Assessment of drug therapy in inflammatory bowel disease.

Hodgson, H. J. F.

doi:10.1111/j.1365-2125.1982.tb01957.x

Cited by 27 publications

(10 citation statements)

References 54 publications

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“…We found that serum solu ble CD25 levels in untreated patients with active UC were higher than those in treated patients with active UC, indi cating an early fall of serum soluble CD25 levels in response to treatment. Corticosteroids and salazosulfapy ridine are reported to suppress the immune activity [21]; this feature might explain these findings in the treated patients. Increased levels of soluble CD25 have been dem onstrated not only in serum, but also in supernatants of colonic biopsy homogenates, sonicated colonic mucosal biopsy specimens, and isolated colonic lamina propria mononuclear cells obtained from patients with active UC, although these levels did not correlate with soluble CD25 levels in serum [22][23][24], Here, we found no significant positive correlation between the serum soluble CD25 lev els and the numbers of lamina propria CD25+ cells in all patients with UC.…”

Section: Discussionmentioning

confidence: 62%

Activated CD4+ and CDS+ Cells in the Colonic Mucosa of Ulcerative Colitis Patients: Their Relationship to HLA-DR Antigen Expression on the Colonic Epithelium and Serum Soluble CD25 Levels

Sasakawa¹,

Takizawa²,

Bannai³

et al. 1995

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This study was performed to clarify the relationship between activated (HLA-DR-expressing) CD4+ and CD8+ cells in the colonic lamina propria of ulcerative colitis and other immunological factors, i.e., epithelial DR expression, serum soluble CD25 levels, and colonic mucosal CD25+ cells. The frequency of epithelial DR expression was positively correlated with the numbers of CD4+ and CD8+ cells. The percentages activated CD4+/CD4+ cells were higher in mucosae with DR- epithelium than in mucosae with DR+ epithelium. The serum soluble CD25 levels were increased in ulcerative colitis, and there was an inverse correlation between these levels and the relative number of activated CD4+ cells in untreated active disease. These results suggest that interactions among mucosal CD4+ cells, colonic epithelium, and serum soluble CD25 might play an important role in the pathogenesis of ulcerative colitis.

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Section: Discussionmentioning

confidence: 62%

Activated CD4+ and CDS+ Cells in the Colonic Mucosa of Ulcerative Colitis Patients: Their Relationship to HLA-DR Antigen Expression on the Colonic Epithelium and Serum Soluble CD25 Levels

Sasakawa¹,

Takizawa²,

Bannai³

et al. 1995

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“…C-reactive pro-tein is a cytokine induced liver derived acute phase protein. 6 As such, it may be influenced by a number of variables, including corticosteroid therapy, that are not directly related to changes in Crohn's disease activity.…”

Section: Hudson a J Wakefield R A Hutton E A Sankey A P Dhillonmentioning

confidence: 99%

“…Sections showing areas oi scopically non-inflamed non-ul1 and other areas with inflammatior and immunostained with mono glycoprotein IIIa (1:5 dilution, High Wycombe, UK) and po Activation of coagulation was confirmed at presentation in these patients by raised o fibrinopeptide-A and d-dimer concentrations 60 0 (normal range <3 ng/ml and <300 ng/ml respeco tively). The fibrinopeptide-A's were higher * (median 5 (95% CI [3][4][5][6][7][8][9][10][11][12] ng/ml) at presentation o 00 with active disease compared with remission 0 (median 2 (95% CI 0 8-2 8) ng/ml).3 The differ-:: 8o ence did not reach statistical significance; 00 p=0 141, Wilcoxon's rank-sum test. There was 0 no significant correlation between fibropeptide-A and factor XIIIA (Spearman rank correlation, p= 0 9).…”

Section: Patientsmentioning

confidence: 99%

Factor XIIIA subunit and Crohn's disease.

Hudson

Wakefield²,

Hutton³

et al. 1993

Gut

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Factor XIIIA is the active subunit of plasma factor XIII that is responsible for cross linking fibrin into a stable clot. Sixteen patients with Crohn's disease were studied prospectively from relapse (Crohn's disease activity index >150) into remission. Plasma factor XIIIA concentrations were significantly lower in active disease (median 63 (95% CI 46-72) U/dl) than remission (median 90 (95% CI 60-112) U/dl; p=0002). Plasma factor XIIIA concentrations correlated positively with the activity index (p=0005) and platelet count (p=0003), and negatively with serum albumin (p=0 006). In five patients with persistent aggressive disease, the factor XIIIA concentration remained below the lower range of normal despite apparent clinical improvement in response to medical treatment. Tissues from three patients who underwent surgical resection during the study were immunostained for factor XIIIA. Gut mucosal and submucosal macrophages stained strongly for factor XIIIA. In one patient, capillary thrombi near superficial mucosal erosions immunostained for factor XIIIA in macroscopicaily normal mucosa. Similar changes were identified in more severely inflamed sections ofintestine from the other two patients. The demonstration of significantly low plasma factor XIIIA concentrations in active Crohn's disease, and the immunostaining of factor XIIIA in capillary thrombi in the bowel wall, suggest that activation of coagulation may be involved in the pathogenesis of Crohn's disease. The plasma factor XIIIA concentration may prove a useful laboratory marker of disease activity.

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“…the extent of previous bowel re section, the presence of fibrous strictures and the degree of malnutrition. As medical ther apy in Crohn's disease is primarily directed against bowel inflammation, there has been concern whether the clinical indices such as the CDA1 may overestimate disease activity because it may be affected by noninflamma tory factors [5]. This study, using a specific quantitative assessment of gut inflammatory activity, demonstrates that the CDA1 in fact underestimates gut inflammation with 89% of the studies performed when the CDAI was in the range of clinical remission having greater faecal 11'In granulocyte excretion than a control series of patients with IBS.…”

Section: Discussionmentioning

confidence: 99%

Clinical Remission in Crohn’s Disease – Assessment Using Faecal <sup>111</sup>ln Granulocyte Excretion

Saverymuttu¹

1986

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The value of the Crohn’s disease activity index (CDAI) in defining clinical remission in Crohn’s disease has been assessed in 71 studies using a new method to quantitate gut inflammatory activity: faecal ¹¹¹In-labelled granulocyte excretion. The range of faecal ¹¹¹In granulocyte excretion in the irritable bowel syndrome was found to be 0.2–1.9% (mean ± SD 0.98 ± 0.55%) of injected dose. 63 (89%) of studies with a CDAI less than 150 and 88% of studies with a serum albumin greater than 35 g/l had faecal ¹¹¹ln granulocyte excretion above the upper limit found in the irritable bowel syndrome ranging from 2.4% to 40%. This study shows that the majority of patients with Crohn’s disease in clinical remission have significant gut inflammatory activity. Whether treatment of this activity will alter the natural history of the disease needs prospective evaluation.

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Assessment of drug therapy in inflammatory bowel disease.

Cited by 27 publications

References 54 publications

Activated CD4+ and CDS+ Cells in the Colonic Mucosa of Ulcerative Colitis Patients: Their Relationship to HLA-DR Antigen Expression on the Colonic Epithelium and Serum Soluble CD25 Levels

Activated CD4+ and CDS+ Cells in the Colonic Mucosa of Ulcerative Colitis Patients: Their Relationship to HLA-DR Antigen Expression on the Colonic Epithelium and Serum Soluble CD25 Levels

Factor XIIIA subunit and Crohn's disease.

Clinical Remission in Crohn’s Disease – Assessment Using Faecal <sup>111</sup>ln Granulocyte Excretion

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