Optimising management strategies of inflammatory bowel disease in resource-limited settings in Asia

Ng, Siew C.; Mak, Joyce Wing Yan; Pal, Partha; Banerjee, Rupa

doi:10.1016/s2468-1253(20)30298-3

Cited by 13 publications

(12 citation statements)

References 80 publications

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“…45,47 The availability of biologics and reimbursement policies vary widely in the resource limited countries of Asia. 48 The use of biologic therapy is likely to increase in IBD-ENC countries with widespread availability and use of lower cost biosimilar alternatives. Step-up therapy is generally followed in the region, and biologics are only added for severe disease.…”

Section: Discussionmentioning

confidence: 99%

“…Compare this with Japan, where 30–40% of CD patients receive biologic therapy and almost all expenses of IBD treatment are borne by the government 45,47 . The availability of biologics and reimbursement policies vary widely in the resource limited countries of Asia 48 . The use of biologic therapy is likely to increase in IBD‐ENC countries with widespread availability and use of lower cost biosimilar alternatives.…”

Section: Discussionmentioning

confidence: 99%

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Emerging inflammatory bowel disease demographics, phenotype, and treatment in South Asia, South‐East Asia, and Middle East: Preliminary findings from the Inflammatory Bowel Disease‐Emerging Nations' Consortium

Banerjee

Pal

Hilmi

et al. 2022

J of Gastro and Hepatol

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Background and Aim: Inflammatory bowel disease (IBD) is emerging in the newly industrialized countries of South Asia, South-East Asia, and the Middle East, yet epidemiological data are scarce. Methods: We performed a cross-sectional study of IBD demographics, disease phenotype, and treatment across 38 centers in 15 countries of South Asia, South-East Asia, and Middle East. Intergroup comparisons included gross national income (GNI) per capita. Results: Among 10 400 patients, ulcerative colitis (UC) was twice as common as Crohn's disease (CD), with a male predominance (UC 6678, CD 3495, IBD unclassified 227, and 58% male). Peak age of onset was in the third decade, with a low proportion of elderly-onset IBD (5% age > 60). Familial IBD was rare (5%). The extent of UC was predominantly distal (proctitis/left sided 67%), with most being treated with mesalamine (94%), steroids (54%), or immunomodulators (31%). Ileocolic CD (43%) was the commonest, with low rates of perianal disease (8%) and only 6% smokers. Diagnostic delay for CD was common (median 12 months; interquartile range 5-30). Treatment of CD included mesalamine, steroids, and immunomodulators (61%, 51%, and 56%, respectively), but a fifth received empirical antitubercular therapy. Treatment with biologics was uncommon (4% UC and 13% CD), which increased in countries with higher GNI per capita. Surgery rates were 0.1 (UC) and 2 (CD) per 100 patients per year.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Emerging inflammatory bowel disease demographics, phenotype, and treatment in South Asia, South‐East Asia, and Middle East: Preliminary findings from the Inflammatory Bowel Disease‐Emerging Nations' Consortium

Banerjee

Pal

Hilmi

et al. 2022

J of Gastro and Hepatol

Self Cite

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show abstract

“…Consequently, IBD has become a global public health challenge that demands attention and resources to manage. 2,3 1.1 Pathophysiology and pathogenesis of IBD IBD is a condition that can lead to fever, abdominal pain, diarrhea, rectal bleeding, and weight loss, significantly impacting the patients' quality of life. 4 UC symptoms are primarily characterized by continuous ulceration of the colon mucosa, abscesses, and inflammatory reactions that start in the rectum and gradually spread to the proximal colon.…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, IBD has become a global public health challenge that demands attention and resources to manage. 2,3…”

Section: Introductionmentioning

confidence: 99%

Orally-administered nanomedicine systems targeting colon inflammation for the treatment of inflammatory bowel disease: latest advances

Hu,

Zhao,

et al. 2024

J. Mater. Chem. B

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“…These disorders are characterized by relapsing and remitting intestinal inflammation with epithelial damage. The incidence and prevalence of IBD are rising globally [ 1 , 2 ]. The etiology of IBD is multifactorial, including genetic susceptibility, dysregulated immune response, and gut microbiome dysregulation, as well as environmental factors.…”

Section: Introductionmentioning

confidence: 99%

α-Bisabolol Mitigates Colon Inflammation by Stimulating Colon PPAR-γ Transcription Factor: In Vivo and In Vitro Study

et al. 2022

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The incidence and prevalence of inflammatory bowel disease (IBD, Crohn’s disease, and ulcerative colitis) are increasing worldwide. The etiology of IBD is multifactorial, including genetic predisposition, dysregulated immune response, microbial dysbiosis, and environmental factors. However, many of the existing therapies are associated with marked side effects. Therefore, the development of new drugs for IBD treatment is an important area of investigation. Here, we investigated the anti-inflammatory effects of α-bisabolol, a naturally occurring monocyclic sesquiterpene alcohol present in many aromatic plants, in colonic inflammation. To address this, we used molecular docking and dynamic studies to understand how α-bisabolol interacts with PPAR-γ, which is highly expressed in the colonic epithelium: in vivo (mice) and in vitro (RAW264.7 macrophages and HT-29 colonic adenocarcinoma cells) models. The molecular docking and dynamic analysis revealed that α-bisabolol interacts with PPAR-γ, a nuclear receptor protein that is highly expressed in the colon epithelium. Treatment with α-bisabolol in DSS-administered mice significantly reduced Disease Activity Index (DAI), myeloperoxidase (MPO) activity, and colonic length and protected the microarchitecture of the colon. α-Bisabolol treatment also reduced the expression of proinflammatory cytokines (IL-6, IL1β, TNF-α, and IL-17A) at the protein and mRNA levels. The expression of COX-2 and iNOS inflammatory mediators were reduced along with tissue nitrite levels. Furthermore, α-bisabolol decreased the phosphorylation of activated mitogen-activated protein kinase (MAPK) signaling and nuclear factor kappa B (NFκB) proteins and enhanced colon epithelial PPAR-γ transcription factor expression. However, the PPAR-α and β/δ expression was not altered, indicating α-bisabolol is a specific stimulator of PPAR-γ. α-Bisabolol also increased the PPAR-γ transcription factor expression but not PPAR-α and β/δ in pretreated in LPS-stimulated RAW264.7 macrophages. α-Bisabolol significantly decreased the expression of proinflammatory chemokines (CXCL-1 and IL-8) mRNA in HT-29 cells treated with TNF-α and HT-29 PPAR-γ promoter activity. These results demonstrate that α-bisabolol mitigates colonic inflammation by inhibiting MAPK signaling and stimulating PPAR-γ expression.

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Optimising management strategies of inflammatory bowel disease in resource-limited settings in Asia

Cited by 13 publications

References 80 publications

Emerging inflammatory bowel disease demographics, phenotype, and treatment in South Asia, South‐East Asia, and Middle East: Preliminary findings from the Inflammatory Bowel Disease‐Emerging Nations' Consortium

Emerging inflammatory bowel disease demographics, phenotype, and treatment in South Asia, South‐East Asia, and Middle East: Preliminary findings from the Inflammatory Bowel Disease‐Emerging Nations' Consortium

Orally-administered nanomedicine systems targeting colon inflammation for the treatment of inflammatory bowel disease: latest advances

α-Bisabolol Mitigates Colon Inflammation by Stimulating Colon PPAR-γ Transcription Factor: In Vivo and In Vitro Study

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