Recent advances in clinical practice: a systematic review of isolated colonic Crohn's disease: the third IBD?

Subramanian, Sreedhar; Ekbom, Anders; Rhodes, Jonathan M.

doi:10.1136/gutjnl-2016-312673

Cited by 74 publications

(62 citation statements)

References 177 publications

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“…Isolated colonic CD is regarded as a separate entity, and diffuse colon involvement is associated with more severe outcome . Our data showed patients with isolated colon involvement had a higher uric acid to creatinine ratio than non‐L2 patients and UC.…”

Section: Discussionmentioning

confidence: 61%

“…This might be an evidence of enhanced intestinal purine metabolism in colonic CD, suggesting that isolated colonic CD might be positioned at one end of the IBD spectrum rather than in the midway between CD with small intestine involvement and UC. Oxidative stress stimulates the immune response and initiates IBD, and xanthine oxidase mainly functions in the mucosal layer as superoxide producing enzyme, generating reactive oxygen species and leading to gastrointestinal injuries. Because UC causes mucosal destruction while CD is characterized by submucosal inflammation, xanthine oxidase level in the luminal epithelium is increased in CD but not in UC .…”

Section: Discussionmentioning

confidence: 99%

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Altered uric acid metabolism in isolated colonic Crohn's disease but not ulcerative colitis

Zhu

Feng

Zhang

et al. 2018

J of Gastro and Hepatol

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Altered uric acid metabolism in isolated colonic Crohn's disease but not ulcerative colitis

Zhu

Feng

Zhang

et al. 2018

J of Gastro and Hepatol

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“…How this corresponds to our findings remains to be elucidated. In the above-mentioned study and by other studies, it has been suggested that ileal and ileocolonic (L1/L3) and isolated colonic (L2) Crohn's disease are different entities ( 26 , 27 ). In our cohort of patients who underwent proct(ocol)ectomies, we did not observe differences in the mesenteric macrophages of patients with L2 and L3 disease.…”

Section: Discussionmentioning

confidence: 84%

Anatomical Variation in Mesenteric Macrophage Phenotypes in Crohn's Disease

Meer

Wasmann

Bilt

et al. 2020

Clin Transl Gastroenterol

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INTRODUCTION: Clinical trials are currently investigating whether an extended mesenteric resection for ileocecal resections could reduce postoperative recurrence in Crohn's disease. Resection of the mesorectum, which contains proinflammatory macrophages, during proct(ocol)ectomy, is associated with reduced recurrent inflammation and improved wound healing. We aimed to characterize the macrophages in the ileocecal mesentery, which were compared with those in the mesorectum, to provide a biological rationale for the ongoing trials. METHODS: In 13 patients with Crohn's disease and 4 control patients undergoing a proctectomy, tissue specimens were sampled at 3 locations from the mesorectum: distal (rectum), middle, and proximal (sigmoid). In 38 patients with Crohn's disease and 7 control patients undergoing ileocecal resections, tissue specimens also obtained from 3 locations: adjacent to the inflamed terminal ileum, adjacent to the noninflamed ileal resection margin, and centrally along the ileocolic artery. Immune cells from these tissue specimens were analyzed by flow cytometry for expression of CD206 to determine their inflammatory status. RESULTS: In the mesorectum, a gradient from proinflammatory to regulatory macrophages from distal to proximal was observed, corresponding to the adjacent inflammation of the intestine. By contrast, the ileocecal mesentery did not contain high amounts of proinflammatory macrophages adjacent to the inflamed tissue, and a gradient toward a more proinflammatory phenotype was seen in the central mesenteric area. DISCUSSION: Although the mesentery is a continuous structure, the mesorectum and the ileocecal mesentery show different immunological characteristics. Therefore, currently, there is no basis to perform an extended ileocecal resection in patients with Crohn's disease.

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“…The current therapeutic strategies for IBD are generally limited, but recent clinical advancement has occurred in immunotherapy using monoclonal antibodies. This approach is directed against inflammatory mediators, such as TNF-α (Targan 2006 ; Subramanian et al 2017 ; Gecse and Lakatos 2017 ; Chan and Ng 2017 ). However, these biological agents are expensive and result in severe side effects and life threatening complications (Cote-Daigneault et al 2015 ; Blonski and Lichtenstein 2006 ; Clarke and Regueiro 2012 ; Cohen and Thomas 2006 ).…”

Section: Introductionmentioning

confidence: 99%

Caffeic acid phenethyl ester is protective in experimental ulcerative colitis via reduction in levels of pro-inflammatory mediators and enhancement of epithelial barrier function

et al. 2017

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BackgroundInhibition of the nuclear factor kappa beta (NF-κβ) pathway has been proposed as a therapeutic target due to its key role in the expression of pro-inflammatory genes, including pro-inflammatory cytokines, chemokines, and adhesion molecules. Caffeic acid phenethyl ester (CAPE) is a naturally occurring anti-inflammatory agent, found in propolis, and has been reported as a specific inhibitor of NF-κβ. However, the impact of CAPE on levels of myeloperoxidases (MPO) and pro-inflammatory cytokines during inflammation is not clear. The aims of this study were to investigate the protective efficacy of CAPE in the mouse model of colitis and determine its effect on MPO activity, pro-inflammatory cytokines levels, and intestinal permeability.MethodDextran sulphate sodium was administered in drinking water to induce colitis in C57/BL6 mice before treatment with intraperitoneal administration of CAPE (30 mg kg−1 day−1). Disease activity index (DAI) score, colon length and tissue histology levels of MPO, pro-inflammatory cytokines, and intestinal permeability were observed.ResultsCAPE-treated mice had lower DAI and tissue inflammation scores, with improved epithelial barrier protection and significant reduction in the level of MPO and pro-inflammatory cytokines.ConclusionOur results show that CAPE is effective in suppressing inflammation-triggered MPO activity and pro-inflammatory cytokines production while enhancing epithelial barrier function in experimental colitis. Thus, we conclude that CAPE could be a potential therapeutic agent for further clinical investigations for treatment of inflammatory bowel diseases in humans.Electronic supplementary materialThe online version of this article (doi:10.1007/s10787-017-0364-x) contains supplementary material, which is available to authorized users.

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Recent advances in clinical practice: a systematic review of isolated colonic Crohn's disease: the third IBD?

Cited by 74 publications

References 177 publications

Altered uric acid metabolism in isolated colonic Crohn's disease but not ulcerative colitis

Altered uric acid metabolism in isolated colonic Crohn's disease but not ulcerative colitis

Anatomical Variation in Mesenteric Macrophage Phenotypes in Crohn's Disease

Caffeic acid phenethyl ester is protective in experimental ulcerative colitis via reduction in levels of pro-inflammatory mediators and enhancement of epithelial barrier function

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