Factors associated with disease activity of pouchitis after surgery for ulcerative colitis

Kuisma, Juha; Järvinen, H; Kahri, Arvi; Färkkilä, Martti

doi:10.1080/00365520410004668

Cited by 91 publications

(44 citation statements)

References 16 publications

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“…Genetic polymorphisms such as those of IL-1 receptor antagonist [38,39,40] and NOD2/CARD15 [40] may increase the risk for pouchitis. The reported risk factors for pouchitis also include noncarrier status of TNF allele 2 [39] , extensive UC [4,41,42] , backwash ileitis [41] , pre-proctocolectomy thrombocytosis [43] , extra-intestinal manifestations, especially PSC [3,35,44,45] , the presence of serum perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) [46,47] , being a non-smoker [36,42,48] , and use of non-steroidal anti-inflammator y dr ugs (NSAID) [42,48] . In addition to p-ANCA, the presence of serologic markers, anti-Saccharomyces cervesiae antibodies to CD-related antigen from Pseudomonas fluorescens or outer membrane porin C of Escherichia coli in patients with preoperative indeterminate colitis appears to be associated with persistent inflammation of the pouch after restorative proctocolectomy [49] .…”

Section: Risk Factorsmentioning

confidence: 99%

Pouchitis

Yu¹,

Shao²,

Shen³

2007

WJG

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While restorative proctocolectomy with ileal pouch-anal anastomosis has significantly improved the quality of life in patients with underlying ulcerative colitis who require surgery, complications can occur. Pouchitis as the most common long-term complication represents a spectrum of disease processes ranging from acute, antibioticresponsive type to chronic antibiotic-refractory entity. Accurate diagnosis using a combined assessment of symptoms, endoscopy and histology and the stratification of clinical phenotypes is important for treatment and prognosis the disease. The majority of patients respond favorably to antibiotic therapy. However, management of chronic antibiotic-refractory pouchitis remains a challenge.

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Section: Risk Factorsmentioning

confidence: 99%

Pouchitis

Yu¹,

Shao²,

Shen³

2007

WJG

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“…Tobacco smoking was often reported to have a beneficial outcome on the course of activity of UC (Boyko et al, 1987;Mokbel et al, 1998;Gheorghe et al, 2004;Höie et al, 2007) and to decrease the need for colon surgery (Odes et al, 2001;Cosnes, 2004). Smokers with UC who quit smoking experienced an increase in disease activity, and symptoms improved in ex-smokers who returned to smoking (de Castella, 1982;Motley et al, 1987;Rudra et al, 1989;Kuisma et al, 2004). Although cigarette smoke contains hundreds of substances, there is evidence that nicotine and/or its metabolites, such as cotinine, account for the beneficial effect of smoking.…”

Section: Introductionmentioning

confidence: 99%

Novel Insights on the Effect of Nicotine in a Murine Colitis Model

AlSharari

Akbarali

Abdullah

et al. 2012

J Pharmacol Exp Ther

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Studies showed that nicotine has a positive influence on symptoms of ulcerative colitis. In the present study, we explored the effect of nicotine treatment using different routes of administration in the dextran sodium sulfate (DSS) colitis mouse model. We also investigated the effects of cotinine, a major metabolite of nicotine, in the model. C57BL6 adult male mice were given DSS solution freely in the drinking water for seven consecutive days, and tap water was given thereafter. Disease severity, length of the colon, colon tissue histology, and inflammatory markers, including colonic myeloperoxidase activity and colonic tumor necrosis factor-a levels, were evaluated. The effect of nicotine and cotinine treatments via various different routes of administration were examined the DSS model. In addition, we measured the plasma levels of nicotine and cotinine in our treatment protocols. Administration of low, but not high, doses of oral nicotine in DSS-treated mice resulted in a significant decrease in disease severity, histologic damage scores, as well as colonic level of tumor necrosis factor-a. However, the anti-inflammatory effect of nicotine was not seen after chronic s.c. or minipump infusion of the drug. Differences in plasma levels of nicotine and cotinine do not seem to account for this lack of effect. Finally, oral cotinine alone failed to show a significant effect in the DSS model of colitis. These results highlight that dose and route of administration play a critical role in the protective effect of nicotine in the DSS mouse colitis model.

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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

Digestion

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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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Factors associated with disease activity of pouchitis after surgery for ulcerative colitis

Cited by 91 publications

References 16 publications

Pouchitis

Pouchitis

Novel Insights on the Effect of Nicotine in a Murine Colitis Model

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

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