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Shibuya T, Nomura O, Nomura K, Haraikawa M, Haga K, Ishikawa D, Osada T, Yamaji K, Ikeda S, Nagahara A. Efficacy of cytapheresis for induction therapy and extra-intestinal skin manifestations of ulcerative colitis. Ther Apher Dial 2022; 26:522-528. [PMID: 35247233 DOI: 10.1111/1744-9987.13823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 12/14/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In recent years, the prevalence of inflammatory bowel diseases has been increasing in Japan due to the westernization of lifestyles. Many patients have been reported to have extra-intestinal manifestations (EIMs) at least once. Skin lesions occur with a high degree of frequency among EIMs, with erythema nodosum (EN) and pyoderma gangrenosum (PG) the main complications. Cytapheresis is again attracting attention as a treatment with few side effects. METHODS We investigated the therapeutic effect of cytapheresis on ulcerative colitis (UC) and cutaneous EIMs. Between 2008 and 2021, 240 patients with active UC had induction therapy by cytapheresis at our hospital. RESULTS Remission and response rates were 50.0% and 67.5%, respectively. Apheresis was performed on 7 patients with PG and 5 patients with EN with a good response. Serious adverse events were not observed. CONCLUSION This retrospective assessment of efficacy showed that EN and PG responded favorably to cytapheresis. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Tomoyoshi Shibuya
- Department of Gastroenterology, Juntendo University school of medicine
| | - Osamu Nomura
- Department of Gastroenterology, Juntendo University school of medicine
| | - Kei Nomura
- Department of Gastroenterology, Juntendo University school of medicine
| | - Mayuko Haraikawa
- Department of Gastroenterology, Juntendo University school of medicine
| | - Keiichi Haga
- Department of Gastroenterology, Juntendo University school of medicine
| | - Dai Ishikawa
- Department of Gastroenterology, Juntendo University school of medicine
| | - Taro Osada
- Department of Gastroenterology Juntendo University Urayasu Hospital
| | - Ken Yamaji
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine
| | - Shigaku Ikeda
- Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine
| | - Akihito Nagahara
- Department of Gastroenterology, Juntendo University school of medicine
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Higashi Y, Ibusuki A, Baba N, Hatanaka M, Tada KI, Kanekura T. Granulocyte and monocyte adsorptive apheresis for pyoderma gangrenosum. Ther Apher Dial 2021; 26:450-455. [PMID: 34369050 DOI: 10.1111/1744-9987.13720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 06/22/2021] [Accepted: 08/06/2021] [Indexed: 11/29/2022]
Abstract
Pyoderma gangrenosum (PG), a chronic aseptic inflammatory skin disease characterized by skin ulcers with elevated and undermined borders, is resistant to conventional therapies. PG is elicited by activated neutrophils and macrophages and is often associated with systemic diseases such as inflammatory bowel disease, rheumatoid arthritis, aortitis syndrome, and hematopoietic disorders. This single-center study assessed the efficacy and safety of selectively depleting myeloid-lineage leukocytes in patients with PG. Patients with PG, aged 20 or over, received 5 or 10 treatment sessions of granulocyte and monocyte adsorption apheresis (GMA), once or twice a week. Treatment efficacy was assessed based on the rate of skin ulcer reduction, the visual analog scale of pain, and the physician's global assessment of the skin lesions. A complete response (CR) was obtained in eight patients, a nearly complete response (nCR) in three patients, and a partial response (PR) in two patients. In four of the other six, the disease remained stable (SD) and in two we observed disease progression (PD). No severe adverse events were recorded. Our results suggest that GMA is a useful and safe treatment modality for PG.
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Affiliation(s)
- Yuko Higashi
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Atsuko Ibusuki
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Naoko Baba
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Miho Hatanaka
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ko-Ichi Tada
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takuro Kanekura
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Feng BS, Wu YJ, Zeng XH, Yu D, Liu ZQ, Zhou CJ, Liu ZG, Zheng PY, Yang PC. Bcl2L12 mediates effects of protease-activated receptor-2 on the pathogenesis of Th2-dominated responses of patients with ulcerative colitis. Arch Biochem Biophys 2018; 657:8-14. [PMID: 30217509 DOI: 10.1016/j.abb.2018.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 09/03/2018] [Accepted: 09/08/2018] [Indexed: 02/06/2023]
Abstract
The immune dysregulation plays an important role in the pathogenesis of ulcerative colitis (UC). Bcl2 like protein-12 (Bcl2L12) and mast cells are involved in immune dysregulation of UC. This study aims to elucidate the role of Bcl2L12 in the contribution to the pathogenesis of T helper (Th)2-biased inflammation in UC patients. The results showed that Bcl2L12 was expressed by peripheral CD4+ T cells that was associated with Th2 polarization in UC patients. Bcl2L12 mediated the protease-activated receptor-2 (PAR2)-induced IL-4 expression in CD4+ cells. Activation of PAR2 increased expression of Bcl2L12 in CD4+ T cells. Bcl2L12 mRNA decayed spontaneously in CD4+ T cells after separated from UC patients which was prevented by activating PAR2. Bcl2L12 mediated the binding between GATA3 and the Il4 promoter in CD4+ T cells. Mice with Bcl2L12 deficiency failed to induce Th2-biased inflammation in the colon mucosa. We conclude that CD4+ T cells from UC patients expressed high levels of Bcl2L12; the latter plays an important role in the development of Th2-biased inflammation in the intestine. Bcl2L12 may be a novel therapeutic target in the treatment of Th2-biased inflammation.
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Affiliation(s)
- Bai-Sui Feng
- Department of Gastroenterology, The Second Hospital, Zhengzhou University, Zhengzhou, China
| | - Yong-Jin Wu
- The Affiliated ENT Hospital and Research Center of Allergy & Immunology, Shenzhen University School of Medicine, Shenzhen, China
| | - Xian-Hai Zeng
- The Affiliated ENT Hospital and Research Center of Allergy & Immunology, Shenzhen University School of Medicine, Shenzhen, China
| | - Dian Yu
- The Affiliated ENT Hospital and Research Center of Allergy & Immunology, Shenzhen University School of Medicine, Shenzhen, China
| | - Zhi-Qiang Liu
- The Affiliated ENT Hospital and Research Center of Allergy & Immunology, Shenzhen University School of Medicine, Shenzhen, China
| | - Cai-Jie Zhou
- Longgang Chinese Traditional Medical Hospital and Beijing University of Chinese Medicine Shenzhen Hospital, Shenzhen, China
| | - Zhi-Gang Liu
- The Affiliated ENT Hospital and Research Center of Allergy & Immunology, Shenzhen University School of Medicine, Shenzhen, China
| | - Peng-Yuan Zheng
- Department of Gastroenterology, The Fifth Hospital, Zhengzhou University, Zhengzhou, China.
| | - Ping-Chang Yang
- The Affiliated ENT Hospital and Research Center of Allergy & Immunology, Shenzhen University School of Medicine, Shenzhen, China.
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Dignass A, Akbar A, Baumgart DC, Bommelaer G, Bouguen G, Cadiot G, Gillessen A, Grimaud JC, Hart A, Hoque S, Makins R, Michiels C, Moreau J, Premchand P, Ramlow W, Schanz S, Subramanian S, von Tirpitz C, Bonaz B. Granulocyte/monocyte adsorptive apheresis for the treatment of therapy-refractory chronic active ulcerative colitis. Scand J Gastroenterol 2018. [PMID: 29513111 DOI: 10.1080/00365521.2018.1447598] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Current options for patients with steroid-dependent, chronic-active ulcerative colitis (UC) with insufficient response/intolerance to immunosuppressants (ISs) and/or biologics are limited. The aim of this study was to assess the long-term outcome of granulocyte/monocyte adsorptive (GMA) apheresis (Adacolumn®) in this population. MATERIALS AND METHODS Ninety five adults with steroid-dependent active UC and insufficient response/intolerance to IS and/or TNF inhibitors received 5-8 aphereses in a single induction series of ≤10 weeks. Endpoints included rates of remission (clinical activity index [CAI] ≤ 4) at weeks 24 and 48. RESULTS Of 94 patients (ITT population), remission and response rates were 34.0% and 44.7% at week 24, and 33.0% and 39.4% at week 48. Among 30 patients with prior failure of IS and biologics, 33.3% and 20.0% were in remission at weeks 24 and 48. At both weeks, 19.2% of patients achieved steroid-free remission. Sustained remission or response occurred in 27.7% of patients at 48 weeks. The cumulative colectomy rate at week 96 was 23.4%. Safety was consistent with previous findings. CONCLUSIONS This study confirms findings of the 12-week interim analysis and demonstrates that GMA apheresis provides a safe and beneficial long-term outcome for patients with chronic active UC resistant/intolerant to IS and/or TNF inhibitors.
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Affiliation(s)
- Axel Dignass
- a Department of Gastroenterology, Hepatology, Oncology and Metabolic Diseases , Markus-Krankenhaus , Frankfurt/Main , Germany
| | - Ayesha Akbar
- b IBD Unit, St. Mark's Hospital and Academic Institute , London , UK
| | - Daniel C Baumgart
- c Department of Medicine, Division of Gastroenterology and Hepatology , Charité Medical Center - Virchow Hospital, Medical School of the Humboldt-University of Berlin , Berlin , Germany
| | - Gilles Bommelaer
- d Service Hépatologie-Gastroentérologie, CHU Clermont-Ferrand , Clermont-Ferrand , France
| | - Guillaume Bouguen
- e Service des Maladies de l'Appareil Digestif et CIC1414, University Hospital of Rennes , Pontchaillou , France
| | - Guillaume Cadiot
- f Service d'Hépato-gastro-entérologie, CHU du Reims, Hôpital Robert Debré , Reims Cedex , France
| | | | | | - Ailsa Hart
- b IBD Unit, St. Mark's Hospital and Academic Institute , London , UK
| | - Syed Hoque
- i Barts Health NHS Trust, Whipps Cross University Hospital , London , UK
| | | | | | | | | | - Wolfgang Ramlow
- n Clinic for Nephrology, Dialysis and Apheresis , Rostock , Germany
| | | | - Sreedhar Subramanian
- p Department of Gastroenterology , Royal Liverpool University Hospital , Liverpool , UK
| | | | - Bruno Bonaz
- r Clinique Universitaire d'Hépato-Gastroentérologie, CHU Grenoble , Grenoble , France
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Immunological Mechanisms of Adsorptive Cytapheresis in Inflammatory Bowel Disease. Dig Dis Sci 2017; 62:1417-1425. [PMID: 28432476 DOI: 10.1007/s10620-017-4577-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 04/08/2017] [Indexed: 02/06/2023]
Abstract
Ulcerative colitis and Crohn's disease are the two main forms of inflammatory bowel disease (IBD). The study of immunological pathways involved in the onset of IBD is of fundamental importance to identify potential biological markers of disease activity and specific targets for therapy. Removing excess and activated circulating leukocytes with adsorptive cytapheresis has been shown to be a potentially effective treatment for patients with an inflamed bowel. Adsorptive cytapheresis is a non-pharmacological approach for active IBD, in which known sources of inflammatory cytokines such as activated myeloid lineage leucocytes are selectively depleted from the circulatory system. The decrease in inflammatory load caused by removing these cells is thought to enhance drug therapy and thereby promote disease remission. The benefit of cytapheresis appears to rest upon its ability to reduce levels of certain immune cell populations; however, whether this depletion results in further changes in lymphocyte populations and cytokine production needs further clarification. In this review, we aim to summarize existing evidence on the role of cytapheresis in patients with IBD, its effect on cytokine levels and cellular populations, and to discuss its potential impact on disease activity.
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Beltrán B, Sáez-González E, Moret I, Díaz-Jaime FC, Alvarez-Sotomayor D, Cerrillo E, Iborra M, Bastida G, Aguas M, Nos P. Adsorptive granulocyte/monocyte apheresis use in severe ulcerative colitis and determination of changes in plasma cytokines. J Clin Apher 2017; 33:99-103. [DOI: 10.1002/jca.21552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 03/13/2017] [Accepted: 04/10/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Belén Beltrán
- Gastroenterology Department; La Fe University and Polytechnic Hospital; Valencia Spain
- Inflammatory Bowel Disease Research Group, IIS Hospital La Fe; Valencia Spain
- Networked Biomedical Research Centre for Hepatic and Digestive Diseases (CIBEREHD); Barcelona Spain
| | - Esteban Sáez-González
- Gastroenterology Department; La Fe University and Polytechnic Hospital; Valencia Spain
| | - Inés Moret
- Gastroenterology Department; La Fe University and Polytechnic Hospital; Valencia Spain
- Inflammatory Bowel Disease Research Group, IIS Hospital La Fe; Valencia Spain
- Networked Biomedical Research Centre for Hepatic and Digestive Diseases (CIBEREHD); Barcelona Spain
| | - Francia C. Díaz-Jaime
- Gastroenterology Department; La Fe University and Polytechnic Hospital; Valencia Spain
| | | | - Elena Cerrillo
- Gastroenterology Department; La Fe University and Polytechnic Hospital; Valencia Spain
- Inflammatory Bowel Disease Research Group, IIS Hospital La Fe; Valencia Spain
| | - Marisa Iborra
- Gastroenterology Department; La Fe University and Polytechnic Hospital; Valencia Spain
- Inflammatory Bowel Disease Research Group, IIS Hospital La Fe; Valencia Spain
- Networked Biomedical Research Centre for Hepatic and Digestive Diseases (CIBEREHD); Barcelona Spain
| | - Guillermo Bastida
- Gastroenterology Department; La Fe University and Polytechnic Hospital; Valencia Spain
- Inflammatory Bowel Disease Research Group, IIS Hospital La Fe; Valencia Spain
- Networked Biomedical Research Centre for Hepatic and Digestive Diseases (CIBEREHD); Barcelona Spain
| | - Mariam Aguas
- Gastroenterology Department; La Fe University and Polytechnic Hospital; Valencia Spain
- Inflammatory Bowel Disease Research Group, IIS Hospital La Fe; Valencia Spain
- Networked Biomedical Research Centre for Hepatic and Digestive Diseases (CIBEREHD); Barcelona Spain
| | - Pilar Nos
- Gastroenterology Department; La Fe University and Polytechnic Hospital; Valencia Spain
- Inflammatory Bowel Disease Research Group, IIS Hospital La Fe; Valencia Spain
- Networked Biomedical Research Centre for Hepatic and Digestive Diseases (CIBEREHD); Barcelona Spain
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Othman ER, Hornung D, Hussein M, Abdelaal II, Sayed AA, Fetih AN, Al-Hendy A. Soluble tumor necrosis factor-alpha receptors in the serum of endometriosis patients. Eur J Obstet Gynecol Reprod Biol 2016; 200:1-5. [DOI: 10.1016/j.ejogrb.2016.02.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/07/2016] [Accepted: 02/11/2016] [Indexed: 01/07/2023]
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Leitner GC, Vogelsang H. Pharmacological- and non-pharmacological therapeutic approaches in inflammatory bowel disease in adults. World J Gastrointest Pharmacol Ther 2016; 7:5-20. [PMID: 26855808 PMCID: PMC4734954 DOI: 10.4292/wjgpt.v7.i1.5] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 12/14/2015] [Accepted: 01/08/2016] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel diseases (IBDs) are a group of chronic inflammatory conditions mainly of the colon and small intestine. Crohn's disease (CD) and ulcerative colitis (UC) are the most frequent types of IBD. IBD is a complex disease which arises as a result of the interaction of environmental, genetic and immunological factors. It is increasingly thought that alterations of immunological reactions of the patients to their own enterable bacteria (microfilm) may contribute to inflammation. It is characterized by mucosal and sub mucosal inflammation, perpetuated by infiltration of activated leukocytes. CD may affect the whole gastrointestinal tract while UC only attacks the large intestine. The therapeutic goal is to achieve a steroid-free long lasting remission in both entities. UC has the possibility to be cured by a total colectomy, while CD never can be cured by any operation. A lifelong intake of drugs is mostly necessary and essential. Medical treatment of IBD has to be individualized to each patient and usually starts with anti-inflammatory drugs. The choice what kind of drugs and what route administered (oral, rectal, intravenous) depends on factors including the type, the localization, and severity of the patient's disease. IBD may require immune-suppression to control symptoms such as prednisolone, thiopurines, calcineurin or sometimes folic acid inhibitors or biologics like TNF-α inhibitors or anti-integrin antibodies. For both types of disease (CD, UC) the same drugs are available but they differ in their preference in efficacy between CD and UC as 5-aminosalicylic acid for UC or budesonide for ileocecal CD. As therapeutic alternative the main mediators of the disease, namely the activated pro-inflammatory cytokine producing leukocytes can be selectively removed via two apheresis systems (Adacolumn and Cellsorba) in steroid-refractory or dependent cases. Extracorporeal photopheresis results in an increase of regulatory B cells, regulatory CD8(+) T cells and T-regs Type 1. Both types of apheresis were able to induce clinical remission and mucosal healing accompanied by tapering of steroids.
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Hashiguchi K, Takeshima F, Akazawa Y, Matsushima K, Minami H, Machida H, Yamaguchi N, Shiozawa K, Ohba K, Ohnita K, Ichikawa T, Isomoto H, Nakao K. Advantages of fecal lactoferrin measurement during granulocyte and monocyte adsorptive apheresis therapy in ulcerative colitis. Digestion 2015; 91:208-17. [PMID: 25823500 DOI: 10.1159/000375301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 01/16/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Fecal lactoferrin has been introduced as a useful tool for the diagnosis and monitoring of inflammatory bowel disease (IBD). The aim of this study was to assess if fecal lactoferrin can be employed to predict or estimate the effect of granulocyte and monocyte adsorptive apheresis (GMA) in ulcerative colitis (UC). METHODS This was a prospective study involving 21 patients with UC. Patients with moderately-to-severely active UC who were scheduled to undergo GMA were recruited. Changes in fecal lactoferrin concentration were compared between the GMA-responder and -nonresponder groups. RESULTS In the GMA-responder group, fecal lactoferrin significantly increased 1 week after the introduction of GMA and then significantly decreased after GMA sessions. Fecal lactoferrin concentrations were significantly higher in the GMA-responder group than in the GMA-nonresponder group at 1 and 2 weeks after the introduction of GMA. Multivariate logistic regression analysis revealed that fecal lactoferrin concentration 1 week after the introduction of GMA was the most contributing factor for the effectiveness of GMA in patients with UC. CONCLUSIONS In the GMA-responder group, fecal lactoferrin concentration significantly increased 1 week after the introduction of GMA. Fecal lactoferrin may be beneficial for predicting clinical response of GMA in patients with UC at an early stage of GMA treatment.
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Affiliation(s)
- Keiichi Hashiguchi
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan
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Wen YL, Niu JK, Miao YL. Non-drug treatment of inflammatory bowel disease. Shijie Huaren Xiaohua Zazhi 2015; 23:3720-3728. [DOI: 10.11569/wcjd.v23.i23.3720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel disease (IBD) is an idiopathic, chronic, nonspecific inflammatory disease. IBD is comprised of two major types, ulcerative colitis (UC) and Crohn's disease (CD), and is hard to be cured. Currently, aminosalicylic acid preparations, corticosteroids and immunosuppressant drugs are the main treatments for the disease, but there exists poor drug efficacy in some cases, and patients are prone to side effects. Biological agents greatly improve the efficacy, but for a small number of refractory patients, comprehensive intervention containing non-drug treatments is needed. Non-drug treatments like fecal microbiota transplantation (FMT), stem cell transplantation, and granulocyte and monocyte apheresis (GMA) have shown enormous potential for the treatment of IBD, and have become a hot spot of IBD treatment research in recent years. In this paper, we review the non-drug treatments for IBD, in order to broaden the horizons of clinicians in the treatment of IBD.
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Zhang D, Wei C, Yao J, Cai X, Wang L. Interleukin-10 gene-carrying bifidobacteria ameliorate murine ulcerative colitis by regulating regulatory T cell/T helper 17 cell pathway. Exp Biol Med (Maywood) 2015; 240:1622-9. [PMID: 25956685 DOI: 10.1177/1535370215584901] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 03/10/2015] [Indexed: 12/12/2022] Open
Abstract
Ulcerative colitis (UC) is a chronic inflammatory bowel disease suggested to be closely related to the imbalance of regulatory T cell/T helper 17 cell (Treg/Th17) signaling. Previously, we constructed an interleukin-10 (IL-10) expression vector, BL-hIL-10, and proved that it ameliorates dextran sulfate sodium-induced intestinal inflammation in mice. In this study, we further explored the mechanisms underlying BL-hIL-10 treatment from the Treg/Th17 imbalance perspective. Our results showed that the oral administration of BL-hIL-10 reduced the UC inflammation in mice significantly, which was assessed by disease activity index, spleen index, and pathological changes in colon tissue. Moreover, the mice after BL-hIL-10 treatment had increased proportion of Treg cells while Th17 cells decreased greatly, leading to the reconstruction of Treg/Th17 balance. Furthermore, the Th17 cell-secreted factors, such as IL-6, IL-17, and IL-23, were reduced, but the Treg-related factors, IL-10 and Transforming growth factor-β1 (TGF-β1), were elevated accordingly. Finally, Western blot confirmed the inhibition of nuclear hypoxia-inducible factor-1α (HIF-1α) and cytoplasmic mechanistic target of rapamycin (mTOR) and signal transducer and activator of transcription 3 (STAT3) in intestinal tissues. In conclusion, oral administration of BL-hIL-10 can alleviate the inflammation responses of UC in murine model through the restoration of Treg/Th17 imbalance, which might be at least partially due to the inhibition of hypoxia-mTOR-HIF-1α-Th17 axis as well as IL-6-STAT3-HIF-1α-Th17 pathway.
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Affiliation(s)
- Dingguo Zhang
- Department of Gastroenterology, Jinan University of Medical Sciences, Shenzhen People's Hospital, Engineering Technology Research and Development Center of Shenzhen, Shenzhen, Guangdong 518020, ChinaThe first two authors contributed to this research equally
| | - Cheng Wei
- Department of Gastroenterology, Jinan University of Medical Sciences, Shenzhen People's Hospital, Engineering Technology Research and Development Center of Shenzhen, Shenzhen, Guangdong 518020, ChinaThe first two authors contributed to this research equally
| | - Jun Yao
- Department of Gastroenterology, Jinan University of Medical Sciences, Shenzhen People's Hospital, Engineering Technology Research and Development Center of Shenzhen, Shenzhen, Guangdong 518020, ChinaThe first two authors contributed to this research equally
| | - Xiaoyan Cai
- Department of Gastroenterology, Jinan University of Medical Sciences, Shenzhen People's Hospital, Engineering Technology Research and Development Center of Shenzhen, Shenzhen, Guangdong 518020, ChinaThe first two authors contributed to this research equally
| | - Lisheng Wang
- Department of Gastroenterology, Jinan University of Medical Sciences, Shenzhen People's Hospital, Engineering Technology Research and Development Center of Shenzhen, Shenzhen, Guangdong 518020, ChinaThe first two authors contributed to this research equally
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12
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Korolkova OY, Myers JN, Pellom ST, Wang L, M'Koma AE. Characterization of Serum Cytokine Profile in Predominantly Colonic Inflammatory Bowel Disease to Delineate Ulcerative and Crohn's Colitides. CLINICAL MEDICINE INSIGHTS. GASTROENTEROLOGY 2015; 8:29-44. [PMID: 26078592 PMCID: PMC4459555 DOI: 10.4137/cgast.s20612] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 11/23/2014] [Accepted: 11/23/2014] [Indexed: 02/05/2023]
Abstract
BACKGROUND As accessible diagnostic approaches fail to differentiate between ulcerative colitis (UC) and Crohn’s colitis (CC) in one-third of patients with predominantly colonic inflammatory bowel disease (IBD), leading to inappropriate therapy, we aim to investigate the serum cytokine levels in these patients in search of molecular biometric markers delineating UC from CC. METHODS We measured 38 cytokines, chemokines, and growth factors using magnetic-bead-based multiplex immunoassay in 25 UC patients, 28 CC patients, and 30 controls. Our results are compared with those from a review of current literature regarding advances in serum cytokine profiles and associated challenges preventing their use for diagnostic/prognostic purposes. RESULTS Univariate analysis showed statistically significant increases of eotaxin, GRO, and TNF-α in UC patients compared to controls (Ctrl); interferon γ, interleukin (IL)-6, and IL-7 in CC group compared to Ctrl; and IL-8 in both UC and CC versus Ctrl. No cytokines were found to be different between UC and CC. A generalized linear model identified combinations of cytokines, allowing the identification of UC and CC patients, with area under the curve (AUC) = 0.936, as determined with receiver operating characteristic (ROC) analysis. CONCLUSIONS The current knowledge available about circulating cytokines in IBD is often contradictory. The development of an evidence-based tool using cytokines for diagnostic accuracy is still preliminary.
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Affiliation(s)
- Olga Y Korolkova
- Laboratory of Inflammatory Bowel Disease Research, Department of Biochemistry and Cancer Biology, Meharry Medical College School of Medicine, Nashville, Tennessee
| | - Jeremy N Myers
- Laboratory of Inflammatory Bowel Disease Research, Department of Biochemistry and Cancer Biology, Meharry Medical College School of Medicine, Nashville, Tennessee
| | - Samuel T Pellom
- Laboratory of Inflammatory Bowel Disease Research, Department of Biochemistry and Cancer Biology, Meharry Medical College School of Medicine, Nashville, Tennessee
| | - Li Wang
- Department of Statistics, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Amosy E M'Koma
- Laboratory of Inflammatory Bowel Disease Research, Department of Biochemistry and Cancer Biology, Meharry Medical College School of Medicine, Nashville, Tennessee. ; Department of General Surgery, Colon and Rectal Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee. ; Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
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De Cassan C, Savarino E, Marson P, Tison T, Hatem G, Sturniolo GC, D’Incà R. Granulo-monocyto apheresis is more effective in mild ulcerative colitis than in moderate to severe disease. World J Gastroenterol 2014; 20:17155-17162. [PMID: 25493030 PMCID: PMC4258586 DOI: 10.3748/wjg.v20.i45.17155] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 05/17/2014] [Accepted: 06/26/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate whether the effectiveness of Granulo-monocyto apheresis (GMA), a technique that consists of the extracorporeal removal of granulocytes and monocytes from the peripheral blood, might vary according to the severity of ulcerative colitis (UC) in patients with mild to moderate-severe disease UC activity.
METHODS: We retrospectively reviewed prospectively collected data of patients undergoing GMA at our inflammatory bowel disease centre who had at least a 6 mo of follow-up. The demographics, clinical and laboratory data were extracted from the patients’ charts and electronic records. The severity of UC was scored according to the Modified Truelove Witts Severity Index (MTWSI). A clinical response was defined as a decrease from baseline of ≥ 2 points or a value of MTWSI ≤ 2 points.
RESULTS: A total of 41 (24 males/17 females; mean age 47 years) patients were included in the study. After GMA cycle completion, 21/28 (75%) of mild UC patients showed a clinical response compared with 7/13 (54%) of patients with moderate to severe disease (P = 0.27). At 6-mo, 14/28 (50%) of the mild UC patients maintained a clinical response compared with 2/13 (15%) of the patients with moderate to severe disease (P = 0.04). After the GMA cycle completion and during the 6-mo follow up period, 13/16 (81%) and 9/16 (56%) of mild UC patients with intolerance, resistance and contraindications to immunosuppressants and/or biologics showed a clinical response compared with 2/6 (33%) and 0/6 (0%) of patients with moderate to severe disease activity with these characteristics (P = 0.05 and P = 0.04, respectively).
CONCLUSION: Patients with mild UC benefit from GMA more than patients with moderate to severe disease in the short-term period. GMA should be considered a valid therapeutic option in cases of contraindications to immunosuppressants, corticosteroids and/or biologics.
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Nishise S, Abe Y, Nomura E, Sato T, Sasaki Y, Iwano D, Yoshizawa K, Yagi M, Nishise Y, Ueno Y. Relationship Between Tumor Necrosis Factor-α Release and Granulocyte and Monocyte Adsorption to Cellulose Acetate Beads. Ther Apher Dial 2014; 18:252-7. [DOI: 10.1111/1744-9987.12212] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Shoichi Nishise
- Department of Gastroenterology; Yamagata University Faculty of Medicine; Yamagata Japan
| | - Yasuhiko Abe
- Department of Gastroenterology; Yamagata University Faculty of Medicine; Yamagata Japan
| | - Eiki Nomura
- Department of Gastroenterology; Yamagata University Faculty of Medicine; Yamagata Japan
| | - Takeshi Sato
- Department of Gastroenterology; Yamagata University Faculty of Medicine; Yamagata Japan
| | - Yu Sasaki
- Department of Gastroenterology; Yamagata University Faculty of Medicine; Yamagata Japan
| | - Daisuke Iwano
- Department of Gastroenterology; Yamagata University Faculty of Medicine; Yamagata Japan
| | - Kazuya Yoshizawa
- Department of Gastroenterology; Yamagata University Faculty of Medicine; Yamagata Japan
| | - Makoto Yagi
- Department of Gastroenterology; Yamagata University Faculty of Medicine; Yamagata Japan
| | - Yuko Nishise
- Department of Gastroenterology; Yamagata University Faculty of Medicine; Yamagata Japan
| | - Yoshiyuki Ueno
- Department of Gastroenterology; Yamagata University Faculty of Medicine; Yamagata Japan
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