1
|
Sárdy M, Borovaya A, Horváth ON, Folwaczny C, Schmitt W, Schmidt T, Hertl M, Ruzicka T. Erfolgreiche Rituximab-Behandlung des bullösen Pemphigoids bei Jugendlichen mit ösophagealer Vernarbung aufgrund von “epitope spreading”. J Dtsch Dermatol Ges 2016; 14:618-21. [DOI: 10.1111/ddg.12902_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Miklós Sárdy
- Abteilung für Dermatologie und Allergologie; Ludwig-Maximilians-Universität; München
| | - Alena Borovaya
- Abteilung für Dermatologie und Allergologie; Ludwig-Maximilians-Universität; München
| | - Orsolya N. Horváth
- Abteilung für Dermatologie und Allergologie; Ludwig-Maximilians-Universität; München
| | | | - Wolfgang Schmitt
- Abteilung für Gastroenterologie und Hepatologie; Klinikum Neuperlach; Städtisches Klinikum München
| | - Thomas Schmidt
- Abteilung für Dermatologie und Allergologie; Philipps-Universität; Marburg
| | - Michael Hertl
- Abteilung für Dermatologie und Allergologie; Philipps-Universität; Marburg
| | - Thomas Ruzicka
- Abteilung für Dermatologie und Allergologie; Ludwig-Maximilians-Universität; München
| |
Collapse
|
2
|
Sárdy M, Borovaya A, Horváth ON, Folwaczny C, Schmitt W, Schmidt T, Hertl M, Ruzicka T. Successful rituximab treatment of juvenile bullous pemphigoid with esophageal scarring due to epitope spreading. J Dtsch Dermatol Ges 2016; 14:618-21. [PMID: 27240075 DOI: 10.1111/ddg.12902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Miklós Sárdy
- Department of Dermatology and Allergology, Ludwig -Maximilian University, Munich, Germany
| | - Alena Borovaya
- Department of Dermatology and Allergology, Ludwig -Maximilian University, Munich, Germany
| | - Orsolya N Horváth
- Department of Dermatology and Allergology, Ludwig -Maximilian University, Munich, Germany
| | | | - Wolfgang Schmitt
- Department of Gastroenterology and Hepatology, -Klinikum Neuperlach, City Hospital Munich, Germany
| | - Thomas Schmidt
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - Michael Hertl
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - Thomas Ruzicka
- Department of Dermatology and Allergology, Ludwig -Maximilian University, Munich, Germany
| |
Collapse
|
3
|
Schmidt F, Janssen G, Martin G, Lorenz R, Loeschke K, Soyka M, Folwaczny C, Schaefer M. Factors influencing long-term changes in mental health after interferon-alpha treatment of chronic hepatitis C. Aliment Pharmacol Ther 2009; 30:1049-59. [PMID: 19691667 DOI: 10.1111/j.1365-2036.2009.04123.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Antiviral treatment with interferon-alpha (IFN-alpha) is associated with several acute psychiatric side effects. Little is known about long-term effects on mental health after treatment independent from viral response and the influence of pre-existing psychiatric risk-factors. AIM To evaluate long-term effects of antiviral treatment with interferon-alpha (IFN-alpha) on mental health in patients with psychiatric risk factors. METHOD We prospectively investigated long-term mental health changes in 81 hepatitis C virus-infected patients. Psychiatric outcome was measured with the Montgomery-Asberg Depression Scale (MADRS), Brief Psychiatric Rating Scale, the Global Social Functioning Scale and the Global Clinical Impression Scale 6 months after the end of antiviral treatment with IFN-alpha and ribavirin. RESULTS Six months after antiviral therapy, 49% of the patients showed a worsening and 27.2% an improvement of depression scores. The most important predictor for a long-term improvement of depression scores was a pre-treatment MADRS score > or =5 (OR 14.21, 95% CI: 2.51-81.30). Patients with pre-existing psychiatric disorders (OR = 0.117, 95% CI: 0.024-0.558), methadone substitution (OR = 0.20, 95% CI: 0.045-0.887) or genotype 2/3 (OR = 0.341, 95% CI: 0.138-0.845) were significantly less likely to show a long-term worsening of depressive symptoms. CONCLUSIONS Pre-existing psychiatric risk factors increase the chance for a long-term improvement and reduce the risk for a long-term worsening of mental health after antiviral treatment of chronic hepatitis C with IFN-alpha.
Collapse
Affiliation(s)
- F Schmidt
- Department of Psychiatry, Ludwig-Maximilians University, Munich, Germany
| | | | | | | | | | | | | | | |
Collapse
|
4
|
Folwaczny C. [Intestinal cancer precaution. Virtual coloscopy--as carcinogenic as 9000 cigarettes]. MMW Fortschr Med 2009; 151:21. [PMID: 19472662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
|
5
|
Beynon V, Cotofana S, Brand S, Lohse P, Mair A, Wagner S, Mussack T, Ochsenkühn T, Folwaczny M, Folwaczny C, Glas J, Török HP. NOD2/CARD15 genotype influences MDP-induced cytokine release and basal IL-12p40 levels in primary isolated peripheral blood monocytes. Inflamm Bowel Dis 2008; 14:1033-40. [PMID: 18383179 DOI: 10.1002/ibd.20441] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The functional link between mutations in NOD2 and Crohn's disease (CD) has not been entirely elucidated. The 1007fs mutation results in loss of NF-kappaB activation in response to muramyl dipeptide (MDP) but has also been linked to an increased IL-1beta processing and IL-12 release. METHODS We investigated the basal and MDP-triggered mRNA expression and protein release for TNF-alpha, IL-10, IL-1beta, and IL-12p40 in peripheral blood monocytes from 40 CD patients and 15 healthy individuals with different NOD2 genotypes. RESULTS Monocytes from individuals with 2 mutated NOD2 alleles (homozygous and compound-heterozygous individuals) displayed an impaired release of TNF-alpha and IL-10 but also of IL-1beta and IL-12p40 in response to MDP. In contrast to other NOD2 variants, the presence of at least 1 1007fs allele in double-mutated individuals completely abrogated NOD2 receptor function. Interestingly, monocytes from CD patients with 2 mutated NOD2 alleles displayed significantly higher basal levels of IL-12p40 in cell culture supernatants compared to wildtype CD patients and control individuals (P = 0.002 and P = 0.008, respectively). This was regardless of the IL23R genotype and was not mirrored by increased IL-12p40 plasma levels in these individuals. CONCLUSIONS The CD-associated NOD2 variants lead, in a dose- and mutation-dependent manner, to an impaired release of TNF-alpha, IL-10, IL-1beta, and IL-12p40 in response to MDP. The finding of increased basal levels for IL-12p40-related cytokines in monocytes with 2 mutated NOD2 alleles is likely to set a new link between NOD2 mutations and the inflammatory mechanisms underlying CD.
Collapse
Affiliation(s)
- Vanessa Beynon
- Department of Surgery, Innenstadt, University of Munich, Germany
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Glas J, Konrad A, Schmechel S, Dambacher J, Seiderer J, Schroff F, Wetzke M, Roeske D, Török HP, Tonenchi L, Pfennig S, Haller D, Griga T, Klein W, Epplen JT, Folwaczny C, Lohse P, Göke B, Ochsenkühn T, Mussack T, Folwaczny M, Müller-Myhsok B, Brand S. The ATG16L1 gene variants rs2241879 and rs2241880 (T300A) are strongly associated with susceptibility to Crohn's disease in the German population. Am J Gastroenterol 2008; 103:682-91. [PMID: 18162085 DOI: 10.1111/j.1572-0241.2007.01694.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES We analyzed ATG16L1, a recently identified Crohn's disease (CD) susceptibility gene, in a large cohort with inflammatory bowel disease (IBD) including potential interactions with other IBD genes as well as factors regulating its gene expression. METHODS Genomic DNA from 2,890 Caucasians including 768 patients with CD, 507 patients with ulcerative colitis (UC), and 1,615 healthy controls was analyzed for 9 different ATG16L1 single nucleotide polymorphisms (SNPs). Genotyping included CARD15/NOD2 variants p.Arg702Trp, p.Gly908Arg, and p.Leu1007fsX1008 and polymorphisms in SLC22A4/OCTN1 (1672 C-->T) and SLC22A5/OCTN2 (-207 G-->C) as well as 10 CD-associated IL23R variants. The transcriptional regulation of ATG16L1 was studied in intestinal epithelial cells following stimulation with Toll-like receptor (TLR) ligands and proinflammatory cytokines and in a murine ileitis model and CD biopsies. RESULTS All nine ATG16L1 gene variants analyzed displayed highly significant associations with CD demonstrating a CD-protective effect for the minor allele. The strongest associations were found for rs2241879 and the coding SNP rs2241880 (T300A); P= 3.6 x 10(-6) and 3.7 x 10(-6), respectively (OR 0.74, 95% CI 0.65-0.84 for both variants). The genotype-phenotype analysis revealed no significant associations. In UC, only rs6431660 was weakly disease-associated. There was no evidence for epistasis between the ATG16L1 gene and other susceptibility genes (IL23R, CARD15, SLC22A4/5). ATG16L1 mRNA expression was not upregulated in CD and murine ileitis, and was less than threefold increased in cells stimulated with proinflammatory cytokines and TLR ligands. CONCLUSION ATG16L1 is a CD susceptibility gene without epistatic interaction with other CD susceptibility genes and is not upregulated in intestinal inflammation.
Collapse
Affiliation(s)
- Jürgen Glas
- Department of Medicine II-Grosshadern, University of Munich, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Glas J, Seiderer J, Wetzke M, Konrad A, Török HP, Schmechel S, Tonenchi L, Grassl C, Dambacher J, Pfennig S, Maier K, Griga T, Klein W, Epplen JT, Schiemann U, Folwaczny C, Lohse P, Göke B, Ochsenkühn T, Müller-Myhsok B, Folwaczny M, Mussack T, Brand S. rs1004819 is the main disease-associated IL23R variant in German Crohn's disease patients: combined analysis of IL23R, CARD15, and OCTN1/2 variants. PLoS One 2007; 2:e819. [PMID: 17786191 PMCID: PMC1950565 DOI: 10.1371/journal.pone.0000819] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2007] [Accepted: 08/04/2007] [Indexed: 01/08/2023] Open
Abstract
Background The IL23R gene has been identified as a susceptibility gene for inflammatory bowel disease (IBD) in the North American population. The aim of our study was to test this association in a large German IBD cohort and to elucidate potential interactions with other IBD genes as well as phenotypic consequences of IL23R variants. Methods Genomic DNA from 2670 Caucasian individuals including 833 patients with Crohn's disease (CD), 456 patients with ulcerative colitis (UC), and 1381 healthy unrelated controls was analyzed for 10 IL23R SNPs. Genotyping included the NOD2 variants p.Arg702Trp, p.Gly908Arg, and p.Leu1007fsX1008 and polymorphisms in SLC22A4/OCTN1 (1672 C→T) and SLC22A5/OCTN2 (–207 G→C). Results All IL23R gene variants analyzed displayed highly significant associations with CD. The strongest association was found for the SNP rs1004819 [P = 1.92×10−11; OR 1.56; 95 % CI (1.37–1.78)]. 93.2% of the rs1004819 TT homozygous carriers as compared to 78% of CC wildtype carriers had ileal involvement [P = 0.004; OR 4.24; CI (1.46–12.34)]. The coding SNP rs11209026 (p.Arg381Gln) was protective for CD [P = 8.04×10−8; OR 0.43; CI (0.31–0.59)]. Similar, but weaker associations were found in UC. There was no evidence for epistasis between the IL23R gene and the CD susceptibility genes CARD15 and SLC22A4/5. Conclusion IL23R is an IBD susceptibility gene, but has no epistatic interaction with CARD15 and SLC22A4/5. rs1004819 is the major IL23R variant associated with CD in the German population, while the p.Arg381Gln IL23R variant is a protective marker for CD and UC.
Collapse
Affiliation(s)
- Jürgen Glas
- Department of Medicine II - Grosshadern, University of Munich, Munich, Germany
- Clinic for Preventive Dentistry and Parodontology, University of Munich, Munich, Germany
| | - Julia Seiderer
- Department of Medicine II - Grosshadern, University of Munich, Munich, Germany
| | - Martin Wetzke
- Department of Medicine II - Grosshadern, University of Munich, Munich, Germany
- Clinic for Preventive Dentistry and Parodontology, University of Munich, Munich, Germany
| | - Astrid Konrad
- Department of Medicine II - Grosshadern, University of Munich, Munich, Germany
| | - Helga-Paula Török
- Department of Medicine II - Grosshadern, University of Munich, Munich, Germany
| | - Silke Schmechel
- Department of Medicine II - Grosshadern, University of Munich, Munich, Germany
| | - Laurian Tonenchi
- Clinic for Preventive Dentistry and Parodontology, University of Munich, Munich, Germany
| | - Christine Grassl
- Clinic for Preventive Dentistry and Parodontology, University of Munich, Munich, Germany
| | - Julia Dambacher
- Department of Medicine II - Grosshadern, University of Munich, Munich, Germany
| | - Simone Pfennig
- Department of Medicine II - Grosshadern, University of Munich, Munich, Germany
| | - Kerstin Maier
- Clinic for Preventive Dentistry and Parodontology, University of Munich, Munich, Germany
| | - Thomas Griga
- Department of Internal Medicine, Knappschaftskrankenhaus Dortmund, Dortmund, Germany
| | - Wolfram Klein
- Department of Human Genetics, Ruhr-University Bochum, Bochum, Germany
| | - Jörg T. Epplen
- Department of Human Genetics, Ruhr-University Bochum, Bochum, Germany
| | - Uwe Schiemann
- Department of General Internal Medicine, Inselspital Bern, Bern, Switzerland
| | | | - Peter Lohse
- Institute of Clinical Chemistry, Grosshadern, University of Munich, Munich, Germany
| | - Burkhard Göke
- Department of Medicine II - Grosshadern, University of Munich, Munich, Germany
| | - Thomas Ochsenkühn
- Department of Medicine II - Grosshadern, University of Munich, Munich, Germany
| | | | - Matthias Folwaczny
- Clinic for Preventive Dentistry and Parodontology, University of Munich, Munich, Germany
| | - Thomas Mussack
- Department of Surgery, University of Munich, Munich, Germany
| | - Stephan Brand
- Department of Medicine II - Grosshadern, University of Munich, Munich, Germany
- * To whom correspondence should be addressed. E-mail:
| |
Collapse
|
8
|
Folwaczny C. [Efficient diagnostics for elevated transaminases]. MMW Fortschr Med 2007; 149:44-8; quiz 49. [PMID: 17703692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The diagnosis of the cause of elevated transaminases is carried out stepwise. First, a medical history is taken and a physical examination and sonography of the abdomen are performed. The second step includes laboratory tests for chronic hepatitis B and C, hereditary haemochromatosis, Wilson's disease, autoimmune hepatitis and alpha-1-antitrypsin deficiency. The third step comprises the identification of possible extrahepatic causes. Serological tests to exclude celiac disease should be first carried out when TSH and CK values do not yield an indicative finding.
Collapse
Affiliation(s)
- C Folwaczny
- Arztehaus Harlaching, Isenschmidstr. 19, D-81545 München.
| |
Collapse
|
9
|
Glas J, Török HP, Tonenchi L, Wetzke M, Beynon V, Teshome MY, Cotofana S, Schiemann U, Griga T, Klein W, Epplen JT, Folwaczny C, Folwaczny M, Mussack T, Weiss EH. The 14-bp deletion polymorphism in the HLA-G gene displays significant differences between ulcerative colitis and Crohn's disease and is associated with ileocecal resection in Crohn's disease. Int Immunol 2007; 19:621-6. [PMID: 17446213 DOI: 10.1093/intimm/dxm027] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
HLA-G is a non-classical MHC class Ib molecule predominantly expressed in cytotrophoblasts and under pathological conditions also in chronically inflamed and in malignant tissues. Recently an increased expression of HLA-G was found in ulcerative colitis (UC), but not in Crohn's disease (CD). The HLA-G gene is located in IBD3, a linkage region for inflammatory bowel disease (IBD). A 14-bp deletion polymorphism (Del+/Del-) within exon 8 of the HLA-G gene might influence transcription activity and is therefore of potential functional relevance. To investigate whether the 14-bp deletion polymorphism is associated with IBD, 371 patients with CD, 257 patients with UC and 739 controls were genotyped. The heterozygous genotype (P = 0.031) and the Del+ phenotype (P = 0.038) were significantly increased, whereas the homozygous Del- phenotype (P = 0.038) was significantly decreased in UC when compared with CD. Thus, the 14-bp deletion polymorphism within the HLA-G gene displayed significant differences between UC and CD. Moreover, a significant increase of the Del+ allele (P = 0.002) and the Del+/Del+ genotype (P = 0.013) and a consecutive decrease of the Del-/- genotype (P = 0.024) were observed in those CD cases positive for ileocecal resection. Thus, a potential effect of the HLA-G gene in IBD may affect both UC and CD. Other polymorphisms linked to the 14-bp deletion polymorphism might also contribute to immunopathogenesis. As there are several partly functional polymorphisms within the promoter region potentially influencing HLA-G expression, further studies in IBD are necessary in the context of differential expression of HLA-G between UC and CD.
Collapse
Affiliation(s)
- Jürgen Glas
- Chirurgische Klinik und Poliklinik-Innenstadt, Klinikum der Universität München, Munich, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
|
11
|
Török HP, Glas J, Lohse P, Folwaczny C. Genetic variants and the risk of Crohn's disease: what does it mean for future disease management? Expert Opin Pharmacother 2006; 7:1591-602. [PMID: 16872262 DOI: 10.1517/14656566.7.12.1591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Genetic research in inflammatory bowel disease, especially in Crohn's disease, has made significant progress during recent years. There have been > 10 total genome scans that have been performed, and susceptibility loci on several chromosomes have been identified. Together with candidate gene studies, these scans have led to the identification of several susceptibility genes, with CARD15 being the most important. These genetic data have already provided important insights into the pathophysiology of inflammatory bowel disease and are stimulating future research. On the other hand, genotype-phenotype associations have illustrated the heterogenic nature of the disease. Although the clinical application of this knowledge is so far limited, there is significant optimism that an individual management of patients based on genetic data will be possible in the near future.
Collapse
Affiliation(s)
- Helga-Paula Török
- Department of Surgery Innenstadt, Ludwig-Maximilians University, Nussbaumstrasse 20, D-80336 Munich, Germany.
| | | | | | | |
Collapse
|
12
|
Glas J, Török HP, Tonenchi L, Hamann S, Malachova O, Euba A, Folwaczny C, Folwaczny M. A645G (Lys216Glu) polymorphism of the bactericidal/permeability-increasing protein gene in periodontal disease. Int J Immunogenet 2006; 33:255-60. [PMID: 16893388 DOI: 10.1111/j.1744-313x.2006.00608.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Bactericidal/permeability-increasing protein (BPI) is a member of the pattern recognition receptors of the innate immune system and recognizes lipopolysaccharides (LPS), a bacterial component belonging to the pathogen-associated molecular patterns (PAMPs). BPI mediates the neutralization of LPS and increases the phagocytosis and cytotoxicity against bacteria. Recently, the functionally effective polymorphism A645G resulting in the amino acid alteration Lys216Glu has been described. The aim of the study was to investigate the association of the A645G polymorphism with chronic periodontal disease. The study population comprised 123 patients with periodontal disease (36 with mild, 52 with moderate and 35 with severe periodontitis) and 122 healthy, unrelated control individuals. Genotyping of the BPI gene polymorphism A645G (Lys216Glu) was performed by polymerase chain reaction and restriction fragment length polymorphism analysis. Statistical analysis was carried out employing the chi(2) test with Yates correction. Genotype and allele frequencies of the polymorphism tested herein showed no significant differences between periodontal disease as compared to the control group. The frequencies of the G allele were 52.4% in patients with periodontal disease and 49.2% in the control individuals (P = 0.528). Moreover, no significant associations could be detected after stratification for disease severity and according to gender. The present study does not give evidence for the contribution of the BPI gene to the genetic background of chronic periodontal disease.
Collapse
Affiliation(s)
- J Glas
- Poliklinik für Zahnerhaltung und Parodontologie, Ludwig-Maximilians Universität, München, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Glas J, Török HP, Tonenchi L, Müller-Myhsok B, Mussack T, Wetzke M, Klein W, Epplen JT, Griga T, Schiemann U, Lohse P, Seiderer J, Schnitzler F, Brand S, Ochsenkühn T, Folwaczny M, Folwaczny C. Role of the NFKB1 -94ins/delATTG promoter polymorphism in IBD and potential interactions with polymorphisms in the CARD15/NOD2, IKBL, and IL-1RN genes. Inflamm Bowel Dis 2006; 12:606-11. [PMID: 16804398 DOI: 10.1097/01.ibd.0000225346.23765.6b] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Recently, an association of the NFKB1 polymorphism -94ins/delATTG with ulcerative colitis (UC) has been reported. This 4-bp insertion/deletion polymorphism is localized in the promoter region of the NFKB1 gene and appears to be functionally relevant. The aim of the present study was to confirm the association of the -94ins/delATTG (W/D) NFKB1 promoter polymorphism with UC in a population of German origin and to test for a potential association with Crohn's disease (CD). Furthermore, potential interactions of the -94ins/delATTG polymorphism with the IKBL and the IL-1RN genes should be determined. MATERIALS AND METHODS The study population comprised 630 patients with CD, 365 patients with UC, and 974 healthy controls. Genotyping was performed using polymerase chain reaction and restriction fragment length polymorphism analysis. For statistical evaluation, the chi-square test and the Fisher exact test were used. RESULTS No significant association of the W/D NFKB1 polymorphism with CD or UC was detected. In addition, no significant interactions between the -94ins/delATTG NFKB1 polymorphism and polymorphisms within the IKBL and the IL-1RN genes, respectively, were found in CD or UC. Also, no significant interactions of the NFKB1 polymorphism with mutations of the CARD15/NOD2 gene and with clinical phenotypes were detected in CD. Moreover, no associations of the NFKB1 polymorphism were found in UC depending on disease localization. CONCLUSIONS The present study could not confirm the reported association of the -94ins/delATTG NFKB1 polymorphism with UC and also found no evidence for a role of this polymorphism in CD. The results do not give evidence for a role of this NFKB1 polymorphism in the pathogenesis of UC and CD.
Collapse
Affiliation(s)
- Jürgen Glas
- Chirurgische Klinik und Poliklinik-Innenstadt, München, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
|
15
|
Schneider D, Folwaczny C. [10 minute consultation. Crohn disease as suspected diagnosis]. MMW Fortschr Med 2006; 148:67-8. [PMID: 16805198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Affiliation(s)
- D Schneider
- Klinikum der Universität München, Chirurgische Klinik und Poliklinik-Innenstadt.
| | | |
Collapse
|
16
|
Schneider DD, Folwaczny C. [Not Available]. MMW Fortschr Med 2006; 148:67-68. [PMID: 27379767 DOI: 10.1007/bf03364656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Daniel D Schneider
- Chirurgische Klinik und Poliklinik-Innenstadt, Universität München (LMU), Nußbaumstr. 20, D-80336, München, Deutschland.
| | - C Folwaczny
- Chirurgische Klinik und Poliklinik-Innenstadt, Universität München (LMU), Nußbaumstr. 20, D-80336, München, Deutschland
| |
Collapse
|
17
|
Abstract
Dilatation of the colon and the rectum, which is not attributable to aganglionosis, is a rare finding and can be the result of intractable chronic constipation. We report a rare case of a 29-year-old male patient with impressive megacolon, in whom Hirschsprung's or Chagas disease was ruled out. In the present case, dilatation of the colon was most likely due to a behavioral disorder with habitual failure of defecation. Chronic stool retention led to a bizarre bulging of the large bowel with displacement of the other abdominal organs and severe occult blood loss. Because of two episodes of life-threatening gastrointestinal bleeding despite conventional treatment of constipation, a surgical approach for bowel restoration was necessary. Temporary loop ileostomy had to be performed for de-pressurization of the large bowel and the subsequent possibility for effective antegrade colonic lavage to remove impacted stools. Shortly after the operation, the patient was healthy and could easily manage the handling of the ileostomy. However, the course of the megacolon in this young adult cannot be predicted and the follow-up will have to reveal if regression of this extreme colonic distension with reestablishment of regular rectal perception will occur.
Collapse
Affiliation(s)
- Ingo Mecklenburg
- Department of Gastroenterology and Endoscopy, Medizinische Poliklinik, Klinikum Innenstadt, Ludwig-Maximilians-University, Pettenkoferstr. 8a, 80336 Munich, Germany
| | | | | | | | | |
Collapse
|
18
|
Schiemann U, Günther S, Gross M, Henke G, Müller-Koch Y, König A, Muders M, Folwaczny C, Mussack T, Holinski-Feder E. Preoperative serum levels of the carcinoembryonic antigen in hereditary non-polyposis colorectal cancer compared to levels in sporadic colorectal cancer. ACTA ACUST UNITED AC 2006; 29:356-60. [PMID: 16122885 DOI: 10.1016/j.cdp.2005.04.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2005] [Accepted: 04/01/2005] [Indexed: 11/16/2022]
Abstract
BACKGROUND Carcinoembryonic antigen (CEA) serves as the most widely used and most cost-effective tumor marker in colorectal cancer for almost 30 years. Recent publications about serum CEA levels are based on patient groups without definite differentiation between hereditary and non-hereditary forms of colorectal cancer. PATIENTS AND METHODS We compared preoperative CEA serum levels from 105 patients with hereditary non-polyposis colorectal cancer (HNPCC) and 107 patients with sporadic colorectal cancer including influences of age and Dukes stage. CEA values in cases of HNPCC were correlated to the findings of microsatellite analyses, mutation analyses of the MMR genes (MLH1, MSH2) and respective immunohistochemistries. RESULTS Thirty-three HNPCC patients (31%) and 37 patients with sporadic CRC (34%) revealed elevated CEA levels higher than 5 ng/ml. The mean preoperative CEA level in all Dukes stages of HNPCC patients was lower with 31.7 +/- 180 ng/ml than in sporadic colorectal cancer with 68.3 +/- 424 ng/ml, but without significance (p = 0.72). HNPCC tumors with signs of de-differentiation (G3 and G4) revealed significantly higher CEA values with 62.2 +/- 262 ng/ml in comparison to well-differentiated tumors (G1 and G2) with 5.0 +/- 9.6 ng/ml (p = 0.02). HNPCC patients with "classical characteristics" (high microsatellite instability (MSI), MMR gene mutation, loss of MMR protein expression) had lower preoperative CEA serum levels than those without equivalent genetic alterations, but without reaching statistical significance. CEA levels of HNPCC tumors increased significantly under occurrence of metastases with mean values of 170.3 +/- 343 (p < 0.02). CONCLUSIONS Normal preoperative serum CEA levels do not have the same validity for all colorectal cancer patients. Low CEA levels in HNPCC patients could occur due to well-differentiated tumors and should be considered more critically than in sporadic CRC patients. Further studies including comparison of postoperative CEA development are necessary to elucidate the importance of these results.
Collapse
|
19
|
Ebert MPA, Lendeckel U, Westphal S, Dierkes J, Glas J, Folwaczny C, Roessner A, Stolte M, Malfertheiner P, Röcken C. The angiotensin I-converting enzyme gene insertion/deletion polymorphism is linked to early gastric cancer. Cancer Epidemiol Biomarkers Prev 2006; 14:2987-9. [PMID: 16365022 DOI: 10.1158/1055-9965.epi-05-0411] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The insertion/deletion polymorphism of the angiotensin I-converting enzyme (ACE) gene has recently been linked to the pathogenesis and progression of human cancers. Using genomic DNA from 88 patients with early gastric cancer confined either to mucosa (pT(1a)) or submucosa (pT(1b)), we assessed the insertion (I) and deletion (D) polymorphism by PCR analysis and compared it with a large noncancer control population (n = 145). In the noncancer control group, the II genotype was observed in 33 (23%) individuals, whereas the ID and DD genotypes were found in 72 (50%) and 40 (27%) individuals, respectively. Interestingly, in the cancer group, we found the II genotype in six (7%) patients and the ID genotype in 46 (52%) individuals, whereas the DD genotype was observed in 36 (41%) individuals (P = 0.0034). Accordingly, the odds ratio for the II genotype was 0.20 [95% confidence interval (95% CI), 0.08-0.54; P = 0.009] and 0.55 for the ID/II genotype (95% CI, 0.31-0.96; P = 0.044) using the high-activity genotype DD as the reference category. No correlation was found among tumor type, tumor stage, the presence of Helicobacter pylori, and the ACE genotype. Our study provides further evidence that the ACE insertion/deletion gene polymorphism may be linked to the development of early gastric cancer.
Collapse
Affiliation(s)
- Matthias P A Ebert
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Magdeburg, Leipziger Strasse 44, D-39120 Magdeburg, Germany.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Török HP, Glas J, Hollay HC, Gruber R, Osthoff M, Tonenchi L, Brückl C, Mussack T, Folwaczny M, Folwaczny C. Serum antibodies in first-degree relatives of patients with IBD: a marker of disease susceptibility? A follow-up pilot-study after 7 years. Digestion 2006; 72:119-23. [PMID: 16172548 DOI: 10.1159/000088366] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2005] [Accepted: 07/25/2005] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Various disease-specific serum antibodies were described in patients with inflammatory bowel disease and their yet healthy first-degree relatives. In the latter, serum antibodies are commonly regarded as potential markers of disease susceptibility. The present long-term follow-up study evaluated the fate of antibody-positive first-degree relatives. PATIENTS AND METHODS 25 patients with Crohn's disease, 19 patients with ulcerative colitis and 102 first-degree relatives in whom presence of ASCA, pANCA, pancreatic- and goblet-cell antibodies had been assessed were enrolled. The number of incident cases with inflammatory bowel disease was compared between antibody-positive and antibody-negative first-degree relatives 7 years after storage of serum samples. RESULTS 34 of 102 (33%) first-degree relatives were positive for at least one of the studied serum antibodies. In the group of first-degree relatives, one case of Crohn's disease and one case of ulcerative colitis were diagnosed during the follow-up period. However, both relatives did not display any of the investigated serum antibodies (p=1). DISCUSSION The findings of our pilot study argue against a role of serum antibodies as a marker of disease susceptibility in first-degree relatives of patients with inflammatory bowel disease. However, these data have to await confirmation in larger ideally prospective multicenter studies before definite conclusions can be drawn.
Collapse
Affiliation(s)
- H P Török
- Chirurgische Klinik und Poliklinik-Innenstadt, München, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
|
22
|
Folwaczny M, Glas J, Török HP, Tonenchi L, Paschos E, Malachova O, Bauer B, Folwaczny C. Prevalence of the -295 T-to-C promoter polymorphism of the interleukin (IL)-16 gene in periodontitis. Clin Exp Immunol 2005; 142:188-92. [PMID: 16178875 PMCID: PMC1809474 DOI: 10.1111/j.1365-2249.2005.02902.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Interleukin (IL)-16 is involved in the regulation of the expression of several proinflammatory cytokines, i.e. tumour necrosis factor (TNF)alpha and interleukin (IL)-1beta. The present study aimed to determine the prevalence of the -295 promoter polymorphism of the interleukin (IL)-16 gene in periodontal disease. A total of 123 patients with periodontal disease and 122 healthy controls were genotyped for the -295 IL-16 promoter polymorphism. Genotyping has been performed by PCR and restriction fragment length polymorphism (RFLP) analysis. The frequencies of alleles and genotypes as well of haplotypes within both study groups were compared using the Pearson chi(2) test at a level of significance of 5% (P < 0.05). The distribution of genotypes for the -295 IL-16 gene polymorphism showed no significant difference between periodontitis patients and healthy control subjects (P = 0.886). Also stratification analysis according to the disease severity revealed no significant difference regarding the genotype distribution among both study groups. Herein the IL-16 -295 gene polymorphism was not associated with chronic periodontitis.
Collapse
Affiliation(s)
- M Folwaczny
- Poliklinik für Zahnerhaltung und Parodontologie, Standort Innenstadt, Ludwig-Maximilians Universität, München, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Glas J, Török HP, Daczo J, Tonenchi L, Folwaczny M, Folwaczny C. The leukocyte count predicts the efficacy of treatment with azathioprine in inflammatory bowel disease. Eur J Med Res 2005; 10:535-8. [PMID: 16356870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
INTRODUCTION Azathioprine has variable efficacy in inflammatory bowel disease. Previous studies suggested that either neutropenia, an increase in the mean corpuscular volume, the assessment of thiopurine methyl-transferase activity or erythrocyte 6-thioguanine values might predict the treatment response. However, due to the conflicting results of the preceding studies there are yet no established laboratory values which allow an estimation of the clinical response. PATIENTS AND METHODS 45 patients with Crohn's disease and 39 patients with ulcerative colitis were enrolled in this retrospective evaluation. After a minimum of six months therapy with azathioprine patients in remission were compared with those who did not achieve a stable remission with respect to the number of leucocytes, lymphocytes, neutrophil granulocytes and the mean corpuscular volume. RESULTS Patients who went into remission during treatment with azathioprine displayed significantly lower leukocyte counts if compared to patients who were not in remission (p = 0.004 in Crohn's disease and 0.003 in ulcerative colitis). A similar tendency was also observed with respect to the granulocyte count (p = 0.007 in Crohn's disease and 0.004 in ulcerative colitis). The mean corpuscular volume did not correlate with the response to purine analogues. DISCUSSION The absolute leukocyte count and the percentage of granulocytes seem to predict the response to purine analogues in inflammatory bowel disease and possibly offers a feasible and cost effective diagnostic tool for the assessment of therapeutic efficacy. Subsequent preferably prospective studies should aim to define the optimal cut-off value for the leukocyte count.
Collapse
Affiliation(s)
- J Glas
- Medizinische Poliklinik - Innenstadt, Germany
| | | | | | | | | | | |
Collapse
|
24
|
Glas J, Török HP, Tonenchi L, Kapser J, Schiemann U, Müller-Myhsok B, Folwaczny M, Folwaczny C. Association of polymorphisms in the interleukin-18 gene in patients with Crohn's disease depending on the CARD15/NOD2 genotype. Inflamm Bowel Dis 2005; 11:1031-7. [PMID: 16306764 DOI: 10.1097/01.mib.0000187574.41290.b1] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
UNLABELLED An increased expression of interleukin-18 (IL-18), a proinflammatory cytokine inducing interferon-gamma, has been found in Crohn's disease (CD). In the IL-18 gene, several partly functional relevant polymorphisms are known. This study sought to investigate associations of IL-18 polymorphisms in inflammatory bowel disease and CD according to CARD15/NOD2 mutation status and clinical phenotypes. METHODS The IL-18 polymorphisms -607, -137, and the third position of codon 35 (c35/3) were genotyped in 210 patients with CD, 140 patients with ulcerative colitis, and 265 healthy controls using polymerase chain reaction and restriction fragment length polymorphism analysis. RESULTS Frequencies of alleles and genotypes of the 3 polymorphisms and of the respective haplotypes and diplotypes displayed no significant differences between the whole groups of patients with CD and ulcerative colitis, respectively, compared with the controls. After stratification of patients with CD for CARD15/NOD2 status, significant associations of genotypes -137 CC (P = 0.018) and c35/3 CC (P = 0.010) and of the diplotype 2-2 (P = 0.018) were found in cases carrying CARD15/NOD2 mutations. Associations of genotypes -137 GG (P = 0.015) and c35/3 AA (P = 0.030) with colonic disease only in cases positive for CARD15/NOD2 mutations and of the genotype -607 AA (P = 0.007) with fistulas in cases negative for CARD15/NOD2 mutations were observed. CONCLUSIONS In this study, significant differences of several genotypes and diplotypes within the IL-18 gene in CD depending on CARD15/NOD2 status have been found. In context with an increased expression of IL-18 in CD, it remains to be shown whether the expression of IL-18 is influenced by CARD15/NOD2 mutation status.
Collapse
Affiliation(s)
- Jürgen Glas
- Medizinische Poliklinik-Innenstadt, Munich, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Beynon V, Török HP, Glas J, Schaaf A, Wagner S, Lohse P, Ochsenkühn T, Mussack T, Folwaczny M, Folwaczny C. Trägern von Mutationen in beiden CARD15-Allelen (double-dose-Mutationen) zeigen eine gestörte monozytäre Zytokinproduktion nach Stimulation mit MDP. Z Gastroenterol 2005. [DOI: 10.1055/s-2005-921805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
26
|
Glas J, Török HP, Tonenchi L, Kapser J, Schiemann U, Folwaczny M, Folwaczny C. Assoziation des Interleukin-18 (IL-18)-Gens beim Morbus Crohn in Abhängigkeit vom CARD15/NOD2-Status. Z Gastroenterol 2005. [DOI: 10.1055/s-2005-921798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
27
|
Török HP, Glas J, Tonenchi L, Schiemann U, Mussack T, Folwaczny C. Keine Assoziation des Polymorphismus Ala893Ser/Thr im MDR1-Gen mit chronisch-entzündlichen Darmerkrankungen. Z Gastroenterol 2005. [DOI: 10.1055/s-2005-921802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
28
|
Tonenchi L, Török HP, Glas J, Folwaczny C. Promotorpolymorphismen im Caspase 6-Gen bei chronisch-entzündlichen Darmerkrankungen. Z Gastroenterol 2005. [DOI: 10.1055/s-2005-921800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
29
|
Török HP, Glas J, Tonenchi L, Lohse P, Müller-Myhsok B, Limbersky O, Neugebauer C, Schnitzler F, Seiderer J, Tillack C, Brand S, Brünnler G, Jagiello P, Epplen JT, Griga T, Klein W, Schiemann U, Folwaczny M, Ochsenkühn T, Folwaczny C. Polymorphisms in the DLG5 and OCTN cation transporter genes in Crohn's disease. Gut 2005; 54:1421-7. [PMID: 15955786 PMCID: PMC1774699 DOI: 10.1136/gut.2005.066340] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS Recent data suggest identification of causal genetic variants for inflammatory bowel disease in the DLG5 gene and in the organic cation transporter (OCTN) cluster, both situated in previously described linkage regions. PATIENTS AND METHODS The polymorphisms in DLG5 (113 G-->A, 4136 C-->A, and DLG5_e26), SLC22A4 (1672 C-->T), and SLC22A5 (-207 G-->C) were assessed in 625 patients with Crohn's disease (CD), 363 patients with ulcerative colitis (UC), and 1012 healthy controls. Association with disease susceptibility, clinical phenotypes, and possible genetic interactions of these polymorphisms with disease associated CARD15/NOD2 mutations was analysed. RESULTS No significant association of DLG5 polymorphisms with CD or UC was observed. Homozygosity for the OCTN-TC haplotype was associated with an increased CD risk (OR = 1.65), which was even greater in the presence of CARD15 mutations. Genotype-phenotype analysis revealed that this association was particularly strong in patients with colonic disease. The TC haplotype was associated with non-fistulising non-fibrostenotic disease, an earlier age of disease onset, and reduced need for surgery. CONCLUSION Our observations argue against a role of DLG5 polymorphisms in the susceptibility for inflammatory bowel disease, whereas the OCTN polymorphisms are associated with CD. However, due to the comparable weak association observed herein, extended linkage disequilibrium analyses of these variants with the IBD5 haplotype tagged single nucleotide polymorphims might be advisable before definitive conclusions about their causative role in CD can be drawn.
Collapse
Affiliation(s)
- H-P Török
- Chirurgische Klinik und Poliklinik-Standort Innenstadt, and Medizinische Poliklinik-Standort Innenstadt, Ludwig-Maximilians-Universität München, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Török HP, Glas J, Beynon V, Folwaczny M, Folwaczny C. Persistent dyspeptic symptoms in long-standing ulcerative colitis. Inflamm Bowel Dis 2005; 11:951-2. [PMID: 16189428 DOI: 10.1097/01.mib.0000182870.68811.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
|
31
|
Affiliation(s)
- Jürgen Glas
- Medizinische Poliklinik, Innenstadt, Klinikum der Universität München, München, Germany
| | - Helga-Paula Török
- Chirurgische Klinik und Poliklinik, Innenstadt and Medizinische Poliklinik, Innenstadt, Klinikum der Universität München, München, Germany
| | - Christian Folwaczny
- Chirurgische Klinik und Poliklinik, Grosshadern, Klinikum der Universität München, München, Germany
| | - Agnes Schneider
- Institut für Pathologie, Klinikum Bayreuth, Bayreuth, Germany
| | - Manfred Stolte
- Institut für Pathologie, Klinikum Bayreuth, Bayreuth, Germany
| | - Günter Brünnler
- Labor für Immungenetik, Kinderklinik und Kinderpoliklinik, Klinikum der Universität München, München, Germany
| | - Ekehard D. Albert
- Labor für Immungenetik, Kinderklinik und Kinderpoliklinik, Klinikum der Universität München, München, Germany
| | - Reinhard Kopp
- Chirurgische Klinik und Poliklinik, Grosshadern, Klinikum der Universität München, München, Germany
| |
Collapse
|
32
|
Folwaczny C, Glas J, Folwaczny M, Török HP. Autologous hematopoietic stem cell transplantation in refractory Crohn's disease: a feasible therapeutic approach? Gastroenterology 2005; 128:2180; author reply 2180-1. [PMID: 15940662 DOI: 10.1053/j.gastro.2005.04.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
|
33
|
Abstract
OBJECTIVE To evaluate whether gastric scintigraphy with quantitative analysis of gastric peristalsis may be a useful tool for documenting the effects of prokinetic therapy. METHODS Gastric emptying was determined in eight patients with insulin dependent diabetes mellitus (IDDM) and nine patients with progressive systemic sclerosis (PSS) after ingestion of a semi-solid test meal. Fourier analysis of condensed images was used to evaluate contraction amplitudes of the entire stomach, as well as frequency and velocity of gastric contractions. Patients were studied twice, first under baseline conditions and then after 4 weeks of continuous oral prokinetic therapy with cisapride (10 mg t.i.d.). Findings were compared with data derived from 15 healthy controls. RESULTS At baseline conditions IDDM and PSS patients exhibited reduced gastric peristalsis and delayed emptying compared to controls. After 4 weeks of prokinetic treatment, gastric contraction amplitudes increased significantly, especially in the gastric corpus and the proximal stomach, associated with a slight improvement of gastric emptying. Changes in frequency and velocity of gastric contractions during prokinetic treatment correlated with the improvement of gastric motility and emptying. CONCLUSIONS Prokinetic therapy with cisapride stimulates gastric motility, and could be non-invasively monitored by scintigraphy. This radionuclide technique provides a number of relevant parameters of gastric function, such as gastric emptying, contraction amplitudes, frequency and velocity of gastric contractions, which give crucial insights into the mechanisms of action of prokinetic drugs.
Collapse
Affiliation(s)
- Rainer Linke
- Department of Nuclear Medicine, University of Munich, Germany.
| | | | | | | | | | | |
Collapse
|
34
|
Griga T, Wilkens C, Schmiegel W, Folwaczny C, Hagedorn M, Duerig N, Epplen J, Klein W. Association between the promoter polymorphism T/C at position -159 of the CD14 gene and anti-inflammatory therapy in patients with inflammatory bowel disease. Eur J Med Res 2005; 10:183-6. [PMID: 15946916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Immune response to intestinal bacteria and genetic predisposition seem to play a crucial role in the pathogenesis of inflammatory bowel disease. A single nucleotide polymorphism in the promoter of the lipopolysaccharide-receptor CD14 gene (T/C at position -159) has recently been described. To evaluate the role of the CD14 gene in anti-inflammatory therapy, the functionally relevant T(-159)-->C promoter polymorphism has been genotyped in 72 patients with inflammatory bowel disease and associated with the cumulative steroid dose. Cumulative corticosteroid dose was significantly higher in ulcerative colitis patients with the TT genotype (2447.7 +/- 927.0 mg/yr) compared with the CT genotype (142.3 +/- 142.3 mg/yr, p=0.016) and the CC genotype (391.7 +/- 272.7 mg/yr, p=0.047). In contrast, in patients with Crohn's disease there was no significant difference of the cumulative corticosteroid doses between the various T(-159)-->C promoter CD14 genotypes. An altered immune response to lipopolysaccharides with influence on the anti-inflammatory therapy seems to play a role in the genetic predisposition to ulcerative colitis. Genetic stratification will lead to the development of individualized therapies in inflammatory bowel disease.
Collapse
Affiliation(s)
- T Griga
- Department of Gastroenterology, University Hospital Bergmannsheil, Bürkle-de-la-Camp-Platz 1, D-44789 Bochum, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Folwaczny M, Glas J, Török HP, Tonenchi L, Paschos E, Bauer B, Limbersky O, Folwaczny C. Polymorphisms of the interleukin-18 gene in periodontitis patients. J Clin Periodontol 2005; 32:530-4. [PMID: 15842270 DOI: 10.1111/j.1600-051x.2005.00711.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Interleukin (IL)-18 regulates the expression of the proinflammatory cytokine interferon (IFN)-gamma. The present study sought to test the putative involvement of six different IL-18 gene polymorphisms in pre-disposition to destructive periodontal disease. METHODS A total of 123 patients with periodontitis and 121 healthy controls were genotyped for six IL-18 polymorphisms at position -656, -607, -137, +113, +127 and codon 35/3. Genotyping has been performed by PCR and restriction fragment length polymorphism analysis. The frequencies of alleles and genotypes as well of haplotypes within both study groups were compared using the Pearson Chi-square test at a level of significance of 5% (p<0.05). RESULTS Coseggregation was found to be 100% for the two polymorphisms at position -656 and -607 as well as for the polymorphisms at position -137, +113, and +127. The distribution of genotypes for the IL-18 gene polymorphism at position -656/-607 (p=0.854), at position -137/+113/+127 (p=0.320), and at codon 35/3 (p=0.481) was not significantly different among periodontitis patients if compared with healthy control subjects. The distribution of haplotype combinations for the -607 and -137 polymorphism also showed not significant difference between the both study groups (p=0.545). CONCLUSION Herein the six different IL-18 gene polymorphisms were not associated with destructive periodontal disease.
Collapse
Affiliation(s)
- Matthias Folwaczny
- Poliklinik für Zahnerhaltung und Parodontologie, Standort Innenstadt, München, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Klein W, Tromm A, Folwaczny C, Hagedorn M, Duerig N, Epplen J, Schmiegel W, Griga T. A polymorphism of the bactericidal/permeability increasing protein (BPI) gene is associated with Crohn's disease. J Clin Gastroenterol 2005; 39:282-3. [PMID: 15758620 DOI: 10.1097/01.mcg.0000155127.20290.07] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
BACKGROUND The bactericidal/permeability increasing protein (BPI) is involved in the elimination of gram-negative bacteria. A functionally relevant single nucleotide polymorphism of the BPI gene causes an amino acid exchange (Glu216Lys). STUDY To evaluate whether this single nucleotide polymorphism contributes to the predisposition to inflammatory bowel disease, we compared the allele frequencies of 265 patients with Crohn's disease, 207 patients with ulcerative colitis, and 608 healthy controls. RESULTS The Glu/Glu genotype frequency was decreased significantly in Crohn's disease patients as compared with controls (P < 0.027). No differences were obvious in patients with ulcerative colitis. CONCLUSIONS Failure of the innate intestinal immune system could be involved in the pathogenesis of Crohn's disease via reduced/impaired defense against gram-negative bacteria.
Collapse
Affiliation(s)
- Wolfram Klein
- Department of Human Genetics, Ruhr-University, Bochum, Germany
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Issing WJ, Karkos PD, Perreas K, Folwaczny C, Reichel O. Dual-probe 24-hour ambulatory pH monitoring for diagnosis of laryngopharyngeal reflux. J Laryngol Otol 2005; 118:845-8. [PMID: 15638969 DOI: 10.1258/0022215042703660] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Patients with gastroesophageal reflux disease may suffer from a variety of symptoms from the upper aerodigestive tract. The objective of this study was to determine the impact of dual-probe 24-hr pH monitoring in the diagnosis of reflux-related otolaryngological disorders. METHODS Twenty-two patients with symptoms such as chronic cough, globus pharyngeus, heartburn, dysphonia and burning sensation of the tongue underwent a complete ear, nose and throat examination, 24-hr dual-probe pH monitoring, and oesophago-gastro-duodenoscopy. RESULTS pH monitoring revealed gastroesophageal (distal) reflux in all patients and pharyngeal (proximal) reflux in 21 patients. Treatment consisted of a proton pump inhibitor (esomeprazole). Within 4 weeks 68 per cent of patients had no laryngopharyngeal symptoms; within 8 weeks 95 per cent of patients were symptom-free. CONCLUSIONS Patients with atypical reflux symptoms such as hoarseness, globus sensation or throat-clearing responded well to anti-reflux treatment.
Collapse
Affiliation(s)
- W J Issing
- Department of Otolaryngology, The Freeman Hospital, Newcastle Upon Tyne NE7 7DN, UK.
| | | | | | | | | |
Collapse
|
38
|
Klein W, Tromm A, Folwaczny C, Hagedorn M, Duerig N, Epplen J, Schmiegel W, Griga T. The G2964A polymorphism of the STAT6 gene in inflammatory bowel disease. Dig Liver Dis 2005; 37:159-61. [PMID: 15888279 DOI: 10.1016/j.dld.2004.10.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2004] [Accepted: 10/21/2004] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Linkage of inflammatory bowel diseases to chromosome 12p13.2-q24.1 (IBD2) has been confirmed in several genome wide screens. The STAT6 gene is located within this chromosomal region. The transcription factor STAT6 is involved in the regulation of the TH1/TH2 immune response. Increased production of TH1 cytokines is crucial in the pathogenesis of Crohn's disease. PATIENTS AND METHODS Therefore, we genotyped a single nucleotide polymorphism in the 3' untranslated region of the STAT6 gene (G2964A) in 243 patients with Crohn's disease, 100 patients with ulcerative colitis and 548 healthy controls. RESULTS In comparison to controls, the G allele and the GG genotype frequencies were significantly increased only in Crohn's disease patients without a variation in the CARD15 gene (p<0.03 and p<0.02, respectively). CONCLUSIONS Alterations in the STAT6 pathway may play a crucial role in the pathogenesis of distinct subgroups of patients with Crohn's disease.
Collapse
Affiliation(s)
- W Klein
- Department of Human Genetics, Ruhr-University, 44780 Bochum, Germany
| | | | | | | | | | | | | | | |
Collapse
|
39
|
|
40
|
Glas J, Török HP, Schneider A, Brünnler G, Kopp R, Albert ED, Stolte M, Folwaczny C. Allele 2 of the interleukin-1 receptor antagonist gene is associated with early gastric cancer. J Clin Oncol 2005; 22:4746-52. [PMID: 15570075 DOI: 10.1200/jco.2004.03.034] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE In advanced gastric cancer (tumor stages T2-T4), associations with polymorphisms of the interleukin-1 (IL-1) gene cluster have been made. In early-stage gastric cancer, which we defined as adenocarcinoma confined to the mucosa or submucosa (stage T1), the role of host genetic susceptibility remains to be determined. PATIENTS AND METHODS Eighty-eight patients with early-stage gastric cancer (stage T1, 77 positive for Helicobacter pylori) and 145 controls were genotyped for polymorphisms in the IL-1 gene cluster and the tumor necrosis factor alpha (TNF-A) gene. Statistical analysis was performed using the chi2 test and the Fisher's exact test, respectively. RESULTS The homozygous genotype IL-1RN*2/2 of the IL-RN gene was strongly associated with early-stage gastric cancer (P < .0001), whereas further associations with the IL-1 gene cluster were not observed. A weak association of the TNF-A-308A allele with the diffuse type of early-stage gastric cancer, and an association with a composite of two or three proinflammatory polymorphisms, which predispose to increased production of the proinflammatory cytokines IL-1beta and TNF-alpha, could also be demonstrated. CONCLUSION The genotype IL-1RN*2/2 seems to be associated with early-stage gastric cancer. As opposed to advanced-stage gastric cancer, further proinflammatory cytokine polymorphisms were not associated independently, but might act in combination and mirror early steps of gastric carcinogenesis in hosts colonized by Helicobacter pylori. However, these findings await confirmation in future trials and should be underscored by gene expression studies.
Collapse
Affiliation(s)
- Jürgen Glas
- Medizinische Poliklinik, Chirurgische Klinik und Poliklinik, Klinikum der Universität München, Standort Innenstadt, Germany
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Abstract
Potential implications of antibody markers in Crohn's disease: Diagnostic markers, alone or in conjunction with other antibodies? Delineation of clinical phenotypes? Markers of disease behaviour? Markers of (genetic) susceptibility? Identification of genetically homogenous subgroups? Bridge between basic science and clinic? The exact role of serum antibodies in inflammatory bowel disease remains a matter of ongoing debate. Although a direct implication in the disease pathogenesis is unlikely, their diagnostic potential in cases of an undetermined colitis or in defining clinical phenotypes in Crohn's disease has been shown in several studies. Serum antibodies might also be helpful in predicting the disease behaviour and are thus valuable tools in the choice of medical or surgical therapy.
Collapse
Affiliation(s)
- H-P Török
- Medizinische Poliklinik, Chirurgische Klinik und Poliklinik, Klinikum der Universität-Standort Innenstadt, Ludwig-Maximilians University, München, Germany
| | | |
Collapse
|
42
|
Greth J, Török HP, Koenig A, Folwaczny C. Comparison of inflammatory bowel disease at younger and older age. Eur J Med Res 2004; 9:552-4. [PMID: 15689301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
OBJECTIVE In a substantial number of patients inflammatory bowel disease develops past the age of 40 years. However, data about the clinical presentation and disease behaviour in this age group are scarce. METHODS The following parameters were evaluated retrospectively in 191 consecutive patients with inflammatory bowel disease: Gender, age at diagnosis, leading symptoms, disease localization and behaviour (e. g. fistulizing, fibrostenotic or inflammatory), extraintestinal manifestations, medication, smoking habits, dysplasia, cancer and mortality. RESULTS In 16 % of patients inflammatory bowel disease had been diagnosed past the age of 40 years. In elderly patients with ulcerative colitis male gender was predominant. Diarrhea, abdominal pain and anaemia were observed more frequently in younger patients, whereas the remainder of parameters showed an equal distribution in both age groups. CONCLUSIONS Younger patients are frequently afflicted by symptoms which potentially impair the quality of life. However, in this retrospective single center evaluation the disease localization and behaviour of inflammatory bowel disease in elderly patients was comparable to young adults. Due to a potential referral bias, these data await confirmation in larger prospective multicenter trials.
Collapse
Affiliation(s)
- J Greth
- Medizinische Poliklinik, Standort- Innenstadt, Klinikum der Ludwig-Maximilians Universität, München, Germany
| | | | | | | |
Collapse
|
43
|
Török HP, Glas J, Gruber R, Brumberger V, Strasser C, Kellner H, Märker-Hermann E, Folwaczny C. Inflammatory bowel disease-specific autoantibodies in HLA-B27-associated spondyloarthropathies: increased prevalence of ASCA and pANCA. Digestion 2004; 70:49-54. [PMID: 15308872 DOI: 10.1159/000080081] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2003] [Accepted: 06/22/2004] [Indexed: 02/04/2023]
Abstract
AIMS An association between inflammatory bowel disease (IBD) and spondyloarthropathies (SpA) has repeatedly been reported. The aim of the present study was to investigate whether serologic markers of IBD, e.g. antibodies against Saccharomyces cerevisiae (ASCA), antibodies against exocrine pancreas (PAB) and perinuclear antineutrophil cytoplasmic antibodies (pANCA) are present in HLA-B27-associated SpA. METHODS 87 patients with HLA-B27-positive SpA and 145 controls were tested for ASCA, PAB and pANCA employing ELISA or indirect immunofluorescence, respectively. Antibody-positive patients were interviewed regarding IBD-related symptoms using a standardized questionnaire. RESULTS/CONCLUSION When compared to the controls, ASCA IgA but not ASCA IgG levels were significantly increased in patients with SpA, in particular in ankylosing spondylitis (AS) and undifferentiated SpA (uSpA). pANCA were found in increased frequency in patients with SpA whereas PAB were not detected. The existence of autoantibodies was not associated with gastrointestinal symptoms but sustains the presence of a pathophysiological link between bowel inflammation and SpA.
Collapse
Affiliation(s)
- H-P Török
- Medizinische Poliklinik, Ludwig-Maximilians-Universität, München, Germany
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Abstract
BACKGROUND A single-nucleotide promoter polymorphism in the CD14 gene was associated with various inflammatory conditions. The present study sought to determine the frequency of the CD14 -159C-to-T polymorphism among subjects with periodontitis and healthy control individuals. METHODS A total of 70 patients with periodontal disease and 75 healthy controls were genotyped for the CD14 -159C-to-T polymorphism. Genotyping was performed by polymerase chain reaction and restriction fragment length polymorphism analysis. The allele frequencies and distribution of genotypes within both study groups were compared using Fisher's exact test at a level of significance of 5% (p<0.05). RESULTS Overall, the frequency for the CD14 -159T allele in patients with periodontitis was 39.3% (55/140) and 48.0% (72/150) for the controls (p=0.135). The CD14 -159C allele was significantly more prevalent (p=0.013) among females with periodontitis (33.3%; 24/72) as compared with healthy control subjects (55.6%; 30/54). In contrast, the distribution of the CD14 -159C-to-T polymorphism showed no significant difference among males with and without periodontitis (p=0.816). CONCLUSION Herein, the C -159T promoter polymorphism of the CD14 gene was associated in female but not in male patients with periodontal disease.
Collapse
Affiliation(s)
- Matthias Folwaczny
- Poliklinik für Zahnerhaltung und Parodontologie, Ludwig-Maximilians Universität, München, Germany.
| | | | | | | | | |
Collapse
|
45
|
Mussack T, Siveke JT, Pfeifer KJ, Folwaczny C. Klippel-Trenaunay syndrome with involvement of coecum and rectum: a rare cause of lower gastrointestinal bleeding. Eur J Med Res 2004; 9:515-7. [PMID: 15649861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
Klippel-Trenaunay syndrome (KTS) is a congenital malformation usually presenting limb asymmetry, abnormal development of the deep and superficial veins, and cutaneous capillary malformations. We describe the case of a 56-year-old male KTS patient who suffered from recurrent but life non-threatening lower gastrointestinal bleeding. Colonoscopy revealed multiple extensive cavernous hemangiomas in the coecum and the ascending colon as well as the sigmoid colon and the rectum. MR imaging showed numerous dilated vessels within the left gluteal and inguinal region. The mucosal and the submucosal layers particularly of the sigmoid colon and rectum appeared markedly broadened and displayed high signal intensities in the STIR sequences. Due to only moderate oozing at time of admission the patient was treated with oral iron supplementation so far.
Collapse
Affiliation(s)
- Thomas Mussack
- Department of Surgery Innenstadt, Klinikum der Universität München, Nussbaumstrasse 20, D-80336 Munich, Germany.
| | | | | | | |
Collapse
|
46
|
Abstract
Although standard medical therapy in Crohn's disease is efficient in most patients, a substantial proportion of patients suffering from chronic active disease do not adequately respond to standard therapy. In these patients, alternative regimens have to be considered. Due to the major advances in understanding the pathogenesis of this complex disease involving genetic, environmental, microbial and immunological factors, various new biological therapies targeting key mechanisms have emerged. In this review, a critical appraisal of modern therapeutical concepts will be presented, focusing on antibody and small inhibitory molecule therapies, including inhibition of TNF-alpha and other pro-inflammatory cytokines, adhesion molecules and T cell activation, as well as hormonal therapies.
Collapse
Affiliation(s)
- J T Siveke
- II. Med. Klinik, Klinikum rechts der Isar Technische Universität München, Germany
| | | |
Collapse
|
47
|
|
48
|
Török HP, Glas J, Tonenchi L, Mussack T, Folwaczny C. Polymorphisms of the lipopolysaccharide-signaling complex in inflammatory bowel disease: association of a mutation in the Toll-like receptor 4 gene with ulcerative colitis. Clin Immunol 2004; 112:85-91. [PMID: 15207785 DOI: 10.1016/j.clim.2004.03.002] [Citation(s) in RCA: 163] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2004] [Revised: 03/02/2004] [Accepted: 03/02/2004] [Indexed: 12/17/2022]
Abstract
Genes encoding for receptors of the innate immune system are potential candidates for susceptibility to inflammatory bowel disease, e.g., mutations in the cytosolic receptor NOD2/CARD15 were associated with Crohn's disease. Herein, two mutations of the Toll-like receptor (TLR)-4 gene (Asp299Gly and Thr399Ile) resulting in impaired lipopolysaccharide signaling, the -159C/T promotor polymorphism of the CD14 gene, polymorphisms of the lipopolysaccharide binding protein gene and the bactericidal permeability increasing protein gene were evaluated in 102 patients with Crohn's disease, 98 patients with ulcerative colitis and 145 healthy controls. The allele and carrier frequencies for the Thr399Ile mutation in TLR4 gene were significantly increased in ulcerative colitis when compared to the controls (P = 0.014 and P = 0.018, respectively). None of the other five polymorphisms was associated with inflammatory bowel disease. In conclusion, a novel association between a functional polymorphism in TLR4 and ulcerative colitis is reported. This observation underscores the importance of impaired innate immunity in inflammatory bowel disease.
Collapse
Affiliation(s)
- Helga-Paula Török
- Medizinische Klinik und Medizinische Poliklinik, Standort Innenstadt, Klinikum der Universität München, 80336 Munich, Germany.
| | | | | | | | | |
Collapse
|
49
|
Abstract
The 3020insC mutation of the NOD2/CARD15 gene leads to impaired activation of nuclear factor-kappa B (NF-kappaB) in vitro. As the destruction of periodontal tissue is mediated via activation of NF-kappaB, with subsequent transcription of proinflammatory cytokines, the c-insertion mutation of the NOD2/CARD15 gene might contribute to the proposed genetic background of periodontitis. The present study analysed the frequency of this mutation in 80 patients with chronic periodontal disease and 122 healthy controls. The 3020insC mutation was identified by employing the polymerase chain reaction followed by restriction fragment length polymorphism analysis. The prevalence of the 3020insC mutation of the NOD2/CARD15 protein in patients with periodontitis was 1.9% (three of 160) and that for the control group was 2.0% (five of 244) (P = 0.942). Hence, unlike in Crohn's disease, the 3020insC mutation of the NOD2/CARD15 gene does not seem to influence the pathophysiology of periodontitis.
Collapse
Affiliation(s)
- Matthias Folwaczny
- Poliklinik für Zahnerhaltung und Parodontologie, Ludwig-Maximilians Universität, München, Germany.
| | | | | | | | | |
Collapse
|
50
|
Abstract
BACKGROUND Immunosuppressive therapy employing purine analogues is the therapeutic mainstay in patients with chronic active ulcerative colitis. However, despite therapeutic optimization according to thiopurine-methyltransferase activity or red blood cell 6-thioguanine levels, a substantial proportion of patients does not tolerate azathioprine or 6-mercaptopurine or relapses during this treatment. In the latter multiple therapeutic regimens comprising 6-thioguanine, cyclosporin or tacrolimus, methotrexate, cyclophosphamide, infliximab, interferons, heparin, leukocyte apheresis, and various other regimens might be considered aiming at long-term remission. Many of these treatment forms have only been evaluated in small mostly uncontrolled trials. OBJECTIVE In this review existing treatment modalities and future options for patients with chronic active ulcerative colitis will be discussed focusing on immunomodulating approaches.
Collapse
Affiliation(s)
- J T Siveke
- II. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | | |
Collapse
|