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45 záznamů v Medvik Filtry

Článek

De Novo Crohn's Disease in Children With Ulcerative Colitis Undergoing Ileal Pouch-Anal Anastomosis: A Multicenter, Retrospective Study From the Pediatric IBD Porto Group of the ESPGHAN

Martinelli, Massimo
Autor Martinelli, Massimo Section of Pediatrics, Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
Romeo, Erminia
Autor Romeo, Erminia Digestive Endoscopy and Surgery Unit, Bambino Gesu Children's Hospital-IRCCS, Rome, Italy
Caldaro, Tamara
Autor Caldaro, Tamara Digestive Endoscopy and Surgery Unit, Bambino Gesu Children's Hospital-IRCCS, Rome, Italy
Dimakou, Konstantina
Autor Dimakou, Konstantina Division of Gastroenterology and Hepatology, First Department of Pediatrics, Children's Hospital Agia Sofia, University of Athens, Athens, Greece
Papadopoulou, Alexandra
Autor Papadopoulou, Alexandra Division of Gastroenterology and Hepatology, First Department of Pediatrics, Children's Hospital Agia Sofia, University of Athens, Athens, Greece
Matar, Manar
Autor Matar, Manar Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel-Aviv University, Petah-Tikva, Israel
Assa, Amit
Autor Assa, Amit ORCID Juliet Keidan institute of Pediatric Gastroenterology and Nutrition, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
Dipasquale, Valeria
Autor Dipasquale, Valeria Pediatric Gastroenterology and Cystic Fibrosis Unit, University of Messina, Messina, Italy
Romano, Claudio
Autor Romano, Claudio Pediatric Gastroenterology and Cystic Fibrosis Unit, University of Messina, Messina, Italy
Aloi, Marina
Autor Aloi, Marina Pediatric Gastroenterology Unit, Department of Women's and Children's Health, Sapienza University, Rome, Italy

Inflammatory bowel diseases. 2024 ; 30 (9) : 1475-1481. [pub] 20240903

Inflamm Bowel Dis
ISSN 1536-4844
Medvik
Zdroj

BACKGROUND AND AIMS: We sought to define the prevalence and to characterize possible predictive factors of Crohn's disease (CD) occurring in children with ulcerative colitis (UC) after ileal pouch-anal anastomosis (IPAA). METHODS: This was a multicenter, retrospective study including 15 centers of the Porto IBD group of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition. Children with a confirmed diagnosis of UC undergoing colectomy with IPAA and a minimal follow up of 6 months were identified. The following data were collected: demographic data; endoscopic and histologic data; disease activity; laboratory exams; therapeutic history; indication for surgery, type, and timing; and IPAA functional outcomes and complications. In de novo CD cases, time of diagnosis, phenotype, location, and therapies were gathered. RESULTS: We identified 111 UC children undergoing IPAA from January 2008 to June 2018 (median age at colectomy: 13 years; age range: 1-18 years; female/male: 59/52). The median time from diagnosis to colectomy was 16 (range, 0-202) months. At the last follow-up, 40 (36%) of 111 children developed pouchitis. The criteria for de novo CD were met in 19(17.1%) of 111 children with a 25-month median (range, 3-61 months). At last follow-up, 12 (63.1%) of 19 were treated with biologics and in 5 (26.3%) of 19 children, the pouch was replaced with definitive ileostomy. In a multivariable logistic regression model, decreased preoperative body mass index z scores (odds ratio, 2.2; 95% confidence interval, 1.1-4.4; P = .01) resulted as the only variable associated with CD development. CONCLUSIONS: Children with UC undergoing IPAA carry a high risk of developing subsequent CD. De novo CD cases showed decreased preoperative body mass index z scores, identifying a poor nutritional status as a possible predictive factor.

MeSH
Crohnova nemoc * chirurgie MeSH
dítě MeSH
kojenec MeSH
kolektomie škodlivé účinky MeSH
lidé MeSH
mladiství MeSH
následné studie MeSH
pooperační komplikace etiologie epidemiologie MeSH
pouchitis * etiologie epidemiologie MeSH
předškolní dítě MeSH
proktokolektomie rekonstrukční * škodlivé účinky MeSH
retrospektivní studie MeSH
rizikové faktory MeSH
ulcerózní kolitida * chirurgie MeSH
Check Tag
dítě MeSH
kojenec MeSH
lidé MeSH
mladiství MeSH
mužské pohlaví MeSH
předškolní dítě MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
multicentrická studie MeSH

Článek online

IL-17-driven induction of Paneth cell antimicrobial functions protects the host from microbiota dysbiosis and inflammation in the ileum

Mucosal immunology. 2023 ; 16 (4) : 373-385. [pub] 20230203

Mucosal Immunol
ISSN 1935-3456
Medvik
Zdroj

Interleukin (IL)-17 protects epithelial barriers by inducing the secretion of antimicrobial peptides. However, the effect of IL-17 on Paneth cells (PCs), the major producers of antimicrobial peptides in the small intestine, is unclear. Here, we show that the targeted ablation of the IL-17 receptor (IL-17R) in PCs disrupts their antimicrobial functions and decreases the frequency of ileal PCs. These changes become more pronounced after colonization with IL-17 inducing segmented filamentous bacteria. Mice with PCs that lack IL-17R show an increased inflammatory transcriptional profile in the ileum along with the severity of experimentally induced ileitis. These changes are associated with a decrease in the diversity of gut microbiota that induces a severe ileum pathology upon transfer to genetically susceptible mice, which can be prevented by the systemic administration of IL-17a/f in microbiota recipients. In an exploratory analysis of a small cohort of pediatric patients with Crohn's disease, we have found that a portion of these patients exhibits a low number of lysozyme-expressing ileal PCs and a high ileitis severity score, resembling the phenotype of mice with IL-17R-deficient PCs. Our study identifies IL-17R-dependent signaling in PCs as an important mechanism that maintains ileal homeostasis through the prevention of dysbiosis.