Budesonide treatment of patients with collagenous colitis restores normal eosinophil and T-cell activity in the colon

Wagner, Michael; Lampinen, Maria; Sangfelt, Per; Agnarsdóttir, Margrét; Carlson, Marie

doi:10.1002/ibd.21188

Cited by 25 publications

(21 citation statements)

References 56 publications

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“…Since treatment, for instance corticosteroids [24,25], could influence the histology as in classical IBD [26], we cannot exclude that at least steroids could have an impact on the disease course and the histological features. Consequently, the patient files were scrutinized for information about treatment.…”

Section: Discussionmentioning

confidence: 99%

Are collagenous and lymphocytic colitis different aspects of the same disease?

Vigren

Olesen

Benoni

et al. 2012

Scandinavian Journal of Gastroenterology

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Section: Discussionmentioning

confidence: 99%

Are collagenous and lymphocytic colitis different aspects of the same disease?

Vigren

Olesen

Benoni

et al. 2012

Scandinavian Journal of Gastroenterology

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“…Therefore, there has been a search for alternative biomarkers reflecting mucosal inflammation. In addition to the characteristic infiltration of lymphocytes, infiltrates of eosinophil granulocytes are seen in CC 40. They are regarded as proinflammatory cells with the ability to release cytotoxic proteins, such as eosinophil protein X and fecal eosinophil cationic protein.…”

Section: Diagnosismentioning

confidence: 99%

Diagnosis and management of microscopic colitis: current perspectives

Bohr¹,

Wickbom²,

Hegedus³

et al. 2014

CEG

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Collagenous colitis and lymphocytic colitis, together constituting microscopic colitis, are common causes of chronic diarrhea. They are characterized clinically by chronic nonbloody diarrhea and a macroscopically normal colonic mucosa where characteristic histopathological findings are seen. Previously considered rare, they now have emerged as common disorders that need to be considered in the investigation of the patient with chronic diarrhea. The annual incidence of each disorder is five to ten per 100,000 inhabitants, with a peak incidence in 60- to 70-year-old individuals and a predominance of female patients in collagenous colitis. The etiology and pathophysiology are not well understood, and the current view suggests an uncontrolled mucosal immune reaction to various luminal agents in predisposed individuals. Clinical symptoms comprise chronic diarrhea, abdominal pain, fatigue, weight loss, and fecal incontinence that may impair the patient’s health-related quality of life. An association is reported with other autoimmune disorders, such as celiac disease, thyroid disorders, diabetes mellitus, and arthritis. The best-documented treatment, both short-term and long-term, is budesonide, which induces clinical remission in up to 80% of patients after 8 weeks’ treatment. However, after successful budesonide therapy is ended, recurrence of clinical symptoms is common, and the best possible long-term management deserves further study. The long-term prognosis is good, and the risk of complications, including colonic cancer, is low. We present an update of the epidemiology, pathogenesis, diagnosis, and management of microscopic colitis.

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“…Only very limited data are available on treatment for refractory microscopic colitis, though there is some response to anti-TNF therapy in three out of four patients treated with infliximab or adalimumab for over 1 year [47]. Possible benefits of steroids could be restoration of normal eosinophil and T-cell activation state, amplification of bile acid transporter expression, and decreased colonic water secretion [48][49][50].…”

Section: Microscopic Colitismentioning

confidence: 95%