- Publikační typ
- abstrakt z konference MeSH
V dnešnej dobe existuje niekoľko druhov liečby nešpecifických zápalov čreva alebo ich kombinácií, medzi ktorými sa často neľahko rozhodujeme. Príchod nových biologík umožňuje optimalizovať liečbu a podstatne zlepšiť priebeh ochorenia. Vedolizumab je monoklonálna protilátka proti α4β7 integrínu selektívna pre črevo, ktorá inhibuje vaskulárnu adhéziu leukocytov a ich migráciu do mukózy čreva interakciou s mukóznymi adresínmi črevných ciev. Je indikovaný u pacientov so stredne ťažkou a ťažkou formou ulceróznej kolitídy (UC - ulcerative colitis) a Crohnovej choroby. Nedávne štúdie potvrdzujú vyššiu efektivitu a bezpečnosť liečby vedolizumabom, či už u bionaivných pacientov v porovnaní s exponovanými anti-tumor nektorizujícímu faktoru (EVOLVE), alebo v priamom (head-to-head) porovnaní s adalimumabom (VARSITY), kde sa potvrdila vyššia klinická a endoskopická remisia u pacientov s UC.
Currently, there are several types of treatment for inflammatory bowel disease, but it is often difficult to decide on the best treatment. The arrival of new biologics helps us to optimize treatment and improve significantly the course of the disease. Vedolizumab is a monoclonal antibody against integrin α4β7. It is gut selective and inhibits vascular adhesion of leucocytes and their migration to the mucosa of the gut, as well as their interactions with mucosal addresins of the gut wall. It is approved for the treatment of moderate to severe form of ulcerative colitis (UC) and Crohn's disease. Recent studies confirm higher effectivityhave confirmed it to be more effective and safer than adalimumab (VARSITY clinical trial) in both bionaive and anti-tumor necrosis factor exposed (EVOLVE) patients, with higher clinical and endoscopic remission in patients with UC.
It is well known that smoking is the risk factor in the development and clinical course of Crohn s disease (CD), but on the other hand, smoking is a protective factor against ulcerative colitis (UC). The pathways that are influenced by smoking in CD and UC are poorly understood. The aim of our study was to analyse the influence of smoking on the mRNA expression of cytokines in mucosa in patients with CD and UC. We performed a cross-sectional study. The cohort consisted of 86 IBD patients (48 CD patients and 38 UC patients) and took place at the IBD Centre at the University Hospital Bratislava-Ružinov. We took the demographic and clinical data of each patient, including information about their smoking habits. We performed a colonoscopy on each patient and took biopsies from both inflamed and non-inflamed sigma (CD, UC) and terminal ileum (CD). mRNA was extracted from mucosal biopsy samples for each cytokine and was normalized to a housekeeping gene (GAPDH). Finally, we compared the mRNA expression of target cytokines in the mucosa of smokers and non-smokers in IBD patients. Smokers with Crohn s disease have a significantly higher mRNA expression of pro-inflammatory cytokine TNF ? (p=0.003) in inflamed mucosa in sigma compared with non-smokers. In smokers with ulcerative colitis, we observed significantly higher mRNA expression of anti-inflammatory cytokine IL 10 (p=0.022) in non-inflamed mucosa of sigma. Similarly, smokers with UC have a significantly decreased mRNA expression of cytokine TLR 2 (p=0.024) and CCR1 (p=0.049) in non-inflamed mucosa of sigma. Based on our results, smoking has a positive influence on cessation and the clinical course of UC due to the stimulation of anti-inflammatory cytokine IL 10 in mucosa. On the other hand, smokers with CD have a higher expression of pro-inflammatory cytokine TNF ?, which could be associated with a worsening of the disease and response to therapy.
- MeSH
- Crohnova nemoc metabolismus MeSH
- cytokiny metabolismus MeSH
- dospělí MeSH
- kouření tabáku metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- messenger RNA metabolismus MeSH
- mladý dospělý MeSH
- průřezové studie MeSH
- senioři MeSH
- střevní sliznice metabolismus MeSH
- ulcerózní kolitida metabolismus MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Cholelithiasis is more common in patients with Crohn's disease (CD) than in the healthy population. The aim here was to examine risk factors for cholelithiasis in a cohort of CD patients and to compare the prevalence of cholelithiasis in a cohort of CD patients with that in a control group. This was a single-center retrospective case-control study. The cohort comprised all consecutive CD patients who underwent abdominal ultrasound from January 2007 to January 2018. The control group comprised age- and gender-matched non-CD patients referred for upper gastrointestinal tract dyspepsia. The study included 238 CD patients and 238 controls. The prevalence of cholelithiasis in the CD and control groups was 12.6 % and 9.2 %, respectively (risk ratio (RR), 1.36; p=0.24). Univariate analysis revealed that cholelithiasis was associated with multiple risk factors. Multivariate analysis identified age (OR, 1.077; 95 % CI, 1.043-1.112; p<0.001) and receipt of parenteral nutrition (OR, 1.812; 95 % CI, 1.131-2.903; p=0.013) as independent risk factors for cholelithiasis in CD patients. The prevalence of cholelithiasis in CD patients was higher than that in the control group; however, the difference was not statistically significant. Age and receipt of parenteral nutrition were independent risk factors for cholelithiasis in CD patients.
- MeSH
- cholelitiáza epidemiologie etiologie MeSH
- Crohnova nemoc komplikace MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- prevalence MeSH
- retrospektivní studie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika MeSH
58-ročný pacient bol prijatý do nemocnice pre bolesti brucha, žalúdočný vred a zhoršené hepatálne parametre. Na CT boli zistené mnohopočetné ložiská charakteru metastáz v hepare, početná lymfadenopatia až pakety zväčšených lymfatických uzlín hlavne v oblasti retroperitonea, peripankreaticky a v oblasti distálneho žalúdka, takisto aj ložiská v pľúcach, pravdepodobne metastázy. Histopatologicky sa potvrdil papilárny adenokarcinóm z oblasti vredu žalúdka v prepylorickej oblasti. Vzhľadom k diseminácii ochoreniam bola prognóza nepriaznivá, onkológ neindikoval onkologickú liečbu, pokračovali sme v liečbe v zmysle best supportive care.
A 58-year-old patient was admitted to hospital due to abdominal pain, gastric ulcer and deterioration of blood liver test results. Multiple hepatic lesions suspicious of metastatic process were found on the abdominal CT, as well as lymphadenopathy and packets of lymph nodes, mainly in the retroperitoneal area, the peripancreatic area and the distal part of the stomach. Pulmonary lesions suspicious of metastatic process were also described on the CT. Papillary gastric adenocarcinoma from the prepyloric area was confirmed by histopathology. As the disease was disseminated, prognosis was poor, the oncologist did not approve oncology treatment and we continued with treatment in the sense of the best supportive care.
- MeSH
- bolesti břicha etiologie MeSH
- fatální výsledek MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfadenopatie MeSH
- metastázy nádorů MeSH
- nádory jater sekundární MeSH
- nádory žaludku diagnóza MeSH
- paliativní péče MeSH
- papilární adenokarcinom * diagnóza MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
