1
|
Dragoni G, Innocenti T, Amiot A, Castiglione F, Melotti L, Festa S, Savarino EV, Truyens M, Argyriou K, Noviello D, Molnar T, Bouillon V, Bezzio C, Eder P, Fernandes S, Kagramanova A, Armuzzi A, Oliveira R, Viola A, Ribaldone DG, Drygiannakis I, Viganò C, Calella F, Gravina AG, Pugliese D, Chaparro M, Ellul P, Vieujean S, Milla M, Caprioli F. Rates of Adverse Events in Patients With Ulcerative Colitis Undergoing Colectomy During Treatment With Tofacitinib vs Biologics: A Multicenter Observational Study. Am J Gastroenterol 2024:00000434-990000000-01014. [PMID: 38305302 DOI: 10.14309/ajg.0000000000002676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 08/17/2023] [Accepted: 12/28/2023] [Indexed: 02/03/2024]
Abstract
INTRODUCTION Patients with ulcerative colitis (UC) receiving immunosuppressive drugs are at substantial risk of colectomy. We aimed to assess the risk of postoperative complications of tofacitinib exposure before colectomy in comparison with biologics. METHODS A multicenter, retrospective, observational study was conducted in patients with UC who underwent total colectomy for medically refractory disease, exposed to tofacitinib or a biologic before surgery. Primary outcome was the occurrence of any complication within 30 (early) and 90 (late) days after surgery. Secondary outcomes were the occurrence of infections, sepsis, surgical site complications, venous thromboembolic events (VTE), hospital readmissions, and redo surgery within the same timepoints. RESULTS Three hundred one patients (64 tofacitinib, 162 anti-tumor necrosis factor-α agents, 54 vedolizumab, and 21 ustekinumab) were included. No significant differences were reported in any outcome, except for a higher rate of early VTE with anti-tumor necrosis factor-α agents ( P = 0.047) and of late VTE with vedolizumab ( P = 0.03). In the multivariate analysis, drug class was not associated with a higher risk of any early and late complications. Urgent colectomy increased the risk of any early (odds ratio [OR] 1.92, 95% confidence interval [CI] 1.06-3.48) complications, early hospital readmission (OR 4.79, 95% CI 1.12-20.58), and early redo surgery (OR 7.49, 95% CI 1.17-47.85). A high steroid dose increased the risk of any early complications (OR 1.96, 95% CI 1.08-3.57), early surgical site complications (OR 2.03, 95% CI 1.01-4.09), and early redo surgery (OR 7.52, 95% CI 1.42-39.82). Laparoscopic surgery decreased the risk of any early complications (OR 0.54, 95% CI 0.29-1.00), early infections (OR 0.39, 95% CI 0.18-0.85), and late hospital readmissions (OR 0.34, 95% CI 0.12-1.00). DISCUSSION Preoperative tofacitinib treatment demonstrated a postoperative safety profile comparable with biologics in patients with UC undergoing colectomy.
Collapse
Affiliation(s)
- Gabriele Dragoni
- IBD Referral Centre, Careggi University Hospital, Florence, Italy
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence, Italy
| | - Tommaso Innocenti
- IBD Referral Centre, Careggi University Hospital, Florence, Italy
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence, Italy
| | - Aurelién Amiot
- Department of Gastroenterology, Henri Mondor University Hospital, Paris Est-Creteil University, Creteil, France
| | - Fabiana Castiglione
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
| | - Laura Melotti
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | | | | | - Marie Truyens
- Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
| | | | - Daniele Noviello
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Tamas Molnar
- Department of Gastroenterology, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Vincent Bouillon
- Department of Gastroenterology, Erasme University Hospital, Brussels, Belgium
| | - Cristina Bezzio
- IBD Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Medicine-Poznań University of Medical Sciences, Heliodor Święcicki University Hospital, Poznań, Poland
| | - Samuel Fernandes
- Department of Gastroenterology and Hepatology, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisboa, Portugal
- Clínica Universitária da Faculdade de Medicina de Lisboa, Lisboa, Portugal
| | - Anna Kagramanova
- Moscow Clinical Scientific Center named after A.S. Loginov, Moscow, Russian Federation
| | | | - Raquel Oliveira
- Gastroenterology Department, Algarve University Hospital Centre-Portimão Unit, Algarve, Portugal
| | - Anna Viola
- IBD-Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | | | - Ioannis Drygiannakis
- Department of Gastroenterology, University Hospital of Heraklion, Heraklion, Greece
| | - Chiara Viganò
- Division of Gastroenterology, Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Fondazione IRCCS San Gerardo dei Tintori, Monza, Italia
| | - Francesca Calella
- SOC Gastroenterologia ed endoscopia digestiva, Azienda USL Toscana Centro, Ospedale "San Giuseppe," Empoli, Italy
| | - Antonietta Gerarda Gravina
- Hepatogastroenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Daniela Pugliese
- CEMAD, IBD Unit, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - María Chaparro
- Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Madrid, Spain
| | - Pierre Ellul
- Department of Medicine, Division of Gastroenterology, Mater Dei Hospital, Msida, Malta
| | - Sophie Vieujean
- Hepato-Gastroenterology and Digestive Oncology, University Hospital CHU of Liège, Liège, Belgium
| | - Monica Milla
- IBD Referral Centre, Careggi University Hospital, Florence, Italy
| | - Flavio Caprioli
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
2
|
Nijakowski K, Motylewska B, Banasik E, Rutkowski R, Tsaryk V, Łuczak J, Korybalska K, Witowski J, Surdacka A, Eder P. Treatment regimens and disease activity could alter salivary myeloperoxidase levels in patients with inflammatory bowel diseases. Pol Arch Intern Med 2024; 134:16596. [PMID: 38164522 DOI: 10.20452/pamw.16596] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Inflammatory bowel diseases (IBDs) present with alternating periods of exacerbation and remission; therefore, it is necessary to develop noninvasive diagnostic tools to control the disease activity and improve therapeutic effectiveness. Recently, we have found that patients with ulcerative colitis (UC) who qualified for biologic therapy had significantly lower salivary myeloperoxidase (MPO) levels. OBJECTIVES This cross‑sectional study aimed to assess the impact of IBD activity and applied treatment on salivary antioxidant system as reflected by the levels of catalase, total antioxidant status, and MPO. PATIENTS AND METHODS The study group comprised 99 patients diagnosed with Crohn disease (CD) and 61 patients with UC. The Crohn Disease Activity Index and modified Mayo scale were used to estimate the clinical activity of CD and UC, respectively. Unstimulated whole mixed saliva was collected. Salivary levels of selected markers were measured with enzyme‑linked immunosorbent assays and colorimetric assays. RESULTS The patients with clinically active UC showed significantly decreased median (interquartile range) salivary MPO levels (79.4 [30.1-157.5] vs 94.8 [58.2-274.7] ng/ml) with significant correlations with the endoscopic stage on the Mayo scale (R = 0.423; P = 0.02). Receiver operating characteristic analysis confirmed a potential usefulness of MPO concentrations in predicting clinically active UC (area under the curve = 0.654; P = 0.03; cutoff <210.4 ng/ml). Moreover, in the patients treated with biologics and without steroid therapy, salivary MPO concentrations negatively correlated with neutrophil counts in the individuals with UC and positively with C‑reactive protein level in the patients with CD. CONCLUSIONS Salivary MPO levels changed depending on the disease activity in the patients with UC. Decreased MPO concentration in the saliva could be a predictor of clinically active UC.
Collapse
Affiliation(s)
- Kacper Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznań, Poland.
| | - Barbara Motylewska
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznań, Poland
| | - Estera Banasik
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznań, Poland
| | - Rafał Rutkowski
- Department of Pathophysiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Vasili Tsaryk
- Student’s Scientific Group, Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznań, Poland
| | - Joanna Łuczak
- Department of Pathophysiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Katarzyna Korybalska
- Department of Pathophysiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Janusz Witowski
- Department of Pathophysiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznań, Poland
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznań, Poland
| |
Collapse
|
3
|
Mahadea DS, Stawczyk-Eder K, Eder P, Zielecki P, Dobrowolska A, Łykowska-Szuber L. Atypical COVID-19-related erythema nodosum in a patient with ulcerative colitis treated with upadacitinib. Pol Arch Intern Med 2024; 134:16626. [PMID: 38095332 DOI: 10.20452/pamw.16626] [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] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
|
4
|
Geldof J, Truyens M, Hanssens M, Van Gucht E, Holvoet T, Elorza A, Bouillon V, Barros S, Martins V, Argyriou K, Potamianos S, Diculescu M, Stroie T, Bossuyt P, Moens A, Theodoraki E, Koutroubakis IE, Pedro J, Fernandes S, Nikolaou P, Karmiris K, Baert FJ, Ferreiro-Iglesias R, Peeters H, Claeys S, Casanova MJ, Eder P, Porter RJ, Arnott I, Karakan T, Mesonero F, Revés J, Van Dyck E, Jauregui-Amezaga A, Mañosa M, Rivière P, Marquez Mosquera L, Portela F, Pimentel R, Lobaton T. Prophylactic versus endoscopy-driven treatment of Crohn's postoperative recurrence: A retrospective, multicentric European study (PORCSE study). J Crohns Colitis 2024:jjae011. [PMID: 38243807 DOI: 10.1093/ecco-jcc/jjae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND AND AIMS No consensus exists on optimal strategy to prevent postoperative recurrence (POR) after ileocecal resection (ICR) for Crohn's disease (CD).We compared early medical prophylaxis versus expectant management with treatment driven by findings at elective endoscopy 6-12 months after ICR. METHODS A retrospective, multicentric, observational study was performed. CD-patients undergoing first ICR were assigned to cohort1 if a biologic or immunomodulator was (re)started prophylactically after ICR, or to cohort2 if no postoperative prophylaxis was given and treatment was started as reaction to elective endoscopic findings. Primary endpoint was rate of endoscopic POR (Rutgeerts>i1). Secondary endpoints were severe endoscopic POR (Rutgeerts i3/i4), clinical POR, surgical POR and treatment burden during follow-up. RESULTS Of 346 included patients, 47.4% received prophylactic postoperative treatment (proactive/cohort1) and 52.6% did not (reactive/cohort2).Endoscopic POR (Rutgeerts>i1) rate was significantly higher in cohort2 (41.5% vs 53.8%, OR1.81, P=0.039) at endoscopy 6-12 months after surgery. No significant difference in severe endoscopic POR was found (OR1.29, P=0.517). Cohort2 had significantly higher clinical POR rates (17.7% vs 35.7%, OR3.05, P=0.002) and numerically higher surgical recurrence rates (6.7% vs 13.2%, OR2.59, P=0.051). Cox proportional hazards regression analysis showed no significant difference in time to surgical POR of proactive versus expectant/reactive approach (HR2.50, P=0.057). Quasi-Poisson regression revealed a significantly lower treatment burden for immunomodulator use in cohort2 (mean ratio 0.53, P=0.002), but no difference in burden of biologics or combination treatment. CONCLUSIONS The PORCSE study showed lower rates of endoscopic POR with early postoperative medical treatment compared to expectant management after first ileocecal resection for Crohn's disease.
Collapse
Affiliation(s)
- Jeroen Geldof
- Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium
| | - Marie Truyens
- Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium
| | - Michiel Hanssens
- Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium
| | - Emily Van Gucht
- Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium
| | - Tom Holvoet
- Department of Gastroenterology and Hepatology, VITAZ, Sint-Niklaas, Belgium
| | - Ainara Elorza
- Department of Gastroenterology, Hospital Universitario de Galdakao, Biocruces Bizkaia Health Research Institute, Vizcaya, Spain
| | - Vincent Bouillon
- Department of Gastroenterology, Erasme University Hospital, Brussels, Belgium
| | - Sónia Barros
- Department of Gastroenterology - Algarve Universitary Medical Center, Portugal
| | - Viviana Martins
- Department of Gastroenterology - Algarve Universitary Medical Center, Portugal
| | - Konstantinos Argyriou
- University Hospital of Larisa - IBD unit, Department of Gastroenterology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Greece
| | - Spyridon Potamianos
- University Hospital of Larisa - IBD unit, Department of Gastroenterology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Greece
| | - Mircea Diculescu
- Gastroenterology and Hepatology Center Fundeni Clinical Institute, Carol Davila University of Medicine Bucharest, Bucharest, Romania
| | - Tudor Stroie
- Gastroenterology and Hepatology Center Fundeni Clinical Institute, Carol Davila University of Medicine Bucharest, Bucharest, Romania
| | - Peter Bossuyt
- Imelda GI clinical research center, Department of Gastroenterology, Imelda General Hospital, Bonheiden, Belgium
| | - Annick Moens
- Imelda GI clinical research center, Department of Gastroenterology, Imelda General Hospital, Bonheiden, Belgium
| | - Eirini Theodoraki
- Department of Gastroenterology, University Hospital Heraklion, Heraklion, Greece
| | | | - Juliana Pedro
- Department of Gastroenterology and Hepatology, Hospital Santa Maria, Centro Hospital Universitario de Liboa Norte, Lisbon, Portugal
| | - Samuel Fernandes
- Department of Gastroenterology and Hepatology, Hospital Santa Maria, Centro Hospital Universitario de Liboa Norte, Lisbon, Portugal
| | | | | | - Filip J Baert
- Department of Gastroenterology, AZ Delta, Roeselare, Belgium
| | - Rocio Ferreiro-Iglesias
- Inflammatory Bowel Diseases Unit, Department of Gastroenterology, Hospital Clinico Universitario de Santiago, Fundación Instituto de investigación Sanitaria de Santiago de Compostela, Galicia, Spain
| | - Harald Peeters
- Department of Gastroenterology, AZ Sint-Lucas, Ghent, Belgium
| | - Sophie Claeys
- Department of Gastroenterology, AZ Sint-Lucas, Ghent, Belgium
| | - Mariá José Casanova
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Ross J Porter
- Edinburgh IBD unit, Western General Hospital, NHS Lothian - Edinburgh, Edinburgh, Scotland
| | - Ian Arnott
- Edinburgh IBD unit, Western General Hospital, NHS Lothian - Edinburgh, Edinburgh, Scotland
| | | | - Francisco Mesonero
- Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y Cajal, Spain
| | - Joana Revés
- Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal
| | - Evi Van Dyck
- Department of Gastroenterology, AZ Klina, Brasschaat, Belgium
| | - Aranzazu Jauregui-Amezaga
- Department of Gastroenterology and Hepatology, University Hospital Antwerp, Belgium. Laboratory of Experimental Medicine and Pediatrics (LEMP), Division of Gastroenterology-Hepatology, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Míriam Mañosa
- Centro de Investigacion Biomédica en Red de Enfermedades Hepaticas y Digestivas CIBERehd. Hospital Department of Gastroenterology and Hepatology, Universitario Germans Trias i Pujol, Barcelona, Spain
| | - Pauline Rivière
- Department of Hepato-Gastroenterology and digestive oncology, CHU Bordeaux, Hôpital Haut Levêque, Bordeaux, France
| | | | - Francisco Portela
- Department of Gastroenterology, Hospital and University of Coimbra, Portugal
| | - Raquel Pimentel
- Department of Gastroenterology, Hospital and University of Coimbra, Portugal
| | - Triana Lobaton
- Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium
| |
Collapse
|
5
|
Zagórowicz E, Cichoż-Lach H, Kopertowska-Majchrzak M, Eder P, Stawczyk-Eder K, Talar-Wojnarowska R, Zatorski H, Solarska-Półchłopek A, Filip R, Janiak M, Skrobot K, Kłopocka M, Liebert A, Kaczka A, Wojciechowski K, Drygała S, Michalak A. Real-world effectiveness and safety of vedolizumab induction therapy for ulcerative colitis: A prospective nationwide Polish observational study. ADV CLIN EXP MED 2024; 33:69-77. [PMID: 37166016 DOI: 10.17219/acem/162969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/17/2022] [Accepted: 04/03/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Vedolizumab is recommended as a first-line biological treatment, along with other biological drugs, in ulcerative colitis (UC) patients in whom conventional therapy failed and as a second-line biological treatment following a failure of a tumor necrosis factor alpha (TNF-α) antagonist. OBJECTIVES We aimed to assess the real-world effectiveness and safety of vedolizumab induction therapy in UC patients treated in the scope of the National Drug Program (NDP) in Poland. MATERIAL AND METHODS The endpoints were the proportions of patients who reached clinical response, clinical remission and mucosal healing at week 14. Partial Mayo scores, Mayo subscores and C-reactive protein (CRP) levels were also evaluated. RESULTS Our study population consisted of 100 patients (55 biologic-naïve and 45 biologic-exposed). The median total Mayo score at baseline was 10 (interquartile range (IQR): 9-11), and 52 patients (52%) had extensive colitis. The clinical response at week 14 was achieved in 83 (83%) and clinical remission in 24 (24%) cases. Mucosal healing was observed in 56 (62%) patients at week 14. In patients with prior failure of biologic treatment (n = 25), 17 (68%) responded to vedolizumab treatment. A decrease in the median CRP level (from 3.7 mg/L to 2.6 mg/L) and the median total Mayo score (from 10 to 4) was observed. No new safety concerns were recorded and no patients discontinued the treatment due to adverse events (AEs). CONCLUSIONS Vedolizumab was effective and safe as induction therapy for UC in a Polish real-world population including patients with severely active UC and a low number of patients with prior biological treatment failures.
Collapse
Affiliation(s)
- Edyta Zagórowicz
- Department of Oncological Gastroenterology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | | | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, H. Święcicki University Hospital, Poznan University of Medical Sciences, Poland
| | - Kamila Stawczyk-Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, H. Święcicki University Hospital, Poznan University of Medical Sciences, Poland
| | | | - Hubert Zatorski
- Department of Digestive Tract Diseases, Medical University of Lodz, Poland
| | - Anna Solarska-Półchłopek
- Department of Oncological Gastroenterology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Rafał Filip
- Department of Gastroenterology with Inflammatory Bowel Disease Unit, Clinical Hospital No. 2, Rzeszów, Poland
| | - Maria Janiak
- Department of Gastroenterology and Hepatology, Medical University of Gdańsk, Poland
| | - Krzysztof Skrobot
- Department of Gastroenterology and Hepatology, Medical University of Gdańsk, Poland
| | - Maria Kłopocka
- Department of Gastroenterology and Nutritional Disorders, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
| | - Ariel Liebert
- Department of Gastroenterology and Nutritional Disorders, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
| | - Aleksandra Kaczka
- Department of Gastroenterology, Military Medical Academy Memorial Teaching Hospital - Central Veterans' Hospital, Łódź, Poland
| | | | - Szymon Drygała
- Medical Affairs, Takeda Pharma sp. z o.o., Warsaw, Poland
| | - Agata Michalak
- Department of Gastroenterology, Medical University of Lublin, Poland
| |
Collapse
|
6
|
Banasik E, Dobrowolska A, Kołodziejczak B, Eder P. Inflammatory bowel diseases and the clinical course of coronavirus disease 2019 - a Polish single-centre experience from the pre-vaccine era. Prz Gastroenterol 2023; 18:409-415. [PMID: 38572464 PMCID: PMC10985744 DOI: 10.5114/pg.2023.133479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/30/2022] [Indexed: 04/05/2024]
Abstract
Introduction The data on the relationship between inflammatory bowel diseases (IBD) and the course of COVID-19 from East-Central Europe are scarce. Aim To assess the frequency of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in IBD patients and the impact of IBD on the COVID-19 course from the perspective of a Polish tertiary centre. Material and methods Data on SARS-CoV-2 infection were retrospectively collected among IBD patients hospitalized in a Polish tertiary centre from March 2020 to May 2021. A questionnaire was used assessing the IBD characteristics, other comorbidities, and the course of COVID-19. Results Among 350 patients, SARS-CoV-2 infection was diagnosed in 32 (9%). Severe COVID-19, defined as the need for hospitalization, was reported in 6 (19%) and mild in 26 (81%) cases. Compared to the mild COVID-19 course, patients with a severe course more often showed a higher IBD activity (3 points [IQR 2.25-3] vs. 1 point [IQR 0-2] in a semi-quantitative scale, p = 0.002), more often received steroids (67% vs. 11%, p = 0.02), and were not treated with biologics (0% vs. 46%, p = 0.07). There was a correlation between the duration of symptomatic infection and the number of comorbidities (r = 0.4, p = 0.04). No death or short-term COVID-19 complications were reported. In 25% of cases, SARS-CoV-2 infection caused new gastrointestinal symptoms. Conclusions IBD is not a risk factor for SARS-CoV-2 infection. Steroids and higher IBD clinical activity may increase the risk of severe COVID-19. The prognosis for COVID-19 in our cohort was good. SARS-CoV-2 infection was a common cause of gastrointestinal symptoms.
Collapse
Affiliation(s)
- Estera Banasik
- Department of Gastroenterology, Dietetics, and Internal Medicine, Poznan University of Medical Sciences, University Clinical Hospital, Poznan, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics, and Internal Medicine, Poznan University of Medical Sciences, University Clinical Hospital, Poznan, Poland
| | - Barbara Kołodziejczak
- Faculty of Mathematics and Computer Science, Adam Mickiewicz University, Poznan, Poland
| | - Piotr Eder
- Department of Gastroenterology, Dietetics, and Internal Medicine, Poznan University of Medical Sciences, University Clinical Hospital, Poznan, Poland
| |
Collapse
|
7
|
Lykowska-Szuber L, Walczak M, Stawczyk-Eder K, Krela-Kazmierczak I, Eder P, Zakerska-Banaszak O, Dobrowolska A, Skrzypczak-Zielinska M. Variants of the CASP9 gene as candidate markers for primary response to anti-TNF therapy in Crohn's disease patients. J Appl Genet 2023; 64:759-768. [PMID: 37658984 PMCID: PMC10632275 DOI: 10.1007/s13353-023-00783-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/05/2023]
Abstract
Anti-tumor necrosis factor (TNF) therapy is used to induce and maintain remission in Crohn's disease (CD) patients. However, primary non-responders to initial treatment constitute 20-40% of cases. The causes of this phenomenon are still unknown. We aim to investigate the impact of the caspase 9 (CASP9) gene variants on the variable reactions of CD patients to anti-TNF therapy. The study group included 196 diagnosed and clinically characterized CD Polish patients following anti-TNF therapy. The sequence of the CASP9 gene was analyzed using next-generation and Sanger sequencing and was analyzed with the response to biological treatment. Using the RT-qPCR analysis, we estimated the CASP9 gene mRNA level in colon biopsies material from inflamed and non-inflamed tissue (21 CD patients: 14 responders and seven non-responders to anti-TNF therapy and six controls), as well as in vitro in a peripheral blood mononuclear cells (PBMCs) from CD patients (seven responders and seven non-responders to anti-TNF therapy) and eight controls. Our findings indicated association of variants rs1052571 and rs4645978 with response to anti-TNF monoclonal antibodies (mAbs). Moreover, we observed tendency for reduced expression after incubation with anti-TNF in the group of CD patients, in contrast to the control group. Our results suggest that response to anti-TNF therapy in CD patients may be an effect of variants of the CASP9 gene as a key effector of the internal pathway of apoptosis; however, further population and functional research are necessary.
Collapse
Affiliation(s)
- Liliana Lykowska-Szuber
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznan, Poland.
| | - Michal Walczak
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Kamila Stawczyk-Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznan, Poland
| | - Iwona Krela-Kazmierczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznan, Poland
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznan, Poland
| | | | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznan, Poland
| | | |
Collapse
|
8
|
Eder P, Verstock B, Culver E, Dragoni G, Kredel LI, Wypych J, de Paredes AGG, Kaniewska M, Leibovitzh H, Lobaton T, Truyens M, Oracz G, Giuseppe Ribaldone D, Starzyńska T, Badaoui A, Rahier JF, Bezzio C, Bossuyt P, Falloon K, Pugliese D, Frakes Vozzo C, Jess T, Larsen L, Olesen SS, Pal P, Chaparro M, Dror D, Ellul P, Gromny I, Janiak M, Maciejewska K, Peleg N, Bar-Gil Shitrit A, Szwed Ł, Talar-Wojnarowska R, Snir Y, Weisshof R, Zittan E, Miechowicz I, Goren I. Autoimmune Pancreatitis in Patients with Inflammatory Bowel Disease: A Real-World Multicentre Collaborative ECCO CONFER Study. J Crohns Colitis 2023; 17:1791-1799. [PMID: 37283545 PMCID: PMC10673810 DOI: 10.1093/ecco-jcc/jjad097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 04/05/2023] [Accepted: 06/06/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Autoimmune pancreatitis [AIP] is rarely associated with inflammatory bowel disease [IBD]. The long-term outcomes of AIP and IBD in patients with coexisting AIP-IBD and predictors of complicated AIP course have rarely been reported. METHODS An ECCO COllaborative Network For Exceptionally Rare case reports project [ECCO-CONFER] collected cases of AIP diagnosed in patients with IBD. Complicated AIP was defined as a composite of endocrine and/or exocrine pancreatic insufficiency, and/or pancreatic cancer. We explored factors associated with complicated AIP in IBD. RESULTS We included 96 patients [53% males, 79% ulcerative colitis, 72% type 2 AIP, age at AIP diagnosis 35 ± 16 years]. The majority of Crohn's disease [CD] cases [78%] had colonic/ileocolonic involvement. In 59%, IBD preceded AIP diagnosis, whereas 18% were diagnosed simultaneously. Advanced therapy to control IBD was used in 61% and 17% underwent IBD-related surgery. In total, 82% of patients were treated with steroids for AIP, the majority of whom [91%] responded to a single course of treatment. During a mean follow-up of 7 years, AIP complications occurred in 25/96 [26%] individuals. In a multivariate model, older age at AIP diagnosis was associated with a complicated AIP course (odds ratio [OR] = 1.05, p = 0.008), whereas family history of IBD [OR = 0.1, p = 0.03], and CD diagnosis [OR = 0.2, p = 0.04] decreased the risk of AIP complications. No IBD- or AIP-related deaths occurred. CONCLUSIONS In this large international cohort of patients with concomitant AIP-IBD, most patients have type 2 AIP and colonic IBD. AIP course is relatively benign and long-term outcomes are favourable, but one-quarter develop pancreatic complications. Age, familial history of IBD, and CD may predict uncomplicated AIP course.
Collapse
Affiliation(s)
- Piotr Eder
- Department of Gastroenterology, Dietetics, and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Bram Verstock
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium; Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Emma Culver
- Translational Gastroenterology Unit, John Radcliffe Hospital and Oxford, NIHR BRC, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Gabriele Dragoni
- Department of Gastroenterology, Careggi University Hospital, Florence, Italy
| | - Lea Isabell Kredel
- Division of Gastroenterology, Infectiology and Rheumatology, Medical Department, Charité-Universitätsmedizin, Berlin, Germany
| | - Joanna Wypych
- Department of Gastroenterology, Surgery and Nutrition, Copernicus Hospital, Gdansk, Poland
| | - Ana Garcia Garcia de Paredes
- Gastroenterology and Hepatology Department. Hospital Universitario Ramon y Cajal. Universidad de Alcala, IRYCIS, Madrid, Spain
| | - Magdalena Kaniewska
- Department of Gastroenterology with IBD Subdivision, National Medical Institute of Ministry of Inferior and Administration, Warsaw, Poland
| | - Haim Leibovitzh
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology & Hepatology, Temerty Faculty of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Triana Lobaton
- Department of Internal Medicine and Pediatrics, Department of Gastroenterology, Ghent University, Ghent, Belgium
| | - Marie Truyens
- Department of Internal Medicine and Pediatrics, Department of Gastroenterology, Ghent University, Ghent, Belgium
| | - Grzegorz Oracz
- Department of Gastroenterology, Hepatology, Feeding Disorder and Pediatrics, The Children’s Memorial Health Institute, Warsaw, Poland; Pediatric Gastroenterology Faculty, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | - Teresa Starzyńska
- Department of Gastroenterology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Abdenor Badaoui
- Department of Gastroenterology, Université Catholique de Louvain, Yvoir, Belgium
| | - Jean-Francois Rahier
- Department of Gastroenterology, Université Catholique de Louvain, Yvoir, Belgium
| | - Cristina Bezzio
- Gastroenterology Unit, Rho Hospital, Rho (MI), ASST Rhodense, Garbagnate Milanese, Italy
| | - Peter Bossuyt
- Imelda GI Clinical Research Center, Imelda General Hospital, Bonheiden, Belgium
| | - Katherine Falloon
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Daniela Pugliese
- CEMAD, IBD UNIT, Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario ‘A. Gemelli’ IRCCS, Rome, Italy
| | - Catherine Frakes Vozzo
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Tine Jess
- Center for Molecular Prediction of Inflammatory Bowel Disease, Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark
| | - Lone Larsen
- Department of Gastroenterology and Hepatology, Aalborg University Hospital, Center for Molecular Prediction of Inflammatory Bowel Disease – PREDICT, Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Søren Schou Olesen
- Centre for Pancreatic Diseases and Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Partha Pal
- Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - María Chaparro
- Department of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - Dikla Dror
- Department of Gastroenterology, Galilee Medical Center, Nahariyya, Israel
| | - Pierre Ellul
- Division of Gastroenterology, Mater dei Hospital, Malta
| | - Iga Gromny
- Division of Dietetics, Department of Gastroenterology and Hepatology, Wroclaw Medical University, Wroclaw, Poland
| | - Maria Janiak
- Department of Gastroenterology and Hepatology, Medical University of Gdańsk, Gdańsk, Poland
| | - Katarzyna Maciejewska
- Department of Gastroenterology with IBD Subdivision, National Medical Institute of Ministry of Inferior and Administration, Warsaw, Poland
| | - Noam Peleg
- The Division of Gastroenterology, Rabin Medical Center, Petach Tikva, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ariella Bar-Gil Shitrit
- IBD MOM Unit, Digestive Diseases Institute, The Hebrew University of Jerusalem, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Łukasz Szwed
- Private Gastroenterology Practice, Nowy Dwór Mazowiecki, Poland
| | | | - Yifat Snir
- Gastroenterology Department, Clalit Health Services, Tel Aviv District, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Roni Weisshof
- Gastroenterology Institute at Rambam Health Care Campus in Haifa, Haifa, Israel
| | - Eran Zittan
- Ellen and Pinchas Mamber Institute of Gastroenterology and Liver Diseases, IBD Unit, Emek Medical Center, Afula, Israel
| | - Izabela Miechowicz
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Idan Goren
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| |
Collapse
|
9
|
Zawada AE, Naskręt D, Piłaciński S, Adamska A, Grzymisławski M, Eder P, Grzelka-Woźniak A, Zozulińska-Ziółkiewicz D, Dobrowolska A. Helicobacter pylori infection is associated with increased accumulation of advanced glycation end products in the skin in patients with type 1 diabetes: A preliminary study. ADV CLIN EXP MED 2023; 32:1009-1016. [PMID: 36881369 DOI: 10.17219/acem/159800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/06/2022] [Accepted: 01/25/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Helicobacter pylori infection (HPI) is more frequently diagnosed in patients with diabetes. Insulin resistance in patients with type 1 diabetes (DMT1) is associated with the accumulation of advanced glycation end products (AGEs) in the skin and progression of chronic complications. OBJECTIVES Assessment of the relationship between the incidence of HPI and skin AGEs in patients with DMT1. MATERIAL AND METHODS The study included 103 Caucasian patients with a DMT1 duration >5 years. A fast qualitative test was performed to detect the HP antigen in fecal samples (Hedrex). The content of AGEs in the skin was estimated using an AGE Reader device (DiagnOptics). RESULTS The HP-positive (n = 31) and HP-negative (n = 72) groups did not differ in terms of age, gender, duration of diabetes, fat content, body mass index (BMI) and lipid profile, metabolic control, and inflammatory response markers. The studied groups differed in the amount of AGEs in the skin. The relationship between HPI and increased AGEs in the skin was confirmed in a multifactor regression model taking into account age, gender, DMT1 duration, glycated hemoglobin A1c (HbA1c), BMI, low-density lipoprotein cholesterol (LDL-C) and the presence of hypertension, and tobacco use. The studied groups also differed in serum levels of vitamin D. CONCLUSIONS Increased accumulation of AGEs in the skin of patients with DMT1 with coexisting HPI suggests that eradication of HP may significantly improve DMT1 outcomes.
Collapse
Affiliation(s)
- Agnieszka Ewa Zawada
- Department of Gastroenterology, Dietetics and Internal Disease, Poznan University of Medical Sciences, Poland
| | - Dariusz Naskręt
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poland
| | - Stanisław Piłaciński
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poland
| | - Anna Adamska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poland
| | - Marian Grzymisławski
- Department of Gastroenterology, Dietetics and Internal Disease, Poznan University of Medical Sciences, Poland
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poland
| | - Agata Grzelka-Woźniak
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poland
| | | | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Disease, Poznan University of Medical Sciences, Poland
| |
Collapse
|
10
|
Zielińska A, Karczewski J, Eder P, Kolanowski T, Szalata M, Wielgus K, Szalata M, Kim D, Shin SR, Słomski R, Souto EB. Scaffolds for drug delivery and tissue engineering: The role of genetics. J Control Release 2023:S0168-3659(23)00355-3. [PMID: 37286137 DOI: 10.1016/j.jconrel.2023.05.042] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/19/2023] [Accepted: 05/29/2023] [Indexed: 06/09/2023]
Abstract
Scaffolds are implants commonly used to deliver cells, drugs, and genes into the body. Their regular porous structure ensures the proper support for cell attachment, proliferation, differentiated function, and migration. Techniques to fabricate a scaffold include leaching, freeze-drying, supercritical fluid technology, thermally induced phase separation, rapid prototyping, powder compaction, sol-gel, and melt molding. Gene delivery from the scaffold represents a versatile approach to influence the environment for managing cell function. Scaffolds can be used for various tissue engineering purposes, e.g. bone formation, periodontal regeneration, cartilage development, artificial corneas, heart valves, tendon repair, or ligament replacement. Moreover, they are also instrumental in cancer therapy, inflammation, diabetes, heart disease, and wound dressings. Scaffolds provide a platform to extend the delivery of drugs and genetic materials at a controlled timeframe, besides potentially being used to prevent infection upon surgery and other chronic diseases, provided that they can be formulated with specific medicines. This review discusses the need to design advanced functional scaffolds with the potential for modified drug delivery and tissue engineering in a synergistic approach. Special attention is given to works published in 2023 to generate the bibliometric map.
Collapse
Affiliation(s)
- Aleksandra Zielińska
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, 60-479 Poznań, Poland; Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
| | - Jacek Karczewski
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Heliodor Święcicki Hospital, Przybyszewskiego 49, 60-355 Poznań, Poland; Department of Environmental Medicine, Poznan University of Medical Sciences, Fredry 10, 61-701 Poznan, Poland
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Heliodor Święcicki Hospital, Przybyszewskiego 49, 60-355 Poznań, Poland
| | - Tomasz Kolanowski
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, 60-479 Poznań, Poland
| | - Milena Szalata
- Department of Biotechnology, Institute of Natural Fibres and Medicinal Plants, National Research Institute, Wojska Polskiego 71B, 60-630 Poznań, Poland
| | - Karolina Wielgus
- Department of Pediatric Gastroenterology and Metabolic Diseases at Poznan University of Medical Sciences, Szpitalna Str. 27/33, 60-572 Poznan, Poland
| | - Marlena Szalata
- Department of Biochemistry and Biotechnology, Poznań University of Life Sciences, Dojazd 11, 60-632 Poznań, Poland
| | - Dohun Kim
- Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chungbuk National University, Chungbuk National University Hospital, Cheong-Ju, South Korea; Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA 02139, USA
| | - Su Ryon Shin
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA 02139, USA
| | - Ryszard Słomski
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, 60-479 Poznań, Poland; Department of Biotechnology, Institute of Natural Fibres and Medicinal Plants, National Research Institute, Wojska Polskiego 71B, 60-630 Poznań, Poland
| | - Eliana B Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira, 228, 4050-313 Porto, Portugal; UCIBIO - Applied Molecular Biosciences Unit, MEDTECH, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal.
| |
Collapse
|
11
|
Lubarska M, Hałasiński P, Hryhorowicz S, Mahadea DS, Łykowska-Szuber L, Eder P, Dobrowolska A, Krela-Kaźmierczak I. Liver Dangers of Herbal Products: A Case Report of Ashwagandha-Induced Liver Injury. Int J Environ Res Public Health 2023; 20:3921. [PMID: 36900932 PMCID: PMC10002162 DOI: 10.3390/ijerph20053921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
In recent years, cases of liver damage caused by ashwagandha herbal supplements have been reported from different parts of the world (Japan, Iceland, India, and the USA). Here, we describe the clinical phenotype of suspected ashwagandha-induced liver injury and the potential causative mechanism. The patient was admitted to the hospital because of jaundice. In the interview, it was reported that he had been taking ashwagandha for a year. Laboratory results showed an increase in total bilirubin, alanine transaminase (ALT), aspartate transaminase (AST), (gamma-glutamyl transpherase (GGT), alkaline phosphatase (ALP), total cholesterol, triglycerides, and ferritin. Based on clinical symptoms and additional tests, the patient was diagnosed with acute hepatitis and referred to a facility with a higher reference rate to exclude drug-induced liver injury. An R-value was assessed, indicative of hepatocellular injury. The result of the 24 h urine collection exceeded the upper limit of normal for copper excretion in urine twice. The clinical condition improved after intensive pharmacological treatment and four plasmapheresis treatments. This case is another showing the hepatotoxic potential of ashwagandha to cause cholestatic liver damage mixed with severe jaundice. In view of several documented cases of liver damage caused by ashwagandha and the unknown metabolic molecular mechanisms of substances contained in it, attention should be paid to patients reporting the use of these products in the past and presenting symptoms of liver damage.
Collapse
Affiliation(s)
- Marta Lubarska
- Department of Gastroenterology, Dietetics and Internal Diseases, University of Medical Sciences Poznan, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Przemysław Hałasiński
- Department of Gastroenterology, Dietetics and Internal Diseases, University of Medical Sciences Poznan, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Szymon Hryhorowicz
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszynska 32, 60-479 Poznan, Poland
| | - Dagmara Santabye Mahadea
- Department of Gastroenterology, Dietetics and Internal Diseases, University of Medical Sciences Poznan, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Liliana Łykowska-Szuber
- Department of Gastroenterology, Dietetics and Internal Diseases, University of Medical Sciences Poznan, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, University of Medical Sciences Poznan, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Diseases, University of Medical Sciences Poznan, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Iwona Krela-Kaźmierczak
- Department of Gastroenterology, Dietetics and Internal Diseases, University of Medical Sciences Poznan, Przybyszewskiego 49, 60-355 Poznan, Poland
| |
Collapse
|
12
|
Eder P, Kłopocka M, Cichoż-Lach H, Talar-Wojnarowska R, Kopertowska-Majchrzak M, Michalak A, Filip R, Waszak K, Stawczyk-Eder K, Janiak M, Skrobot K, Liebert A, Zatorski H, Solarska-Półchłopek A, Krogulecki M, Pękała A, Poniewierka E, Smoła I, Kaczka A, Wojciechowski K, Drygała S, Zagórowicz E. Real-world outcomes of 54-week vedolizumab therapy and response durability after treatment discontinuation in ulcerative colitis: results from a multicenter prospective POLONEZ study. Therap Adv Gastroenterol 2023; 16:17562848231151295. [PMID: 36818601 PMCID: PMC9932778 DOI: 10.1177/17562848231151295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 12/27/2022] [Indexed: 02/17/2023] Open
Abstract
Background Vedolizumab is a gut-selective anti-lymphocyte trafficking agent used to treat ulcerative colitis (UC) and Crohn's disease. Objectives We aimed to evaluate the effectiveness, safety, and durability of the therapeutic effect of vedolizumab after treatment discontinuation in a real-world cohort of patients with UC treated in Poland. Design This was a multicenter, prospective study involving patients with moderate to severely active UC from 12 centers in Poland who qualified for reimbursed treatment with vedolizumab between February and November 2019. Methods The primary endpoints were clinical response (⩾2-point improvement from baseline on partial Mayo score) and clinical remission (partial Mayo score 0-1), including steroid-free remission, at week 54. Other outcomes included response durability at 26 weeks after treatment discontinuation, identification of predictors of response and remission, and safety assessment. Results In all, 100 patients with UC were enrolled (55 biologic naïve and 45 biologic exposed). At baseline, 68% of patients were on corticosteroids and 45% on immunomodulators. Clinical response was observed in 62% of patients, clinical remission in 50%, and steroid-free remission in 42.6% at week 54. Within 26 weeks after treatment discontinuation, 37% of patients who maintained response by week 54 relapsed. The decreased number of liquid stools and rectal bleeding and endoscopic response at week 14 were predictive factors for response at week 54. Time from diagnosis ranging 2-5 years, decreased stool frequency, and non-concomitant use of corticosteroids at baseline and at week 14 were predictive factors for remission at week 54. Partial Mayo score < 3 with no subscale score > 1 at week 54 was a predictive factor for durable response after treatment discontinuation. The rate of serious adverse events related to treatment was 3.63 per 100 patient-years. Conclusion Vedolizumab is effective and safe in UC treatment in Polish patients. However, the relapse rate after the treatment cessation was high. Registration ENCePP (EUPAS34119).
Collapse
Affiliation(s)
- Piotr Eder
- Department of Gastroenterology, Dietetics, and
Internal Diseases, Poznan University of Medical Sciences, H. Święcicki
University Hospital, Poznań, Poland
| | - Maria Kłopocka
- Department of Gastroenterology and Nutritional
Disorders, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in
Toruń, Bydgoszcz, Poland
| | - Halina Cichoż-Lach
- Department of Gastroenterology, Medical
University of Lublin, Lublin, Poland
| | | | | | - Agata Michalak
- Department of Gastroenterology, Medical
University of Lublin, Lublin, Poland
| | - Rafał Filip
- Department of Gastroenterology with IBD Unit,
Clinical Hospital No. 2, Rzeszów, Poland
| | - Katarzyna Waszak
- Department of Gastroenterology, Dietetics, and
Internal Diseases, Poznan University of Medical Sciences, H. Święcicki
University Hospital, Poznań, Poland
| | - Kamila Stawczyk-Eder
- Department of Gastroenterology, Dietetics, and
Internal Diseases, Poznan University of Medical Sciences, H. Święcicki
University Hospital, Poznań, Poland
| | - Maria Janiak
- Department of Gastroenterology and Hepatology,
Medical University of Gdansk, Gdańsk, Poland
| | - Krzysztof Skrobot
- Department of Gastroenterology and Hepatology,
Medical University of Gdansk, Gdańsk, Poland
| | - Ariel Liebert
- Department of Gastroenterology and Nutritional
Disorders, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in
Toruń, Bydgoszcz, Poland
| | - Hubert Zatorski
- Department of Digestive Tract Diseases,
Medical University of Lodz, Łódź, Poland
| | - Anna Solarska-Półchłopek
- Department of Gastroenterology, The Maria
Sklodowska-Curie National Research Institute of Oncology, Warsaw,
Poland,Department of Gastroenterology, Hepatology and
Clinical Oncology, The Medical Center of Postgraduate Education, Warsaw,
Poland
| | - Michał Krogulecki
- Department of Gastroenterology, Military
Institute of Medicine, Warsaw, Poland
| | - Anna Pękała
- Department of Gastroenterology with IBD Unit,
Clinical Hospital No. 2, Rzeszów, Poland
| | - Elżbieta Poniewierka
- Department of Gastroenterology and Hepatology,
Wroclaw Medical University, Wrocław, Poland
| | - Izabela Smoła
- Department of Gastroenterology and Hepatology,
Wroclaw Medical University, Wrocław, Poland
| | - Aleksandra Kaczka
- Department of Gastroenterology, University
Clinical Hospital Military Memorial Medical Academy - Central Veterans’
Hospital, Łódź, Poland
| | | | | | - Edyta Zagórowicz
- Department of Gastroenterology, The Maria
Sklodowska-Curie National Research Institute of Oncology, Warsaw,
Poland,Department of Gastroenterology, Hepatology and
Clinical Oncology, The Medical Center of Postgraduate Education, Warsaw,
Poland
| |
Collapse
|
13
|
Łodyga M, Maciejewska K, Stawczyk-Eder K, Eder P, Dobrowolska A, Wiśniewska-Jarosińska M, Gąsiorowska A, Cicha M, Rydzewska G. Assessment of the activity of the immune system in patients with inflammatory bowel diseases and asymptomatic COVID-19. Prz Gastroenterol 2023; 19:46-53. [PMID: 38571543 PMCID: PMC10985759 DOI: 10.5114/pg.2023.124281] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/05/2023] [Indexed: 04/05/2024]
Abstract
Introduction Although the phenomenon of cytokine storm is well described in patients with severe COVID-19, little is known about the role of the immune system in asymptomatic patients, especially in the group with autoimmune diseases, such as inflammatory bowel disease (IBD). Aim To assess the stimulation of the immune system expressed through the production of cytokines in IBD patients with asymptomatic COVID-19. Material and methods This is a multi-centre, prospective study in which the concentration of many cytokines (IL-1a, IL-1b, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, IL-13, IL- 15, IL-17, IL-23, IFN-γ, TNF-α, TNF-β) was assessed in patients with IBD and asymptomatic SARS-CoV-2 infection diagnosed by serological tests. Results In the group of patients with a recent SARS-CoV-2 infection, defined as positive antibodies in the IgA + IgM class, a higher percentage of patients with the presence of interleukin (IL) 2 (IL-2) was found. No association with other cytokines or effects of IBD activity or treatment was found. However, the effect of the applied treatment on the concentration of some cytokines was found: a negative association of infliximab, vedolizumab, and prednisone with IL-2, a positive correlation of steroids, thiopurines with IL-10, and in the case of tumor necrosis factor-α (TNF-α), negative with infliximab, and positive with vedolizumab. Conclusions The increased concentration of IL-2 may result from its regulatory role in inhibiting excessive activation of the immune system; however, considering the studies of patients with severe COVID-19, its role in the initial phase of SARS-CoV-2 infection requires further research.
Collapse
Affiliation(s)
- Michał Łodyga
- Department of Gastroenterology with the Inflammatory Bowel Disease Subdivision, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
- Department of Internal Medicine, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Maciejewska
- Department of Gastroenterology with the Inflammatory Bowel Disease Subdivision, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Kamila Stawczyk-Eder
- Department of Gastroenterology, Dietetics, and Internal Medicine, Poznan University of Medical Sciences, Heliodor Święcicki University Hospital, Poznan, Poland
| | - Piotr Eder
- Department of Gastroenterology, Dietetics, and Internal Medicine, Poznan University of Medical Sciences, Heliodor Święcicki University Hospital, Poznan, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics, and Internal Medicine, Poznan University of Medical Sciences, Heliodor Święcicki University Hospital, Poznan, Poland
| | | | - Anita Gąsiorowska
- Department of Gastroenterology, Medical University of Lodz, Lodz, Poland
| | - Małgorzata Cicha
- Diagnostic Laboratory, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Grażyna Rydzewska
- Department of Gastroenterology with the Inflammatory Bowel Disease Subdivision, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| |
Collapse
|
14
|
Zielińska A, Eder P, Karczewski J, Szalata M, Hryhorowicz S, Wielgus K, Szalata M, Dobrowolska A, Atanasov AG, Słomski R, Souto EB. Tocilizumab-coated solid lipid nanoparticles loaded with cannabidiol as a novel drug delivery strategy for treating COVID-19: A review. Front Immunol 2023; 14:1147991. [PMID: 37033914 PMCID: PMC10073701 DOI: 10.3389/fimmu.2023.1147991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Commonly used clinical strategies against coronavirus disease 19 (COVID-19), including the potential role of monoclonal antibodies for site-specific targeted drug delivery, are discussed here. Solid lipid nanoparticles (SLN) tailored with tocilizumab (TCZ) and loading cannabidiol (CBD) are proposed for the treatment of COVID-19 by oral route. TCZ, as a humanized IgG1 monoclonal antibody and an interleukin-6 (IL-6) receptor agonist, can attenuate cytokine storm in patients infected with SARS-CoV-2. CBD (an anti-inflammatory cannabinoid and TCZ agonist) alleviates anxiety, schizophrenia, and depression. CBD, obtained from Cannabis sativa L., is known to modulate gene expression and inflammation and also shows anti-cancer and anti-inflammatory properties. It has also been recognized to modulate angiotensin-converting enzyme II (ACE2) expression in SARS-CoV-2 target tissues. It has already been proven that immunosuppressive drugs targeting the IL-6 receptor may ameliorate lethal inflammatory responses in COVID-19 patients. TCZ, as an immunosuppressive drug, is mainly used to treat rheumatoid arthritis, although several attempts have been made to use it in the active hyperinflammatory phase of COVID-19, with promising outcomes. TCZ is currently administered intravenously. It this review, we discuss the potential advances on the use of SLN for oral administration of TCZ-tailored CBD-loaded SLN, as an innovative platform for managing SARS-CoV-2 and related infections.
Collapse
Affiliation(s)
- Aleksandra Zielińska
- Institute of Human Genetics, Polish Academy of Sciences Poznan, Poznan, Poland
- *Correspondence: Aleksandra Zielińska, ; Piotr Eder, ; Eliana B. Souto,
| | - Piotr Eder
- Department of Gastroenterology, Dietetics, and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
- *Correspondence: Aleksandra Zielińska, ; Piotr Eder, ; Eliana B. Souto,
| | - Jacek Karczewski
- Department of Environmental Medicine/Department of Gastroenterology, Human Nutrition and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Marlena Szalata
- Department of Biochemistry and Biotechnology, Poznań University of Life Sciences, Poznań, Poland
| | - Szymon Hryhorowicz
- Institute of Human Genetics, Polish Academy of Sciences Poznan, Poznan, Poland
| | - Karolina Wielgus
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Milena Szalata
- Department of Biotechnology, Institute of Natural Fibres and Medicinal Plants National Research Institute, Poznan, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics, and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Atanas G. Atanasov
- Institute of Genetics and Animal Biotechnology, Magdalenka, Poland
- Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria
- Department of Pharmacognosy, University of Vienna, Vienna, Austria
| | - Ryszard Słomski
- Institute of Human Genetics, Polish Academy of Sciences Poznan, Poznan, Poland
| | - Eliana B. Souto
- UCIBIO – Applied Molecular Biosciences Unit, MEDTECH, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
- *Correspondence: Aleksandra Zielińska, ; Piotr Eder, ; Eliana B. Souto,
| |
Collapse
|
15
|
Godny L, Svolos V, Williams AJ, Czuber-Dochan W, Aloi M, Ibarra A, O'Hanlon DV, Dragoni G, Avni Biron I, Campmans-Kuijpers M, Collins P, Eder P, Pfeffer-Gik T, Jäghult S, Wall CL. Multidisciplinary Perinatal Care in IBD. J Crohns Colitis 2022; 17:663-680. [PMID: 36541887 DOI: 10.1093/ecco-jcc/jjac189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 10/27/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Patients with inflammatory bowel disease [IBD] are often affected during their reproductive years and may have many perinatal queries that require the comprehensive perspectives of a multidisciplinary team [MDT]. The purpose of this topical review is to assess the scientific evidence and provide expert opinion related to nutritional, psychological, and supportive care of women and their infants throughout the prenatal, antenatal, and infant periods. METHODS A consensus expert panel of a paediatrician, gastroenterologists, nurses, and dietitians was convened by the European Crohn's and Colitis Organisation. This panel critically reviewed literature related to the non-medical management of patients with IBD during preconception, pregnancy, the postnatal period, and the first years of the infant's life. Statements were developed using an e-Delphi process over two rounds and were confirmed when ≥80% of experts agreed with the statements. RESULTS A total of 19 current practice positions were developed that cover the preconception period, pregnancy and lactation, and early life exposures associated with risk of IBD. Development of the infant microbiome and its role in the immune system and topics including nutritional optimization, psychological support, and education relating to early life were reviewed. CONCLUSIONS Patients with IBD have unique nutritional and psychosocial needs that may affect fertility and pregnancy outcomes. The early life environment of infants born to parents with IBD may be associated with subsequent development of IBD in offspring. A MDT is the optimal setting to support and counsel patients throughout the perinatal period.
Collapse
Affiliation(s)
- Lihi Godny
- Division of Gastroenterology and Nutrition Unit, Rabin Medical Center, Petah-Tikva, Israel
| | - Vaios Svolos
- Faculty of Health Sciences, Metropolitan College, Larisa, Greece.,Human Nutrition, School of Medicine, Dentistry & Nursing, College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Astrid-Jane Williams
- Department of Gastroenterology, Liverpool Hospital, Sydney.,South Western Sydney Local Health District Clinical School, University of New South Wales, Australia
| | - Wladyslawa Czuber-Dochan
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Marina Aloi
- Pediatric Gastroenterology Unit, Department of Maternal and child health, Sapienza University, Umberto I Hospital, Rome, Italy
| | - Ana Ibarra
- Inflammatory Bowel Disease, Barts Health NHS Trust, London, UK
| | | | - Gabriele Dragoni
- IBD Referral Center, Department of Gastroenterology, Careggi University Hospital, Florence.,Gastroenterology Research Unit, Department of Experimental and Clinical Biochemical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Irit Avni Biron
- Division of Gastroenterology, Rabin Medical Center, Petach Tikva, Israel
| | - Marjo Campmans-Kuijpers
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, the Netherlands
| | - Paul Collins
- Department of Gastroenterology and Hepatology, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznań University of Medical Sciences, Poznań, Poland
| | - Tamar Pfeffer-Gik
- Division of Gastroenterology and Nutrition Unit, Rabin Medical Center, Petah-Tikva, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Catherine L Wall
- Department of Medicine, University of Otago, Christchurch and Nutrition & Dietetics, Te Whatu Ora Waitaha Canterbury, Christchurch, New Zealand
| |
Collapse
|
16
|
Mahajna H, Verstockt B, Bergemalm D, Castiglione F, Rodríguez-Moranta F, Savarino EV, Hoentjen F, Bessissow T, Pokryszka J, Cremer A, Eder P, Truyens M, Yerushalmy-Feler A, Garcia MJ, Kopylov U. Idiopathic Thrombocytopenic Purpura associated with Inflammatory Bowel Disease: a multi-centre ECCO CONFER case series. J Crohns Colitis 2022; 17:722-727. [PMID: 36455965 DOI: 10.1093/ecco-jcc/jjac179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Idiopathic Thrombocytopenic Purpura (ITP) is an acquired haematological disorder with an incidence of 1 to 6 per 100,000/year. ITP and inflammatory bowel disease (IBD) comorbidity has been reported in the literature, but insights regarding the course, outcome and optimal management are limited by its rarity. The current study aimed to evaluate the clinical presentation and outcome of ITP in patients with IBD. METHODS This multicentre retrospective case series was performed as part of the ECCO Collaborative Network of Exceptionally Rare case reports (CONFER) project. Cases of patients with ITP and IBD were collected by participating investigators. Clinical data were recorded in a standardised collection form. RESULTS This report includes 32 patients with concurrent ITP and IBD:10 were females, median age was 32.0 [interquartile range (IQR) 20.5-39.5]. 14 patients had a diagnosis of Crohn's disease (CD) and the other 18 had of ulcerative colitis (UC). The diagnosis of IBD preceded the ITP in 26 patients (median time between diagnoses was 7.0 years [IQR, 1.5-9.5]). Among those patients, 17 patients were in clinical remission at ITP diagnosis. 13 patients were treated with mesalamine, 4 with oral corticosteroids, 1 with rectal corticosteroids, 2 with azathioprine, and 5 with anti-TNF agents. The median platelet count was 35,000/mmc (IQR, 10,000-70,000). 8 patients had rectal bleeding, 13 had skin purpura, 3 had epistaxis, 6 had mucosal petechiae, and 13 were asymptomatic. Regarding ITP treatment, 19 were treated with corticosteroids, 1 with Anti-RhD immunoglobulin, 12 with intravenous immunoglobulins (IVIG), 4 with thrombopoietin, 3 with rituximab and 6 patients eventually required splenectomy. 10 patients needed no treatment directed to the ITP.Three patients required colectomy during term long follow-up, due to IBD or cancer and not to massive bleeding as a complication of ITP. One patient of eight patients who presented with rectal bleeding required splenectomy, and none required urgent colectomy. Two patients died during the follow-up, one of them due to bleeding complication located in the upper gastrointestinal tract.Median follow-up time was 6.5 years [IQR, 3-10]. With long-term follow-up, all patients had platelet count above 50,000/mmc, and 24 were in IBD clinical remission. CONCLUSION Most ITP cases in this case series occurred after the IBD diagnosis and responded well to regular ITP treatment. The course of the ITP in the IBD patients follows an expected course, including response to medical therapy and low rates of splenectomy.
Collapse
Affiliation(s)
- Hussein Mahajna
- Department of Gastroenterology, Sheba Medical Center, Ramat-Gan, Israel
| | - Bram Verstockt
- Dpt. Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.,Dpt. Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Daniel Bergemalm
- Department of Gastroenterology, Faculty of Medicine, and Health, Örebro University, Örebro, Sweden
| | - Fabiana Castiglione
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
| | | | - Edoardo Vincenzo Savarino
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Italy.,Gastroenterology Unit, Azienda Ospedale Università di Padova, Padua, Italy
| | - Frank Hoentjen
- Department of Gastroenterology, Radboud University Medical Center, Nijmegen, The Netherlands.,Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Talat Bessissow
- Department of Gastroenterology, Royal Victoria Hospital, McGill University Health Center, Montreal, QC, Canada
| | - Jagoda Pokryszka
- Department of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Anneline Cremer
- Department of Gastroenterology, Erasme University Hospital, ULB, Brussels, Belgium
| | - Piotr Eder
- Department of Gastroenterology, Dietetics, and Internal Medicine, Poznań University of Medical Sciences, Poland
| | - Marie Truyens
- IBD Unit, Department of Gastroenterology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Anat Yerushalmy-Feler
- Paediatric Gastroenterology Institute, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maria Jose Garcia
- IBD Unit. Gastroenterology and Hepatology Department, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Uri Kopylov
- Department of Gastroenterology, Tel-Hashomer Sheba Medical Center, Ramat Gan, and Sackler Medical School, Tel Aviv, Israel
| |
Collapse
|
17
|
Venkatesh DN, Meyyanathan SN, Kovacevic A, Zielińska A, Fonseca J, Eder P, Dobrowolska A, Souto EB. Effect of Hydrophilic Polymers on the Release Rate and Pharmacokinetics of Acyclovir Tablets Obtained by Wet Granulation: In Vitro and In Vivo Assays. Molecules 2022; 27:molecules27196490. [PMID: 36235026 PMCID: PMC9572380 DOI: 10.3390/molecules27196490] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/21/2022] [Accepted: 09/23/2022] [Indexed: 11/16/2022] Open
Abstract
This study aims to evaluate the feasibility of producing acyclovir-containing modified release matrix tablets by a wet granulation method based on the type and concentration of two pharmaceutical-grade hydrophilic matrix polymers (i.e., hydroxypropyl methylcellulose (HPMC), carbomers, and their combinations) commonly used in biomedical applications. The mechanical properties of the tablets and in vitro and in vivo performance were studied. The physicochemical properties of the raw materials and corresponding physical mixtures were characterized by differential scanning calorimetry, showing that the hydrophilic polymers did not influence the physicochemical properties of the drug. The wet granulation process improved the flow and compression properties of the obtained granules. This method enabled the preparation of the matrix tablets of acyclovir with appropriate mechanical properties concerning hardness and friability. The drug release kinetics was governed by the type and concentration of the hydrophilic polymers composing the matrices. The study has proven that HPMC-composed tablets were superior in modified drug release properties compared to carbomer- and HPMC/carbomer-based tablets. Mathematical analysis of the release profiles, determined in a medium adjusted to pH 1.2 followed by pH 7.4, revealed that the drug released from the hydrophilic tablets followed non-Fickian first-order kinetics. An optimal HPMC-based formulation submitted to accelerated stability studies (40 °C, 75% RH) was stable for three months. A complete cross-over bioavailability study of the selected acyclovir-loaded sustained release tablets and marketed immediate-release tablets were compared in six healthy male volunteers. The extent of drug absorption from the sustained release tablets was significantly greater than that from immediate-release pills, which may improve the drug's antiviral properties attributed to the lower elimination rate and enhanced acyclovir half-life.
Collapse
Affiliation(s)
- D. Nagasamy Venkatesh
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Rocklands, Post Box. No. 20, Elk Hill Road, The Nilgiris, Ooty 643001, Tamil Nadu, India
- Correspondence: (D.N.V.); (E.B.S.)
| | - Subramanianainar N. Meyyanathan
- Department of Pharmaceutical Analysis, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Rocklands, Post Box. No. 20, Elk Hill Road, The Nilgiris, Ooty 643001, Tamil Nadu, India
| | - Andjelka Kovacevic
- Department of Pharmaceutical Technology, Institute of Pharmacy, Friedrich-Schiller University Jena, Helmholtzweg 4, 07743 Jena, Germany
| | - Aleksandra Zielińska
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, 60-479 Poznan, Poland
| | - Joel Fonseca
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Eliana B. Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira, 228, 4050-313 Porto, Portugal
- REQUIMTE/UCIBIO, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira, 228, 4050-313 Porto, Portugal
- Correspondence: (D.N.V.); (E.B.S.)
| |
Collapse
|
18
|
Gościniak A, Eder P, Walkowiak J, Cielecka-Piontek J. Artificial Gastrointestinal Models for Nutraceuticals Research—Achievements and Challenges: A Practical Review. Nutrients 2022; 14:nu14132560. [PMID: 35807741 PMCID: PMC9268564 DOI: 10.3390/nu14132560] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 05/04/2022] [Revised: 06/09/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022] Open
Abstract
Imitating the human digestive system as closely as possible is the goal of modern science. The main reason is to find an alternative to expensive, risky and time-consuming clinical trials. Of particular interest are models that simulate the gut microbiome. This paper aims to characterize the human gut microbiome, highlight the importance of its contribution to disease, and present in vitro models that allow studying the microbiome outside the human body but under near-natural conditions. A review of studies using models SHIME, SIMGI, TIM-2, ECSIM, EnteroMix, and PolyfermS will provide an overview of the options available and the choice of a model that suits the researcher’s expectations with advantages and disadvantages.
Collapse
Affiliation(s)
- Anna Gościniak
- Department of Pharmacognosy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland;
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland;
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Szpitalna 27/33, 60-572 Poznan, Poland;
| | - Judyta Cielecka-Piontek
- Department of Pharmacognosy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland;
- Correspondence:
| |
Collapse
|
19
|
Eder P, Kowalski P, Mastalerz-Migas A, Skrzydlo-Radomanska B, Cichy W, Proga K. Self-Medication with Drotaverine among Patients with Common Abdominal Symptoms and Treatment Efficacy from the Perspectives of Patients and General Practitioners-An Observational, Retrospective, Cross-Sectional Study Using Real-World Data. J Clin Med 2022; 11:jcm11113156. [PMID: 35683543 PMCID: PMC9181793 DOI: 10.3390/jcm11113156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/28/2022] [Accepted: 05/29/2022] [Indexed: 02/05/2023] Open
Abstract
In Poland, drotaverine is the most frequently purchased antispasmodic, yet there is a paucity of real-world data on its use. We evaluated the profiles of patients who used drotaverine, and we investigated prescription patterns among general practitioners (GPs). In this cross-sectional, questionnaire-based study, we asked patients who purchased drotaverine about their reasons for using it, its perceived efficacy, satisfaction with treatment, and physician consultation. We also asked GPs about the status of drotaverine in their practice. Among 650 recruited patients, 74% used drotaverine for pain, 67% for cramps, and 19% for abdominal discomfort. Approximately 83% of patients purchased drotaverine without a physician’s advice. Patients who used it after a physician’s advice were more frequently female, older, and less educated. For all symptoms, mean severity scores decreased by ~5 points (0–10 scale) after the first dose. Ninety-eight percent of patients were satisfied with drotaverine. Among 210 GPs, the percentages prescribing drotaverine were: 42% for irritable bowel syndrome, 89% for cholelithiasis, 60% as supportive therapy for urinary infections, 89% for nephrolithiasis, and 75% for menstruation pain. The GPs perceived drotaverine as more useful, effective, and tolerable than other drugs for abdominal pain or cramps. Drotaverine significantly reduced the severity of all symptoms for which it was taken, and it was perceived as effective and tolerable.
Collapse
Affiliation(s)
- Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Heliodor Swiecicki University Hospital, Poznan University of Medical Sciences, Ul. Przybyszewskiego 49, 60-355 Poznan, Poland
- Correspondence: ; Tel.: +48-61-869-13-43
| | - Piotr Kowalski
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Medical University of Gdansk, Al. Hallera 107, 80-416 Gdansk, Poland;
| | - Agnieszka Mastalerz-Migas
- Department of Family Medicine, Medical University of Wroclaw, Ul. Syrokomli 1, 51-141 Wroclaw, Poland;
| | - Barbara Skrzydlo-Radomanska
- Department and Clinic of Gastroenterology with the Endoscopy Laboratory of the Medical University of Lublin, Aleje Raclawickie 1, 20-059 Lublin, Poland;
| | - Wojciech Cichy
- Faculty of Health Sciences, Calisia University-Kalisz, Ul. Nowy Swiat 4, 62-800 Kalisz, Poland;
| | - Katarzyna Proga
- PEX PharmaSequence Sp. z o.o., Ul. Klobucka 23, 02-699 Warszawa, Poland;
| |
Collapse
|
20
|
Spinelli A, Bonovas S, Burisch J, Kucharzik T, Adamina M, Annese V, Bachmann O, Bettenworth D, Chaparro M, Czuber-Dochan W, Eder P, Ellul P, Fidalgo C, Fiorino G, Gionchetti P, Gisbert JP, Gordon H, Hedin C, Holubar S, Iacucci M, Karmiris K, Katsanos K, Kopylov U, Lakatos PL, Lytras T, Lyutakov I, Noor N, Pellino G, Piovani D, Savarino E, Selvaggi F, Verstockt B, Doherty G, Raine T, Panis Y. ECCO Guidelines on Therapeutics in Ulcerative Colitis: Surgical Treatment. J Crohns Colitis 2022; 16:179-189. [PMID: 34635910 DOI: 10.1093/ecco-jcc/jjab177] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This is the second of a series of two articles reporting the European Crohn's and Colitis Organisation [ECCO] evidence-based consensus on the management of adult patients with ulcerative colitis [UC]. The first article is focused on medical management, and the present article addresses medical treatment of acute severe ulcerative colitis [ASUC] and surgical management of medically refractory UC patients, including preoperative optimisation, surgical strategies, and technical issues. The article provides advice for a variety of common clinical and surgical conditions. Together, the articles represent an update of the evidence-based recommendations of the ECCO for UC.
Collapse
Affiliation(s)
- Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, and Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Stefanos Bonovas
- Department of Biomedical Sciences, and IRCCS Humanitas Research Hospital, Milan, Italy
| | - Johan Burisch
- Gastrounit, Medical Division, and Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, Hvidovre Hospital, University of Copenhagen, Denmark
| | - Torsten Kucharzik
- Department of Gastroenterology, Lüneburg Hospital, University of Hamburg, Lüneburg, Germany
| | - Michel Adamina
- Department of Surgery, Clinic of Visceral and Thoracic Surgery, Cantonal Hospital Winterthur, Zurich.,Department of Biomedical Engineering, Clinical Research and Artificial Intelligence in Surgery, Faculty of Medicine, University of Basel, Allschwil, Switzerland
| | - Vito Annese
- Department of Gastroenterology, Fakeeh University Hospital, Dubai, UAE
| | - Oliver Bachmann
- Department of Internal Medicine I, Siloah St. Trudpert Hospital, Pforzheim.,Hannover Medical School, Hannover, Germany
| | - Dominik Bettenworth
- University Hospital Munster, Department of Medicine B - Gastroenterology and Hepatology, Munster, Germany
| | - Maria Chaparro
- Gastroenterology Unit, IIS-IP, Universidad Autónoma de Madrid [UAM], CIBEREHD, Madrid, Spain
| | - Wladyslawa Czuber-Dochan
- King's College London, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, London, UK
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznań University of Medical Sciences, and Heliodor Święcicki University Hospital, Poznań, Poland
| | - Pierre Ellul
- Department of Medicine, Division of Gastroenterology, Mater Dei Hospital, Msida, Malta
| | - Catarina Fidalgo
- Gastroenterology Division, Hospital Beatriz Ângelo, Loures, Portugal
| | - Gionata Fiorino
- Department of Biomedical Sciences, Humanitas University, and IBD Center, Humanitas Clinical and Research Center, Milan, Italy
| | - Paolo Gionchetti
- IBD Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna DIMEC, University of Bologna, Bologna, Italy
| | - Javier P Gisbert
- Gastroenterology Unit, IIS-IP, Universidad Autónoma de Madrid [UAM], CIBEREHD, Madrid, Spain
| | - Hannah Gordon
- Department of Gastroenterology, Barts Health NHS Trust, Royal London Hospital, London, UK
| | - Charlotte Hedin
- Karolinska Institutet, Department of Medicine Solna, and Karolinska University Hospital, Department of Gastroenterology, Dermatovenereology and Rheumatology, Stockholm, Sweden
| | - Stefan Holubar
- Department of Colon & Rectal Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Marietta Iacucci
- Institute of Immunology and Immunotherapy, University of Birmingham, and Division of Gastroenterology, University Hospitals Birmingham NHS Trust, Birmingham, UK
| | | | - Konstantinos Katsanos
- Department of Gastroenterology and Hepatology, Division of Internal Medicine, University and Medical School of Ioannina, Ioannina, Greece
| | - Uri Kopylov
- Department of Gastroenterology, Tel-HaShomer Sheba Medical Center, Ramat Gan, and Sackler Medical School, Tel Aviv, Israel
| | - Peter L Lakatos
- Division of Gastroenterology, McGill University Health Centre, Montreal, QC, Canada.,1st Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Theodore Lytras
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Ivan Lyutakov
- Department of Gastroenterology, University Hospital 'Tsaritsa Yoanna - ISUL', Medical University Sofia, Sofia, Bulgaria
| | - Nurulamin Noor
- Department of Gastroenterology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Universitá degli Studi della Campania "Luigi Vanvitelli", Naples, Italy, and Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Daniele Piovani
- Department of Biomedical Sciences, Humanitas University, and IRCCS Humanitas Research Hospital, Milan, Italy
| | - Edoardo Savarino
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Francesco Selvaggi
- Department of Advanced Medical and Surgical Sciences, Universitá degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Bram Verstockt
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, and Department of Chronic Diseases, Metabolism and Ageing, TARGID - IBD, KU Leuven, Leuven, Belgium
| | - Glen Doherty
- Department of Gastroenterology and Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Tim Raine
- Department of Gastroenterology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - Yves Panis
- Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy and Université of Paris, France
| |
Collapse
|
21
|
Raine T, Bonovas S, Burisch J, Kucharzik T, Adamina M, Annese V, Bachmann O, Bettenworth D, Chaparro M, Czuber-Dochan W, Eder P, Ellul P, Fidalgo C, Fiorino G, Gionchetti P, Gisbert JP, Gordon H, Hedin C, Holubar S, Iacucci M, Karmiris K, Katsanos K, Kopylov U, Lakatos PL, Lytras T, Lyutakov I, Noor N, Pellino G, Piovani D, Savarino E, Selvaggi F, Verstockt B, Spinelli A, Panis Y, Doherty G. ECCO Guidelines on Therapeutics in Ulcerative Colitis: Medical Treatment. J Crohns Colitis 2022; 16:2-17. [PMID: 34635919 DOI: 10.1093/ecco-jcc/jjab178] [Citation(s) in RCA: 242] [Impact Index Per Article: 121.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Tim Raine
- Department of Gastroenterology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Stefanos Bonovas
- Department of Biomedical Sciences, Humanitas University; IRCCS Humanitas Research Hospital, Milan, Italy
| | - Johan Burisch
- Gastrounit, Medical Division, Hvidovre Hospital; Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, Hvidovre Hospital, University of Copenhagen, Denmark
| | - Torsten Kucharzik
- Department of Gastroenterology, Lüneburg Hospital, University of Hamburg, Lüneburg, Germany
| | - Michel Adamina
- Department of Surgery, Clinic of Visceral and Thoracic Surgery, Cantonal Hospital Winterthur, Zurich, Switzerland
- Department of Biomedical Engineering, Clinical Research and Artificial Intelligence in Surgery, Faculty of Medicine, University of Basel, Allschwil, Switzerland
| | - Vito Annese
- Department of Gastroenterology, Fakeeh University Hospital, Dubai, UAE
| | - Oliver Bachmann
- Department of Internal Medicine I, Siloah St. Trudpert Hospital, Pforzheim; Hannover Medical School, Hannover, Germany
| | - Dominik Bettenworth
- University Hospital Munster, Department of Medicine B - Gastroenterology and Hepatology, Munster, Germany
| | - Maria Chaparro
- Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - Wladyslawa Czuber-Dochan
- King's College London, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, London, UK
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Medicine - Poznań University of Medical Sciences; Heliodor Święcicki University Hospital, Poznań, Poland
| | - Pierre Ellul
- Department of Medicine, Division of Gastroenterology, Mater Dei Hospital, Msida, Malta
| | - Catarina Fidalgo
- Gastroenterology Division, Hospital Beatriz Ângelo, Loures, Portugal
| | - Gionata Fiorino
- Department of Biomedical Sciences, Humanitas University; IBD Center, Humanitas Clinical and Research Center, Milan, Italy
| | - Paolo Gionchetti
- IBD Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna DIMEC, University of Bologna, Bologna, Italy
| | - Javier P Gisbert
- Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - Hannah Gordon
- Department of Gastroenterology, Barts Health NHS Trust, Royal London Hospital, London, UK
| | - Charlotte Hedin
- Karolinska Institutet, Department of Medicine Solna; Karolinska University Hospital, Department of Gastroenterology, Dermatovenereology and Rheumatology, Stockholm, Sweden
| | - Stefan Holubar
- Department of Colon & Rectal Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Marietta Iacucci
- Institute of Immunology and Immunotherapy, NIHR Biomedical Research Centre, University of Birmingham; Division of Gastroenterology, University Hospitals Birmingham NHS Trust, Birmingham, UK
| | | | - Konstantinos Katsanos
- Department of Gastroenterology and Hepatology, Division of Internal Medicine, University and Medical School of Ioannina, Ioannina, Greece
| | - Uri Kopylov
- Department of Gastroenterology, Tel-HaShomer Sheba Medical Center, Ramat Gan, and Sackler Medical School, Tel Aviv, Israel
| | - Peter L Lakatos
- Division of Gastroenterology, McGill University Health Centre, Montreal, QC, Canada
- 1st Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Theodore Lytras
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Ivan Lyutakov
- Department of Gastroenterology, University Hospital 'Tsaritsa Yoanna - ISUL', Medical University Sofia, Sofia, Bulgaria
| | - Nurulamin Noor
- Department of Gastroenterology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Universitá degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
- Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Daniele Piovani
- Department of Biomedical Sciences, Humanitas University; IRCCS Humanitas Research Hospital, Milan, Italy
| | - Edoardo Savarino
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Francesco Selvaggi
- Department of Advanced Medical and Surgical Sciences, Universitá degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Bram Verstockt
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven; Department of Chronic Diseases, Metabolism and Ageing, TARGID - IBD, Leuven, Belgium
| | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University; IRCCS Humanitas Research Hospital, Milan, Italy
| | - Yves Panis
- Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy and Université of Paris, France
| | - Glen Doherty
- Department of Gastroenterology and Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| |
Collapse
|
22
|
Albshesh A, Eder P, Ribaldone DG, Oldenburg B, de Boer NK, Mantzaris GJ, Savarino EV, Dragoni G, Weisshof R, Truyens M, Festa S, Maillard MH, Capirchio L, Filip R, Theodoraki E, Kopylov U. Primary Hypogammaglobulinaemia with Inflammatory Bowel Disease-Like Features: An ECCO CONFER Multicentre Case Series. J Crohns Colitis 2022; 16:91-97. [PMID: 34274962 DOI: 10.1093/ecco-jcc/jjab124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Hypogammaglobulinaemia is a disorder characterized by low serum immunoglobulin levels and a high prevalence of gastrointestinal manifestations. In some cases, clinical and endoscopic features are indistinguishable from those of inflammatory bowel disease [IBD]. METHODS This was a multicentre case series performed as a part of the European Crohn's and Colitis Organisation [ECCO] Collaborative Network of Exceptionally Rare case reports [CONFER] project. RESULTS This report includes 27 patients with primary hypogammaglobulinaemia and IBD-like features: 20 males and seven females, median age 45.6 years (interquartile range [IQR] 35.2-59). Crohn's disease-like features were noted in 23 patients, and four patients had ulcerative colitis-like features. The diagnosis of hypogammaglobulinaemia preceded a diagnosis of IBD-like features in 20 patients [median of 7 years prior, IQR 2.6-20.6 years], and followed the appearance of IBD-like features in seven cases [median of 1 year after, IQR 0.45-5.6 years]. Hypogammaglobulinaemia aetiologies were common variable immunodeficiency [66.6%], agammaglobulinaemia [7.4%], selective IgA-deficiency [11.1%], Good's syndrome [7.4%], IgG subclass deficiency with IgA deficiency [3.7%] and hyper-IgM [3.7%]. In addition to antibiotics and intravenous immunoglobulin [IVIG] for hypogammaglobulinaemia, 12 patients received IBD-related treatment including 5-aminosalicylate agents [two patients], corticosteroids [one patient], thiopurines [three patients], anti-tumour necrosis factor [four patients] and vedolizumab [two patients]. By the end of the follow-up (44.5 months [IQR 18-81]), 21/27 [77%] patients were in clinical remission. CONCLUSION This case series describes IBD-like features in patients with hypogammaglobulinaemia. The diagnosis of IBD-like features mainly occurred after that of hypogammaglobulinaemia, with successful recovery in the majority of cases after appropriate treatment.
Collapse
Affiliation(s)
- Ahmad Albshesh
- Gastroenterology Department, Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznań University of Medical Sciences, Heliodor Święcicki University Hospital, Poznań, Poland
| | | | - Bas Oldenburg
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nanne K de Boer
- Department of Gastroenterology and Hepatology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism Research Insitute (AGEM), Amsterdam, the Netherlands
| | | | - Edoardo Vincenzo Savarino
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Gabriele Dragoni
- IBD Referral Center, Department of Gastroenterology, Careggi University Hospital, Florence, Italy
| | - Roni Weisshof
- Department of Gastroenterology, Rambam Health Care Campus, Haifa, Israel
| | - Marie Truyens
- Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
| | - Stefano Festa
- IBD Unit, Gastroenterology Division, San Filippo Neri Hospital, Rome, Italy
| | - Michel H Maillard
- Division of Gastroenterology and Hepatology, Lausanne University Hospital, Lausanne, Switzerland
| | - Lena Capirchio
- Université Catholique de Louvain, Centre Hospitalier Universitaire Université Catholique de Louvain Namur, Department of Gastroenterology, Yvoir, Belgium
| | - Rafal Filip
- Faculty of Medicine, University of Rzeszow, Rzeszow and Department of Gastroenterology with IBD Unit of Clinical Hospital No 2 im. Św. Jadwigi Królowej, Rzeszow, Poland
| | - Eirini Theodoraki
- Department of Gastroenterology and Hepatology, University Hospital of Heraklion, Heraklion, Greece
| | - Uri Kopylov
- Gastroenterology Department, Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| |
Collapse
|
23
|
Zielińska A, Eder P, Rannier L, Cardoso JC, Severino P, Silva AM, Souto EB. Hydrogels for modified-release drug delivery systems. Curr Pharm Des 2021; 28:609-618. [PMID: 34967292 DOI: 10.2174/1381612828666211230114755] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 12/02/2021] [Indexed: 11/22/2022]
Abstract
Hydrogels for the modified-release drug delivery systems is a continuously growing area of interest for the pharmaceutical industry. According to the global market, the use of polymers in this area is projected to reach $31.4 million by 2027. This review discusses the recent advances and perspectives of hydrogel in drug delivery systems for oral, parenteral, nasal, topical, and ophthalmic. The search strategy did in January 2021, and it conducted an extensive database to identify studies published from January 2010 to December 2020.We described the main characteristic of the polymers to obtain an ideal hydrogel for a specific route of administration and the formulations that was a highlight in the literature. It concluded that the hydrogels are a set useful to decrease the number of doses, side effects, promote adhesion of patient and enhances the bioavailability of the drugs improving the safety and efficacy of the treatment.
Collapse
Affiliation(s)
- Aleksandra Zielińska
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, 60-479 Poznań, Poland
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznań, Poland
| | - Lucas Rannier
- Institute of Technology and Research and University of Tiradentes, Aracaju, Sergipe, Brazil
| | - Juliana C Cardoso
- Institute of Technology and Research and University of Tiradentes, Aracaju, Sergipe, Brazil
| | - Patrícia Severino
- Institute of Technology and Research and University of Tiradentes, Aracaju, Sergipe, Brazil
- Tiradentes Institute, 150 Mt Vernon St, Dorchester, MA 02125, USA
| | - Amélia M Silva
- Department of Biology and Environment, School of Life Sciences and Environment, University of Trás-os-Montes and Alto Douro (UTAD); 5001-801 Vila Real, Portugal
- Centre for Research and Technology of Agro-Environmental and Biological Sciences (CITAB), UTAD, 5001-801 Vila Real, Portugal
| | - Eliana B Souto
- CEB - Centre of Biological Engineering, University of Minho, Campus de Gualtar 4710-057 Braga, Portugal
| |
Collapse
|
24
|
Nijakowski K, Rutkowski R, Eder P, Korybalska K, Witowski J, Surdacka A. Changes in Salivary Parameters of Oral Immunity after Biologic Therapy for Inflammatory Bowel Disease. Life (Basel) 2021; 11:life11121409. [PMID: 34947940 PMCID: PMC8708388 DOI: 10.3390/life11121409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 12/30/2022] Open
Abstract
We previously observed that inflammatory bowel disease (IBD) may compromise oral host defense, as assessed by decreased salivary levels of immunoglobulin A (IgA) and myeloperoxidase (MPO). Biologic therapy with inhibitors of cytokines or adhesion molecules is increasingly used for patients with IBD. Little is known, however, about how this treatment modality affects the release and properties of saliva. Here, we aimed to determine how biologic therapy in patients who had not responded to previous standard treatment with conventional drugs affected the salivary concentration of IgA and MPO. To this end, unstimulated whole mixed saliva was collected before treatment or after 10-12 weeks of therapy from 27 patients with Crohn's disease (CD) and 24 patients with ulcerative colitis (UC). After the induction phase of therapy with biologics, salivary levels of IgA and MPO increased significantly in UC, but not in CD patients. These increases were approximately 8-fold and 6-fold, for IgA and MPO, respectively. Moreover, these effects occurred in UC patients who responded successfully to therapy, but not in those who failed to improve. Furthermore, the relative increases in salivary IgA and MPO correlated with the relative decrease in UC severity, as assessed by the Mayo scale. These data indicate that the successful therapy with biologics in UC patients results also in improved oral host defense. However, it remains to be determined why such an effect does not occur during therapy for CD.
Collapse
Affiliation(s)
- Kacper Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland;
- Correspondence:
| | - Rafał Rutkowski
- Department of Pathophysiology, Poznan University of Medical Sciences, 60-806 Poznan, Poland; (R.R.); (K.K.); (J.W.)
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland;
| | - Katarzyna Korybalska
- Department of Pathophysiology, Poznan University of Medical Sciences, 60-806 Poznan, Poland; (R.R.); (K.K.); (J.W.)
| | - Janusz Witowski
- Department of Pathophysiology, Poznan University of Medical Sciences, 60-806 Poznan, Poland; (R.R.); (K.K.); (J.W.)
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland;
| |
Collapse
|
25
|
Łodyga M, Eder P, Gawron-Kiszka M, Dobrowolska A, Gonciarz M, Hartleb M, Kłopocka M, Małecka-Wojciesko E, Radwan P, Reguła J, Zagórowicz E, Rydzewska G. Guidelines for the management of patients with Crohn's disease. Recommendations of the Polish Society of Gastroenterology and the Polish National Consultant in Gastroenterology. Prz Gastroenterol 2021; 16:257-296. [PMID: 34976235 PMCID: PMC8690943 DOI: 10.5114/pg.2021.110914] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 10/25/2021] [Indexed: 12/13/2022]
Abstract
This paper is an update of the diagnostic and therapeutic recommendations of the National Consultant for Gastroenterology and the Polish Society of Gastroenterology from 2012. It contains 46 recommendations for the diagnosis and treatment, both pharmacological and surgical, of Crohn's disease in adults. The guidelines were developed by a group of experts appointed by the Polish Society of Gastroenterology and the National Consultant in the field of Gastroenterology. The methodology related to the GRADE methodology was used to assess the quality and strength of the available recommendations. The degree of expert support for the proposed statement, assessment of the quality of evidence and the strength of the recommendation was assessed on a 6-point Likert scale. Voting results, quality and strength ratings with comments are included with each statement.
Collapse
Affiliation(s)
- Michał Łodyga
- Department of Gastroenterology with the Inflammatory Bowel Disease Subdivision, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Heliodor Święcicki University Hospital, Poznan, Poland
| | - Magdalena Gawron-Kiszka
- Department of Gastroenterology and Hepatology, Medical University of Silesia, Katowice, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Heliodor Święcicki University Hospital, Poznan, Poland
| | - Maciej Gonciarz
- Department of Gastroenterology and Internal Medicine, Military Institute of Medicine, Warsaw, Poland
| | - Marek Hartleb
- Department of Gastroenterology and Hepatology, Medical University of Silesia, Katowice, Poland
| | - Maria Kłopocka
- Department of Gastroenterology and Nutritional Disorders, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
| | | | - Piotr Radwan
- Department of Gastroenterology, Medical University of Lublin, Lublin, Poland
| | - Jarosław Reguła
- Department of Gastroenterology, Hepatology and Clinical Oncology, Center of Postgraduate Medical Education, Warsaw, Poland
- Department of Oncological Gastroenterology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Edyta Zagórowicz
- Department of Gastroenterology, Hepatology and Clinical Oncology, Center of Postgraduate Medical Education, Warsaw, Poland
- Department of Oncological Gastroenterology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Grażyna Rydzewska
- Department of Gastroenterology with the Inflammatory Bowel Disease Subdivision, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| |
Collapse
|
26
|
Mahadea D, Adamczewska E, Ratajczak AE, Rychter AM, Zawada A, Eder P, Dobrowolska A, Krela-Kaźmierczak I. Iron Deficiency Anemia in Inflammatory Bowel Diseases-A Narrative Review. Nutrients 2021; 13:nu13114008. [PMID: 34836263 PMCID: PMC8624004 DOI: 10.3390/nu13114008] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 12/13/2022] Open
Abstract
Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, is characterized by chronic inflammation of the gastrointestinal tract. IBD has been associated with numerous symptoms and complications, with the most common being iron deficiency anemia (IDA). Iron deficiency in IBD is caused by inadequate intake, malabsorption (including duodenal involvement and surgical removal), and chronic blood loss by mucosal ulcerations. Therefore, an appropriate diet should be enforced. Iron deficiency and iron supplementation have been associated with alterations to gut microbiota. IBD-associated anemia, in particular iron deficiency anemia, is associated with a significant decrease in quality of life and with clinical symptoms such as chronic fatigue, headaches and dizziness, reduced exercise tolerance, pale skin, nails, conjunctiva, and fainting. However, despite these numerous adverse symptoms, IDA remains undertreated. The European Crohn's and Colitis Organisation (ECCO) guidelines state that patients should be monitored for anemia. Adequate treatment, whether oral or intravenous, should be implemented while taking into consideration C-reactive protein values (CRP), hemoglobin levels, and therapeutic response. It should be stressed that every case of anemia in IBD patients should be treated. Intravenous iron formulations, which are more superior compared to the oral form, should be used. There is a need to increase awareness and implementation of international guidelines on iron supplementation in patients with IBD.
Collapse
|
27
|
Skrzypczak D, Skrzypczak-Zielińska M, Ratajczak AE, Szymczak-Tomczak A, Eder P, Słomski R, Dobrowolska A, Krela-Kaźmierczak I. Myostatin and Follistatin-New Kids on the Block in the Diagnosis of Sarcopenia in IBD and Possible Therapeutic Implications. Biomedicines 2021; 9:biomedicines9101301. [PMID: 34680417 PMCID: PMC8533148 DOI: 10.3390/biomedicines9101301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/07/2021] [Accepted: 09/15/2021] [Indexed: 12/16/2022] Open
Abstract
Sarcopenia, which is a decrease in muscle strength and quality of muscle tissue, is a common disorder among patients suffering from inflammatory bowel disease. This particular group of patients often presents with malnutrition and shows low physical activity, which increases the risk of sarcopenia. Another important factor in the development of sarcopenia is an imbalanced ratio of myostatin and follistatin, which may stem from inflammation as well as genetic factors. Currently, research in this area continues, and is aimed at identifying an effective medication for the treatment of this condition. Additionally, we still have no sarcopenia markers that can be used for diagnosis. In this paper, we address the role of myostatin and follistatin as potential markers in the diagnosis of sarcopenia in patients with Crohn’s disease and ulcerative colitis, particularly in view of the genetic and biological aspects. We also present data on new perspectives in the pharmacotherapy of sarcopenia (i.e., myostatin inhibitors and gene therapy). Nevertheless, knowledge is still scarce about the roles of follistatin and myostatin in sarcopenia development among patients suffering from inflammatory bowel disease, which warrants further study.
Collapse
Affiliation(s)
- Dorota Skrzypczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego Street 49, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.)
- Correspondence: (D.S.); (I.K.-K.); Tel.: +48-618691343 (D.S.); +48-601-256-715 (I.K.-K.); Fax: +48-8691-314 (I.K.-K.)
| | - Marzena Skrzypczak-Zielińska
- Institute of Human Genetics, Polish Academy of Sciences Poznan, Strzeszynska Street 32, 60-479 Poznan, Poland; (M.S.-Z.); (R.S.)
| | - Alicja Ewa Ratajczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego Street 49, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.)
| | - Aleksandra Szymczak-Tomczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego Street 49, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.)
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego Street 49, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.)
| | - Ryszard Słomski
- Institute of Human Genetics, Polish Academy of Sciences Poznan, Strzeszynska Street 32, 60-479 Poznan, Poland; (M.S.-Z.); (R.S.)
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego Street 49, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.)
| | - Iwona Krela-Kaźmierczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego Street 49, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.)
- Correspondence: (D.S.); (I.K.-K.); Tel.: +48-618691343 (D.S.); +48-601-256-715 (I.K.-K.); Fax: +48-8691-314 (I.K.-K.)
| |
Collapse
|
28
|
Banasiewicz T, Eder P, Rydzewska G, Reguła J, Dobrowolska A, Durlik M, Wallner G, Dziki A. Statement of the polish expert group on the current practice and prospects for the treatment of complex perianal fistulas in Crohn's disease. Update 2021. Pol Przegl Chir 2021; 93:70-79. [PMID: 34515655 DOI: 10.5604/01.3001.0015.2335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Perianal fistulas in Crohn's disease (CD) are a major problem. In majority of patient, inflammation involves the rectum. Perianal fistulas in CD pose a diagnostic and therapeutic challenge due to severe symptoms and worse prognosis compared to cryptogenic fistulas. The accurate diagnosis is crucial for an effective treatment of CD-related perianal fistulas, and the following should be determined: anatomy of the fistula, possible strictures and inflammation of the alimentary tract, including the rectum and the anal canal. Treatment of fistulas might be challenging and requires cooperation between the colorectal surgeon and the gastroenterologist. The combination of surgical and pharmacological therapy is more effective than surgical or pharmacological therapy alone. In conservative treatment, aminosalicylates or steroids have little significance. In everyday practice, antibacterial chemotherapeutics, antibiotics and thiopurines are applied. The most effective are TNF-neutralizing antibodies, i.e. infliximab (IFX), adalimumab (ADA) and certolizumab (CER). Surgical management can be urgent including drainage. Elective procedures include dissection of the fistula (simple fistula) or more complex interventions such as mucosal flap or ligation of the intersphincteric portion of the fistula. Surgical interventions can be enhanced using the video-assisted anal fistula treatment (VAAFT) or negative-pressure therapy. In extreme cases, creation of a stoma may be necessary. Also, tissue glues or so-called plugs may be applied in managing perianal fistulas. The use of stem cells seems promising, i.e. application of multipotent non-hematopoietic stem cells around the fistula in order to induce immunomodulation and wound healing.
Collapse
Affiliation(s)
- Tomasz Banasiewicz
- Katedra i Klinika Chirurgii Ogólnej, Endokrynologicznej i Onkologii Gastroenterologicznej, Uniwersytet Medyczny w Poznaniu
| | - Piotr Eder
- Katedra i Klinika Gastroenterologii, Dietetyki i Chorób Wewnętrznych, Uniwersytet Medyczny w Poznaniu
| | - Grażyna Rydzewska
- Klinika Chorób Wewnętrznych i Gastroenterologii z Pododdziałem Leczenia Nieswoistych Chorób Zapalnych Jelit Centralnego, Szpital Kliniczny MSWiA w Warszawie
| | - Jarosław Reguła
- Klinika Gastroenterologii, Hepatologii i Onkologii Klinicznej, Centrum Medycznego Kształcenia Podyplomowego, Centrum Onkologii - Instytut im. Marii Skłodowskiej-Curie w Warszawie
| | - Agnieszka Dobrowolska
- Katedra i Klinika Gastroenterologii, Dietetyki i Chorób Wewnętrznych, Uniwersytet Medyczny w Poznaniu
| | - Marek Durlik
- Klinika Chirurgii Gastroenterologicznej i Transplantologii, Centralny Szpital Kliniczny MSWiA w Warszawie
| | - Grzegorz Wallner
- II Klinika Chirurgii Ogólnej, Gastroenterologicznej i Nowotworów Układu Pokarmowego, Uniwersytet Medyczny w Lublinie
| | - Adam Dziki
- Klinika Chirurgii Ogólnej i Kolorektalnej, Uniwersytet Medyczny w Łodzi
| |
Collapse
|
29
|
Cichoż-Lach H, Michalak A, Kopertowska-Majchrzak M, Eder P, Stawczyk-Eder K, Waszak K, Talar-Wojnarowska R, Zatorski H, Solarska-Półchłopek A, Chmielnicki J, Filip R, Pękala A, Janiak M, Skrobot K, Kasińska E, Krogulecki M, Królikowski P, Kłopocka M, Liebert A, Poniewierka E, Smoła I, Gąsiorowska A, Kaczka A, Wypych J, Wojciechowski K, Drygała S, Zagórowicz E. Characteristics of patients with moderate-to-severe ulcerative colitis treated with vedolizumab: results from a Polish multicenter, prospective, observational real-life study (the POLONEZ study). Therap Adv Gastroenterol 2021; 14:17562848211036456. [PMID: 34484422 PMCID: PMC8411627 DOI: 10.1177/17562848211036456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 07/12/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Vedolizumab, a humanized antibody targeting the α4β7 integrin, was proven to be effective in the treatment of moderate-to-severe ulcerative colitis (UC) in randomized clinical trials. The aim of the POLONEZ study is to determine the demographic and clinical characteristics of the patients with UC treated with vedolizumab within the scope of the National Drug Program in Poland and to assess the real-world effectiveness and safety of vedolizumab in the study population. Here we report the demographic and clinical characteristics of these patients. METHODS This prospective study included adult patients eligible for UC treatment with vedolizumab who were recruited from 12 centers in Poland between February and November 2019. Collected data included sex, age, disease duration, presence of extraintestinal manifestations or comorbidities, status of previous biologic treatment, and current concomitant treatment. Disease extent was determined according to the Montreal classification, and disease activity was measured with the Mayo Score. RESULTS A total of 100 (55 biologic-naïve and 45 biologic-exposed) patients were enrolled in the study (51% female, median age 35 years). Among biologic-exposed patients (mostly infliximab-treated), 57% had failed to respond to the therapy. The disease duration was significantly shorter in biologic-naïve (median 5 years) than in biologic-exposed (8 years, p = 0.004) or biofailure patients (7 years, p = 0.04). In the overall population the median Total Mayo Score was 10. Disease extent and activity were similar between the subgroups. CONCLUSIONS Our study indicates that patients treated with vedolizumab in Poland receive the drug relatively early after UC diagnosis, but their disease is advanced. More than half of the patients had not been treated with biologic drugs before initiating vedolizumab. The study was registered in ENCePP database (EUPAS34119). LAY SUMMARY Characteristics of patients treated for ulcerative colitis with vedolizumab in Poland Treatment of moderate-to-severe ulcerative colitis (UC) with the integrin antagonist vedolizumab became available within the Polish National Drug Program (NDP) in 2018. In this study, for the first time, we provide detailed demographic and clinical characteristics of 100 patients (median age 35 years, 51% female) treated with vedolizumab in Poland, of whom 55 were biologic-naïve and 45 biologic-exposed. The median duration of disease was 6 years. The disease duration was shorter in biologic-naïve than in biologic-exposed patients. Most patients were affected by extensive colitis (52%) or left-sided colitis (42%). Median disease activity was 10 according to the Total Mayo Score. Sixty-eight patients received concomitant systemic corticosteroids and 45 patients received immunomodulators. Our findings indicate that Polish patients receiving vedolizumab have a high disease activity and are treated relatively early after UC diagnosis. This might be due to the criteria for inclusion of a patient in the NDP.
Collapse
Affiliation(s)
- Halina Cichoż-Lach
- Department of Gastroenterology, Medical
University of Lublin, Lublin, Poland
| | - Agata Michalak
- Department of Gastroenterology, Medical
University of Lublin, Lublin, Poland
| | | | - Piotr Eder
- Department of Gastroenterology, Dietetics, and
Internal Diseases, Poznan University of Medical Sciences, H. Święcicki
University Hospital, Poznaņ, Poland
| | - Kamila Stawczyk-Eder
- Department of Gastroenterology, Dietetics, and
Internal Diseases, Poznan University of Medical Sciences, H. Święcicki
University Hospital, Poznaņ, Poland
| | - Katarzyna Waszak
- Department of Gastroenterology, Dietetics, and
Internal Diseases, Poznan University of Medical Sciences, H. Święcicki
University Hospital, Poznaņ, Poland
| | | | - Hubert Zatorski
- Department of Digestive Tract Diseases, Medical
University of Lodz, Łódź, Poland
| | - Anna Solarska-Półchłopek
- Department of Gastroenterology, The Maria
Sklodowska-Curie National Research Institute of Oncology, Warsaw,
Poland,Department of Gastroenterology, Hepatology and
Clinical Oncology, The Medical Center of Postgraduate Education, Warsaw,
Poland
| | | | - Rafał Filip
- Department of Gastroenterology with IBD Unit,
Clinical Hospital No. 2, Rzeszów, Poland
| | - Anna Pękala
- Department of Gastroenterology with IBD Unit,
Clinical Hospital No. 2, Rzeszów, Poland
| | - Maria Janiak
- Department of Gastroenterology and Hepatology,
Medical University of Gdańsk, Gdańsk, Poland
| | - Krzysztof Skrobot
- Department of Gastroenterology and Hepatology,
Medical University of Gdańsk, Gdańsk, Poland
| | - Ewa Kasińska
- Department of Gastroenterology, Military
Institute of Medicine, Warsaw, Poland
| | - Michał Krogulecki
- Department of Gastroenterology, Military
Institute of Medicine, Warsaw, Poland
| | - Piotr Królikowski
- Department of Gastroenterology, Military
Institute of Medicine, Warsaw, Poland
| | - Maria Kłopocka
- Department of Gastroenterology and Nutritional
Disorders, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in
Toruń, Bydgoszcz, Poland
| | - Ariel Liebert
- Department of Gastroenterology and Nutritional
Disorders, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in
Toruń, Bydgoszcz, Poland
| | - Elżbieta Poniewierka
- Department of Gastroenterology and Hepatology,
Wrocław Medical University, Wrocław, Poland
| | - Izabela Smoła
- Department of Gastroenterology and Hepatology,
Wrocław Medical University, Wrocław, Poland
| | - Anita Gąsiorowska
- Department of Gastroenterology, University
Clinical Hospital Military Memorial Medical Academy—Central Veterans’
Hospital, Łódź, Poland
| | - Aleksandra Kaczka
- Department of Gastroenterology, University
Clinical Hospital Military Memorial Medical Academy—Central Veterans’
Hospital, Łódź, Poland
| | - Joanna Wypych
- Department of Gastroenterology, Surgery and
Nutrition, Copernicus Hospital, Gdańsk, Poland
| | | | | | - Edyta Zagórowicz
- Department of Gastroenterology, The Maria
Sklodowska-Curie National Research Institute of Oncology, Warsaw,
Poland,Department of Gastroenterology, Hepatology and
Clinical Oncology, The Medical Center of Postgraduate Education, Warsaw,
Poland
| |
Collapse
|
30
|
Łodyga M, Maciejewska K, Eder P, Waszak K, Stawczyk-Eder K, Dobrowolska A, Kaczka A, Gąsiorowska A, Stępień-Wrochna B, Cicha M, Rydzewska G. Social Distancing during COVID-19 Pandemic among Inflammatory Bowel Disease Patients. J Clin Med 2021; 10:3689. [PMID: 34441985 PMCID: PMC8396918 DOI: 10.3390/jcm10163689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/27/2021] [Accepted: 08/18/2021] [Indexed: 01/12/2023] Open
Abstract
(1) Background: Social distancing rules have been widely introduced in the fight against the coronavirus disease 2019 (COVID-19) pandemic. So far, the effectiveness of these methods has not been assessed in the group of inflammatory bowel disease (IBD) patients. (2) Methods: The study included 473 patients with IBD who made 1180 hospital visits from 1 May to 30 September 2020. During each visit, the patients completed a five-step, progressive scale that was developed to assess the degree of social isolation. In parallel, other demographic data were collected and the concentrations of anti-severe acute respiratory coronavirus 2 (SARS-CoV-2) IgG and IgM+IgA antibodies were measured using the ELISA method. (3) Results: The study found a significant correlation between the degree of social distancing and the presence of anti-SARS-CoV-2 antibodies in the groups with the lowest degree of isolation (3 to 5). (4) Conclusions: Maintaining social distancing is an effective method for reducing the spread of SARS-CoV-2 virus among IBD patients.
Collapse
Affiliation(s)
- Michał Łodyga
- Department of Gastroenterology with the Inflammatory Bowel Disease Subdivision, Central Clinical Hospital of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland; (K.M.); (B.S.-W.); (G.R.)
| | - Katarzyna Maciejewska
- Department of Gastroenterology with the Inflammatory Bowel Disease Subdivision, Central Clinical Hospital of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland; (K.M.); (B.S.-W.); (G.R.)
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznań University of Medical Sciences, Heliodor Święcicki University Hospital, 60-355 Poznań, Poland; (P.E.); (K.W.); (K.S.-E.); (A.D.)
| | - Katarzyna Waszak
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznań University of Medical Sciences, Heliodor Święcicki University Hospital, 60-355 Poznań, Poland; (P.E.); (K.W.); (K.S.-E.); (A.D.)
| | - Kamila Stawczyk-Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznań University of Medical Sciences, Heliodor Święcicki University Hospital, 60-355 Poznań, Poland; (P.E.); (K.W.); (K.S.-E.); (A.D.)
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznań University of Medical Sciences, Heliodor Święcicki University Hospital, 60-355 Poznań, Poland; (P.E.); (K.W.); (K.S.-E.); (A.D.)
| | - Aleksandra Kaczka
- Department of Gastroenterology, Medical University of Łódź, 92-213 Łódź, Poland; (A.K.); (A.G.)
| | - Anita Gąsiorowska
- Department of Gastroenterology, Medical University of Łódź, 92-213 Łódź, Poland; (A.K.); (A.G.)
| | - Beata Stępień-Wrochna
- Department of Gastroenterology with the Inflammatory Bowel Disease Subdivision, Central Clinical Hospital of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland; (K.M.); (B.S.-W.); (G.R.)
| | - Małgorzata Cicha
- Diagnostic Laboratory, Central Clinical Hospital of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland;
| | - Grażyna Rydzewska
- Department of Gastroenterology with the Inflammatory Bowel Disease Subdivision, Central Clinical Hospital of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland; (K.M.); (B.S.-W.); (G.R.)
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland
| |
Collapse
|
31
|
Rychter AM, Ratajczak AE, Szymczak-Tomczak A, Michalak M, Eder P, Dobrowolska A, Krela-Kaźmierczak I. Associations of Lifestyle Factors with Osteopenia and Osteoporosis in Polish Patients with Inflammatory Bowel Disease. Nutrients 2021; 13:1863. [PMID: 34070791 PMCID: PMC8227497 DOI: 10.3390/nu13061863] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 01/31/2023] Open
Abstract
Reduced physical activity (PA), smoking, and coffee and alcohol drinking constitute risk factors of osteoporosis in patients with inflammatory bowel disease (IBD). The aim of the study was to measure the bone mineral density (BMD) and frequency of osteopenia and osteoporosis in patients with IBD and their correlation with PA, smoking, coffee, and alcohol. The study group consisted of 208 patients with IBD-103 with Crohn's disease (CD), 105 suffering from ulcerative colitis (UC). Densitometric measurements were performed using the DXA. All patients completed a questionnaire concerning PA, smoking, and coffee and alcohol consumption. The prevalence of osteopenia and osteoporosis (L2-L4) in the IBD group was 48.1%; in the CD group, it amounted to 48.6%, and in the UC group, the prevalence was equal to 33.3%. Patients with CD who were diagnosed with osteopenia and osteoporosis demonstrated reduced PA compared to patients with a normal BMD who exercised regularly (p = 0.0335). A similar observation was made in the group of women with IBD. Women with a normal BMD exercised significantly more often than women suffering from osteopenia and osteoporosis (p = 0.0146). However, no differences in BMD were observed with regard to coffee use, alcohol consumption, or smoking. Thus, since the incidence of osteoporosis in IBD patients is high, it may be dependent on PA.
Collapse
Affiliation(s)
- Anna Maria Rychter
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.); (I.K.-K.)
| | - Alicja Ewa Ratajczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.); (I.K.-K.)
| | - Aleksandra Szymczak-Tomczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.); (I.K.-K.)
| | - Michał Michalak
- Department of Computer Sciences and Statistics, Poznan University of Medical Sciences, 60-806 Poznan, Poland;
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.); (I.K.-K.)
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.); (I.K.-K.)
| | - Iwona Krela-Kaźmierczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland; (A.E.R.); (A.S.-T.); (P.E.); (A.D.); (I.K.-K.)
| |
Collapse
|
32
|
Eder P, Dobrowolska A. Black esophagus: an unusual etiology of upper gastrointestinal bleeding. Pol Arch Intern Med 2021; 131:377-378. [PMID: 33720641 DOI: 10.20452/pamw.15876] [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: 11/23/2022]
Affiliation(s)
- Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland; Heliodor Święcicki University Hospital in Poznan, Poznań, Poland.
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland,Heliodor Święcicki University Hospital in Poznan, Poznań, Poland
| |
Collapse
|
33
|
Szymczak-Tomczak A, Kaczmarek-Ryś M, Hryhorowicz S, Michalak M, Eder P, Skrzypczak-Zielińska M, Łykowska-Szuber L, Tomczak M, Słomski R, Dobrowolska A, Krela-Kaźmierczak I. Vitamin D, Vitamin D Receptor (VDR) Gene Polymorphisms (ApaI and FokI), and Bone Mineral Density in Patients With Inflammatory Bowel Disease. J Clin Densitom 2021; 24:233-242. [PMID: 33172802 DOI: 10.1016/j.jocd.2020.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Received: 04/09/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 02/06/2023]
Abstract
In the etiology of inflammatory bowel disease (IBD) and osteoporosis, the connecting element is the involvement of environmental and genetic factors. Vitamin D receptor (VDR) gene polymorphisms may be associated with the pathogenesis of IBD and bone mineral density (BMD). The study aimed to analyze the relationship between ApaI and FokI polymorphisms of the VDR gene, serum vitamin D concentration, and BMD in patients with IBD. The studied group consisted of 172 patients (85 with Crohn's disease [CD], 87 with ulcerative colitis [UC], and 39 healthy subjects - control group [CG]) were examined. Lumbar spine densitometry (L1-L4) and the femoral neck (FN) measurements were performed using dual-energy X-ray absorptiometry (DXA). Serum concentrations of 25-hydroxyvitamin D were determined using electrochemiluminescence binding assay (ECLIA). Polymorphisms were determined with polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). . We found no statistically significant differences in vitamin D concentration between the 3 studied groups. CD patients who were FF homozygotes had significantly lower FN BMD than FF homozygous from CG (p-value < 0.05). CD patients who were Aa heterozygotes had significantly lower lumbar spine (L2-L4) BMD than Aa heterozygotes from CG (p-value < 0.05). Among patients with the same polymorphic variants, but belonging to different studied groups, statistically significant differences in bone mineral density in the lumbar spine and the closer end of the femoral neck were observed. We consider that it is the disease entity, not the polymorphism variant, may have a decisive impact on BMD.
Collapse
Affiliation(s)
- Aleksandra Szymczak-Tomczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | | | | | - Michał Michalak
- Department of Computer Sciences and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Liliana Łykowska-Szuber
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Maciej Tomczak
- Department of Psychology, Poznan University of Physical Education, Poland
| | - Ryszard Słomski
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Iwona Krela-Kaźmierczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
| |
Collapse
|
34
|
Łodyga M, Maciejewska K, Eder P, Waszak K, Stawczyk-Eder K, Michalak M, Dobrowolska A, Wiśniewska-Jarosińska M, Gąsiorowska A, Cicha M, Wierzba W, Rydzewska G. Inflammatory bowel disease is associated with higher seroprevalence rates of antibodies against SARS-CoV-2. Pol Arch Intern Med 2021; 131:226-232. [PMID: 33544564 DOI: 10.20452/pamw.15796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION According to the current data, there has been no increase in the incidence of COVID‑19 in patients with inflammatory bowel disease (IBD). OBJECTIVES The available data are based on symptomatic cases and do not include the asymptomatic ones. To measure the exact infection rate, we initiated a study that aimed to assess the seroprevalence of anti-SARS‑CoV‑2 antibodies in IBD. PATIENTS AND METHODS A total of 864 individuals were enrolled in the study, including 432 patients with IBD (290 with Crohn disease and 142 with ulcerative colitis) and 432 controls without IBD (healthcare professionals) matched for age and sex. Serum samples were prospectively collected, and the presence of anti-SARS‑CoV‑2 immunoglobulin (Ig) G and IgM + IgA antibodies were measured using the enzyme‑linked immunoassay method (Vircell Microbiologists). RESULTS A significantly higher percentage of positive results for anti-SARS‑CoV‑2 antibodies, both in the IgG and IgM + IgA class, was found in patients with IBD (4.6% and 6%, respectively, compared with 1.6% and 1.1%, respectively, in controls; both P values <0.05). No patient had symptomatic COVID‑19. There was no association among patients' age, sex, drugs used for IBD, or disease activity and the occurrence of IgG antibodies. CONCLUSION Patients with IBD may be at higher risk of developing SARS‑CoV‑2 infection, defined as the presence of elevated levels of anti-SARS‑CoV‑2 IgG antibodies, but not of having a symptomatic and / or severe course of COVID‑19 compared with healthcare professionals without IBD.
Collapse
Affiliation(s)
- Michał Łodyga
- Department of Internal Medicine and Gastroenterology with Inflammatory Bowel Disease Subdivision, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland.
| | - Katarzyna Maciejewska
- Department of Internal Medicine and Gastroenterology with Inflammatory Bowel Disease Subdivision, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Heliodor Święcicki University Hospital, Poznań, Poland
| | - Katarzyna Waszak
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Heliodor Święcicki University Hospital, Poznań, Poland
| | - Kamila Stawczyk-Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Heliodor Święcicki University Hospital, Poznań, Poland
| | - Michał Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznań, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Heliodor Święcicki University Hospital, Poznań, Poland
| | | | - Anita Gąsiorowska
- Department of Gastroenterology, Medical University of Lodz, Łódź, Poland
| | - Małgorzata Cicha
- Diagnostic Laboratory, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Waldemar Wierzba
- Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland,Satellite Campus in Warsaw, University of Humanities and Economics in Lodz, Warsaw, Poland
| | - Grażyna Rydzewska
- Department of Internal Medicine and Gastroenterology with Inflammatory Bowel Disease Subdivision, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland,Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| |
Collapse
|
35
|
Lykowska-Szuber L, Walczak M, Skrzypczak-Zielinska M, Suszynska-Zajczyk J, Stawczyk-Eder K, Waszak K, Eder P, Wozniak A, Krela-Kazmierczak I, Slomski R, Dobrowolska A. Effect of Anti-TNF Therapy on Mucosal Apoptosis Genes Expression in Crohn's Disease. Front Immunol 2021; 12:615539. [PMID: 33767696 PMCID: PMC7985326 DOI: 10.3389/fimmu.2021.615539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/15/2021] [Indexed: 12/22/2022] Open
Abstract
Crohn's disease (CD) is a chronic immune-mediated disorder for which there is not a fully effective treatment. Moreover, biological therapy with anti-tumor necrosis factor-α (anti-TNF-α) monoclonal antibodies leads to an effective response in only 60–70% of patients. Our previous data suggested that specific loci polymorphism of the TNFRSF1B, FCGR3A, IL1R, IL1B, and FAS genes could be a predictor of the primary non-response to anti-TNF therapy in CD patients. In this work, we propose to explain this hypothesis by functional analysis in colon biopsies and in a cell culture model. Using the RT-qPCR analysis, we estimated the FCGR3A, IL1R, TNFRSF1B, IL1B, FAS, and ADAM17 genes mRNA level in colon biopsies material from inflamed and non-inflamed tissue from 21 CD patients (14 responders and 7 non-responders to anti-TNF therapy) and 6 controls, as well as in vitro in a peripheral blood mononuclear cells (PBMCs) from 14 CD patients (seven responders and seven non-responders to anti-TNF therapy) and eight controls cultured for 72 h with 10 μg/ml of anti-TNF antibody. Our findings demonstrated a significant down-regulation of TNFRSF1B gene expression in non-responders both in inflamed and in non-inflamed colon tissue, while the expression of the FCGR3A and IL1B genes was significantly up-regulated in non-responders in the inflamed colon region. In vitro research results indicate that the anti-TNF drug induced a significant decrease in TNFRSF1B, FCGR3A, and FAS gene expression in non-responders. These results show that altered TNFRSF1B, FCGR3A, and IL1B genes expression can be a predictor of the primary non-response to anti-TNF therapy in CD patients.
Collapse
Affiliation(s)
- Liliana Lykowska-Szuber
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Michal Walczak
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | | | - Joanna Suszynska-Zajczyk
- Department of Biochemistry and Biotechnology, Poznan University of Life Sciences, Poznan, Poland
| | - Kamila Stawczyk-Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Waszak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Wozniak
- The NanoBioMedical Centre, Adam Mickiewicz University, Poznan, Poland
| | - Iwona Krela-Kazmierczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Ryszard Slomski
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
36
|
Eder P, Łodyga M, Dobrowolska A, Reguła J, Rydzewska G. Position statement of the Polish Society of Gastroenterology and the National Gastroenterology Consultant on vaccination against COVID-19 among patients with inflammatory bowel diseases. Prz Gastroenterol 2021; 16:2-4. [PMID: 33986880 PMCID: PMC8112264 DOI: 10.5114/pg.2021.103666] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 01/19/2021] [Indexed: 01/25/2023]
Affiliation(s)
- Piotr Eder
- Chair and Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Swiecicki Clinical Hospital, Poznan, Poland
| | - Michał Łodyga
- Department of Internal Diseases and Gastroenterology with Subdivision for the Treatment of Non-Specific Inflammatory Bowel Diseases, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterological Oncology, Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Jarosław Reguła
- Department of Gastroenterological Oncology, Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Grażyna Rydzewska
- Department of Internal Diseases and Gastroenterology with Subdivision for the Treatment of Non-Specific Inflammatory Bowel Diseases, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| |
Collapse
|
37
|
Skrzypczak D, Ratajczak AE, Szymczak-Tomczak A, Dobrowolska A, Eder P, Krela-Kaźmierczak I. A Vicious Cycle of Osteosarcopeniain Inflammatory Bowel Diseases-Aetiology, Clinical Implications and Therapeutic Perspectives. Nutrients 2021; 13:nu13020293. [PMID: 33498571 PMCID: PMC7909530 DOI: 10.3390/nu13020293] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/08/2021] [Accepted: 01/18/2021] [Indexed: 12/13/2022] Open
Abstract
Sarcopenia is a disorder characterized by a loss of muscle mass which leads to the reduction of muscle strength and a decrease in the quality and quantity of muscle. It was previously thought that sarcopenia was specific to ageing. However, sarcopenia may affect patients suffering from chronic diseases throughout their entire lives. A decreased mass of muscle and bone is common among patients with inflammatory bowel disease (IBD). Since sarcopenia and osteoporosis are closely linked, they should be diagnosed as mutual consequences of IBD. Additionally, multidirectional treatment of sarcopenia and osteoporosis including nutrition, physical activity, and pharmacotherapy should include both disorders, referred to as osteosarcopenia.
Collapse
|
38
|
Krela-Kazmierczak I, Szymczak-Tomczak A, Tomczak M, Lykowska-Szuber L, Eder P, Kucharski MA, Stawczyk-Eder K, Waszak K, Karczewski J, Dobrowolska A. Is there a relation between vitamin D, interleukin-17, and bone mineral density in patients with inflammatory bowel disease? Arch Med Sci 2021; 17:662-674. [PMID: 34025836 PMCID: PMC8130475 DOI: 10.5114/aoms.2018.78009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 05/01/2018] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION In inflammatory bowel diseases (IBD), osteopenia and osteoporosis constitute a significant medical problem. Cytokines, especially IL-17, play an important role in the pathogenesis of IBD and osteoporosis. Vitamin D is a regulator of bone metabolism, and helps maintain immune system homeostasis. MATERIAL AND METHODS The research sample consisted of 208 persons: 83 patients (age 35 ±11.99 years) with Crohn's disease (CD); 86 patients (age 39.58 ±14.74 years) with ulcerative colitis (UC); and 39 persons (age 30.74 ±8.63 years) in the control group (CG). Clinical data on bone mineral density of the lumbar spine (L2-L4), bone mineral density of the femoral neck (FN), and body mass index (BMI) were collected. 25OHD and IL-17 serum concentrations were also measured. RESULTS Body mass index (kg/m2) results: in CD, 21.51 ±3.68; in UC, 23.31 ±4.38; and in CG, 24.57 ±3.45 (p < 0.01). Densitometry results for L2-L4 T-score SD: in CD -0.83 ±1.45; in UC -0.47 ±1.15; in CG 0.09 ±0.70. Densitometry results for FN T-score SD: in CD -0.62 ±1.26; in UC -0.29±1.17; in CG 0.41 ±1.03 25OHD (ng/ml) serum concentrations: in CD, 21.33±12.50; in UC, 22.04±9.56; in CG, 21.56±9.11 (ns). IL-17 (pg/ml) serum concentrations: in CD, 8.55±10.99; in UC, 11.67±12.97; in CG, 5.16±9.11 (ns). CONCLUSIONS Inflammatory bowel diseases patients and persons from the CG did not differ in vitamin D or IL-17 levels. Patients with a mild course of the disease had a higher vitamin D concentration and bone mineral density. In UC, higher vitamin D concentrations were associated with lower IL-17 concentrations. The IBD patients with a severe course of the disease had a lower body mass than those in the CG and the patients with a mild course of the disease.
Collapse
Affiliation(s)
- Iwona Krela-Kazmierczak
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Aleksandra Szymczak-Tomczak
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Maciej Tomczak
- Department of Psychology, Poznan University of Physical Education, Poznan, Poland
| | - Liliana Lykowska-Szuber
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Marcin A. Kucharski
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Kamila Stawczyk-Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Waszak
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Karczewski
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
- Department of Environmental Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
39
|
Zielińska A, Kubasiewicz K, Wójcicki K, Silva AM, Nunes FM, Szalata M, Słomski R, Eder P, Souto EB. Two- and Three-Dimensional Spectrofluorimetric Qualitative Analysis of Selected Vegetable Oils for Biomedical Applications. Molecules 2020; 25:molecules25235608. [PMID: 33260612 PMCID: PMC7730717 DOI: 10.3390/molecules25235608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 11/27/2020] [Indexed: 11/16/2022] Open
Abstract
Vegetable oils obtained from different plants are known for their beneficial effects on prophylaxis and supportive treatment of a great deal of inflammatory-mediated conditions. Their wide range of saturated and unsaturated fatty acids, and the presence of other ingredients (e.g., tocopherols, chlorophylls), provide them with anti-inflammatory, antioxidant and anticancer properties, which are worth being exploited. In this study, we have carried out the spectrofluorometric analysis of selected vegetable oils, namely apricot (Prunus armeniaca) kernel oil; blueberry (Vaccinium spp.) seed oil; argan (Argania spinosa) nut oil; kiwi (Actinidia deliciosa) seed oil; grape (Vitis vinifera) seed oil; evening primrose (Oenothera biennis) oil and meadowfoam (Limnanthes alba) seed oil, with the purpose to detect their fluorescent ingredients for further identification and bioactivity comparison. The obtained two- (2D) and three-dimensional (3D) emission spectra offered a complete description of the fluorescent components of the mixture and revealed different features for studied oils.
Collapse
Affiliation(s)
- Aleksandra Zielińska
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, 60-479 Poznań, Poland; (A.Z.); (R.S.)
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - Konrad Kubasiewicz
- Faculty of Chemistry, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 8, 61-614 Poznań, Poland;
| | - Krzysztof Wójcicki
- Institute of Quality Science, Poznań University of Economics and Business, Aleje Niepodległości 10, 61-875 Poznań, Poland;
| | - Amélia M. Silva
- Department of Biology and Environment, University of Trás-os-Montes e Alto Douro, UTAD, Quinta de Prados, P-5001-801 Vila Real, Portugal;
- Centre for Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Quinta de Prados, P-5001-801 Vila Real, Portugal
| | - Fernando M. Nunes
- Department of Chemistry, University of Trás-os-Montes e Alto Douro, UTAD, Quinta de Prados, P-5001-801 Vila Real, Portugal;
- Chemistry Research Centre—Vila Real (CQ-VR), Food and Wine Chemistry Laboratory, University of Trás-os-Montes and Alto Douro (UTAD), Quinta de Prados, P-5001-801 Vila Real, Portugal
| | - Marlena Szalata
- Department of Biochemistry and Biotechnology, Poznań University of Life Sciences, Dojazd 11, 60-632 Poznań, Poland;
| | - Ryszard Słomski
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, 60-479 Poznań, Poland; (A.Z.); (R.S.)
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznań, Poland;
| | - Eliana B. Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
- CEB—Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
- Correspondence: ; Tel.: +351-239-488-400
| |
Collapse
|
40
|
Mahadea DS, Śledzińska E, Dobrowolska A, Krela-Kaźmierczak I, Eder P. A double-edged sword of immunotherapy: new category of colitis mimicking inflammatory bowel disease. Pol Arch Intern Med 2020; 130:1003-1004. [DOI: 10.20452/pamw.15558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
41
|
Zielińska A, Carreiró F, Oliveira AM, Neves A, Pires B, Venkatesh DN, Durazzo A, Lucarini M, Eder P, Silva AM, Santini A, Souto EB. Polymeric Nanoparticles: Production, Characterization, Toxicology and Ecotoxicology. Molecules 2020; 25:E3731. [PMID: 32824172 PMCID: PMC7464532 DOI: 10.3390/molecules25163731] [Citation(s) in RCA: 419] [Impact Index Per Article: 104.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/10/2020] [Accepted: 08/13/2020] [Indexed: 12/12/2022] Open
Abstract
Polymeric nanoparticles (NPs) are particles within the size range from 1 to 1000 nm and can be loaded with active compounds entrapped within or surface-adsorbed onto the polymeric core. The term "nanoparticle" stands for both nanocapsules and nanospheres, which are distinguished by the morphological structure. Polymeric NPs have shown great potential for targeted delivery of drugs for the treatment of several diseases. In this review, we discuss the most commonly used methods for the production and characterization of polymeric NPs, the association efficiency of the active compound to the polymeric core, and the in vitro release mechanisms. As the safety of nanoparticles is a high priority, we also discuss the toxicology and ecotoxicology of nanoparticles to humans and to the environment.
Collapse
Affiliation(s)
- Aleksandra Zielińska
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (A.Z.); (F.C.); (A.M.O.); (A.N.); (B.P.)
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, 60-479 Poznań, Poland
| | - Filipa Carreiró
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (A.Z.); (F.C.); (A.M.O.); (A.N.); (B.P.)
| | - Ana M. Oliveira
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (A.Z.); (F.C.); (A.M.O.); (A.N.); (B.P.)
| | - Andreia Neves
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (A.Z.); (F.C.); (A.M.O.); (A.N.); (B.P.)
| | - Bárbara Pires
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (A.Z.); (F.C.); (A.M.O.); (A.N.); (B.P.)
| | - D. Nagasamy Venkatesh
- JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty 643 001, Tamil Nadu, India;
| | - Alessandra Durazzo
- CREA-Research Centre for Food and Nutrition, Via Ardeatina 546, 00178 Rome, Italy; (A.D.); (M.L.)
| | - Massimo Lucarini
- CREA-Research Centre for Food and Nutrition, Via Ardeatina 546, 00178 Rome, Italy; (A.D.); (M.L.)
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego 49, 60–355 Poznań, Poland;
| | - Amélia M. Silva
- Department of Biology and Environment, University of Tras-os-Montes e Alto Douro, UTAD, Quinta de Prados, 5001-801 Vila Real, Portugal;
- Centre for Research and Technology of Agro-Environmental and Biological Sciences (CITAB-UTAD), Quinta de Prados, 5001-801 Vila Real, Portugal
| | - Antonello Santini
- Department of Pharmacy, University of Napoli Federico II, Via D. Montesano 49, 80131 Napoli, Italy
| | - Eliana B. Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (A.Z.); (F.C.); (A.M.O.); (A.N.); (B.P.)
- CEB—Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| |
Collapse
|
42
|
Walczak M, Lykowska-Szuber L, Plucinska M, Stawczyk-Eder K, Zakerska-Banaszak O, Eder P, Krela-Kazmierczak I, Michalak M, Zywicki M, Karlowski WM, Szalata M, Dobrowolska A, Slomski R, Skrzypczak-Zielinska M. Is Polymorphism in the Apoptosis and Inflammatory Pathway Genes Associated With a Primary Response to Anti-TNF Therapy in Crohn's Disease Patients? Front Pharmacol 2020; 11:1207. [PMID: 32922288 PMCID: PMC7456829 DOI: 10.3389/fphar.2020.01207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/24/2020] [Indexed: 12/18/2022] Open
Abstract
Anti-tumor necrosis factor (TNF) therapy is used for the induction and maintenance of remission in Crohn’s disease (CD) patients. However, primary nonresponders to initial treatment constitute 20%–40% of cases. The causes of this phenomenon are still unknown. In this study, we aimed to determine the genetic predictors of the variable reactions of CD patients to anti-TNF therapy. Using long-range PCR libraries and the next-generation sequencing (NGS) method, we performed broad pharmacogenetic studies including a panel of 23 genes (TNFRSF1A, TNFRSF1B, CASP9, FCGR3A, LTA, TNF, FAS, ADAM17, IL17A, IL6, MMP1, MMP3, S100A8, S100A9, S100A12, TLR2, TLR4, TLR9, CD14, IL23R, IL23, IL1R, and IL1B) in a group of 107 diagnosed and clinically characterized CD patients following anti-TNF therapy. In the studied group, we indicated, in total, 598 single nucleotide variants for all analyzed genomic targets. Twelve patients (11.2%) did not respond to the induction therapy, which was associated with alleles in 11 loci located in FCGR3A (rs7539036, rs6672453, rs373184583, and rs12128686), IL1R (rs2041747), TNFRSF1B (rs5746053), IL1B (rs1071676, rs1143639, rs1143637, and rs1143634), and FAS (rs7896789) genes. After multiple comparison corrections, the results were not statistically significant, however for nonresponders the alleles distribution for those loci presented large differences and specified scheme compared to responders and populations. These findings require further investigation in an independent larger cohort before introducing them for a clinical setting, however, we identified an interesting direction. Polymorphism of the FCGR3A, IL1R, TNFRSF1B, IL1B, and FAS genes could be a predictor of the primary response to anti-TNF therapy in CD patients.
Collapse
Affiliation(s)
- Michal Walczak
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Liliana Lykowska-Szuber
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Marianna Plucinska
- Department of Computational Biology, Faculty of Biology, Institute of Molecular Biology and Biotechnology, Adam Mickiewicz University, Poznan, Poland
| | - Kamila Stawczyk-Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Iwona Krela-Kazmierczak
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Michal Michalak
- Department of Computer Sciences and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Marek Zywicki
- Department of Computational Biology, Faculty of Biology, Institute of Molecular Biology and Biotechnology, Adam Mickiewicz University, Poznan, Poland
| | - Wojciech M Karlowski
- Department of Computational Biology, Faculty of Biology, Institute of Molecular Biology and Biotechnology, Adam Mickiewicz University, Poznan, Poland
| | - Marlena Szalata
- Department of Biochemistry and Biotechnology, University of Life Sciences, Poznan, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Ryszard Slomski
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | | |
Collapse
|
43
|
Zielińska A, Alves H, Marques V, Durazzo A, Lucarini M, Alves TF, Morsink M, Willemen N, Eder P, Chaud MV, Severino P, Santini A, Souto EB. Properties, Extraction Methods, and Delivery Systems for Curcumin as a Natural Source of Beneficial Health Effects. Medicina (Kaunas) 2020; 56:E336. [PMID: 32635279 PMCID: PMC7404808 DOI: 10.3390/medicina56070336] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 02/07/2023]
Abstract
This review discusses the impact of curcumin-an aromatic phytoextract from the turmeric (Curcuma longa) rhizome-as an effective therapeutic agent. Despite all of the beneficial health properties ensured by curcumin application, its pharmacological efficacy is compromised in vivo due to poor aqueous solubility, high metabolism, and rapid excretion that may result in poor systemic bioavailability. To overcome these problems, novel nanosystems have been proposed to enhance its bioavailability and bioactivity by reducing the particle size, the modification of surfaces, and the encapsulation efficiency of curcumin with different nanocarriers. The solutions based on nanotechnology can improve the perspective for medical patients with serious illnesses. In this review, we discuss commonly used curcumin-loaded bio-based nanoparticles that should be implemented for overcoming the innate constraints of this natural ingredient. Furthermore, the associated challenges regarding the potential applications in combination therapies are discussed as well.
Collapse
Affiliation(s)
- Aleksandra Zielińska
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (A.Z.); (H.A.); (V.M.)
- Polish Academy of Sciences, Institute of Human Genetics, Strzeszyńska 32, 60-479 Poznań, Poland
| | - Henrique Alves
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (A.Z.); (H.A.); (V.M.)
| | - Vânia Marques
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (A.Z.); (H.A.); (V.M.)
| | - Alessandra Durazzo
- CREA-Research Centre for Food and Nutrition, Via Ardeatina 546, 00178 Rome, Italy; (A.D.); (M.L.)
| | - Massimo Lucarini
- CREA-Research Centre for Food and Nutrition, Via Ardeatina 546, 00178 Rome, Italy; (A.D.); (M.L.)
| | - Thais F. Alves
- Laboratory of Biomaterials and Nanotechnology, University of Sorocaba-UNISO, Sorocaba, São Paulo 18023-000, Brazil; (T.F.A.); (M.V.C.)
| | - Margreet Morsink
- Center for Biomedical Engineering, Department of Medicine, Brigham and Women& Hospital, Harvard Medical School, 65 Landsdowne Street, Cambridge, MA 02139, USA; (M.M.); (N.W.); (P.S.)
- Translational Liver Research, Department of Medical Cell BioPhysics, Technical Medical Centre, Faculty of Science and Technology, University of Twente, 7522 NB Enschede, The Netherlands
- Department of Developmental BioEngineering, Faculty of Science and Technology, Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands
| | - Niels Willemen
- Center for Biomedical Engineering, Department of Medicine, Brigham and Women& Hospital, Harvard Medical School, 65 Landsdowne Street, Cambridge, MA 02139, USA; (M.M.); (N.W.); (P.S.)
- Department of Developmental BioEngineering, Faculty of Science and Technology, Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznań, Poland;
| | - Marco V. Chaud
- Laboratory of Biomaterials and Nanotechnology, University of Sorocaba-UNISO, Sorocaba, São Paulo 18023-000, Brazil; (T.F.A.); (M.V.C.)
| | - Patricia Severino
- Center for Biomedical Engineering, Department of Medicine, Brigham and Women& Hospital, Harvard Medical School, 65 Landsdowne Street, Cambridge, MA 02139, USA; (M.M.); (N.W.); (P.S.)
- Nanomedicine and Nanotechnology Laboratory (LNMed), Biotechnological Postgraduate Program, and Institute of Technology and Research (ITP), University of Tiradentes (Unit), Av. Murilo Dantas 300, Aracaju 49010-390, Brazil
- Tiradentes Institute, 150 Mt Vernon St, Dorchester, MA 02125, USA
| | - Antonello Santini
- Department of Pharmacy, University of Napoli Federico II, Via D. Montesano 49, 80131 Napoli, Italy
| | - Eliana B. Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (A.Z.); (H.A.); (V.M.)
- CEB—Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| |
Collapse
|
44
|
Zielińska A, Costa B, Ferreira MV, Miguéis D, Louros JMS, Durazzo A, Lucarini M, Eder P, V. Chaud M, Morsink M, Willemen N, Severino P, Santini A, Souto EB. Nanotoxicology and Nanosafety: Safety-By-Design and Testing at a Glance. Int J Environ Res Public Health 2020; 17:E4657. [PMID: 32605255 PMCID: PMC7369733 DOI: 10.3390/ijerph17134657] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/11/2020] [Accepted: 06/23/2020] [Indexed: 01/01/2023]
Abstract
This review offers a systematic discussion about nanotoxicology and nanosafety associated with nanomaterials during manufacture and further biomedical applications. A detailed introduction on nanomaterials and their most frequently uses, followed by the critical risk aspects related to regulatory uses and commercialization, is provided. Moreover, the impact of nanotoxicology in research over the last decades is discussed, together with the currently available toxicological methods in cell cultures (in vitro) and in living organisms (in vivo). A special focus is given to inorganic nanoparticles such as titanium dioxide nanoparticles (TiO2NPs) and silver nanoparticles (AgNPs). In vitro and in vivo case studies for the selected nanoparticles are discussed. The final part of this work describes the significance of nano-security for both risk assessment and environmental nanosafety. "Safety-by-Design" is defined as a starting point consisting on the implementation of the principles of drug discovery and development. The concept "Safety-by-Design" appears to be a way to "ensure safety", but the superficiality and the lack of articulation with which it is treated still raises many doubts. Although the approach of "Safety-by-Design" to the principles of drug development has helped in the assessment of the toxicity of nanomaterials, a combination of scientific efforts is constantly urgent to ensure the consistency of methods and processes. This will ensure that the quality of nanomaterials is controlled and their safe development is promoted. Safety issues are considered strategies for discovering novel toxicological-related mechanisms still needed to be promoted.
Collapse
Affiliation(s)
- Aleksandra Zielińska
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (A.Z.); (B.C.); (M.V.F.); (D.M.); (J.M.S.L.)
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, 60-479 Poznań, Poland
| | - Beatriz Costa
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (A.Z.); (B.C.); (M.V.F.); (D.M.); (J.M.S.L.)
| | - Maria V. Ferreira
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (A.Z.); (B.C.); (M.V.F.); (D.M.); (J.M.S.L.)
| | - Diogo Miguéis
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (A.Z.); (B.C.); (M.V.F.); (D.M.); (J.M.S.L.)
| | - Jéssica M. S. Louros
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (A.Z.); (B.C.); (M.V.F.); (D.M.); (J.M.S.L.)
| | - Alessandra Durazzo
- CREA-Research Centre for Food and Nutrition, Via Ardeatina 546, 00178 Rome, Italy; (A.D.); (M.L.)
| | - Massimo Lucarini
- CREA-Research Centre for Food and Nutrition, Via Ardeatina 546, 00178 Rome, Italy; (A.D.); (M.L.)
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznań, Poland;
| | - Marco V. Chaud
- Laboratory of Biomaterials and Nanotechnology, University of Sorocaba—UNISO, Sorocaba 18023-000, Brazil;
| | - Margreet Morsink
- Center for Biomedical Engineering, Department of Medicine, Brigham and Women& Hospital, Harvard Medical School, 65 Landsdowne Street, Cambridge, MA 02139, USA; (M.M.); (N.W.); (P.S.)
- Translational Liver Research, Department of Medical Cell BioPhysics, Technical Medical Centre, Faculty of Science and Technology, University of Twente, 7522 NB Enschede, The Netherlands
- Department of Developmental BioEngineering, Faculty of Science and Technology, Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands
| | - Niels Willemen
- Center for Biomedical Engineering, Department of Medicine, Brigham and Women& Hospital, Harvard Medical School, 65 Landsdowne Street, Cambridge, MA 02139, USA; (M.M.); (N.W.); (P.S.)
- Department of Developmental BioEngineering, Faculty of Science and Technology, Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands
| | - Patrícia Severino
- Center for Biomedical Engineering, Department of Medicine, Brigham and Women& Hospital, Harvard Medical School, 65 Landsdowne Street, Cambridge, MA 02139, USA; (M.M.); (N.W.); (P.S.)
- Nanomedicine and Nanotechnology Laboratory (LNMed), Institute of Technology and Research (ITP), University of Tiradentes (Unit), Av. Murilo Dantas, 300, Aracaju 49010-390, Brazil
- Tiradentes Institute, 150 Mt Vernon St, Dorchester, MA 02125, USA
| | - Antonello Santini
- Department of Pharmacy, University of Napoli Federico II, 80131 Napoli, Italy
| | - Eliana B. Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (A.Z.); (B.C.); (M.V.F.); (D.M.); (J.M.S.L.)
- CEB—Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| |
Collapse
|
45
|
Krela-Kaźmierczak I, Michalak M, Szymczak-Tomczak A, Czarnywojtek A, Wawrzyniak A, Łykowska-Szuber L, Stawczyk-Eder K, Dobrowolska A, Eder P. Milk and dairy product consumption in patients with inflammatory bowel disease: Helpful or harmful to bone mineral density? Nutrition 2020; 79-80:110830. [PMID: 32563771 DOI: 10.1016/j.nut.2020.110830] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/09/2020] [Accepted: 03/15/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Limiting the consumption of milk and dairy products (DPs) constitutes a risk factor for osteoporosis in patients with inflammatory bowel disease (IBD). The aim of this study was to evaluate bone mineral density (BMD) and the frequency of osteopenia and osteoporosis in patients with IBD. We also investigated the correlation between BMD and consumption of milk and DPs, as well as with calcium, phosphate, and parathyroid hormone (PTH) and 25-hydroxyvitamin D [25(OH)D] serum concentration levels. METHODS The study comprised 208 patients with IBD. Densitometric measurements were performed using the dual-energy x-ray absorpiometry. Before (IBD-I) and after the diagnosis (IBD-II) of IBD, we used a questionnaire to assess the consumption of milk and DPs. Serum concentrations of PTH, 25(OH)D, calcium, and phosphate were determined. RESULTS The prevalence of osteopenia and osteoporosis in the IBD patient group was 48.1%. At the same time, 87% of patients with IBD reported milk consumption. Patients from this group with proper bone mass amounted to 91.7%, whereas patients with osteopenia and osteoporosis comprised 82% (P = 0.0382) of patients. In patients with IBD who consumed milk, femoral neck BMD (0.97 ± 0.17 g/cm2) was higher than in those not drinking milk (0.897 ± 0.154 g/cm2; P = 0.0587). The percentage of patients with IBD consuming DPs was 96.2%; however, this number decreased after diagnosis and was equal to IBD-II: 83% (P < 0.0001). Additionally, concentration levels of 25(OH)D decreased in the IBD group (21.82 ± 10.82 ng/dL). CONCLUSION Not only does IBD entail a high prevalence of osteoporosis, but BMD values are also indirectly affected by the fact that patient consumption of milk and other DPs decreases after diagnosis.
Collapse
Affiliation(s)
- Iwona Krela-Kaźmierczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
| | - Michał Michalak
- Department of Computer Sciences and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Aleksandra Szymczak-Tomczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Agata Czarnywojtek
- Department of Pharmacology, Poznan University of Medical Sciences, Poznan, Poland; Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Wawrzyniak
- Department of Family Medicine, University of Medical Sciences, Poznan, Poland
| | - Liliana Łykowska-Szuber
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Kamila Stawczyk-Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
46
|
Eder P, Dobrowolska A, Rydzewska G. Historical Upheavals and Eponyms in Crohn's Disease-Is There Any Relation? J Crohns Colitis 2020; 14:719. [PMID: 31784738 DOI: 10.1093/ecco-jcc/jjz197] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznań, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznań, Poland
| | - Grażyna Rydzewska
- Department of Gastroenterology with IBD Subdivision of the Central Clinical Hospital of Ministry of Internal Affairs, Warsaw, Poland.,Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
| |
Collapse
|
47
|
Eder P, Łodyga M, Dobrowolska A, Rydzewska G, Kamhieh-Milz J. Addressing multiple gastroenterological aspects of coronavirus disease 2019. Pol Arch Intern Med 2020; 130:420-430. [PMID: 32356641 DOI: 10.20452/pamw.15332] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The outbreak of the coronavirus disease 2019 (COVID‑19) pandemic has become the biggest challenge for the whole human community since many years. It seems that the proper identification of all people infected with severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is the best strategy to limit the transmission. However, in a significant proportion of patients, there are no clinical manifestations of the disease, and symptoms may be very mild or atypical. There is a growing body of evidence that digestive manifestations of COVID‑19 are frequently reported and may precede typical respiratory symptoms. Moreover, SARS‑CoV‑2 particles were found in the gastrointestinal epithelial cells, and viral RNA was detected in the feces of patients with COVID‑19. These data suggest that gastrointestinal symptoms in COVID‑19 are not accidental findings and they may result from direct digestive involvement. Patients with new‑onset diarrhea, abdominal pain, nausea, and vomiting without any other evident etiological factors should be tested for SARS‑CoV‑2 infection. Gastroenterologists and members of other medical specialties should also remember that the current epidemiological situation has changed diagnostic and therapeutic algorithms in the management of several gastrointestinal and liver disorders. This review article summarizes the currently available data on multiple gastroenterological aspects of COVID‑19 and provides information on practical recommendations and position statements of the most prominent associations in the field of gastroenterology, which appeared in response to the emergence of the pandemic.
Collapse
Affiliation(s)
- Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznań University of Medical Sciences, Heliodor Święcicki University Hospital, Poznań, Poland.
| | - Michał Łodyga
- Department of Gastroenterology with the Inflammatory Bowel Disease Subdivision, Central Clinical Hospital of the Ministry of the Interior and Administration,
Warsaw, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznań University of Medical Sciences, Heliodor Święcicki University Hospital, Poznań, Poland
| | - Grażyna Rydzewska
- Department of Gastroenterology with the Inflammatory Bowel Disease Subdivision, Central Clinical Hospital of the Ministry of the Interior and Administration,
Warsaw, Poland; Faculty of Health Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Julian Kamhieh-Milz
- Institute of Transfusion Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany; Wimedko GmbH, Berlin, Germany
| |
Collapse
|
48
|
Philipp C, Sari S, Eder P, Patzl-Fischerleitner E, Eder R. Austrian Pinot blanc wines: Typicity, wine styles and the influence of different oenological decisions on the volatile profile of wines. BIO Web Conf 2019. [DOI: 10.1051/bioconf/20191502005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Pinot blanc is found in all wine regions of Austria. However, it plays an economically subordinate role compared to the most important white grape variety, Grüner Veltliner. The concept of wine typicity and terroir is that the geographical origin and oenological practices, along with the grape variety, make an important contribution to the final expression of the finished wine. The purpose of this study was to discuss different styles of Austrian Pinot blanc wines and to discuss the various wine production decisions in terms of wine stylistics and aromatic profile. 131 commercial Austrian wine samples of the Pinot blanc variety of the 2015 to 2017 vintages were collected and the manufacturer's practices were determined by means of a questionnaire related to the wine styles. Using various GC-SIM-MS methods, more than 100 essential volatile substances were quantified. A trained panel, an expert panel and consumers evaluated the wines based on typicity and quality. 15 typical wines were then assessed on a sensory basis by means of predetermined aroma and wine styles. The four Austrian Pinot blanc wine styles previously discussed and presented by the same authors (citrus (1st style), green apple and green pear (2nd style), ripe yellow apple, quince, cooked pear, bread and honey notes (3rd style), as well as intensive oak notes (4th style)) were able to be partially reproduced by the trained panel. The following three wine styles could be better understood by the consumers: fresh fruity (style A), complex aroma with or without moderate wood (style B) and lots of wood aroma (style C). These styles (A–C) were able to withstand a sensory examination and a discriminant analysis by substance. An oenological guideline could help the producers to achieve the respective style. Austria's wine-growing area is probably too small and the importance of the Pinot blanc variety for the individual areas still too low to support the terroir concept for this grape variety.
Collapse
|
49
|
Krela-Kaźmierczak I, Skrzypczak-Zielińska M, Kaczmarek-Ryś M, Michalak M, Szymczak-Tomczak A, Hryhorowicz ST, Szalata M, Łykowska-Szuber L, Eder P, Stawczyk-Eder K, Tomczak M, Słomski R, Dobrowolska A. ESR1 Gene Variants Are Predictive of Osteoporosis in Female Patients with Crohn's Disease. J Clin Med 2019; 8:jcm8091306. [PMID: 31450614 PMCID: PMC6780775 DOI: 10.3390/jcm8091306] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 01/07/2023] Open
Abstract
Decreased bone mass in patients with inflammatory bowel diseases (IBD) is a clinical problem with extremely severe consequences of osteoporotic fractures. Despite its increasing prevalence and the need for mandatory intervention and monitoring, it is often ignored in IBD patients’ care. Determining the biomarkers of susceptibility to bone mineral density disorder in IBD patients appears to be indispensable. We aim to investigate the impact of estrogen receptor gene (ESR1) gene polymorphisms on bone mineral density (BMD) in patients with ulcerative colitis (UC) and Crohn’s disease (CD), as they may contribute both, to osteoporosis and inflammatory processes. We characterised 197 patients with IBD (97 with UC, 100 with CD), and 41 controls carrying out vitamin D, calcium and phosphorus serum levels, and bone mineral density assessment at the lumbar spine and the femoral neck by dual-energy X-ray absorptiometry (DXA), ESR1 genotyping and haplotype analysis. We observed that women with CD showed the lowest bone density parameters, which corresponded to the ESR1 c.454-397T and c.454-351A allele dose. The ESR1 gene PvuII and XbaI TA (px) haplotype correlated with decreased femoral neck T-score (OR = 2.75, CI = [1.21–6.27], P-value = 0.016) and may be predictive of osteoporosis in female patients with CD.
Collapse
Affiliation(s)
- Iwona Krela-Kaźmierczak
- Department of Gastroenterology, Human Nutrition and Internal Medicine, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznań, Poland
| | | | - Marta Kaczmarek-Ryś
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, 60-479 Poznań, Poland.
| | - Michał Michalak
- Department of Computer Sciences and Statistics, Poznan University of Medical Sciences, Rokietnicka 7, 60-806 Poznań, Poland
| | - Aleksandra Szymczak-Tomczak
- Department of Gastroenterology, Human Nutrition and Internal Medicine, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznań, Poland
| | - Szymon T Hryhorowicz
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, 60-479 Poznań, Poland
| | - Marlena Szalata
- Department of Biochemistry and Biotechnology, Poznan University of Life Sciences, Dojazd 11, 60-637 Poznań, Poland
| | - Liliana Łykowska-Szuber
- Department of Gastroenterology, Human Nutrition and Internal Medicine, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznań, Poland
| | - Piotr Eder
- Department of Gastroenterology, Human Nutrition and Internal Medicine, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznań, Poland
| | - Kamila Stawczyk-Eder
- Department of Gastroenterology, Human Nutrition and Internal Medicine, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznań, Poland
| | - Maciej Tomczak
- Department of Psychology, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871 Poznań, Poland
| | - Ryszard Słomski
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, 60-479 Poznań, Poland
- Department of Biochemistry and Biotechnology, Poznan University of Life Sciences, Dojazd 11, 60-637 Poznań, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Human Nutrition and Internal Medicine, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznań, Poland
| |
Collapse
|
50
|
Banasiewicz T, Eder P, Rydzewska G, Reguła J, Dobrowolska A, Durlik M, Wallner G. Statement of the expert group on the current practice and prospects for the treatment of complex perirectal fistulas in the course of Crohn's disease. Pol Przegl Chir 2019; 91:38-46. [PMID: 30919811 DOI: 10.5604/01.3001.0013.0593] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Perirectal fistulas in the course of Crohn's disease (CD) constitute an important problem in this group of patients. They are observed in a vast majority of patients with involvement through colorectal inflammation. Perirectal fistulas in CD present a great diagnostic and therapeutic challenge due to the intensified clinical symptoms and worse prognosis than in the case of crypt originating fistulas. The condition for implementation of effective treatment of perirectal fistulas in the course of CD is the correct diagnosis, defining the anatomy of fistulas, presence of potential stenoses and inflammation in the gastrointestinal tract. Treatment of these fistulas is difficult and requires close cooperation between the colorectal surgeon and the gastroenterologist. The combination of surgical and pharmacological treatment has higher efficacy compared to surgical treatment or pharmacotherapy alone. In conservative treatment, aminosalicylates and steroids are of minor importance, while chemotherapeutics, antibiotics, and thiopurines find application in daily clinical practice. TNF-α neutralizing antibodies such as infliximab (IFX), adalimumab (ADA) or certolizumab (CER) prove to be the most effective. Surgical treatment may be provided as ad hoc; in this case, drainage procedures are recommended, usually with leaving a loose seton. Planned procedures consist in the excision of fistulas (simple fistulas) or performing more complex procedures, such as advancement flaps or ligation of the intersphincteric fistula tract Surgical measures can be complemented by the use of video technology (video-assisted anal fistula treatment VAAFT) or vacuum therapy. In extreme cases, it may be necessary to create the stoma. Treatment of perirectal fistulas includes adhesives or so-called plugs. High hopes may be associated with the introduction of stem cells into clinical practice, which is the administration of non-hematopoietic multipotent cells to the fistulas to induce the phenomenon of immunomodulation and tissue healing.
Collapse
Affiliation(s)
- Tomasz Banasiewicz
- Katedra i Klinika Chirurgii Ogólnej, Endokrynologicznej i Onkologii Gastroenterologicznej, Uniwersytet Medyczny w Poznaniu
| | - Piotr Eder
- Katedra i Klinika Gastroenterologii, Dietetyki i Chorób Wewnętrznych, Uniwersytet Medyczny w Poznaniu
| | - Grażyna Rydzewska
- Klinika Chorób Wewnętrznych i Gastroenterologii z Pododdziałem Leczenia Nieswoistych Chorób Zapalnych Jelit Centralnego Szpitala Klinicznego MSWiA w Warszawie
| | - Jarosław Reguła
- Klinika Gastroenterologii, Hepatologii i Onkologii Klinicznej Centrum Medycznego Kształcenia Podyplomowego, Centrum Onkologii - Instytut im. Marii Skłodowskiej-Curie w Warszawie
| | - Agnieszka Dobrowolska
- Katedra i Klinika Gastroenterologii, Dietetyki i Chorób Wewnętrznych, Uniwersytet Medyczny w Poznaniu
| | - Marek Durlik
- Klinika Chirurgii Gastroenterologicznej i Transplantologii Centralnego Szpitala Klinicznego MSWiA w Warszawie
| | - Grzegorz Wallner
- II Klinika Chirurgii Ogólnej, Gastroenterologicznej i Nowotworów Układu Pokarmowego, Uniwersytet Medyczny w Lublinie
| |
Collapse
|