Risk of Cancer in Inflammatory Bowel Disease and Pitfalls in Oncologic Therapy

Peixoto, Renata D’Alpino; Ferreira, Artur R.; Cleary, James M.; Fogacci, João P.; Vasconcelos, João Paulo; Jácome, Alexandre A.

doi:10.1007/s12029-022-00816-0

Cited by 4 publications

(5 citation statements)

References 92 publications

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“…The term inflammatory bowel disease (IBD) refers to a group of disorders that are characterized by chronic, progressive immune-mediated inflammation of the digestive tract with frequent extra-intestinal, systemic organ involvement. Ulcerative colitis (UC) and Crohn’s disease (CD) are listed as the prototype disorders [ 135 ]. The GI-tract plays a crucial role in maintaining the host’s immune homeostasis, so a disrupted balance between immune tolerance and inflammation may lead to IBD [ 135 ].…”

Section: Therapeutic Applications Of the Msc-secretome For Autoimmune...mentioning

confidence: 99%

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Mesenchymal Stem Cell-Derived Secretome: A Potential Therapeutic Option for Autoimmune and Immune-Mediated Inflammatory Diseases

Műzes

Sípos

2022

Cells

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Immune-mediated inflammatory diseases (IMIDs) encompass several entities such as “classic” autoimmune disorders or immune-mediated diseases with autoinflammatory characteristics. Adult stem cells including mesenchymal stem cells (MSCs) are by far the most commonly used type in clinical practice. However, due to the possible side effects of MSC-based treatments, there is an increase in interest in the MSC-secretome (containing large extracellular vesicles, microvesicles, and exosomes) as an alternative therapeutic option in IMIDs. A wide spectrum of MSC-secretome-related biological activities has been proven thus far including anti-inflammatory, anti-apoptotic, and immunomodulatory properties. In comparison with MSCs, the secretome is less immunogenic but exerts similar biological actions, so it can be considered as an ideal cell-free therapeutic alternative. Additionally, since the composition of the MSC-secretome can be engineered, for a future perspective, it could also be viewed as part of a potential delivery system within nanomedicine, allowing us to specifically target dysfunctional cells or tissues. Although many encouraging results from pre-clinical studies have recently been obtained that strongly support the application of the MSC-secretome in IMIDs, human studies with MSC-secretome administration are still in their infancy. This article reviews the immunomodulatory effects of the MSC-secretome in IMIDs and provides insight into the interpretation of its beneficial biological actions.

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Section: Therapeutic Applications Of the Msc-secretome For Autoimmune...mentioning

confidence: 99%

“…Ulcerative colitis (UC) and Crohn’s disease (CD) are listed as the prototype disorders [ 135 ]. The GI-tract plays a crucial role in maintaining the host’s immune homeostasis, so a disrupted balance between immune tolerance and inflammation may lead to IBD [ 135 ].…”

Section: Therapeutic Applications Of the Msc-secretome For Autoimmune...mentioning

confidence: 99%

Mesenchymal Stem Cell-Derived Secretome: A Potential Therapeutic Option for Autoimmune and Immune-Mediated Inflammatory Diseases

Műzes

Sípos

2022

Cells

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“…56 Little is known about tumor response in the context of IBD. 4 However, assuming that a complete clinical response is achieved, patients might inquire and even opt for a nonoperative strategy for which we have no information and could be potentially harmful in the context of IBD. Having surgery first eliminates this potential scenario.…”

Section: Feasibility and Advisability Of Radiation In Rectal Cancer I...mentioning

confidence: 99%

mentioning

confidence: 99%

“…Although the genes involved in the carcinogenic process are the same as in sporadic cancers, the sequence in which they mutate in IBD-associated CRC is different, with an early inactivation of p53 and late mutation in the APC gene. 4 Irrespective of this difference in the order in which genes mutate, the treatment for rectal cancer in the context of IBD follows the same principles as in the general population, including a multimodal approach with chemotherapy, radiation therapy (RT), and surgery. Of course, an additional layer of complexity is present in IBD patients, especially in cases where total proctocolectomy (TPC) and ileal pouch-anal anastomosis (IPAA) is the best oncologic option and the only option to restore intestinal continuity.…”

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Rectal Cancer and Radiation in Colitis

Lynn

Cronin

Rangarajan

et al. 2023

Clin Colon Rectal Surg

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Inflammatory bowel disease (IBD) is associated with an increased risk of colorectal cancer. When IBD patients develop a rectal cancer, this should be treated with the same oncological principles and guidelines as the general population. Rectal cancer treatment includes surgery, chemotherapy, and radiation therapy (RT). Many IBD patients will require a total proctocolectomy with an ileal-pouch anal anastomosis (IPAA) and others, restoration of intestinal continuity may not be feasible or advisable. The literature is scarce regarding outcomes of IPAA after RT. In the present review, we will summarize the evidence regarding RT toxicity in IBD patients and review surgical strategies and outcomes of IPAA after RT.

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