Ulcerative Colitis: Planet Earth

von Herbay A, Anonymous00184. · No affiliation provided · Z Gastroenterol. · Pubmed #11215360 No free full text.

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Riemann JF, Anonymous00183. · No affiliation provided · Z Gastroenterol. · Pubmed #11215359 No free full text.

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Melange M, D'Haens G, Devos M, Kartheuser A, Louis E, Pattyn P, Pelckmans P, Penninckx F, Potvin P, Schapira M, Van de Stadt J, Van Gossum AV, Anonymous00094. · No affiliation provided · Acta Gastroenterol Belg. · Pubmed #11189986 No free full text.

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Preiss JC, Blumenstein I, Zeuzem S, Zeitz M. · Medizinische Klinik I, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin. · Z Gastroenterol. · Pubmed #19533543 No free full text.

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Velayos F. · No affiliation provided · Gastrointest Endosc. · Pubmed #19481651 No free full text.

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Hoentjen F, van Bodegraven AA. · No affiliation provided · World J Gastroenterol. · Pubmed #19418577 links to  free full text

Abstract: Inflammatory bowel disease (IBD), in particular Crohn's disease refractory to conventional therapy, fistulizing Crohn's disease and chronic active ulcerative colitis, generally respond well to anti-tumor necrosis factor (TNF) therapy. However, serious side effects do occur, necessitating careful monitoring of therapy. Potential side effects of anti-TNF therapy include opportunistic infections, which show a higher incidence when concomitant immunosuppression is used. Furthermore, antibody formation against anti-TNF is associated with decreased efficacy and an increased frequency of infusion reactions. The hypothesis of a slightly increased risk of lymphomas in IBD patients treated with anti TNF-therapy is debatable, since most studies lack the specific design to properly address this issue. Alarmingly, the occurrence of hepatosplenic T-cell lymphomas coincides with combined immunosuppressive therapy. Despite the potential serious side effects, anti-TNF therapy is an effective and relatively safe treatment option for refractory IBD. Future research is needed to answer important questions, such as the long-term risk of malignancies, safety during pregnancy, when to discontinue and when to switch anti-TNF therapy, as well as to determine the balance between therapeutic and toxic effects.

Hinojosa del Val J, Maroto Arce N. · No affiliation provided · Rev Esp Enferm Dig. · Pubmed #19388795 links to  free full text

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Lakatos PL. · No affiliation provided · World J Gastroenterol. · Pubmed #19370774 links to  free full text

Abstract: 5-aminosalicylate (5-ASA) agents remain the mainstay treatment in ulcerative colitis (UC). A number of oral 5-ASA agents are commercially available, including azobond pro-drugs, as well as delayed- and controlled-release forms of mesalazine. However, poor adherence due to frequent daily dosing and a large number of tablets has been shown to be an important barrier to successful management of patients with UC. Recently, new, once-daily formulations of mesalazine, including the unique multi-matrix delivery system and mesalazine granules, were proven to be efficacious in inducing and maintaining remission in mild-to-moderate UC, with a good safety profile comparable to that of other oral mesalazine formulations. In addition, they offer the advantage of a low pill burden and might contribute to increased long-term compliance and treatment success in clinical practice. This editorial summarizes the available literature on the short- and medium-term efficacy and safety of the new once-daily mesalazine formulations.

Leong RW, Koo JH. · No affiliation provided · J Gastroenterol Hepatol. · Pubmed #19368629 No free full text.

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Timmer A, Obermeier F. · No affiliation provided · BMJ. · Pubmed #19273505 No free full text.

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Holder-Murray J, Fichera A. · No affiliation provided · World J Gastroenterol. · Pubmed #19230038 links to  free full text

Abstract: Preservation of the anal transition zone has long been a significant source of controversy in the surgical management of ulcerative colitis. The two techniques for restorative proctocolectomy and ileal pouch anal anastomosis (RPC IPAA) in common practice are a stapled anastomosis and a handsewn anastomosis; these techniques differ in the amount of remaining rectal mucosa and therefore the presence of the anal transition zone following surgery. Each technique has advantages and disadvantages in long-term functional outcomes, operative and postoperative complications, and risk of neoplasia. Therefore, we propose a selective approach to performing a stapled RPC IPAA based on the presence of dysplasia in the preoperative endoscopic evaluation.

Brant SR. · No affiliation provided · Gastroenterology. · Pubmed #19121319 No free full text.

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Grimm MC, Ng WS. · No affiliation provided · J Gastroenterol Hepatol. · Pubmed #19120867 No free full text.

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Kim KO, Jang BI. · No affiliation provided · Korean J Gastroenterol. · Pubmed #19077493 links to  free full text

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Picco MF. · No affiliation provided · Am J Gastroenterol. · Pubmed #18855853 No free full text.

Abstract: Corticosteroid therapy remains a mainstay in the treatment of active ulcerative colitis. While useful in the induction of remission, corticosteroids should be avoided for maintenance therapy because of lack of efficacy and serious short- and long-term side effects. Bone fracture risk is increased with as little as 3 months of therapy so that safer corticosteroid therapies would have a significant impact. In this issue of American Journal of Gastroenterology, the treatment of mild to moderate ulcerative colitis with dexamethasone 21-P encapsulated erthryocytes (DEE), a novel method of corticosteroid drug delivery, is described. The results suggest similar efficacy as conventional oral corticosteroids with significantly decreased short-term corticosteroid-related side effects. This study was small and follow-up was limited, but the findings are intriguing. These results should prompt further study of this method of drug delivery to confirm efficacy, assess short-term and possibly long-term side effect, and determine whether this translates into better overall safety.

Haboubi N. · No affiliation provided · Colorectal Dis. · Pubmed #18834418 No free full text.

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Hussain SP. · No affiliation provided · Gastroenterology. · Pubmed #18692057 No free full text.

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Stolfi C, Pellegrini R, Franze E, Pallone F, Monteleone G. · No affiliation provided · World J Gastroenterol. · Pubmed #18680220 links to  free full text

Abstract: Patients with ulcerative colitis (UC) and Crohn's disease (CD) are at increased risk for developing colorectal cancer (CRC), and this is believed to be a result of chronic inflammation. Although conclusive evidence is still missing, both epidemiological and experimental observations suggest that certain drugs used to treat inflammation, such as mesalazine, can reduce the incidence of colitis-associated CRC. Therefore, in recent years, several studies have been conducted to dissect the mechanisms by which mesalazine interferes with CRC cell growth and survival. This review summarizes the current information on the molecular mechanisms that underlie the antineoplastic action of mesalazine.

Hanauer SB. · No affiliation provided · Nat Clin Pract Gastroenterol Hepatol. · Pubmed #18670441 No free full text.

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Sanchez-Munoz F, Dominguez-Lopez A, Yamamoto-Furusho JK. · No affiliation provided · World J Gastroenterol. · Pubmed #18666314 links to  free full text

Abstract: Inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), represents a group of chronic disorders characterized by inflammation of the gastrointestinal tract, typically with a relapsing and remitting clinical course. Mucosal macrophages play an important role in the mucosal immune system, and an increase in the number of newly recruited monocytes and activated macrophages has been noted in the inflamed gut of patients with IBD. Activated macrophages are thought to be major contributors to the production of inflammatory cytokines in the gut, and imbalance of cytokines is contributing to the pathogenesis of IBD. The intestinal inflammation in IBD is controlled by a complex interplay of innate and adaptive immune mechanisms. Cytokines play a key role in IBD that determine T cell differentiation of Th1, Th2, T regulatory and newly described Th17 cells. Cytokines levels in time and space orchestrate the development, recurrence and exacerbation of the inflammatory process in IBD. Therefore, several cytokine therapies have been developed and tested for the treatment of IBD patients.

Lakatos PL, Lakatos L. · No affiliation provided · World J Gastroenterol. · Pubmed #18609676 links to  free full text

Abstract: The risk of colorectal cancer for any patient with ulcerative colitis is known to be elevated, and is estimated to be 2% after 10 years, 8% after 20 years and 18% after 30 years of disease. Risk factors for cancer include extent and duration of ulcerative colitis, primary sclerosing cholangitis, a family history of sporadic colorectal cancer, severity of histologic bowel inflammation, and in some studies, young age at onset of colitis. In this review, the authors discuss recent epidemiological trends and causes for the observed changes. Population-based studies published within the past 5 years suggest that this risk has decreased over time, despite the low frequency of colectomies. The crude annual incidence rate of colorectal cancer in ulcerative colitis ranges from approximately 0.06% to 0.16% with a relative risk of 1.0-2.75. The exact mechanism for this change is unknown; it may partly be explained by the more widespread use of maintenance therapy and surveillance colonoscopy.

Huett A, Xavier RJ. · No affiliation provided · Gastroenterology. · Pubmed #18486617 No free full text.

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Achkar JP. · No affiliation provided · Am J Gastroenterol. · Pubmed #18341487 No free full text.

Abstract: The results of recently completed genome-wide association studies have rapidly advanced knowledge of inflammatory bowel disease (IBD) genetics. Several promising associations between IBD and gene variants have been identified with the two best replicated so far being variants in the IL23R and ATG16L1 genes. These findings highlight the importance of the immune system and interactions with intestinal microflora in the pathogenesis of IBD.

Lakatos PL, Szamosi T, Lakatos L. · No affiliation provided · World J Gastroenterol. · Pubmed #18069751 links to  free full text

Abstract: Smoking is an important environmental factor in inflammatory bowel disease (IBD), having different effects in ulcerative colitis (UC) and Crohn's disease (CD). A recent meta-analysis partially confirmed previous findings that smoking was found to be protective against ulcerative colitis and, after onset of the disease, might improve its course, decreasing the need for colectomy. However, smoking increases the risk of developing CD and worsens its course, increasing the need for steroids, immunosuppressants and re-operations. Smoking cessation aggravates ulcerative colitis and improves CD. Data are however, largely conflictive as well as the potential mechanisms involved in this dual relationship are still unknown. In this review article, the authors review the role of smoking in inflammatory bowel diseases.

Boerr L. · No affiliation provided · Acta Gastroenterol Latinoam. · Pubmed #17955723 No free full text.

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