Clinical characteristics and long‐term prognosis of elderly onset ulcerative colitis

Song, Eun Mi; Lee, Ho‐Su; Park, Sang Hyoung; Kim, Gwang Un; Seo, Myeong Sook; Hwang, Sung Wook; Yang, Dan; Kim, Kyung‐Jo; Myung, Seung‐Jae; Yang, Suk‐Kyun; Ye, Byong Duk

doi:10.1111/jgh.13826

Cited by 25 publications

(42 citation statements)

References 35 publications

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“… 21 In another study from South Korea, the incidence of elderly-onset UC increased from 3.9% (1997–1999) to 9.7% (2008–2014) ( P <0.001). 13 Finally, in a study from Hong Kong, the proportion of newly diagnosed elderly-onset UC increased significantly during the past 2 decades (from 3.0% before 1990 to 21.6% after 2010). 16 The parallelism between improved sanitization and IBD emergence is striking from data on IBD incidence in the developing world and may help to unmask likely clues from the “exposome” in the etiology of IBD.…”

Section: Epidemiologymentioning

confidence: 98%

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Management of inflammatory bowel disease in older persons: evolving paradigms

2018

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The incidence and prevalence of inflammatory bowel disease (IBD) is increasing, and considering the aging population, this number is set to increase further in the future. The clinical features and natural history of elderly-onset IBD have many similarities with those of IBD in younger patients, but with significant differences including a broader differential diagnosis. The relative lack of data specific to elderly patients with IBD, often stemming from their typical exclusion from clinical trials, has made clinical decision-making somewhat challenging. Treatment decisions in elderly patients with IBD must take into account age-specific concerns such as comorbidities, locomotor and cognitive function, and polypharmacy, to set realistic treatment targets in order to enable personalized treatment and minimize harm. Notwithstanding paucity of clinical data, recent studies have provided valuable insights, which, taken together with information gleaned from previous studies, can broaden our understanding of IBD. These insights may contribute to the development of paradigms for the holistic and, when possible, evidence-based management of this potentially vulnerable population and are the focus of this review.

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Section: Epidemiologymentioning

confidence: 98%

“…The proportion of patients with elderly-onset IBD varies from 3% to 21% for CD 8 9 10 11 and 7% to 29% for UC ( Table 1 ). 8 9 10 11 12 13 14 15 16 The majority (65%) are diagnosed during the 6th decade, 25% during the 7th decade, and 10% during the 8th decade. 17 …”

Section: Epidemiologymentioning

confidence: 99%

Management of inflammatory bowel disease in older persons: evolving paradigms

2018

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“…A proporção de pacientes diagnosticados com DII aos 60 anos ou mais, demonstrada em uma série de estudos (Tabela 1), varia entre 3 e 21% para DC e de 7 a 29% para a RCU. A maioria (65%) foi diagnosticada durante a 6ª década de vida, 25% na 7ª e 10% na 8ª décadas [4][5][6][7][8][9][10][11][12] . No idoso, a incidência de RCU é maior do que a de DC.…”

Section: Epidemiologiaunclassified

“…Proporção de pacientes diagnosticados após os 60 anos entre todos os pacientes com doença inflamatória intestinal1,[4][5][6][7][8][9][10][11][12] …”

unclassified

Doença inflamatória intestinal no idoso

Machado¹,

Guedes²

2018

Temas De Atualização Da SBAD 2018

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“…In recent years, many serum [ 2 , 3 ] and fecal [ 4 , 5 ] markers have been applied to evaluate the prognosis of ulcerative colitis. However, regions of the intestinal mucosal inflammation, disease status, and drug administration can cause changes in these indicators [ 6 , 7 ]. Thus, reliable biological markers are urgently needed for the diagnosis of ulcerative colitis and the evaluation of the disease prognosis.…”

Section: Introductionmentioning

confidence: 99%

Decreased Breg/Th17 Ratio Improved the Prognosis of Patients with Ulcerative Colitis

Xue

Liang

Chen

2018

Canadian Journal of Gastroenterology and Hepatology

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Objective To investigate the effects of regulatory B (Breg) cells and T helper 17 (Th17) cells on pathogenesis of ulcerative colitis, explore the clinical significance of Breg/Th17 ratio on the prognosis of ulcerative colitis, and provide the theoretical basis for the targeted therapy, diagnosis, and prognosis of the disease. Methods Peripheral blood and colonic mucosa were collected from patients with ulcerative colitis. Hematoxylin-eosin staining was used to observe the pathological changes of colonic mucosa. Flow cytometry was utilized to analyze the percentages of Breg cells and Th17 cells. Real-time fluorescent quantitative polymerase chain reaction and immunohistochemistry were applied to determine the expression of Breg cells-related cytokines IL-10 and Th17 cell transcription factor RORγT. Enzyme-linked immunosorbent assay was employed to detect serum IL-10 and IL-17 levels. Results The colonic mucosa of ulcerative colitis patients presented massive inflammatory cell infiltration and hemorrhagic necrosis. The number of Breg cells and Th17 cells, the gene expressions of IL-10 and RORγT, and serum levels of IL-10 and IL-17 all increased in peripheral blood. Compared with nonremission group, the remission group showed that the percentage of Breg cells reduced, the percentage of Th17 cells increased, and thus the B10/Th17 ratio was significantly decreased in peripheral blood. In addition, serum IL-10 levels diminished, IL-17 levels increased, and thus IL-10/IL-17 ratio was remarkably reduced in remission group. B10/Th17 ratio and IL-10/IL-17 ratio were positively correlated with the severity of disease. Conclusions Breg and Th17 cells participate in the occurrence and development of ulcerative colitis. B10/Th17 ratio and IL-10/IL-17 ratio can be used as prognostic markers for ulcerative colitis. This provides a theoretical basis for design of targeted treatment and prognosis assessment of the disease.

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Clinical characteristics and long‐term prognosis of elderly onset ulcerative colitis

Abstract: Elderly onset ulcerative colitis patients are likely to exhibit distinct features both at diagnosis and during follow-up. It is necessary to pay more attention to, and to conduct further studies on, this particular group of patients.

Cited by 25 publications

References 35 publications

Management of inflammatory bowel disease in older persons: evolving paradigms

Management of inflammatory bowel disease in older persons: evolving paradigms

Doença inflamatória intestinal no idoso

Decreased Breg/Th17 Ratio Improved the Prognosis of Patients with Ulcerative Colitis

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