β-Blocker use is associated with a higher relapse risk of inflammatory bowel disease: a Dutch retrospective case–control study

Willemze, Rose; Bakker, Tinka; Pippias, Maria; Ponsioen, Cyriel Y.; Jonge, Wouter J. de

doi:10.1097/meg.0000000000001016

Cited by 18 publications

(9 citation statements)

References 27 publications

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“…Similarly, in one cohort, use of ARBs was associated with lower use of immunomodulators, lower rates of ileocolonic CD location and trends for reduced need of corticosteroids and lower rates of penetrating CD, indicating milder disease, whereas other antihypertensive classes did not associate with altered IBD outcomes 65 . Previously, IBD patients using β‐blockers for hypertension were found to be at increased risk of relapse 66 . Overall, the few observational studies done to date have provided encouraging results of the benefits of RAS inhibition in IBD, but no prospective studies have been conducted yet.…”

Section: Retrospective Studies In Humansmentioning

confidence: 90%

Renin–angiotensin system in intestinal inflammation—Angiotensin inhibitors to treat inflammatory bowel diseases?

Salmenkari

Korpela

Vapaatalo

2021

Basic Clin Pharma Tox

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Inflammatory bowel diseases (IBDs) are chronic disorders of the gastrointestinal tract, which manifest in recurring gastrointestinal inflammation. The current treatment options of IBD are not curative and are lacking in aspects like prevention of fibrosis. New treatment options are needed to fulfil the unmet needs and provide alternatives to drugs with resistances and side effects. Drugs targeting the renin–angiotensin system (RAS), besides being antihypertensive, also possess anti‐inflammatory and antifibrotic properties and could offer an inexpensive alternative to control inflammation and fibrosis in the gut. RAS inhibitors have been effective in preventing and alleviating colitis in preclinical studies, but available human data are still sparse. This review outlines the pathophysiological functions of RAS in the gut and summarizes preclinical studies utilizing pharmacological RAS inhibitors in the treatment of experimental colitis. We discuss the alterations in intestinal RAS and the available evidence of the benefits of RAS inhibitors for IBD patients. Retrospective studies comparing IBD patients using ACE inhibitors or angiotensin II receptor blockers have provided optimistic results regarding a milder disease course and fewer hospitalizations and corticosteroid use in patients using RAS inhibitors. Prospective studies are needed to evaluate the effectiveness of these promising medications in the treatment of IBD.

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Section: Retrospective Studies In Humansmentioning

confidence: 90%

Renin–angiotensin system in intestinal inflammation—Angiotensin inhibitors to treat inflammatory bowel diseases?

Salmenkari

Korpela

Vapaatalo

2021

Basic Clin Pharma Tox

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“…Therefore, NE has gained increasing recognition as a modulator of intestinal inflammation. Moreover, in a DSS-colitis model, sympathetic denervation lead to worsening of the DSS-induced colitis, whereas sympathetic stimulation caused an improvement [85]. This anti-inflammatory effect of NE acting on the β2-adrenergic receptors was highlighted by the finding, in a human study, that patients with IBD who were using β-blockers had an increased risk of developing a disease relapse as compared with IBD patients that were not using β-blockers [57].…”

Section: Sympathetic Modulation Of Gut Immunitymentioning

confidence: 99%

Neuroimmune Interactions in the Gut and Their Significance for Intestinal Immunity

Brinkman

Hove

Vervoordeldonk

et al. 2019

Cells

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Inflammatory bowel diseases (IBD) have a complex, multifactorial pathophysiology with an unmet need for effective treatment. This calls for novel strategies to improve disease outcome and quality of life for patients. Increasing evidence suggests that autonomic nerves and neurotransmitters, as well as neuropeptides, modulate the intestinal immune system, and thereby regulate the intestinal inflammatory processes. Although the autonomic nervous system is classically divided in a sympathetic and parasympathetic branch, both play a pivotal role in the crosstalk with the immune system, with the enteric nervous system acting as a potential interface. Pilot clinical trials that employ vagus nerve stimulation to reduce inflammation are met with promising results. In this paper, we review current knowledge on the innervation of the gut, the potential of cholinergic and adrenergic systems to modulate intestinal immunity, and comment on ongoing developments in clinical trials.

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“… 47 Moreover, beta blockers exacerbate inflammation in Crohn's disease in humans, increasing the incidence of relapse following surgery. 100 An interpretation of these data is that sympathetic anti‐inflammatory pathways are activated in Crohn's disease and that their effect is mediated via beta receptors.…”

Section: Neural Influences On Inflammation Of the Digestive Tractmentioning

confidence: 99%

Neuronal regulation of the gut immune system and neuromodulation for treating inflammatory bowel disease

2021

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β-Blocker use is associated with a higher relapse risk of inflammatory bowel disease: a Dutch retrospective case–control study

Cited by 18 publications

References 27 publications

Renin–angiotensin system in intestinal inflammation—Angiotensin inhibitors to treat inflammatory bowel diseases?

Renin–angiotensin system in intestinal inflammation—Angiotensin inhibitors to treat inflammatory bowel diseases?

Neuroimmune Interactions in the Gut and Their Significance for Intestinal Immunity

Neuronal regulation of the gut immune system and neuromodulation for treating inflammatory bowel disease

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