Antibiotics for induction and maintenance of remission in Crohn's disease

Townsend, Cassandra M; Parker, Claire E; MacDonald, John K; Nguyen, Tran M; Jairath, Vipul; Feagan, Brian G.; Khanna, Reena

doi:10.1002/14651858.cd012730.pub2

Cited by 32 publications

(17 citation statements)

References 51 publications

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“…In the 3rd European evidence-based consensus, the use of antibiotics in CD patients is appropriate for septic complications, symptoms attributable to bacterial overgrowth or perineal disease (133). However, a Cochrane database systematic review in 2019 reported that the efficacy of antibiotics in inducing remission of CD appeared be modest and might not be clinically meaningful (134). The effect on the maintenance of remission and the risk of severe adverse events in CD was unclear.…”

Section: Antibioticsmentioning

confidence: 99%

Treatment of Inflammatory Bowel Disease: A Comprehensive Review

2021

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Inflammatory bowel disease (IBD), as a global disease, has attracted much research interest. Constant research has led to a better understanding of the disease condition and further promoted its management. We here reviewed the conventional and the novel drugs and therapies, as well as the potential ones, which have shown promise in preclinical studies and are likely to be effective future therapies. The conventional treatments aim at controlling symptoms through pharmacotherapy, including aminosalicylates, corticosteroids, immunomodulators, and biologics, with other general measures and/or surgical resection if necessary. However, a considerable fraction of patients do not respond to available treatments or lose response, which calls for new therapeutic strategies. Diverse therapeutic options are emerging, involving small molecules, apheresis therapy, improved intestinal microecology, cell therapy, and exosome therapy. In addition, patient education partly upgrades the efficacy of IBD treatment. Recent advances in the management of IBD have led to a paradigm shift in the treatment goals, from targeting symptom-free daily life to shooting for mucosal healing. In this review, the latest progress in IBD treatment is summarized to understand the advantages, pitfalls, and research prospects of different drugs and therapies and to provide a basis for the clinical decision and further research of IBD.

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Section: Antibioticsmentioning

confidence: 99%

Treatment of Inflammatory Bowel Disease: A Comprehensive Review

2021

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“…Patients who had undergone ileal resection and were treated with metronidazole, an antibiotic that is usually ineffective in patients with ileitis (180), exhibited a delay in symptomatic recurrence (181). A systematic review of antibiotic therapy in CD patients found that antibiotics likely have a modest effect that may not be clinically relevant (182). Furthermore, to maintain antibiotic treatment efficacy and prevent relapse, longterm treatment is required, as with all therapies for CD (183,184).…”

Section: Therapeutic Targeting Of the Intestinal Microbiota Antibiotimentioning

confidence: 99%

Links Between Inflammatory Bowel Disease and Chronic Obstructive Pulmonary Disease

et al. 2020

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Inflammatory bowel disease (IBD) and chronic obstructive pulmonary disease (COPD) are chronic inflammatory diseases of the gastrointestinal and respiratory tracts, respectively. These mucosal tissues bear commonalities in embryology, structure and physiology. Inherent similarities in immune responses at the two sites, as well as overlapping environmental risk factors, help to explain the increase in prevalence of IBD amongst COPD patients. Over the past decade, a tremendous amount of research has been conducted to define the microbiological makeup of the intestine, known as the intestinal microbiota, and determine its contribution to health and disease. Intestinal microbial dysbiosis is now known to be associated with IBD where it impacts upon intestinal epithelial barrier integrity and leads to augmented immune responses and the perpetuation of chronic inflammation. While much less is known about the lung microbiota, like the intestine, it has its own distinct, diverse microflora, with dysbiosis being reported in respiratory disease settings such as COPD. Recent research has begun to delineate the interaction or crosstalk between the lung and the intestine and how this may influence, or be influenced by, the microbiota. It is now known that microbial products and metabolites can be transferred from the intestine to the lung via the bloodstream, providing a mechanism for communication. While recent studies indicate that intestinal microbiota can influence respiratory health, intestinal dysbiosis in COPD has not yet been described although it is anticipated since factors that lead to dysbiosis are similarly associated with COPD. This review will focus on the gut-lung axis in the context of IBD and COPD, highlighting the role of environmental and genetic factors and the impact of microbial dysbiosis on chronic inflammation in the intestinal tract and lung.

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“…Biofilms play a role in Crohn’s Disease pathology [29], and infection-associated biofilms are often sources of persistence, antibiotic resistance, and tolerance [74,75]. Antibiotic therapy is routinely used as an intervention in CD, and is known to temporarily ameliorate symptoms in the majority of patients [76]. However, relapse during treatment is common and reportedly universal [77] when treatment is halted, suggesting inflammation in relapsing CD may be due to outgrowth of antibiotic resistant or surviving, tolerant bacteria, such as those in mucosa-associated AIEC biofilms.…”

Section: Discussionmentioning

confidence: 99%

A conserved protein, BcmA, mediates motility, biofilm formation, and host colonisation in Adherent InvasiveEscherichia coli

Cogger-Ward

Collins

McLean

et al. 2019

Preprint

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25Adherent Invasive Escherichia coli (AIEC) is a non-diarrhoeagenic intestinal E. coli pathotype 26 associated with Crohn's Disease. AIEC pathogenesis is characterised by biofilm formation, 27 adhesion to and invasion of intestinal epithelial cells, and intracellular replication within 28 epithelial cells and macrophages. Here, we identify and characterise a protein in the 29 prototypical AIEC strain LF82 which is required for efficient biofilm formation and dispersal -30 LF82_p314. LF82 ΔLF82_314 have defective swimming and swarming motility, indicating 31 LF82_p314 is important for flagellar-mediated motility, and thus surface colonisation and 32 biofilm dispersal. Flagellar morphology and chemotaxis in liquid appear unaffected by 33 deletion of LF82_314, suggesting LF82_p314 does not elicit an effect on flagella biogenesis or 34 environmental sensing. Flagellar motility has been implicated in AIEC virulence, therefore we 35 assessed the role of LF82_p314 in host colonisation using a Caenorhabditis elegans model. 36 We found that LF82 ΔLF82_314 have an impaired ability to colonise the C. elegans compared 37 to wild-type LF82. Phylogenetic analysis showed that LF82_314 is conserved in several major 38 enterobacterial pathogens, and suggests the gene may have been acquired horizontally in 39 several genera. Our data suggests LF82_p314 may be a novel component in the flagellar 40 motility pathway and is a novel determinant of AIEC colonisation. Our findings have potential 41 implications not only for the pathogenesis of Crohn's Disease, but also for the course of 42 infection in several major bacterial pathogens. We propose a new designation for LF82_314, 43 biofilm coupled to motility A, or bcmA. 44 Author summary 45 Adherent Invasive Escherichia coli (AIEC) are a group of bacteria implicated in the 46 pathogenesis of Crohn's Disease, a chronic inflammatory bowel disease with no cure. Critical 47 48 colonise the host surface using specialised, propeller-like appendages called flagella. In this 49 paper, we describe a novel protein -LF82_p314 (BcmA) -which is required for efficient 50 flagella-mediated motility and surface colonisation in AIEC. Using a nematode worm 51 (Caenorhabditis elegans) infection model, we show that LF82_p314 enables effective 52 colonisation of the C. elegans gut, suggesting a role for the protein during human infection. 53 These findings indicate BcmA is significant for initial colonisation of the human gut by AIEC, 54 and therefore the onset of Crohn's Disease. 55 Introduction 56 Crohn's Disease (CD) is a chronic and relapsing inflammatory bowel disease presenting with 57 frequent bloody diarrhoea, bowel obstruction, abdominal pain, and extraintestinal 58 manifestations affecting the eyes, skin, joints, and liver (reviewed in [1-3]). CD is a complex 59 syndrome which is understood as an unchecked and inappropriate inflammatory response to 60 intestinal bacteria, potentiated by carriage of one or several of over 180 predisposing 61 immune-related alleles [4-13] and their inter...

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Antibiotics for induction and maintenance of remission in Crohn's disease

Cited by 32 publications

References 51 publications

Treatment of Inflammatory Bowel Disease: A Comprehensive Review

Treatment of Inflammatory Bowel Disease: A Comprehensive Review

Links Between Inflammatory Bowel Disease and Chronic Obstructive Pulmonary Disease

A conserved protein, BcmA, mediates motility, biofilm formation, and host colonisation in Adherent InvasiveEscherichia coli

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