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ABSTRACT: Background: The prevalence of gastric polyps is unknown in Hungary. Aim: The aim of the authors was to assess the prevalence of polypoid lesions of the stomach in the endoscopic centre of the 2nd Department of Medicine, Semmelweis University. Methods: Results of upper gastrointestinal endoscopies carried out between March 2010 and June 2011 were analysed. Results: 193 cases with polyps were diagnosed in 4174 endoscopies (4.62%). Hyperplastic polyps, fundic gland polyps and malignant lesion were detected in 33.67%, 31.09% and 2.07% of the cases, respectively. Proton pump inhibitor use was more frequent among patients diagnosed with fundus gland polyps (p = 0.007), while hyperplastic polyps were diagnosed more frequently in patients with chronic gastritis (p = 0.032). Conclusions: The frequency of gastric polyps was higher than expected from data published in the literature. Long-term proton pump-inhibitor use and chronic gastritis were associated with fundus gland and hyperplastic polyps, respectively. Orv. Hetil., 2013, 154, 770-774.
Orvosi Hetilap 05/2013; 154(20):770-4.
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ABSTRACT: AIMS: The aim of this study is to evaluate the experience of a single coeliac centre over a 15-year-long study period (between November of 1997 and September of 2011). PATIENTS AND METHODS: Charts of 178 patients (139 females) with coeliac disease were retrospectively evaluated. Tests performed: multiple duodenal biopsies, anti-tissue transglutaminase and anti-endomysium antibodies, body mass index calculation, osteodensitometry, evaluation of disorders associated with coeliac disease, and implementation of family screening. RESULTS: Histological samples were available in 133 cases, distribution according to Marsh-Oberhuber classification: M0 in 7%, M1-M2 in 4%, M3a in 26%, M3b in 13%, and M3c in 50% of cases, respectively. Anti-tissue transglutaminase and anti-endomysium antibody tests were available in 158 cases, 132/158 showed seropositivity. Mean body mass index values were 23.05kg/m(2) for males, and 21.07kg/m(2) for females, respectively. Osteodensitometry showed normal values in 46%, osteopenia in 36%, and osteoporosis in 18% of cases, respectively. Coeliac disease associated disorders was present in 63/178 (35%) patients. Ninety coeliacs brought 197 first degree relatives for screening, with 47/197 (23%) relatives proving to have coeliac disease. Correlations between anti-tissue transglutaminase antibody titres and Marsh-Oberhuber classification, and anti-tissue transglutaminase antibody titres and bone mineral density values were found to be statistically significant (p=0.0011, and p=0.001, respectively). CONCLUSIONS: Coeliac disease can become overt at any age. Female predominance is significant. Histology usually showed advanced villous atrophy. Mean body mass index values were within normal range. The high prevalence of associated disorders is also noted. The prevalence of 24% of coeliac disease among first degree relatives underlines the necessity of family screening.
European Journal of Internal Medicine 03/2013; · 2.00 Impact Factor
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ABSTRACT: Inflammatory bowel disease is a chronic disorder affecting young adults in their reproductive years, hence its populational consequences are not negligible. While fertility in inflammatory bowel disease is the same with the general population (except for male patients with sulphasalazine treatment and females with ileum-poch anal anastomosis), "voluntary childlessness" is higher, 14-18%. Patients require accurate counseling addressing fertility, pregnancy course and outcome. They need to be informed appropriately about risks and benefits of medications in inflammatory bowel disease in order to assist their decision making, decrease "voluntary childlessness" and improve compliance. Authors review the issues related to fertility, outcome of pregnancy, medical treatment options before and during pregnancy as well as during breastfeeding in inflammatory bowel disease. Orv. Hetil., 2012, 153, 1855-1862.
Orvosi Hetilap 11/2012; 153(47):1855-62.
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Gábor Horváth,
Klaudia Farkas,
Renáta Hollósi,
Ferenc Nagy,
Zoltán Szepes,
Mária Papp,
Károly Palatka, Pál Miheller,
László Lakatos,
Tamás Szamosi,
Tibor Nyári,
Tibor Wittmann,
Tamás Molnár
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ABSTRACT: Abstract Objectives. Inflammatory bowel diseases (IBD) have a huge impact on the patients' lives and require continuous medication and long-term medical follow-up. The Short Form Health Survey (SF-36) is a commonly used questionnaire measuring health-related quality of life (HRQOL). Our aim was to evaluate whether HRQOL influences medication adherence and vice versa in IBD patients, and to find relationships between demographic parameters, therapeutic modalities and non-adherence or HRQOL. Patients and methods. Five hundred ninety-two IBD patients treated at six Hungarian tertiary centers were enrolled. Patients completed the SF-36 questionnaire and a medication adherence report scale during their visits. The associations between demographic parameters, HRQOL, different kinds of therapies and non-adherence were analyzed. Results. The most affected dimension was physical functioning and least affected were the social functions. About 42.7% of the patients revealed their HRQOL to be acceptable. About 74.6% of the patients believed that the prescribed medications actually improved their HRQOL. Diarrhea was the most common and most severe symptom during the course of the disease. Non-adherence was reported in 13.4% of the patients. 'Forgetting to take the medication' was the main reason for non-adherence in 67.6% of the cases. Medication adherence was significantly higher among nonsmoker patients, and also in the case of immunomodulator therapy. There was no association between the sum of HRQOL and different subscores and non-adherence. Conclusion. Inflammatory bowel disease is associated with low HRQOL, which is not affected by drug therapy. The impaired quality of life in IBD is mainly influenced by the disease itself.
Scandinavian journal of gastroenterology 08/2012; 47(11):1298-303. · 2.08 Impact Factor
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ABSTRACT: Coeliac disease (gluten-sensitive enteropathy, sprue) is a chrocic disorder of the small bowel leading to malabsorption.
charts of all patients with coeliac disease treated at the 2nd Department of Medicine, Semmelweis University were evaluated.
The authors retrospectively analysed the results of a total of 132 patients with coeliac disease (107 females and 25 males; mean age, 37 years; median, 35 years; range, 19-78 years) attending the centre between 1999 and 2010. The authors routinely performed the following investigations in patients with suspected coeliac disease: multiple biopsies taken from the duodenum, tissue transglutaminase antibody or endomysial antibody based serology, body mass index calculation, osteodensitometry, evaluation of disorders associated with coeliac disease, family history for coeliac disease, and implementation of family-screening for coeliac disease given the agreement of the index patients.
Histological samples were available in 101 cases, and distributions of data according to the Marsh-classification were as follows: negative in 9%, M3a in 27%, M3b in 18%, and M3c in 46% of cases, respectively. Serological results were available in 117 cases. 93/117 (79%) showed seropositivity. Body mass index was calculated for 95 patients, and the mean value for males was 22.4 kg/m² (range, 17-30.3 kg/m²), whereas the mean value for females was 20.7 kg/m² (range, 15.2-30.4 kg/m²). Osteodensitometry was performed in 90 patients; 45 patients (50%) proved normal, 31 (34%) had osteopenia, and 15 (26%) had osteoporosis. Coeliac disease associated disorders were present in 45/132 patients (34%; 6 males). Associated disorders were as follows: 15 dermatitis herpetiformis Duhring, 15 thyroid diseases (5 hypo- and 10 hyperthyroidism), 6 Crohn's disease, 3 selective IgA-deficiency, 2 endometrioses, 1 systemic lupus erythematosus, 1 myasthenia gravis, and 1 type-1 diabetes mellitus. Sixty-four of the 132 index patients brought 133 first-degree relatives for family screening (serology), where 26/133 (19.5%; 17 females) first-degree relatives proved to suffer from coeliac disease.
The age distribution of this cohort demonstrates that coeliac disease can present at any age. Similarly to those of other coeliac disease centres, female predominance is significant. Histology usually showed advanced villous atrophy. Serological results were usually in conjunction with the histological results and proved to be useful for monitoring dietary compliance and for accomplishing family screening. The mean body mass index values were in the normal range confirming that adult patients with coeliac disease are usually not malnourished. The 20% prevalence of coeliac disease among first-degree relatives underlines the necessity of family screening.
Orvosi Hetilap 05/2012; 153(20):776-85.
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Pál Miheller,
Ferenc Nagy,
Károly Palatka,
István Altorjay,
Gábor Horváth,
Katalin Lőrinczy,
László Újszászy,
Zsolt Virányi,
Attila Szepes,
Tamás Molnár,
Klaudia Farkas,
Zoltán Szepes,
Tibor Nyári,
Tibor Wittmann,
Zsolt Tulassay
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ABSTRACT: Prospective data collection seems to be essential in evidence-based medicine. Because of the new therapeutic options, the need for standard data collection and testing has significantly increased. In Hungary, a registry for patients with inflammatory bowel disease has already been set up, which makes it possible for clinicians to collect prospective data on their patients.
Basic characteristics of the database of patients with ulcerative colitis are presented in this paper.
The inflammatory bowel disease registry uses the programme of Microsoft Access database management system. Data are stored in a central server.
The incidence of inflammatory bowel diseases has been permanently increasing in Hungary; however, its overall prevalence is still low among the European countries. The frequent administration of immunosuppressive medications (azathioprine and corticosteroids) and their increased doses worsen the estimation of the activity.
1., It would be very useful to gain prospective data from all national centres. This kind of database would be able to give a complete picture regarding the Hungarian therapeutical practice. 2., Medications of patients may alter the clinical value of the laboratory findings in the process of determining the severity of the disease.
Orvosi Hetilap 05/2012; 153(18):702-12.
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ABSTRACT: Diagnosis and therapy of osteoporosis associated with gastrointestinal diseases is a remarkable problem. Osteoporosis is most
common in celiac disease, Crohn’s disease, chronic liver disease, and in postgastrectomy patients. Protocols regarding prevention,
diagnosis and therapy are based on results gained from patients with osteoporosis in the general population. This review aims
to summarize the special aspects and most important clinical data regarding the bone loss associated with gastrointestinal
diseases.
KeywordsOsteoporosis-Bone-Celiac disease-Inflammatory bowel disease-Chronic liver disease-Postgastrectomy
Clinical Reviews in Bone and Mineral Metabolism 04/2012; 8(3):140-148.
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ABSTRACT: In the last two decades, the treatment paradigms for Crohn's disease and ulcerative colitis have significantly changed inclusive of a continuously increasing role of biological therapy (anti TNFs). Some patients, however, experience lack or loss of response to biological treatment, and in such cases the management of patients is often empirical. In this review, the authors aim to summarize the available data regarding epidemiology and predictors of loss of response to biological therapy considering the clinical factors and the relationship between serum concentrations, antibodies against biological agents, respectively. Monitoring drug levels and antibodies is expected to play an important role in the management of loss of response (i.e. to confirm adherence, allow dose adjustment, or provide rationale for switching to another biological agent or to a different class of biological agent) in the coming years. The optimal method of detection and cut-off values are, however, not clear. In clinical practice, meticulous complex assessment of clinical symptoms, confirmation of active disease by endoscopic or radiological imaging, and excluding complications remain necessary.
Orvosi Hetilap 02/2012; 153(5):163-73.
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ABSTRACT: It has been suggested that matrix metalloproteinases (MMPs) may play a role in the pathogenesis of inflammatory bowel diseases (IBD). However, the impact of serum MMPs and their inhibitors [tissue inhibitors of metalloproteinases (TIMPs)] have scarcely been investigated in the same experimental setting in ulcerative colitis (UC) and Crohn's disease (CD) as well as their correlation with IBD activity.
MMP-2, MMP-7, MMP-9, TIMP-1 and TIMP-2 serum antigen levels were determined in 23 patients with UC, 25 patients with CD and 10 healthy control patients by enzyme-linked immunoassay technique. Statistical analysis with one-way ANOVA and Student's t tests was performed. A linear regression analysis or a Spearman's r test was used to assess correlation. Differences were considered significant with p < 0.05.
Serum antigen concentrations of MMP-9, TIMP-1 and TIMP-2 were significantly higher in UC and CD patients compared to controls. MMP-7 was also significantly higher in CD compared with controls. Elevated MMP-9 and TIMP-1 antigen levels showed significant positive correlation with disease activity of IBD. MMP-2 and TIMP-2 levels inversely correlated with CD activity. Significant correlations were found between MMP-9/TIMP-1 and MMP-2/TIMP-2 antigen levels in both UC and CD.
We demonstrated that serum antigen concentrations of MMP-9, TIMP-1 and TIMP-2 were significantly increased in patients with UC and CD compared to controls. Our results suggest that MMPs and TIMPs may contribute to the inflammatory and remodeling processes in IBD. Serum MMP-9 and TIMP-1 might be useful as additional biomarkers in the assessment of IBD activity.
Digestive Diseases 01/2012; 30(3):289-95. · 2.37 Impact Factor
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Lajos Sándor Kiss,
Tamás Szamosi,
Tamás Molnár, Pál Miheller,
László Lakatos,
Aron Vincze,
Károly Palatka,
Zsolt Bartha,
Beáta Gasztonyi,
Agnes Salamon, [......],
Zsolt Tulassay,
Ferenc Nagy,
Mária Szenes,
Gábor Veres,
Barbara Dorottya Lovász,
Zsuzsanna Végh,
Petra Anna Golovics,
Miklós Szathmári,
Mária Papp,
Péter László Lakatos
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ABSTRACT: Adalimumab is a fully human monoclonal antibody targeting tumor necrosis factor with proven efficacy in the treatment of Crohn's disease in clinical trials. The aim of the present study was to investigate the predictors of medium term clinical efficacy and mucosal healing during adalimumab therapy in patients with Crohn's disease in specialized centers approved for biological therapy in Hungary.
Data of 201 Crohn's disease patients were prospectively captured (male/female: 112/89, median age: 24 years, duration: 8 years). Previous infliximab therapy was given in 97 (48.3%) patients, concomitant steroids in 41.3% and azathioprine in 69.2% (combined: 26.4%) of patients.
Overall clinical response and remission rates at 24 and 52 weeks were 78% and 52%, and 69.4% and 44.4%, respectively. Endoscopic improvement and healing was achieved in 43.1% and 23.6%, respectively. In a logistic regression model, clinical efficacy and normalized C-reactive protein at week 12, need for combined immunosuppression at induction, shorter disease duration and smoking were identified as independent predictors for 12-month clinical outcome, while normalized C-reactive protein at week 12, clinical remission at week 24, frequency of previous relapses and smoking were associated to endoscopic improvement/healing. Dose intensification to weekly dosing was needed in 16.4%. Parallel azathioprine therapy and clinical remission at week 12 was inversely associated to dose escalation to weekly dosing.
Clinical efficacy and normalized C-reactive protein at week 12, need for combined immunosuppression, luminal disease and smoking are predictors for medium term clinical efficacy/mucosal healing during adalimumab therapy, while parallel azathioprine therapy may decrease the probability for dose escalation.
Orvosi Hetilap 09/2011; 152(36):1433-42.
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ABSTRACT: Matrix metalloproteinases play an important role in extracellular matrix remodelling. It has been proposed that matrix metalloproteinase-9 (MMP-9) is involved in epithelial damage in ulcerative colitis (UC). However, to our knowledge, no data are available in terms of MMP-9 expression in microscopic colitis. Determination of mucosal protein expression levels of MMP-9 in lymphocytic colitis (LC), collagenous colitis (CC) and UC. MMP-9 immunohistochemical expressions were analyzed in paraffin-embedded tissue samples by immunohistochemistry including patients with LC, CC, UC, active diverticulitis, inactive diverticular disease and healthy control subjects. UC was also subgrouped according to the severity of inflammation. Immunostaining was determined semiquantitatively. Independent colonic biopsies from healthy and severe UC cases were used for gene expression analyses. For further comparison MMP-9 serum antigen levels were also determined in patients with UC and control patients without macroscopic or microscopic changes during colonoscopy. MMP-9 mucosal expression was significantly higher in UC (26.7 ± 19.5%) compared to LC (6.6 ± 9.3%), CC (6.4 ± 7.6%), active diverticulitis (5.33 ± 2.4%), inactive diverticular disease (5.0 ± 2.2%) and controls (6.3 ± 2.6%) (P < 0.001). The immunohistochemical expression of MMP-9 in LC and CC was similar as compared to controls. MMP-9 expression was significantly higher in each inflammatory group of UC compared to controls (mild: 11.0 ± 2.8%, moderate: 23.9 ± 3.7%, severe UC: 52.6 ± 3.9% and 6.3 ± 2.6%, respectively, P < 0.005). The gene expression microarray data and RT-PCR results demonstrated a significantly higher expression of MMP-9 in severely active UC compared to healthy controls (P < 0.001). Significantly higher MMP-9 serum antigen concentrations were observed in UC patients compared with the control group (P < 0.05). MMP-9 seems to play no role in the inflammatory process of LC and CC. In contrast, the mucosal up-regulation of MMP-9 correlated with the severity of inflammation in UC. The increased MMP-9 expression could contribute to the severity of mucosal damage in active UC.
Pathology & Oncology Research 06/2011; 18(1):85-91. · 1.37 Impact Factor
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Journal of gastrointestinal and liver diseases: JGLD 03/2011; 20(1):101-2. · 1.81 Impact Factor
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ABSTRACT: The neuroendocrine marker, chromogranin A (CgA) increases during medium- or long-term proton-pump inhibitor (PPI) treatment. Aims: To analyze the effect of ultra-short-term and diverse dose of PPI therapy on serum CgA and gastrin levels and evaluate the effect of PPI treatment cessation.
Fasting serum CgA and gastrin were determined in newly diagnosed gastroesophageal reflux disease (GERD) patients (n = 54) treated with diverse doses of PPI during a 28-day period, in patients treated with PPIs for at least 6 months (n = 42), and in subjects where PPI treatment could be stopped (n = 11).
A significant stepwise increase of CgA levels was observed after 5 days during the 28-day period treatment with all PPI doses. Gastrin increased significantly also in the standard and high-dose PPI subgroups. The most prominent increase of CgA was observed in the high-dose PPI subgroup. Serum CgA and gastrin were markedly elevated after 6 months of PPI treatment, and decreased significantly after 5 days of PPI discontinuation.
Serum CgA increases significantly even after ultra-short-term (5 days) PPI therapy. After long-term treatment, 5-day cessation of PPI therapy is sufficient to decrease significantly both CgA and gastrin levels.
Digestion 02/2011; 84(1):22-8. · 2.05 Impact Factor
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ABSTRACT: Microscopic colitis presents with similar symptoms to classic inflammatory bowel diseases. Osteoporosis is a common complication of Crohn's disease but there are no data concerning bone metabolism in microscopic colitis.
The aim of the present study was to evaluate bone density and metabolism in patients with microscopic colitis.
Fourteen patients microscopic colitis were included in the study, and 28 healthy persons and 28 age and gender matched Crohn's disease patients were enrolled as controls. Bone mineral density was measured using dual x-ray absorptiometry at the lumbar spine, femoral neck and the radius. Serum bone formation and bone resorption markers (osteocalcin and beta-crosslaps, respectively) were measured using immunoassays.
Low bone mass was measured in 57.14% patients with microscopic colitis. Bone mineral density at the femoral neck in patients suffering from microscopic colitis and Crohn's disease was lower than in healthy controls (0.852 ± 0.165 and 0.807 ± 0.136 vs. 1.056 ± 0.126 g/cm²; p < 0.01). Bone mineral density at the non-dominant radius was decreased in microscopic colitis patients (0.565 ± 0.093 vs. 0.667 ± 0.072 g/cm²; p < 0.05) but unaffected in Crohn's disease patients (0.672 ± 0.056 g/cm²). Mean beta-crosslaps concentration was higher in microscopic colitis and Crohn's disease patients than controls (417.714 ± 250.37 and 466.071 ± 249.96 vs. 264.75 ± 138.65 pg/ml; p < 0.05). A negative correlation between beta-crosslaps concentration and the femoral and radius t-scores was evident in microscopic colitis patients.
Low bone mass is frequent in microscopic colitis, and alterations to bone metabolism are similar to those present in Crohn's disease. Therefore, microscopic colitis-associated osteopenia could be a significant problem in such patients.
BMC Gastroenterology 01/2011; 11:58. · 2.42 Impact Factor
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ABSTRACT: There is limited data on pregnancy outcome in inflammatory bowel diseases (IBD) (Crohn's disease [CD] and ulcerative colitis [UC]) from Eastern Europe. The aim of our multicenter study was to compare the pregnancy outcomes and the data of infants in pregnancies before and after the diagnosis of IBD.
97 pregnancies in women with IBD (36 CD and 61 UC) and 70 pregnancies in the same women before the diagnosis of IBD (24 CD and 46 UC) were compared. The influence of disease activity and medical treatment during pregnancy on gestational age at birth, birth weight, health status of the newborns and the frequency of childhood diseases were analyzed.
Preterm birth and low birth weight were more common in IBD compared to those pregnancies delivered before the diagnosis of the disease (p = 0.008, p = 0.048). The occurrence of congenital abnormalities was not influenced by IBD, whereas childhood diseases occurred more frequently in the offspring of mothers with active UC. Disease activity in CD and UC during pregnancy did not predispose to abnormal birth outcome, compared to inactive disease. The type of medical treatment did not affect the pregnancy outcome in IBD.
Preterm birth and low birth weight were more common in IBD. The medical treatment of the active disease during pregnancy did not increase the frequency of abnormal birth outcomes. Medical maintenance treatment should be continued during pregnancy to avoid relapses, although IBD seems to be an independent risk factor for low birth weight and preterm birth.
Scandinavian journal of gastroenterology 11/2010; 45(11):1302-6. · 2.08 Impact Factor
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László Lakatos,
Zsófia Czeglédi,
Gyula Dávid,
Zsófi Kispál,
Lajos S Kiss,
Károly Palatka,
Tünde Kristóf,
Tamás Molnár,
Agnes Salamon,
Pál Demeter, Pál Miheller,
Tamás Szamosi,
János Banai,
Mária Papp,
László Bene,
Agota Kovács,
István Rácz,
Péter László Lakatos
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ABSTRACT: Previous studies have suggested an increasing use of complementary and alternative medicine (CAM) in patients with inflammatory bowel disease (IBD). Furthermore, a significant number of IBD patients fail to comply with treatment. The aim of our study was to evaluate the prevalence of non-adherence the use of CAM in Hungarian patients with IBD.
A total of 655 consecutive IBD patients (Crohn's disease [CD]: 344, age: 38.2 + or - 12.9 years; ulcerative colitis [UC]: 311, age: 44.9 + or - 15.3 years) were interviewed during the visit at specialists by self-administered questionnaire including demographic and disease-related data, as well as items analyzing the extent of non-adherence and CAM use. Patients taking more then 80% of each prescribed medicine were classified as adherent.
The overall rate of self reported non-adherence (CD: 20.9%, UC: 20.6%) and CAM (CD: 31.7%, UC: 30.9%) use was not different between CD and UC. The most common causes of non-adherence were: forgetfulness (47.8%), too many/unnecessary pills (39.7%), being afraid of side effects (27.9%) and too frequent dosing. Most common forms of CAM were herbal tee (47.3%), homeopathy (14.6%), special diet (12.2%), and acupuncture (5.8%). In CD, disease duration, date of last follow-up visit, educational level and previous surgeries were predicting factors for non-adherence. Alternative medicine use was associated in both diseases with younger age, higher educational level and immunosuppressant use. In addition, CAM use in UC was more common in females and in patients with supportive psychiatric/psychological therapy.
Non-adherence and CAM use is common in patients with IBD. Special attention should be paid to explore the identified predictive factors during follow-up visits to improve adherence to therapy and improving patient-doctor relationship.
Orvosi Hetilap 02/2010; 151(7):250-8.
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Gastroenterology 01/2010; 138(5). · 11.68 Impact Factor
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Lilla Lakner,
Veronika Csöngei,
Lili Magyari,
Márta Varga, Pál Miheller,
Patrícia Sarlós,
Péter Orosz,
Zsolt Bári,
István Takács,
Luca Járomi,
Eniko Sáfrány,
Csilla Sipeky,
Judit Bene,
Zsolt Tulassay,
Zoltán Döbrönte,
Béla Melegh
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ABSTRACT: The IBD5 locus (MIM#606348) on chromosome 5q31 has been demonstrated to confer increased risk for inflammatory bowel disease. Controversial reports have been published about the significance of individual loci located in this region. Here we investigated the possible genetic association of inflammatory bowel diseases with C1672T of SLC22A4 and G-207C SLC22A5 alleles, and with IGR2096a_1 (rs12521868) and IGR2198a_1 (rs11739135) susceptibility variants of the IBD5 region located on chromosome 5q31.
Total of 440 patients, 206 with Crohn's disease, 234 with ulcerative colitis, and 279 controls were studied by PCR-RFLP methods.
Neither the C1672T, and G-207C alleles, nor the TC haplotype were found to confer risk for Crohn's disease or ulcerative colitis. By contrast, both of the minor allele frequencies of IGR2096a_1 T (48.1%) and IGR2198a_1 C (46.1%) were increased in Crohn's disease subjects as compared with the controls (38.5% and 38.4%, respectively; p<0.05). Using regression analysis adjusted to age and gender these alleles were found to confer risk for Crohn's disease (OR=1.694, 95% CI: 1.137-2.522; p=0.010 for T allele, OR=1.644, 95% CI=1.103-2.449; p=0.015 for C allele of IGRs). In UC no such associations were found.
Our results revealed the susceptibility nature of the examined IGR minor alleles in Hungarians, which nation differs historically from the surrounding Caucasian populations in origin of the founders of the state.
Orvosi Hetilap 08/2009; 150(29):1375-80.
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ABSTRACT: Vitamin D is essential for osteopenia therapy in Crohn's disease (CD). The active form of vitamin-D (aVD) is the 1,25(OH)2D. There are no data available whether aVD or plain vitamin-D (pVD) has any advantage in managing osteoporosis in CD or has any effect on the activity of the disease itself. Our work is a prospective study to compare the effects of aVD and pVD on bone metabolism and the clinical course of CD.
In all, 37 inactive CD patients were involved in the study and divided into 2 age-, gender-, and t-score-matched groups. Group A was treated with aVD while group B received pVD. Osteocalcin, beta-CrossLaps, osteoprotegerin, and receptor activator nuclear factor kappa-B ligand concentrations were estimated at the start of the study and at 6 weeks and 3 and 12 months. The activity of CD was also measured clinically and by laboratory parameters.
At week 6 the Crohn's Disease Activity Index (CDAI) scores and concentration of C-reactive protein decreased (69.44 +/- 58.6 versus 57.0 +/- 54.89 and 15.8 +/- 23.57 mmol/L versus 7.81 +/- 3.91 mmol/L, respectively, P < 0.05) parallel with markers of bone turnover (beta-CrossLaps: 0.46 +/- 0.21 ng/mL versus 0.40 +/- 0.25 ng/mL, and osteocalcin: 32.29 +/- 15.3 ng/mL versus 29.98 +/- 14.14 ng/mL, P < 0.05); however, osteoprotegerin concentration (marker of osteoblast activity) increased (3.96 +/- 2.1 pg/mL versus 4.58 +/- 2.19 pg/mL) in group A, but did not change in group B. Osteocalcin and beta-CrossLaps concentrations changed more significantly by the 3rd month; however, these changes disappeared by the 12th month.
According to our study, aVD has a more prominent short-term beneficial effect on bone metabolism and disease activity in CD compared with pVD.
Inflammatory Bowel Diseases 04/2009; 15(11):1656-62. · 4.86 Impact Factor
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Lilla Lakner,
Veronika Csöngei,
Patrícia Sarlós,
Luca Járomi,
Eniko Sáfrány,
Márta Varga,
Péter Orosz,
Lili Magyari,
Judit Bene, Pál Miheller,
Zsolt Tulassay,
Béla Melegh
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ABSTRACT: We investigated the possible association of IBD with C1672T of SLC22A4 and G-207C of SLC22A5 alleles, and with the novel IGR2096a_1 (rs12521868) and IGR2198a_1 (rs11739135) susceptibility loci, all located on IBD5 locus of chromosome 5q31.
DNA of 217 Crohn's disease, 252 ulcerative colitis, and 290 control patients were analyzed by polymerase chain reaction/restriction fragment length polymorphism methods.
Neither the C1672T and G-207C alleles, nor the TC haplotype were found to be risk factors. By contrast, the minor allele frequencies of IGR2096a_1 T (47.2%) and IGR2198a_1 C (45.9%) were increased in Crohn's disease compared with the controls (38.2% and 37.7%, respectively; p < 0.05); multivariate regression analysis revealed a risk nature for Crohn's disease (OR = 1.748, 95% CI 1.186-2.574; p = 0.007 for T allele, OR = 1.646, 95% CI 1.119-2.423, p = 0.011 for C allele of IGRs).
The data suggest a special haplotype arrangement of susceptibility genes at the IBD5 locus in Hungarians, which nation differs historically from the surrounding Caucasian ethnicities in its origin.
International Journal of Colorectal Disease 02/2009; 24(5):503-7. · 2.38 Impact Factor
