Search results for "CROHN DISEASE"

Adalimumab vs Azathioprine in the Prevention of Postoperative Crohn's Disease Recurrence. A GETECCU Randomised Trial.

2017

Background and aims Postoperative recurrence of Crohn's disease [POR-CD] is almost certain if no prophylaxis is administered. Evidence for optimal treatment is lacking. Our aim was to compare the efficacy of adalimumab [ADA] and azathioprine [AZA] in this setting. Methods We performed a phase 3, 52-week, multicentre, randomised, superiority study [APPRECIA], in which patients with ileocolonic resection were randomised either to ADA 160-80-40 mg subcutaneously [SC] or AZA 2.5 mg/kg/day, both associated with metronidazole. The primary endpoint was endoscopic recurrence at 1 year [Rutgeerts i2b, i3, i4], as evaluated by a blinded central reader. Results We recruited 91 patients [median age 35.…

Large retroperitoneal abscess extended to the inferior right limb secondary to a perforated ileal Crohn’s disease: the importance of the multidiscipl…

2016

The typical complications of Crohn's disease concerns small and large bowel. The full thickness inflammation of the intestinal wall develops in strictures, fistulas and abdominal abscesses. Nowadays the most accepted therapeutic for intra-abdominal abscess option is antibiotic therapy and, in case of need, percutaneous drainage of the abscess. If the abscess passes through the pelvic foramen the abscess can involve the inferior limbs. We report a case a perforation of terminal ileum in Crohn's disease complicated by a large abscess of the right iliac fossa reaching the spaces between the anterior lateral muscles of the right thigh as far as the anterior lateral pre-tibial region. We discuss…

Imaging techniques in inflammatory bowel disease: recent trends, questions and answers

2009

Summary Imaging techniques have undergone substantial progress in recent years and contribute significantly in the diagnosis of inflammatory bowel diseases in conjunction with patient history, clinical and laboratory examination. Modern cross-sectional imaging modalities such as computed tomography and magnetic resonance imaging allow an evaluation not only of the complete bowel wall of the small intestine, but also of extraluminal structures. They constitute a major diagnostic component in the initial workup, in stricturing or fistulizing disease and in suspected abscess. Transabdominal ultrasonography has been re-appreciated in these settings as an easy- and ready-to-use tool yielding rea…

Gene transfer approaches for the treatment of inflammatory bowel disease.

2003

The pathogenesis of Crohn's disease and ulcerative colitis, the two major forms of inflammatory bowel disease, involves a complex interplay between certain genetic, environmental and immunological factors. Considerable research progress in the last decade defined key inflammatory pathways in the inflamed gut and identified new potential therapeutic targets. Since the current medical treatment with corticosteroids and anti-inflammatory drugs is often associated with undesired side effects and cannot completely cure IBD, these current advances in our understanding of intestinal pathology may now allow the development of new biologic treatment strategies including gene therapy. In this review,…

Zur Immunpathogenese der chronisch entz�ndlichen Darmerkrankungen

2000

Die chronisch entzundlichen Darmerkrankungen (CED: Morbus Crohn, Colitis ulcerosa) sind durch schubartig verlaufende destruierende Entzundungsreaktionen der Darmschleimhaut gekennzeichnet. In den letzten Jahren konnte gezeigt werden, das bei diesen Erkrankungen eine pathologische Aktivierung des intestinalen Immunsystems durch mucosale Antigene auftritt. In der chronischen Phase der Erkankungen sowie bei der Entwicklung postoperativer Rezidive sind Anderungen in der Zellmigration sowie der Cytokinproduktion intestinaler Zellen wahrscheinlich von entscheidender Bedeutung. Basierend auf diesen neuen pathogenetischen Erkenntnissen werden zur Zeit innovative klinische Behandlungsstrategien gete…

Vitamin A (Retinol) und Retinolbindendes-Protein (RBP) im Serum bei Maldigestion, Malabsorption und Lebercirrhose

1974

Bei Normalpersonen und Patienten mit Malabsorption, Maldigestion und Lebercirrhose wurden vor und nach oraler Belastung mit 600 000 E Vitamin-A-palmitat bzw. wasserloslichem Vitamin A im Serum der Spiegel des Vitamin A (Retinol), des Retinol-bindenden Proteins (RBP) und Praealbumin bestimmt. In der Kontrolle steigt das Retinol nach Belastung signifikant an und erreicht nach 5 Std sein Maximum. Das RBP liegt im Mittel bei 42,25 mg/L, der Praealbuminspiegel bei 400 mg/L. Patienten mit Malabsorption und Lebercirrhose zeigen vor und nach Belastung mit Vitamin-A-palmitat einen gegenuber der Kontrolle verminderten Retinolspiegel. In der Gruppe der Maldigestion ist der Nuchternspiegel des Retinols…

The frame-shift mutation of the NOD2/CARD15 gene is significantly increased in ulcerative colitis: An ∗IG-IBD study

2004

Immunohistological differential diagnosis of inflammatory colonic diseases.

1984

Immunohistological investigations were carried out on human colonic tissue from, I healthy mucosa, 2 slightly inflamed mucosa, 3 mucosa with ulcerative colitis, 4 mucosa with Crohn's colitis, using antibodies against immunoglobulins and complement components. All our antibodies, including F(ab')2 fragments, demonstrated a progressive increase of labelled cells from healthy mucosa through slightly inflamed mucosa to mucosa with ulcerative colitis, in contrast to a complete absence of labelled cells in cases of Crohn's disease. The results are discussed with regard to their pathogenesis and their clinical significance for the differentiation of ulcerative colitis and Crohn's colitis.

Predominant role of NF-kappa B p65 in the pathogenesis of chronic intestinal inflammation.

1998

NF-kappa B is a key transcription factor of lymphocytes and macrophages with important regulatory functions in the immune system and inflammatory processes. These functions are at least partially based on its ability to regulate the promoters of a variety of genes whose products, such as cytokines, adhesion molecules and acute phase proteins, are critical for inflammatory processes. In the present study, we describe a method to treat established intestinal inflammation by local or systemic application of antisense phosphorothioate oligonucleotides targeting the translation start site of the p65 subunit of NF-kappa B. Specific downregulation of p65 by administration of antisense phosphorothi…

Differential TNF-Signaling in Chronic Inflammatory Disorders

2004

TNF-alpha is a pleiotropic cytokine with strong proinflammatory and immunomodulatory properties. TNF-alpha plays a critical role in many acute or chronic inflammatory diseases and anti-TNF-strategies have proven to be clinically effective. Two TNF-specific cell surface receptors TNF-R1 and TNF-R2 have been identified and the function of these receptors and the downstream intracellular signal transduction pathways have been extensively studied in vitro. For a long time TNF-R1 was considered to be the predominant mediator of TNF-signaling, whereas TNF-R2 was ascribed only auxilliary function. However, there is increasing clinical and experimental evidence for an important independent role of …