According to several studies, women with Crohn's disease (CD) had reduced fertility, which is mostly due to voluntary decisions and reduced ovarian reserve. In our study, we aimed to compare reproductive health parameters (RHP), previous pregnancy complications and outcomes, and ovarian reserve (OR) assessed by the anti-Mullerian hormone (AMH) in CD patients with healthy controls. In CD patients, we also compared OR according to disease phenotypes. Consecutive pre-menopausal women with CD from two IBD centers were included. The control group consisted of age and BMI-matched healthy controls. We used a questionnaire that included RHP, CD phenotype, and CD activity. Serum AMH was assessed by the Elecsys AMH plus essay. We enrolled 50 patients and 56 controls with a median age of 31 years. All CD patients were in clinical remission. We observed no difference in RHP or AMH (median 2.6 vs. 2.1 ug/l, p = 0.98), or the proportion of low OR (AMH<1,77, 38 vs. 41.1 %, p=0.84). The slope of age-related decrease did not differ between the groups. The subgroup of CD patients after surgery and those older than 30 years with CD for >5years had a steeper decrease in AMH (slope -0.12 vs. -0.29, p = 0.04 and -0.31 vs. -0.2, p = 0.029). In a multivariate analysis, age was the single independent predictor of low OR (OR=1.25). In women with Crohn's disease, once the disease activity is under control, the reproductive health and ovarian reserve do not substantially differ from healthy controls.

• MeSH
• antimülleriánský hormon krev   MeSH
• Crohnova nemoc krev   patofyziologie   MeSH
• dospělí MeSH
• lidé MeSH
• ovariální rezerva * MeSH
• reprodukční anamnéza MeSH
• reprodukční zdraví MeSH
• studie případů a kontrol MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Fatty acid (FA) profiles as potentially relevant components of Crohn's disease (CD) have been insufficiently analysed. We sought to explore the plasma profiles of n-3 and n-6 polyunsa-turated fatty acids (PUFAs) in newly diagnosed untreated active CD. We included 26 consecutive CD pediatric patients (<19 years) and 14 healthy controls (HCs). Disease characteristics, including inflammatory markers, dietary histories, and the Pediatric Crohn's Disease Activity Index (PCDAI), were obtained. The profiles of plasma FAs in plasma lipid classes were analysed by gas chromatography with FID detection of methyl esters. The erythrocyte sedimentation rate, C-reactive protein level and fecal calprotectin level (all p<0.001) were significantly higher in CD patients than in HCs. Most changes were observed in plasma phospholipids (PLs), such as a higher content of n-3 and changes in n-6 long-chain PUFAs in the CD group. The CD group had a lower ratio of n-6/n-3 PUFAs in PLs (p<0.001) and triacylglycerols (TAGs) (p<0.01). Correlations of the FA content in plasma PLs with disease activity scores of CD were also observed, which were positive for the sum of monounsaturated fatty acids (MUFAs) as well as oleic acid (18:1n-9) (both p<0.05). The metabolism of PUFAs is significantly altered even in treatment-naive newly diagnosed active pediatric CD, and the content of major FAs in PLs correlates with disease activity and inflammatory markers, thus probably contributing to the still unclear early disease pathogenesis.

• MeSH
• Crohnova nemoc krev   MeSH
• dieta statistika a číselné údaje   MeSH
• lidé MeSH
• mastné kyseliny krev   MeSH
• mladiství MeSH
• prospektivní studie MeSH
• studie případů a kontrol MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Asprosin, coiled-coil domain-containing 80(CCDC80) and angiopoietin-like4(ANGPTL4) are newly discovered adipocytokine that affects glucose tolerance, insulin resistance and cardiovascular diseases. The goal of this study was to investigate if a relationship exists among asprosin, CCDC80 and ANGPTL4 and inflammatory bowel disease (IBD). Fifty subjects with newly diagnosed IBD and fifty healthy individuals were enrolled. Patients were treated with standard therapies for 3 months. Plasma asprosin, CCDC80 and ANGPTL4 levels were measured with enzyme-linked immunosorbent assay. High resolution ultrasound was used to measure brachial artery diameter at rest, after reactive hyperemia (flow-mediated dilation, FMD) and after sublingual glyceryltrinitrate.Compare with healthy individuals, plasma CCDC80,erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels and homeostasis modelassessment of insulin resistance (HOMA-IR) were significantly higher (p < 0.05, respectively), whereas plasma asprosin,ANGPTL4 levels and FMD were significantly lower inboth UC and CD patients(p <0.05). Plasma CCDC80 levels were significantly higher in patients with CD (p<0.05), while plasma asprosin and ANGPTL4 levels were lower (p<0.05) as compared with those in patients with UC. Standard therapies increased plasma asprosin, ANGPTL4 levels and FMD in both UC and CD (p<0.05),UC and CD patientswhile decreased plasma CCDC80, ESR, CRP levels and HOMA-IR (p<0.05). The changes in HOMA-IR and FMD were correlated with the changes in plasma asprosin, CCDC80 and ANGPTL4 levels over the study period (p<0.05). Plasma asprosin, CCDC80 and ANGPTL4 levels may be applied as a significant marker for early stage of insulin resistance and atherosclerosis in IBD, especially of CD.

• MeSH
• angiopoetinu podobný protein 4 MeSH
• ateroskleróza diagnostické zobrazování   etiologie   MeSH
• biologické markery krev   MeSH
• Crohnova nemoc krev   komplikace   diagnóza   MeSH
• dospělí MeSH
• extracelulární matrix - proteiny krev   MeSH
• fibrilin 1 krev   MeSH
• hodnocení rizik MeSH
• inzulinová rezistence * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• prognóza MeSH
• rizikové faktory kardiovaskulárních chorob MeSH
• studie případů a kontrol MeSH
• ulcerózní kolitida krev   komplikace   diagnóza   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

BACKGROUND AND AIMS: Patients' perspectives after switching from originator to biosimilar adalimumab have yet to be assessed. We evaluated the efficacy of switching from the originator adalimumab to a biosimilar compound [SB5] in patients with inflammatory bowel disease [IBD]. METHODS: Data on IBD patients who were switched from the originator to biosimilar adalimumab [SB5] at IBD Center ISCARE were analysed. Disease activity was assessed using standard clinical indices (Harvey-Bradshaw index [HBI] for Crohn's disease [CD] and partial Mayo score for ulcerative colitis [UC]), and laboratory parameters (C-reactive protein [CRP] and faecal calprotectin [FC]). Trough levels and anti-drug antibodies were measured. Patients were evaluated 10 weeks [W10] after the switch, and results were compared with the control group of patients on originator compound. RESULTS: A total of 93 patients switched to biosimilar adalimumab were included [CD 86%] and were matched to 93 controls for age, gender, diagnosis, and disease activity. There was no difference in the disease activity in either SWITCH or ORIGINATOR cohorts between Weeks 0 and 10. Similarly, no difference was found between cohorts at both prespecified time points. Moreover, no significant differences in CRP or FC concentrations were seen between W0 and W10 either in the SWITCH, or in the ORIGINATOR cohort [p >0.05]. Adalimumab serum trough levels remained stable after the switch. No new safety signals were detected. CONCLUSIONS: Our study confirmed that switching IBD patients from the originator adalimumab to a biosimilar compound [SB5] does not affect treatment efficacy.

• MeSH
• adalimumab krev   imunologie   terapeutické užití   MeSH
• biosimilární léčivé přípravky krev   terapeutické užití   MeSH
• C-reaktivní protein metabolismus   MeSH
• centra terciární péče MeSH
• Crohnova nemoc krev   farmakoterapie   MeSH
• dospělí MeSH
• feces chemie   MeSH
• gastrointestinální látky krev   imunologie   terapeutické užití   MeSH
• leukocytární L1-antigenní komplex analýza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhrada léků MeSH
• protilátky krev   MeSH
• retrospektivní studie MeSH
• stupeň závažnosti nemoci MeSH
• ulcerózní kolitida krev   farmakoterapie   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: In adults, infliximab (IFX) levels correlate with disease activity, and antibodies to IFX (ATIs) predict treatment failure. We aimed to determine the association of IFX levels and ATIs with disease activity in a paediatric population. We prospectively collected blood, stool, and clinical data from 65 patients (age 10.5-15.1 years) with Crohn's disease (CD) before IFX administration, and measured IFX trough levels, ATIs, and faecal calprotectin levels (CPT). Samples were collected during maintenance therapy. We used multivariate analysis to identify the predictors of IFX levels. SUMMARY: Lower levels of IFX were associated with ATIs positivity (OR 0.027, 95% CI 0.009-0.077). Higher C-reactive protein (CRP) level, erythrocyte sedimentation rate, and CPT levels were found in patients with lower IFX levels. The optimal combination of sensitivity (0.5) and specificity (0.74) for disease activity was calculated for IFX levels ≥1.1 µg/mL using CRP level <5 mg/L as a marker of laboratory remission. In a model that used CPT ≤100 µg/g as the definition of remission, the optimal IFX trough level was 3.5 µg/mL. No independent association between remission and ATIs was found in our study population. However, we found an independentz association between IFX levels and serum albumin levels (OR 1.364, 95% CI 1.169-1.593), p < 0.001. Key Messages: The paediatric population was similar to adult populations in terms of the association between IFX and ATIs as well as between IFX and disease activity.

• MeSH
• biologické markery metabolismus   MeSH
• C-reaktivní protein metabolismus   MeSH
• Crohnova nemoc krev   farmakoterapie   MeSH
• dítě MeSH
• feces chemie   MeSH
• indukce remise MeSH
• infliximab aplikace a dávkování   terapeutické užití   MeSH
• krevní sedimentace MeSH
• leukocytární L1-antigenní komplex metabolismus   MeSH
• lidé MeSH
• mladiství MeSH
• plocha pod křivkou MeSH
• ROC křivka MeSH
• terapie neúspěšná MeSH
• zánět patologie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH

Úvod: Kostnú remodeláciu regulujú hormóny a lokálne rastové faktory. Nedostatok vitamínu D sa často vyskytuje u pacientov s chronickým ochorením, ale aj v zdravej detskej populácii. Ciele: Zistiť výskyt deficitu vitamínu D a zmien niektorých regulačných faktorov kostného metabolizmu u slovenských detí. Metódy: V prospektívnej monocentrickej štúdii sme na jar (marec – máj) a/alebo na jeseň (september – november) stanovili sérovú koncentráciu vitamínu 25-OH-D3 a parametrov kostného metabolizmu u reprezentatívnej vzorky 6–18-ročných detí. Výsledky: Do štúdie sme zaradili 199 detí, u 70 sme uskutočnili párový odber na jar aj na jeseň. Koncentrácia vitamínu D bola v celom súbore 22,5 ± 9,3 ng/ml so štatisticky významnou sezónnou variabilitou (20,4 ± 9,1 ng/ml na jar vs. 25,7 ± 8,9 ng/ml na jeseň, p <0,0001), ktorá sa potvrdila v kontrolnej skupine zdravých detí (n = 84) ako aj u detí s chronickým ochorením (n = 72), okrem detí so zápalovým ochorením čreva (n = 43). Deficit vitamínu D bol prítomný celkovo vo 20,0 % prípadov, na jar u 27,3 % a na jeseň u 9,3 %. Koncentrácia parathormónu bola u detí s deficitom vitamínu D zvýšená v 57,1 % a negatívne korelovala s koncentráciou vitamínu D (r = -0,541, p = 0,001). U adolescentných detí koncentrácia vitamínu D pozitívne korelovala s koncentráciou osteoprotegerínu (r = 0,362, p = 0,036) a pomerom OPG/RANKL (r = 0,524, p = 0,001) a negatívne s koncentráciou RANKL (r = -0,524, p = 0,001). Záver: Zistili sme vysokú prevalenciu nedostatku vitamínu D, ktorý bol asociovaný so zvýšeným parathormónom a u adolescentných detí so zvýšenou koncentráciou RANKL s možným nepriaznivým vplyvom na kostný metabolizmus. Je potrebné zvýšenie povedomia rodičov o potrebe suplementácie vitamínu D v zimných mesiacoch u chronicky chorých ako aj zdravých detí. KĽÚČOVÉ SLOVÁ: deti, kostný metabolizmus, chronické ochorenia, Crohnova choroba, ulcerózna kolitída, nešpecifické zápalové ochorenia čreva, vitamín D, parathormón, osteoprotegerín, RANKL

Background: Bone remodelling is regulated by hormones and paracrine factors. Vitamin D deficiency is often present in patients with chronic disease, but also among healthy children. Aims: To investigate vitamin D deficiency and other markers of bone metabolism among Slovak out-patients and hospitalized children. Methods: In this prospective single center study serum levels of vitamin 25-OH-D3 and bone markers were investigated in spring (march-may) and/or in autumn (september – november) in children aged 6–18 years. Results: We enrolled 199 children, in 70 we performed two examinations in spring and in autumn. Serum level of vitamin D in the entire cohort was 22.5 ± 9.3 ng/ml with a significant seasonal variability (20.4 ± 9.1 ng/ml in spring vs. 25.7 ± 8.9 ng/ml in autumn, p<0.0001) that was present in both the control group (n=84) and in children with chronic disease (n=72), except children with inflammatory bowel disease (n=43). Overall, vitamin D deficiency was present in 20.0% of cases, in spring in 27.3% and in autumn in 9.3%. Parathyroid hormone was elevated in 57.1% of patients with vitamin D deficiency and correlated negatively with vitamin D levels (r=-0.541, p=0.001). In adolescent children, vitamin D level correlated positively with osteoprotegerin level (r=0.362, p=0.036) and the OPG/RANKL ratio (r=0.524, p=0.001) and negatively with RANKL level (r=-0.524, p=0.001). Conclusion: We found a high prevalence of insufficient vitamin D levels that was associated with increased parathyroid hormone and in adolescents with increased RANKL level with potentially negative impact on bone health. It is important to draw parents ́attention to the importance of vitamin D supplementation, particularly in winter, in both, children with chronic diseases as well as healthy ones.

• MeSH
• chronická nemoc MeSH
• Crohnova nemoc * komplikace   krev   MeSH
• dítě MeSH
• kalcifediol krev   MeSH
• kosti a kostní tkáň metabolismus   MeSH
• lidé MeSH
• ligand RANK krev   MeSH
• mladiství MeSH
• nedostatek vitaminu D * epidemiologie   krev   MeSH
• neparametrická statistika MeSH
• osteoprotegerin krev   MeSH
• parathormon krev   MeSH
• prospektivní studie MeSH
• roční období MeSH
• ulcerózní kolitida * komplikace   krev   MeSH
• vitamin D krev   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• Publikační typ
• práce podpořená grantem MeSH
• srovnávací studie MeSH

• MeSH
• biologické markery analýza   MeSH
• C-reaktivní protein analýza   MeSH
• Crohnova nemoc krev   patologie   MeSH
• feces chemie   MeSH
• idiopatické střevní záněty * krev   patologie   MeSH
• leukocytární L1-antigenní komplex analýza   MeSH
• lidé MeSH
• reakce akutní fáze imunologie   krev   MeSH
• ulcerózní kolitida krev   patologie   MeSH
• zánět imunologie   krev   MeSH
• Check Tag
• lidé MeSH

• Klíčová slova
• top-down strategie,
• MeSH
• časové faktory MeSH
• Crohnova nemoc * farmakoterapie   krev   MeSH
• dítě MeSH
• indukce remise MeSH
• infliximab MeSH
• kongresy jako téma MeSH
• lidé MeSH
• mladiství MeSH
• monoklonální protilátky * aplikace a dávkování   terapeutické užití   MeSH
• off-label použití léčivého přípravku MeSH
• TNF-alfa * antagonisté a inhibitory   aplikace a dávkování   terapeutické užití   MeSH
• ulcerózní kolitida * farmakoterapie   krev   MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

AIM: Patients with inflammatory bowel disease (IBD) are prone to cardiovascular disorders, although there is little research to support this assertion, and other data are controversial in children. We aimed to determine the extent of premature atherosclerosis in Crohn's disease (CD) by measuring reactive hyperaemia index (RHI) as a functional marker of endothelial dysfunction (ED). METHODS: Twenty-one patients with CD and twelve healthy matched subjects were enrolled in the study. Diagnosis was based on the standard clinical, endoscopic and histological criteria, including the Paediatric Crohn's disease Activity Index. ED was assessed using the plethysmographic RHI, combined with specific biochemical markers of ED. RESULT: RHI values were significantly lower in the patients with CD than the controls (p < 0.05). E-selectin (p < 0.05), asymmetric dimethylarginine (p < 0.01) and high-sensitive CRP (p < 0.05), but not vascular cells adhesive molecule-1 values, were significantly increased in the CD subjects compared with the control group. CONCLUSION: Significantly decreased RHI and elevated plasma levels of specific biochemical parameters seems to be related to systemic inflammation and ED in children with CD. Our results support the hypothesis regarding RHI and ED in paediatric CD. This combined method assessment might be a useful tool for detection of ED and stratification of cardiovascular risk in patients with CD.

• MeSH
• ateroskleróza MeSH
• biologické markery krev   MeSH
• cévní endotel patofyziologie   MeSH
• Crohnova nemoc krev   komplikace   patofyziologie   MeSH
• hyperemie komplikace   patofyziologie   MeSH
• lidé MeSH
• mladiství MeSH
• studie případů a kontrol MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• apendektomie MeSH
• Crohnova nemoc * diagnóza   komplikace   krev   patofyziologie   terapie   MeSH
• dospělí MeSH
• ileum patofyziologie   MeSH
• kolonografie počítačovou tomografií MeSH
• kolonoskopie MeSH
• lidé MeSH
• nemoci ilea etiologie   MeSH
• počítačová rentgenová tomografie MeSH
• žilní trombóza * diagnóza   patofyziologie   terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH
• výukové testy MeSH