Antibiotics in Crohn's disease

Colombel, J.-F.; Cortot, Antoine; Kruiningen, Herbert J. Van

doi:10.1136/gut.48.5.647

Cited by 24 publications

(13 citation statements)

References 7 publications

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“…Patients with Crohn’s disease exhibit high mucosal levels of certain cytokines including IL-23, IL-12, IL-18, IFNγ, IL-17 and TNF [6-12] and respond to anti-TNF and anti-IL-12/IL-23p40 monoclonal antibody treatment [13,14]. Further evidence of a role for bacteria in the pathogenesis is the attenuation of symptoms after antibiotic treatment [15,16]. …”

Section: Introductionmentioning

confidence: 99%

Endogenous antigen presenting cell-derived IL-10 inhibits T lymphocyte responses to commensal enteric bacteria

2009

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Section: Introductionmentioning

confidence: 99%

Endogenous antigen presenting cell-derived IL-10 inhibits T lymphocyte responses to commensal enteric bacteria

2009

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“…Both are metabolized to the active agent 6-Thioguanine. 4 Cyclosporine Decreases T-cell proliferation and activation by inhibiting production of interleukin-1. …”

Section: Resultsmentioning

confidence: 99%

“…However, it is theorized that a genetically vulnerable host mounts an inappropriate response to what should be an unremarkable environmental stimulus. 3,4 Oral lesions in CD are well described and reflect the mucosal lesions seen in the rest of the gut. They include mucosal tags, 'cobblestoning' of the buccal mucosa, lip swelling with or without fissures (Fig 3a), linear ulcers, an erythematous mucogingivitis (Fig 3b) and apthous ulceration.…”

Section: Discussionmentioning

confidence: 99%

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Crohn's disease with oral presenting signs masquerading as chronic osteomyelitis

Aquilina¹,

Savage²,

Lynham³

2003

Australian Dental Journal

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Background: A case of Crohn's disease (CD) was diagnosed following recognition of oral and systemic signs and symptoms in a 19-year-old male patient. Methods: Clinical investigation utilized included blood tests (full blood count, electrolytes, urea, creatinine, liver function tests), computed tomogrphy scans, magnetic resonance imaging scans, oral biopsies, colonoscopy and biopsies of the terminal ileum and colon. Results: A diagnosis of CD was made which then allowed appropriate medical treatment to be initiated. Conclusion:The importance of a thorough medical history and full physical examination with appropriate investigations as dictated by clinical findings is demonstrated.

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“…57 Antibiotic therapy for CD has been used to target mycobacterial infection and more broadly to target aerobes, anaerobes, Gram positive and negative bacteria. [57][58][59] Combination antibiotic therapy targeting Mycobacterium avium subspecies paratuberculosis showed a modest initial effect that was not sustained. 60 Rahimi et al 61 conducted a meta-analysis of randomised placebo-controlled trials covering a total of 804 patients with active CD, and concluded that those receiving antibiotics, particularly metronidazole, ciprofloxacin and cotrimoxazole, were 2.3 times more likely to show clinical improvement compared with placebo.…”

Section: Efficacy Of Antibioticsmentioning

confidence: 99%

The Role of Bacteria in the Pathogenesis of Inflammatory Bowel Disease

Friswell¹,

Campbell²,

Rhodes³

2010

Gut Liver

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Crohn's disease (CD) and ulcerative colitis (UC) have features that suggest bacterial involvement, and all genetic models of inflammatory bowel disease (IBD) require the presence of commensal bacteria. CD is associated with innate immune response genes such as NOD2/CARD15 and the autophagy genes ATG16L1 and IRGM. However, IBD responds to immunosuppression, suggesting that any bacteria involved are not acting as conventional pathogens. Molecular techniques are rapidly advancing our knowledge of the gut microbiota. In CD there is reduced diversity, and notably a reduction in the probiotic Faecalibacterium prausnitzii, the presence of which in the terminal ileum is associated with a reduced risk of recurrence following surgery. There is also a consistent increase in mucosa-associated Escherichia coli with an "adherent and invasive" phenotype, which allows them to replicate inside macrophages and induce granulomas. Speculation that CD could be caused by the Mycobacterium avium subspecies paratuberculosis (MAP) continues. The response to antitumor necrosis factor treatments suggests that, if relevant at all, MAP is not acting as a conventional pathogen. However, there is increased colonization by MAP in CD, and there is evidence that it could have an indirect effect mediated by the suppression of macrophage function. UC relapse is frequently associated with infection by pathogens, but there is less evidence for involvement of a specific bacterial species. Poor barrier integrity followed by an inflammatory reaction to bacterial components, with chronicity maintained by an autoimmune process, seems a plausible pathogenic model. Bacterial theories of pathogenesis are now becoming testable by targeted therapeutic interventions.

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Antibiotics in Crohn's disease

Cited by 24 publications

References 7 publications

Endogenous antigen presenting cell-derived IL-10 inhibits T lymphocyte responses to commensal enteric bacteria

Endogenous antigen presenting cell-derived IL-10 inhibits T lymphocyte responses to commensal enteric bacteria

Crohn's disease with oral presenting signs masquerading as chronic osteomyelitis

The Role of Bacteria in the Pathogenesis of Inflammatory Bowel Disease

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