Purpose Cytomegalovirus (CMV) infection has been found to be associated with a reactivation of ulcerative colitis (UC) and with an impaired response to medical therapy. In the past, only limited data were available on the long-term outcome for UC patients with positive tissue CMV-PCR in the colonic mucosa. Methods Between January 2010 and April 2015, we performed a qualitative PCR screening for CMV DNA in one biopsy from most actively inflamed rectal mucosa (tCMV-PCR). All tCMV-PCR-positive patients received 900 mg of valganciclovir b.i.d. for at least 15 days. We analyzed the association of the tCMV-PCR status with the time to steroid-free remission (SFR) and with the risk of proctocolectomy during the further course. Results One hundred eight consecutive patients (50 women, 58 men, median age 41 years, median UC duration 6 years) with active UC not responding to anti-inflammatory medication were analyzed. Eight of the 24 tCMV-PCR-positive patients (33.3%) compared to ten of the 84 tCMV-PCR-negative patients (11.9%) underwent proctocolectomy during a median follow-up of 52 months (p < 0.005). The median time from CMV diagnosis to colectomy was 501 days (median, interquartile range (IQR): 170, 902 days) in tCMV-PCR-positive and 958 days (IQR: 287, 1328 days) in tCMV-PCR-negative patients (p < 0.01). The median time to SFR was 126 days in tCMV-PCR-positive patients vs. 63 days in tCMV-PCR-negative patients (p < 0.01). Conclusions The detection of the CMV DNA in the colonic mucosa of patients with active UC is associated with a longer time to steroid-free UC remission and with an increased rate and earlier need of proctocolectomy.
Der starke Anstieg der Pentylurofuransäure 1 im Harn nach Einnahme einer Probe des F‐Säure‐methylesters 2a beweist, daß der menschliche Körper im Gegensatz zum Organismus der Ratte befähigt ist, nicht nur die lange Seitenkette der F‐Säure abzubauen, sondern auch die Methylgruppe in Position 3 des Furanringes zu oxidieren. Als Nebenprodukt dieses Stoffwechselversuches wurde die Furandicarbonsäure 3d gefunden. Diese ist bei Ratten eines der Hauptstoffwechselprodukte eines F‐Säuremethylestergemisches. Darüber hinaus ließ sich 3d auch vor Einnahme des F‐Säure‐methylesters 2a in menschlichem Harn nachweisen. Damit ist wahrscheinlich geworden, daß F‐Säure auch im menschlichen Organismus vorhanden ist.
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