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ABSTRACT: BACKGROUND:: Ileocolonoscopy is the gold standard to assess postoperative recurrence (POR) in patients with Crohn's disease (CD) who have undergone ileocolic resection. Although computed tomographic enterography (CTE) yields striking findings in the small bowel of CD, its role in POR is undefined. The aim of this study was to compare ileocolonoscopy and CTE for evaluating POR in CD. METHODS:: The analysis included 32 patients with CD with ileocolic resection. Ileocolonoscopy and CTE were performed within 1 week. Endoscopic recurrence was defined using Rutgeerts score (i0-i4), whereas CTE recurrence was assessed according to a previously validated CTE score (CTE0-CTE3). Patients were followed up for a maximum of 30 months, and the primary endpoint was reoperation. RESULTS:: There was a good correlation between endoscopic and CTE recurrence (r = 0.782, P < 0.0001). Moreover, CTE identified the presence of jejunal and proximal ileum disease (n = 7), fistula (n = 3), and abscess (n = 4). Therapeutic management was thereby modified in 8 of 32 patients (25.0%). Eleven patients received major reoperation. There was no significant difference regarding the rate of reoperation between subgroups' Rutgeerts score i3-4 and i0-2 (P > 0.05), whereas there was significant difference between subgroups' CTE2-CTE3 and CTE0-CTE1 (P < 0.05). CONCLUSIONS:: CTE is a reliable method in assessing POR in patients with CD who have undergone ileocolic resection. CTE may serve as an important complementary tool to endoscopy for evaluation of the postoperative course of CD.
Inflammatory Bowel Diseases 03/2013; · 4.86 Impact Factor
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ABSTRACT: Abstract Background and aims. To investigate the risk factors for primary surgery and postoperative recurrence in a cohort of Chinese Crohn's disease (CD) patients. Methods. Medical notes of consecutive diagnosed patients from 2003 until 2010 were reviewed. Fifty-seven postoperative patients - finished regular follow-up - were recruited for postoperative recurrence analysis. Results. One hundred eleven of 323 (34.4%) patients of this cohort underwent primary surgery. The cumulative frequency of resection was 16.6%, 35.4%, 53%, and 94.5% for 1, 5, 10, and 30 years, respectively, after onset of disease. Male (OR: 1.994; 95% CI: 1.291-3.078, p = 0.002), stricture (OR: 4.832; 95% CI: 3.064-7.621, p = 0.000), or penetrating (OR: 4.923; 95% CI: 3.060-7.919, p = 0.000) were associated with an increased risk for primary surgery, while early use of immunomodulators was (OR: 0.438; 95% CI: 0.218-0.880, p = 0.020) associated with a decreased risk. Fifty-seven (21.1%) patients were diagnosed as postoperative clinical recurrence and the cumulative recurrence rates were 6.1%, 17.1%, and 36.8% for 1, 2, and 3 years, respectively. Perianal disease was associated with an increased risk for clinical recurrence (OR: 5.606; 95% CI: 1.59-19.766, p = 0.007). Conclusions. The operation frequency is high in CD. Male, penetrating, and stricture diseases are associated with an increased risk for primary surgery while early use of immunomodulators is associated with a decreased risk. The postoperative recurrence rate is also high. Patients with perianal disease are at higher risk for clinical recurrence.
Scandinavian journal of gastroenterology 07/2012; 47(10):1181-91. · 2.08 Impact Factor
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Xiang Gao,
Fang-bin Zhang,
Liang Ding,
Hui Liu,
Xue-ding Wang,
Bai-li Chen,
Hui-chang Bi,
Ying-lian Xiao,
Li-zi Zhao,
Min-hu Chen,
Min Huang,
Pin-jin Hu
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ABSTRACT: To investigate the potential influence of 5-aminosalicylic acid (5-ASA) on the induction of myelotoxicity during thiopurine therapy in inflammatory bowel disease patients.
(a) The retrospective study included inflammatory bowel disease patients treated with azathioprine (AZA)/6-mercaptopurine (6-MP). Thiopurine methyltransferase (TPMT) activity and 6-thioguanine nucleotide (6-TGN) levels were detected at stable medication points. (b) The prospective study was performed in active disease patients: 4 weeks of AZA 50 mg/day followed by concomitant 5-ASA 3 g/day for another 4 weeks. 6-TGN was analyzed at weeks 4 and 8.
(a) Of the 139 retrospective study patients, 45 were on AZA/6-MP+5-ASA and 94 on AZA/6-MP alone. The myelotoxicity rates were 47 and 16%, respectively. Multivariates regression analysis indicated that the administration of concomitant 5-ASA was the only risk factor associated with myelotoxicity (odds ratio=3.45, 95% confidence interval 1.31-9.04, P=0.01). (b) Thiopurine methyltransferase activity was not significantly different between patients on AZA/6-MP+5-ASA and patients on AZA/6-MP alone (P=0.78). (c) 6-TGN levels were significantly higher in samples on AZA/6-MP+5-ASA than those on AZA/6-MP (P=0.003) alone. (d) Sixteen patients completed the prospective study. After 4 weeks on AZA 50 mg/day, 6-TGN levels of 13 patients were less than 230 pmol/8×10 RBC. After another 4 weeks' cotreatment with mesalazine 3 g/day, 12 patients had 6-TGN levels at least 230 pmol/8×10 RBC, five patients had 6-TGN levels at least 420 pmol/8×10 RBC, and two of these five patients developed myelotoxicity.
The risk of thiopurine-induced myelotoxicity markedly increases in patients treated with combined 5-ASA and 2 mg/kg/day AZA therapy, which may be correlated to the increase in 6-TGN. 50 mg daily AZA when concomitant 5-ASA might help maintain an effective 6-TGN level without increasing the risk of myelotoxicity.
European journal of gastroenterology & hepatology 05/2012; 24(8):958-64. · 1.66 Impact Factor
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ABSTRACT: To compare the efficacy of step-up and top-down infliximab therapy on patients with Crohn's disease (CD).
A prospective and open-label study was performed by the First Affiliated Hospital of SUN Yat-sen University during September 2007 to December 2010. Active CD patients who were refractory to steroid/immunomodulator or who were steroid-dependent were enrolled into step-up group. Active CD patients who had no steroid or immunomodulator therapy before were enrolled into top-down group. All patients were intravenously infused with infliximab of 5 mg/kg body weight in an induction regimen of 3 doses at week 0, 2 and 6, followed by maintenance dosing every 8 weeks beginning at week 14. The clinical and endoscopic follow up lasted 30 weeks. Clinical symptoms and mucosal healing status under endoscopy were evaluated by follow-up at week 10 and 30.
Forty-one CD patients were enrolled, with 24 in step-up group and 17 in top-down group. There were significant differences in disease duration (P = 0.006), combination therapy (P < 0.001) and severity of disease (P = 0.011) in baseline between step-up and top-down groups. At week 10 and 30 during treatment, the clinical remission rates in step-up group were 45.8% (11/24) and 58.3% (14/24) respectively; the mucosal healing rates in step-up group were 33.3% (8/24) and 54.2% (13/24) respectively; the clinical remission rates in top-down group were 70.6% (12/17) and 82.4% (14/17) respectively; and the mucosal healing rates in top-down group were 35.3% (6/17) and 52.9% (9/17) respectively. No significant differences in clinical remission and mucosal healing rates at both week 10 and 30 were observed between the two groups. The prevalences of adverse events in step-up and top-down group were 41.7% (10/24) and 29.4% (5/17) respectively (P = 0.422).
Both step-up and top-down infliximab therapy can induce remission in more than half of CD patients, while top-down therapy might be more beneficiary to symptom and endoscopic remission.
Zhonghua nei ke za zhi [Chinese journal of internal medicine] 02/2012; 51(2):100-3.
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ABSTRACT: Fecal calprotectin (FC) is a relatively new marker of intestinal inflammation. Recently, many studies have extended its role in predicting relapse of quiescent inflammatory bowel disease (IBD), but the reported results have been inconsistent. We aimed to perform a meta-analysis of the predictive capacity of FC in IBD relapse.
We systematically searched the Medline, Web of Science, Cochrane Library, and EMBASE databases for prospective studies that used FC concentrations at remission in predicting relapse of Crohn's disease (CD) and ulcerative colitis (UC). Pooled sensitivity, specificity, and other diagnostic indices were evaluated.
A total of 672 IBD patients (318 UC and 354 CD) from six different studies were analyzed. The pooled sensitivity and specificity of FC to predict relapse of quiescent IBD was 78% (95% confidence interval [CI]: 72-83) and 73% (95% CI: 68-77), respectively. The area under the summary receiver-operating characteristic (sROC) curve was 0.83 and the diagnostic odds ratio was 10.31 (95% CI: 5.05-21.06). The capacity of FC to predict relapse was comparable between UC and CD. In CD patients the predictive value of FC in isolated small bowel CD was not assessed due to insufficiency of available data. Compared with all enrolled CD patients, FC appeared to be more accurate in ileocolonic and colonic CD.
As a simple and noninvasive marker, FC is useful to predict relapse in quiescent IBD patients. (Inflamm Bowel Dis 2012).
Inflammatory Bowel Diseases 01/2012; 18(10):1894-9. · 4.86 Impact Factor
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Liang Ding PhD,
Fang-bin Zhang MD,
Hui Liu MS,
Xiang Gao MD,
Hui-chang Bi PhD,
Xue-ding Wang PhD,
Bai-li Chen MD,
Yu Zhang PhD,
Li-zi Zhao PhD,
Guo-ping Zhong PhD, [......], Xiang Gao,
Hui‐chang Bi,
Xue‐ding Wang,
Bai‐li Chen,
Yu Zhang,
Li‐zi Zhao,
Guo‐ping Zhong,
Pin‐jin Hu,
Min‐hu Chen,
Ming Huang
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ABSTRACT: Background:Thiopurine drugs are widely used in the treatment of inflammatory bowel disease (IBD). The polymorphic enzyme thiopurine S-methyltransferase (TPMT) is of importance for thiopurine metabolism and adverse events occurrence. The role of other thiopurine-metabolizing enzymes is less well known. This study investigated the effects of TPMT and hypoxanthine guanine phosphoribosyltransferase (HPRT) activities on 6-thioguanine nucleotides (6-TGNs) concentrations and thiopurine-induced leukopenia in patients with IBD.Methods:Clinical data and blood samples were collected from 120 IBD patients who were receiving azathioprine (AZA)/6-mercaptopurine (6-MP) therapy. Erythrocyte TPMT, HPRT activities and 6-TGNs concentrations were determined. HPRT activity and its correlation with TPMT activity, 6-TGNs level, and leukopenia were evaluated.Results:The HPRT activity of all patients ranged from 1.63–3.33 (2.31 ± 0.36) μmol/min per g Hb. HPRT activity was significantly higher in patients with leukopenia (27, 22.5%) than without (P < 0.001). A positive correlation between HPRT activity and 6-TGNs concentration was found in patients with leukopenia (r = 0.526, P = 0.005). Patients with HPRT activity > 2.70 μmol/min per g Hb could have an increased risk of developing leukopenia (odds ratio = 7.47, P < 0.001). No correlation was observed between TPMT activity and HPRT activity, 6-TGNs concentration, or leukopenia.Conclusions:High levels of HPRT activity could be a predictor of leukopenia and unsafe 6-TGN concentrations in patients undergoing AZA/6-MP therapy. This could partly explain the therapeutic response or toxicity that could not be adequately explained by the polymorphisms of TPMT. (Inflamm Bowel Dis 2011;)
Inflammatory Bowel Diseases 12/2011; 18(1):63 - 73. · 4.86 Impact Factor
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ABSTRACT: The frequency of Crohn's disease in China is increasing, but few reports are available on clinical features, phenotypes according to the Montreal classification, or risk factors for surgery in mainland China.
This study aimed to assess clinical presentation, phenotypes according to the Montreal classification, and potential risk factors for initial surgery in patients with Crohn's disease in southern China.
This was an observational study designed as a retrospective analysis of a historical cohort.
The study was conducted at a tertiary referral hospital, Guangzhou, China.
Medical records of 212 consecutive patients with Crohn's disease were reviewed; data from 205 patients who met inclusion criteria were analyzed.
The value of age, location, and behavior of disease according to the Montreal system, smoking behavior, and other clinical variables as potential risk factors in predicting the requirement for initial surgery was assessed by use of Cox regression analysis.
A total of 205 patients were studied. Abdominal pain (181 patients, 88.3%) was the most common clinical presentation. At the time of diagnosis, age was between 17 and 40 years in 145 patients (70.7%). The Montreal classification of disease location was L3 (ileocolonic) in 114 patients (55.6%), disease behavior was classified as inflammatory in 133 patients (64.9%). During the course of their disease (median, 4 years; range, 1-21 years), 79 patients (38.5%) required bowel resection. Kaplan-Meier analysis showed that the overall cumulative rate of primary bowel surgery was 17.6% at 1 year after onset of symptoms, 20.3% at 2 years, 35.2% at 5 years, and 58.3% at 10 years. In our final Cox model, stricturing (HR, 3.67; 95% CI, 2.14-6.29; P < .001), penetrating behavior (HR, 4.60; 95% CI, 2.58-8.22; P < .001), and smoking habit (HR, 2.02; 95% CI, 1.15-3.53; P = .014) were significantly associated with an increased risk for bowel resection.
The study was limited by its retrospective nature.
In Chinese patients with Crohn's disease, abdominal pain is the most common clinical presentation, and the most common phenotypes are age 17 to 40 years at diagnosis, ileocolonic disease location, and inflammatory disease behavior. More than one-third of patients require surgery at a median of 4 years after onset of symptoms. Stricturing, penetrating disease, and smoking are associated with an increased risk of requiring bowel resection.
Diseases of the Colon & Rectum 09/2011; 54(9):1147-54. · 3.13 Impact Factor
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Liang Ding,
Fang-bin Zhang,
Hui Liu, Xiang Gao,
Hui-chang Bi,
Xue-ding Wang,
Bai-li Chen,
Yu Zhang,
Li-zi Zhao,
Guo-ping Zhong,
Pin-jin Hu,
Min-hu Chen,
Ming Huang
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ABSTRACT: Thiopurine drugs are widely used in the treatment of inflammatory bowel disease (IBD). The polymorphic enzyme thiopurine S-methyltransferase (TPMT) is of importance for thiopurine metabolism and adverse events occurrence. The role of other thiopurine-metabolizing enzymes is less well known. This study investigated the effects of TPMT and hypoxanthine guanine phosphoribosyltransferase (HPRT) activities on 6-thioguanine nucleotides (6-TGNs) concentrations and thiopurine-induced leukopenia in patients with IBD.
Clinical data and blood samples were collected from 120 IBD patients who were receiving azathioprine (AZA)/6-mercaptopurine (6-MP) therapy. Erythrocyte TPMT, HPRT activities and 6-TGNs concentrations were determined. HPRT activity and its correlation with TPMT activity, 6-TGNs level, and leukopenia were evaluated.
The HPRT activity of all patients ranged from 1.63-3.33 (2.31 ± 0.36) μmol/min per g Hb. HPRT activity was significantly higher in patients with leukopenia (27, 22.5%) than without (P < 0.001). A positive correlation between HPRT activity and 6-TGNs concentration was found in patients with leukopenia (r = 0.526, P = 0.005). Patients with HPRT activity > 2.70 μmol/min per g Hb could have an increased risk of developing leukopenia (odds ratio = 7.47, P < 0.001). No correlation was observed between TPMT activity and HPRT activity, 6-TGNs concentration, or leukopenia.
High levels of HPRT activity could be a predictor of leukopenia and unsafe 6-TGN concentrations in patients undergoing AZA/6-MP therapy. This could partly explain the therapeutic response or toxicity that could not be adequately explained by the polymorphisms of TPMT.
Inflammatory Bowel Diseases 03/2011; 18(1):63-73. · 4.86 Impact Factor
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ABSTRACT: To investigate the risk factors for the initial bowel resection and postoperative recurrence in a cohort of patients with Crohn disease(CD).
A total of 216 consecutive patients who were regularly followed up in the Department of Gastroenterology at the First Affiliated Hospital of Sun Yat-sen University between 2003 and 2009 were included. Probabilities for initial intestinal resection were calculated with Kaplan-Meier method. The influence of concomitant covariates on the cumulative probability rates was examined using Cox proportional hazard model. The risk of postoperative recurrence, including endoscopic recurrence, clinical recurrence and surgical recurrence, was also investigated during the follow-up. Logistic analysis was performed for the risk factors of recurrence.
The median follow-up was 55 months. A total of 44 patients(20.4%) underwent bowel resection. The cumulative frequency of surgery was 11%, 25%, and 45% at 1, 5, and 10 years after initial onset. Multivariate analyses showed that age at diagnosis and disease behavior were independent risk factors for initial intestinal resection(P<0.05). All but 4 patients had complete follow-up after the surgery with a median duration of 20.4 months. Endoscopic recurrence rate was 52.6% within 1 year, and clinical recurrence rate was 22.5%. Median time to clinical recurrence was 22.6 months. Multivariate analyses showed that perianal disease was the only independent risk factor for clinical recurrence(P<0.05). During the follow-up 2 patients(5%) underwent further operation and both had the same indications for the reoperation as that for the initial surgery.
Patients with CD have a high frequency of surgery and the postoperative recurrent rate is also high. Age at diagnosis and disease behavior are associated with the probability of initial surgery. The presence of perianal disease is associated with a higher risk of clinical recurrence.
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 03/2011; 14(3):176-80.
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Shenghong Zhang,
Bihui Zhong,
Kang Chao,
Yingliang Xiao,
Yi Cui, Xiang Gao,
Baili Chen,
Yao He,
Pinjin Hu,
Minhu Chen,
Hazel M Mitchell
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ABSTRACT: Based on 16S rRNA gene PCR, no significant difference was observed in rates of detection of Helicobacter species in intestinal biopsy specimens from 160 Chinese inflammatory bowel disease (IBD) patients (10%) and 80 controls (6.3%). By using a [(13)C]urea breath test, the H. pylori infection rate in 208 Chinese IBD patients (19.7%) was found to be significantly lower than that in 416 controls (48.8%).
Journal of clinical microbiology 02/2011; 49(5):1987-9. · 4.16 Impact Factor
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ABSTRACT: To explore the clinical characteristics, therapeutic responses and outcomes of pediatric Crohn's disease (CD).
From a hospital-derived incidence cohort, 20 Crohn's disease patients (aged 0.5 - 15 years old at diagnosis), diagnosed from 2003 to 2009, received a follow-up period of more than one year. The patients were phenotyped according to Montreal standards. PCDAI was introduced to assess the disease activity and the Hyams J rules adopted to evaluate the therapeutic efficacies. The treatment was individualized based on the overall evaluation of child.
Of these 20 patients, 55% were 7 - 12 years old at the diagnosis time. The male: female ratio was 1.5:1. At the time of diagnosis, the common manifestations included abdominal pain (95.0%), fever (80.0%) and diarrhea (80.0%). Growth retardation was detected in 50% of the cases. Complicated behavior was observed in 45% patients at diagnosis. The most frequent disease location at diagnosis was terminal ileum/colon (55%). Upper GI tract involvement was quite common in children (20%). Non-penetrating non-stricture (50%) behavior was most frequent at diagnosis. Ultimately, corticosteroids plus 6-MP/AZA treatment was administrated in 11 cases. Of these, 9 (82%) successfully withdrew the corticosteroids and maintained a complete remission. Colonoscopy was repeated in 6 complete remission cases and 4 of them achieved a complete mucosa healing. The mean follow-up period was 23 months (range: 12 - 59). At the endpoint of follow-up, 15 cases achieved a complete remission, 4 had a partial remission, 1 underwent operation and none of them died. The children who successfully withdrew from corticosteroids and achieved a complete remission could catch up the height of their age group. 6-MP/AZA associated severe adverse effects were reported at 17% in this group.
Growth retardation is predominant in pediatric CD and it may provide diagnostic clues. Immunosuppressant therapy may improve the natural history of this disease. It is safe under close monitoring.
Zhonghua yi xue za zhi 04/2010; 90(16):1113-6.
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ABSTRACT: To evaluate the prevalence of low bone mineral density in patients with inflammatory bowel disease (IBD)and to identify its risk factors.
A cross-sectional survey was carried out in IBD patients. Anthropometric measures, biochemical markers of nutrition and bone mineral density measurement were completed for these patients as well as healthy control subjects.
Seventy-seven Crohn's disease (CD) and 43 ulcerative colitis (UC) patients were enrolled, and 37 healthy volunteers were recruited as healthy controls (HC). The T value of CD patients, UC patients and HC was -1.72 +/- 1.20, -1.26 +/- 1.12 and -0.62 +/- 0.87 respectively and the T value of CD patients was significantly lower than that of HC (P = 0.000). The prevalence of osteoporosis in CD, UC and HC was 23.3%, 14.0% and 0 respectively. The prevalence of osteoporosis in CD was higher than that in HC (P = 0.003). Logistic regression analysis indicated that low BMI (BMI < or = 18.4 kg/m(2)) was an independent risk factor for osteoporosis both in CD (OR = 11.25, 95%CI 3.198 - 39.580, P = 0.000) and in UC (OR = 14.50, 95%CI 1.058 - 88.200, P = 0.045) patients. Age, disease duration, clinical activity active index (CDAI), oral steroid therapy, immunosuppressant treatment and serum vitamin D concentration were not found to be correlated with osteoporosis in IBD patients.
Low bone mineral density is common in both CD and UC patients and low BMI is an independent risk factor for osteoporosis in IBD patients.
Zhonghua nei ke za zhi [Chinese journal of internal medicine] 10/2009; 48(10):833-6.
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ABSTRACT: The functional polymorphism of interleukin (IL)-17F 7488 A > G was found to be associated with autoimmune inflammatory diseases and also high IL-17F intestinal expression in inflammatory bowel disease (IBD) was detected. The purpose of this study was to investigate the association between the polymorphism and IBD in the Chinese population and to elucidate potential interactions between IL-17F genotypes and clinical phenotypes.
DNA was extracted from peripheral blood cells of 148 ulcerative colitis (UC), 134 Crohn's disease (CD) patients and 373 age- and gender-matched healthy controls. The IL-17F 7488 A > G polymorphism was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and sequencing.
In UC patients, the homozygous GG genotype frequency was significantly lower than that in the controls (0.0% versus 3.8%, p=0.014); Compared to that of wild-type AA patients, the AG heterozygous carriers have a later onset (43.3+/-11.1 years versus 34.6+/-14.8 years, p = 0.012) and a significantly higher incidence of mild severity (94.1% versus 61.0%, p = 0.009, OR = 0.96, 95% CI = 0.94-0.96), respectively, indicating that subjects with the GG genotype have a slightly decreased risk of 0.96 times for UC compared with that of other genotypes. Further analysis also revealed that G carrier subjects were more likely to present mild severity and had 10.2 times higher incidence of getting mild severity than those with AA genotype (OR = 10.2, 95% CI = 1.3-81.0).
This study shows that IL-17F 7488 A > G polymorphism is associated with weak UC protection in the Chinese population. The clinical phenotypes of UC are also affected by this polymorphism.
Scandinavian journal of gastroenterology 03/2009; 44(6):720-6. · 2.08 Impact Factor
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ABSTRACT: To investigate the single nucleotide polymorphism (SNPs) distribution of NOD2/CARD15 (R702W, G908R), OCTN1 1672C/T and OCTN2-207G/C in Chinese patients with inflammatory bowel disease (IBD).
A total of 61 patients with Crohn's disease (CD), 151 patients with ulcerative colitis (UC), and 200 unrelated healthy controls were genotyped. Genotyping was performed by sequence specific primer polymerase chain reaction (PCR-SSP) or by restriction fragment length polymorphism (PCR-RFLP) analysis.
Among the subjects in our study groups, including patients with CD, UC and healthy controls, none had OCTN and CARD15 variants and very rare IBD family history was found in our patients with the percentage of 0 (0/61 with CD) and 1.3% (2/151 with UC).
Our results indicate that although OCTN or CARD15 variation is associated with susceptibility to IBD in Western populations, these might be rare and may not be associated with susceptibility to IBD in Chinese patients.
World Journal of Gastroenterology 09/2008; 14(31):4923-7. · 2.47 Impact Factor
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ABSTRACT: The expression of signal transducers and activators of transcription 3 (STAT3) is increased in Crohn's disease (CD), and nuclear translocated STAT3 is also found in the disease. However, the role of STAT3 protein on the pathogenesis of CD is not clear. This study was executed to investigate the role of STAT3 protein on the pathogenesis of trinitrobenzene sulfonic acid (TNBS)-induced colitis, the pathogenesis of which is CD-like.
TNBS-induced colitis was produced, and STAT3 antisense oligonucleotide was administrated intracolonically during the early phase of colitis. The mice were killed 7 days later, and the expressions of STAT3 and phosphorylated STAT3 were identified by Western blot and immunofluorescence. The lamina propria mononuclear cells (LPMCs) were isolated freshly, and the percent of cell death and the expressions of Bcl-2 and Bax in LPMCs were evaluated. Colonic tissue damage and the production of inflammatory cytokines were measured also.
Administration of STAT3 antisense oligonucleotide effectively inhibited STAT3 expression and phosphorylation in inflamed colonic mucosa of colitis. The mice that were administered STAT3 antisense oligonucleotide showed less colonic tissue damage with decreased production of inflammatory cytokines such as TNF-alpha and INF-gamma in mucosa compared with that of those TNBS-induced colitis. Administration of STAT3 antisense oligonucleotide successfully induced apoptosis of LPMCs and counteracted the unbalanced expressions of Bcl-2 and Bax in LPMCs from colitis.
STAT3 activation may play an important role in the inflammatory process of TNBS-induced colitis, and inhibiting STAT3 activation during the early phase of the inflammatory response may have a beneficial effect on the colitis.
International Journal of Colorectal Disease 07/2007; 22(6):625-35. · 2.38 Impact Factor
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ABSTRACT: To determine the accuracy of the assay using perinuclear antineutrophil cytoplasmic antibody (pANCA) and anti-saccharomyces cerevisiae antibodies (ASCA) in diagnosing ulcerative colitis (UC) and Crohn's disease (CD) and whether the presence of ASCA and pANCA antibodies could differentiate either CD from UC, or inflammatory bowel disease (IBD) from normal controls.
Serum samples were obtained from 34 patients with CD and 29 with UC, and from 25 normal volunteers. Diagnosis was established on clinical findings, X-ray or endoscopy and histology. Determination of ASCA and pANCA antibodies was performed using indirect immunofluorescence technique.
47.1% patients with CD against 69.0% patients with UC expressed pANCA (P < 0.05). Vice versa 58.6% patients with UC against 11.8% patients with CD expressed ASCA (P < 0.05). The sensibility, specificity and positive predictive value of combination of positive ASCA and negative pANCA to diagnosis CD was 0, 89.7% and 0 respectively, and those of combination of positive pANCA and negative ASCA to diagnosis of UC was 20.7%, 64.7% and 33.3% respectively.
The positive of either ASCA or pANCA are not enough sensible to screen the IBD, but useful to diagnosis IBD. The combination pANCA and ASCA can not be as a serum differential diagnosis marker for IBD.
Zhonghua nei ke za zhi [Chinese journal of internal medicine] 07/2005; 44(6):428-30.
