC varies from a stable course with prolonged remission to recurrent flare-ups, which is the return of symptoms after a period of remission [ 1 ]. Reports have shown numerous factors contributing to UC relapses, such as genetic susceptibility and fecal incontinence [ 2 ]. Histologically, a distinct characteristic of UC is the identification of uninterrupted inflammation in the colon, exhibiting features such as redness, disrupted vascular pattern, bleeding, and ulcerations [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is considered a part of the inflammatory bowel disease together with Crohn’s disease [ 1 ]. The exact cause of ulcerative colitis is yet to be determined, but various mechanisms have been proposed; these include genetic susceptibility and immune dysregulation [ 2 ]. Here, we report a case of ulcerative colitis flare induced by isotretinoin.…”

Section: Introductionmentioning

confidence: 99%

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Ulcerative Colitis Flare Post Isotretinoin Use: A Case Report

AlHussein,

AlHussain

2023

Cureus

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Ulcerative colitis (UC) is an inflammatory bowel disease characterized by chronic intestinal inflammation. We present a case of UC flare induced by isotretinoin, a medication commonly used for the treatment of severe acne. A 36-year-old male with a history of UC in remission presented with moderate-severe cystic acne and was started on isotretinoin. After four months of treatment, he developed symptoms of UC flare, including bloody diarrhea. A colonoscopy revealed ulcerative pancolitis, and isotretinoin was discontinued. The patient was subsequently treated with adalimumab and azathioprine, achieving good disease control. This case highlights the potential link between isotretinoin and UC exacerbation, suggesting the need for further research to understand the underlying mechanisms and assess the risk associated with isotretinoin use in patients with UC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ulcerative Colitis Flare Post Isotretinoin Use: A Case Report

AlHussein,

AlHussain

2023

Cureus

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“…For instance, in the context of gout, MSU crystalinduced changes in expression of circadian clock components in macrophages could result in changes in circadian control of inflammatory pathway activity that are specific to gout and not seen in other diseases. It is interesting to note that NLRP3 inflammasome activation is a central feature of ulcerative colitis, a disease also associated with acute inflammatory flares [143]. However, although there is evidence that circadian clock disruption could contribute to risk of colitis flare [137,138], there is currently no evidence of an increased risk of colitis flare at night [143].…”

Section: Circadian Involvement In Gout Flares In the Broader Context ...mentioning

confidence: 99%

“…It is interesting to note that NLRP3 inflammasome activation is a central feature of ulcerative colitis, a disease also associated with acute inflammatory flares [143]. However, although there is evidence that circadian clock disruption could contribute to risk of colitis flare [137,138], there is currently no evidence of an increased risk of colitis flare at night [143].…”

Section: Circadian Involvement In Gout Flares In the Broader Context ...mentioning

confidence: 99%

Circadian Rhythms in NLRP3 Inflammasome Regulation: Possible Implications for the Nighttime Risk of Gout Flares

Poulsen,

Dalbeth

2024

GUCDD

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Gout flares more frequently start late at night or in the early morning compared to during the day. The reasons for this are unknown. Activation of the NLRP3 inflammasome in monocytes/macrophages is central to initiation of gout flares. Here, we review the mechanisms by which circadian clocks control the NLRP3 inflammasome and the implications of this for the nighttime pattern of gout flares. Several hormones involved in inflammation regulation, e.g., glucocorticoids, melatonin and melanocortins, are under circadian control, with both circulating hormone levels as well as the expression of their receptors on target tissues showing time-of day differences. In addition, the NLRP3 inflammasome is also under the control of the macrophage circadian clock, leading to time-of-day differences in expression of NLRP3 inflammasome components and susceptibility to inflammasome-activating stimuli. MSU crystal exposure leads to altered expression of circadian clock components in macrophages, leading to time-of-day-specific loss of repression of NLRP3 inflammasome activity. Taken together, there is clear evidence that circadian clocks regulate the NLRP3 inflammasome and that this regulation may be compromised by MSU crystal exposure in gout. Circadian control of the inflammasome may be one of the factors contributing to nighttime susceptibility to gout flares.

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Factors Affecting Ulcerative Colitis Flare-Ups: Associations With Smoking Habits and Other Patient Characteristics

Cited by 2 publications

References 33 publications

Ulcerative Colitis Flare Post Isotretinoin Use: A Case Report

Ulcerative Colitis Flare Post Isotretinoin Use: A Case Report

Circadian Rhythms in NLRP3 Inflammasome Regulation: Possible Implications for the Nighttime Risk of Gout Flares

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